Transcranial magnetic stimulation primes the effects of exercise therapy in multiple sclerosis

J Neurol. 2011 Jul;258(7):1281-7. doi: 10.1007/s00415-011-5924-1. Epub 2011 Feb 1.


Exercise therapy (ET) can be beneficial in disabled multiple sclerosis (MS) patients. Intermittent transcranial magnetic theta burst stimulation (iTBS) induces long-term excitability changes of the cerebral cortex and may ameliorate spasticity in MS. We investigated whether the combination of iTBS and a program of ET can improve motor disability in MS patients. In a double-blind, sham-controlled trial, 30 participants were randomized to three different interventions: iTBS plus ET, sham stimulation plus ET, and iTBS alone. Before and after 2 weeks of treatment, measures of spasticity through the modified Ashworth scale (MAS) and the 88 items Multiple Sclerosis Spasticity Score questionnaire (MSSS-88), fatigue through the Fatigue Severity Scale (FSS), daily living activities (ADL) through the Barthel index and health-related quality of life (HRQoL) through the 54 items Multiple Sclerosis Quality of life inventory (MSQoL-54) were collected. iTBS plus ET reduced MAS, MSSS-88, FSS scores, while in the Barthel index and MSQoL-54, physical composite scores were increased. iTBS alone caused a reduction of the MAS score, while none of the measured scales showed significant changes after sham iTBS plus ET. iTBS associated with ET is a promising tool for motor rehabilitation of MS patients.

Publication types

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

MeSH terms

  • Adult
  • Disability Evaluation
  • Double-Blind Method
  • Evoked Potentials, Motor / physiology
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis / physiopathology
  • Multiple Sclerosis / rehabilitation*
  • Multiple Sclerosis / therapy*
  • Range of Motion, Articular / physiology
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Time Factors
  • Transcranial Magnetic Stimulation / methods*