Trans‐Spinal Theta Burst Magnetic Stimulation in Parkinson's Disease and Gait Disorders

Abstract Background Gait disorders in patients with Parkinson's disease (PD) can become disabling with disease progression without effective treatment. Objectives To investigate the efficacy of intermittent θ burst trans‐spinal magnetic stimulation (TsMS) in PD patients with gait and balance disorders. Methods This was a randomized, parallel, double‐blind, controlled trial. Active or sham TsMS was applied at third thoracic vertebra with 100% of the trans‐spinal motor threshold, during 5 consecutive days. Participants were evaluated at baseline, immediately after last session, 1 and 4 weeks after last session. Primary outcome was Total Timed Up and Go (TUG) values comparing active versus sham phases 1 week after intervention. The secondary outcome measurements consisted of motor, gait and balance scales, and questionnaires for quality of life and cognition. Results Thirty‐three patients were included, average age 68.5 (6.4) years in active group and 70.3 (6.3) years in sham group. In active group, Total TUG mean baseline was 107.18 (95% CI, 52.1–116.1), and 1 week after stimulation was 93.0 (95% CI, 50.7–135.3); sham group, Total TUG mean baseline was 101.2 (95% CI, 47.1–155.3) and 1 week after stimulation 75.2 (95% CI 34.0–116.4), P = 0.54. Similarly, intervention had no significant effects on secondary outcome measurements. During stimulation period, five patients presented with mild side effects (three in active group and two in sham group). Discussion TsMS did not significantly improve gait or balance analysis in patients with PD and gait disorders. The protocol was safe and well tolerated. © 2024 International Parkinson and Movement Disorder Society.