Focal Dystonia Clinical Trial
Official title:
Effectiveness of rTMS and Retraining in the Treatment of Focal Hand Dystonia
This study is exploring a new experimental procedure in dystonia called repetitive transcranial magnetic brain stimulation (TMS) combined with rehabilitation. The purpose of the study is to determine whether repetitive TMS is effective as a treatment to reduce symptoms in dystonia as demonstrated by improved motor performance.
BACKGROUND: Though the etiology of focal hand dystonia (FHD) is uncertain, two primary
factors implicated in the development of dystonic symptoms are excessive cortical
excitability and impaired sensorimotor processing.
OBJECTIVE: The purpose of this study was to determine the functional efficacy and neural
effects of a Dual intervention of rTMS and sensorimotor retraining. Our working hypothesis
is: subjects receiving the combined intervention will (1) display significantly improved
handwriting measures; (2) report significant improvement in daily functional ability; (3)
display reduced hand cramping compared; and (4) demonstrate reduced corticospinal
excitability after the Dual intervention when compared to the rTMS+ stretching and massage
(Sham) intervention.
METHODS: A randomized, single-subject, multiple baseline design with crossover is used for
this study that will examine ten subjects with FHD with two interventions: five days of
low-frequency 1 Hz rTMS + sensorimotor retraining (Dual intervention) vs. rTMS + stretching
and massage (Sham). The rTMS is applied to the premotor cortex at 1 Hz at 90% resting motor
threshold for 1200 pulses. For sensorimotor retraining, a subset of the Learning-based
Sensorimotor Training program was followed.
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