scholarly journals Effect of high rate rTMS on somatosensory evoked potential in migraine

Cephalalgia ◽  
2016 ◽  
Vol 37 (13) ◽  
pp. 1222-1230 ◽  
Author(s):  
Jayantee Kalita ◽  
Sanjeev K Bhoi ◽  
Usha K Misra
Keyword(s):  
Cortical Neurons ◽  
Evoked Potential ◽  
Therapeutic Response ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Hot Spot ◽  
High Rate ◽  
Somatosensory Evoked Potential ◽  
Sham Stimulation ◽  
The Third ◽  
Abductor Digiti Minimi

Background Sensitization and impaired habituation of cortical neurons have been reported in migraineurs. Repetitive transcranial magnetic stimulation (rTMS) may change these phenomena and be the basis of therapeutic response. We report the effect of 10 Hz rTMS on sensitization and habituation of median somatosensory evoked potential (SEP) in migraineurs, and correlate these changes with clinical response. Methods Migraineurs having four or more episodes of headache per month were included and their clinical details were noted. Three sessions of 10 Hz rTMS, 600 pulses in 412.4 seconds were delivered on the left frontal cortex corresponding to the hot spot of right abductor digiti minimi, on alternate days. Median SEP was done before and 30 minutes after the third rTMS session. Sensitization (block I N20 amplitude) and impaired habituation (if N20 amplitude of block 2 or 3 were not suppressed compared to block I) were noted. The reduction in frequency and severity of headache in the next month were noted and correlated with SEP changes. Results Ninety-four migraineurs were included; 56 received true rTMS and 38 sham stimulation. Following stimulation, reduction in N20 amplitude of block 1 correlated with a reduction in frequency and severity of headache at one month. The impaired habituation significantly improved in the true rTMS group compared to sham stimulation, and correlated with a reduction in the severity of headache but not with frequency. Conclusion In migraineurs, 10 Hz rTMS improves habituation and may be the biological basis of headache relief.

Selective Modification of Somatosensory Evoked Potential during Voluntary Finger Movement in Humans

1997 ◽  
Vol 85 (1) ◽  
pp. 259-266 ◽  
Author(s):  
Y. Nishihira ◽  
K. Funase ◽  
H. Araki ◽  
K. Imanaka
Keyword(s):  
Evoked Potentials ◽  
Somatosensory Evoked Potentials ◽  
Voluntary Movement ◽  
Evoked Potential ◽  
Somatosensory Evoked Potential ◽  
Finger Movement ◽  
The Third ◽  
Middle Latency ◽  
The Relationship

We examined changes in somatosensory evoked potentials (SEPs) during voluntary movement of fingers innervated by the stimulated nerve and those not innervated by the stimulated nerve and the relationship to the kind of movement modality. Analysis showed that the amplitude of most components at F3, C3', and P3, except for P45 at C3, N35 and P45 at P3, decreased during voluntary finger movement tasks. Further, we found that the components of P40 at F3, P45 at C3', and N35 at P3 were increased during the voluntary pulling movement of the second and the third digits compared to those during the voluntary pushing movement of the fourth and the fifth digits, whereas all other components were decreased at F3, C3', and P3. We also found that not all components of SEPs were decreased while some SEPs in middle latency were increased. In conclusion, we confirmed the selectivity in attenuation of the SEPs. Moreover, we noted an interesting finding that the selectivity of attenuation of the SEPs was most frequently observed in the N20, P30 (P25 at F3), N35 (N30 at F3), and P45 (P40 at F3) components at F3, C3', and P3.

Is β endorphin related to migraine headache and its relief?

Cephalalgia ◽  
2013 ◽  
Vol 33 (5) ◽  
pp. 316-322 ◽  
Author(s):  
Usha K Misra ◽  
Jayantee Kalita ◽  
Gyanesh M Tripathi ◽  
Sanjeev K Bhoi
Keyword(s):  
Chronic Migraine ◽  
Functional Disability ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Hot Spot ◽  
International Headache Society ◽  
Episodic Migraine ◽  
Gender And Age ◽  
Before And After ◽  
Basal Plasma ◽  
Abductor Digiti Minimi

Background Low β endorphin level in serum and cerebrospinal fluid (CSF) has been reported in migraine. The basis of pain relief in migraine by repetitive transcranial magnetic stimulation (rTMS) may be related to β endorphin (BE), which has not been evaluated. It is proposed to measure plasma β endorphin level in migraine patients and the change in β endorphin level following rTMS, and to correlate these changes with migraine relief. Methods Twenty-five patients with migraine diagnosed as per International Headache Society criteria and 20 gender- and age-matched controls were included. Their clinical characteristics including duration of migraine, its frequency, severity and functional disability, triggers, allodynia and number of analgesic used were noted. Plasma β endorphin level was estimated before and after the third rTMS session. rTMS was delivered on the hot spot of right abductor digiti minimi on alternate days for 3 days and each session consisted of 600 pulses at 10 Hz. The clinical response was noted weekly for 1 month and correlated with β endorphin level. Results The median age of the patients was 35 (20–50) years and 19 were females. Eight patients had episodic and 17 chronic migraine. β endorphin level was significantly lower in migraine (4.35 ± 2.29 ng/ml) compared to controls (6.68 ± 2.93 ng/ml). β endorphin level was lower in chronic compared to episodic migraine (3.74 ± 2.20 versus 5.65 ± 2.02 ng/ml). Following rTMS, the headache frequency, severity, functional disability and analgesic intake significantly reduced on the seventh day of rTMS and remained significant until the fourth week compared to the baseline. The clinical improvement was associated with increase in β endorphin level (4.35 ± 2.29 versus 6.58 ± 3.33 ng/ml). Conclusion It can be concluded from this study that the basal plasma β endorphin level was low in migraine patients, especially in chronic migraine. The improvement in migraine after rTMS was associated with increase in β endorphin level.

Multifocal Noninvasive Magnetic Stimulation of the Primary Motor Cortex in Type 1 Myotonic Dystrophy –A Proof of Concept Pilot Study

2021 ◽  
pp. 1-10
Author(s):  
Ericka Greene ◽  
Jason Thonhoff ◽  
Blessy S. John ◽  
David B. Rosenfield ◽  
Santosh A. Helekar
Keyword(s):  
Motor Cortex ◽  
Myotonic Dystrophy ◽  
Muscle Function ◽  
Magnetic Stimulation ◽  
Primary Motor Cortex ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Compound Muscle Action Potential ◽  
Sham Stimulation ◽  
Stimulation Of

Background: Repeated neuromuscular electrical stimulation in type 1 Myotonic Dystrophy (DM1) has previously been shown to cause an increase in strength and a decrease in hyperexcitability of the tibialis anterior muscle. Objective: In this proof-of-principle study our objective was to test the hypothesis that noninvasive repetitive transcranial magnetic stimulation of the primary motor cortex (M1) with a new portable wearable multifocal stimulator causes improvement in muscle function in DM1 patients. Methods: We performed repetitive stimulation of M1, localized by magnetic resonance imaging, with a newly developed Transcranial Rotating Permanent Magnet Stimulator (TRPMS). Using a randomized within-patient placebo-controlled double-blind TRPMS protocol, we performed unilateral active stimulation along with contralateral sham stimulation every weekday for two weeks in 6 adults. Methods for evaluation of muscle function involved electromyography (EMG), hand dynamometry and clinical assessment using the Medical Research Council scale. Results: All participants tolerated the treatment well. While there were no significant changes clinically, EMG showed significant improvement in nerve stimulus-evoked compound muscle action potential amplitude of the first dorsal interosseous muscle and a similar but non-significant trend in the trapezius muscle, after a short exercise test, with active but not sham stimulation. Conclusions: We conclude that two-week repeated multifocal cortical stimulation with a new wearable transcranial magnetic stimulator can be safely conducted in DM1 patients to investigate potential improvement of muscle strength and activity. The results obtained, if confirmed and extended by future safety and efficacy trials with larger patient samples, could offer a potential supportive TRPMS treatment in DM1.

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