Studying Repetitive Transcranial Magnetic Stimulation rTMS to Treat Levodopa-Induced Dyskinesia in Parkinsons Disease Comparing Effects of Gamma and Beta Frequency Brain Stimulation on Dyskinesia Symptoms

What this Trial Is About

Researchers are evaluating repetitive transcranial magnetic stimulation rTMS as a treatment for levodopa-induced dyskinesia LID in people with Parkinsons Disease PD. The study focuses on stimulating the pre-supplementary motor area pre-SMA to see if this can delay the start of dyskinesia after levodopa intake and reduce its severity. This research aims to identify the best rTMS targets, parameters, and understand the mechanisms behind LID in PD. Participants will receive rTMS bursts targeting the pre-SMA using a device called the MagVenture Cool-B70 coil. The study includes groups receiving real stimulation at gamma frequency 130Hz or beta frequency 20Hz and corresponding sham inactive stimulations for 30 minutes. The stimulation intensity and location will be optimized based on brain anatomy and electric field simulations. The study compares the effects of these different burst frequencies on LID symptoms. During the study, participants will be assessed using the Unified Dyskinesia Rating Scale UDysRS and monitored for the time dyskinesia begins after taking 150% of their usual morning levodopa dose. Movement symptoms will also be evaluated using the Movement Disorder Society-Unified Parkinsons Disease Rating Scale. A clinician unaware of the treatment group will perform ratings. The study follows a randomized, double-blind design and includes assessments up to 40 minutes after levodopa intake, with safety and response monitored throughout.

rTMS as an Intervention for Levodopa-induced Dyskinesia