Feasibility of repetitive transcranial magnetic stimulation on non-motor symptoms of spinocerebellar ataxia type 3: a secondary analysis of a randomized clinical trial

IntroductionSpinocerebellar ataxia type 3 (SCA3) poses challenges for patients due to motor dysfunctions and non-motor symptoms (NMS), such as sleep disorders, cognitive deficits, and mood disturbances. These issues significantly impact the quality of life, with limited benefits from conventional ph...

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Main Authors: Hua Wu, Hao-Ling Xu, Xia-Hua Liu, Arif Sikandar, Wei Lin, Mao-Lin Cui, Ming-Xia Kang, Yi-Ru Zheng, Shi-Rui Gan, Liang-Liang Qiu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1567292/full
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author Hua Wu
Hua Wu
Hao-Ling Xu
Xia-Hua Liu
Arif Sikandar
Wei Lin
Mao-Lin Cui
Ming-Xia Kang
Ming-Xia Kang
Yi-Ru Zheng
Yi-Ru Zheng
Shi-Rui Gan
Shi-Rui Gan
Liang-Liang Qiu
Liang-Liang Qiu
author_facet Hua Wu
Hua Wu
Hao-Ling Xu
Xia-Hua Liu
Arif Sikandar
Wei Lin
Mao-Lin Cui
Ming-Xia Kang
Ming-Xia Kang
Yi-Ru Zheng
Yi-Ru Zheng
Shi-Rui Gan
Shi-Rui Gan
Liang-Liang Qiu
Liang-Liang Qiu
author_sort Hua Wu
collection DOAJ
description IntroductionSpinocerebellar ataxia type 3 (SCA3) poses challenges for patients due to motor dysfunctions and non-motor symptoms (NMS), such as sleep disorders, cognitive deficits, and mood disturbances. These issues significantly impact the quality of life, with limited benefits from conventional pharmacotherapies. This study explores the potential of repetitive transcranial magnetic stimulation (rTMS) as a treatment for SCA3-related NMS.MethodsThis is a secondary analysis of a randomized, double-blind, sham-controlled trial (The Chinese Clinical Trial Registry identifier is ChiCTR1800020133). Thirty-seven SCA3 patients included underwent either real (n = 21) or sham (n = 16) rTMS over 15 days, targeting the cerebellum. Study outcomes included the Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale (AIS), Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Hamilton Anxiety Rating Scale (HARS), and Hamilton Depression Rating Scale (HDRS), assessed baseline and post-intervention.ResultsThe results disclosed significant time effects for all the outcomes with post hoc comparisons showing differences of baseline and post-treatment evaluation, with decreases for PSQI, AIS, HARS, and HDRS as well as increase for MMSE and MoCA. Correlation analyses revealed no significant predictors of rTMS response based on age at onset, disease duration, number of expanded CAG repeat lengths, or baseline motor symptom severity scores.ConclusionRepetitive transcranial magnetic stimulation is a feasible treatment of non-motor related symptoms in patients with SCA3, including sleep, cognition, and mood disorders. The treatment is well-tolerated, and its feasibility appears independent of demographic or disease severity indicators. These findings encourage further exploration of rTMS as a safe alternative for managing SCA3 NMS.
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spelling doaj-art-b2a5e4f220304e37ab9f2cbcd73ca1772025-08-20T03:13:29ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-05-011610.3389/fneur.2025.15672921567292Feasibility of repetitive transcranial magnetic stimulation on non-motor symptoms of spinocerebellar ataxia type 3: a secondary analysis of a randomized clinical trialHua Wu0Hua Wu1Hao-Ling Xu2Xia-Hua Liu3Arif Sikandar4Wei Lin5Mao-Lin Cui6Ming-Xia Kang7Ming-Xia Kang8Yi-Ru Zheng9Yi-Ru Zheng10Shi-Rui Gan11Shi-Rui Gan12Liang-Liang Qiu13Liang-Liang Qiu14Department of Neurology and Institute of Neurology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Neurology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Neurology and Institute of Neurology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Rehabilitation Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Neurology and Institute of Neurology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Neurology and Institute of Neurology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Neurology and Institute of Neurology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Neurology and Institute of Neurology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Neurology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Neurology and Institute of Neurology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Neurology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Neurology and Institute of Neurology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Neurology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Neurology and Institute of Neurology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Neurology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaIntroductionSpinocerebellar ataxia type 3 (SCA3) poses challenges for patients due to motor dysfunctions and non-motor symptoms (NMS), such as sleep disorders, cognitive deficits, and mood disturbances. These issues significantly impact the quality of life, with limited benefits from conventional pharmacotherapies. This study explores the potential of repetitive transcranial magnetic stimulation (rTMS) as a treatment for SCA3-related NMS.MethodsThis is a secondary analysis of a randomized, double-blind, sham-controlled trial (The Chinese Clinical Trial Registry identifier is ChiCTR1800020133). Thirty-seven SCA3 patients included underwent either real (n = 21) or sham (n = 16) rTMS over 15 days, targeting the cerebellum. Study outcomes included the Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale (AIS), Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Hamilton Anxiety Rating Scale (HARS), and Hamilton Depression Rating Scale (HDRS), assessed baseline and post-intervention.ResultsThe results disclosed significant time effects for all the outcomes with post hoc comparisons showing differences of baseline and post-treatment evaluation, with decreases for PSQI, AIS, HARS, and HDRS as well as increase for MMSE and MoCA. Correlation analyses revealed no significant predictors of rTMS response based on age at onset, disease duration, number of expanded CAG repeat lengths, or baseline motor symptom severity scores.ConclusionRepetitive transcranial magnetic stimulation is a feasible treatment of non-motor related symptoms in patients with SCA3, including sleep, cognition, and mood disorders. The treatment is well-tolerated, and its feasibility appears independent of demographic or disease severity indicators. These findings encourage further exploration of rTMS as a safe alternative for managing SCA3 NMS.https://www.frontiersin.org/articles/10.3389/fneur.2025.1567292/fullrepetitive transcranial magnetic stimulation (rTMS)spinocerebellar ataxia type 3 (SCA3)non-motor symptoms (NMS)sleep disturbancecerebellumcognitive deficits
spellingShingle Hua Wu
Hua Wu
Hao-Ling Xu
Xia-Hua Liu
Arif Sikandar
Wei Lin
Mao-Lin Cui
Ming-Xia Kang
Ming-Xia Kang
Yi-Ru Zheng
Yi-Ru Zheng
Shi-Rui Gan
Shi-Rui Gan
Liang-Liang Qiu
Liang-Liang Qiu
Feasibility of repetitive transcranial magnetic stimulation on non-motor symptoms of spinocerebellar ataxia type 3: a secondary analysis of a randomized clinical trial
Frontiers in Neurology
repetitive transcranial magnetic stimulation (rTMS)
spinocerebellar ataxia type 3 (SCA3)
non-motor symptoms (NMS)
sleep disturbance
cerebellum
cognitive deficits
title Feasibility of repetitive transcranial magnetic stimulation on non-motor symptoms of spinocerebellar ataxia type 3: a secondary analysis of a randomized clinical trial
title_full Feasibility of repetitive transcranial magnetic stimulation on non-motor symptoms of spinocerebellar ataxia type 3: a secondary analysis of a randomized clinical trial
title_fullStr Feasibility of repetitive transcranial magnetic stimulation on non-motor symptoms of spinocerebellar ataxia type 3: a secondary analysis of a randomized clinical trial
title_full_unstemmed Feasibility of repetitive transcranial magnetic stimulation on non-motor symptoms of spinocerebellar ataxia type 3: a secondary analysis of a randomized clinical trial
title_short Feasibility of repetitive transcranial magnetic stimulation on non-motor symptoms of spinocerebellar ataxia type 3: a secondary analysis of a randomized clinical trial
title_sort feasibility of repetitive transcranial magnetic stimulation on non motor symptoms of spinocerebellar ataxia type 3 a secondary analysis of a randomized clinical trial
topic repetitive transcranial magnetic stimulation (rTMS)
spinocerebellar ataxia type 3 (SCA3)
non-motor symptoms (NMS)
sleep disturbance
cerebellum
cognitive deficits
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1567292/full
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