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Fox Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000864","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006111","name":"Minist\u00e9rio da Ci\u00eancia, Tecnologia e Ensino Superior","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006111","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008530","name":"Fundo Europeu de Desenvolvimento Regional","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000874","name":"National Alliance for Research on Schizophrenia & Depression","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000874","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000781","name":"European Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000781","id-type":"DOI","asserted-by":"publisher"}]},{"name":"European Union\u2019s Horizon 2020 Research and Innovation Programme"},{"name":"BOUNCE project"},{"name":"FAITH project"},{"name":"Partnership Agreement Lisboa 2020\u2014Programa Operacional Regional de Lisboa"},{"name":"National Funds from Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","id":[{"id":"https:\/\/ror.org\/00snfqn58","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Despite the availability of effective treatments, many symptoms of Parkinson\u2019s disease remain insufficiently addressed. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive neuromodulation technique, may help fill these therapeutic gaps, but its clinical role remains unclear. We conducted an umbrella review of systematic reviews and a scoping review of original studies on rTMS for Parkinson\u2019s disease, focusing on motor and non-motor symptoms. Review-level evidence and guideline statements support probable benefit of high-frequency rTMS targeting bilateral motor areas (particularly primary motor cortex) for improving motor symptoms. Low-frequency stimulation of premotor and cerebellar circuits has also shown signals for reducing levodopa-induced dyskinesias, although evidence is less definitive. For non-motor symptoms, high-frequency rTMS of the left dorsolateral prefrontal cortex (DLPFC) appears clearly beneficial for depression, with positive signals for cognitive symptoms, while right-DLPFC stimulation has shown preliminary signals on sleep disturbances. Across most domains, conclusions are limited by small sample sizes, short follow-up periods, heterogeneous stimulation protocols, inconsistent outcome measures and variable methodological quality of both trials and reviews. Evidence therefore remains insufficient to support broad clinical implementation across many symptom domains. Future research should adopt a circuit-based, symptom-specific approach, aligning stimulation targets with the neural substrates of each symptom. This requires clear inclusion criteria, well-characterized patient subgroups and standardized outcome measures across studies. The current literature suggests that rTMS may have therapeutic potential as part of multidisciplinary Parkinson\u2019s disease care, but adequately powered and rigorous trials are needed to determine its clinical utility and define where it may meaningfully address persistent therapeutic gaps.<\/jats:p>","DOI":"10.1093\/braincomms\/fcag346","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:33:38Z","timestamp":1788867218000},"source":"Crossref","is-referenced-by-count":0,"title":["Repetitive transcranial magnetic stimulation as adjunctive treatment in Parkinson\u2019s disease: are we missing opportunities? An umbrella and scoping review"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3587-8553","authenticated-orcid":false,"given":"Marcelo D","family":"Mendon\u00e7a","sequence":"first","affiliation":[{"name":"Champalimaud Clinical Centre, Digital Neurotherapeutics Centre and Neuroscience of Disease Programme, Champalimaud Foundation , Lisboa 1400-038 ,","place":["Portugal"]},{"name":"NOVA Medical School, NMS, Universidade NOVA de Lisboa , Lisboa 1169-056 ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1267-645X","authenticated-orcid":false,"given":"Gon\u00e7alo","family":"Cotovio","sequence":"additional","affiliation":[{"name":"Champalimaud Clinical Centre, Digital Neurotherapeutics Centre and Neuroscience of Disease Programme, Champalimaud Foundation , Lisboa 1400-038 ,","place":["Portugal"]},{"name":"NOVA Medical School, NMS, Universidade NOVA de Lisboa , Lisboa 1169-056 ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3138-2975","authenticated-orcid":false,"given":"Raquel","family":"Barbosa","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Neurosciences, Parkinson Expert Center, Centre d'Investigation Clinique CIC1436, NeuroToul COEN Center , Toulouse 31300 ,","place":["France"]},{"name":"NS-PARK\/FCRIN Network, University Hospital of Toulouse , Toulouse 31300 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Pascal","family":"Lefaucheur","sequence":"additional","affiliation":[{"name":"UR4391, ENT Team, Faculty of Health, Paris-Est Creteil University , Cr\u00e9teil 94000 ,","place":["France"]},{"name":"Department of Clinical Neurophysiology, Henri Mondor University Hospital, AP-HP , Cr\u00e9teil 94000 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3950-5113","authenticated-orcid":false,"given":"Joaquim J","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa , Lisbon 1649-028 ,","place":["Portugal"]},{"name":"CNS - Campus Neurol\u00f3gico , Torres Vedras 2560-280 ,","place":["Portugal"]},{"name":"Department of Neurosciences and Mental Health, Neurology, Unidade Local de Sa\u00fade de Santa Maria , Lisbon 1649-035 ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5071-3007","authenticated-orcid":false,"given":"Albino J","family":"Oliveira-Maia","sequence":"additional","affiliation":[{"name":"Champalimaud Clinical Centre, Digital Neurotherapeutics Centre and Neuroscience of Disease Programme, Champalimaud Foundation , Lisboa 1400-038 ,","place":["Portugal"]},{"name":"NOVA Medical School, NMS, Universidade NOVA de Lisboa , Lisboa 1169-056 ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"2026092911171005100_fcag346-B1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2024-080952","article-title":"Projections for prevalence of Parkinson\u2019s disease and its driving factors in 195 countries and territories to 2050: Modelling study of global burden of disease study 2021","volume":"388","author":"Su","year":"2025","journal-title":"BMJ"},{"issue":"8","key":"2026092911171005100_fcag346-B2","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1002\/mds.27372","article-title":"International Parkinson and movement disorder society evidence-based medicine review: Update on treatments for the motor symptoms of Parkinson\u2019s disease","volume":"33","author":"Fox","year":"2018","journal-title":"Mov 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