- Email: [email protected]
PTMS23 Intracortical circuits and cortical plasticity in facial muscles
14th ECCN / 4th ICTMS/DCS excitability was evaluated before and after navigation-guided 5 Hz-rTMS of the primary motor cortex corresponding to the painful hand. Resting motor threshold, amplitude of motor evoked potential, duration of cortical silent period, short interval intracortical inhibition (SICI) and intracortical facilitation (ICF) were measured as parameters of cortical excitability with single- or paired-pulse TMS methods. Pain reduction of rTMS was assessed with a visual analogue scale (VAS). Results: Eight of 20 patients showed 30% pain reduction in their VAS after rTMS (good responders). SICI in all patients and ICF in good responders were significantly lower than those in the controls at baseline (0.34±0.40 vs. 0.55±0.17, p = 0.045 and 1.10±0.35 vs. 1.71±0.79, p = 0.034, respectively) which were in line with previous reports. The rate of ICF increase in good responders after rTMS was significantly larger than that in the other patients (1.60±0.67 vs. 1.04±0.41, p = 0.042). There were no significant differences or changes in the other parameters. Conclusions: Our findings suggested that restoration of abnormal cortical excitability might be one of the mechanisms underlying pain relief as a result of rTMS in CPSP.
S187 Results: In both relaxed and active DAO, MEP amplitude was decreased (p < 0.001) at 2 3 ms ISIs, and increased (p < 0.001) at 10 15 ms ISIs, after paired pulse TMS. Facial nerve stimulation in the SAI paradigm did not affect MEP amplitude, either in the active or in the relaxed DAO. By contrast it was significantly increased after PAS both in resting (p = 0.047) and active (p = 0.008) conditions. Interestingly, this effect was more prominent after 0 10 min (early plasticity; p = 0.011) in the relaxed DAO and after 20 30 min (late plasticity p = 0.005) in the active DAO. Conclusions: SICI and ICF circuits are active in the facial motor cortex both in resting and active conditions. First evidence of LTP-like plasticity in FM is reported. Further studies are needed to understand how and why PAS works in FM despite the absence of SAI. A second point to be clarified is the different PAS time course in resting and active states. PTMS24 Modulation of sensorimotor cortex by repetitive peripheral magnetic stimulation E. Gallasch1 , M. Christova1 , D. Rafolt2 , A. Kunz3 , S. Golaszewski3 Department of Physiology, Medical University of Graz, Graz, Austria, 2 Center for Medical Physics and Biomedical Engineering, Vienna, Austria, 3 Department of Neurology, Paracelsus Medical University of Salzburg, Salzburg, Austria
1
PTMS22 Motor cortex remodeling in young epileptic cerebral palsy patient F. Pilato1 , F. Capone1 , P. Profice1 , R. Di Iorio1 , M. Dileone1 , D. Battaglia2 , F. Ranieri1 , L. Florio1 , M. Caulo1 , V. Di Lazzaro1 1 Dept. of Neuroscience, Rome, Italy, 2 Istituto di Neuropsichiatria Infantile, Rome, Italy
PTMS23 Intracortical circuits and cortical plasticity in facial muscles
Introduction: Repetitive peripheral magnetic stimulation (rPMS), applied transcutaneously to the muscle, has been developed for treatment of motor deficits after stroke. Objective: The study investigates the cortical neuromodulatory effect of rPMS in healthy subjects using Transcranial Magnetic Stimulation (TMS) and fMRI. Methods: Three groups were investigated: rPMS-25 Hz, rPMS-10 Hz and rPMS-sham. pRMS was delivered on the right forearm (over the flexor carpi radialis muscle) with figure of eight coil with intensity 150% of the individual motor threshold (24 29% of the max output of the stimulator) in a pattern 10 s on 10 s off. The stimulation duration was 20 min. The measured TMS parameters were: recruitment curve (RC), Shortlasting Intracortical inhibition (SICI) and intracortical facilitation (ICF). Five assessments were performed: T0 (pre), T1 (post 0 min), T2 (post 30 min), T3 (post1 h), T4 (post 2 h). MEPs were recorded from flexor carpi radialis (FCR) and extensor carpi radialis (ECR) muscle. Additionally the rPMS-25 Hz was examined with fMRI at pre- and post-stimulation on 22 subjects. Results: rPMS-10 Hz did not cause prominent effects in RC. In contrast rPMS-25 Hz induced significant increase lasting up to 30 min post stimulation. The effect is reversible after the first hour. Sham stimulation induced no effect which shows that the changes are specific. No changes were observed at the antagonist ECR. rPMS-25 Hz induced decrease in SICI and a tendency of increased ICF only at the stimulated muscle. Results from fMRI assessments will be further discussed. Conclusions: The post-stimulation effects give evidence for a functional reorganization of the motor cortex after rPMS-25 Hz. The present results are provide important information about proper stimulation set and have the potential to prove the clinical application of rPMS in neurorehabilitation.
G. Pilurzi1 , A. Hasan2 , M. Van den Bos2 , E. Tolu1 , F. Deriu1 , J. Rothwell2 Dept. Biomedical Sciences, University of Sassari, Sassari, Italy, 2 Sobell Dept. of Neuroscience and Movement Disorders, Institute of Neurology, UCL, London, United Kingdom
PTMS25 Long-term effects induced by quadripulse stimulation in Huntington’s disease
Introduction: Here we describe pre- and post-operative neurophysiological and functional Magnetic Resonance Imaging (fMRI) findings in a young epileptic girl with right hemiplegic cerebral palsy. Objectives: Aim of the study was to demonstrate the feasibility of Transcranial magnetic stimulation (TMS) and fMRI for predicting a postsurgical outcome and for evaluating functional cortical reorganization. Methods: We used TMS and fMRI to evaluate the excitability of the human motor cortex and cortical map representation before and after functional hemispherectomy. TMS was performed using single and paired pulse stimulation protocol. Cortical silent periods (CSPs), short interval intracortical inhibition (SICI), volume, area and center of gravity (CoG) of cortical map representation were studied before and after surgery. fMRI was done using the Blood oxygenation level dependent (BOLD) technique with block-designed protocols. Results: After surgery the patient showed an improvement of her clinical status and TMS and fMRI demonstrated a reshaping of cortical representation of motor cortex and a significant reduction of Cortical Silent Periods (CSP). Conclusions: Before surgery, the combination of a clinical, neurophysiological and neuroradiological approach may be predictable of the neurological outcome in epileptic patients. Moreover the patient we describe provides new pieces of information in the mechanisms of plasticity underlying motor recovery after epilepsy surgery.
1
Introduction: The role of intracortical circuits in the modulation of facial muscle (FM) activity is controversial and both sensorimotor integration and LTP-like plasticity, which play an important role in motor learning, have never been investigated in the cranial district. Objectives: To investigate, in FM of normal subjects, short-interval intracortical inhibition (SICI), intracortical facilitation (ICF), shortafferent inhibition (SAI) and effects of paired associative stimulation (PAS). Methods: MEPs were evoked in relaxed and active contralateral depressor angulis oris (DAO) muscle of 9 subjects. SICI and ICF were tested by paired pulse TMS: intestimulus intervals (ISI): 2 3 ms and 10 15 ms. SAI was tested in 5 subjects by pairing (ISIs: 5, 10, 15, 20, 25, 30 ms) the electrical stimulation (ES) of the facial nerve, with TMS of the facial motor cortex. Resting and active MEPs were acquired (n = 20) before and after PAS (200 pairs of ES and TMS; 20 ms ISI, 0.25 Hz, at rest). PAS effects were tested after 0 10 min and 20 30 min. ANOVA and post hoc t-Test were done.
O. Shinya1 , Y. Terao1 , Y. Shirota1 , R. Tsutsumi1 , J. Goto1 , Y. Ichikawa1 , S. Tsuji1 , Y. Ugawa2 , R. Hanajima1 1 Department of Neurology, University of Tokyo, 7 3-1, Hongo, Bunkyo-ku Tokyo, Japan, 2 Department of Neurology, Fukushima Medical University, 1, Hikarigaoka, Fukushima-city, Fukuhima, Japan Introduction: In Huntington’s disease (HD) patients, conventional repetitive transcranial magnetic stimulation (rTMS) did not induce long term potentiation (LTP)-like effects and continuous theta burst stimulation (cTBS) did not long term depression (LTD)-like effects, which indicates abnormal cortical plasticity in HD. Objectives: To see whether a newly developed, powerful quadripulse stimulation (QPS) (Hamada M et al. Clin Neurophysiol 2007; 118: 2672 and J Physiol 2008; 586: 3927) is able to induce some plastic changes in HD. Methods: Five HD patients were recruited. Motor evoked potentials (MEPs) to a single pulse TMS were recorded from the first dorsal interossei (FDI) muscle at more affected side before and after QPS. QPS protocol
S187 Results: In both relaxed and active DAO, MEP amplitude was decreased (p < 0.001) at 2 3 ms ISIs, and increased (p < 0.001) at 10 15 ms ISIs, after paired pulse TMS. Facial nerve stimulation in the SAI paradigm did not affect MEP amplitude, either in the active or in the relaxed DAO. By contrast it was significantly increased after PAS both in resting (p = 0.047) and active (p = 0.008) conditions. Interestingly, this effect was more prominent after 0 10 min (early plasticity; p = 0.011) in the relaxed DAO and after 20 30 min (late plasticity p = 0.005) in the active DAO. Conclusions: SICI and ICF circuits are active in the facial motor cortex both in resting and active conditions. First evidence of LTP-like plasticity in FM is reported. Further studies are needed to understand how and why PAS works in FM despite the absence of SAI. A second point to be clarified is the different PAS time course in resting and active states. PTMS24 Modulation of sensorimotor cortex by repetitive peripheral magnetic stimulation E. Gallasch1 , M. Christova1 , D. Rafolt2 , A. Kunz3 , S. Golaszewski3 Department of Physiology, Medical University of Graz, Graz, Austria, 2 Center for Medical Physics and Biomedical Engineering, Vienna, Austria, 3 Department of Neurology, Paracelsus Medical University of Salzburg, Salzburg, Austria
1
PTMS22 Motor cortex remodeling in young epileptic cerebral palsy patient F. Pilato1 , F. Capone1 , P. Profice1 , R. Di Iorio1 , M. Dileone1 , D. Battaglia2 , F. Ranieri1 , L. Florio1 , M. Caulo1 , V. Di Lazzaro1 1 Dept. of Neuroscience, Rome, Italy, 2 Istituto di Neuropsichiatria Infantile, Rome, Italy
PTMS23 Intracortical circuits and cortical plasticity in facial muscles
Introduction: Repetitive peripheral magnetic stimulation (rPMS), applied transcutaneously to the muscle, has been developed for treatment of motor deficits after stroke. Objective: The study investigates the cortical neuromodulatory effect of rPMS in healthy subjects using Transcranial Magnetic Stimulation (TMS) and fMRI. Methods: Three groups were investigated: rPMS-25 Hz, rPMS-10 Hz and rPMS-sham. pRMS was delivered on the right forearm (over the flexor carpi radialis muscle) with figure of eight coil with intensity 150% of the individual motor threshold (24 29% of the max output of the stimulator) in a pattern 10 s on 10 s off. The stimulation duration was 20 min. The measured TMS parameters were: recruitment curve (RC), Shortlasting Intracortical inhibition (SICI) and intracortical facilitation (ICF). Five assessments were performed: T0 (pre), T1 (post 0 min), T2 (post 30 min), T3 (post1 h), T4 (post 2 h). MEPs were recorded from flexor carpi radialis (FCR) and extensor carpi radialis (ECR) muscle. Additionally the rPMS-25 Hz was examined with fMRI at pre- and post-stimulation on 22 subjects. Results: rPMS-10 Hz did not cause prominent effects in RC. In contrast rPMS-25 Hz induced significant increase lasting up to 30 min post stimulation. The effect is reversible after the first hour. Sham stimulation induced no effect which shows that the changes are specific. No changes were observed at the antagonist ECR. rPMS-25 Hz induced decrease in SICI and a tendency of increased ICF only at the stimulated muscle. Results from fMRI assessments will be further discussed. Conclusions: The post-stimulation effects give evidence for a functional reorganization of the motor cortex after rPMS-25 Hz. The present results are provide important information about proper stimulation set and have the potential to prove the clinical application of rPMS in neurorehabilitation.
G. Pilurzi1 , A. Hasan2 , M. Van den Bos2 , E. Tolu1 , F. Deriu1 , J. Rothwell2 Dept. Biomedical Sciences, University of Sassari, Sassari, Italy, 2 Sobell Dept. of Neuroscience and Movement Disorders, Institute of Neurology, UCL, London, United Kingdom
PTMS25 Long-term effects induced by quadripulse stimulation in Huntington’s disease
Introduction: Here we describe pre- and post-operative neurophysiological and functional Magnetic Resonance Imaging (fMRI) findings in a young epileptic girl with right hemiplegic cerebral palsy. Objectives: Aim of the study was to demonstrate the feasibility of Transcranial magnetic stimulation (TMS) and fMRI for predicting a postsurgical outcome and for evaluating functional cortical reorganization. Methods: We used TMS and fMRI to evaluate the excitability of the human motor cortex and cortical map representation before and after functional hemispherectomy. TMS was performed using single and paired pulse stimulation protocol. Cortical silent periods (CSPs), short interval intracortical inhibition (SICI), volume, area and center of gravity (CoG) of cortical map representation were studied before and after surgery. fMRI was done using the Blood oxygenation level dependent (BOLD) technique with block-designed protocols. Results: After surgery the patient showed an improvement of her clinical status and TMS and fMRI demonstrated a reshaping of cortical representation of motor cortex and a significant reduction of Cortical Silent Periods (CSP). Conclusions: Before surgery, the combination of a clinical, neurophysiological and neuroradiological approach may be predictable of the neurological outcome in epileptic patients. Moreover the patient we describe provides new pieces of information in the mechanisms of plasticity underlying motor recovery after epilepsy surgery.
1
Introduction: The role of intracortical circuits in the modulation of facial muscle (FM) activity is controversial and both sensorimotor integration and LTP-like plasticity, which play an important role in motor learning, have never been investigated in the cranial district. Objectives: To investigate, in FM of normal subjects, short-interval intracortical inhibition (SICI), intracortical facilitation (ICF), shortafferent inhibition (SAI) and effects of paired associative stimulation (PAS). Methods: MEPs were evoked in relaxed and active contralateral depressor angulis oris (DAO) muscle of 9 subjects. SICI and ICF were tested by paired pulse TMS: intestimulus intervals (ISI): 2 3 ms and 10 15 ms. SAI was tested in 5 subjects by pairing (ISIs: 5, 10, 15, 20, 25, 30 ms) the electrical stimulation (ES) of the facial nerve, with TMS of the facial motor cortex. Resting and active MEPs were acquired (n = 20) before and after PAS (200 pairs of ES and TMS; 20 ms ISI, 0.25 Hz, at rest). PAS effects were tested after 0 10 min and 20 30 min. ANOVA and post hoc t-Test were done.
O. Shinya1 , Y. Terao1 , Y. Shirota1 , R. Tsutsumi1 , J. Goto1 , Y. Ichikawa1 , S. Tsuji1 , Y. Ugawa2 , R. Hanajima1 1 Department of Neurology, University of Tokyo, 7 3-1, Hongo, Bunkyo-ku Tokyo, Japan, 2 Department of Neurology, Fukushima Medical University, 1, Hikarigaoka, Fukushima-city, Fukuhima, Japan Introduction: In Huntington’s disease (HD) patients, conventional repetitive transcranial magnetic stimulation (rTMS) did not induce long term potentiation (LTP)-like effects and continuous theta burst stimulation (cTBS) did not long term depression (LTD)-like effects, which indicates abnormal cortical plasticity in HD. Objectives: To see whether a newly developed, powerful quadripulse stimulation (QPS) (Hamada M et al. Clin Neurophysiol 2007; 118: 2672 and J Physiol 2008; 586: 3927) is able to induce some plastic changes in HD. Methods: Five HD patients were recruited. Motor evoked potentials (MEPs) to a single pulse TMS were recorded from the first dorsal interossei (FDI) muscle at more affected side before and after QPS. QPS protocol