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Transcranial magnetic stimulation primes the effects of exercise therapy in multiple sclerosis

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Abstract

Exercise therapy (ET) can be beneficial in disabled multiple sclerosis (MS) patients. Intermittent transcranial magnetic theta burst stimulation (iTBS) induces long-term excitability changes of the cerebral cortex and may ameliorate spasticity in MS. We investigated whether the combination of iTBS and a program of ET can improve motor disability in MS patients. In a double-blind, sham-controlled trial, 30 participants were randomized to three different interventions: iTBS plus ET, sham stimulation plus ET, and iTBS alone. Before and after 2 weeks of treatment, measures of spasticity through the modified Ashworth scale (MAS) and the 88 items Multiple Sclerosis Spasticity Score questionnaire (MSSS-88), fatigue through the Fatigue Severity Scale (FSS), daily living activities (ADL) through the Barthel index and health-related quality of life (HRQoL) through the 54 items Multiple Sclerosis Quality of life inventory (MSQoL-54) were collected. iTBS plus ET reduced MAS, MSSS-88, FSS scores, while in the Barthel index and MSQoL-54, physical composite scores were increased. iTBS alone caused a reduction of the MAS score, while none of the measured scales showed significant changes after sham iTBS plus ET. iTBS associated with ET is a promising tool for motor rehabilitation of MS patients.

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Acknowledgments

We thank Dr. Alessandro Moscatelli for helpful statistical advice. This investigation was supported by Fondazione Italiana Sclerosi Multipla (Progetto Speciale 2010) to DC.

Conflict of interest

The authors have no financial interests or conflicts of interest to disclose.

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Authors and Affiliations

  1. Dipartimento di Neuroscienze, Clinica Neurologica, Università Tor Vergata, Via Montpellier 1, 00133, Rome, Italy

    Francesco Mori, Claudia Codecà, Hajime Kusayanagi, Fabrizia Monteleone, Giorgio Bernardi, Giacomo Koch & Diego Centonze

  2. Fondazione Santa Lucia/Centro Europeo per la Ricerca sul Cervello (CERC), Via del Fosso di Fiorano 64, 00143, Rome, Italy

    Francesco Mori, Claudia Codecà, Hajime Kusayanagi, Fabrizia Monteleone, Giorgio Bernardi, Giacomo Koch & Diego Centonze

  3. Dipartimento di Sanità Pubblica e Biologia Cellulare, Medicina Fisica e Riabilitativa, Università Tor Vergata, Via Montpellier 1, 00133, Rome, Italy

    Concetta Ljoka, Elisabetta Magni, Andrea Sancesario & Calogero Foti

Authors
  1. Francesco Mori
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  2. Concetta Ljoka
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  3. Elisabetta Magni
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  4. Claudia Codecà
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  5. Hajime Kusayanagi
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  6. Fabrizia Monteleone
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  7. Andrea Sancesario
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  8. Giorgio Bernardi
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  9. Giacomo Koch
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  10. Calogero Foti
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  11. Diego Centonze
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Corresponding author

Correspondence to Diego Centonze.

Additional information

C. Foti and D. Centonze equally contributed to the present work.

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Mori, F., Ljoka, C., Magni, E. et al. Transcranial magnetic stimulation primes the effects of exercise therapy in multiple sclerosis. J Neurol 258, 1281–1287 (2011). https://doi.org/10.1007/s00415-011-5924-1

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  • DOI: https://doi.org/10.1007/s00415-011-5924-1

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