Patients with focal arm dystonia have increased sensitivity to slow-frequency repetitive TMS of the dorsal premotor cortex.

Details

Serval ID
serval:BIB_26C5E26A9951
Type
Article: article from journal or magazin.
Collection
Publications
Title
Patients with focal arm dystonia have increased sensitivity to slow-frequency repetitive TMS of the dorsal premotor cortex.
Journal
Brain
Author(s)
Siebner H.R., Filipovic S.R., Rowe J.B., Cordivari C., Gerschlager W., Rothwell J.C., Frackowiak R.S., Bhatia K.P.
ISSN
0006-8950 (Print)
ISSN-L
0006-8950
Publication state
Published
Issued date
2003
Volume
126
Number
Pt 12
Pages
2710-2725
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Abstract
We used PET to examine the pattern and time course of changes produced by repetitive transcranial magnetic stimulation (rTMS) over the dorsal premotor cortex (PMd) in healthy subjects and in patients with primary focal dystonia. Subjects received 1800 stimuli of subthreshold 1 Hz rTMS or sham stimulation to the left PMd. Afterwards, we measured regional cerebral blood flow (rCBF) as a marker of synaptic activity at rest and during performance of freely selected random finger movement. In both groups of subjects, real rTMS caused widespread bilateral decreases in neuronal activity in prefrontal, premotor, primary motor cortex, and left putamen. Conversely, rCBF in the cerebellum increased. Effects were equivalent at rest and during movement, indicating that the pattern of movement-related activation did not change. rTMS-induced changes in neuronal activity lasted for at least 1 h except in the medial aspect of the left globus pallidus. Conditioning effects on neuronal activity were larger in the patients than in the healthy subjects: there was a greater decrease of rCBF in lateral and medial premotor areas, putamen, and thalamus, including the stimulated premotor cortex, and a larger increase in cerebellar rCBF. Our findings indicate that, in healthy subjects and patients with dystonia, a single session of rTMS can produce powerful and widespread changes in regional synaptic activity as indexed by rCBF. Since the greater effects of premotor rTMS were not related to any differences in task performance, increased responsiveness of the motor system to rTMS reveals a physiological trait that characterizes patients with focal arm dystonia.
Keywords
Adult, Aged, Arm/physiopathology, Brain/radionuclide imaging, Cerebrovascular Circulation, Dystonic Disorders/physiopathology, Electric Stimulation/methods, Female, Humans, Magnetics, Male, Middle Aged, Motor Cortex/physiopathology, Motor Cortex/radionuclide imaging, Movement, Synapses/physiology, Tomography, Emission-Computed, Single-Photon
Pubmed
Web of science
Open Access
Yes
Create date
11/09/2011 18:41
Last modification date
20/08/2019 13:05
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