Therapeutic efficacy of transcranial magnetic stimulation for hereditary spinocerebellar degeneration

We applied transcranial magnetic stimulation (TMS) as a therapeutic approac h for patients with spinocerebellar degeneration (SCD). The subjects were f our familial SCD patients (three men and one woman) aged from 27 to 76 year s old. They mere genetically analysed as two spinocerebellar ataxia type 6 (SCA 6), one SCA 1, and one SCA 7. The durations of their illness ranged fr om 1 to 7 years. Ten consecutive magnetic pulses mere delivered over the sc alp corresponding to the right cerebellar hemisphere, the middle of the cer ebellum and the left cerebellar hemisphere, respectively, every day for 21 days. In all patients, the time and the number of steps required for a 10 m walk examination mere significantly decreased after TMS trial compared wit h those before TMS. The number of feasible steps in tandem gait test increa sed. The total length of tracing body balance for 30 seconds measured by gr avinometer was significantly decreased. However, nystagmus, dysarthria or i ncoordination of the upper limbs did not change after TMS trial. It is of i nterest that the blood flow of the cerebellar hemisphere, putamen and pens were significantly increased during the TMS trial. Although we do not know the exact mechanism by which TMS improved the ataxic gait, me speculate the increase of blood flow in the cerebellum, putamen and pens tabes part in t he improvement. These findings suggest that TMS over the cerebellum may be an effective therapy for patients with SCD.