Personalized Transcranial Magnetic Stimulation to Treat Parkinsonian Disorders Including Parkinsons Disease, Multiple System Atrophy, and Progressive Supranuclear Palsy

What this Trial Is About

This research aims to assess the effects of individualized repetitive transcranial magnetic stimulation rTMS on motor and non-motor symptoms in patients with parkinsonian disorders, including Parkinsons disease, multiple system atrophy, and progressive supranuclear palsy. The study explores which symptoms respond to this brain stimulation approach and to what extent, focusing on feasibility, safety, and clinical outcomes using network-guided targeting based on MRI and EEG imaging. Participants receive personalized intermittent theta burst stimulation targeting specific brain regions identified through structural and functional MRI within the somato-cognitive action network. Treatment involves 10 consecutive working days with daily sessions of rTMS using a figure-of-eight coil at 100% resting motor threshold, delivering a total of 14,400 pulses per day. Before treatment, clinical assessments, MRI, and EEG are conducted, and similar evaluations are performed immediately after treatment and at 10 weeks follow-up to monitor changes. Throughout the study, participants maintain stable medications and rehabilitation routines. Researchers assess motor function, mobility, balance, ataxia, non-motor symptoms, autonomic function, and urinary function using clinical scales. Brain network changes are evaluated through MRI and EEG. The primary outcomes include improvements in motor symptoms, mobility, and non-motor symptoms measured at baseline, post-treatment, and 10 weeks later. The total participation spans screening, a 2-week treatment phase, and a 10-week follow-up period.

Individualized Transcranial Magnetic Stimulation in Parkinsonian Disorders