Evidence map›Paper›PMID 34102418›Full record

Trial reportParkinsonism & related disorders2021

Paired inhibitory stimulation and gait training modulates supplemental motor area connectivity in freezing of gait.

Daniel H Lench, Will DeVries, Tonisha E Kearney-Ramos, Alyssa Chesnutt, Eric D Monsch, Aaron E Embry, Jade D Doolittle, Steven A Kautz, Colleen A Hanlon, Gonzalo J Revuelta

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Parkinsonism & related disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 8 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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  16. Neuromodulation of Cortical Targets in Freezing of Gait.The European journal of neuroscience · 2026
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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

10 authors.

Daniel H LenchDepartment of Neurology, Medical University of South Carlina, Charleston, SC, USA.
Will DeVriesDepartment of Psychiatry, Medical University of South Carolina, Charleston, SC, USA.
Tonisha E Kearney-RamosDivision on Substance Use Disorders, Columbia University Irving Medical Center, New York, NY, USA.
Alyssa ChesnuttDepartment of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.
Eric D MonschDepartment of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.
Aaron E EmbryDepartment of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.
Jade D DoolittleDepartment of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.
Steven A KautzDepartment of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA.
Colleen A HanlonDepartment of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Gonzalo J RevueltaDepartment of Neurology, Medical University of South Carlina, Charleston, SC, USA. Electronic address: revuelta@musc.edu.

Funding

Treating Depression and Enhancing Locomotor Recovery Post-strokeP20GM109040 · NIGMS · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI KAUTZ, STEVEN A. · 2014 to 2024
$23.5M
Techniques DevelopmentP2CHD086844 · NICHD · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI KAUTZ, STEVEN A. · 2015 to 2024
$12.7M
Identification of Gait and Imaging Markers for Freezing of Gait in Parkinson's DiseaseK23NS091391 · NINDS · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI REVUELTA, GONZALO JAVIER · 2015 to 2019
$982k
RR&D Research Career Scientist Award ApplicationIK6RX003075 · VA · RALPH H JOHNSON VA MEDICAL CENTER · PI KAUTZ, STEVEN A. · 2020 to 2025
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NICHD NIH HHS P2C HD086844NIGMS NIH HHS P20 GM109040NINDS NIH HHS K23 NS091391RRD VA IK6 RX003075
6 · The paper itself

Abstract

introductionFreezing of gait (FOG) is a debilitating feature of Parkinson's disease (PD). Evidence suggests patients with FOG have increased cortical control of gait. The supplementary motor area (SMA) may be a key structure due to its connectivity with locomotor and cognitive networks. The objectives of this study were to determine (1) if SMA connectivity is disrupted in patients with FOG and (2) if "inhibitory" repetitive transcranial magnetic stimulation can decrease maladaptive SMA connectivity.

methodsTwo experiments were performed. In experiment 1 resting-state (T2* BOLD imaging) was compared between 38 PD freezers and 17 PD controls. In experiment 2, twenty PD patients with FOG were randomized to either 10 sessions of real or sham rTMS to the SMA (1 Hz, 110% motor threshold, 1200 pulses/session) combined with daily gait training.

results(Experiment 1) Freezers had increased connectivity between the left SMA and the vermis of the cerebellum and decreased connectivity between the SMA and the orbitofrontal cortex (p

conclusionsThe SMA in freezers is hyper-connected to the cerebellum, a key locomotor region which may represent maladaptive compensation. In this preliminary study, 1 Hz rTMS reduced SMA connectivity however, this was not specific to the locomotor regions. Intervention outcomes may be improved with subject specific targeting of SMA.

Indexed as

ConnectomeNeurological RehabilitationTranscranial Magnetic StimulationAgedCerebellumCombined Modality TherapyExercise TherapyFemaleGait Disorders, NeurologicHumansMagnetic Resonance ImagingMaleMiddle AgedMotor CortexParkinson DiseaseConnectivityFreezingGaitParkinson's diseaseTranscranial magnetic stimulation

Identifiers

PMID34102418
PMCPMC8485722

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.