Inhibitory rTMS in Dystonic Wilson Patients

Summary

Wilson disease is a genetic disorder resulting in copper accumulation in liver, brain and eye. The neurologic complications include dystonic syndrome, which is a prolonged and excessive muscle activation responsible for abnormal postures. Hand dystonia prevents daily life activities such as writing, which is particularly disabling, since writing is the only mean of communication in these patients with significant slurred speech. Treatment is limited and only partially effective.

Low frequency (\<or=1Hz) repetitive transcranial magnetic stimulation (rTMS) has shown inhibiting properties when applied over the cortex. Since dystonia has been correlated to hyperactivation of the neurons of the somatosensory cortex (SSC), we hypothesize that one single 20-minute session of 1 Hz rTMS applied on left SSC will improve writing of the right dystonic hand, assessed immediately at the end of the session.

Conditions

• Wilson Disease
• Movement Disorders
• Repetitive Transcranial Magnetic Stimulation

Interventions

DEVICE

Repetitive Transcranial Magnetic Stimulation (rTMS)

Inhibitory 1 Hz rTMS, delivered to left somatosensory cortex during rest. Intervention is delivered during 20 minutes in one single session.

OTHER

pre and post-rTMS electroencephalogram

to verify the absence of infraclinical seizures

OTHER

WCRS

Writer's cramp rating scale

OTHER

handwriting scale DPRE

handwriting in development and being evaluated by the NRC Wilson

OTHER

visual analog scale of discomfort writing and parameters collected on touchpad

Sponsors & Collaborators

• Assistance Publique - Hôpitaux de Paris

  lead OTHER

Principal Investigators

• Nathalie KUBIS, MD, PhD · Physiology Department, Lariboisière Hospital

• Jean-Marc TROCELLO, MD · Neurology, Lariboisière Hospital

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Model

CROSSOVER

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2014-01-31

Primary Completion

2015-07-31

Completion

2015-07-31

Countries

• France

Study Locations