Cervical Dystonia Clinical Trial
Official title:
Identification of Optimal Stimulation Site for Cervical Dystonia Symptoms: An Exploratory Study
The overall objective of this application is to therapeutically target the dysfunctional premotor-motor interaction in dystonia—and to provide a focused treatment of specific anatomical networks in order to reduce side effects and to improve symptom control over conventional therapies.
We propose using repetitive transcranial magnetic stimulation (rTMS) over distinct premotor
areas in patients with cervical dystonia (CD) with the goal of improving symptoms and
reducing unwanted side effects. The knowledge gained in this proposed research will identify
a specific premotor area to be targeted with rTMS that is expected to result in a novel
intervention that could enhance or replace current treatments for CD. rTMS could be included
as an adjunct treatment to botulinum toxin that could sustain treatment effect and decrease
the frequency of re-injection, potentially resulting in cost savings without a decrease in
symptom control. In addition to medical cost reduction, improved quality of life could be
expected with the successful development of therapies that extend dystonia symptom control.
rTMs has been FDA-approved for the treatment of depression and our proposal uses an even
lower stimulation rate, suggesting continued use within clearly safe parameters. Successful
completion of this research could lead to rapid adoption of this therapeutic modality.
We will test the hypothesis that rTMS of a distinct premotor site will provide more
effective treatment of CD than non-specific activation of the entire premotor region. This
will be done by performing a randomized, observer-blinded exploratory pilot study to
determine the optimal site of rTMS over various sites of the premotor and motor cortex to
improve the symptoms of cervical dystonia. Completion of this aim should lead to development
of targeted TMS therapy for CD.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment
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