Predicting Clinical Respondence of Repetitive Transcranial Magnetic Stimulation in Parkinson's Disease Using White Matter Functional Characteristics

Abstract

Abstract Objective The aim of this study was to predict the clinical respondence of rTMS in PD by WM.Methods According to the Unified Parkinson’s Disease Rating Scale Part III (UPDRSIII) score reduction, Sixty-eight PD patients treated with rTMS for 14 days were divided into a responsive (R) group (UPDRSIII score reduction ≥ 30%, n = 20) and a nonresponsive (NR) group (UPDRSIII score reduction ≤ 30%, n = 48). The difference of low frequency fluctuation amplitude (ALFF) and fraction ALFF (fALFF) before rTMS and the correlation with UPDRSIII improvement were analyzed between the two groups.Results The ALFF values of the bilateral upper corticospinal tract and fALFF values of the left anterior thalamic radiation in R group were higher than those in NR group. The ALFF value of the bilateral superior longitudinal fasciculus, the bilateral lower corticospinal tract, the left Forceps major and the right anterior thalamic radiation in R group was lower than that in NR group. Pearson correlation analysis showed that the UPDRSIII deduction score was positively correlated with the bilateral upper corticospinal fasciculus and bilateral anterior thalamic radiation and negatively correlated with the bilateral lower corticospinal tract and the bilateral superior longitudinal fasciculus. The ALFF value of the upper right corticospinal tract and the lower right corticospinal tract and the fALFF value of the bilateral anterior thalamic radiation were included in the prediction model, and the prediction efficiency was 100%.Conclusion WM could be used as a predictor of the clinical efficacy of rTMS in PD.