Effectiveness of repetitive transcranial magnetic stimulation on hypomimia induced sialorrhea among Parkinsons: a case study

Subramaniyan Ramesh; Kishoremoy Das; Vignesh Srinivasan; Prathap Suganthirababu

doi:10.18203/2320-6012.ijrms20252909

Authors

Subramaniyan Ramesh Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
Kishoremoy Das Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
Vignesh Srinivasan Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
Prathap Suganthirababu Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20252909

Keywords:

Hypomimia, Parkinson’s disease, Radboud oral motor inventory for PD, Sialorrhea clinical scale for PD, Transcranial magnetic stimulation

Abstract

Excessive drooling (sialorrhea) in Parkinson’s disease (PD) affects quality of life, often linked to hypomimia. Conventional treatments have limitations, while repetitive transcranial magnetic stimulation (rTMS) shows promise but remains understudied for sialorrhea. A 74-year-old male with PD underwent rTMS and exercise therapy for eight weeks. Pre-treatment scores were 63 in sialorrhea clinical scale for PD and 7 on the Radboud oral motor inventory for PD (ROMP), improving to 48 and 5. Surface electromyography (SEMG) showed increased zygomaticus major activity (10.5 µV to 16.2 µV) and corrugator supercilii (17.3 µV to 22.7 µV), suggesting rTMS may improve sialorrhea and orofacial function in PD.

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