Affiliations: [a]
Department of Neurology, University Hospital Bonn, Bonn, Germany
| [b]
German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| [c] Brain Science Tools BV, De Bilt, The Netherlands
| [d]
Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| [e] SRH Gesundheitszentrum Bad Wimpfen GmbH, Bad Wimpfen, Germany
Correspondence:
[*]
Address for correspondence: Marcus Grobe-Einsler, MD, Department of Neurology, University Hospital Bonn, Venusberg-Campus 1, 553127 Bonn, NRW, Germany. E-mail: [email protected].
Abstract: BACKGROUND:Cerebellar ataxia, neuropathy and bilateral vestibular areflexia (CANVAS) is a rare neurodegenerative disease affecting the cerebellum, the peripheral nervous system and the vestibular system. Due to the lack of approved drugs, therapy comprises physiotherapy and speech therapy. Transcranial magnetic stimulation is a promising non-invasive therapeutic option to complement classical symptomatic therapies. OBJECTIVE:To test feasibility of the combination of transcranial magnetic stimulation using an accelerated protocol and standard symptomatic therapy in patients with CANVAS. METHODS:Eight patients with genetically confirmed CANVAS were assigned to either verum or sham cerebellar transcranial magnetic stimulation using an accelerated protocol. Treatment duration was limited to 5 days. Additionally, patients in both groups received symptomatic therapy (speech and physiotherapy) for the duration of the study. RESULTS:All patients completed the stimulation protocol. Adverse events were rare. Ataxia severity improved in the verum group only. CONCLUSION:The combination of transcranial magnetic stimulation and classic symptomatic therapy is feasible in a neuro-rehabilitation setting and potentially ameliorates ataxia severity.
Keywords: Ataxia, movement disorders, neurodegenerative diseases, transcranial magnetic stimulation, cerebellum, neurological rehabilitation
