Publication date: Jun 10, 2019
In this review, we discuss the clinical and electrophysiological effects, and the future directions of invasive and non-invasive brain stimulations in Parkinson’s disease (PD). Deep brain stimulation (DBS) can improve motor symptoms in moderate to advanced PD. However, the optimal stimulation paradigm for non-motor symptoms, freezing of gait and the optimal timing of DBS are still under investigations. The findings of pathological oscillations and abnormal frequency to amplitude coupling provide models to develop adaptive DBS. Transcranial magnetic stimulation (TMS) revealed abnormal cortical excitability and plasticity in PD. Consecutive sessions of high frequency, repetitive TMS on the motor cortex showed promising results. Paired TMS and DBS at specific times provided a novel way to investigate PD pathophysiology and has potential as a future treatment. Transcranial direct current stimulation or transcranial alternating current stimulation with multifocal electrodes or at specific phases of oscillation are also potential future strategies. This article is protected by copyright. All rights reserved.
Chen, K.S. and Chen, R. Invasive and non-invasive brain stimulation in Parkinson’s disease: Clinical effects and future perspectives. 21112. 2019 Clin Pharmacol Ther.
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