What question did this study set out to answer?

This study aimed to evaluate the impact of intermittent theta-burst stimulation on balance function in frail older adults.

May 28, 2026Open Access

Effect of cerebellar vermis intermittent theta-burst stimulation on balance function in frail older adults: a randomized controlled trial

Key Points

This study aimed to evaluate the impact of intermittent theta-burst stimulation on balance function in frail older adults.
Randomized control trial design over 4 weeks involving 48 subjects.
Subjects received either iTBS or sham stimulation and underwent various balance evaluations pre- and post-intervention.
Cortical activity was measured using functional near-infrared spectroscopy.
The BBS improved significantly in the iTBS group (p<0.001).
Statistically significant increases were noted in TFI (p<0.001) and SOT (p<0.05).
No significant difference was found in the TUG test between groups (p > 0.05).

Abstract

BACKGROUND: With the increasing population of frail older adults, their compromised balance functions pose risks of falls and mortality. Effectively enhancing balance function could mitigate adverse health outcomes. This study aimed to evaluate the effect of intermittent theta-burst stimulation (iTBS) on balance function in frail older adults. METHODS: Fourty-eight subjects were randomly assigned to receive iTBS and sham stimulation in a randomized control trial design over a period of 4 weeks. Before and after intervention, related balance evaluation data was collected, including berg balance scale (BBS) score, Time-up and go (TUG) test, Sensory Organization Test (SOT) and Limit of Stability (LOS) data obtained through the Balance Master system. Additionally, cortical activity was recorded using functional near-infrared spectroscopy (fNIRS), fNIRS was used as an exploratory neuroimaging measure. The Tilburg Frailty Indicator (TFI) was also assessed. RESULTS: A total of 45 subjects (mean SD age, 67.69 8.16 years; 33 females 73.7%) completed the trial were enrolled and randomized to receive iTBS (n = 23) or sham stimulation (n = 22). After intervention, the BBS (p 0.05). And study showed a significant difference in HbO levels for the left DLPFC (p < 0.05; 95% CI: -0.066, -0.003) and bilateral SMA (p<0.05, 95% CI: -0.061, -0.007; p<0.05, 95% CI: -0.072, -0.016) before and after the intervention. No significant adverse effects were reported on all subjects. CONCLUSIONS: Our findings indicate that iTBS could promote balance function, as evidenced by an increase in the BBS score, improvements in SOT and LOS, as well as elevated levels of oxygenated hemoglobin (HbO) in the dorsolateral prefrontal cortex (DLPFC) and supplementary motor area (SMA). CLINICAL TRIAL NUMBER: This clinical study was registered at Chinese Clinical Trial Registry (ChiCTR, ChiCTR2500097468; registered on 19/02/2025).

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