Prolonged cortical silent period is related to poor fitness and fatigue, but not tumor necrosis factor, in Multiple Sclerosis

Chaves, Arthur R.; Kelly, Liam; Moore, Craig S.; Stefanelli, Mark; Ploughman, Michelle

doi:10.1016/j.clinph.2018.12.015

Cited by 36 publications

(41 citation statements)

References 93 publications

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“…Another neurophysiological measure which can be assessed through TMS is the cortical silent period (CSP) that is an interruption of the voluntary muscle contraction after a TMS pulse over the contralateral motor cortex and is thought to be mediated by GABA-B inhibitory neurotransmission, (54). CSP duration in PwMS predicted fatigue and was associated with poor cardiovascular fitness (55).…”

Section: Neurophysiology As Investigating Tool For the Pathogenic Mecmentioning

confidence: 99%

The Potential Role of Neurophysiology in the Management of Multiple Sclerosis-Related Fatigue

et al. 2020

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Fatigue is a very common symptom among people with multiple sclerosis (MS), but its management in clinical practice is limited by the lack of clear evidence about the pathogenic mechanisms, objective tools for diagnosis, and effective pharmacological treatments. In this scenario, neurophysiology could play a decisive role, thanks to its ability to provide objective measures and to explore the peripheral and the central structures of the nervous system. We hereby review and discuss current evidence about the potential role of neurophysiology in the management of MS-related fatigue. In the first part, we describe the use of neurophysiological techniques for exploring the pathogenic mechanisms of fatigue. In the second part, we review the potential application of neurophysiology for monitoring the response to pharmacological therapies. Finally, we show data about the therapeutic implications of neurophysiological techniques based on non-invasive brain stimulation.

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Section: Neurophysiology As Investigating Tool For the Pathogenic Mecmentioning

confidence: 99%

The Potential Role of Neurophysiology in the Management of Multiple Sclerosis-Related Fatigue

et al. 2020

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“…However, in this study, there was no significant difference in the bEMG between stimulation conditions. Second, the fatigue of contraction may have affect cSP duration [50,51]. In this study, to prevent the effects of fatigue, the interval between experiments was long, and the target level of force was set to 20% of MVC.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, there may be effects on M1 from 20 to 40 ms after single-pulse cerebellar TMS. Based on these hypotheses, in this study, we investigated whether cerebellar TMS would modulate cSP after M1-TMS beyond this time window, with inter-stimulus intervals (ISIs) of 0, 10,20,30,40,50,60,70, and 80 ms.…”

Section: Introductionmentioning

confidence: 99%

Cerebellar Transcranial Magnetic Stimulation Reduces the Silent Period on Hand Muscle Electromyography During Force Control

Matsugi

Douchi

Suzuki³

et al. 2020

Brain Sciences

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This study aimed to investigate whether cerebellar transcranial magnetic stimulation (C-TMS) affected the cortical silent period (cSP) induced by TMS over the primary motor cortex (M1) and the effect of interstimulus interval (ISI) on cerebellar conditioning and TMS to the left M1 (M1-TMS). Fourteen healthy adult participants were instructed to control the abduction force of the right index finger to 20% of the maximum voluntary contraction. M1-TMS was delivered during this to induce cSP on electromyograph of the right first dorsal interosseous muscle. TMS over the right cerebellum (C-TMS) was conducted prior to M1-TMS. In the first experiment, M1-TMS intensity was set to 1 or 1.3 × resting motor threshold (rMT) with 20-ms ISI. In the second experiment, the intensity was set to 1 × rMT with ISI of 0, 10, 20, 30, 40, 50, 60, 70, or 80 ms, and no-C-TMS trials were inserted. In results, cSP was significantly shorter in 1 × rMT condition than in 1.3 × rMT by C-TMS, and cSP was significantly shorter for ISI of 20–40 ms than for the no-C-TMS condition. Further, motor evoked potential for ISI40-60 ms were significantly reduced than that for ISI0. Thus, C-TMS may reduce cSP induced by M1-TMS with ISI of 20–40 ms.

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“…Different mechanisms have been postulated, including white matter and cortical lesions, endocrine alterations, and the influence of neuroinflammation on brain functioning (80,81). Enhanced GABAergic activity tested with SICI and CSP has been specifically implicated in MS fatigue (82,83). In line with the hypothesis of increased M1 inhibition in fatigued MS patients, one study has demonstrated that a fatiguing motor task was associated with increased CSP duration.…”

Section: Tms Alterations Could Be Associated With Specific Ms Clinicamentioning

confidence: 97%

Inflammation and Corticospinal Functioning in Multiple Sclerosis: A TMS Perspective

et al. 2020

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Transcranial magnetic stimulation (TMS) has been employed in multiple sclerosis (MS) to assess the integrity of the corticospinal tract and the corpus callosum and to explore some physiological properties of the motor cortex. Specific alterations of TMS measures have been strongly associated to different pathophysiological mechanisms, particularly to demyelination and neuronal loss. Moreover, TMS has contributed to investigate the neurophysiological basis of MS symptoms, particularly those not completely explained by conventional structural damage, such as fatigue. However, variability existing between studies suggests that alternative mechanisms should be involved. Knowledge of MS pathophysiology has been enriched by experimental studies in animal models (i.e., experimental autoimmune encephalomyelitis) demonstrating that inflammation alters synaptic transmission, promoting hyperexcitability and neuronal damage. Accordingly, TMS studies have demonstrated an imbalance between cortical excitation and inhibition in MS. In particular, cerebrospinal fluid concentrations of different proinflammatory and anti-inflammatory molecules have been associated to corticospinal hyperexcitability, highlighting that inflammatory synaptopathy may represent a key pathophysiological mechanism in MS. In this perspective article, we discuss whether corticospinal excitability alterations assessed with TMS in MS patients could be useful to explain the pathophysiological correlates and their relationships with specific MS clinical characteristics and symptoms. Furthermore, we discuss evidence indicating that, in MS patients, inflammatory synaptopathy could be present since the early phases, could specifically characterize relapses, and could progressively increase during the disease course.

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Prolonged cortical silent period is related to poor fitness and fatigue, but not tumor necrosis factor, in Multiple Sclerosis

Cited by 36 publications

References 93 publications

The Potential Role of Neurophysiology in the Management of Multiple Sclerosis-Related Fatigue

The Potential Role of Neurophysiology in the Management of Multiple Sclerosis-Related Fatigue

Cerebellar Transcranial Magnetic Stimulation Reduces the Silent Period on Hand Muscle Electromyography During Force Control

Inflammation and Corticospinal Functioning in Multiple Sclerosis: A TMS Perspective

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