Transcranial magnetic stimulation (TMS) is a procedure that has been shown to improve fatigue in chronic sufferers. It uses a plastic covered coil that sends a magnetic pulse through the skull into the brain and by targeting particular areas in the brain it can be used to help modulate the perception of fatigue. The study intends to use this technique to treat such a disabling symptom in patients who suffer from Multiple System Atrophy (MSA). Initially the aim is to study this technique in 22 MSA patients who are suffering from fatigue . These patients would require an resting-state funtional MRI before and after the stimulation. The stimulation would be performed ten sessions and the patients would be assessed by a clinician using well recognized clinical tools. It is anticipated that there will be a meaningful improvement in fatigue. It is also anticipated that TMS is a safety technique to use in MSA patients . Our findings will revealed that fatigue may be associated with an altered default mode network and sensorimotor network connectivity in MSA patients. We hypothesize that these divergent motor and cognitive networks connectivity changes and their adaptive or maladaptive functional outcome may play a prominent role in the pathophysiology of fatigue in MSA.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
22
Transcranial magnetic stimulation (TMS) is a non-invasive method that uses electromagnetic induction to produce electric currents in the cortex that are strong enough to depolarise neurons sufficiently to trigger action potentials. It is an outpatient based procedure that when used in conjunction with a neuro-navigation system, specific cortical areas can be targeted for greater accuracy and efficacy. In clinical studies, TMS is delivered as trains of pulses (repetitive TMS, rTMS) to prolong its effects. While the exact mechanism of TMS treatment fatigue is unknown, it is thought to regulate the activity of the complex cortical and subcortical networks connectivity changes involved in the processing of fatigue signals.
The Neurology Department of Xuanwu Hospital,Capital Medical University
Beijing, Beijing Municipality, China
Changes in Fatigue Severity Scale-9 (FSS-9)
To quantify changes of the severity of fatigue.The higher the score, the worse the fatigue.
Time frame: Pre-treatment, post-treatment 0, 2, 4 weeks
Changes in 17-item Hamilton Depression Scale(HAMD-17)
To quantify changes of the severity of depression.The higher the score, the worse the depression.
Time frame: Pre-treatment, post-treatment 0, 2, 4 weeks
Changes in Hamilton Anxiety Scale(HAMA)
To quantify changes of the severity of anxiety.The higher the score, the worse the anxiety.
Time frame: Pre-treatment, post-treatment 0, 2, 4 weeks
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