Effect of Repetitive Transcranial Magnetic Stimulation on Freezing of gait in Parkinson’s patients a Randomized control trial

Freezing of gait (FOG) is a highly disabling motor symptom in Parkinson’s disease (PD), affecting approximately 32% of patients and contributing significantly to falls, injuries, and reduced quality of life (Giladi et al., 1992; Moore et al., 2007). Despite optimal pharmacologic and surgical treatments, such as levodopa therapy and deep brain stimulation, FOG often persists or worsens (Bloem et al., 2015; Xu et al., 2021). Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising non-invasive neuromodulation technique that may modulate motor networks involved in gait (Fregni & Pascual-Leone, 2007; Elahi et al., 2009). High-frequency rTMS targeting motor and supplementary motor areas has shown potential in improving motor function and reducing FOG severity (Chou et al., 2015; Zhu et al., 2015; Xie et al., 2020; Deng et al., 2022). However, the evidence remains limited due to small sample sizes and inconsistent protocols. This study aims to evaluate the efficacy of rTMS in managing FOG in PD through a rigorously designed clinical trial, potentially offering a novel therapeutic avenue for a symptom that currently lacks effective long-term treatment.