1,721,016 research outputs found
Mapping of interictal epileptic discharges: Comparison of results from event-related BOLD MRI and dipole source analysis
No full textMapping of interictal epileptic discharges: Comparison of results from event-related BOLD MRI and dipole source analysis
No full textPaired-pulse repetitive transcranial magnetic stimulation of the human motor cortex
No full textIn nine healthy humans we modulated corticospinal excitability by using conditioning-test paired-pulse transcranial magnetic stimulation in a repetitive mode (rTMS), and we compared its effect to conventional single-pulse rTMS. We applied 80 single pulses or 80 paired pulses to the motor cortex at frequencies ranging from 0.17 to 5 Hz. The conditioning-test intervals were 2, 5, or 10 ms. Motor evoked potential (MEP) amplitudes from the abductor digiti minimi (ADM) as target muscle and extensor carpi radialis (ECR) indicated the excitability changes during and after rTMS. During paired-pulse rTMS at a facilitatory conditioning-test interval of 10 ms, we observed a facilitation of MEPs at 1, 2, and 5 Hz. A similar facilitation was found during single-pulse rTMS, when stimulus intensity was adjusted to evoke MEPs of comparable size. Using an inhibitory conditioning-test interval of 2 ms, paired-pulse rTMS at frequencies of 1 and 2 Hz caused no change in MEP size during the train. However, paired-pulse rTMS at 5 Hz caused a strong enhancement of MEP size, indicating a loss of paired-pulse inhibition during the rTMS train. Since no facilitatory effect was observed during single-pulse rTMS with an adjusted stimulus intensity, the MEP enhancement during 5 Hz rTMS was specific for "inhibitory" paired-pulse rTMS. After 5 Hz rTMS MEPs were facilitated for 1 min, and this effect was not substantially different between paired-pulse rTMS and single-pulse rTMS. The correlation between ADM and ECR was most pronounced at 5 Hz rTMS. We conclude that paired-pulse rTMS is a suitable tool to study changes in corticospinal excitability during the course of rTMS. In addition, our data suggest that short trains of paired-pulse rTMS are not superior to single-pulse rTMS in inducing lasting inhibition or facilitation
Inverse correlation of intracortical inhibition and brain-stem inhibition in humans
No full textObjective: To determine whether intracortical inhibition and the conditioned blink reflex R2 inhibition correlate in healthy subjects. Background: In Parkinson's disease and in focal dystonia the intracortical inhibition and the conditioned blink reflex R2 inhibition are abnormally weak. Methods: In 10 healthy humans (average age 25.7 years) we investigated the intracortical excitability of the optimal representation of the abductor digiti minimi of the dominant hand using transcranial magnetic stimulation with a conditioning pulse (90% active motor threshold) followed by a pulse of 120% resting motor threshold after an interstimulus interval ranging from 1 to 30 ms. We investigated the blink reflex with two suprathreshold stimuli over the supraorbital nerve and EMG recording from the orbicularis oculi ipsilateral to electrical stimulation, the interstimulus intervals were 100, 250 and 500 ms. Results: The intracortical inhibition, but not the intracortical facilitation, was inversely and significantly correlated with the R2 inhibition on the side of transcranial stimulation, but not with the contralateral R2 inhibition. Conclusions: The correlation of intracortical inhibitory interneurons and ipsilateral blink reflex interneurons may indicate a common influence, possibly from the basal ganglia, on either circuit, or a direct influence of cortical circuits on brain-stem circuits via corticopontine pathways. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved
Suprathreshold repetitive transcranial magnetic stimulation elevates thyroid-stimulating hormone in healthy male subjects
No full textRepetitive transcranial magnetic stimulation (rTMS) has been introduced as a new antidepressive treatment strategy. The mode of action by which the antidepressive effect is brought about is not yet clear. Other antidepressive treatment strategies such as sleep deprivation are associated with an increase of plasma thyroid-stimulating hormone (TSH) levels that correlate with clinical improvement. In the present study, the effect of left prefrontal suprathreshold (120% of motor threshold) rTMS on TSH plasma levels of 19 healthy male subjects was investigated in comparison with subthreshold (80% of motor threshold) and sham stimulation. Suprathreshold rTMS was followed by a significant relative increase of TSH levels 10 and 60 minutes after stimulation in comparison with subthreshold and sham stimulation. The more pronounced effect of suprathreshold rTMS on TSH plasma levels might be important for the determination of optimal stimulation parameters in the treatment of depressed patients
Normal intracortical excitability in developmental stuttering
No full textPersistent developmental stuttering (PDS) shares clinical features with task-specific dystonias. In these dystonias, intracortical inhibition is abnormally weak. We therefore sought to determine intracortical inhibition and intracortical facilitation in PDS. In 18 subjects with PDS since childhood (mean age, 39.4 [SD 13.0] years) and 18 speech-fluent controls (43.6 [14.3] years), we investigated resting and active motor thresholds as well as intracortical inhibition and facilitation of the optimal representation of the abductor digiti minimi of the dominant hand using transcranial magnetic stimulation. In PDS, the resting and active motor thresholds were increased, whereas intracortical inhibition and facilitation were normal. Normal intracortical excitability makes a pathophysiological analogy between focal dystonia and PDS less likely. The enhanced motor threshold suggests reduced motor cortical neuronal membrane excitability in PDS. (C) 2003 Movement Disorder Society
Lasting influence of repetitive transcranial magnetic stimulation on intracortical excitability in human subjects
No full textWe studied the effects of a train of 30 pulses of repetitive transcranial magnetic stimulation (rTMS) at frequencies of 5 and 15 Hz and at an intensity of 120% of resting motor threshold on human motor cortex excitability. Intracortical inhibition (ICI) and intracortical facilitation (ICF) after rTMS were tested by a conditioning-test designed paired-pulse paradigm. After 15 Hz rTMS, ICI was significantly reduced for 3.2 min, ICF was enhanced for 1.5 min, muscle evoked potentials from single TMS were increased in the first 30 s only. After 5 Hz rTMS ICI was significantly reduced in the first 32 s. We conclude that high-frequency suprathreshold rTMS transiently suppresses the activity of the intracortical inhibitory circuitry and, with a different time course, increases the excitability of the excitatory circuitry. (C) 2000 Elsevier Science ireland Ltd. All rights reserved
COGNITIVE PERFORMANCE IN PATIENTS WITH FOCAL AND PRIMARY GENERALIZED EPILEPSY UNDER LEVETIRACETAM OR TOPIRAMATE MONOTHERAPY: A PROSPECTIVE PSEUDO-RANDOMIZED STUDY
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