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94. Increase of periodic limb movement index in obstructive sleep apnea syndrome after CPAP treatment
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Society Proceedings / Clinical Neurophysiology 120 (2009) e147–e180
92. The differences between 0.2 and 0.8 Hz monophasic rTMS effect on SEP in writer’s cramp—Ryo Urushihara, Yuki Hosono, Nagako Murase, Hideki Shimazu, Kotaro Asanuma, Ryuji Kaji (The University of Tokushima, Tokushima, Japan) We have reported that monophasic stimulation has more profound clinical effects on writer’s cramp than biphasic in low frequency repetitive transcranial magnetic stimulation (rTMS) (Hosono et al., 2008). In this study, to optimize the clinical uses of rTMS, we compared the effects of rTMS on somatosensory evoked potentials (SEPs) and pen pressure using different frequencies of monophasic stimulation in writer’s cramp. At 0.2 or 0.8 Hz, 250 monophasic magnetic stimuli were applied over the left premotor cortex in 4 patients with writer’s cramp. Just before and after rTMS, we recorded SEPs from the right median nerve and pen pressure using computer-assisted rating system of handwriting. We compared the changes (subtracted values before from after rTMS) of the amplitudes of each SEP component and pen pressure with paired t-test. The change of N60 component from F3 in 0.2 Hz condition were larger than 0.8 Hz (p < 0.05). In 0.2 Hz condition, pen pressure also shown the larger change than 0.8 Hz (p >< 0.05). Average values of N60 component amplitude and pen pressure tended to decrease after 0.2 Hz rTMS. These results suggest that 0.2 Hz monophasic rTMS has more profound clinical effects on writer’s cramp than 0.8 Hz. doi:10.1016/j.clinph.2009.02.098
93. Hypometabolism on 18FDG-positron emission tomography in medial temporal lobe epilepsy: Correlation with postoperative seizure outcome—Kimiaki Hashiguchi, Takato Morioka, Kazuhiro Samura, Fumiaki Yoshida, Yasushi Miyagi, Tomio Sasaki (Kyushu University, Fukuoka, Japan) Objective: The relationship between the extent of the hypometabolism on 18Fluolodeoxy glucose-positron emission tomography (FDG-PET) and the postoperative seizure outcome was examined in cases with medial temporal lobe epilepsy. Methods: Fifty-six cases who underwent anterior temporal lobectomy were included in this study. The existence of hypometabolism in medial (MTL) and lateral temporal lobe (LTL) was visually evaluated. The outcome was classified according to the Engel’s classification. Results: The outcome was class I in 36 cases, class II in 10 cases, class III in 9 cases and class IV in 1 case. No metabolic change in MTL was observed in 8 cases, and the outcome of these cases was not favorable (class III and IV: 50%). Outcome of the cases with hypometabolism in MTL (21 cases), and both MTL and LTL (26 cases) were similar (class I & II: 81 % and 92%, respectively). In two cases with hypometabolism extended to outside of the unilateral anterior temporal lobe, the surgical outcome was poor (class III: 100%). Conclusions: Favorable outcome is expected if the hypometabolism is localized in MTL and LTL. doi:10.1016/j.clinph.2009.02.099
94. Increase of periodic limb movement index in obstructive sleep apnea syndrome after CPAP treatment—Yasunori Oka, Yuichi Inoue (Japan Somnology Center, Tokyo, Japan) Introduction: Periodic limb movements (PLM) are often seen concurrently in patients with obstructive sleep apnea syndrome
(OSAS), and were reported to increase after CPAP treatment. The aim of our study was to compare the change of PLM index after CPAP treatment among different age groups and different OSAS severity. Methods: Four hundred and eighty-two OSAS patients who underwent both baseline polysomnography (PSG) and CPAP titration PSG were included. Positive PLMI increase was judged when PLMI increased more than 50% at CPAP titration. Patients were divided into young (<40 years), middle aged (40–60 years) and elderly (>60 years) groups. Patients were also divided into severe OSAS (AHI > 30/h) and mild-moderate OSAS (10 < AHI < 30/h). Percentage of patients with positive PLMI increase was compared among the groups. Results: Fifty-seven patients (11.8%) showed positive PLMI increase at CPAP titration. Percentage of patients with PLMI increase was significantly higher in severe OSAS (14.1%) than in mild-moderate OSAS (5.9%). Percentage of patients with PLMI increase was also significantly different among the young group (7.2%), the middle aged group (11.5%) and the elderly group (20.2%). Conclusion: Increase of PLMI after CPAP treatment was more frequent in patients with severe OSAS, and there was a significant age effect on the change of PLMI. doi:10.1016/j.clinph.2009.02.100
95. Altered transcallosal inhibition during action observation of unilateral finger movement through mirror: A TMS study—Hiroyuki Otsuka, Daisuke Matsuzawa, Kenji Numata, Susumu Yoshida, Ken Nakazawa, Eiji Shimizu (Chiba university, Chiba, Japan) Introduction: Mirror Therapy for hemiparetic patients facilitates bilateral movements with illusory visual feedback of the movement. Several lines of evidence indicate that transcallosal inhibition may be reduced bi-directionally during bilateral movements. We hypothesized that the reduction would be involved during action observation of unilateral movement through mirror. Methods: Nine neurologically healthy volunteers were enrolled. Using transcranial magnetic stimulation (TMS), we assessed corticospinal excitability as motor evoked potentials (MEP) of the left (relaxed) abductor pollicis brevis (APB), and transcallosal inhibition as ipsilateral silent period (iSP) of the right APB during two conditions; watching right thumb movement directly (control condition) and right thumb movement reflected in a mirror (mirror condition). Results: Compared to the control condition, the MEP amplitudes were significantly increased in the mirror condition, and the iSP durations were significantly shortened. Conclusions: The results suggest that, in mirror therapy, the excitability of corticospinal output of ipsilateral motor cortex is increased, whereas the transcranial inhibition from ipsilateral to contralateral motor cortex is reduced. Mirror therapy would activate bilateral motor network and thereby improve affected limb. doi:10.1016/j.clinph.2009.02.101
96. Ionic mechanisms for cold paresis in juvenile muscular atrophy of distal upper extremity (Hirayama disease)—Setsu Sawai, Sonoko Misawa, Kazuaki Kanai, Sagiri Isose, Kazumoto Shibuya, Satoshi Kuwabara (Chiba University School of Medicine, Chiba, Japan) Cold paresis is characteristic feature of juvenile muscular atrophy of distal upper extremity (Hirayama disease). The aim of this study was to investigate changes in axonal excitability properties as the
Society Proceedings / Clinical Neurophysiology 120 (2009) e147–e180
92. The differences between 0.2 and 0.8 Hz monophasic rTMS effect on SEP in writer’s cramp—Ryo Urushihara, Yuki Hosono, Nagako Murase, Hideki Shimazu, Kotaro Asanuma, Ryuji Kaji (The University of Tokushima, Tokushima, Japan) We have reported that monophasic stimulation has more profound clinical effects on writer’s cramp than biphasic in low frequency repetitive transcranial magnetic stimulation (rTMS) (Hosono et al., 2008). In this study, to optimize the clinical uses of rTMS, we compared the effects of rTMS on somatosensory evoked potentials (SEPs) and pen pressure using different frequencies of monophasic stimulation in writer’s cramp. At 0.2 or 0.8 Hz, 250 monophasic magnetic stimuli were applied over the left premotor cortex in 4 patients with writer’s cramp. Just before and after rTMS, we recorded SEPs from the right median nerve and pen pressure using computer-assisted rating system of handwriting. We compared the changes (subtracted values before from after rTMS) of the amplitudes of each SEP component and pen pressure with paired t-test. The change of N60 component from F3 in 0.2 Hz condition were larger than 0.8 Hz (p < 0.05). In 0.2 Hz condition, pen pressure also shown the larger change than 0.8 Hz (p >< 0.05). Average values of N60 component amplitude and pen pressure tended to decrease after 0.2 Hz rTMS. These results suggest that 0.2 Hz monophasic rTMS has more profound clinical effects on writer’s cramp than 0.8 Hz. doi:10.1016/j.clinph.2009.02.098
93. Hypometabolism on 18FDG-positron emission tomography in medial temporal lobe epilepsy: Correlation with postoperative seizure outcome—Kimiaki Hashiguchi, Takato Morioka, Kazuhiro Samura, Fumiaki Yoshida, Yasushi Miyagi, Tomio Sasaki (Kyushu University, Fukuoka, Japan) Objective: The relationship between the extent of the hypometabolism on 18Fluolodeoxy glucose-positron emission tomography (FDG-PET) and the postoperative seizure outcome was examined in cases with medial temporal lobe epilepsy. Methods: Fifty-six cases who underwent anterior temporal lobectomy were included in this study. The existence of hypometabolism in medial (MTL) and lateral temporal lobe (LTL) was visually evaluated. The outcome was classified according to the Engel’s classification. Results: The outcome was class I in 36 cases, class II in 10 cases, class III in 9 cases and class IV in 1 case. No metabolic change in MTL was observed in 8 cases, and the outcome of these cases was not favorable (class III and IV: 50%). Outcome of the cases with hypometabolism in MTL (21 cases), and both MTL and LTL (26 cases) were similar (class I & II: 81 % and 92%, respectively). In two cases with hypometabolism extended to outside of the unilateral anterior temporal lobe, the surgical outcome was poor (class III: 100%). Conclusions: Favorable outcome is expected if the hypometabolism is localized in MTL and LTL. doi:10.1016/j.clinph.2009.02.099
94. Increase of periodic limb movement index in obstructive sleep apnea syndrome after CPAP treatment—Yasunori Oka, Yuichi Inoue (Japan Somnology Center, Tokyo, Japan) Introduction: Periodic limb movements (PLM) are often seen concurrently in patients with obstructive sleep apnea syndrome
(OSAS), and were reported to increase after CPAP treatment. The aim of our study was to compare the change of PLM index after CPAP treatment among different age groups and different OSAS severity. Methods: Four hundred and eighty-two OSAS patients who underwent both baseline polysomnography (PSG) and CPAP titration PSG were included. Positive PLMI increase was judged when PLMI increased more than 50% at CPAP titration. Patients were divided into young (<40 years), middle aged (40–60 years) and elderly (>60 years) groups. Patients were also divided into severe OSAS (AHI > 30/h) and mild-moderate OSAS (10 < AHI < 30/h). Percentage of patients with positive PLMI increase was compared among the groups. Results: Fifty-seven patients (11.8%) showed positive PLMI increase at CPAP titration. Percentage of patients with PLMI increase was significantly higher in severe OSAS (14.1%) than in mild-moderate OSAS (5.9%). Percentage of patients with PLMI increase was also significantly different among the young group (7.2%), the middle aged group (11.5%) and the elderly group (20.2%). Conclusion: Increase of PLMI after CPAP treatment was more frequent in patients with severe OSAS, and there was a significant age effect on the change of PLMI. doi:10.1016/j.clinph.2009.02.100
95. Altered transcallosal inhibition during action observation of unilateral finger movement through mirror: A TMS study—Hiroyuki Otsuka, Daisuke Matsuzawa, Kenji Numata, Susumu Yoshida, Ken Nakazawa, Eiji Shimizu (Chiba university, Chiba, Japan) Introduction: Mirror Therapy for hemiparetic patients facilitates bilateral movements with illusory visual feedback of the movement. Several lines of evidence indicate that transcallosal inhibition may be reduced bi-directionally during bilateral movements. We hypothesized that the reduction would be involved during action observation of unilateral movement through mirror. Methods: Nine neurologically healthy volunteers were enrolled. Using transcranial magnetic stimulation (TMS), we assessed corticospinal excitability as motor evoked potentials (MEP) of the left (relaxed) abductor pollicis brevis (APB), and transcallosal inhibition as ipsilateral silent period (iSP) of the right APB during two conditions; watching right thumb movement directly (control condition) and right thumb movement reflected in a mirror (mirror condition). Results: Compared to the control condition, the MEP amplitudes were significantly increased in the mirror condition, and the iSP durations were significantly shortened. Conclusions: The results suggest that, in mirror therapy, the excitability of corticospinal output of ipsilateral motor cortex is increased, whereas the transcranial inhibition from ipsilateral to contralateral motor cortex is reduced. Mirror therapy would activate bilateral motor network and thereby improve affected limb. doi:10.1016/j.clinph.2009.02.101
96. Ionic mechanisms for cold paresis in juvenile muscular atrophy of distal upper extremity (Hirayama disease)—Setsu Sawai, Sonoko Misawa, Kazuaki Kanai, Sagiri Isose, Kazumoto Shibuya, Satoshi Kuwabara (Chiba University School of Medicine, Chiba, Japan) Cold paresis is characteristic feature of juvenile muscular atrophy of distal upper extremity (Hirayama disease). The aim of this study was to investigate changes in axonal excitability properties as the