Repetitive transcranial magnetic stimulation of the motor cortex ameliorates spasticity in multiple sclerosis.Neurology. 2007 Mar 27; 68(13):1045-50.Neur
To investigate whether repetitive transcranial magnetic stimulation (rTMS) can modify spasticity.
We used high-frequency (5 Hz) and low-frequency (1 Hz) rTMS protocols in 19 remitting patients with relapsing-remitting multiple sclerosis and lower limb spasticity.
A single session of 1 Hz rTMS over the leg primary motor cortex increased H/M amplitude ratio of the soleus H reflex, a reliable neurophysiologic measure of stretch reflex. Five hertz rTMS decreased H/M amplitude ratio of the soleus H reflex and increased corticospinal excitability. Single sessions did not induce any effect on spasticity. A significant improvement of lower limb spasticity was observed when rTMS applications were repeated during a 2-week period. Clinical improvement was long-lasting (at least 7 days after the end of treatment) when the patients underwent 5 Hz rTMS treatment during a 2-week protocol. No effect was obtained after a 2-week sham stimulation.
Repetitive transcranial magnetic stimulation may improve spasticity in multiple sclerosis.