The 1-Hz rTMS of 320 stimuli with an intensity of 90% of motor threshold was applied over the vertex of the skull using a round coil in a day. The effects of short-term (treated in 5 successive days) treatment was examined in 6 patients and long-term (treated in every one or two weeks for six months) treatment was examined in five. Unified Parkinson's Disease Rating Scale (UPDRS), motor evoked potential threshold (MT) and cortical silent period (SP) were recorded before and one day after the short-term treatment. In the long-term treatment, same recordings were obtained in every two months. After the short-term treatment, the total UPDRS scores was reduced from 37 +/- 3.3 (mean +/- S.E.) to 31 +/- 3.1 and the SP duration was prolonged from 98.9 +/- 24.7 to 106 +/- 22.0 significantly (P < 0.05 by Wilcoxon Matched Pairs Teat). After the long-term treatment, both total UPDRS scores and MEP threshold was reduced from 33 +/- 5.8 to 30 +/- 5.3 and from 75 +/- 7.2 to 69 +/- 5.7, respectively two months after the initiation of the treatment. Both values reduced continuously until the end of treatment, and a significant linear correlation was noted (r = 0.98) between them. Our results show the beneficial effects of rTMS and suggest the possible mechanism that the alteration of brain excitability induced by rTMS mediate therapeutic effects in patients with Parkinson's disease.

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