Reshaping “Cerebellar Inhibition”: Mechanistic Insights and Precision Medicine Perspectives for rTMS in Machado-Joseph Disease
- VernacularTitle:重塑“小脑抑制”：重复经颅磁刺激治疗马查多-约瑟夫病的机制解析与精准医疗展望
- Author:
Ya-Zhen HAN
1
;
Jie ZHOU
1
;
Yu-Chao CHEN
2
;
Zhong-Ming GAO
2
;
Xian-Wei CHE
1
Author Information
- Publication Type:Journal Article
- Keywords: Machado-Joseph disease (spinocerebellar ataxia type 3, SCA3); transcranial magnetic stimulation-electroencephalography (TMS-EEG); cerebello-cortical inhibition; neuromodulation; precision medicine
- From: Progress in Biochemistry and Biophysics 2026;53(2):505-510
- CountryChina
- Language:English
- Abstract: Machado-Joseph disease, or spinocerebellar ataxia type 3 (SCA3), represents the most common autosomal dominant cerebellar ataxia worldwide. Despite its progressive and debilitating nature, disease-modifying therapies remain elusive. Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising non-invasive intervention; however, its clinical application has been hindered by inconsistent protocols and a lack of mechanistic understanding. A recent landmark study published in Brain Stimulation by Chen et al. addressed these challenges by combining a high-dose intermittent theta-burst stimulation (iTBS) protocol with concurrent transcranial magnetic stimulation-electroencephalography (TMS-EEG). This commentary provides an in-depth analysis of their findings, highlighting the restoration of cerebello-cortical inhibition (CBI) as a key therapeutic mechanism. Furthermore, we discuss the broader implications of this work, proposing that future translational research should integrate accelerated iTBS (aiTBS) paradigms, cortical response measurements (CRM), and individualized neuro-navigation to establish a new era of precision neuromodulation for ataxia.
