Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technology that can modulate cerebral cortical excitability. Electroencephalography (EEG) microstate analysis is an important tool for studying dynamic changes in brain functional activity. This study explores the pathophysiological changes in Parkinson's disease (PD) patients by analyzing the EEG microstate of PD patients, and analyzes the impact of rTMS on the clinical symptoms of PD patients. In a trial, 25 patients with PD and 18 healthy subjects of the same age were included. The clinical scale (the third part of Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (UPDRS-III) and Montreal Cognitive Assessment (MoCA)) scores of each patient were evaluated and the microstate characteristic parameters of all subjects were calculated. 10 Hz rTMS was used to stimulate the bilateral primary motor cortex (M1) of PD patients. After two weeks of treatment (10 times), the clinical scale score of each patient was re-evaluated and the microstate characteristic parameters were calculated. At the baseline, the occurrence, duration and coverage of microstate C in PD patients were significantly higher than those in healthy controls (P <0.05),and were significantly negatively correlated with the MoCA score (P <0.05). The duration and coverage of microstate D in PD patients were significantly lower than those in healthy controls (P <0.05), and were significantly negatively correlated with UPDRS-III score (P <0.05). After rTMS treatment in the PD group, the scale score of UPDRS-III was significantly reduced (P <0.05) and the scale score of MoCA was significantly increased. Moreover, the occurrence and coverage of microstate B were significantly increased (p <0.05). The occurrence, duration and coverage of microstate C were significantly reduced (P <0.05). The occurrence, duration and coverage of microstate D were significantly increased (P <0.05). This study shows that abnormal brain functional activity of PD patients can change microstate characteristic parameters, and these changes are significantly related to the decline of motor and cognitive functions. Furthermore, rTMS can improve the motor and cognitive functions and adjust the microstate characteristic parameters of PD patients. EEG microstate analysis can reflect the therapeutic effect of rTMS on PD patients.