Zhou XL, Li Y, Xia W, Zheng YY, Wu AP. Advances in transcranial magnetic stimulation for psychological symptom management in Parkinson’s disease. World J Psychiatry 2025; 15(9): 108497 [DOI: 10.5498/wjp.v15.i9.108497]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Psychiatry. Sep 19, 2025; 15(9): 108497 Published online Sep 19, 2025. doi: 10.5498/wjp.v15.i9.108497
Advances in transcranial magnetic stimulation for psychological symptom management in Parkinson’s disease
Xiao-Li Zhou, Yan Li, Wan Xia, Ying-Ying Zheng, Ai-Ping Wu
Xiao-Li Zhou, Wan Xia, Ying-Ying Zheng, Ai-Ping Wu, Department of Rehabilitation, Zhejiang Hospital, Hangzhou 310012, Zhejiang Province, China
Yan Li, Department of Neurology, Zhejiang Hospital, Hangzhou 310012, Zhejiang Province, China
Author contributions: Zhou XL conducted literature review and initial drafting; Li Y provided neurological expertise and clinical experience; Xia W handled literature screening and data organization; Zheng YY focused on transcranial magnetic stimulation applications and manuscript revision, and corresponding author Wu AP oversaw research design, overall coordination, and final review.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: May 16, 2025 Revised: June 16, 2025 Accepted: July 18, 2025 Published online: September 19, 2025 Processing time: 102 Days and 1.4 Hours
Abstract
Parkinson’s disease patients, in addition to typical motor symptoms, often experience various psychological symptoms, including depression, anxiety, cognitive impairment, impulse control disorders, and psychotic symptoms. These symptoms severely affect patients’ quality of life and may even cause a greater disease burden than motor symptoms. This review focuses on the application progress of transcranial magnetic stimulation (TMS) as a non-invasive neuromodulation technique in the treatment of psychological symptoms in Parkinson’s disease. Studies have shown that repetitive TMS (rTMS) has significant improvement effects on Parkinson’s disease-related depressive symptoms, with mechanisms possibly related to the regulation of the prefrontal-striatal dopamine pathway and the promotion of neuroplasticity. For anxiety symptoms, continuous theta burst stimulation has shown potential in indirect regulation of the amygdala and hippocampal regions. For cognitive impairment, high-frequency rTMS applied to the dorsolateral prefrontal cortex can improve executive function deficits, while bilateral coordinated stimulation protocols help enhance attention and memory functions. For impulse control disorders in Parkinson’s disease patients, inhibitory stimulation applied to the orbitofrontal cortex can alleviate pathological gambling and compulsive behaviors. In terms of sleep disorders, TMS has also shown potential efficacy in regulating circadian rhythms and improving rapid eye movement sleep behavior disorder. However, current research still has limitations such as small sample sizes, non-standardized stimulation protocols, and insufficient evaluation of long-term efficacy. Future research directions should focus on optimizing stimulation parameters, exploring individualized treatment protocols, integrating multimodal imaging assessments, and conducting large-sample randomized controlled trials to clarify the clinical application value of TMS in the rehabilitation of psychological symptoms in Parkinson’s disease, providing new approaches for the comprehensive management of this common neurodegenerative disease.
Core Tip: This review summarizes recent advances in transcranial magnetic stimulation (TMS) for managing psychological symptoms in Parkinson’s disease, including depression, anxiety, cognitive impairment, impulse control disorders, and sleep disturbances. It highlights the neurophysiological mechanisms of TMS, such as modulation of the prefrontal-striatal dopamine pathway and promotion of neuroplasticity. Clinical applications of repetitive TMS and theta burst stimulation are discussed, along with individualized parameter optimization strategies. The article also outlines future directions involving deep TMS, neuronavigation, and personalized protocols, offering novel insights into non-invasive neuromodulation for comprehensive symptom management in Parkinson’s disease.
