Intracortical inhibition abnormality during the remission phase of multiple sclerosis is related to upper limb dexterity and lesions

Nantes, Julia C.; Zhong, Jidan; Holmes, Scott A.; Whatley, Benjamin P.; Narayanan, Sridar; Lapierre, Yves; Arnold, Douglas L.; Koski, Lisa

doi:10.1016/j.clinph.2015.08.011

Cited by 27 publications

(57 citation statements)

References 51 publications

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“…Several manuscripts reported that RMT was significantly higher in PwMS compared to HC 25‐29 . However, no intergroup difference in RMT was found by in the majority of the studies 30‐36 …”

Section: Resultsmentioning

confidence: 93%

“…MEP amplitude is a measure of corticospinal excitability 44 . The majority of studies (Table 2) showed that MEP amplitude was significantly reduced in PwMS when compared to HC 25,28‐30,32,35,36,39,45 . However, Sheean et al, Thickbroom et al, and Liepert et al did not find MEP amplitudes to differ from HC in PwMS 33,38,46 .…”

Section: Resultsmentioning

confidence: 97%

“… 26,33,35,37‐39 No intergroup difference was found in Thickbroom et al 36 Nantes et al further divided the group of PwMS with a relapsing‐remitting MS (RRMS) into a group with preserved and a group with impaired motor function , respectively. Prolonged MEP latency was found in the impaired group when compared to both HC and the MS group with preserved motor function ( P < .001) 35 . Firmin et al 40 assessed the individual latency distribution in order to assess slower parts of central motor pathways.…”

Section: Resultsmentioning

confidence: 99%

“…Cortical silent period (CSP) is thought to reflect intracortical inhibition and manifests as an interruption of electromyography (EMG) activity following a suprathreshold TMS pulse 35 . Neva et al 26 also demonstrated a significant delay of the onset of CSP in PwMS compared to HC, which can be a reflection of prolonged MEP duration in PwMS or an abnormal regulatory mechanism of local corticospinal inhibitory mechanisms.…”

Section: Resultsmentioning

confidence: 99%

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Neurophysiological impairments in multiple sclerosis—Central and peripheral motor pathways

et al. 2020

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A systematic review of the literature was conducted comparing neurophysiological outcomes in persons with multiple sclerosis (PwMS) to healthy controls (HC), in studies of the central nervous system (CNS) function comprising motor evoked potentials (MEP) elicited by transcranial magnetic stimulation (TMS) and in studies of the peripheral nervous system (PNS) function comprising electroneuronography (ENG) outcomes elicited by peripheral nerve stimulation. Studies comparing neuromuscular function, assessed during maximal voluntary contraction (MVC) of muscle, were included if they reported muscle strength along with muscle activation by use of electromyography (EMG) and/or interpolated twitch technique (ITT). Studies investigating CNS function showed prolonged central motor conduction times, asymmetry of nerve conduction motor pathways, and prolonged latencies in PwMS when compared to HC. Resting motor threshold, amplitude, and cortical silent periods showed conflicting results. CNS findings generally correlated with disabilities. Studies of PNS function showed near significant prolongation in motor latency of the median nerve, reduced nerve conduction velocities in the tibial and peroneal nerves, and decreased compound muscle action potential amplitudes of the tibial nerve in PwMS. ENG findings did not correlate with clinical severity of disabilities. Studies of neuromuscular function showed lower voluntary muscle activation and increased central fatigue in PwMS, whereas EMG showed divergent muscle activation (ie, EMG amplitude) during MVC. When comparing the existing literature on neurophysiological motor examinations in PwMS and HC, consistent and substantial impairments of CNS function were seen in PwMS, whereas impairments of the PNS were less pronounced and inconsistent. In addition, impairments in muscle activation were observed in PwMS.

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Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Neurophysiological impairments in multiple sclerosis—Central and peripheral motor pathways

et al. 2020

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“…Exclusion criteria included: claustrophobia, typical contraindications to MRI (e.g. pregnancy, pacemaker, ferromagnetic metal in body), history of mental illness or serious health conditions other than MS. As this study was completed as a portion of a larger study that explored the association of neuroexcitability and brain damage in people with MS (Nantes et al 2015) using transcranial magnetic stimulation (TMS), exclusion criteria also included relative contraindications for undergoing TMS procedures (i.e., medications that lower the seizure threshold, personal or immediate family history of seizure, or ferromagnetic metal in or near the head), and medications that are known to modify intracortical excitability. A control group of 21 age-and sexmatched right-handed HCs was also recruited.…”

Section: Participantsmentioning

confidence: 99%

Combined structural and functional patterns discriminating upper limb motor disability in multiple sclerosis using multivariate approaches

Zhong

Chen

Nantes

et al. 2016

Brain Imaging and Behavior

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A structural or functional pattern of neuroplasticity that could systematically discriminate between people with impaired and preserved motor performance could help us to understand the brain networks contributing to preservation or compensation of behavior in multiple sclerosis (MS). This study aimed to (1) investigate whether a machine learning-based technique could accurately classify MS participants into groups defined by upper extremity function (i.e. motor function preserved (MP) vs. motor function impaired (MI)) based on their regional grey matter measures (GMM, cortical thickness and deep grey matter volume) and inter-regional functional connection (FC), (2) investigate which features (GMM, FC, or GMM + FC) could classify groups more accurately, and (3) identify the multivariate patterns of GMM and FCs that are most discriminative between MP and MI participants, and between each of these groups and the healthy controls (HCs). With 26 MP, 25 MI, and 21 HCs (age and sex matched) underwent T1-weighted and resting-state functional MRI at 3 T, we applied support vector machine (SVM) based classification to learn discriminant functions indicating regions in which GMM or between which FCs were most discriminative between groups. This study demonstrates that there exist structural and FC patterns sufficient for correct classification of upper limb motor ability of people with MS. The classifier with GMM + FC features yielded the highest accuracy of 85.61 % (p < 0.001) to distinguish between the MS groups using leave-one-out cross-validation. It suggests that a machine-learning approach combining structural and functional features is useful for identifying the specific neural substrates that are necessary and sufficient to preserve motor function among people with MS.

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The corticospinal tract in multiple sclerosis: correlation between cortical excitability and magnetic resonance imaging measures

Kauv,

Chalah,

Créange

et al. 2024

J Neural Transm

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Multiple sclerosis (MS) is a central nervous system disease involving gray and white matters. Transcranial magnetic stimulation (TMS) and magnetic resonance imaging (MRI) could help identify potential markers of disease evolution, disability, and treatment response. This work evaluates the relationship between intracortical inhibition and facilitation, motor cortex lesions, and corticospinal tract (CST) integrity. Consecutive adult patients with progressive MS were included. Sociodemographic and clinical data were collected. MRI was acquired to assess primary motor cortex lesions (double inversion and phase-sensitive inversion recovery) and CST integrity (diffusion tensor imaging). TMS outcomes were obtained: motor evoked potentials (MEP) latency, resting motor threshold, short-interval intracortical facilitation (ICF) and inhibition. Correlation analysis was performed. Twenty-five patients completed the study (13 females, age: 55.60 ± 11.49 years, Expanded Disability Status Score: 6.00 ± 1.25). Inverse correlations were found between ICF mean and each of CST radial diffusivity (RD) (ρ =-0.56; p < 0.01), CST apparent diffusion coefficient (ADC) (ρ=-0.44; p = 0.03), and disease duration (ρ=-0.46; p = 0.02). MEP latencies were directly correlated with disability scores (ρ = 0.55; p < 0.01). High ADC/RD and low ICF have been previously reported in patients with MS. While the former could reflect structural damage of the CST, the latter could hint towards an aberrant synaptic transmission as well as a depletion of facilitatory compensatory mechanisms that helps overcoming functional decline. The findings suggest concomitant structural and functional abnormalities at later disease stages that would be accompanied with a heightened disability. The results should be interpreted with caution mainly because of the small sample size that precludes further comparisons (e.g., treated vs. untreated patients, primary vs. secondary progressive MS). The role of these outcomes as potential MS biomarkers merit to be further explored.

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Intracortical inhibition abnormality during the remission phase of multiple sclerosis is related to upper limb dexterity and lesions

Cited by 27 publications

References 51 publications

Neurophysiological impairments in multiple sclerosis—Central and peripheral motor pathways

Neurophysiological impairments in multiple sclerosis—Central and peripheral motor pathways

Combined structural and functional patterns discriminating upper limb motor disability in multiple sclerosis using multivariate approaches

The corticospinal tract in multiple sclerosis: correlation between cortical excitability and magnetic resonance imaging measures

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