[Repetitive Transcranial Magnetic Stimulation for Parkinson's Disease: A Review].

This study aimed to review the effectiveness of repetitive transcranial magnetic stimulation (rTMS) for Parkinson's disease (PD). rTMS can modulate the neural networks in the human brain for a certain period, i.e., it can induce neural plasticity. Randomized, double-blind, sham-controlled, multicenter studies on rTMS for PD have been conducted three times in Japan (in 2003, 2008, and 2013). These studies revealed that 5-Hz rTMS over the supplementary motor area (SMA) is the most effective modality for improving motor symptoms. Several functional imaging studies showed reduced SMA excitability in patients with PD, probably secondary to basal ganglia dysfunction. Therefore, 5-Hz rTMS is assumed to normalize SMA excitability and amend basal ganglia function secondarily. Currently, a phase III trial is being conducted in Japan. Therefore, in the near future, 5-Hz rTMS can be used as a therapeutic modality for PD treatment. In addition, several powerful rTMS have been developed recently, including quadripulse stimulation (QPS), which most potently induces neural plasticity. QPS is also expected to be a potential therapeutic tool to treat patients with PD.