• Seung Yeol Lee, Min-Su Kim, Won Hyuk Chang, Jin-Whan Cho, Jin-Young Youn, and Yun-Hee Kim.
• Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
• Restor. Neurol. Neurosci. 2014 Jan 1; 32 (6): 743-53.

PurposeThe aim of this study was to investigate the site-specific effects of repetitive transcranial magnetic stimulation (rTMS) on freezing of gait (FOG) in patients with parkinsonism.MethodsTwenty patients with parkinsonism and FOG were included. A single session of 10 Hz rTMS was applied over three different cortical regions of the dominant hemisphere: the primary motor cortex of the lower leg (M1-LL), the supplementary motor area (SMA), and the dorsolateral prefrontal cortex (DLPFC). We also performed sham stimulation as a control. The Timed Up and Go (TUG) test, Turn Steps and Turn Time in 180° turning, Unified Parkinson's Disease Rating Scale (UPDRS) part III, FOG Questionnaire (FOG-Q), and motor evoked potential (MEP) studies were performed before and after each intervention.ResultsThere were significant improvements in TUG test times after rTMS over the M1-LL and the DLPFC. Improvement was significantly greater after the M1-LL stimulation than sham condition. The M1-LL and DLPFC stimulation also resulted in significant improvements in both the number of Turn Steps and Turn Time. UPDRS-III scores were significantly decreased after the M1-LL and DLPFC stimulation.ConclusionsUse of 10 Hz rTMS on the M1-LL and DLPFC is therapeutically effective for FOG in patients with parkinsonism.

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