Evidence map›Paper›PMID 28509934›Full record

Trial reportExperimental brain research2017

The role of the prefrontal cortex in freezing of gait in Parkinson's disease: insights from a deep repetitive transcranial magnetic stimulation exploratory study.

Moria Dagan, Talia Herman, Anat Mirelman, Nir Giladi, Jeffrey M Hausdorff

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Experimental brain research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03552861 (Standardization and Optimization of TMS Protocols for the Treatment of Early and Mild-to-late Stage Parkinson's Disease With Depression or Cognitive Impairment), which is not on this map. Cited by 31 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 6 pooled it
4.5field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03552861 naunknown statusnot on this mapstarted 2018, after this paper: background citation

Standardization and Optimization of TMS Protocols for the Treatment of Early and Mild-to-late Stage Parkinson's Disease With Depression or Cognitive Impairment

TypeinterventionalSponsorGuangdong Provincial People's HospitalRan2018 to 2021Enrolled252ConditionsTMS Protocols in the Treatment of PDArmsrepetitive transcranial magnetic stimulation(rTMS)
3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 6 syntheses or guidelines pooled it, 67 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Trial
  8. Multitarget transcranial direct current stimulation for freezing of gait in Parkinson's disease.Movement disorders : official journal of the Movement Disorder Society · 2018
    Trial
  9. Review
  10. Neuromodulation of Cortical Targets in Freezing of Gait.The European journal of neuroscience · 2026
    Review
  11. Article
  12. Clinical neurophysiology in the treatment of movement disorders: IFCN handbook chapter.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2024
    Review
  13. Article
  14. Article
  15. Review
  16. Article
  17. Article
  18. Discussion of Research Priorities for Gait Disorders in Parkinson's Disease.Movement disorders : official journal of the Movement Disorder Society · 2022
    Review
  19. Article
  20. Non-invasive Brain Stimulation for Central Neuropathic Pain.Frontiers in molecular neuroscience · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Moria DaganCenter for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv, Israel.
Talia HermanCenter for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv, Israel.
Anat MirelmanCenter for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv, Israel.
Nir GiladiSagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
Jeffrey M HausdorffCenter for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv, Israel. jhausdor@tlvmc.gov.il.
Tel Aviv University · ILTel Aviv Sourasky Medical Center · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Freezing of Gait (FOG) is one of the most debilitating gait impairments in Parkinson's disease (PD), leading to increased fall risk and reduced health-related quality of life. The utility of parkinsonian medications is often limited in the case of FOG and it frequently becomes dopamine resistant. Recent studies have suggested that pre-frontal cortex (PFC) dysfunction contributes to FOG; however, most previous findings provide only indirect evidence. To better understand the role of the PFC, we aimed to investigate the impact of high frequency, deep, repetitive transcranial magnetic stimulation (drTMS) of the medial PFC on FOG and its mediators. Nine patients with advanced PD participated in a randomized, cross-over exploratory study. We applied drTMS over the medial PFC for 16 weeks, with real and sham conditions; each condition included an intensive (i.e., 3 times a week) phase and a maintenance (once a week) phase. Scores on a FOG-provoking test, the motor part of the Unified Parkinson's Disease Rating Scale, and gait variability significantly improved after real drTMS, but not after the sham condition. Self-report of FOG severity and cognitive scores did not improve. Due to discomfort and pain during treatment, two patients dropped out and the study was halted. These initial findings support the cause-and-effect role of the pre-frontal cortex in FOG among patients with PD. Due to the small sample size, findings should be interpreted cautiously. Further studies are needed to more fully assess the role of the medial PFC in the underlying mechanism of FOG and the possibility of using non-invasive brain stimulation to modify FOG.

Indexed as

AgedAged, 80 and overCross-Over StudiesFemaleGaitGait Disorders, NeurologicHumansMaleParkinson DiseasePrefrontal CortexSelf ReportSeverity of Illness IndexTranscranial Magnetic StimulationTreatment OutcomeDeep TMSFreezing of gaitNon-invasive brain stimulationParkinson’s diseaserTMS

Identifiers

PMID28509934
OpenAlexW2616447787

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.