Changes of cortical excitability of human motor cortex in spinocerebellar ataxia type 2

Restivo, Domenico A.; Lanza, Sara; Saponara, R.; Rapisarda, Giuseppe; Giuffrida, Salvatore; Palmeri, Agostino

doi:10.1016/s0022-510x(02)00086-2

Cited by 24 publications

(16 citation statements)

References 30 publications

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“…Likewise, as in case of the BARS score, it was mainly the M-VEPs and the pattern reversal VEPs evoked by the smallest check size that showed a significant positive correlation. A similar positive correlation between cortical function and the worsening of the clinical state as assessed by the Inherited Ataxia Progression State or the duration of SCA2 disease was observed by Restivo et al [24] using the cortical silent period and transcranial magnetic stimulation. The authors speculated that the reason for this relationship was the gradual loss of the cerebellar neurons and a decrease of the facilitatory influence to the motor cortex.…”

Section: Cerebellar Deficit and Visual Pathologysupporting

confidence: 78%

“…It is generally accepted that clinical signs vary within a genetic subtype and between SCAs [26] and that the symptoms of progression can be different even for the same family members [27]. Also, Restivo et al [24] found no correlation between CAG repeats and the cortical silent period. Our group included a mother (S9) and daughter (S1), and they did not agree in the extent of visual pathologies.…”

Section: Cag Repeatsmentioning

confidence: 99%

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An Electrophysiological Study of Visual Processing in Spinocerebellar Ataxia Type 2 (SCA2)

et al. 2010

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Reports of visual functional impairment in spinocerebellar ataxia type 2 (SCA2) have been studied previously using pattern reversal visually evoked potentials (VEPs) with contradictory results. To provide additional evidence to this area, visual functions were studied using VEPs and event-related potentials (ERPs) in a group of ten patients with genetically verified SCA2. The electrophysiological examination included pattern reversal and motion-onset VEPs as well as visually driven oddball ERPs with an evaluation of a target and a pre-attentive response. In six patients, we found abnormal visual/cognitive processing that differed from normal values in latency, but not in the amplitude of the dominant VEP/ERP peaks. Among the VEPs/ERPs used, the motion-onset VEPs exhibited the highest sensitivity and showed a strong Spearman correlation to SCA2 duration (from r = 0.82 to r = 0.90, p < 0.001) and clinical state assessed by Brief Ataxia Rating Scale (from r = 0.71 (p = 0.022) to r = 0.80 (p < 0.001)). None of the VEP/ERP latencies showed a correlation to the triplet repeats of the SCA2 gene. In three patients, we did not find any visual/cognitive pathology, and one subject showed only a single subtle prolongation of the VEP peak. The observed visual/cognitive deficit was related to the subjects' clinical state and the illness duration, but no relationship to the genetic marker of SCA2 was found. From the VEP/ERP types used, the motion-onset VEPs seems to be the most promising candidate for clinical state monitoring rather than a tool for early diagnostic use.

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Section: Cerebellar Deficit and Visual Pathologysupporting

confidence: 78%

Section: Cag Repeatsmentioning

confidence: 99%

An Electrophysiological Study of Visual Processing in Spinocerebellar Ataxia Type 2 (SCA2)

et al. 2010

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“…In our sample of cerebellar patients there was, at baseline, a defective efficacy of the ICF that is consistent with previous studies. Several studies found a similar loss of ICF in cerebellar stroke patients (Liepert et al, 1998(Liepert et al, , 2004Restivo et al, 2002). Moreover, we previously demonstrated that in healthy subjects cerebellar iTBS was also effective in modulating ICF circuits in the contralateral M1 (Koch et al, 2008).…”

Section: Discussionsupporting

confidence: 61%

Cerebellar theta burst stimulation in stroke patients with ataxia

Bonnı̀

Ponzo

Caltagirone

et al. 2014

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SummaryEvidence for effective improvement of the symptoms of cerebellar stroke is still limited. Here, we investigated the effects of repetitive transcranial magnetic stimulation (rTMS) applied over the injured cerebellar hemisphere in six patients with posterior circulation stroke. We applied a two-week course of cerebellar intermittent theta burst stimulation (iTBS). Before and after the iTBS treatment, paired-pulse TMS methods were used to explore: i) the functional connectivity between the cerebellar hemisphere and the contralateral primary motor cortex (M1), by means of the cerebellar brain inhibition (CBI) protocol; and ii) the intracortical circuits in the contralateral M1, by means of the short intra-cortical inhibition (SICI) and intra-cortical facilitation (ICF) protocols. Patients were also evaluated using the Modified International Cooperative Ataxia Rating Scale (MICARS). Cerebellar iTBS induced a decrease in CBI and an increase in ICF at an interstimulus interval of 15 msec. These neurophysiological changes were paralleled by a clinical improvement, shown by the MICARS posture and gait subscale scores. Cerebellar iTBS could be a promising tool to promote recovery of cerebellar stroke patients. KEY WORDS: cerebellar stroke; theta burst stimulation; intracortical facilitation IntroductionPatients affected by ischemic or hemorrhagic stroke present motor disturbances such as ataxia, intention tremor, axial latero-pulsion and dysarthria. Ataxia is a common impairment after posterior circulation stroke Cerebellar theta burst stimulation in stroke patients with ataxia (PCS) involving the cerebellum or brainstem, and it restricts patients in their mobility and activities of daily living (Teasell et al., 2002). Various strategies have been suggested to improve the symptoms of cerebellar stroke, but the evidence of their effectiveness is still limited (Kruger et al., 2007). Repetitive transcranial magnetic stimulation (rTMS) has recently been proposed as a potentially useful method for modulating the excitability of cerebellothalamo-cortical (CTC) pathways, which could have a favorable effect on the cerebellar deficit (Koch, 2010). The current study was conducted to investigate the effects of a two-week course of cerebellar intermittent theta burst stimulation (iTBS) in a sample of six chronic stroke patients affected by PCS. This protocol is known to induce an increase in the excitability of the CTC pathways (Koch et al., 2008). Before and after the iTBS treatment we used paired-pulse TMS methods to explore: i) the functional connectivity between the affected cerebellar hemisphere and the contralateral motor cortex (M1), assessing cerebellar brain inhibition (CBI), and ii) the excitability of the contralateral M1, assessing short intra-cortical inhibition (SICI) and intra-cortical facilitation (ICF). In addition, all the patients were submitted to clinical evaluation: the Modified International Cooperative Ataxia Rating Scale (MICARS) was administered to investigate whether the iTBS protocol could improve ...

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“…A prolonged SP has been observed previously in patients with degenerative cerebellar ataxia disease (Liepert et al, 1998;Nakashima et al, 1995;Oechsner and Zangemeister, 1999;Restivo et al, 2002;Schwenkreis et al, 2002;Wessel et al, 1996). The lengthening of the SP might not be a common phenomenon in all sub-types of SCA due to the genetic heterogeneity (Liepert et al, 1998;Nakashima et al, 1995;Oechsner and Zangemeister, 1999;Restivo et al, 2002;Schwenkreis et al, 2002;Wessel et al, 1996). The assessment method, such as the TMS intensity and definition of SP, could also affect the values of this parameter.…”

Section: Discussionmentioning

confidence: 84%

“…This made the absolute duration of the SP incomparable to its value in the studies using a higher TMS intensity (Liepert et al, 1998;Nakashima et al, 1995;Wessel et al, 1996). Furthermore, the onset of the SP was defined inconsistently in these studies, sometimes as beginning at the stimulation artifact (Cantello et al, 2007), sometimes at the onset of the MEP (Restivo et al, 2002), and others at the onset of EMG suppression. Likely, the average duration of the SP in our healthy controls was comparable to the studies that used a relatively low TMS-induced intensity with the SP measured from the onset of EMG suppression (Garvey et al, 2001;Ridding et al, 1995;Vry et al, 2008).…”

Section: Discussionmentioning

confidence: 98%

Neuromuscular electrical stimulation of the median nerve facilitates low motor cortex excitability in patients with spinocerebellar ataxia

Chen¹,

Chuang²,

Yang³

et al. 2015

Journal of Electromyography and Kinesiology

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The neuromodulation of motor excitability has been shown to improve functional movement in people with central nervous system damage. This study aimed to investigate the mechanism of peripheral neuromuscular electrical stimulation (NMES) in motor excitability and its effects in people with spinocerebellar ataxia (SCA). This single-blind case-control study was conducted on young control (n=9), age-matched control (n=9), and SCA participants (n=9; 7 SCAIII and 2 sporadic). All participants received an accumulated 30 min of NMES (25 Hz, 800 ms on/800 ms off) of the median nerve. The central motor excitability, measured by motor evoked potential (MEP) and silent period, and the peripheral motor excitability, measured by the H-reflex and M-wave, were recorded in flexor carpi radialis (FCR) muscle before, during, and after the NMES was applied. The results showed that NMES significantly enhanced the MEP in all 3 groups. The silent period, H-reflex and maximum M-wave were not changed by NMES. We conclude that NMES enhances low motor excitability in patients with SCA and that the mechanism of the neuromodulation was supra-segmental. These findings are potentially relevant to the utilization of NMES for preparation of motor excitability. The protocol was registered at Clinicaltrials.gov (NCT02103075).

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Changes of cortical excitability of human motor cortex in spinocerebellar ataxia type 2

Cited by 24 publications

References 30 publications

An Electrophysiological Study of Visual Processing in Spinocerebellar Ataxia Type 2 (SCA2)

An Electrophysiological Study of Visual Processing in Spinocerebellar Ataxia Type 2 (SCA2)

Cerebellar theta burst stimulation in stroke patients with ataxia

Neuromuscular electrical stimulation of the median nerve facilitates low motor cortex excitability in patients with spinocerebellar ataxia

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