Through rTMS, motor dysfunction and non-motor dysfunction of PD patients can be improved, working and living ability and quality of life of patients can be improved, and social burden and family burden can be reduced.
According to the inclusion criteria, a total of 200 patients with Parkinson's disease were planned to be enrolled in each center, and randomly divided into control group (conventional treatment) and observation group (conventional treatment +rTMS) for a treatment cycle of 4 weeks. They were followed up for 3 months before treatment, 2 weeks and 4 weeks, respectively, after treatment, to evaluate the efficacy and function. The unified Parkinson's Disease Rating Scale (UPDRS) was used. Cognitive function assessment Monteller Cognitive Assessment Scale (MoCA); Barthel Index for daily living activities; Depression assessment Hamilton Depression Scale (HAMD); Hamilton Anxiety Scale (HAMA); Sleep assessment PD Sleep Scale (PDSS); Pain assessment King Parkinson's Pain Assessment (KPPS) and adverse events were recorded.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
200
Routine treatment in Neurology department, including drug treatment,etc.
Add rTMS to routine treatment. Low frequency rTMS is often used to treat cortical hyperexcitability and high frequency rTMS to treat hypoexcitability
rTMS
Nantong, Jiangsu, China
RECRUITINGUnified Parkinson's disease rating Scale (UPDRS)
16 items, each with a score of 0-4, and the score is directly proportional to the severity of PD motor symptoms.
Time frame: The assessments are conducted at the baseline, 2nd week, 4th week, and 3 months after the end of treatment.
Montreal Cognitive Assessment Scale (MoCA)
Full score of 30 points,\>=26 points normal,. Mild cognitive impairment (MCI) on a scale of 18-26, moderate on a scale of 10-17, and severe on a scale of\<10.
Time frame: The assessments are conducted at the baseline, 2nd week, 4th week, and 3 months after the end of treatment.
King's Parkinson's Pain Assessment (KPPS)
Evaluate the pain degree and quality of life of patients with Parkinson's disease, including 14 items in 7 aspects, including skeletal muscle pain, Chronic pain, symptom fluctuation related pain, nocturnal pain, orofacial pain, distention pain, and nerve root pain. Each score is expressed as pain severity (0-3 levels) multiplied by frequency (0-4 levels), that is, 0-12 points. The total score is 168 points. The higher the score, the more severe the pain.
Time frame: The assessments are conducted at the baseline, 2nd week, 4th week, and 3 months after the end of treatment.
PD Sleep Scale (PDSS)
Evaluate the patient's sleep status, with a total of 15 items on the scale. Each item is scored on a scale of 0-10 points, with a lower score indicating poorer sleep status.
Time frame: The assessments are conducted at the baseline, 2nd week, 4th week, and 3 months after the end of treatment.
Activities of daily living Assessment - Barthel
The total score of the index is 100 points, and the higher the score, the better the self-care ability and the less dependence. Those scoring above 60 can basically complete basic Activities of daily living, 59-41 need some help to complete, 40-21 need a lot of help. Those who score below 20 are in complete need of help and cannot take care of themselves.
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Time frame: The assessments are conducted at the baseline, 2nd week, 4th week, and 3 months after the end of treatment.
Hamilton Depression Scale (HAMD)
Evaluate depressive status, including 14 5-level scoring items (0-4 points) and 10 3-level scoring items (0-2 points). Score\<8, no depression; 8 to 35 points, may be mild or moderate depression 35 points, may be severe depression.
Time frame: The assessments are conducted at the baseline, 2nd week, 4th week, and 3 months after the end of treatment.
Hamilton Anxiety Scale (HAMA)
Include 14 projects. All items of HAMA adopt a 5-level scoring method of 0\~4 points, and the criteria of each level are: (0) is Asymptomatic; (1) Light; (2) Moderate; (3) Heavy; (4) Extremely heavy. The total score of HAMA can better reflect the severity of anxiety symptoms. The total score can be used to evaluate the severity of anxiety symptoms and evaluate the effectiveness of various drugs and psychological interventions in patients with anxiety and depression disorders. According to the data provided by the collaborative group of the Chinese scale, if the total score exceeds 29 points, it may be severe anxiety; Above 21 points, there must be obvious anxiety; If the score exceeds 14, there must be anxiety; If the score exceeds 7, there may be anxiety; If the score is less than 7, there are no symptoms of anxiety. Generally speaking, the total score of HAMA is higher than 14 points, indicating clinically significant anxiety symptoms for the evaluated subject.
Time frame: The assessments are conducted at the baseline, 2nd week, 4th week, and 3 months after the end of treatment.