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Deep Repetitive Transcranial Magnetic Stimulation (dTMS) for Multiple Sclerosis (MS) Fatigue, Irritability and Parasthesias: Case Report

Brain Stimulation, 5, 7, pages e24 - e25

Background

Conventional rTMS has demonstrated efficacy in reducing MS associated fatigue and spasticity. The H1 dTMS coil is currently FDA approved for the treatment of depression has never been tested in MS patients.

Objective

We report on dTMS treatment of a 55-year-old physician with MS associated fatigue, irritability, tingling and numbness on ulnar aspects of both of his hands effecting his instrumentation. His concomitant medications were Escitalopram 15mg and Interferon beta 1b.

Methods

dTMS was administered using the H1 Coil over the motor cortex 10HZ, 80%MT, 2 second stimulation, 1 second intertrain interval, 70 trains, 1400 total pulses, followed by the moving the H1 coil over the prefrontal cortex 18HZ, 120%MT, 2 second stimulation, 20 second inter train interval, 39 trains, 1404 total pulses.

Results

After nine treatments he was in complete remission, with normal energy, resolution of his parasthesias and subjective improvement of his psychomotor speed. He stayed in remission for five months, when he required another eight treatments. He remained in recovery for 18 months.

Conclusions

This is the first report dTMS in the treatment of MS associated irritability, fatigue and parasthesias.

Footnotes

a Advanced Mental Health Care Inc

Conflicts of interest: Dr. Tendler and Dr. DeLuca have financial interest in Brainsway.