Transcranial Magnetic Stimulation in Progressive Supranuclear Palsy
Cerebellar Transcranial Magnetic Stimulation for Motor Control in Progressive Supranuclear Palsy
Oregon Health and Science University
30 participants
Jan 17, 2020
INTERVENTIONAL
Conditions
Summary
The objective of this proposal is to investigate the effect of non-invasive repetitive cerebellar transcranial magnetic stimulation (rTMS) on motor control in progressive supranuclear (PSP). The central hypothesis is that augmenting cerebellar inhibition via cerebellar rTMS will decrease postural instability in patients with PSP. We will use functional near infrared spectroscopy (fNIRS) to examine changes in motor and premotor cortical activity after cerebellar rTMS.
Eligibility
Inclusion Criteria8
- probable or possible PSP by the revised MDS PSP Criteria (Hoglinger 2017)
- age 40-85 at time of screening
- ability to understand and cooperate with simple instructions in English
- ability to read at 6th grade reading level in English
- ability to stand unassisted for at least 30 seconds and to be able walk independently with a walker
- ability to refrain from new physical and speech therapy programs for the duration of the study
- ability to remain on stable doses of any cholinergic, dopaminergic, serotonergic sedative or NMDA receptor antagonists for the duration of the study
- females of child-bearing age must perform a urine pregnancy test and be on reliable birth control during the course of the study
Exclusion Criteria2
- other significant neurological or vestibular disorders
- presence of electrically, magnetically or mechanically activated implants or history of injurious metal exposure in eyes, head, or body
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Interventions
Aim 1: To determine the clinical effects of rTMS targeting the cerebellum on postural instability in PSP. The hypothesis to be tested is that TMS augmentation of cerebellar inhibition will improve cerebellum-dependent balance symptoms of PSP for a period of time sufficient to improve rehabilitation outcomes. The investigators will measure a battery of objective posturography metrics and other measures of motor control, including sway and center of pressure changes to backward tilt and forward translation. Aim 2: We will use functional near infrared spectroscopy (fNIRS) to examine changes in motor and premotor cortical activity after cerebellar rTMS. The hypothesis to be tested is that premotor and motor cortical activity will decrease after cerebellar rTMS compared to sham TMS, reflecting improved cerebellar inhibition of the motor cortex after the intervention.
Locations(1)
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NCT04468932