Publication

Mixed effectiveness of rTMS and retraining in the treatment of focal hand dystonia

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Last modified
  • 02/20/2025
Type of Material
Authors
    Teresa J. Kimberley, University of MinnesotaRebekah L. S. Schmidt, University of MinnesotaMo Chen, University of MinnesotaDennis D. Dykstra, University of MinnesotaCathrin Buetefisch, Emory University
Language
  • English
Date
  • 2015-07-09
Publisher
  • Frontiers
Publication Version
Copyright Statement
  • © 2015 Kimberley, Schmidt, Chen, Dykstra and Buetefisch.
License
Final Published Version (URL)
Title of Journal or Parent Work
ISSN
  • 1662-5161
Volume
  • 9
Start Page
  • 385
End Page
  • 385
Grant/Funding Information
  • Funding provided by the National Institutes of Health, Office of Rare Diseases Research in the National Center for Advancing Translational Sciences under the award number NS065701.
  • National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR000114
Abstract
  • UNLABELLED: Though the pathophysiology of dystonia remains uncertain, two primary factors implicated in the development of dystonic symptoms are excessive cortical excitability and impaired sensorimotor processing. The aim of this study was to determine the functional efficacy of an intervention combining repetitive transcranial magnetic stimulation (rTMS) and sensorimotor retraining. A randomized, single-subject, multiple baseline design with crossover was used to examine participants with focal hand dystonia (FHD) (n = 9). INTERVENTION: 5 days rTMS + sensorimotor retraining (SMR) vs. Five days rTMS + control therapy (CTL) (which included stretching and massage). The rTMS was applied to the premotor cortex at 1 Hz at 80% resting motor threshold for 1200 pulses. For sensorimotor retraining, a subset of the Learning-based Sensorimotor Training program was followed. Each session in both groups consisted of rTMS followed immediately by 30 min of the therapy intervention (SMR or CTL). Contrary to our hypothesis, group analyses revealed no additional benefit from the SMR training vs. CTL. When analyzed across group however, there was significant improvement from the first baseline assessment in several measures, including tests of sensory ability and self-rated changes. The patient rated improvements were accompanied by a moderate effect size suggesting clinical meaningfulness. These results provide encouragement for further investigation of rTMS in FHD with a need to optimize a secondary intervention and determine likely responders vs. non-responders.
Author Notes
Keywords
Research Categories
  • Biology, Neuroscience
  • Health Sciences, Rehabilitation and Therapy

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