TMS Treatment in Multiple System Atrophy With Fatigue
TMS Treatment in Multiple System Atrophy With Fatigue
Transcranial magnetic stimulation (TMS) is a procedure that has been shown to improve fatigue
 in chronic sufferers. It uses a plastic covered coil that sends a magnetic pulse through the
 skull into the brain and by targeting particular areas in the brain it can be used to help
 modulate the perception of fatigue.

 The study intends to use this technique to treat such a disabling symptom in patients who
 suffer from Multiple System Atrophy (MSA). Initially the aim is to study this technique in 22
 MSA patients who are suffering from fatigue . These patients would require an resting-state
 funtional MRI before and after the stimulation. The stimulation would be performed ten
 sessions and the patients would be assessed by a clinician using well recognized clinical
 tools.

 It is anticipated that there will be a meaningful improvement in fatigue. It is also
 anticipated that TMS is a safety technique to use in MSA patients . Our findings will
 revealed that fatigue may be associated with an altered default mode network and sensorimotor
 network connectivity in MSA patients. We hypothesize that these divergent motor and cognitive
 networks connectivity changes and their adaptive or maladaptive functional outcome may play a
 prominent role in the pathophysiology of fatigue in MSA.
Inclusion Criteria:

 1. Patients with Multiple system atrophy diagnosed as "possible" or "probable" according
 to the 2008 MDS clinical diagnostic criteria;

 2. Age ≥30Aged ≤ 75years old;

 3. right handedness

 4. MMSE>24

 5. the dosage and species of anti-parkinson drug is maintained during the treatment;

 6. The patient or his/her legal guardian agreed to participate in the trial and signed
 the informed consent.Ability to follow research plans and visit plans.

 7. FSS≥4

 Exclusion Criteria:

 1. Serious medical and mental illness;

 2. History of stroke, intracranial tumor and other central nervous system;

 3. Patients with suicidal tendencies and psychotic symptoms.

 4. MRI for contraindications, such as metal implants, claustrophobia, etc

 5. Contraindications for TMS (such as history of seizures, pregnant women, installation
 of pacemakers, metal inclusions in the body, intracranial hypertension, severe
 bleeding tendency, etc.)

 6. Patients who received TMS treatment for nearly half a year.