Effects of Transcranial Magnetic Stimulation on Brain Functional Networks in Patients With Akinetic-rigid Parkinson's Disease

Objective The efficacy of repeated transcranial magnetic stimulation (rTMS) as a noninvasive neuromodulation technique in patients with Parkinson's disease (PD) has not been fully validated. In this study, we combined clinical scale evaluation, brain electrical source and brain network to explore the effects of high-frequency repetitive transcranial magnetic stimulation on patients with akinetic-rigid Parkinson's disease (AR-PD). Methods A total of 18 patients with AR-PD were included. The EEG signals were traced by standard low-resolution electromagnetic tomography (sLORETA), then the brain functional network was constructed by complex network theory, and the network topological characteristics were compared and analyzed from the perspective of collaborative work between brain regions. Results The results showed that there were significant differences in prefrontal cortex and primary motor cortex after magnetic stimulation (P<0.05). The network connectivity of brain regions associated with motor sensory production, motor planning, and motor execution was significantly enhanced (P<0.05) and the change in the mean cluster coefficient of topological features of brain functional networks was significantly correlated with the change in Parkinson's uniform rating scale score (P<0.05). Conclusion It is speculated that rTMS improves the information transmission ability of AR-PD patients from motor sensation generation to motor execution. This study can provide a theoretical basis for the relationship between the improvement of motor symptoms of AR-PD patients by rTMS and the reintegration of sensorimotor network.