Effects of internal globus pallidus stimulation on motor cortex excitability
Identifieur interne : 000B12 ( PascalFrancis/Checkpoint ); précédent : 000B11; suivant : 000B13Effects of internal globus pallidus stimulation on motor cortex excitability
Auteurs : Robert Chen [Canada] ; Rami R. Garg [Canada] ; Andres M. Lozano [Canada] ; Anthony E. Lang [Canada]Source :
- Neurology [ 0028-3878 ] ; 2001.
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- Pascal (Inist)
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- topic : Adulte.
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Abstract
Article abstract-Background: Deep brain stimulation is a promising treatment for PD, but its physiologic effects and mechanisms of action remain poorly understood. Magnetic stimulation studies have revealed abnormalities in several different excitatory and inhibitory circuits in the motor cortex in PD. Methods: The physiologic effects of internal globus pallidus (GPi) stimulation in seven patients with PD and seven age-matched healthy volunteers were studied. The stimulators were set at the optimal parameters (ON), at half the optimal amplitude (Half-Amp), or switched off (OFF) in random order. Patients were taking their usual medications. Magnetic stimulation was applied to the motor cortex, and motor evoked potentials (MEP) were recorded from the contralateral first dorsal interosseous muscle. Several excitatory and inhibitory pathways that have been found to be abnormal in PD were tested. Results: The motor threshold (MT), MEP recruitment curve (stimulus intensities from 100 to 150% of MT), short and long interval intracortical inhibition, and intracortical facilitation were similar in the three stimulator conditions tested both at rest and during voluntary contraction. The silent period (SP) was longer in the OFF and Half-Amp conditions than in normal control subjects. In the stimulator ON condition, the SP was significantly reduced compared with the OFF condition and became similar to that in normal control subjects. Conclusions: GPi stimulation while on dopaminergic medications reduced the SP following magnetic stimulation but did not change corticospinal excitability or other measures of intracortical inhibition and facilitation. The reduction of SP may be related to the antidyskinetic and levodopa-blocking effects of ventral GPi stimulation.
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Garg</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Division of Neurology, Toronto Western Hospital and Toronto Western Research Institute, University Health Network, University of Toronto</s1><s2>Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Division of Neurosurgery, Toronto Western Hospital and Toronto Western Research Institute, University Health Network, University of Toronto</s1><s2>Ontario</s2><s3>CAN</s3><sZ>3 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. 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Garg</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Division of Neurology, Toronto Western Hospital and Toronto Western Research Institute, University Health Network, University of Toronto</s1><s2>Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Division of Neurosurgery, Toronto Western Hospital and Toronto Western Research Institute, University Health Network, University of Toronto</s1><s2>Ontario</s2><s3>CAN</s3><sZ>3 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Division of Neurology, Toronto Western Hospital and Toronto Western Research Institute, University Health Network, University of Toronto</s1><s2>Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author></analytic><series><title level="j" type="main">Neurology</title><title level="j" type="abbreviated">Neurology</title><idno type="ISSN">0028-3878</idno><imprint><date when="2001">2001</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Neurology</title><title level="j" type="abbreviated">Neurology</title><idno type="ISSN">0028-3878</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Electrical stimulus</term><term>Excitability</term><term>Exploration</term><term>Instrumentation therapy</term><term>Magnetic stimulus</term><term>Motor cortex</term><term>Motor evoked potential</term><term>Pallidum</term><term>Parkinson disease</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Parkinson maladie</term><term>Stimulus électrique</term><term>Pallidum</term><term>Stimulus magnétique</term><term>Cortex moteur</term><term>Potentiel évoqué moteur</term><term>Excitabilité</term><term>Traitement instrumental</term><term>Exploration</term><term>Adulte</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Adulte</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Article abstract-Background: Deep brain stimulation is a promising treatment for PD, but its physiologic effects and mechanisms of action remain poorly understood. Magnetic stimulation studies have revealed abnormalities in several different excitatory and inhibitory circuits in the motor cortex in PD. Methods: The physiologic effects of internal globus pallidus (GPi) stimulation in seven patients with PD and seven age-matched healthy volunteers were studied. The stimulators were set at the optimal parameters (ON), at half the optimal amplitude (Half-Amp), or switched off (OFF) in random order. Patients were taking their usual medications. Magnetic stimulation was applied to the motor cortex, and motor evoked potentials (MEP) were recorded from the contralateral first dorsal interosseous muscle. Several excitatory and inhibitory pathways that have been found to be abnormal in PD were tested. Results: The motor threshold (MT), MEP recruitment curve (stimulus intensities from 100 to 150% of MT), short and long interval intracortical inhibition, and intracortical facilitation were similar in the three stimulator conditions tested both at rest and during voluntary contraction. The silent period (SP) was longer in the OFF and Half-Amp conditions than in normal control subjects. In the stimulator ON condition, the SP was significantly reduced compared with the OFF condition and became similar to that in normal control subjects. Conclusions: GPi stimulation while on dopaminergic medications reduced the SP following magnetic stimulation but did not change corticospinal excitability or other measures of intracortical inhibition and facilitation. The reduction of SP may be related to the antidyskinetic and levodopa-blocking effects of ventral GPi stimulation.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0028-3878</s0></fA01><fA02 i1="01"><s0>NEURAI</s0></fA02><fA03 i2="1"><s0>Neurology</s0></fA03><fA05><s2>56</s2></fA05><fA06><s2>6</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Effects of internal globus pallidus stimulation on motor cortex excitability</s1></fA08><fA11 i1="01" i2="1"><s1>CHEN (Robert)</s1></fA11><fA11 i1="02" i2="1"><s1>GARG (Rami R.)</s1></fA11><fA11 i1="03" i2="1"><s1>LOZANO (Andres M.)</s1></fA11><fA11 i1="04" i2="1"><s1>LANG (Anthony E.)</s1></fA11><fA14 i1="01"><s1>Division of Neurology, Toronto Western Hospital and Toronto Western Research Institute, University Health Network, University of Toronto</s1><s2>Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ></fA14><fA14 i1="02"><s1>Division of Neurosurgery, Toronto Western Hospital and Toronto Western Research Institute, University Health Network, University of Toronto</s1><s2>Ontario</s2><s3>CAN</s3><sZ>3 aut.</sZ></fA14><fA20><s1>716-723</s1></fA20><fA21><s1>2001</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>6345</s2><s5>354000098749010050</s5></fA43><fA44><s0>0000</s0><s1>© 2001 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>50 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>01-0194465</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Neurology</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Article abstract-Background: Deep brain stimulation is a promising treatment for PD, but its physiologic effects and mechanisms of action remain poorly understood. Magnetic stimulation studies have revealed abnormalities in several different excitatory and inhibitory circuits in the motor cortex in PD. Methods: The physiologic effects of internal globus pallidus (GPi) stimulation in seven patients with PD and seven age-matched healthy volunteers were studied. The stimulators were set at the optimal parameters (ON), at half the optimal amplitude (Half-Amp), or switched off (OFF) in random order. Patients were taking their usual medications. Magnetic stimulation was applied to the motor cortex, and motor evoked potentials (MEP) were recorded from the contralateral first dorsal interosseous muscle. Several excitatory and inhibitory pathways that have been found to be abnormal in PD were tested. Results: The motor threshold (MT), MEP recruitment curve (stimulus intensities from 100 to 150% of MT), short and long interval intracortical inhibition, and intracortical facilitation were similar in the three stimulator conditions tested both at rest and during voluntary contraction. The silent period (SP) was longer in the OFF and Half-Amp conditions than in normal control subjects. In the stimulator ON condition, the SP was significantly reduced compared with the OFF condition and became similar to that in normal control subjects. Conclusions: GPi stimulation while on dopaminergic medications reduced the SP following magnetic stimulation but did not change corticospinal excitability or other measures of intracortical inhibition and facilitation. The reduction of SP may be related to the antidyskinetic and levodopa-blocking effects of ventral GPi stimulation.</s0></fC01><fC02 i1="01" i2="X"><s0>002B26I</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Parkinson maladie</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Parkinson disease</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Parkinson enfermedad</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Stimulus électrique</s0><s5>04</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Electrical stimulus</s0><s5>04</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Estímulo eléctrico</s0><s5>04</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Pallidum</s0><s5>05</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Pallidum</s0><s5>05</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Pallidum</s0><s5>05</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Stimulus magnétique</s0><s5>07</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Magnetic stimulus</s0><s5>07</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Estímulo magnético</s0><s5>07</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Cortex moteur</s0><s5>08</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Motor cortex</s0><s5>08</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Corteza motora</s0><s5>08</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Potentiel évoqué moteur</s0><s5>10</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Motor evoked potential</s0><s5>10</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Potencial evocado motor</s0><s5>10</s5></fC03><fC03 i1="07" i2="X" l="FRE"><s0>Excitabilité</s0><s5>13</s5></fC03><fC03 i1="07" i2="X" l="ENG"><s0>Excitability</s0><s5>13</s5></fC03><fC03 i1="07" i2="X" l="SPA"><s0>Excitabilidad</s0><s5>13</s5></fC03><fC03 i1="08" i2="X" l="FRE"><s0>Traitement instrumental</s0><s5>17</s5></fC03><fC03 i1="08" i2="X" l="ENG"><s0>Instrumentation therapy</s0><s5>17</s5></fC03><fC03 i1="08" i2="X" l="SPA"><s0>Tratamiento instrumental</s0><s5>17</s5></fC03><fC03 i1="09" i2="X" l="FRE"><s0>Exploration</s0><s5>18</s5></fC03><fC03 i1="09" i2="X" l="ENG"><s0>Exploration</s0><s5>18</s5></fC03><fC03 i1="09" i2="X" l="SPA"><s0>Exploración</s0><s5>18</s5></fC03><fC03 i1="10" i2="X" l="FRE"><s0>Adulte</s0><s5>20</s5></fC03><fC03 i1="10" i2="X" l="ENG"><s0>Adult</s0><s5>20</s5></fC03><fC03 i1="10" i2="X" l="SPA"><s0>Adulto</s0><s5>20</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Homme</s0></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Human</s0></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Hombre</s0></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Système nerveux pathologie</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>37</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Système nerveux central pathologie</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Central nervous system disease</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0><s5>38</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Encéphale pathologie</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Cerebral disorder</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Encéfalo patología</s0><s5>39</s5></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Extrapyramidal syndrome</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0><s5>40</s5></fC07><fC07 i1="06" i2="X" l="FRE"><s0>Maladie dégénérative</s0><s5>41</s5></fC07><fC07 i1="06" i2="X" l="ENG"><s0>Degenerative disease</s0><s5>41</s5></fC07><fC07 i1="06" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0><s5>41</s5></fC07><fC07 i1="07" i2="X" l="FRE"><s0>Stimulation instrumentale</s0><s5>45</s5></fC07><fC07 i1="07" i2="X" l="ENG"><s0>Instrumental stimulation</s0><s5>45</s5></fC07><fC07 i1="07" i2="X" l="SPA"><s0>Estimulación instrumental</s0><s5>45</s5></fC07><fC07 i1="08" i2="X" l="FRE"><s0>Electrodiagnostic</s0><s5>53</s5></fC07><fC07 i1="08" i2="X" l="ENG"><s0>Electrodiagnosis</s0><s5>53</s5></fC07><fC07 i1="08" i2="X" l="SPA"><s0>Electrodiagnóstico</s0><s5>53</s5></fC07><fN21><s1>134</s1></fN21></pA></standard></inist><affiliations><list><country><li>Canada</li></country><region><li>Ontario</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><country name="Canada"><region name="Ontario"><name sortKey="Chen, Robert" sort="Chen, Robert" uniqKey="Chen R" first="Robert" last="Chen">Robert Chen</name></region><name sortKey="Garg, Rami R" sort="Garg, Rami R" uniqKey="Garg R" first="Rami R." last="Garg">Rami R. Garg</name><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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