Correlates of disability in multiple sclerosis detected by transcranial magnetic stimulation

Schmierer, Klaus; Irlbacher, Kerstin; Grosse, Pascal; Röricht, Simone; Meyer, Bernd‐Ulrich

doi:10.1212/wnl.59.8.1218

Cited by 77 publications

(80 citation statements)

References 41 publications

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“…Onset and end latency of the TCI were taken at the initial and final intersections of the averaged signal with baseline indicating 80% of the background EMG level; the duration of EMG suppression between these two points was computed automatically [Inghilleri et al, 1993;Pascual-Leone et al, 2002;Schmierer et al, 2002]. Transcallosal conduction times were determined by subtracting the onset latency of the corticospinally mediated EMG response from the onset latency of TCI in the same FDI [Schmierer et al, 2002].…”

Section: Measurements and Analysismentioning

confidence: 99%

“…Transcallosal conduction times were determined by subtracting the onset latency of the corticospinally mediated EMG response from the onset latency of TCI in the same FDI [Schmierer et al, 2002].…”

Section: Measurements and Analysismentioning

confidence: 99%

“…In patients with MS, atrophy and dysfunction of the CC are common findings, even in the early stages of disease, and have been demonstrated with conventional MRI [Pozzilli et al, 1991;Rao et al, 1989], diffusion tensor imaging (DTI) [Ciccarelli et al, 2003], MRS [Ranjeva et al, 2003], and TMS [Schmierer et al, 2002].…”

Section: Introductionmentioning

confidence: 99%

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Effect of corpus callosum damage on ipsilateral motor activation in patients with multiple sclerosis: A functional and anatomical study

Lenzi¹,

Conte²,

Mainero³

et al. 2006

Human Brain Mapping

109

102

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Functional MRI (fMRI) studies have shown increased activation of ipsilateral motor areas during hand movement in patients with multiple sclerosis (MS). We hypothesized that these changes could be due to disruption of transcallosal inhibitory pathways. We studied 18 patients with relapsing-remitting MS. Conventional T1- and T2-weighted images were acquired and lesion load (LL) measured. Diffusion tensor imaging (DTI) was performed to estimate fractional anisotropy (FA) and mean diffusivity (MD) in the body of the corpus callosum (CC). fMRI was obtained during a right-hand motor task. Patients were studied to evaluate transcallosal inhibition (TCI, latency and duration) and central conduction time (CCT). Eighteen normal subjects were studied with the same techniques. Patients showed increased MD (P < 0.0005) and reduced FA (P < 0.0005) in the body of the CC. Mean latency and duration of TCI were altered in 12 patients and absent in the others. Between-group analysis showed greater activation in patients in bilateral premotor, primary motor (M1), and middle cingulate cortices and in the ipsilateral supplementary motor area, insula, and thalamus. A multivariate analysis between activation patterns, structural MRI, and neurophysiological findings demonstrated positive correlations between T1-LL, MD in the body of CC, and activation of the ipsilateral motor cortex (iM1) in patients. Duration of TCI was negatively correlated with activation in the iM1. Our data suggest that functional changes in iM1 in patients with MS during a motor task partially represents a consequence of loss of transcallosal inhibitory fibers.

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Section: Measurements and Analysismentioning

confidence: 99%

Section: Measurements and Analysismentioning

confidence: 99%

See 1 more Smart Citation

Effect of corpus callosum damage on ipsilateral motor activation in patients with multiple sclerosis: A functional and anatomical study

Lenzi¹,

Conte²,

Mainero³

et al. 2006

Human Brain Mapping

109

102

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show abstract

“…The most relevant finding of this study was the delay in latency of tcMMEPs in vehicle groups, but not in prophylactic or therapeutic teriflunomide-treated groups. Patients with MS exhibit a delay in the latency of TMS-induced MEPs, which correlates with disability (Michels et al, 1993;Schmierer et al, 2002;Conte et al, 2009;Kale et al, 2009). Latency delays can result from inflammation and demyelination and are observed during the acute, relapsing, and remitting phases of EAE.…”

Section: Effects Of Teriflunomide On Da Eae Rat Electrophysiology 207mentioning

confidence: 99%

Effects of Prophylactic and Therapeutic Teriflunomide in Transcranial Magnetic Stimulation–Induced Motor-Evoked Potentials in the Dark Agouti Rat Model of Experimental Autoimmune Encephalomyelitis

Iglesias-Bregna

Hanák

et al. 2013

J Pharmacol Exp Ther

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Teriflunomide is a once-daily oral immunomodulatory agent recently approved in the United States for the treatment of relapsing multiple sclerosis (RMS). This study investigated neurophysiological deficits in descending spinal cord motor tracts during experimental autoimmune encephalomyelitis (EAE; a model of multiple sclerosis) and the functional effectiveness of prophylactic or therapeutic teriflunomide treatment in preventing the debilitating paralysis observed in this model. Relapsing-remitting EAE was induced in Dark Agouti rats using rat spinal cord homogenate. Animals were treated with oral teriflunomide (10 mg/kg daily) prophylactically, therapeutically, or with vehicle (control). Transcranial magnetic motor-evoked potentials were measured throughout the disease to provide quantitative assessment of the neurophysiological status of descending motor tracts. Axonal damage was quantified histologically by silver staining. Both prophylactic and therapeutic teriflunomide treatment significantly reduced maximum EAE disease scores (P , 0.0001 and P 5 0.0001, respectively) compared with vehicle-treated rats. Electrophysiological recordings demonstrated that both teriflunomide treatment regimens prevented a delay in wave-form latency and a decrease in wave-form amplitude compared with that observed in vehicle-treated animals. A significant reduction in axonal loss was observed with both teriflunomide treatment regimens compared with vehicle (P , 0.0001 and P 5 0.0014, respectively). The results of this study suggest that therapeutic teriflunomide can prevent the deficits observed in this animal model in descending spinal cord motor tracts. The mechanism behind reduced axonal loss and improved motor function may be primarily the reduced inflammation and consequent demyelination observed in these animals through the known effects of teriflunomide on impairing proliferation of stimulated T cells. These findings may have significant implications for patients with RMS.

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“…On the other side of the spectrum, decreased IHI has been reported in patients with schizophrenia (Daskalakis et al 2002a) and epilepsy (Hanajima et al 2001). Patients with multiple sclerosis (Boroojerdi et al 1998;Schmierer et al 2002), schizophrenia (Bajbouj et al 2004;Boroojerdi et al 1999), focal hand dystonia (Niehaus et al 2001), and parkinsonian syndromes (Wolters et al 2004) have abnormal ipsilateral silent periods, another marker of transcallosal interactions. In some cases, the severity of clinical impairment correlated with the magnitude of IHI abnormality (Murase et al 2004;Schmierer et al 2002).…”

mentioning

confidence: 99%

High Level Bilateral Talks. Focus on “Effect of Low-Frequency Repetitive Transcranial Magnetic Stimulation on Interhemispheric Inhibition”

Harris-Love¹,

Cohen²

2005

Journal of Neurophysiology

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Correlates of disability in multiple sclerosis detected by transcranial magnetic stimulation

Abstract: The combination of central motor latencies and transcallosal inhibition evoked by transcranial magnetic stimulation yields objective data to estimate disease progression in MS as assessed by the EDSS.

Cited by 77 publications

References 41 publications

Effect of corpus callosum damage on ipsilateral motor activation in patients with multiple sclerosis: A functional and anatomical study

Effect of corpus callosum damage on ipsilateral motor activation in patients with multiple sclerosis: A functional and anatomical study

Effects of Prophylactic and Therapeutic Teriflunomide in Transcranial Magnetic Stimulation–Induced Motor-Evoked Potentials in the Dark Agouti Rat Model of Experimental Autoimmune Encephalomyelitis

High Level Bilateral Talks. Focus on “Effect of Low-Frequency Repetitive Transcranial Magnetic Stimulation on Interhemispheric Inhibition”

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