Therapeutic effect of levodopa-carbidopa-entacapone combined with rTMS in Parkinson's disease

Parkinson's disease (PD) is a neurodegenerative disorder characterized by progressive tissue deterioration. This study evaluated the effects of levodopa-carbidopa-entacapone (LCE) combined with high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) in elderly PD patients. Participants were divided into an observation group (HF-rTMS + LCE) and a control group (HF-rTMS alone). Motor and cognitive function, quality of life, and adverse effects were assessed before treatment and at 8 weeks, 16 weeks, and 6 months post-treatment. Both groups showed no significant differences in baseline data. However, post-treatment, the observation group demonstrated superior clinical improvements. The Unified Parkinson's Disease Rating Scale-III (UPDRS-III) score significantly decreased from 43.40 +/- 3.94 to 34.73 +/- 5.05 at 6 months (P<0.01), while the Berg Balance Scale (BBS) score increased from 30.97 +/- 5.17 to 46.35 +/- 5.75 (P<0.01). The Timed Up and Go test (TUGT) time reduced from 13.12 +/- 2.23 seconds to 8.62 +/- 2.50 seconds (P<0.01), and the Parkinson's Disease Questionnaire (PDQ-39) score decreased from 37.32 +/- 3.69 to 25.75 +/- 4.59 (P<0.01). Additionally, the Montreal Cognitive Assessment (MoCA) score increased from 22.05 +/- 2.24 to 28.15 +/- 1.99 (P<0.001). Adverse effects were similar between groups (16.7% vs. 15%, P>0.05). These results suggest HF-rTMS combined with LCE enhances motor function, balance, cognition, and quality of life in elderly PD patients without increasing adverse effects.