Study on rTMS’s therapeutic effect on constipation in Parkinson’s disease via the brain-gut axis theory

OBJECTIVE: This study investigates the therapeutic effects of repetitive transcranial magnetic stimulation (rTMS) on constipation in Parkinson's disease (PD) patients, based on the brain-gut axis theory. METHODS: = 29). Both patients and outcome assessors were blinded to the allocation. Constipation severity was assessed using the Constipation Severity Scale (CSS), and bowel movements were evaluated with the Spontaneous Bowel Movement (SBM) and Complete Spontaneous Bowel Movement (CSBM) frequencies. Depression severity was assessed using the Hamilton Depression Rating Scale (HAMD). Brain-gut peptides, serotonin (5-HT), brain-derived neurotrophic factor (BDNF), and inflammatory cytokines (IL-6, IL-8, IFN-γ) were measured via ELISA. Patient quality of life was assessed using the Patient Assessment of Constipation Quality of Life (PAC-QOL) instrument. Daily sessions were administered consecutively over a 14-day period. RESULTS: < 0.05). CONCLUSIONS: rTMS targeting the left dorsolateral prefrontal cortex, combined with conventional drug therapy, significantly improves constipation and depressive symptoms in PD patients over a short-term period, potentially through mechanisms involving the brain-gut axis.