Ipsilateral silent period: A marker of callosal conduction abnormality in early relapsing–remitting multiple sclerosis?

Jung, Patrick; Beyerle, A.; Humpich, Marek; Neumann‐Haefelin, Tobias; Lanfermann, Heinrich; Ziemann, Ulf

doi:10.1016/j.jns.2006.08.008

Cited by 39 publications

(35 citation statements)

References 41 publications

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“…To the best of our knowledge, this is the first time that impaired S-IHI is demonstrated in RRMS patients by means of the bifocal paired TMS protocol [Ferbert et al, 1992]. These results are in line with previous studies that showed abnormally lengthened onset latency and/or prolonged duration of the ipsilateral silent period, suggestive of [Boroojerdi et al, 1998;Hö ppner et al, 1999;Schmierer et al, 2000] but not specifically testing a motor callosal conduction deficit in MS patients [Jung et al, 2006]. In contrast, L-IHI was not affected in RRMS when compared to healthy subjects (Fig.…”

Section: Cmf Effective Connectivity In Early Rrms Patientssupporting

confidence: 92%

“…9.0 ms to the slightly contracting (10-20% of maximum) first dorsal interosseus (FDI) muscle of both hands, and for the patients, EDSS 2.0. Normal central motor conduction time was employed as an inclusion criterion to exclude the possibility that abnormal corticospinal conduction contaminated the measurements of primary interest of this study on interhemispheric inhibition [Jung et al, 2006]. Exclusion criteria comprised of the usual contraindications for MRI and TMS.…”

Section: Subjectsmentioning

confidence: 99%

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Motor callosal disconnection in early relapsing‐remitting multiple sclerosis

Wahl

Hübers

Lauterbach-Soon

et al. 2011

Human Brain Mapping

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In relapsing-remitting multiple sclerosis (RRMS) the corpus callosum (CC) is often and early affected by macroscopic lesions when investigated by conventional MRI. We sought to determine to which extent microstructural and effective disconnection of the CC are already present in RRMS patients at the earliest stages of the disease prior to evidence of macroscopic CC lesion. We compared 16 very early RRMS patients (median expanded disability status scale (EDSS), 1.5; range, 0-2.0) to an age-matched group of healthy controls and focused analysis to the motor CC, i.e. that part of the CC relaying interhemispheric motor information. A combined functional magnetic resonance imaging/diffusion tensor imaging fiber-tracking procedure was applied to identify the callosal motor fibers (CMFs) connecting the hand areas of the primary motor cortices of the two hemispheres. Fractional anisotropy (FA) within the motor CC (FA-CC) assessed the CMF microstructural integrity. Bifocal paired transcranial magnetic stimulation (TMS) tested short-interval interhemispheric inhibition (S-IHI), an established measure of CMF effective connectivity. FA-CC and S-IHI were significantly reduced in early RRMS compared to healthy controls. Furthermore, a significant linear correlation between microstructure (FA-CC) and function (S-IHI) in the controls was broken down in the patients. These abnormalities were obtained in the absence of macroscopic CMF lesion in conventional MRI, and whilst motor hand/arm function in the nine-hole-peg test and corticospinal conduction time were normal. Findings suggest that reductions in FA and S-IHI may serve as surrogate markers of motor callosal disconnection at the earliest stages of RRMS prior to development of macroscopic lesion.

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Section: Cmf Effective Connectivity In Early Rrms Patientssupporting

confidence: 92%

Section: Subjectsmentioning

confidence: 99%

Motor callosal disconnection in early relapsing‐remitting multiple sclerosis

Wahl

Hübers

Lauterbach-Soon

et al. 2011

Human Brain Mapping

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“…Despite the suggestion that subcortical or ipsilateral cortico-spinal mechanisms may play a role in the physiology of the iSP, the inhibitory action appears to be mediated mainly by transcallosal pathways, especially the first phase of the iSP [6,11,12,14,27,28]. Changes in iSP duration have been shown to be the most sensitive parameters for detecting demyelination [15]. As not only iSP latency, but also iSP duration, and additionally TCT alterations-reflecting neurophysiological callosal dysfunction substantially on a supraspinal level-were correlated with increasing CMA in our study, it may be hypothesized that chronic demyelination of callosal inhibitory pathways due to chronic hypoperfusion in CMA patients is an important mechanism contributing to callosal dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…ISP testing is a simple and robust technique for assessing the inhibitory transcallosal pathways by analysis of iSP onset, duration and depth. ISP duration is suggested to be an indicator of the degree to which the contralateral corticospinal tract is affected [15]. The callosal specifity of measurements may be enhanced by calculation of the transcallosal conduction time (TCT), considering the central motor conduction time (CMCT).…”

Section: Introductionmentioning

confidence: 99%

Altered callosal function in cerebral microangiopathy

et al. 2009

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Callosal dysfunction is known to be evident in a variety of neurodegenerative and inflammatory diseases of the central nervous system. Cerebral microangiopathy (CMA) may also affect callosal pathways by chronic demyelination. The aim of the present study was to investigate callosal function with respect to the extent of CMA. Callosal function was tested by a bimanual tapping task and by analysis of the ipsilateral silent period (iSP) and the transcallosal conduction time (TCT) using transcranial magnetic stimulation. Results were correlated to the extent of CMA measured by cranial magnetic resonance imaging (cMRI) in 44 patients with CMA compared to 10 control subjects. The extent of CMA was quantified by a cMRI score. Additionally, callosal atrophy was quantified by cMRI morphometry. Frequency of pathological iSP findings or disturbed bimanual tapping was significantly correlated to a higher CMA score. Moreover, the extent of CMA was significantly correlated to the degree of callosal atrophy. It is concluded that CMA considerably affects callosal pathways, possibly by chronic demyelination of callosal fibres. As the extent of CMA and atrophy of the corpus callosum is correlated to callosal dysfunction, analysis of the iSP can be used to assess the clinical impact of CMA detected by cMRI.

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“…Diese Ergebnisse konnten Jung u. Mitarb. in einem größeren Pa− tientenkollektiv nicht bestätigen [22]. Sie fanden weder eine größere Sensitivität der iSP gegen− über der zentralmotorischen Leitungszeit (ZML) noch waren iSP und ZML als unabhängig vonei− nander anzusehen [22].…”

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Neurophysiologische Diagnostik des transkallosalen Systems bei neurodegenerativen Erkrankungen

Wittstock¹,

Benecke²

2008

Klin Neurophysiol

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Ipsilateral silent period: A marker of callosal conduction abnormality in early relapsing–remitting multiple sclerosis?

Cited by 39 publications

References 41 publications

Motor callosal disconnection in early relapsing‐remitting multiple sclerosis

Motor callosal disconnection in early relapsing‐remitting multiple sclerosis

Altered callosal function in cerebral microangiopathy

Neurophysiologische Diagnostik des transkallosalen Systems bei neurodegenerativen Erkrankungen

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