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Repetitive Transcranial Magnetic Stimulation Not Beneficial in Severe Choreiform Movements of Huntington Disease

Shukla, Aniket MD, DPM; Jayarajan, Rajan Nishanth MD; Muralidharan, Kesavan; Jain, Sanjeev MD, DPM

doi: 10.1097/YCT.0b013e3182711dfc
Online Articles

Repetitive transcranial magnetic stimulation (rTMS) has been used therapeutically for reducing choreiform movements in patients with Huntington disease. There have been case studies reporting improvement in choreiform movements with administration of low-frequency rTMS lasting for a brief period. We report a case series where application of 7 consecutive sessions of bilateral low-frequency rTMS over the scalp area corresponding to supplementary motor area in patients with severe Huntington chorea did not reduce the intensity of choreiform movements even transiently. Hence, the proposed role of rTMS in reducing intensity of choreiform movements by altering neuronal plasticity may not hold true in severe cases.

From the Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India.

Received for publication April 13, 2012; accepted August 2, 2012.

Reprints: Aniket Shukla, MD, DPM, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 29, Karnataka, India (e-mail: aniketdshukla@gmail.com).

The authors have no conflicts of interest or financial disclosures to report.

Authors’ contribution: Drs Aniket Shukla, Rajan Jayarajan, Muralidharan Kesavan, and Sanjeev Jain together contributed to diagnosis and treatment of the patients in the hospital mentioned in this case series. Drs Shukla and Jayarajan executed the therapeutic intervention of rTMS under the supervision of Drs Muralidharan and Sanjeev Jain. All the authors have contributed in the analysis of the results of therapeutic intervention and in literature review and discussion of the findings.

© 2013 by Lippincott Williams & Wilkins