Inferior parietal lobule stimulation in task-specific focal hand dystonia: A randomized, crossover clinical trial.
OBJECTIVE: To determine the effect of inhibitory repetitive transcranial magnetic stimulation (rTMS) delivered to the left inferior parietal lobule (IPL) on the severity of task-specific focal hand dystonia. METHODS: In this randomized, sham-controlled, double-blind crossover study, participants rec...
| Publicado en: | Annals of Movement Disorders Vol. 7; no. 2; pp. 94 - 102 |
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| Autores principales: | , , , , , , , , , , , , , , , |
| Formato: | research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Wolters Kluwer India Pvt Ltd
May-Aug2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=181418256&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 181418256 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 25903446 MUZX jtl: Annals of Movement Disorders issn: 25903446 maglogo: N pubinfo: dt: May-Aug2024 vid: 7 iid: 2 pid: 16919 pub: Wolters Kluwer India Pvt Ltd artinfo: ui: 181418256 181418256 181418256 10.4103/aomd.aomd_18_24 181418256 ppf: 94 ppct: 8 formats: tig: atl: Inferior parietal lobule stimulation in task-specific focal hand dystonia: A randomized, crossover clinical trial. aug: au: Bhadran, Seetha Lekshmi Reghu, Anandapadmanabhan Gupta, Rajiv Radhakrishnan, Divya M. Vishnoi, Aayushi Gupta, Anu Vishnu, Venugopalan Y. Upadhyay, Ashish Kumaran, Senthil Kumar, Nand Bhatia, Renu Bhatia, Rohit Singh, Mamta Bhushan Srivastava, Achal K. Srivastava, Padma Rajan, Roopa affil: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India sug: subj: Parietal Lobe Physiopathology Focal Hand Dystonia Physiopathology Focal Hand Dystonia Therapy Task Performance and Analysis Transcranial Magnetic Stimulation Methods Severity of Illness Evaluation Treatment Outcomes Human India Male Female Adolescence Adult Middle Age Randomized Controlled Trials Random Assignment Crossover Design Double-Blind Studies Scales Kinematics Evaluation Goniometry Torsion Abnormality Patient-Reported Outcomes Right-Handedness Protocols Confidence Intervals Descriptive Statistics Writing Academic Medical Centers Tertiary Health Care Botulinum Toxins Therapeutic Use Phenomenological Research Paradigms Electroencephalography Nonparametric Statistics T-Tests Chi Square Test Fisher's Exact Test Analysis of Covariance Data Analysis Software Neuroradiography Summated Rating Scaling Memory Evaluation Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: OBJECTIVE: To determine the effect of inhibitory repetitive transcranial magnetic stimulation (rTMS) delivered to the left inferior parietal lobule (IPL) on the severity of task-specific focal hand dystonia. METHODS: In this randomized, sham-controlled, double-blind crossover study, participants received single sessions of low-frequency (1 Hz) inhibitory rTMS (1200 pulses) and sham stimulation to the left IPL. At baseline and after each session, we assessed the Writer's Cramp Rating Scale (WCRS), kinematic analysis using an electrogoniometer, a torsiometer, and the patient-reported improvement on a Likert scale. RESULTS: We recruited 16 right-handed patients with task-specific focal hand dystonia [age: 33.3 ± 11.7 years, 13 male). The mean WCRS score at baseline was 5.8 ± 3.4 in group A (where first 1 Hz rTMS and then sham was applied) and 13.4 ± 5.2 in group B (where first sham and then 1 Hz rTMS were applied). An inhibitory rTMS protocol applied to the left IPL resulted in a statistically significant improvement in the WCRS total score [WCRS difference real minus sham mean (SD): −1 (1.3), (95% confidence interval (CI): −2, −1), p = 0.002] and writing movement score [WMS mean difference (SD): −1 (1.4), CI: (−2, 0), p = 0.005], irrespective of the sequence in which they received the intervention. Secondary outcomes were similar between the groups. CONCLUSION: In patients with task-specific focal hand dystonia, a single session of rTMS to the left IPL resulted in a modest reduction of focal hand dystonia severity. The results serve as a proof-of-concept for future studies to assess the clinical effects of multiple sessions of left IPL inhibition to modulate the abnormally hyperexcitable premotor–parietal–putaminal circuitry in task-specific focal hand dystonia. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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