An interventional study of Repetitive transcranial magnetic stimulation (rTMS) in Palsy Supranuclear and Supranuclear Palsy, Progressive, sponsored by Oregon Health and Science University. Recruiting at 1 site in United States. Open to participants aged 40 Years to 85 Years. Per ClinicalTrials.gov, last updated 2025-05-29.
Sponsored by Oregon Health and Science University · Not applicable, Interventional, and Treatment
The objective of this proposal is to investigate the effect of non-invasive repetitive cerebellar transcranial magnetic stimulation (rTMS) on motor control in progressive supranuclear (PSP). The central hypothesis is that augmenting cerebellar inhibition via cerebellar rTMS will decrease postural instability in patients with PSP. We will use functional near infrared spectroscopy (fNIRS) to examine changes in motor and premotor cortical activity after cerebellar rTMS.
Exclusion Criteria:
After completing their baseline assessment, participants randomized to this arm will initially take part in a 2-week TMS intervention. After the midpoint assessment and subsequent a 1-month washout, these participants will then complete a 2-week sham TMS period prior to their final assessment.
Device: Repetitive transcranial magnetic stimulation (rTMS)
After completing their baseline assessment, participants randomized to this arm will initially take part in a 2-week sham TMS period. After the midpoint assessment and subsequent a 1-month washout, these participants will then complete a 2-week TMS intervention prior to their final assessment.
Device: Repetitive transcranial magnetic stimulation (rTMS)
Aim 1: To determine the clinical effects of rTMS targeting the cerebellum on postural instability in PSP. The hypothesis to be tested is that TMS augmentation of cerebellar inhibition will improve cerebellum-dependent balance symptoms of PSP for a period of time sufficient to improve rehabilitation outcomes. The investigators will measure a battery of objective posturography metrics and other measures of motor control, including sway and center of pressure changes to backward tilt and forward translation. Aim 2: We will use functional near infrared spectroscopy (fNIRS) to examine changes in motor and premotor cortical activity after cerebellar rTMS. The hypothesis to be tested is that premotor and motor cortical activity will decrease after cerebellar rTMS compared to sham TMS, reflecting improved cerebellar inhibition of the motor cortex after the intervention.
objective posturography
The primary endpoint is center of pressure shifts with tilt and with translation, and body sway in quiet stance.
Time frame: assessed on 4 days during the 8 week study period
fNIRS
functional near infrared spectroscopy of premotor and motor areas during balance testing
Time frame: assessed on 4 days during the 8 week study period
speech analysis
speech sample assessment conducted by investigator
Time frame: assessed on 4 days during the 8 week study period
Plan to share: No
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Oregon Health and Science University