Mild cerebello-thalamo-cortical impairment in patients with normal dopaminergic scans (SWEDD)

Schirinzi, Tommaso; Lorenzo, Francesco Di; Ponzo, Viviana; Palmieri, Maria Giuseppina; Bentivoglio, Anna Rita; Schillaci, Orazio; Pisani, Antonio; Koch, Giacomo

doi:10.1016/j.parkreldis.2016.03.023

Cited by 22 publications

(20 citation statements)

References 26 publications

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“…Our results are consistent with previous observations showing that it is possible to modulate the motor cortex from the cerebellum using cerebellar cTBS (Koch et al, 2008; Li Voti et al, 2014; Schirinzi et al, 2016). The novel finding of this study is that cerebellar cTBS reduced the M1 excitability in patients with CD though not in those with FHD.…”

Section: Discussionsupporting

confidence: 93%

“…We found a significant inhibitory effect of cerebellar cTBS on M1 excitability at 5–10 min after stimulation but it should be acknowledged that synaptic plasticity in the cerebello-thalamo-cortical circuit may require a longer time to allow biological changes as shown by experimental recordings in vitro (Aumann et al, 2000) and neurophysiological studies in humans (Schirinzi et al, 2016). Since we only assessed CD and FHD patients we cannot easily generalize our findings to patients with other forms of focal dystonia.…”

Section: Discussionmentioning

confidence: 81%

“…The cTBS protocol consists of high frequency (50 Hz) burst of three stimuli, repeated at 5 Hz for an overall duration of 40 s. Cerebellar real cTBS was delivered with the coil positioned over the cerebellar hemisphere, i.e., 3 cm laterally to and 1 cm below the inion, while cerebellar sham cTBS consisted of the stimulation of neck muscles. Sham cTBS does not stimulate the cerebellum but does induce slight twitches in the neck muscle similar to those induced by real cTBS (Koch et al, 2008; Hoffland et al, 2012, 2013; Li Voti et al, 2014; Schirinzi et al, 2016). …”

Section: Methodsmentioning

confidence: 81%

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Effects of cerebellar theta-burst stimulation on arm and neck movement kinematics in patients with focal dystonia

Bologna

Paparella

Fabbrini

et al. 2016

Clinical Neurophysiology

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Objective To investigate the cerebellar inhibitory influence on the primary motor cortex in patients with focal dystonia using a cerebellar continuous theta-burst stimulation protocol (cTBS) and to evaluate any relationship with movement abnormalities. Methods Thirteen patients with focal hand dystonia, 13 patients with cervical dystonia and 13 healthy subjects underwent two sessions: (i) cTBS over the cerebellar hemisphere (real cTBS) and (ii) cTBS over the neck muscles (sham cTBS). The effects of cerebellar cTBS were quantified as excitability changes in the contralateral primary motor cortex, as well as possible changes in arm and neck movements in patients. Results Real cerebellar cTBS reduced the excitability in the contralateral primary motor cortex in healthy subjects and in patients with cervical dystonia, though not in patients with focal hand dystonia. There was no correlation between changes in primary motor cortex excitability and arm and neck movement kinematics in patients. There were no changes in clinical scores or in kinematic measures, after either real or sham cerebellar cTBS in patients. Conclusions The reduced cerebellar inhibitory modulation of primary motor cortex excitability in focal dystonia may be related to the body areas affected by dystonia as opposed to being a widespread pathophysiological abnormality. Significance The present study yields information on the differential role played by the cerebellum in the pathophysiology of different focal dystonias.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 81%

Section: Methodsmentioning

confidence: 81%

See 1 more Smart Citation

Effects of cerebellar theta-burst stimulation on arm and neck movement kinematics in patients with focal dystonia

Bologna

Paparella

Fabbrini

et al. 2016

Clinical Neurophysiology

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show abstract

“…Four PD patients and one ART were not included in our data analysis because of middle ear disease revealed by the acoustic impedance test The PD group, by history, showed a mean disease duration of 8.7 ± 1.1 years and, on clinical examination, a mean UPDRS III score of 9.64 ± 5.6 (range, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19], H&Y staging ranged from 1.5 to 3 (mean 2.4 ± 1.2).…”

Section: Resultsmentioning

confidence: 99%

“…Idiopathic PD was diagnosed in accordance with the British Parkinson's Disease Society Brain Bank criteria [7] and confirmed with DaTscan. ART patients were enrolled from a cohort of subjects [8,9], previously referred to as "SWEDD" (scans without evidence of dopaminergic deficit) [10][11][12]. As the nomenclature and definition of this group of patients is still unclear, we refer to this population as ART.…”

Section: Subjects Enrollment and Evaluationmentioning

confidence: 99%