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

Neurology. 2007 Mar 27;68(13):1045-50. doi: 10.1212/01.wnl.0000257818.16952.62.


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.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • H-Reflex / physiology
  • Humans
  • Leg / physiopathology
  • Male
  • Middle Aged
  • Motor Cortex / physiopathology*
  • Multiple Sclerosis / complications*
  • Multiple Sclerosis / physiopathology
  • Muscle Contraction / physiology
  • Muscle Hypertonia / etiology
  • Muscle Hypertonia / physiopathology
  • Muscle Hypertonia / therapy
  • Muscle Spasticity / etiology*
  • Muscle Spasticity / physiopathology
  • Muscle Spasticity / therapy*
  • Muscle, Skeletal / innervation
  • Muscle, Skeletal / physiopathology
  • Pyramidal Tracts / physiopathology
  • Reflex, Abnormal / physiology
  • Transcranial Magnetic Stimulation / methods*
  • Treatment Outcome