Double-blind, randomized, placebo controlled trial on the effect of 10 days low-frequency rTMS over the vertex on sleep in Parkinson’s disease

Arias, Pablo; Vivas, Jamile; Grieve, Kenneth L.; Cudeiro, Javier

doi:10.1016/j.sleep.2010.05.003

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Volume 11, Issue 8 , Pages 759-765, September 2010

Double-blind, randomized, placebo controlled trial on the effect of 10 days low-frequency rTMS over the vertex on sleep in Parkinson’s disease

Pablo Arias
- Neuroscience and Motor Control Group (NEUROcom), Department of Medicine-INEF and Institute for Biomedical Research (INIBIC), University of A Coruña, Spain
Jamile Vivas
- Neuroscience and Motor Control Group (NEUROcom), Department of Medicine-INEF and Institute for Biomedical Research (INIBIC), University of A Coruña, Spain
Kenneth L. Grieve
- Neuroscience and Motor Control Group (NEUROcom), Department of Medicine-INEF and Institute for Biomedical Research (INIBIC), University of A Coruña, Spain
- Faculty of Life Sciences, The University of Manchester, UK
Javier Cudeiro
- Neuroscience and Motor Control Group (NEUROcom), Department of Medicine-INEF and Institute for Biomedical Research (INIBIC), University of A Coruña, Spain
- Corresponding author. Address: Neuroscience and Motor Control Group (NEUROcom), Department of Medicine-INEF and Institute for Biomedical Research (INIBIC), University of A Coruña, 15006 Coruna, Spain. Tel.: +34 981 167000x5859; fax: +34 981 167155.

Received 8 April 2010; received in revised form 18 May 2010; accepted 19 May 2010.

Abstract

Objective

A recent report indicates repetitive transcranial magnetic stimulation (rTMS) improves sleep in Parkinson’s disease (PD). The aim of this work is to evaluate the effect of 10days rTMS on sleep parameters in PD patients.

Methods

Double-blind, placebo-controlled design. Eighteen idiopathic PD patients completed the study. Sleep parameters were evaluated through actigraphy and the Parkinson’s Disease Sleep Scale (PDSS), along with depression (Hamilton Depression Rating Scale, HDS), and the Unified Parkinson’s Disease Rating Scale (UPDRS). Evaluations were carried out before treatment with rTMS (pre-evaluation, PRE), after the rTMS treatment programme (post-evaluation, POST), and one week after POST (POST-2). Nine PD patients received real rTMS and the other 9 received sham rTMS daily for 10days, (100 pulses at 1Hz) applied with a large circular coil over the vertex.

Results

Stimulation had no effect over actigraphic variables. Conversely PDSS, HDS, and UPDRS were significantly improved by the stimulation. Notably, however, these changes were found equally in groups receiving real or sham stimulation.

Conclusions

rTMS, using our protocol, has no therapeutic value on the sleep of PD patients, when compared to appropriate sham controls. Future works assessing the possible therapeutic role of rTMS on sleep in PD should control the effect of placebo.

Keywords: Parkinson, Sleep, Repetitive transcranial magnetic stimulation (rTMS), Actigraphy, Depression, Therapy