Parkinson's Disease (PD)TMSNCT06982638
Accelerated TMS for Freezing of Gait in Parkinson's Disease
A study testing TMS+ Gait training in people with Parkinson's Disease (PD), run by Medical University of South Carolina at 1 site in United States.
Trial summary
The goal of this clinical trial is to learn whether a personalized brain stimulation method called repetitive transcranial magnetic stimulation (rTMS), combined with walking exercises, is a practical and tolerable approach to help people with Parkinson's disease who experience freezing of gait (FOG). Read more about this study
- Who is it for?
- Ages 50 to 80 years
- Conditions the study is for
- Parkinson's Disease (PD)
- What is being tested?
- TMS+ Gait training
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 12 participants
- Where
- 1 siteUnited States
- Study dates
- 21 Nov 2024to 31 Dec 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 50 to 80 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- 50-80 years of age
- diagnosis of PD based on UK Brain Bank diagnostic criteria 55
- presence of FOG defined as a score of 1 on part 1 of the nFOGQ in which a video showing different types of freezing is played for the patient, a score of 1 represents a positive response of having experienced such an episode over the last month
- no dopaminergic medication changes in the month prior
- observed FOG rated as >1 in item 3.11 of the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS).
Who cannot join
- a history of other significant gait impairment unrelated to PD (e.g. orthopedic deformities)
- inability to complete gait assessments (timed up and go task) without assistance or assist devices
- barriers to making contact between the TMS coil and the skin (e.g. braids that cannot be removed)
- failing to meet all criteria on a standardized MRI/TMS safety screening: This includes, but is not limited to, the presence of claustrophobia, implanted electronic devices (e.g., pacemakers), metallic objects or fragments (e.g., bullets), and non-removable hair clips or piercings.
- individuals with a diagnosis of psychosis or any other cognitive impairments that would make them unable to understand and follow study instructions or to consent for themselves.
- pregnancy
- individuals with a history of seizure
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
United States1 site, 1 recruiting
- Recruiting
Medical University of South Carlina
Charleston, South Carolina, 29414
Niloufar Malakouti, MD, MSc, 843-792-0235, malakout@musc.edu
Gonzalo Revuelta, DO
About this study
The goal of this clinical trial is to learn whether a personalized brain stimulation method called repetitive transcranial magnetic stimulation (rTMS), combined with walking exercises, is a practical and tolerable approach to help people with Parkinson's disease who experience freezing of gait (FOG). FOG is a disabling symptom where people temporarily feel stuck and unable to start walking, even though they want to move.
The main questions this study aims to answer are:
Read more
Can people with Parkinson's disease and FOG tolerate this combined rTMS and walking training procedure?
Can researchers successfully enroll and retain participants for this multi-visit intervention?
Does the combination of rTMS and gait training show early signs of improving gait and reducing freezing episodes?
This study does not include a comparison or placebo group. All participants will receive the same intervention.
Participants will:
Attend up to 15 study visits over about 16 weeks, with the option to combine visits to reduce burden.
Complete brain imaging (MRI) before and after the intervention to guide and evaluate treatment.
Receive a form of brain stimulation (rTMS) using a safe, non-invasive coil placed over a specific part of the brain called the supplementary motor area (SMA). The target is personalized using each person's MRI data.
Participate in walking exercises that include cognitive tasks (dual-task gait training) after each set of brain stimulation sessions.
Undergo assessments of walking ability, Parkinson's disease symptoms, and brain response to stimulation.
Be videotaped during walking tasks to assess gait changes, while wearing small motion sensors on the body.
Complete questionnaires about symptoms, safety, and tolerability.
This study is being conducted at the Medical University of South Carolina (MUSC) and includes up to 15 adults between the ages of 50 and 80 who have been diagnosed with Parkinson's disease and experience FOG.
Although rTMS is already FDA-cleared for depression and other conditions, it has not been approved for freezing of gait, and its use in this study is considered investigational. The stimulation device used has been determined to be non-significant risk (NSR) by the FDA.
The study does not offer direct medical benefit to participants, but results from this trial may help researchers develop future treatments and better understand how brain stimulation affects walking difficulties in Parkinson's disease.
Participation is voluntary, and individuals can withdraw from the study at any time without affecting their medical care
- Conditions
- Parkinson's Disease (PD)
- Being tested
- TMS+ Gait training
- Keywords
- TMS, Parkinson's Disease (PD), Gait training, Freezing of gait
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
TMS+ Gait trainingDevice
Participants in this single-arm study will receive a personalized, accelerated course of continuous theta burst stimulation (cTBS) over a functionally defined subregion of the supplementary motor area (SMA), which is individually targeted using resting-state functional MRI. The stimulation will be delivered using a MagPro Cool-B65 A/P figure-of-eight coil at 110% of resting motor threshold.
Each participant will undergo 6 treatment visits over 2 weeks , receiving 8 rTMS sessions per day (600 pulses/session), totaling 28,800 pulses across the study. TMS sessions will be interleaved with dual-task gait training involving cognitive walking exercises. Gait training will be conducted for 30 minutes per visit, immediately following stimulation blocks. Safety, tolerability, adherence, gait performance, and neuroplasticity will be evaluated pre- and post-intervention using clinical scales, motor evoked potentials (MEPs), and functional MRI.
| Study group | Role | What they receive |
|---|---|---|
| TMS+Gait training | Experimental | Participants in this single-arm study will receive a personalized, accelerated course of continuous theta burst stimulation (cTBS) over a functionally defined subregion of the supplementary motor area (SMA), which is individually targeted using resting-state functional MRI. The stimulation will be delivered using a MagPro Cool-B65 A/P figure-of-eight coil at 110% of resting motor threshold.
Each participant will undergo 6 treatment visits over 2 weeks , receiving 8 rTMS sessions per day (600 pulses/session), totaling 28,800 pulses across the study. TMS sessions will be interleaved with dual-task gait training involving cognitive walking exercises. Gait training will be conducted for 30 minutes per visit, immediately following stimulation blocks. Safety, tolerability, adherence, gait performance, and neuroplasticity will be evaluated pre- and post-intervention using clinical scales, motor evoked potentials (MEPs), and functional MRI. Receives: Device: TMS+ Gait training |
What is being measured
The primary outcome is the main question the study is designed to answer.
Tolerability of the Intervention
Participant-reported discomfort after each TMS session using a modified version of the Non-Invasive Brain Stimulation (NIBS) Tolerability Questionnaire, which rates six side effects (headache, pain, scalp irritation, facial twitching, fatigue, fear/anxiety) from 1 (Mild) to 10 (Severe).
Measured: Immediately after each TMS session during the 6 treatment days
Adherence to Study Visits
The proportion of scheduled study visits completed by each participant, calculated as the number of attended sessions divided by the number of planned sessions.
Measured: Across the total study duration, up to 16 weeks
Secondary outcomes (3)
Change in Freezing of Gait Questionnaire Scores (nFOG-Q)
Difference in participant-reported FOG severity using the New Freezing of Gait Questionnaire (nFOG-Q) from baseline to post-intervention.
Measured: nFOG-Q will be assessed at 5 time points: 1)Baseline 2) immediately after completion of intervention 3) one month after completion of intervention, 4)two months after completion of intervention 5) three months after completion of intervention
Change in MDS-UPDRS Gait Item Scores
Changes in the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) gait-related items, especially item 3.11 (FOG), assessed before and after the intervention.
Measured: Baseline and after completion of intervention, up to 16 weeks
Change in SMA Functional Connectivity
Pre-to-post change in resting-state fMRI connectivity between the supplementary motor area (SMA) and other brain regions, particularly the cerebellar locomotor region (CLR).
Measured: Baseline and after completion of intervention, up to 16 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 May 2025
- Study start21 Nov 2024
- Primary completion31 Dec 2026 (estimated)
- Study completion31 Dec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Parkinson's Disease (PD)Studies of the same condition, open and under way.
- More trials run by Medical University of South CarolinaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 12 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Medical University of South Carolina
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Gonzalo Revuelta, Medical University of South Carolina
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06982638
- Sponsor's protocol ID
- Pro00138900
- Acronym
- TMS
- Status last verified
- Jan 2026
- First submitted
- 23 Apr 2025
- Last updated
- 7 Jan 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 7 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Accelerated TMS for Freezing of Gait in Parkinson's Disease
- ClinicalTrials.gov ID
- NCT06982638
- Acronym / sponsor ID
- TMS / Pro00138900
- Conditions
- Parkinson's Disease (PD)
- Keywords
- TMS, Parkinson's Disease (PD), Gait training, Freezing of gait
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 12 participants (estimated)
- Lead sponsor
- Medical University of South CarolinaUniversity, hospital or other
- Study start
- 21 Nov 2024 (actual)
- Primary completion
- 31 Dec 2026 (estimated)
- Study completion
- 31 Dec 2026 (estimated)
- First posted
- 21 May 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical trial is to learn whether a personalized brain stimulation method called repetitive transcranial magnetic stimulation (rTMS), combined with walking exercises, is a practical and tolerable approach to help people with Parkinson's disease who experience freezing of gait (FOG). FOG is a disabling symptom where people temporarily feel stuck and unable to start walking, even though they want to move.
The main questions this study aims to answer are:
Can people with Parkinson's disease and FOG tolerate this combined rTMS and walking training procedure?
Can researchers successfully enroll and retain participants for this multi-visit intervention?
Does the combination of rTMS and gait training show early signs of improving gait and reducing freezing episodes?
This study does not include a comparison or placebo group. All participants will receive the same intervention.
Participants will:
Attend up to 15 study visits over about 16 weeks, with the option to combine visits to reduce burden.
Complete brain imaging (MRI) before and after the intervention to guide and evaluate treatment.
Receive a form of brain stimulation (rTMS) using a safe, non-invasive coil placed over a specific part of the brain called the supplementary motor area (SMA). The target is personalized using each person's MRI data.
Participate in walking exercises that include cognitive tasks (dual-task gait training) after each set of brain stimulation sessions.
Undergo assessments of walking ability, Parkinson's disease symptoms, and brain response to stimulation.
Be videotaped during walking tasks to assess gait changes, while wearing small motion sensors on the body.
Complete questionnaires about symptoms, safety, and tolerability.
This study is being conducted at the Medical University of South Carolina (MUSC) and includes up to 15 adults between the ages of 50 and 80 who have been diagnosed with Parkinson's disease and experience FOG.
Although rTMS is already FDA-cleared for depression and other conditions, it has not been approved for freezing of gait, and its use in this study is considered investigational. The stimulation device used has been determined to be non-significant risk (NSR) by the FDA.
The study does not offer direct medical benefit to participants, but results from this trial may help researchers develop future treatments and better understand how brain stimulation affects walking difficulties in Parkinson's disease.
Participation is voluntary, and individuals can withdraw from the study at any time without affecting their medical care
Study design
- Primary purpose
- Other
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| TMS+Gait training | Experimental | Device: TMS+ Gait trainingParticipants in this single-arm study will receive a personalized, accelerated course of continuous theta burst stimulation (cTBS) over a functionally defined subregion of the supplementary motor area (SMA), which is individually targeted using resting-state functional MRI. The stimulation will be delivered using a MagPro Cool-B65 A/P figure-of-eight coil at 110% of resting motor threshold. Each participant will undergo 6 treatment visits over 2 weeks , receiving 8 rTMS sessions per day (600 pulses/session), totaling 28,800 pulses across the study. TMS sessions will be interleaved with dual-task gait training involving cognitive walking exercises. Gait training will be conducted for 30 minutes per visit, immediately following stimulation blocks. Safety, tolerability, adherence, gait performance, and neuroplasticity will be evaluated pre- and post-intervention using clinical scales, motor evoked potentials (MEPs), and functional MRI. |
Who may qualify
- Ages
- 50 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- 50-80 years of age
- diagnosis of PD based on UK Brain Bank diagnostic criteria 55
- presence of FOG defined as a score of 1 on part 1 of the nFOGQ in which a video showing different types of freezing is played for the patient, a score of 1 represents a positive response of having experienced such an episode over the last month
- no dopaminergic medication changes in the month prior
- observed FOG rated as >1 in item 3.11 of the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS).
Key exclusion criteria (7 listed)
- a history of other significant gait impairment unrelated to PD (e.g. orthopedic deformities)
- inability to complete gait assessments (timed up and go task) without assistance or assist devices
- barriers to making contact between the TMS coil and the skin (e.g. braids that cannot be removed)
- failing to meet all criteria on a standardized MRI/TMS safety screening: This includes, but is not limited to, the presence of claustrophobia, implanted electronic devices (e.g., pacemakers), metallic objects or fragments (e.g., bullets), and non-removable hair clips or piercings.
- individuals with a diagnosis of psychosis or any other cognitive impairments that would make them unable to understand and follow study instructions or to consent for themselves.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| TMS+ Gait trainingParticipants in this single-arm study will receive a personalized, accelerated course of continuous theta burst stimulation (cTBS) over a functionally defined subregion of the supplementary motor area (SMA), which is individually targeted using resting-state functional MRI. The stimulation will be delivered using a MagPro Cool-B65 A/P figure-of-eight coil at 110% of resting motor threshold. Each participant will undergo 6 treatment visits over 2 weeks , receiving 8 rTMS sessions per day (600 pulses/session), totaling 28,800 pulses across the study. TMS sessions will be interleaved with dual-task gait training involving cognitive walking exercises. Gait training will be conducted for 30 minutes per visit, immediately following stimulation blocks. Safety, tolerability, adherence, gait performance, and neuroplasticity will be evaluated pre- and post-intervention using clinical scales, motor evoked potentials (MEPs), and functional MRI. | Device | TMS+Gait training |
Primary outcome
Tolerability of the Intervention
Time frame: Immediately after each TMS session during the 6 treatment days
Participant-reported discomfort after each TMS session using a modified version of the Non-Invasive Brain Stimulation (NIBS) Tolerability Questionnaire, which rates six side effects (headache, pain, scalp irritation, facial twitching, fatigue, fear/anxiety) from 1 (Mild) to 10 (Severe).
Adherence to Study Visits
Time frame: Across the total study duration, up to 16 weeks
The proportion of scheduled study visits completed by each participant, calculated as the number of attended sessions divided by the number of planned sessions.
3 secondary outcomes
Change in Freezing of Gait Questionnaire Scores (nFOG-Q)
Time frame: nFOG-Q will be assessed at 5 time points: 1)Baseline 2) immediately after completion of intervention 3) one month after completion of intervention, 4)two months after completion of intervention 5) three months after completion of intervention
Change in MDS-UPDRS Gait Item Scores
Time frame: Baseline and after completion of intervention, up to 16 weeks
Change in SMA Functional Connectivity
Time frame: Baseline and after completion of intervention, up to 16 weeks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 Jan 2026.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing TMS+ Gait training in people with Parkinson's Disease (PD), run by Medical University of South Carolina at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 7 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Niloufar Malakouti, MD, MSc (843-792-0235, malakout@musc.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Tolerability of the Intervention (time frame: Immediately after each TMS session during the 6 treatment days). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Jan 2026.