Repetitive paired-pulse transcranial magnetic stimulation at I-wave intervals (iTMS) increases cortical excitability and improves movement initiation in Parkinson’s Disease (PD)

Rodrigues, Julian P.; Walters, Sue; Stell, Rick; Thickbroom, G.W.; Mastaglia, Francis

doi:10.1016/j.clinph.2007.10.055

Cited by 1 publication

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“…Map shifts correlate with the severity of clinical symptoms (UPDRS) and suggest an ongoing process of cortical reorganization with functional consequences [ 24 ]. Dopamine has been implicated in the modulation of neuroplasticity [ 19 ], and the loss of dopaminergic neurons in PD may have secondary effects on cortical organization or limit the natural ability of plasticity mechanisms to compensate for disease-related processes, and there is some indication that NBS may be more effective when applied during levodopa therapy, when plasticity mechanisms may be more functional [ 26 , 27 ]. As well, cortical rTMS interventions can lead to release of dopamine in the basal ganglia and raise serum dopamine levels [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

Plasticity in neurological disorders and challenges for noninvasive brain stimulation (NBS)

Thickbroom

Mastaglia

2009

J NeuroEngineering Rehabil

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There has been considerable interest in trialing NBS in a range of neurological conditions, and in parallel the range of NBS techniques available continues to expand. Underpinning this is the idea that NBS modulates neuroplasticity and that plasticity is an important contributor to functional recovery after brain injury and to the pathophysiology of neurological disorders. However while the evidence for neuroplasticity and its varied mechanisms is strong, the relationship to functional outcome is less clear and the clinical indications remain to be determined. To be maximally effective, the application of NBS techniques will need to be refined to take into account the diversity of neurological symptoms, the fundamental differences between acute, longstanding and chronic progressive disease processes, and the differential part played by functional and dysfunctional plasticity in diseases of the brain and spinal cord.

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