Superconditioning TMS for examining upper motor neuron function in MND.

Superconditioning TMS for examining upper motor neuron function in MND.

Publication date: Jun 07, 2019

We used transcranial magnetic stimulation (TMS) of motor cortex, including a novel four-pulse superconditioning (TMSsc) paradigm, in repeated examinations of motor-evoked potentials (MEPs) in eight subjects with motor neuron disease (MND), including seven with amyotrophic lateral sclerosis (ALS). The goals were: (1) to look for evidence of cortical hyperexcitability, including a reduction in short-interval intracortical inhibition (SICI); and (2) to examine the utility of using TMSsc for quantifying upper motor neuron function during MND progression. Testing of abductor pollicis brevis (APB) and tibialis anterior (TA) muscles bilaterally was carried out every 3 months in MND subjects for up to 2 years; results were compared to those from a cohort of 15 control subjects. Measures of SICI were not significantly different between control and MND subjects for either APB or TA muscles. Other measures of cortical excitability, including TMS threshold and MEP amplitude, were consistent with lowered cortical excitability in MND subjects. Certain combinations of superconditioning TMS were capable of causing stronger inhibition or facilitation of MEPs compared to dual-pulse TMS, for both APB and TA target muscles. Moreover, there were multiple cases in which target muscles unresponsive to strong single-pulse TMS, whether at rest or when tested with an active contraction, showed an MEP in response to TMSsc optimized for facilitation. Our findings suggest that a multi-faceted neurophysiologic protocol for examining upper motor neuron function in MND subjects might benefit from inclusion of TMSsc testing.

Calancie, B., Young, E., Watson, M.L., Wang, D., and Alexeeva, N. Superconditioning TMS for examining upper motor neuron function in MND. 18280. 2019 Exp Brain Res.

Concepts Keywords
Abductor Pollicis Brevis Faceted neurophysiologic protocol
ALS Contraction
Amplitude MND
Amyotrophic Lateral Sclerosis ALS
Cohort Neuroscience
Cortical Branches of biology
MEP Nervous system
Motor Cortex Motor system
Motor Evoked Potentials Rare diseases
Motor Neuron Efferent neurons
Paradigm Neurophysiology
Protocol Electrotherapy
Tibialis Anterior Motor neuron disease
Transcranial Magnetic Stimulation Transcranial magnetic stimulation
Upper Motor Neuron Evoked potential
Amyotrophic lateral sclerosis
Faceted neurophysiologic protocol

Semantics

Type Source Name
disease MESH multi
gene UNIPROT REST
disease MESH multiple
gene UNIPROT NLN
gene UNIPROT CTSL
gene UNIPROT RNPEP
gene UNIPROT SOD1
gene UNIPROT IGFALS
disease DOID amyotrophic lateral sclerosis
disease MESH amyotrophic lateral sclerosis
disease DOID motor neuron disease
disease MESH motor neuron disease
gene UNIPROT PYCARD
gene UNIPROT TYMS
drug DRUGBANK Tilmicosin

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