Researchers have used repetitive magnetic stimulation on the brain of a man who’d had a cerebellar stroke 12 years ago, improving his walking speed, balance, and coordination. The innovative treatment could help people whose movement has been impaired even years after a stroke.
A stroke that damages the brain’s cerebellum, the region that controls movement, can cause ataxia, impairing coordination and balance. While cerebellar ataxia can range from mild to severe, it's often characterized by an unsteady, staggering gait, loss of fine muscle movement, slurred speech, and difficulty swallowing.
Treatment for cerebellar ataxia is limited to physical and occupational therapy and, if required, speech therapy. However, a recent case study by researchers at UCLA Health describes a promising new treatment for the condition: repetitive transcranial magnetic stimulation, or rTMS.
“This case represents the first instance of bilateral cerebellar rTMS used to treat post-stroke cerebellar ataxia,” said Evan Hy Einstein, lead and corresponding author of the study.
Transcranial magnetic stimulation (TMS) is a safe, non-invasive treatment involving placing a coil on the head that generates magnetic fields targeting a specific area of the brain. In rTMS, magnetic pulses are given repeatedly for therapeutic effect. rTMS has been used to treat depression in patients who haven’t responded to or can’t tolerate antidepressant medication.
In the current study, the patient, a 58-year-old male who’d had a sudden cerebellar stroke 12 years previously, presented with a persistent slow and unsteady gait and difficulties with balance and stability despite intensive rehabilitation. He was not able to rise from sitting without aid and was unable to bend over to pick up an item from the floor. He used a rolling walker for stability and, before rTMS treatment, walked 10 meters (32.8 ft) at a speed of 0.57 meters per second (m/s).
The man was given five daily sessions of rTMS, targeting the cerebellum on the right and left. He tolerated the sessions without reporting any side effects. After five days of treatment, the man’s walking speed had improved to 0.60 m/s. He was able to rise from a seated position unaided and could easily bend to pick a pencil up off the floor. He reported improved balance and stability while performing activities of daily living, such as showering and shaving, which he did without using hand supports, something he was unable to do before the treatment.
“Further research is warranted to ascertain long-term clinical benefits and explore the underlying neural mechanisms of this innovative treatment, but it underscores the potential of tailored treatment protocols that consider the specific etiology of ataxia,” Einstein said.
The study was published in the journal The Cerebellum.
Source: UCLA Health
