ParkinsonFranceV1, PascalFrancis, Corpus, bibRecord, 000C59

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

Identifieur interne : 000C59 ( PascalFrancis/Corpus ); précédent : 000C58; suivant : 000C60

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 ; Xavier Drouot ; Florian Von Raison ; Isabelle Menard-Lefaucheur ; Pierre Cesaro ; Jean-Paul Nguyen

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.

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.

Notice en format standard (ISO 2709)

Pour connaître la documentation sur le format Inist Standard.

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C01	`01`		`ENG`	@0 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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Format Inist (serveur)

NO :	PASCAL 05-0381052 INIST
ET :	Improvement of motor performance and modulation of cortical excitability by repetitive transcranial magnetic stimulation of the motor cortex in Parkinson's disease
AU :	LEFAUCHEUR (Jean-Pascal); DROUOT (Xavier); VON RAISON (Florian); MENARD-LEFAUCHEUR (Isabelle); CESARO (Pierre); NGUYEN (Jean-Paul)
AF :	Service de Physiologie-Explorations Fonctionnelles, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, 51 avenue de Lattre de Tassigny/94010 Créteil/France (1 aut., 2 aut., 4 aut.); INSERM U421, Faculté de Médecine de Créteil/Créteil/France (1 aut., 2 aut.); Service de Neurologie, Hôpital Henri Mondor/Créteil/France (3 aut., 5 aut.); Service de Neurochirurgie, Hôpital Henri Mondor/Créteil/France (6 aut.)
DT :	Publication en série; Niveau analytique
SO :	Clinical neurophysiology; ISSN 1388-2457; Irlande; Da. 2004; Vol. 115; No. 11; Pp. 2530-2541; Bibl. 2 p.1/4
LA :	Anglais
EA :	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.
CC :	002B17G; 002A25E; 002B24D02
FD :	Excitabilité; Stimulus répétitif; Cortex moteur; Main; Parkinson maladie; Homme; Electrodiagnostic; Neuromodulation; Stimulation magnétique transcrânienne; Période muette; Bradykinésie
FG :	Encéphale pathologie; Voie motrice; Extrapyramidal syndrome; Maladie dégénérative; Système nerveux central pathologie; Système nerveux pathologie
ED :	Excitability; Repetitive stimulus; Motor cortex; Hand; Parkinson disease; Human; Electrodiagnosis; Neuromodulation; Transcranial magnetic stimulation; Silent period; Bradykinesia
EG :	Cerebral disorder; Motor pathway; Extrapyramidal syndrome; Degenerative disease; Central nervous system disease; Nervous system diseases
SD :	Excitabilidad; Estímulo repetitivo; Corteza motora; Mano; Parkinson enfermedad; Hombre; Electrodiagnóstico; Neuromodulación
LO :	INIST-5626E.354000120476100140
ID :	05-0381052

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Pascal:05-0381052

Le document en format XML

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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>
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<fA08 i1="01" i2="1" l="ENG"><s1>Improvement of motor performance and modulation of cortical excitability by repetitive transcranial magnetic stimulation of the motor cortex in Parkinson's disease</s1>
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<fA14 i1="01"><s1>Service de Physiologie-Explorations Fonctionnelles, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, 51 avenue de Lattre de Tassigny</s1>
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<fA21><s1>2004</s1>
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<fC01 i1="01" l="ENG"><s0>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.</s0>
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<server><NO>PASCAL 05-0381052 INIST</NO>
<ET>Improvement of motor performance and modulation of cortical excitability by repetitive transcranial magnetic stimulation of the motor cortex in Parkinson's disease</ET>
<AU>LEFAUCHEUR (Jean-Pascal); DROUOT (Xavier); VON RAISON (Florian); MENARD-LEFAUCHEUR (Isabelle); CESARO (Pierre); NGUYEN (Jean-Paul)</AU>
<AF>Service de Physiologie-Explorations Fonctionnelles, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, 51 avenue de Lattre de Tassigny/94010 Créteil/France (1 aut., 2 aut., 4 aut.); INSERM U421, Faculté de Médecine de Créteil/Créteil/France (1 aut., 2 aut.); Service de Neurologie, Hôpital Henri Mondor/Créteil/France (3 aut., 5 aut.); Service de Neurochirurgie, Hôpital Henri Mondor/Créteil/France (6 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>Clinical neurophysiology; ISSN 1388-2457; Irlande; Da. 2004; Vol. 115; No. 11; Pp. 2530-2541; Bibl. 2 p.1/4</SO>
<LA>Anglais</LA>
<EA>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.</EA>
<CC>002B17G; 002A25E; 002B24D02</CC>
<FD>Excitabilité; Stimulus répétitif; Cortex moteur; Main; Parkinson maladie; Homme; Electrodiagnostic; Neuromodulation; Stimulation magnétique transcrânienne; Période muette; Bradykinésie</FD>
<FG>Encéphale pathologie; Voie motrice; Extrapyramidal syndrome; Maladie dégénérative; Système nerveux central pathologie; Système nerveux pathologie</FG>
<ED>Excitability; Repetitive stimulus; Motor cortex; Hand; Parkinson disease; Human; Electrodiagnosis; Neuromodulation; Transcranial magnetic stimulation; Silent period; Bradykinesia</ED>
<EG>Cerebral disorder; Motor pathway; Extrapyramidal syndrome; Degenerative disease; Central nervous system disease; Nervous system diseases</EG>
<SD>Excitabilidad; Estímulo repetitivo; Corteza motora; Mano; Parkinson enfermedad; Hombre; Electrodiagnóstico; Neuromodulación</SD>
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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

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