Altered dorsal premotor-motor interhemispheric pathway activity in focal arm dystonia

被引:39
作者
Koch, Giacomo [1 ,2 ,3 ]
Schneider, Susanne [1 ]
Baeumer, Tobias [4 ]
Franca, Michele [1 ]
Muenchau, Alexander [4 ]
Cheeran, Binith [1 ]
Fernandez Del Olmo, Miguel [1 ,5 ]
Cordivari, Carla [1 ]
Rounis, Elisabeth [1 ]
Caltagirone, Carlo [2 ,3 ]
Bhatia, Kailash [1 ]
Rothwell, John C. [1 ]
机构
[1] UCL, Sobell Dept Motor Neurosci & Movement Disorders, Inst Neurol, London WC1N 3BG, England
[2] Fdn Santa Lucia IRCCS, Lab Neurol Clin & Comportamentale, Rome, Italy
[3] Univ Roma Tor Vergata, Neurol Clin, Dipartimento Neurosci, Rome, Italy
[4] Univ Med Ctr Hamburg Eppendorf, Dept Neurol, Hamburg, Germany
[5] Univ A Coruna, Inst Phys Educ & Sport, INEF Galicia, La Coruna, Spain
基金
英国医学研究理事会;
关键词
paired transcranial magnetic stimulation; rTMS; connectivity; dystonia; premotor cortex; cortical inhibition; transcallosal inhibition;
D O I
10.1002/mds.21881
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Given the possible role of dorsal premotor cortex (PMd) in the pathophysiology of dystonia, we used transcranial magnetic stimulation (TMS) methods to study PMd and PMd-primary motor cortex (MI) interactions in patients with focal arm dystonia. Here, we tested the connectivity between left PMd and right M1 as well as the intracortical excitability of PMd in 11 right-handed patients with focal arm/hand dystonia and nine age-matched healthy controls. The results showed that excitability of the inhibitory connection between PMd and M1 was reduced in patients, but there was no significant difference to healthy subjects in the excitability of the facilitatory connection. A triple stimulation technique in which pairs of TMS pulses are given over PMd and their interaction measured in terms of the effect on the baseline PMd-M1 connection failed to reveal the usual pattern of interaction between the pairs of PMd stimuli. Indeed, the results in patients were similar to those seen in a group of young healthy subjects after the excitability of PMd had been changed by pretreatment with high-frequency rTMS. We suggest that reduced transcallosal inhibition from the PMd may be involved in the altered pattern of abnormal muscle contractions of agonists and antagonists (overflow). (c) 2008 Movement Disorder Society.
引用
收藏
页码:660 / 668
页数:9
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