Effect of cerebellar high frequency repetitive transcranial magnetic stimulation on the balance of MS patients with ataxia

Multiple Sclerosis is a chronic autoimmune disease affecting the central nervous system, leading to progressive motor dysfunction and balance deficits. Balance impairments were evident as one of the earliest signs of the disease with a substantial majority of Multiple Sclerosis (MS) patients, between 50% and 80%, exhibiting signs of abnormalities in postural control and gait shortly after diagnosis. Although disease-modifying therapies have advanced, there remains an unmet need for effective treatments that target motor and cognitive impairments. The Purpose of the study: was to investigate the impact of cerebellar high frequency repetitive Transcranial Magnetic Stimulation in improving postural control, balance and functional ambulation in individuals with Multiple Sclerosis. Of the 40 patients with multiple sclerosis, the group receiving cerebellar Real repetitive Transcranial Magnetic Stimulation (rTMS) showed significant reduction in the Expanded Disability Status Scale and the International Cooperative Ataxia Rating Scale. This group also showed significant improvement in balance performance and gait speed, evident by the results of Center of Pressure measurement under both eyes open and eyes closed conditions, assessed by static posturography. The 10-meter walk test also showed significant improvements in comparison to the control group who received sham rTMS. Cerebellar rTMS is a promising therapeutic tool for addressing motor and balance dysfunction in MS. Its inclusion in comprehensive rehabilitation programs may enhance the functional independence for patients affected by this challenging condition.