The Effect of Different Techniques of Repetitive Transcranial Magnetic Stimulation on Parkinsonian Tremor

Authors

  • Doaa A. Mekkawy Neurology department, Faculty of medicine, Cairo University,Egypt
  • Christine Ragaie Neurology department ,Faculty of medicine, Cairo University , Egypt https://orcid.org/0000-0002-5795-5217
  • Hanan Amer Neurology department, Faculty of medicine, Cairo University ,Egypt
  • Hala ElHabashy Clinical neurophysiology, Faculty of medicine, Cairo University,Egypt
  • Hatem Shehata Neurology department, Faculty of medicine, Cairo University ,Egypt
  • Mohammad Edrees Mohammad Neurology department ,Faculty of medicine, Cairo University , Egypt

DOI:

https://doi.org/10.15540/nr.13.2.136

Keywords:

rTMS, Parkinson's Disease, tremor, UPDRS, EMG

Abstract

Background. Tremor in Parkinson’s disease (PD) is usually a disabling symptom that doesn’t adequately respond to medications. Recently, the European clinical guidelines recommended repetitive transcranial magnetic stimulation (rTMS) as a Grade-B recommendation for improving motor function in PD. Objectives. To study the effect of different rTMS protocols on PD tremor. Methods. 60 PD patients were divided randomly into three groups equally according to rTMS protocols received; they were divided into Group I (5 Hz), Group II (1 Hz), and Group III (sham). Sessions were applied daily for 2 weeks. All patients were subjected to clinical assessment using different assessment tools; tremor Unified Parkinson’s Disease Rating Scale (UPDRS) as well as total UPDRS, tremor amplitude and frequency by EMG before sessions, after last session, and 1 month later. Results. Group I showed the most significant reduction in mean UPDRS (tremor and total) after the last session and
1 month later (p < .001). Group I had the highest reduction in mean tremor amplitude and frequency by EMG after the last session and 1 month later (p < .001; p < .05, respectively). Conclusion. 5 Hz rTMS protocol was the most effective in improving PD tremor.

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Published

2026-06-29

How to Cite

Mekkawy, D. A., Ragaie, C., Amer, H., ElHabashy, H., Shehata, H., & Edrees Mohammad, M. (2026). The Effect of Different Techniques of Repetitive Transcranial Magnetic Stimulation on Parkinsonian Tremor. NeuroRegulation, 13(2), 136. https://doi.org/10.15540/nr.13.2.136

Issue

Vol. 13 No. 2 (2026)

Section

Research Papers

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Copyright (c) 2026 Doaa A. Mekkawy, Christine Ragaie, Hanan Amer, Hala ElHabashy, Hatem Shehata, Mohammad Edrees Mohammad

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