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Pain is a frequent symptom in Parkinson's disease. Previous studies have shown that pain perception was altered in Parkinson's disease patients and could be related to nociceptive cortical area hyperactivation. Repetitive Transcranial Magnetic Stimulation is an electrophysiological tool which can modify cortical excitability. Its efficacy was demonstrated in neuropathic pain. This is a randomized, double blind cross-over study. In this study, subjective pain threshold (using thermal stimulation (Thermotest)).will be evaluated in 3 groups of subjects: healthy volunteers, painful Parkinson's patients and pain free Parkinson's disease patients. Each group will receive a high frequency Repetitive Transcranial Magnetic Stimulation and placebo stimulation in different order with a gap of one week.
The investigators supposed that a 20 Hz Repetitive Transcranial Magnetic Stimulation session with an infraliminary intensity on the primary cortical motor, modulating nociceptive cortical areas activity, could modify the nociceptive threshold perception in Parkinson's patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| healthy volunteers | Other | All the patients and healthy volunteers will receive high frequency Repetitive Transcranial Magnetic Stimulation and placebo stimulation |
|
| painful Parkinson's disease patients | Other | All the patients and healthy volunteers will receive high frequency Repetitive Transcranial Magnetic Stimulation and placebo stimulation |
|
| painless Parkinson's disease patients | Other | All the patients and healthy volunteers will receive high frequency Repetitive Transcranial Magnetic Stimulation and placebo stimulation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Repetitive Transcranial Magnetic Stimulation | Device | Repetitive Transcranial Magnetic Stimulation will be applied on the contralateral primary cortical motor on the painful side for the Parkinson's disease patients and on the left primary cortical motor for the healthy volunteer. The stimulation frequency will be 20 Hz during 26 min with an intensity stimulation equal of 95% of the motor threshold. |
| Measure | Description | Time Frame |
|---|---|---|
| Change of subjective pain threshold determined using thermal stimulation (Thermotest) with the method of levels after rTMS session | Change from baseline after each Repetitive Transcranial Magnetic Stimulation session (active and placebo) | D1 T0, D1 T1h30mn, D7 T0, D7 T1h30mn |
| Measure | Description | Time Frame |
|---|---|---|
| Analgesic effect of Repetitive Transcranial Magnetic Stimulation using Visual Analogue Scale | Change from baseline after each Repetitive Transcranial Magnetic Stimulation session (active and placebo) | D1 T0, D1 T1h30mn, D7 T0, D7 T1h30mn |
| - Clinical evaluation of the severity of the motor handicap of patients using Unified's Parkinson's Disease Rating Scale (UPDRSIII) |
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Inclusion Criteria:
For patients:
For Healthy volunteers
Exclusion Criteria:
For patients:
For Healthy volunteers:
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| Name | Affiliation | Role |
|---|---|---|
| Christine Brefel-Courbon, MD | Toulouse Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Purpan Hospital | Toulouse | 31000 | France |
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| ID | Term |
|---|---|
| D010300 | Parkinson Disease |
| ID | Term |
|---|---|
| D020734 | Parkinsonian Disorders |
| D001480 | Basal Ganglia Diseases |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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| ID | Term |
|---|---|
| D050781 | Transcranial Magnetic Stimulation |
| ID | Term |
|---|---|
| D055909 | Magnetic Field Therapy |
| D013812 | Therapeutics |
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|
|
Change from baseline after each Repetitive Transcranial Magnetic Stimulation session (active and placebo) |
| D1 T0, D1 T1h30mn, D7 T0, D7 T1h30mn |
| Mood assessment using Visual Analogue Scale | Change from baseline after each Repetitive Transcranial Magnetic Stimulation session (active and placebo) | D1 T0, D1 T1h30mn, D7 T0, D7 T1h30mn |
| D009422 | Nervous System Diseases |
| D009069 | Movement Disorders |
| D000080874 | Synucleinopathies |
| D019636 | Neurodegenerative Diseases |