Neural bases of motor fatigue in multiple sclerosis: A multimodal approach using neuromuscular assessment and TMS-EEG

Leodori, Giorgio; Mancuso, Marco; Maccarrone, Davide; Tartaglia, Matteo; Ianniello, Antonio; Certo, Francesco; Baione, Viola; Ferrazzano, Gina; Malimpensa, Leonardo; Belvisi, Daniele; Pozzilli, Carlo; Berardelli, Alfredo; Conte, Antonella

doi:10.1016/j.nbd.2023.106073

Cited by 12 publications

(10 citation statements)

References 83 publications

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“…In the field of neurophysiology, several studies investigated the differences in neurophysiological parameters between MS patients and healthy controls (for an overview, see [17,56]). With respect to the CSP as a measurement of motor cortex excitability and the balance between inhibitory and excitatory mechanisms, in particular, the results are somewhat heterogenous, as studies revealed an increased [25,26], decreased [25], or equal [24,32] CSP duration. In interpreting the results of these studies, it is important to note that differ-ent measurement parameters were chosen in each of the different studies since there is no widely used standardized measurement procedure.…”

Section: Discussionmentioning

confidence: 99%

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The Cortical Silent Period and Its Association with Fatigue in Multiple Sclerosis: The Need for Standardized Data Collection

Strauss,

Herr,

Nafz

et al. 2023

Brain Sciences

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The cortical silent period (CSP), assessed with transcranial magnetic stimulation (TMS), provides insights into motor cortex excitability. Alterations in the CSP have been observed in multiple sclerosis (MS), although a comparison of the sometimes contradictory results is difficult due to methodological differences. The aim of this study is to provide a more profound neurophysiological understanding of fatigue’s pathophysiology and its relationship to the CSP. Twenty-three patients with MS, along with a matched control group, underwent comprehensive CSP measurements at four intensities (125, 150, 175, and 200% resting motor threshold), while their fatigue levels were assessed using the Fatigue Scale for Motor and Cognitive Functions (FSMC) and its motor and cognitive subscore. MS patients exhibited a significantly increased CSP duration compared to controls (p = 0.02), but CSP duration was not associated with the total FSMC, or the motor or cognitive subscore. Our data suggest a systematic difference in MS patients compared to healthy controls in the CSP but no association with fatigue when measured with the FSMC. Based on these results, and considering the heterogeneous literature in the field, our study highlights the need for a more standardized approach to neurophysiological data collection and validation. This standardization is crucial for exploring the link between TMS and clinical impairments in diseases like MS.

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Section: Discussionmentioning

confidence: 99%

“…In the field of MS, changes in the duration of the CSP have been observed, with contradictory results of unaltered, increased, and decreased duration compared to healthy controls [17,25,31,32]. Additionally, Nantes et al revealed an association between prolonged CSP and upper limb motor impairment [33].…”

Section: Introductionmentioning

confidence: 99%

The Cortical Silent Period and Its Association with Fatigue in Multiple Sclerosis: The Need for Standardized Data Collection

Strauss,

Herr,

Nafz

et al. 2023

Brain Sciences

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“…Preprocessing was in accordance with the established protocol by Rogasch et al [ 31 ] and other previous studies [ 32 , 33 , 34 , 35 ].…”

Section: Methodsmentioning

confidence: 99%

Motor Cortical Correlates of Paired Associative Stimulation Induced Plasticity: A TMS-EEG Study

et al. 2023

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Paired associative stimulation (PAS) is a non-invasive brain stimulation technique that modulates synaptic plasticity in the human motor cortex (M1). Since previous studies have primarily used motor-evoked potentials (MEPs) as outcome measure, cortical correlates of PAS-induced plasticity remain unknown. Therefore, the aim of this observational study was to investigate cortical correlates of a standard PAS induced plasticity in the primary motor cortex by using a combined TMS-EEG approach in a cohort of eighteen healthy subjects. In addition to the expected long-lasting facilitatory modulation of MEPs amplitude, PAS intervention also induced a significant increase in transcranial magnetic stimulation-evoked potentials (TEPs) P30 and P60 amplitude. No significant correlation between the magnitude of PAS-induced changes in TEP components and MEP amplitude were observed. However, the linear regression analysis revealed that the combined changes in P30 and P60 component amplitudes significantly predicted the MEP facilitation after PAS. The findings of our study offer novel insight into the neurophysiological changes associated with PAS-induced plasticity at M1 cortical level and suggest a complex relationship between TEPs and MEPs changes following PAS.

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“…Motor fatigue is a current sign mentioned by patients with MS and can considerably affect their capability to carry out everyday tasks. Many studies have observed positive results using exercise interventions on fatigue, depression, and stress in people with MS [9][10][11]. Due to the conditions of the coronavirus pandemic and the particular conditions of MS patients who suffer from immunodeficiency, the home-based exercise protocol was designed to ensure that the subjects are under safe conditions.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Eight Weeks of Training Aerobic and Resistance on Selected Functional Capacities Among Women With Depression and Multiple Sclerosis

Alipour Abedi,

Saidie,

Rahmani Nia

et al. 2023

PTJ

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Purpose: Multiple sclerosis is an autoimmune disease with a very high prevalence all over the world in recent years. Therefore, this research intended to examine the impact of resistance and aerobic exercises on selected functional capacities and cognitive indicators in depressed women with multiple sclerosis (MS). Methods:The current study was semi-experimental with a pre-test and post-test design. In this survey, 30 women with MS (25-50 years old) with an expanded disability status scale range between 0-5.5, and depression among those who visited the neurology clinic at Guilan University of Medical Sciences (Bethat) were selected. The study included a control group (n=10) and two intervention groups: resistance (n=10) and aerobic (n=10) exercises. To evaluate the variables of stress, depression, fatigue, and functional capacities, the following questionnaires and tests were used: Perceived stress scale, Beck's depression inventory, fatigue severity scale, 10-meter walk test (10MWT), 6-minute walk test (6MWT), timed up and go (TUG), and 30-second chair stand (30 CST) tests. Exercises of aerobic were done at an intensity of 40_60% of the maximum rate of heart for 10-30 minutes. Home-based resistance training, including a hypertrophy phase (four weeks), and strength and power phase (four weeks) was conducted at an intensity of 0.5-1.5% of the subjects' body weight. The duration of the training for both groups was eight weeks. The data were analyzed by repeated-measures two-way ANOVA by SPSS software, version 26. The significance level was set at 0.05.Results: Both resistance and aerobic training had a significant intra-group impact on various factors (P≤0.05). Specifically, perceived stress (P=0.01) and depression level (P=0.001), and 10-MWT (P=0.01), 6MWT (P=0.001), and 30 CST (P=0.001) results showed statistically notable improvements. Regarding the inter-group effect, notable dissimilarities were seen in depression and functional strength of lower limbs (30 CST) among the three groups (P≤0.05). Noteworthy, variations were also found in fatigue and the timed up-and-go test. Conclusion:Both aerobic and resistance exercises can be considered effective interventions for improving depression, perceived stress, and functional capacity in individuals with MS.

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Neural bases of motor fatigue in multiple sclerosis: A multimodal approach using neuromuscular assessment and TMS-EEG

Cited by 12 publications

References 83 publications

The Cortical Silent Period and Its Association with Fatigue in Multiple Sclerosis: The Need for Standardized Data Collection

The Cortical Silent Period and Its Association with Fatigue in Multiple Sclerosis: The Need for Standardized Data Collection

Motor Cortical Correlates of Paired Associative Stimulation Induced Plasticity: A TMS-EEG Study

The Effect of Eight Weeks of Training Aerobic and Resistance on Selected Functional Capacities Among Women With Depression and Multiple Sclerosis

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