Transcranial magnetic stimulation combined with virtual reality improves quality of life in patients with Parkinson’s disease with depression

Purpose To determine whether combining transcranial magnetic stimulation (TMS) with virtual reality (VR) provides superior improvement in quality of life, depression and anxiety symptoms, cognitive function, and motor performance in patients with Parkinson’s disease with depression (PD-D), compared with TMS alone. Methods We prospectively analyzed 234 cases of Parkinson’s disease with depression (PD-D) admitted to our hospital from January 2022 to December 2024, of which 17 cases did not meet the inclusion criteria, 23 cases were excluded by the exclusion criteria, and 4 cases withdrew halfway, and finally 190 cases of PD-D were included. One hundred and ninety patients with PD-D as the subjects of this study. According to the patients’ treatment willingness, they were categorized into TMS group (TMS treatment, N = 106), TMS + VR group (TMS combined with VR treatment, N = 84). Clinical baseline data such as gender, age, body mass index (BMI), duration of PD, history of smoking, history of alcohol consumption, history of diabetes mellitus, history of hypertension, education level, place of residence, marital status, and H-Y staging were collected from all subjects. Results Compared with the pre-treatment, the HAMA-14, HAMD-17, UPDRS-III scores and PDQ-39 total scores and their sub-scores decreased significantly in both groups after treatment, and their MoCA, MMSE, and ADL-BI scores increased significantly (all p < 0.05); and the magnitude of the changes in each of the scores was more pronounced in the TMS + VR group than in the TMS group (all p < 0.001). (all p < 0.001). However, there was no statistically significant difference in adverse effects between the two groups ( p > 0.05). Conclusion The combination of TMS and VR significantly improved the depression and anxiety symptoms, motor function and quality of life of PD-D patients, and the safety was good, which opened up a new path for personalized treatment of PD-D.