Effect of repetitive transcranial magnetic stimulation over the cerebellum on patients with ataxia after posterior circulation stroke: A pilot study

OBJECTIVE: To investigate the safety, feasibility and preliminary efficacy of low-frequency repetitive transcranial magnetic stimulation (rTMS) over the cerebellum in ataxic patients with acute posterior circulation stroke. DESIGN: Randomized, double-blind, sham-controlled pilot study. PATIENTS: Thirty-two ataxic patients with posterior circulation stroke were randomized to real (n = 22) and sham (n = 10) rTMS groups. METHODS: Patients received 5 15-min sessions of 1 Hz cerebellar rTMS over 5 consecutive days. Compliance and adverse events for the rTMS sessions were checked. The 10-m walk test (10MWT) and Berg Balance Scale (BBS) were completed before rTMS, immediately and 1 month after the last rTMS session. RESULTS: Compliance with the rTMS was 100% and no adverse events were reported in either group. 10MWT and BBS of real rTMS group improved significantly (p < 0.01). Percentage changes immediately after the last rTMS session for time and steps in the 10MWT and BBS in the real vs sham group were: -16.7 ± 35.1% vs -8.4 ± 72.5%, -8.5 ± 23.0% vs -0.3 ± 28.4% and 46.4 ± 100.2% vs 36.6 ± 71.6%, respectively. CONCLUSION: This study demonstrated that 1 Hz rTMS over the cerebellum is safe, feasible and may have a beneficial effect in ataxic patients with posterior circulation stroke.