Repetitive Transcranial Magnetic Stimulation in the Motor Symptoms of Parkinson's Disease

Systematic Review

Abstract

Introduction: Parkinson's disease (PD) is mainly represented by motor symptoms such as tremor, bradykinesia, stiffness and postural instability. The repetitive transcranial magnetic stimulation (rTMS) is a painless and non-invasive technique that modulates the excitability of the brain, and may contribut to obtain positive therapeutic results in the rehabilitation of these dysfunctions. Objectives: To analyze, through a systematic review, the use of repetitive transcranial magnetic stimulation in the treatment of the motor symptoms of individuals with Parkinson's disease. Methods: Systematic review of PEDro, SCIELO and PubMed and BVS Regional portal during June and July 2018, combining the descriptors "Transcranial Magnetic Stimulation", "Parkinson's Disease" and "Therapeutics" in English and Portuguese. We included randomized clinical trials published between 2009 and 2018 that addressed the rTMS technique in the treatment of motor symptoms in PD. We found 1011 articles and excluded those that were duplicated, did not meet the eligibility criteria, did not fit the researched topic or did not present the full text available. Results: We analyzed 14 studies with a score of 8.21 ± 1.48 on the Pedro scale. In these studies, 467 subjects classified as Hoehn Yahr of 2, 3 and 4 were assessed for motor function and then submitted to rTMS with varying frequencies, being used: 1Hz, 5Hz, 10Hz, 25Hz and 50Hz. Conclusion: EMTr have importance under the motor symptoms, among them: speech, facial expression, tremor, rigidity, dexterity, agility, posture, gait and postural stability. It is recommended to carry out more studies using rTMS in the rehabilitation of freezing and functional capacity.