ORIGINAL RESEARCH article
Front. Neurol.
Sec. Sleep Disorders
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1567292
Feasibility of repetitive transcranial magnetic stimulation on non-motor symptoms of spinocerebellar ataxia type 3: A secondary analysis of a randomized clinical trial
Provisionally accepted
Hua Wu1
Hao-Ling Xu1
Xia-Hua Liu2
Sikandar Arif1
Wei Lin1
Mao-Lin Cui1
Ming-Xia Kang1
Yi-Ru Zheng1
Shi-Rui Gan1
Liang-Liang Qiu1*- 1Department of Neurology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China
- 2Department of Rehabilitation Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China
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Introduction: Spinocerebellar 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 SCA3related NMS.: This 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.The 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.rTMS 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.
Keywords: repetitive transcranial magnetic stimulation ( rTMS ), Spinocerebellar ataxia type 3 (SCA3), Non-motor symptoms (NMS), Sleep disturbance, Cerebellum, cognitive deficits, Mood disturbances
Received: 27 Jan 2025; Accepted: 17 Apr 2025.
Copyright: © 2025 Wu, Xu, Liu, Arif, Lin, Cui, Kang, Zheng, Gan and Qiu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Liang-Liang Qiu, Department of Neurology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China
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