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UBC Theses and Dissertations

Effect of repetitive transcranial magnetic stimulation over supplementary motor area in individuals with Parkinson disease Randhawa, Bubblepreet Kaur


Introduction: Parkinson Disease (PD) is a characterized by bradykinesia along with altered oscillations in the basal ganglia (BG) and cortex resulting from loss of dopaminergic neurons in the substantia nigra. In addition, PD is linked to decreased activation of the Supplementary Motor Area (SMA) attributed to altered cortico-basal ganglia pathways resulting in poverty of movement. Purpose: The main goal of the study was to determine whether 5 Hz rTMS over SMA improved motor control - indexed by a serial targeting task (STT) and a handwriting task in individuals with PD. Secondary aims were to 1) record change in cortical oscillations using electroencephalogram (EEG) during STT performance, and 2) to consider the role of the SMA in motor imagery in individuals with PD as indexed by a break test. Methods: In a cross-over design, individuals with PD were randomized to receive either 5 Hz or control rTMS over the SMA. Three experimental tasks were administered prior to and immediately after the rTMS intervention with right hand; the STT, a handwriting task, and a break test. EEG was collected during STT and cortical excitability was indexed by assessing resting motor threshold (RMT). Results: Participants showed an improved motor performance in STT post 5 Hz rTMS. There was concurrent reduction in θ and α oscillations during the reaction time phase of the task in frontocentral and central EEG channels along with lowered RMT in M1 post 5 Hz rTMS. In the handwriting task, participants showed improvement in stroke size, axial pressure after 5 Hz rTMS. Both groups’ (5 Hz and control) performance on the break test was similar. Conclusion: The findings of this thesis suggest that 5 Hz rTMS is beneficial at least in the short-term for individuals with PD. 5 Hz rTMS improved motor performance, shifted cortical oscillations and cortical excitability. However, these effects were noted for only a single session. The results of this thesis may contribute to future research related to development of rTMS as a therapeutic option for individuals with PD.

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