This randomized double-blinded trial investigated the efficacy of dual-site repetitive transcranial magnetic stimulation (rTMS) combined with transcutaneous magnetic spinal cord stimulation in treating levodopa-unresponsive freezing of gait (FOG) in Parkinson's disease (PD). 57 PD patients were randomized to dual-site (bilateral primary motor cortex of the lower leg (M1-LL) and lumbar spinal cord), single-site (bilateral M1-LL only), or sham stimulation. Low-frequency rTMS significantly improved FOG, gait, and motor functions compared to sham at 1 day and 1 month post-intervention. The dual-site protocol showed superior efficacy over single-site, correlating with reduced intracortical inhibition. This suggests cerebrospinal dual-site stimulation as a promising treatment for levodopa-unresponsive FOG in PD.

Lina Wang, Huimin Sun, Heng Zhang, Min Ji, Caiting Gan, Aidi Shan, Xingyue Cao, Yongsheng Yuan, Kezhong Zhang