Rationale for the efficiency of transcranial magnetic stimulation in multiple sclerosis
The aim. Based on the analysis and comprehensive clinical and neurological evaluation of the results to substantiate the effectiveness of transcranial magnetic stimulation (TMS) in the treatment and rehabilitation of patients with multiple sclerosis (MS).
Methods. A total of 110 MS patients were included in the study. The control group consisted of 30 patients who received pathogenetic therapy and 80 patients who underwent a course of rhythmic transcranial magnetic stimulation (rTMS) together with pathogenetic therapy.
Results. The results obtained during the study indicate the complex multifactorial nature of fatigue and its significant impact on the clinical manifestations of MS. Also, the use of rTMS reduced the severity of the main neurological symptoms of MS. The improvement in the overall EDSS scale in the group of patients receiving rTMS was statistically significant: from 5.0±1.9 points to 4.5±2.0 points (p<0.01), in the comparison group (p>0.05). Under the influence of TMS, gait function improved, but these indicators were statistically insignificant (p>0.05). The greatest effect of rTMS was obtained on the manifestations of fatigue and also extended to its cognitive and psychosocial components. The obtained patterns are confirmed in the analysis of indicators on the SCA and FS scales. Involvement in the treatment of patients with MS rTMS allowed to achieve a significant reduction in the manifestations of all components of fatigue: from 76.0±20.9 points to 75.5±20.5 points (p<0.05).
The data obtained during the study confirm the effectiveness, safety and viability of non-invasive neuromodulation by rTMS in the treatment and rehabilitation of patients with MS.
Conclusions. The use of rTMS has a positive effect on the manifestations of fatigue, both motor and cognitive, in patients with MS at all types of course and at different stages of progression. Non-invasiveness, safety and ease of use, the possibility of differentiated use allow the use of rTMS in the clinic of rehabilitation treatment and become an important component of active drug and non-drug rehabilitation of patients with MS.
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