Researchers used repetitive magnetic stimulation of the brain of a man who had suffered a cerebellar stroke 12 years ago to improve his walking speed, balance and coordination. This innovative treatment could help people who still have limited mobility years after a stroke.A stroke that damages the cerebellum of the brain (the area that controls movement) can cause ataxia, which affects coordination and balance. Cerebellar ataxia can range in severity from mild to severe and typically manifests as an unsteady gait, staggering steps, loss of fine motor movements, slurred speech, and difficulty swallowing.
Treatment of cerebellar ataxia is limited to physical and occupational therapy and, if necessary, speech therapy. However, a recent case study by researchers at UCLA Medical Center describes a promising new treatment: repetitive transcranial magnetic stimulation (rTMS).
"This case is the first to use bilateral cerebellar transcranial magnetic stimulation to treat post-stroke cerebellar ataxia," said Evan Hy Einstein, first and corresponding author of the study.
Transcranial magnetic stimulation (TMS) is a safe, non-invasive treatment that uses coils placed around the head to generate magnetic fields that target specific areas of the brain. Transcranial magnetic stimulation has been used to treat patients with depression who are unresponsive to or intolerant to antidepressant medications.
In the current study, the patient was a 58-year-old man who suffered a sudden cerebellar stroke 12 years ago and, despite intensive rehabilitation therapy, continued to have a slow and unsteady gait and difficulties with balance and stability. He is unable to stand from a sitting position or bend down to pick up an object from the floor without assistance. He uses a rolling walker for stability and was able to walk 10 meters (32.8 feet) at a speed of 0.57 meters per second before receiving transcranial magnetic stimulation treatment.
He received transcranial magnetic stimulation treatments five times a day, targeting the left and right sides of the cerebellum. He received treatment and reported no side effects. Five days after treatment, the man's walking speed increased to 0.60 meters/second. He is able to stand from a sitting position without assistance and can easily bend down to pick up a pencil from the floor. He reports that his balance and stability have improved while performing activities of daily living, such as showering and shaving, without the need for hand support, which he was unable to do before treatment.
"Further research is needed to determine long-term clinical efficacy and explore the underlying neural mechanisms of this innovative therapy, but it highlights the potential for customized treatment options that take into account the specific cause of ataxia," Einstein said.
The research was published in the journal The Cerebellum.