Long-term motor cortex stimulation for amyotrophic lateral sclerosis
Received 11 November 2008; received in revised form 27 March 2009; accepted 22 April 2009. published online 25 May 2009.
Background
Motor cortex stimulation has been proposed for treatment of amyotrophic lateral sclerosis (ALS) and preliminary studies have reported a slight reduction of disease progression using both invasive and noninvasive repetitive stimulation of the motor cortex.
Objective
The aim of this proof of principle study was to investigate the effects of motor cortex stimulation performed for a prolonged period (about 2 years) on ALS progression.
Methods
Two patients were included in the study; the first patient was treated with monthly cycles of repetitive transcranial magnetic stimulation (rTMS) and the second one was treated with chronic epidural motor cortex stimulation. The rate of progression of the disease before and during treatment was compared.
Results
The treatments were well tolerated by the patients. Both patients deteriorated during treatment; however, the patient treated with rTMS showed a slight reduction in deterioration rate.
Conclusions
Although we cannot be sure whether the effects observed in the patient treated with rTMS can be attributed to this form of stimulation, our study set the groundwork for possible future studies investigating the effects of rTMS, for a prolonged period, on a larger group of ALS patients.
cInstitute of Neurosurgery, Università Cattolica, L.go A. Gemelli 8, 00168 Rome, Italy
Correspondence: Dr. Vincenzo Di Lazzaro, Istituto di Neurologia, Università Cattolica, L.go A. Gemelli 8, 00168 Rome, Italy.
This work was supported by the Ministero della Salute (Ricerca finalizzata Bando 2007-Repetitive transcranial magnetic stimulation as novel therapeutic approach for amyotrophic lateral sclerosis-Regione Abruzzo).
ABSTRACT