Contributions
Abstract: 194
Type: Oral
Abstract Category: Therapy - symptomatic - 33 Treatment of specific symptoms
Introduction: Ataxia is a common yet difficult symptom to manage in people with multiple sclerosis (MS) with a variety of treatments, ranging from pharmacotherapy and neurorehabilitation to stereotactic surgical interventions. However, little is known about the role of repetitive transcranial magnetic stimulation (rTMS) in management of ataxia in MS.
Objectives: To evaluate the efficacy and safety of high-frequency rTMS in management of “truncal ataxia” in patients with relapsing remitting multiple sclerosis (RRMS).
Methods: Study design. Randomized, single-blind, sham-controlled pilot study.
Patients. Forty-three patients with RRMS and truncal ataxia (G+2 and +3 in cerebellum functional system scoring) were randomized to either real (n=20) or sham (n=19) rTMS groups. All patients received their disease modifying drugs (DMD) and their last relapse was at least 6 months prior to study commencement. Included patients were subjected to intensive rehabilitation program that included specific gait training, lumbar stabilization exercises balance exercises and enhancing motor relearning techniques. The rTMS protocol included 12 sessions over 4 weeks, with 20 trains 20 seconds apart of 50 stimuli (at 5 Hz of 80% of MT) using figure-of-8-shape coil over cerebellum. Compliance and adverse events for the rTMS sessions were checked. The 10-m walk test (10MWT) (at a self-selected speed with or without a gait aid) and Berg Balance Scale (BBS) were assessed before rTMS and immediately after the last rTMS session. Intention-to-treat analyses were used in analyzing functional outcomes (time of 10MWT, and BBS).
Results: Compliance with the rTMS was 100% with mild and transitory adverse events [nausea (n=2), headache (n=2), dizziness (n=1)]. The 10MWT and BBS of real rTMS group improved significantly
(p< 0.01). Percentage changes after the last rTMS session for time in the 10MWT and BBS in the real vs sham group were: -27.27% vs -14.74%, and 36.4% vs 19.6% respectively.
Conclusion: High frequency rTMS over the cerebellum is safe, feasible and effective treatment option in ataxic patients with RRMS.
Disclosure:
Nevin M. Shalaby. Nothing to disclose
Alaa Elmazny. Nothing to disclose Hatem S. Shehata. Nothing to disclose
Abstract: 194
Type: Oral
Abstract Category: Therapy - symptomatic - 33 Treatment of specific symptoms
Introduction: Ataxia is a common yet difficult symptom to manage in people with multiple sclerosis (MS) with a variety of treatments, ranging from pharmacotherapy and neurorehabilitation to stereotactic surgical interventions. However, little is known about the role of repetitive transcranial magnetic stimulation (rTMS) in management of ataxia in MS.
Objectives: To evaluate the efficacy and safety of high-frequency rTMS in management of “truncal ataxia” in patients with relapsing remitting multiple sclerosis (RRMS).
Methods: Study design. Randomized, single-blind, sham-controlled pilot study.
Patients. Forty-three patients with RRMS and truncal ataxia (G+2 and +3 in cerebellum functional system scoring) were randomized to either real (n=20) or sham (n=19) rTMS groups. All patients received their disease modifying drugs (DMD) and their last relapse was at least 6 months prior to study commencement. Included patients were subjected to intensive rehabilitation program that included specific gait training, lumbar stabilization exercises balance exercises and enhancing motor relearning techniques. The rTMS protocol included 12 sessions over 4 weeks, with 20 trains 20 seconds apart of 50 stimuli (at 5 Hz of 80% of MT) using figure-of-8-shape coil over cerebellum. Compliance and adverse events for the rTMS sessions were checked. The 10-m walk test (10MWT) (at a self-selected speed with or without a gait aid) and Berg Balance Scale (BBS) were assessed before rTMS and immediately after the last rTMS session. Intention-to-treat analyses were used in analyzing functional outcomes (time of 10MWT, and BBS).
Results: Compliance with the rTMS was 100% with mild and transitory adverse events [nausea (n=2), headache (n=2), dizziness (n=1)]. The 10MWT and BBS of real rTMS group improved significantly
(p< 0.01). Percentage changes after the last rTMS session for time in the 10MWT and BBS in the real vs sham group were: -27.27% vs -14.74%, and 36.4% vs 19.6% respectively.
Conclusion: High frequency rTMS over the cerebellum is safe, feasible and effective treatment option in ataxic patients with RRMS.
Disclosure:
Nevin M. Shalaby. Nothing to disclose
Alaa Elmazny. Nothing to disclose Hatem S. Shehata. Nothing to disclose