What is RTMS?.. Transcranial Magnetic Stimulation (TMS) is a non-invasive form of brain stimulation based on the principle of electromagnetic induction of an electric field first introduced by Barker et al.... In TMS, a magnetic coil is placed on the scalp to deliver a short pulse and current. It is applied above to the target area of the brain.. It activates the cerebral cortex of neurons at a depth of 1.5 to 3.0 cm... Related article: Therapeutic applications of magnetic brain stimulation What is the therapeutic mechanism of rTMS? Types of TMS include the following: - Single-pulse TMS in which one pulse is applied to a certain part of the cerebral cortex... - Double-pulse TMS in which two single-pulse pulses are applied to the cerebral cortex with a short time interval from each other.... - Repetitive TMS (rTMS) in which a group of pulses are applied to the cerebral cortex, a specific period of TMS is used.. Assess the response of the cerebral cortex, while paired TMS is used to examine cortical connections as well as inhibitory and excitatory interactions in the cerebral cortex.. Repetitive TMS (rTMS) has the ability to produce changes in brain activity that last longer than the period of stimulation.... Work? It involves transsynaptic signaling to regions that are anatomically or functionally connected to the site of stimulation, and its effectiveness depends on various parameters including rTMS frequency, duration, and intensity. For example, low-frequency rTMS (LF-rTMS) (≤1 Hz) has been shown to be more effective than high-frequency (HF-rTMS) (>1 Hz) motor cortex. In addition, rTMS appears to induce changes in neural excitability, metabolism, and blood flow directly in the target region and its interconnected regions. Finally, the after-effects are thought to reflect changes in synaptic function known as long-term potentiation (DLT). rTMS balances LTP/LTD, which underlies several cognitive functions such as memory and learning. In addition to LF-rTMS and HF-rTMS, theta burst stimulation (TBS) constitutes a relatively developed rTMS protocol that is thought to promote synaptic plasticity... TBS is a high-frequency stimulation with high-intensity pulses.. It is subthreshold, typically around 80% of motor threshold (MT), and can be intermittent or continuous (to sequence iTBS or cTBS).... The alternating protocol is generally considered to increase excitability in which motor potentials affect the cortex.. It is generally thought to have a combination of inhibitory and enhancing effects.... Overall, the ability to modify targeted neural circuits with minimal adverse effects and little or no pain makes rTMS an attractive alternative for the treatment of a variety of conditions, including those affecting movement. slow.... Therefore, its use in clinical settings has expanded widely since its introduction in 1985, as an accepted psychiatric disorder now a widespread treatment option for... However, since pharmacological and non-pharmacological treatments for movement disorders have often been proven to be ineffective, rTMS has attracted increasing attention.... Movement disorders associated with rtMS are treatable.. In general, the following disorders and diseases can be treated using rtMS: - Parkinson's disease (PD) - Tic disorder (TS) - Dystonia - Essential Tremor (ET) - progressive supranuclear palsy (PSP) - Huntington's disease (HD) ### Parkinson's disease (PD) PD is a chronic degenerative brain disorder characterized by the degeneration of dopaminergic neurons in the substantia nigra (SNPc) leading to a rigid hypokinetic state.... The disease is characterized by tremors, rigidity, bradykinesis and unsteadiness.... Related article: Parkinson's treatment with rtms #### Movement symptoms of Parkinson's PD is the most studied movement disorder based on TMS, especially in the treatment of motor symptoms... Initially, drugs such as levodopa or dopaminergic agonists can control these symptoms, but as the disease progresses, the effect of these drugs decreases.. Abnormalities in the basal ganglia of the thalamus are responsible for the symptoms of PD.. Premotor cortex (PMC) and supplementary motor cortex (SMA), several studies of rTMS for have been used to improve brain function in PD....Depending on the target, cortical stimulation to improve motor function or other PD-related symptoms, such as depression....rTMS has shown promising results in improving gait and other motor symptoms, providing an r-frequency-capable therapeutic alternative to HMS..modulates cortical activity and has been reported to have significant benefits for general motor function in PD....PD patients treated with Low-frequency rTMS improves psychomotor speed performance....improvements are greater in the drug-free state....studies in patients with PD have shown that a single session of rTMS can improve some or all motor symptoms, and repeated motor effects in a single session of at least 20-30 minutes can result....rTMS applied at a frequency of 5 Hz to the foot region of the motor cortex has shown improvements in walking.... #### Non-motor symptoms of PD Immobility symptoms are often seen in patients with PD.. These symptoms include delirium, depression, visual disturbances, diplopia, bowel and bladder disorders, daytime sleepiness, vivid dreams, parasomnia, loss of smell and taste, orthostatic vertigo, etc.. PD... (TS) Tourette syndrome (TS) is a chronic childhood-onset neurological disorder characterized by numerous motor and vocal tics... Many children recover by adolescence, however, some adults with TS continue to experience severe symptoms and significant disability.. The pathophysiology is involuntary tics... rTMS at frequencies of 1 Hz and 15 Hz has been used in adults with TS. In this treatment, there was no worsening of tics or other involuntary movements, and as a result, the use of rMST is completely safe. The cortical excitability of the motor cortex and brainstem is increased in patients with dystonia....Studies on the brain have shown abnormalities in glucose metabolism and perfusion....This increase in cortical excitability and facilitation can be suppressed by rTMS and thus reduce motor symptoms..Studies have shown hyperactivity of the deep nuclei and cerebellar cortex in the ET generation.... Pathogenesis is involved.... Low-frequency (1 Hz) repetitive intercranial magnetic stimulation of the cerebellum effectively modulates the reduction of cerebellar output (GA). PSP is a progressive neurological disorder for which no specific treatment has yet been found.. Low-frequency rTMS of the cerebellum has suppressive effects known as cerebellar disinhibition (CBI).. This suggests that Purkinje cells or dentate pathways (thalamus) of the cortex are involved in PSP.. PSP patients... down may restore balance in the circuit and improve some PSP symptoms.. Also using rTMS with High frequency on the motor cortex of clinically diagnosed PSP patients leads to transient improvement in axial symptoms without any side effects.. ### Huntington's disease (HD) HD is a neurogenetic process caused by a CAG triple repeat mutation in the short arm of chromosome 4, which codes for the huntingtin protein. This elongation of the CAG triplet encodes glutamine and causes abnormal intracellular protein accumulation, ultimately leading to mitochondrial dysfunction, mitochondrial dysfunction, and A-cell dysfunction. cortical excitability underlying ganglionic circuit dysfunction.. have shown motor... Since HD is a hyperkinetic disorder, low-frequency rTMS can be useful for cortical stimulation. The results of studies have shown that the use of rTMS with low frequency (1 Hz) improves couric movements. Conclusion According to the explanations presented in this article, it can be concluded that rTMS is a safe and potential treatment option for patients with movement disorders. Of course, active research in this field continues and in the future more information can be obtained to evaluate the effectiveness of **magnetic brain stimulation in the treatment of movement disorders**. rtms center in Tehran? Noor Ali neurology clinic is equipped with the best rtms center in Tehran, where the latest rtms devices are used to treat all kinds of diseases and disorders of the brain, nerves and psyche...