{"doi":"10.1002/ana.25881","title":"Transcranial Magnetic Stimulation Promotes Gait Training in Parkinson Disease","abstract":"OBJECTIVE: To determine whether priming with 1 or 25Hz repetitive transcranial magnetic stimulation (rTMS) will enhance the benefits from treadmill training up to 3 months postintervention in people with Parkinson disease (PD), and to evaluate the underlying changes in cortical excitability. METHODS: This randomized double-blind, placebo-controlled trial was conducted between October 2016 and December 2018. Fifty-one participants with PD were randomized to receive 12 sessions of rTMS (25Hz, 1Hz, or sham) followed by treadmill training. All participants were assessed at baseline and 1 day, 1 month, and 3 months postintervention. Primary outcome was fastest walking speed, and secondary outcomes were timed up-and-go test (TUG), dual-task TUG (DT-TUG), motor section of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS-III), and electrophysiological evaluation of cortical excitability by TMS. RESULTS: The 1 and 25Hz rTMS groups produced a greater improvement in fastest walking speed at 1 day and 3 months postintervention than the sham group. Only the 1 and 25Hz rTMS groups sustained the improvements in TUG, and had a significant improvement in DT-TUG and MDS-UPDRS-III for up to 3 months. Behavioral improvements correlated with increased cortical silent period and short-interval intracortical inhibition in both groups receiving real rTMS. INTERPRETATION: Priming with 1 and 25Hz rTMS can augment the benefits of treadmill training and lead to long-term motor improvement up to 3 months postintervention. The motor improvement at follow-up was associated with a normalization of cortical excitability, which in turn suggests an alteration of the homeostatic plasticity range. Rebalancing cortical excitability by rTMS appears critical for plasticity induction. ANN NEUROL 2020;88:933-945.","journal":"Annals of Neurology","year":2020,"id":53944,"datarank":2.4689572633365047,"base_score":4.718498871295094,"endowment":4.718498871295094,"self_citation_contribution":0.7077748306942643,"citation_network_contribution":1.7611824326422403,"self_endowment_contribution":0.7077748306942643,"citer_contribution":1.7611824326422403,"corpus_percentile":null,"corpus_rank":null,"citation_count":111,"citer_count":103,"citers_with_citation_signal":73,"citers_with_endowment":73,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8856,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":276753,"name":"Margaret Kit‐Yi Mak","orcid":null,"position":1,"is_corresponding":false},{"id":106066,"name":"Mark Hallett","orcid":null,"position":2,"is_corresponding":false},{"id":275937,"name":"Chloe Lau Ha Chung","orcid":"0000-0002-4716-1034","position":0,"is_corresponding":true}],"reference_count":56,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-18T20:45:25.145885Z","pmid":"32827221","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}