ParkinsonFranceV1, Main, Merge, bibRecord, 003439

Improvement of motor performance and modulation of cortical excitability by repetitive transcranial magnetic stimulation of the motor cortex in Parkinson's disease

Identifieur interne : 003439 ( Main/Merge ); précédent : 003438; suivant : 003440

Improvement of motor performance and modulation of cortical excitability by repetitive transcranial magnetic stimulation of the motor cortex in Parkinson's disease

Auteurs : Jean-Pascal Lefaucheur [France] ; Xavier Drouot [France] ; Florian Von Raison [France] ; Isabelle Menard-Lefaucheur [France] ; Pierre Cesaro [France] ; Jean-Paul Nguyen [France]

Source :

Clinical neurophysiology [ 1388-2457 ] ; 2004.

RBID : Pascal:05-0381052

Descripteurs français

Pascal (Inist)
- Excitabilité, Stimulus répétitif, Cortex moteur, Main, Parkinson maladie, Homme, Electrodiagnostic, Neuromodulation, Stimulation magnétique transcrânienne, Période muette, Bradykinésie.
Wicri :
- topic : Homme.

English descriptors

KwdEn :
- Bradykinesia, Electrodiagnosis, Excitability, Hand, Human, Motor cortex, Neuromodulation, Parkinson disease, Repetitive stimulus, Silent period, Transcranial magnetic stimulation.

Abstract

Objective: To assess the effects of focal motor cortex stimulation on motor performance and cortical excitability in patients with Parkinson's disease (PD). Methods: Repetitive transcranial magnetic stimulation (rTMS) was performed on the left motor cortical area corresponding to the right hand in 12 'off-drug' patients with PD. The effects of subthreshold rTMS applied at 0.5 Hz (600 pulses) or at 10 Hz (2000 pulses) using a 'real' or a 'sham' coil were compared to those obtained by a single dose of 1-dopa. The assessment included a clinical evaluation by the Unified Parkinson's Disease Rating Scale and timed motor tasks, and a neurophysiological evaluation of cortical excitability by single- and paired-pulse TMS techniques. Results: 'Real' rTMS at 10 or 0.5 Hz, but not 'sham' stimulation, improved motor performance. High-frequency rTMS decreased rigidity and bradykinesia in the upper limb contralateral to the stimulation, while low-frequency rTMS reduced upper limb rigidity bilaterally and improved walking. Concomitantly, 10 Hz rTMS increased intracortical facilitation, while 0.5 Hz rTMS restored intracortical inhibition. Conclusions: Low- and high-frequency rTMS of the primary motor cortex lead to significant but differential changes in patients with PD both on clinical and electrophysiological grounds. The effects on cortical excitability were opposite to previous observations made in healthy subjects, suggesting a reversed balance of cortical excitability in patients with PD compared to normals. However, the underlying mechanisms of these changes remain to determine, as well as the relationship with clinical presentation and response to 1-dopa therapy. Significance: The present study gives some clues to appraise the role of the primary motor cortex in PD. Clinical improvement induced by rTMS was too short-lasting to consider therapeutic application, but these results support the perspective of the primary motor cortex as a possible target for neuromodulation in PD.

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Le document en format XML

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<author><name sortKey="Nguyen, Jean Paul" sort="Nguyen, Jean Paul" uniqKey="Nguyen J" first="Jean-Paul" last="Nguyen">Jean-Paul Nguyen</name>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Bradykinesia</term>
<term>Electrodiagnosis</term>
<term>Excitability</term>
<term>Hand</term>
<term>Human</term>
<term>Motor cortex</term>
<term>Neuromodulation</term>
<term>Parkinson disease</term>
<term>Repetitive stimulus</term>
<term>Silent period</term>
<term>Transcranial magnetic stimulation</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Excitabilité</term>
<term>Stimulus répétitif</term>
<term>Cortex moteur</term>
<term>Main</term>
<term>Parkinson maladie</term>
<term>Homme</term>
<term>Electrodiagnostic</term>
<term>Neuromodulation</term>
<term>Stimulation magnétique transcrânienne</term>
<term>Période muette</term>
<term>Bradykinésie</term>
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<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term>
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<front><div type="abstract" xml:lang="en">Objective: To assess the effects of focal motor cortex stimulation on motor performance and cortical excitability in patients with Parkinson's disease (PD). Methods: Repetitive transcranial magnetic stimulation (rTMS) was performed on the left motor cortical area corresponding to the right hand in 12 'off-drug' patients with PD. The effects of subthreshold rTMS applied at 0.5 Hz (600 pulses) or at 10 Hz (2000 pulses) using a 'real' or a 'sham' coil were compared to those obtained by a single dose of 1-dopa. The assessment included a clinical evaluation by the Unified Parkinson's Disease Rating Scale and timed motor tasks, and a neurophysiological evaluation of cortical excitability by single- and paired-pulse TMS techniques. Results: 'Real' rTMS at 10 or 0.5 Hz, but not 'sham' stimulation, improved motor performance. High-frequency rTMS decreased rigidity and bradykinesia in the upper limb contralateral to the stimulation, while low-frequency rTMS reduced upper limb rigidity bilaterally and improved walking. Concomitantly, 10 Hz rTMS increased intracortical facilitation, while 0.5 Hz rTMS restored intracortical inhibition. Conclusions: Low- and high-frequency rTMS of the primary motor cortex lead to significant but differential changes in patients with PD both on clinical and electrophysiological grounds. The effects on cortical excitability were opposite to previous observations made in healthy subjects, suggesting a reversed balance of cortical excitability in patients with PD compared to normals. However, the underlying mechanisms of these changes remain to determine, as well as the relationship with clinical presentation and response to 1-dopa therapy. Significance: The present study gives some clues to appraise the role of the primary motor cortex in PD. Clinical improvement induced by rTMS was too short-lasting to consider therapeutic application, but these results support the perspective of the primary motor cortex as a possible target for neuromodulation in PD.</div>
</front>
</TEI>
<affiliations><list><country><li>France</li>
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<region><li>Île-de-France</li>
</region>
<settlement><li>Créteil</li>
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<tree><country name="France"><region name="Île-de-France"><name sortKey="Lefaucheur, Jean Pascal" sort="Lefaucheur, Jean Pascal" uniqKey="Lefaucheur J" first="Jean-Pascal" last="Lefaucheur">Jean-Pascal Lefaucheur</name>
</region>
<name sortKey="Cesaro, Pierre" sort="Cesaro, Pierre" uniqKey="Cesaro P" first="Pierre" last="Cesaro">Pierre Cesaro</name>
<name sortKey="Drouot, Xavier" sort="Drouot, Xavier" uniqKey="Drouot X" first="Xavier" last="Drouot">Xavier Drouot</name>
<name sortKey="Drouot, Xavier" sort="Drouot, Xavier" uniqKey="Drouot X" first="Xavier" last="Drouot">Xavier Drouot</name>
<name sortKey="Lefaucheur, Jean Pascal" sort="Lefaucheur, Jean Pascal" uniqKey="Lefaucheur J" first="Jean-Pascal" last="Lefaucheur">Jean-Pascal Lefaucheur</name>
<name sortKey="Menard Lefaucheur, Isabelle" sort="Menard Lefaucheur, Isabelle" uniqKey="Menard Lefaucheur I" first="Isabelle" last="Menard-Lefaucheur">Isabelle Menard-Lefaucheur</name>
<name sortKey="Nguyen, Jean Paul" sort="Nguyen, Jean Paul" uniqKey="Nguyen J" first="Jean-Paul" last="Nguyen">Jean-Paul Nguyen</name>
<name sortKey="Von Raison, Florian" sort="Von Raison, Florian" uniqKey="Von Raison F" first="Florian" last="Von Raison">Florian Von Raison</name>
</country>
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</record>

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	La maladie de Parkinson en France (serveur d'exploration)
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La maladie de Parkinson en France (serveur d'exploration)

Improvement of motor performance and modulation of cortical excitability by repetitive transcranial magnetic stimulation of the motor cortex in Parkinson's disease

Improvement of motor performance and modulation of cortical excitability by repetitive transcranial magnetic stimulation of the motor cortex in Parkinson's disease

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Links to Exploration step

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri