The Cerebellum as a Potential Treatment Site for PD Motor Symptoms
- Conditions
- Parkinson's Disease
- Interventions
- Device: Magstim Rapid 2 Repetitive Transcranial Magnetic StimulationDevice: Magstim Rapid 2 Sham Stimulation
- Registration Number
- NCT02387346
- Lead Sponsor
- Sun Life Financial Movement Disorders Research and Rehabilitation Centre
- Brief Summary
The role of the cerebello-thalamo-cortical loop in the generation of tremor, gait impairments and postural instability has been made evident. The current study will use a Magstim Rapid 2 to deliver rTMS with the aim of modulating the activity in the vermal/paravermal region of the cerebellum, and consequently the cerebello-thalamo-cortical pathway. Analysis of the effects of an acute session of stimulation will be made to determine the therapeutic potential of the protocol. Motor symptom improvement will be assessed immediately following stimulation to detect motor symptom improvement up to one hour following stimulation, providing insight into the effectiveness of the protocol to produce benefits which outlast the period of stimulation.
Participants will each receive one session of stimulation in the ON state of medication. A pre-assessment will be performed before beginning the session and a post-assessment will be performed immediately following stimulation. There will be two groups, which will both undergo the exact same protocol, however one group will receive real stimulation, and one group will receive sham stimulation.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 50
- diagnosed with idiopathic Parkinson's disease
- ability to walk 10 metres unassisted
- ability to stand for 5 minutes unassisted
- understand verbal instructions in English
- presence of brain implants (aneurysm clips, deep brain stimulation electrodes)
- cochlear implants
- diagnosed with vascular Parkinson's disease
- history or increased risk of seizure
- severe dyskinesia of neck muscles
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Real Stimulation Magstim Rapid 2 Repetitive Transcranial Magnetic Stimulation Participants in this group will receive Repetitive Transcranial Magnetic Stimulation, characterized by 900 pulses at 1Hz over the medial cerebellum at 120% resting motor threshold of the right first dorsal interosseous. Sham Stimulation Magstim Rapid 2 Sham Stimulation Participants will receive Sham Repetitive Transcranial Magnetic Stimulation by having the coil angled at 90 degrees to the scalp; this will allow adequate noise output from the stimulator in the absence on real magnetic stimulation.
- Primary Outcome Measures
Name Time Method Balance: Postural Stability Testing (quiet stance on a balance force plate) Immediately post stimulation, effects up to one hour 3 trials lasting 30 seconds each of quiet stance on a balance force plate, where postural deviations from a central reference point on the platform will give an overall measure of postural sway, as well as score in the medial-lateral and anterior-posterior direction
Tremor: Kinesia Homeview Tablet (tremor magnitude, frequency and amplitude can be measured with wireless finger accelerometer) Immediately post stimulation, effects up to one hour With the use of a wireless finger accelerometer, tremor magnitude, frequency and amplitude can be measured during the upper limb movement tasks (such as rapid alternation and pointing tasks)
Gait (GaitRite carpet using Zeno software to measure spatial and temporal aspects of gait.) Immediately post stimulation, effects up to one hour 5 trials of self-paced gait on a GaitRite carpet using Zeno software to measure spatial and temporal aspects of gait.
Balance: Sensory Integration Testing (modified clinical test of sensory integration on balance (m-CTSIB) Immediately post stimulation, effects up to one hour In accordance with the modified clinical test of sensory integration on balance (m-CTSIB), where four trials lasting 20 seconds each measure balance during various sensory conditions: 1) eyes open, firm platform, 2) eyes closed, firm platform, 3) eyes open, foam platform, 4) eyes closed, foam platform.
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
Sun Life Financial Movement Disorders Research & Rehabilitation Centre
🇨🇦Waterloo, Ontario, Canada