Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
Copyright © 2016 The Korean Movement Disorder Society
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References | Patient group | Study design | Intervention | Target of the stimulation | Effect |
---|---|---|---|---|---|
Siebner et al. [16] | 16 WC patients and 11 HV | Open-label | Single session of 1 Hz rTMS at 10% below the RMT (1,800 biphasic stimuli) | Left M1 | Significantly reduced mean writing pressure, normalization of the deficient cortico-cortical inhibition, and prolongation of the cSP |
Murase et al. [15] | 9 WC and 7 HV | Single-blinded | Single session of 0.2 Hz rTMS at 85% RMT (250 monophasic stimuli) vs. sham | M1, PMC, and SMA | Decreased tracking error and pen pressure with PMC stimulation, prolongation of cSP with PMC stimulation |
Borich et al. [17] | 6 FHD (3 WC and 3 MD) and 9 HV | Single-blinded partial cross-over | 1 Hz rTMS at 90% RMT (900 monophasic stimuli) vs. sham for 5 days | PMC | Improved handwriting performance and reduced cortical excitability 10 days post treatment |
Havrankova et al. [18] | 11 WC | Double-blinded cross-over | 1 Hz at 90% AMT (biphasic 1,800 stimuli) vs. sham-rTMS for 5 days | SI contralateral to affected hand | Subjective and objective improvement in writing 2 weeks post treatment associated with increased task-related BOLD in fMRI |
Huang et al. [19] | 18 WC and 8 HV | Single-blinded randomized parallel | cTBS (3-pulse 50 Hz burst every 200 ms at 80% AMT for 40 sec) vs. sham daily for 5 days | Left PMC | More subjective improvement in writing with real rTMS Restoration of SICI, PMC-M1 interaction, and reduced M1 plasticity |
Kimberley et al. [20] | 12 FHD | Single-blinded randomized with partial cross-over | 1 Hz rTMS with 90% RMT (biphasic 1,800 stimuli) vs. sham during non-dystonic writing movement for 5 days | Contralateral PMC | Prolonged cSP and reduced pen force |
Kimberley et al. [21] | 9 FHD | Randomized with cross-over | 5 days 1 Hz rTMS at 80% RMT (biphasic 1,200 pulses) + sensorimotor retraining vs. rTMS + control therapy | PMC | No additional benefit from sensorimotor retraining |
rTMS: repetitive transcranial magnetic stimulation, WC: writer’s cramp, HV: healthy volunteer, RMT: resting motor threshold, cSP: cortical silent period, PMC: premotor cortex, SMA: supplementary motor area, FHD: focal hand dystonia, MD: musician’s dystonia, AMT: active motor threshold, BOLD: blood oxygenation level dependent, fMRI: functional magnetic resonance imaging, cTBS: continuous theta burst stimulation, SICI: short latency intracortical inhibition, M1: motor cortex.
References | Patient group | Study design | Intervention | Target of the stimulation | Effect |
---|---|---|---|---|---|
Buttkus et al. [26] | 10 MD (guitarists) | Double-blinded randomized with cross-over | Single session of cathodal tDCS (2 mA for 20 min) vs. placebo | Left M1 | No change in fine motor control after 30 min |
Benninger et al. [24] | 12 WC | Double-blinded randomized, sham-controlled with parallel | Prolonged sessions (3 in 1 week) of cathodal tDCS | M1 contralateral to FHD | No positive effects in clinical measures nor handwriting and cortical excitability |
Buttkus et al. [25] | 9 MD (pianists) | Double-blinded sham-controlled with cross-over | Anodal tDCS, cathodal tDCS (2 mA for 20 min) during sensorimotor retraining | Left M1 | No favorable result in behavior |
Furuya et al. [27] | 10 MD, 10 healthy musicians (pianists) | Double-blinded sham-controlled with cross-over | tDCS (2 mA for 24 min) during bimanual mirrored finger movements | Bihemispheric motor cortices | Improved rhythmic accuracy of sequential finger movements with cathodal-affected and anodal-unaffected tDCS |
Sadnicka et al. [29] | 10 WC | Single-blinded sham-controlled with cross-over | Single session anodal tDCS (sham-controlled) | Cerebellum | No changes in clinical symptoms nor in M1 plasticity |
Bradnam et al. [28] | 8 FHD (5 WC, 3 MD) and 8 HV | Double-blinded randomized sham-controlled with cross-over | Anodal, cathodal (2 mA, 20 min) or sham tDCS | Cerebellum | Improved writing kinematics and decreased CBI with anodal tDCS |
Rosset-Llobet et al. [30] | 30 MD | Parallel double-blind randomized design | tDCS (real vs. sham) for 30 min coupled with 1 hr sensory motor retuning therapy for 2 weeks (10 days) | Cathode over left and anode over right parietal regions | Improved dystonia severity score in both groups; more benefit in real tDCS than sham group |
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References | Patient group | Study design | Intervention | Target of the stimulation | Effect |
---|---|---|---|---|---|
Siebner et al. [16] | 16 WC patients and 11 HV | Open-label | Single session of 1 Hz rTMS at 10% below the RMT (1,800 biphasic stimuli) | Left M1 | Significantly reduced mean writing pressure, normalization of the deficient cortico-cortical inhibition, and prolongation of the cSP |
Murase et al. [15] | 9 WC and 7 HV | Single-blinded | Single session of 0.2 Hz rTMS at 85% RMT (250 monophasic stimuli) vs. sham | M1, PMC, and SMA | Decreased tracking error and pen pressure with PMC stimulation, prolongation of cSP with PMC stimulation |
Borich et al. [17] | 6 FHD (3 WC and 3 MD) and 9 HV | Single-blinded partial cross-over | 1 Hz rTMS at 90% RMT (900 monophasic stimuli) vs. sham for 5 days | PMC | Improved handwriting performance and reduced cortical excitability 10 days post treatment |
Havrankova et al. [18] | 11 WC | Double-blinded cross-over | 1 Hz at 90% AMT (biphasic 1,800 stimuli) vs. sham-rTMS for 5 days | SI contralateral to affected hand | Subjective and objective improvement in writing 2 weeks post treatment associated with increased task-related BOLD in fMRI |
Huang et al. [19] | 18 WC and 8 HV | Single-blinded randomized parallel | cTBS (3-pulse 50 Hz burst every 200 ms at 80% AMT for 40 sec) vs. sham daily for 5 days | Left PMC | More subjective improvement in writing with real rTMS Restoration of SICI, PMC-M1 interaction, and reduced M1 plasticity |
Kimberley et al. [20] | 12 FHD | Single-blinded randomized with partial cross-over | 1 Hz rTMS with 90% RMT (biphasic 1,800 stimuli) vs. sham during non-dystonic writing movement for 5 days | Contralateral PMC | Prolonged cSP and reduced pen force |
Kimberley et al. [21] | 9 FHD | Randomized with cross-over | 5 days 1 Hz rTMS at 80% RMT (biphasic 1,200 pulses) + sensorimotor retraining vs. rTMS + control therapy | PMC | No additional benefit from sensorimotor retraining |
References | Patient group | Study design | Intervention | Target of the stimulation | Effect |
---|---|---|---|---|---|
Buttkus et al. [26] | 10 MD (guitarists) | Double-blinded randomized with cross-over | Single session of cathodal tDCS (2 mA for 20 min) vs. placebo | Left M1 | No change in fine motor control after 30 min |
Benninger et al. [24] | 12 WC | Double-blinded randomized, sham-controlled with parallel | Prolonged sessions (3 in 1 week) of cathodal tDCS | M1 contralateral to FHD | No positive effects in clinical measures nor handwriting and cortical excitability |
Buttkus et al. [25] | 9 MD (pianists) | Double-blinded sham-controlled with cross-over | Anodal tDCS, cathodal tDCS (2 mA for 20 min) during sensorimotor retraining | Left M1 | No favorable result in behavior |
Furuya et al. [27] | 10 MD, 10 healthy musicians (pianists) | Double-blinded sham-controlled with cross-over | tDCS (2 mA for 24 min) during bimanual mirrored finger movements | Bihemispheric motor cortices | Improved rhythmic accuracy of sequential finger movements with cathodal-affected and anodal-unaffected tDCS |
Sadnicka et al. [29] | 10 WC | Single-blinded sham-controlled with cross-over | Single session anodal tDCS (sham-controlled) | Cerebellum | No changes in clinical symptoms nor in M1 plasticity |
Bradnam et al. [28] | 8 FHD (5 WC, 3 MD) and 8 HV | Double-blinded randomized sham-controlled with cross-over | Anodal, cathodal (2 mA, 20 min) or sham tDCS | Cerebellum | Improved writing kinematics and decreased CBI with anodal tDCS |
Rosset-Llobet et al. [30] | 30 MD | Parallel double-blind randomized design | tDCS (real vs. sham) for 30 min coupled with 1 hr sensory motor retuning therapy for 2 weeks (10 days) | Cathode over left and anode over right parietal regions | Improved dystonia severity score in both groups; more benefit in real tDCS than sham group |
rTMS: repetitive transcranial magnetic stimulation, WC: writer’s cramp, HV: healthy volunteer, RMT: resting motor threshold, cSP: cortical silent period, PMC: premotor cortex, SMA: supplementary motor area, FHD: focal hand dystonia, MD: musician’s dystonia, AMT: active motor threshold, BOLD: blood oxygenation level dependent, fMRI: functional magnetic resonance imaging, cTBS: continuous theta burst stimulation, SICI: short latency intracortical inhibition, M1: motor cortex.
tDCS: transcranial direct current stimulation, MD: musician’s dystonia, WC: writer’s cramp, HV: healthy volunteer, FHD: focal hand dystonia, CBI: cerebellar inhibition, M1: motor cortex.