Increased intracortical inhibition in hyperglycemic hemichorea-hemiballism.
Identifieur interne : 000207 ( Main/Exploration ); précédent : 000206; suivant : 000208Increased intracortical inhibition in hyperglycemic hemichorea-hemiballism.
Auteurs : Jie-Yuan Li [République populaire de Chine] ; Robert ChenSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2015.
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Chorea (therapy), Dyskinesias (etiology), Dyskinesias (therapy), Evoked Potentials, Motor (drug effects), Female, Humans, Hyperglycemia (complications), Hyperglycemia (therapy), Male, Middle Aged, Motor Cortex (drug effects), Motor Cortex (surgery), Psychomotor Agitation (therapy), Transcranial Magnetic Stimulation (methods), gamma-Aminobutyric Acid (therapeutic use).
- MESH :
- chemical , therapeutic use : gamma-Aminobutyric Acid.
- complications : Hyperglycemia.
- drug effects : Evoked Potentials, Motor, Motor Cortex.
- etiology : Dyskinesias.
- methods : Transcranial Magnetic Stimulation.
- surgery : Motor Cortex.
- therapy : Chorea, Dyskinesias, Hyperglycemia, Psychomotor Agitation.
- Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged.
Abstract
Hemichorea-hemiballism (HC-HB) in uncontrolled diabetes mellitus is an uncommon manifestation of hyperglycemia. The pathophysiology of hyperglycemic HC-HB is not well understood. A previous report showed increased intracortical inhibition in the motor cortex in a patient with diabetes with HC-HB. The objective of this study is to investigate motor cortex excitability in patients with hyperglycemic HC-HB. We hypothesized that intracortical inhibition measured with transcranial magnetic stimulation, which likely reflects the excitability of cortical γ-aminobutyric acid (GABA)ergic circuits, would be impaired in patients with hyperglycemic HC-HB. We studied 15 patients with mean age 71.5 years (range, 48-94 y) and 12 age-matched healthy subjects. The motor cortex contralateral to the hemichorea was tested. Transcranial magnetic stimulation measures included motor evoked potential, recruitment curve, GABAA mediated short interval intracortical inhibition, intracortical facilitation, and GABAB mediated silent period duration and long interval intracortical inhibition. No significant difference was found in motor threshold, recruitment curve response, short interval intracortical inhibition, or intracortical facilitation in both rest and active conditions between patients with hyperglycemic HC-HB and normal subjects. However, long interval intracortical inhibition was significantly increased during muscle activation but not at rest in patients with hyperglycemic HC-HB. The silent period duration is also increased in patients with hyperglycemic HC-HB. We concluded that long interval intracortical inhibition and silent period are increased in the motor cortex contralateral to the hemichorea in hyperglycemic HC-HB, but only during muscle activation. Hemichorea-hemiballism may be associated with increased GABAB receptor-mediated inhibitory activity in the motor cortex.
DOI: 10.1002/mds.25940
PubMed: 24919927
Affiliations:
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Le document en format XML
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Faculty of Medicine, School of Medicine, National Yang-Ming University, Taiwan, R.O.C.; Department of Nursing, Yuh-Ing Junior College of Health Care & Management, Taiwan, R.O.C.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Division of Neurology, Kaohsiung Veterans General Hospital, Taiwan, R.O.C.; Faculty of Medicine, School of Medicine, National Yang-Ming University, Taiwan, R.O.C.; Department of Nursing, Yuh-Ing Junior College of Health Care & Management, Taiwan</wicri:regionArea><wicri:noRegion>Taiwan</wicri:noRegion></affiliation></author><author><name sortKey="Chen, Robert" sort="Chen, Robert" uniqKey="Chen R" first="Robert" last="Chen">Robert Chen</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2015" type="published">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Chorea (therapy)</term><term>Dyskinesias (etiology)</term><term>Dyskinesias (therapy)</term><term>Evoked Potentials, Motor (drug effects)</term><term>Female</term><term>Humans</term><term>Hyperglycemia (complications)</term><term>Hyperglycemia (therapy)</term><term>Male</term><term>Middle Aged</term><term>Motor Cortex (drug effects)</term><term>Motor Cortex (surgery)</term><term>Psychomotor Agitation (therapy)</term><term>Transcranial Magnetic Stimulation (methods)</term><term>gamma-Aminobutyric Acid (therapeutic use)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>gamma-Aminobutyric Acid</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Hyperglycemia</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Evoked Potentials, Motor</term><term>Motor Cortex</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Dyskinesias</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Transcranial Magnetic Stimulation</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Motor Cortex</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Chorea</term><term>Dyskinesias</term><term>Hyperglycemia</term><term>Psychomotor Agitation</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Hemichorea-hemiballism (HC-HB) in uncontrolled diabetes mellitus is an uncommon manifestation of hyperglycemia. The pathophysiology of hyperglycemic HC-HB is not well understood. A previous report showed increased intracortical inhibition in the motor cortex in a patient with diabetes with HC-HB. The objective of this study is to investigate motor cortex excitability in patients with hyperglycemic HC-HB. We hypothesized that intracortical inhibition measured with transcranial magnetic stimulation, which likely reflects the excitability of cortical γ-aminobutyric acid (GABA)ergic circuits, would be impaired in patients with hyperglycemic HC-HB. We studied 15 patients with mean age 71.5 years (range, 48-94 y) and 12 age-matched healthy subjects. The motor cortex contralateral to the hemichorea was tested. Transcranial magnetic stimulation measures included motor evoked potential, recruitment curve, GABAA mediated short interval intracortical inhibition, intracortical facilitation, and GABAB mediated silent period duration and long interval intracortical inhibition. No significant difference was found in motor threshold, recruitment curve response, short interval intracortical inhibition, or intracortical facilitation in both rest and active conditions between patients with hyperglycemic HC-HB and normal subjects. However, long interval intracortical inhibition was significantly increased during muscle activation but not at rest in patients with hyperglycemic HC-HB. The silent period duration is also increased in patients with hyperglycemic HC-HB. We concluded that long interval intracortical inhibition and silent period are increased in the motor cortex contralateral to the hemichorea in hyperglycemic HC-HB, but only during muscle activation. Hemichorea-hemiballism may be associated with increased GABAB receptor-mediated inhibitory activity in the motor cortex.</div></front></TEI><affiliations><list><country><li>République populaire de Chine</li></country></list><tree><noCountry><name sortKey="Chen, Robert" sort="Chen, Robert" uniqKey="Chen R" first="Robert" last="Chen">Robert Chen</name></noCountry><country name="République populaire de Chine"><noRegion><name sortKey="Li, Jie Yuan" sort="Li, Jie Yuan" uniqKey="Li J" first="Jie-Yuan" last="Li">Jie-Yuan Li</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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