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Sensorimotor network connectivity correlates with motor improvement after repetitive transcranial magnetic stimulation in patients with Parkinson's disease

  • Author Footnotes
    2 These authors have contributed equally to this work and share the first authorship.
    Shumei Chi
    Footnotes
    2 These authors have contributed equally to this work and share the first authorship.
    Affiliations
    Department of Neurology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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  • Author Footnotes
    2 These authors have contributed equally to this work and share the first authorship.
    Xinrui Wen
    Footnotes
    2 These authors have contributed equally to this work and share the first authorship.
    Affiliations
    Department of Neurology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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  • Yang Yu
    Affiliations
    Department of Physical Medicine and Rehabilitation of the Affiliated Sir Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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  • Guanjun Wang
    Affiliations
    Department of Radiology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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  • Jie Zhang
    Affiliations
    Rehabilitation Medicine Center & Rehabilitation Research Institute of Zhejiang Province, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
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  • Chuang Xue
    Affiliations
    Department of Physiotherapy Treatment Center, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, China
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  • Xiaoying Zhang
    Affiliations
    Department of Neurology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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  • Zheng Wang
    Affiliations
    Department of Neurology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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  • Meiduo Gesang
    Affiliations
    Department of Neurology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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  • Jiefang Chen
    Affiliations
    Department of Neurology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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  • Sha Wu
    Affiliations
    Department of Neurology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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  • Man Jin
    Affiliations
    Department of Neurology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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  • Author Footnotes
    1 These authors have contributed equally to this work and share the last authorship.
    Jian Liu
    Correspondence
    Corresponding author.
    Footnotes
    1 These authors have contributed equally to this work and share the last authorship.
    Affiliations
    Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, China
    Search for articles by this author
  • Author Footnotes
    1 These authors have contributed equally to this work and share the last authorship.
    Benyan Luo
    Correspondence
    Corresponding author.
    Footnotes
    1 These authors have contributed equally to this work and share the last authorship.
    Affiliations
    Department of Neurology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
    Search for articles by this author
  • Author Footnotes
    1 These authors have contributed equally to this work and share the last authorship.
    2 These authors have contributed equally to this work and share the first authorship.

      Highlights

      • HF-rTMS over SMA imposed positive effects on motor improvements in PD patients.
      • Patients with lower sensorimotor degree centrality indicated better responses.
      • The sensorimotor network might be involved in motor improvement after rTMS.

      Abstract

      Background

      Emerging evidence suggests that repetitive transcranial magnetic stimulation (rTMS) generally improves Parkinson's disease (PD) motor symptoms. However, personal responses to rTMS might be different. In this study, we explore the connectivity changes in PD patients with different responses to rTMS.

      Methods

      Among PD patients, 25 were treated with 10Hz-rTMS and seven were with sham rTMS over the supplementary motor area for 10 days. Resting-state functional connectivity magnetic resonance imaging (rs-fMRI) was performed in PD patients before and after rTMS stimulation. Neuropsychological scales such as Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) were collected synchronously with rs-fMRI. To explore the connectivity changes after rTMS, degree centrality was calculated.

      Results

      13 out of 25 participants were responsive to 10Hz rTMS. Degree centrality patterns in the left sensorimotor regions are primarily responsible for the differences between responsive and non-responsive individuals. Improvement in motor symptoms was substantially related to the baseline degree centrality in the left PreCG and the left PoCG. The performance in distinguishing non-responders from responders was further validated by the ROC analysis utilizing DC characteristics. Lastly, we found that connectivity increased in left PreCG and PoCG in patients with a better response to the rTMS.

      Conclusion

      Taken together, these results suggest that the sensorimotor network is involved in the motor improvement following rTMS treatment, with patients with lower sensorimotor connectivity showing a tendency for greater motor improvement to HF-rTMS.

      Keywords

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