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NEUROLOGY 2007;68:1045-1050
© 2007 American Academy of Neurology

Repetitive transcranial magnetic stimulation of the motor cortex ameliorates spasticity in multiple sclerosis

D. Centonze, MD, G. Koch, MD, V. Versace, MD, F. Mori, MD, S. Rossi, MD, L. Brusa, MD, K. Grossi, MD, F. Torelli, MD, C. Prosperetti, MD, A. Cervellino, MD, G. A. Marfia, MD, P. Stanzione, MD, M. G. Marciani, MD, L. Boffa, MD and G. Bernardi, MD

From Clinica Neurologica, Dipartimento di Neuroscienze, Università Tor Vergata, Rome, Italy, and Fondazione Santa Lucia IRCCS, Rome, Italy.

Address correspondence and reprint requests to Dr. Diego Centonze, Clinica Neurologica, Dipartimento di Neuroscienze, Università di Tor Vergata, via Montpellier 1, 00133 Rome, Italy; e-mail: centonze{at}uniroma2.it; or Dr. Giacomo Koch, Clinica Neurologica, Dipartimento di Neuroscienze, Università di Tor Vergata, via Montpellier 1, 00133 Rome, Italy; e-mail: giakoch{at}libero.it

Objective: To investigate whether repetitive transcranial magnetic stimulation (rTMS) can modify spasticity.

Methods: We used high-frequency (5 Hz) and low-frequency (1 Hz) rTMS protocols in 19 remitting patients with relapsing–remitting multiple sclerosis and lower limb spasticity.

Results: A single session of 1 Hz rTMS over the leg primary motor cortex increased H/M amplitude ratio of the soleus H reflex, a reliable neurophysiologic measure of stretch reflex. Five hertz rTMS decreased H/M amplitude ratio of the soleus H reflex and increased corticospinal excitability. Single sessions did not induce any effect on spasticity. A significant improvement of lower limb spasticity was observed when rTMS applications were repeated during a 2-week period. Clinical improvement was long-lasting (at least 7 days after the end of treatment) when the patients underwent 5 Hz rTMS treatment during a 2-week protocol. No effect was obtained after a 2-week sham stimulation.

Conclusions: Repetitive transcranial magnetic stimulation may improve spasticity in multiple sclerosis.

*These authors contributed equally to the present work.

This study was supported by a grant from Agenzia Spaziale Italiana to G.B.

Disclosure: The authors report no conflicts of interest.

Received November 29, 2005. Accepted in final form November 27, 2006.


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G Koch, S Rossi, C Prosperetti, C Codeca, F Monteleone, L Petrosini, G Bernardi, and D Centonze
Improvement of hand dexterity following motor cortex rTMS in multiple sclerosis patients with cerebellar impairment
Multiple Sclerosis, August 1, 2008; 14(7): 995 - 998.
[Abstract] [PDF]


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