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Neurodegenerative Disease

Neuroplasticity

Session: Oral Presentations: Neurodegenerative Disease 1

Neuroimaging mechanisms of low-frequency repetitive transcranial magnetic stimulation for treatment of SCA3/MJD: a double-blind randomized sham-controlled trial

Wednesday, November 1, 2023
10:20 AM – 10:26 AM  
Location: STATION 6

    Presenting Author(s)

  • Xin-Yuan Chen, MD

    The First Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China
    Department of Rehabilitation Medicine, The First Affiliated Hospital, Fujian Medical University, United States

    • Non-presenting Author(s)

  • Lz

    Lin zhang

    student
    The First Affiliated Hospital of Fujian Medical University, United States

  • YL

    Yan-Hua Lian

    graduate-student
    The First Affiliated Hospital of Fujian Medical University, United States

  • JN

    Jun Ni

    Department Head
    the first Affiliated Hospital of Fujian Medical University, United States

Research Objectives: To investigate the efficacy and mechanism of low-frequency Repetitive transcranial magnetic stimulation (rTMS) in patients with Spinocerebellar ataxia type 3/Machado-Joseph Disease (SCA3/MJD).

Design: A prospective, randomized, double-blind, and sham-controlled design.

Setting: Hospital

Participants: Twenty-two patients with SCA3/MJD were randomly recruited and divided into two groups, Active group (AC group, n=11) and Sham group (SH group, n=11). The former received actual rTMS (AC group, and the latter received sham rTMS.

Interventions: Each participant in both groups underwent 30 minutes of 1 Hz rTMS stimulation, differing only in terms of stimulator placement, for 15 consecutive days.

Main Outcome Measures: The primary outcomes are the International Cooperative Ataxia Rating Scale (ICARS) scores and Resting-state fMRI indicators, such as ALFF values, ReHo values, and functional connectivity.

Results: Compared with those at baseline, ICARS scores decreased more in the AC group than in the SH group after 15 days’ intervention. Imaging indicators showed that ALFF values increased in the posterior cerebellar lobe and cerebellar tonsil after AC stimulation. Moreover, ReHo values increased in posterior lobe of cerebellum, tonsil of cerebellum, and middle temporal gyrus, and functional connectivity also increased in the left occipital lobe, superior occipital gyrus, visual association cortex, middle temporal gyrus, and temporal lobe.

Conclusions: In conclusion, our study has shown that low-frequency rTMS on the cerebellum may have a therapeutic effect on SCA3/MJD-induced ataxia. We provide further evidence that rTMS effects may propagate to brain regions far from the point of stimulation, possibly by modulating their intrinsic connections to the same functional network regions. This study demonstrates the therapeutic potential of rTMS for SCA3/MJD, which is difficult to treat with drug.

Author(s) Disclosures: The authors declare that they have no confict of interest.

Learning Objectives:

  • Upon completion, participant will be able to confirm that low-frequency rTMS on the cerebellum may have a therapeutic effect on SCA3-induced ataxia.
  • Upon completion, participant will be able to consider that Resting-state fMRI is a reliable means to study the mechanism of rTMS in the treatment of neurodegenerative diseases.
  • Upon completion, participant will be able to know that rTMS effects may propagate to brain regions far from the point of stimulation.