scholarly journals Intracortical and Intercortical Motor Disinhibition to Transcranial Magnetic Stimulation in Newly Diagnosed Celiac Disease Patients

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1530
Author(s):  
Francesco Fisicaro ◽  
Giuseppe Lanza ◽  
Carmela Cinzia D’Agate ◽  
Raffaele Ferri ◽  
Mariagiovanna Cantone ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Rating Scale ◽  
De Novo ◽  
Motor Evoked Potentials ◽  
Silent Period ◽  
Cross Sectional ◽  
Transcallosal Inhibition ◽  
Resting Motor Threshold

Background: Celiac disease (CD) may present or be complicated by neurological and neuropsychiatric manifestations. Transcranial magnetic stimulation (TMS) probes brain excitability non-invasively, also preclinically. We previously demonstrated an intracortical motor disinhibition and hyperfacilitation in de novo CD patients, which revert back after a long-term gluten-free diet (GFD). In this cross-sectional study, we explored the interhemispheric excitability by transcallosal inhibition, which has never been investigated in CD. Methods: A total of 15 right-handed de novo, neurologically asymptomatic, CD patients and 15 age-matched healthy controls were screened for cognitive and depressive symptoms to the Montreal Cognitive Assessment (MoCA) and the 17-item Hamilton Depression Rating Scale (HDRS), respectively. TMS consisted of resting motor threshold, amplitude, latency, and duration of the motor evoked potentials, duration and latency of the contralateral silent period (cSP). Transcallosal inhibition was evaluated as duration and latency of the ipsilateral silent period (iSP). Results: MoCA and HDRS scored significantly worse in patients. The iSP and cSP were significantly shorter in duration in patients, with a positive correlation between the MoCA and iSP. Conclusions: An intracortical and interhemispheric motor disinhibition was observed in CD, suggesting the involvement of GABA-mediated cortical and callosal circuitries. Further studies correlating clinical, TMS, and neuroimaging data are needed.

scholarly journals Preserved central cholinergic functioning to transcranial magnetic stimulation in de novo patients with celiac disease

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261373
Author(s):  
Giuseppe Lanza ◽  
Francesco Fisicaro ◽  
Carmela Cinzia D’Agate ◽  
Raffaele Ferri ◽  
Mariagiovanna Cantone ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
De Novo ◽  
Systemic Disease ◽  
Conduction Time ◽  
Healthy Controls ◽  
Resting Motor Threshold ◽  
Significant Difference ◽  
Interstimulus Intervals

Background Celiac disease (CD) is now viewed as a systemic disease with multifaceted clinical manifestations. Among the extra-intestinal features, neurological and neuropsychiatric symptoms are still a diagnostic challenge, since they can precede or follow the diagnosis of CD. In particular, it is well known that some adults with CD may complain of cognitive symptoms, that improve when the gluten-free diet (GFD) is started, although they may re-appear after incidental gluten intake. Among the neurophysiological techniques, motor evoked potentials (MEPs) to transcranial magnetic stimulation (TMS) can non-invasively probe in vivo the excitation state of cortical areas and cortico-spinal conductivity, being also able to unveil preclinical impairment in several neurological and psychiatric disorders, as well as in some systemic diseases affecting the central nervous system (CNS), such as CD. We previously demonstrated an intracortical disinhibition and hyperfacilitation of MEP responses to TMS in newly diagnosed patients. However, no data are available on the central cholinergic functioning indexed by specific TMS measures, such as the short-latency afferent inhibition (SAI), which might represent the neurophysiological correlate of cognitive changes in CD patients, also at the preclinical level. Methods Cognitive and depressive symptoms were screened by means of the Montreal Cognitive Assessment (MoCA) and the 17-item Hamilton Depression Rating Scale (HDRS), respectively, in 15 consecutive de novo CD patients and 15 healthy controls. All patients were on normal diet at the time of the enrolment. Brain computed tomography (CT) was performed in all patients. SAI, recorded at two interstimulus intervals (2 and 8 ms), was assessed as the percentage amplitude ratio between the conditioned and the unconditioned MEP response. Resting motor threshold, MEP amplitude and latency, and central motor conduction time were also measured. Results The two groups were comparable for age, sex, anthropometric features, and educational level. Brain CT ruled out intracranial calcifications and clear radiological abnormalities in all patients. Scores at MoCA and HDRS were significantly worse in patients than in controls. The comparison of TMS data between the two groups revealed no statistically significant difference for all measures, including SAI at both interstimulus intervals. Conclusions Central cholinergic functioning explored by the SAI of the motor cortex resulted to be not affected in these de novo CD patients compared to age-matched healthy controls. Although the statistically significant difference in MoCA, an overt cognitive impairment was not clinically evident in CD patients. Coherently, to date, no study based on TMS or other diagnostic techniques has shown any involvement of the central acetylcholine or the cholinergic fibers within the CNS in CD. This finding might add support to the vascular inflammation hypothesis underlying the so-called “gluten encephalopathy”, which seems to be due to an aetiology different from that of the cholinergic dysfunction. Longitudinal studies correlating clinical, TMS, and neuroimaging data, both before and after GFD, are needed.

scholarly journals Disrupted Central Inhibition after Transcranial Magnetic Stimulation of Motor Cortex in Schizophrenia with Long-Term Antipsychotic Treatment

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Aulikki Ahlgrén-Rimpiläinen ◽  
Hannu Lauerma ◽  
Seppo Kähkönen ◽  
Ilpo Rimpiläinen
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Motor Cortex ◽  
Magnetic Stimulation ◽  
Motor Evoked Potentials ◽  
Silent Period ◽  
Single Pulse ◽  
Contralateral Side ◽  
Antipsychotic Treatment ◽  
Stimulation Of

Aims. Schizophrenia is a neuropsychiatric disorder associated with mental and motor disturbances. We aimed to investigate motor control, especially central silent period (CSP) in subjects with schizophrenia (n=11) on long-term antipsychotic treatment compared to healthy controls (n=9). Methods. Latency and duration of motor evoked potentials (MEPs) and CSPs were measured with the help of single pulse transcranial magnetic stimulation (TMS) and intramuscular electrodes. After stimulation of the dominant and nondominant motor cortex of abductor digiti minimi (ADM) and tibialis anterior (TA) muscle areas, respective responses were measured on the contralateral side. Results. MEPs did not differ significantly between the groups. Multiple CSPs were found predominantly in subjects with schizophrenia, which showed a higher number of CSPs in the dominant ADM and the longest summarized duration of CSPs in the nondominant ADM (P<0.05) compared to controls. Conclusions. There were multiple CSPs predominantly in the upper extremities and in the dominant body side in subjects with schizophrenia. Behind multiple CSPs may lie an impaired regulation of excitatory or inhibitory neurotransmitter systems in central motor pathways. Further research is needed to clarify the role of the intramuscular recording methods and the effect of antipsychotics on the results.

scholarly journals Evaluation of a novel 5 day accelerated 1 Hz repetitive transcranial magnetic stimulation protocol in major depression

2020 ◽  
Author(s):  
Jean-Philippe Miron ◽  
Molly Hyde ◽  
Linsay Fox ◽  
Jack Sheen ◽  
Helena Voetterl ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Rating Scale ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Delayed Effect ◽  
Open Label ◽  
Serious Adverse Events ◽  
Resting Motor Threshold ◽  
Dorsolateral Prefrontal ◽  
The Right

BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) is an effective intervention in major depressive disorder (MDD) but requires daily travel to a treatment clinic over several weeks. Shorter rTMS courses retaining similar effectiveness would thus increase the practicality and scalability of the technique, and therefore its accessibility. OBJECTIVE We assessed the feasibility of a novel 5 day accelerated 1 Hz rTMS protocol. We hypothesized that this novel rTMS protocol would be safe and well-tolerated while shortening the overall treatment course. METHODS We conducted a prospective, single-arm, open-label feasibility study. Thirty (30) participants received a one-week (5 days) accelerated (8 sessions per day, 40 sessions total) course of 1 Hz rTMS (600 pulses per session, 50-minute intersession interval) over the right dorsolateral prefrontal cortex (R-DLPFC) using a figure-of-eight coil at 120% of the resting motor threshold (rMT). Depression severity was assessed on the Beck Depression Inventory-II (BDI-II) and 17-item Hamilton Rating Scale for Depression (HRSD-17). RESULTS Response and remission rates 1 week after treatment were 33.3% and 13.3% respectively and increased to 43.3% and 30.0% at 4 weeks after treatment. No serious adverse events occurred. All participants reported manageable pain levels. CONCLUSION 1 Hz rTMS administered 8 times daily for 5 days is safe and well-tolerated. Efficacy at the end of the course was similar to a standard daily course of 1 Hz rTMS, and there appears to be an additional delayed effect. Further validation in a randomized trial is required.

scholarly journals Preserved Transcallosal Inhibition to Transcranial Magnetic Stimulation in Nondemented Elderly Patients with Leukoaraiosis

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Giuseppe Lanza ◽  
Rita Bella ◽  
Salvatore Giuffrida ◽  
Mariagiovanna Cantone ◽  
Giovanni Pennisi ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Elderly Patients ◽  
Magnetic Stimulation ◽  
Motor Evoked Potentials ◽  
Early Stage ◽  
Brain Magnetic Resonance Imaging ◽  
Single Pulse ◽  
Neuropsychological Profile ◽  
Resting Motor Threshold ◽  
Significant Difference

Structural corpus callosum (CC) changes in patients with leukoaraiosis (LA) are significantly associated with cognitive and motor impairment. The aim of this study is to investigate the transcallosal fibers functioning by means of transcranial magnetic stimulation (TMS) in elderly patients with LA. The resting motor threshold (rMT), the motor-evoked potentials (MEPs), and the controlateral (cSP) and ipsilateral silent periods (iSP) were determined using single-pulse TMS in 15 patients and 15 age-matched controls. The neuropsychological profile and the vascular burden at brain magnetic resonance imaging (MRI) were concomitantly explored. Patients reported abnormal scores at tests evaluating executive control functions. No significant difference was found in TMS measures of intra- and intercortical excitability. No CC lesion was evident at MRI. Transcallosal inhibitory mechanisms to TMS seem to be spared in LA patients, a finding which is in line with neuroimaging features and suggests a functional integrity of the CC despite the ischemic interruption of corticosubcortical loops implicated in cognition and behavior. The observed neurophysiological finding differs from that reported in degenerative dementia, even in the preclinical or early stage. In our group of patients, the pure extent of LA is more related to impairment of frontal lobe abilities rather than functional callosal changes.

Effect of Low-Frequency Repetitive Transcranial Magnetic Stimulation on Interhemispheric Inhibition

2005 ◽  
Vol 94 (3) ◽  
pp. 1668-1675 ◽  
Author(s):  
Pramod Kr. Pal ◽  
Ritsuko Hanajima ◽  
Carolyn A. Gunraj ◽  
Jie-Yuan Li ◽  
Aparna Wagle-Shukla ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Evoked Potentials ◽  
Magnetic Stimulation ◽  
Motor Evoked Potentials ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Low Frequency ◽  
Conditioning Stimulus ◽  
Interhemispheric Inhibition ◽  
Resting Motor Threshold ◽  
Low Frequency Rtms

We studied the effects of 1-Hz repetitive transcranial magnetic stimulation (rTMS) on the excitability of interhemispheric connections in 13 right-handed healthy volunteers. TMS was performed using figure-eight coils, and surface electromyography (EMG) was recorded from both first dorsal interosseous (FDI) muscles. A paired-pulse method with a conditioning stimulus (CS) to the motor cortex (M1) followed by a test stimulus to the opposite M1 was used to study the interhemispheric inhibition (ppIHI). Both CS and TS were adjusted to produce motor-evoked potentials of ∼1 mV in the contralateral FDI muscles. After baseline measurement of right-to-left IHI (pre-RIHI) and left-to-right IHI (pre-LIHI), rTMS was applied over left M1 at 1 Hz with 900 stimuli at 115% of resting motor threshold. After rTMS, ppIHI was studied using both the pre-rTMS CS (post-RIHI and post-LIHI) and an adjusted post-rTMS CS set to produce 1-mV motor evoked potentials (MEPs; post-RIHIadj and post-LIHIadj). The TS was set to produce 1-mV MEPs. There was a significant reduction in post-LIHI ( P = 0.0049) and post-LIHIadj ( P = 0.0169) compared with pre-LIHI at both interstimulus intervals of 10 and 40 ms. Post-RIHI was significantly reduced compared with pre-RIHI ( P = 0.0015) but pre-RIHI and post-RIHIadj were not significantly different. We conclude that 1-Hz rTMS reduces IHI in both directions but is predominantly from the stimulated to the unstimulated hemisphere. Low-frequency rTMS may be used to modulate the excitability of IHI circuits. Treatment protocols using low-frequency rTMS to reduce cortical excitability in neurological and psychiatric conditions need to take into account their effects on IHI.

Transcallosal inhibition in patients with callosal infarction

2013 ◽  
Vol 109 (3) ◽  
pp. 659-665 ◽  
Author(s):  
Jie-Yuan Li ◽  
Ping-Hong Lai ◽  
Robert Chen
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Corpus Callosum ◽  
Healthy Subjects ◽  
Magnetic Stimulation ◽  
Silent Period ◽  
Normal Subjects ◽  
Interhemispheric Inhibition ◽  
Transcallosal Inhibition ◽  
Long Latency ◽  
Pass Through

Recent studies in normal subjects suggested that callosal motor fibers pass through the posterior body of the corpus callosum (CC), but this has not been tested in patients with callosal infarction. The objective of this study is to define the pathways involved in transcallosal inhibition by examining patients with infarctions in different subregions of the CC. We hypothesized that patients with lesions in the posterior one-half of the CC would have greater reduction in transcallosal inhibition between the motor cortices. Twenty-six patients with callosal infarction and 14 healthy subjects were studied. The callosal lesions were localized on sagittal MRI and were attributed to one of five segments of the CC. Transcranial magnetic stimulation was used to assess ipsilateral silent period (iSP) and short- and long-latency interhemispheric inhibition (SIHI and LIHI, respectively) originating from both motor cortices. The results showed that the iSP areas and durations were markedly reduced bilaterally in patients with callosal infarction compared with normal subjects. Patients with callosal infarctions also had less IHI bidirectionally compared with normal subjects. iSP areas and durations were lower in patients with lesions than in patients without lesions in segment 3 (posterior midbody) of the CC. Lesion burden in the posterior one-half of the CC negatively correlated transcallosal inhibition measured with iSP and SIHI. Our study suggests that callosal infarction led to reduced transcallosal inhibition, as measured by iSP, SIHI, and LIHI. Fibers mediating transcallosal inhibition cross the CC mainly in the posterior one-half.

scholarly journals The spectral features of EEG responses to transcranial magnetic stimulation of the primary motor cortex depend on the amplitude of the motor evoked potentials

2017 ◽  
Author(s):  
Matteo Fecchio ◽  
Andrea Pigorini ◽  
Angela Comanducci ◽  
Simone Sarasso ◽  
Silvia Casarotto ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Motor Cortex ◽  
Evoked Potentials ◽  
Magnetic Stimulation ◽  
Primary Motor Cortex ◽  
Motor Evoked Potentials ◽  
Spectral Features ◽  
Time Frequency ◽  
Resting Motor Threshold ◽  
Wide Range

ABSTRACTTranscranial magnetic stimulation (TMS) of the primary motor cortex (M1) can excite both cortico-cortical and cortico-spinal axons resulting in TMS-evoked potentials (TEPs) and motor-evoked potentials (MEPs), respectively. Despite this remarkable difference with other cortical areas, the influence of motor output and its amplitude on TEPs is largely unknown. Here we studied TEPs resulting from M1 stimulation and assessed whether their waveform and spectral features depend on the MEP amplitude. To this aim, we performed two separate experiments. In experiment 1, single-pulse TMS was applied at the same supra-threshold intensity on primary motor, prefrontal, premotor and parietal cortices and the corresponding TEPs were compared by means of local mean field power and time-frequency spectral analysis. In experiment 2 we stimulated M1 at resting motor threshold in order to elicit MEPs characterized by a wide range of amplitudes. TEPs computed from high-MEP and low-MEP trials were then compared using the same methods applied in experiment 1. In line with previous studies, TMS of M1 produced larger TEPs compared to other cortical stimulations. Notably, we found that only TEPs produced by M1 stimulation were accompanied by a late (∼300 ms after TMS) event-related desynchronization (ERD), whose magnitude was strongly dependent on the amplitude of MEPs. Overall, these results suggest that M1 produces peculiar responses to TMS possibly reflecting specific anatomo-functional properties, such as the re-entry of proprioceptive feedback associated with target muscle activation.

Facilitatory conditioning of the supplementary motor area in humans enhances the corticophrenic responsiveness to transcranial magnetic stimulation

2010 ◽  
Vol 108 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Mathieu Raux ◽  
Haiqun Xie ◽  
Thomas Similowski ◽  
Lisa Koski
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Time Course ◽  
Primary Motor Cortex ◽  
Supplementary Motor Area ◽  
Motor Evoked Potentials ◽  
Motor Area ◽  
Motor Threshold ◽  
Functional Connection ◽  
Resting Motor Threshold

Inspiratory loading in awake humans is associated with electroencephalographic signs of supplementary motor area (SMA) activation. To provide evidence for a functional connection between SMA and the diaphragm representation in the primary motor cortex (M1DIA), we tested the hypothesis that modulating SMA activity using repetitive transcranial magnetic stimulation (rTMS) would alter M1DIA excitability. Amplitude and latency of diaphragm motor evoked potentials (MEPDIA), evoked through single pulse M1DIA stimulation, before and up to 16 min after SMA stimulation, were taken as indicators of M1DIA excitability. MEPs from the first dorsal interosseous muscle (FDI, MEPFDI) served as a control. Four SMA conditioning sessions were performed in random order at 1-wk intervals. Two aimed at increasing SMA activity (5 and 10 Hz, both at 110% of FDI active motor threshold; referred to as 5Hz and 10Hz, respectively), and two aimed at decreasing it (1 Hz either at 110% of FDI active or resting motor threshold, referred to as aMT or rMT, respectively). The 5Hz protocol increased MEPDIA and MEPFDI amplitudes with a maximum 11–16 min poststimulation ( P = 0.04 and P = 0.02, respectively). The 10Hz protocol increased MEPFDI amplitude with a similar time course ( P = 0.03) but did not increase MEPDIA amplitude ( P = 0.32). Both aMT and rMT failed to decrease MEPDIA or MEPFDI amplitudes ( P = 0.23 and P = 0.90, respectively, for diaphragm and P = 0.48 and P = 0.14 for FDI). MEPDIA and MEPFDI latencies were unaffected by rTMS. These results demonstrate that 5-Hz rTMS over the SMA can increase the excitability of M1DIA. These observations are consistent with the hypothesis of a functional connection between SMA and M1DIA.

scholarly journals Probing the Brain–Body Connection Using Transcranial Magnetic Stimulation (TMS): Validating a Promising Tool to Provide Biomarkers of Neuroplasticity and Central Nervous System Function

2021 ◽  
Vol 11 (3) ◽  
pp. 384
Author(s):  
Arthur R. Chaves ◽  
Nicholas J. Snow ◽  
Lynsey R. Alcock ◽  
Michelle Ploughman
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Transcranial Magnetic Stimulation ◽  
Clinical Outcomes ◽  
Cognitive Processing ◽  
Magnetic Stimulation ◽  
Silent Period ◽  
Central Nervous System Dysfunction ◽  
Resting Motor Threshold ◽  
Motor Outcomes

Transcranial magnetic stimulation (TMS) is a non-invasive method used to investigate neurophysiological integrity of the human neuromotor system. We describe in detail, the methodology of a single pulse TMS protocol that was performed in a large cohort of people (n = 110) with multiple sclerosis (MS). The aim was to establish and validate a core-set of TMS variables that predicted typical MS clinical outcomes: walking speed, hand dexterity, fatigue, and cognitive processing speed. We provide a brief and simple methodological pipeline to examine excitatory and inhibitory corticospinal mechanisms in MS that map to clinical status. Delayed and longer ipsilateral silent period (a measure of transcallosal inhibition; the influence of one brain hemisphere’s activity over the other), longer cortical silent period (suggestive of greater corticospinal inhibition via GABA) and higher resting motor threshold (lower corticospinal excitability) most strongly related to clinical outcomes, especially when measured in the hemisphere corresponding to the weaker hand. Greater interhemispheric asymmetry (imbalance between hemispheres) correlated with poorer performance in the greatest number of clinical outcomes. We also show, not surprisingly, that TMS variables related more strongly to motor outcomes than non-motor outcomes. As it was validated in a large sample of patients with varying severities of central nervous system dysfunction, the protocol described herein can be used by investigators and clinicians alike to investigate the role of TMS as a biomarker in MS and other central nervous system disorders.

Transcallosal motor disinhibition to transcranial magnetic stimulation in de novo patients with Celiac disease

2021 ◽  
Vol 429 ◽  
pp. 118559
Author(s):  
Francesco Fisicaro ◽  
Giuseppe Lanza ◽  
Carmela D'Agate ◽  
Raffaele Ferri ◽  
Mariagiovanna Cantone ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
De Novo
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