Centonze, DDCentonzeKoch, GGKochVersace, VVVersaceASI Sponsor2020-09-172020-09-172007-03-01https://hdl.handle.net/20.500.13025/2029OBJECTIVE: To investigate whether repetitive transcranial magnetic stimulation (rTMS) can modify spasticity. METHODS: We used high-frequency (5 Hz) and low-frequency (1 Hz) rTMS protocols in 19 remitting patients with relapsing-remitting multiple sclerosis and lower limb spasticity. RESULTS: A single session of 1 Hz rTMS over the leg primary motor cortex increased H/M amplitude ratio of the soleus H reflex, a reliable neurophysiologic measure of stretch reflex. Five hertz rTMS decreased H/M amplitude ratio of the soleus H reflex and increased corticospinal excitability. Single sessions did not induce any effect on spasticity. A significant improvement of lower limb spasticity was observed when rTMS applications were repeated during a 2-week period. Clinical improvement was long-lasting (at least 7 days after the end of treatment) when the patients underwent 5 Hz rTMS treatment during a 2-week protocol. No effect was obtained after a 2-week sham stimulation. CONCLUSIONS: Repetitive transcranial magnetic stimulation may improve spasticity in multiple sclerosisAbnormal: physiologyAdultFemaleH-ReflexH-Reflex: physiologyHumansLegLeg: physiopathologyMaleMiddle AgedMotor CortexMotor Cortex: physiopathologyMultiple SclerosisMultiple Sclerosis: complicationsMultiple Sclerosis: physiopathologyMuscleMuscle ContractionMuscle Contraction: physiologyMuscle HypertoniaMuscle Hypertonia: etiologyMuscle Hypertonia: physiopathologyMuscle Hypertonia: therapyMuscle SpasticityMuscle Spasticity: etiologyMuscle Spasticity: physiopathologyMuscle Spasticity: therapyPyramidal TractsPyramidal Tracts: physiopathologyReflexSkeletalSkeletal: innervationSkeletal: physiopathologyTranscranial Magnetic StimulationTranscranial Magnetic Stimulation: methodsTreatment Outcomejournal article54dcce098580fe1368eeb1af10.1212/01.wnl.0000257818.16952.62http://www.neurology.org/cgi/content/abstract/68/13/104554dcce098580fe1368eeb1af