Cortical inhibition in Parkinson's disease: New insights from early, untreated patients
Cortical inhibition in Parkinson's disease: New insights from early, untreated patients
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DOI：
10.1016/j.neuroscience.2007.08.033
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发表时间：
2007-11-30
期刊：
影响因子：
3.3
通讯作者：
Monaco, F.
中科院分区：
文献类型：
--
作者：
Cantello, R.;Tarletti, R.;Monaco, F.
经颅磁刺激(TMS)为特发性帕金森病(IPD)的病理生理基础和治疗策略的潜在靶点开辟了重要的前景。研究主要集中在运动皮质抑制现象上。然而，患者和方法的不同导致了一些差异，特别是在所谓的长潜伏期皮质抑制(LICI)方面。我们希望通过研究早期药物未治疗的患者，并通过复制在IPD中检测病理性LICI的原始方法来挑战这些争议。我们研究了18名未经治疗的非对称性IPD患者在疾病早期在身体较多和较少帕金森病侧的第一背侧骨间肌肉诱发的运动电位。我们有12名健康对照。TMS变量为主动运动阈值、运动诱发电位大小、皮质静止期和LICI。平均主动运动阈值在患者和对照组中相似，但其变异性在患者中显著更高(P<；0.05)。患侧皮质静止期有缩短的趋势(P=0.1)。患者，尤其是受累较重的一侧，表现出晚期的LICI峰，而对照组中没有这种峰(P<；0.05)。这种影响与静默期的持续时间无关。然而，静止期短的患者和对照组的LICI也较短(P<；0.05)。LICI的变化与帕金森症状的严重程度有很强的相关性(P=0.1)。因此，本研究明确地强化了LPD的TMS研究结果，认为这是一种“纯粹的”疾病病理生理学特征。晚期LICI的病理强化可作为IPD的一个候选生理标志，可在各种诊断或治疗情况下进行检测。(C)2007年IBRO。爱思唯尔有限公司出版。保留所有权利。
Transcranial magnetic stimulation (TMS) has opened important perspectives on the pathophysiological bases and potential targets of treatment strategies for idiopathic Parkinson's disease (IPD). Studies have been mainly focusing on motor cortical inhibitory phenomena. However, differences in patients and methods caused several discrepancies, particularly on the so-called long-latency cortical inhibition (LICI). We wanted to challenge such controversies by studying early, drug-naive patients, and by reproducing the original method that detected a pathologic LICI in IPD.We studied the motor potentials evoked in the first dorsal interosseous muscle on the more and the less parkinsonian side of the body in 18 asymmetrical untreated IPD patients in the early stages of their disease. We had 12 healthy controls. The TMS variables were the active motor threshold, the size of the motor-evoked potential, the cortical silent period and LICI. Average active motor threshold was similar in patients and controls, but its variability was significantly higher among patients (P < 0.05). There was a trend for the cortical silent period to be shorter on the more affected side of the patients (P=0.1). Patients, especially on their more affected side, exhibited a late LICI peak, which was absent among controls (P < 0.05). This effect was independent of the silent period duration. However, patients and controls having a short silent period also had a shorter LICI (P < 0.05). Changes in LICI had a strong trend to correlate to the severity of the parkinsonian signs (P=0.1).Thus, the present study definitely reinforced several previous TMS findings in lPD as a feature of the "pure" disease pathophysiology. The pathologic enhancement of late LICI can act as a candidate physiological hallmark of IPD, to be tested in various diagnostic or therapeutic circumstances. (c) 2007 IBRO. Published by Elsevier Ltd. All rights reserved.