Non-invasive Brain Stimulation and Exercise Intervention for Patients With Motor Neuron Disease

After screening process, eligible participants will be invited to visit Chula Neuroscience Center for the baseline assessments which will take proximately 2 hours. The baseline assessments will be as follow: 1. Demographic information such as age, sex, body height, body weight, body mass index, date of diagnosis, type of MND, and current medications. 2. Questionnaires including amyotrophic lateral sclerosis functional rating scale - revised version (ALSFRS-R), penn upper motor neuron score (PUMNS), patient health questionnaire (PHQ-9), and EuroQol 5-Dimension 5-level (EQ-5D-5L). 3. Clinical assessments including hand grip test, pinch grip test, and hand function. 4. Lung function tests such as forced vital capacity (FVC). 5. Neurophysiological assessment by using transcranial magnetic stimulation (TMS) 6. Electromyography (EMG) including compound muscle action potential (CMAP), motor unit number estimation (MScan fit-MUNE), and motor unit number index (MUNIX). 7. Magnetic resonance imaging (MRI)