Three different short-interval intracortical inhibition methods in early diagnosis of amyotrophic lateral sclerosis

Tankisi, Hatice; Pia, Hossein; Strunge, Kristine; Howells, James; Çengiz, Bülent; Samušytė, Gintautė; Koltzenburg, M; Fuglsang‐Frederiksen, Anders; Bostock, Hugh

doi:10.1080/21678421.2022.2101926

Cited by 14 publications

(24 citation statements)

References 27 publications

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“…1 Case reports with similar clinical features have been documented and diagnostic criteria for a unique clinical entity have been proposed. 2 With results from short-interval intracortical inhibition (SICI) transcranial magnetic stimulation (TMS) studies, 3 we present a case of Mills' syndrome with evidence of cortical hyperexcitability corresponding to the asymptomatic limb.…”

Section: Hyperexcitability Of the Asymptomatic Motor Cortex In A Case...mentioning

confidence: 99%

Hyperexcitability of the asymptomatic motor cortex in a case of Mills' syndrome

Conwill,

Alix,

Shaw

2024

Muscle and Nerve

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Section: Hyperexcitability Of the Asymptomatic Motor Cortex In A Case...mentioning

confidence: 99%

Hyperexcitability of the asymptomatic motor cortex in a case of Mills' syndrome

Conwill,

Alix,

Shaw

2024

Muscle and Nerve

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“…Across the range of measures obtained in relation to motor cortical function, reduction of SICI appears the be the most sensitive TMS biomarker of cortical hyperexcitability, reliably differentiating ALS from mimic disorders at an early stage in the disease process [67]. Newly developed parallel threshold-tracking methods have demonstrated even greater sensitivity to distinguish mimics compared with conventional protocols [68 ▪ ]. A recent study also identified a distinct pattern of cortical excitability across cognitive phenotypes in ALS.…”

Section: Cortical Hyperexcitability As a Diagnostic Biomarkermentioning

confidence: 99%

Cortical hyperexcitability in amyotrophic lateral sclerosis: from pathogenesis to diagnosis

Timmins

Vucic

Kiernan

2023

Current Opinion in Neurology

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Purpose of review Identification of upper motor neuron involvement remains a critical component of a diagnosis of amyotrophic lateral sclerosis (ALS), although supportive clinical signs are often not easily appreciated, particularly in the early symptomatic stages of the disease. Although diagnostic criteria have been developed to facilitate improved detection of lower motor neuron impairment through electrophysiological features that have improved diagnostic sensitivity, assessment of upper motor neuron involvement remains problematic. Recent findings Recent evidence has emerged about pathophysiological processes, particularly glutamate-mediated excitotoxicity, which has resulted in the development of novel diagnostic investigations and uncovered potential therapeutic targets. Advances in genetics, including the C9orf72 gene, have changed concepts of ALS, from being classified as a neuromuscular disease to a disease that forms a continuum with other primary neurodegenerative disorders, particularly frontotemporal dementia. Transcranial magnetic stimulation has been utilized to provide pathophysiological insights, leading to the development of diagnostic and therapeutic biomarkers, which are now being introduced into the clinical setting. Summary Specifically, the advent of cortical hyperexcitability has been consistently identified as an early and intrinsic feature of ALS. With greater accessibility of TMS techniques promoting clinical utilization, TMS measures of cortical function may develop as a diagnostic biomarker, with further potential utility in the clinical trial setting for monitoring of neuroprotective and genetic-based therapies.

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“…Thus, T‐SICIp avoids a systematic methodological limitation of T‐SICIs that SICI values at one ISI are strongly biased by the SICI values of the preceding ISI 12 . Furthermore, in a head‐to‐head comparison of the three SICI methods in the early diagnosis of ALS, the improved methodology of T‐SICIp was more sensitive than either T‐SICIs 14 or A‐SICI 14,15 …”

Section: Introductionmentioning

confidence: 99%

“…If caffeine does alter corticospinal excitability as measured with SICI, control for caffeine consumption would be important. in the diagnosis of amyotrophic lateral sclerosis 10–12,14,15,19,20 …”

Section: Introductionmentioning

confidence: 99%

“…12 Furthermore, in a head-to-head comparison of the three SICI methods in the early diagnosis of ALS, the improved methodology of T-SICIp was more sensitive than either T-SICIs 14 or A-SICI. 14,15 Caffeine is consumed widely, mainly in coffee, tea, and energy drinks, and improves alertness and physical performance. Caffeine acts in relevant and normal daily doses of one or two cups of coffee (50-400 mg per day) as an antagonist of the adenosine receptor A 2A , and the mechanisms are critically involved in wake-sleep processes in human.…”

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confidence: 99%

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Caffeine and cortical excitability, as measured with paired‐pulse transcranial magnetic stimulation

Strunge,

Bostock,

Howells

et al. 2023

Muscle and Nerve

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Introduction/AimsThe transcranial magnetic stimulation tests of short‐interval intracortical inhibition (SICI) by both conventional amplitude measurements (A‐SICI) and threshold‐tracking (T‐SICI) are important methods to investigate intracortical inhibitory circuits, and T‐SICI has been proposed to aid the diagnosis of amyotrophic lateral sclerosis. Beverages containing caffeine are widely consumed, and caffeine has been reported to affect cortical excitability. The aim of this study was to determine whether these SICI tests are affected by caffeine.MethodsTwenty‐four healthy subjects (13 females, 11 males, aged from 19 to 31, mean: 26.2 ± 2.4 years) were studied in a single fixed‐dose randomized double‐blind placebo‐controlled cross‐over trial of 200 mg caffeine or placebo ingested as chewing gum. A‐SICI and T‐SICI, using parallel tracking (T‐SICIp), were performed before and after chewing gum.ResultsThere was no significant change in SICI parameters after placebo in A‐SICI (p > .10) or T‐SICIp (p > .30), and no significant effect of caffeine was found on A‐SICI (p > .10) or T‐SICIp (p > .50) for any of the interstimulus intervals.DiscussionThere is no need for caffeine abstention before measurements of SICI by either the T‐SICI or A‐SICI measurements.

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Three different short-interval intracortical inhibition methods in early diagnosis of amyotrophic lateral sclerosis

Abstract: Introduction, Methods, Results, Discussion: 3170 Number of figures: 5 Number of color figures: 3 Number of tables: 1 Three different short-interval intracortical inhibition methods in early diagnosis of amyotrophic lateral sclerosis

Cited by 14 publications

References 27 publications

Hyperexcitability of the asymptomatic motor cortex in a case of Mills' syndrome

Hyperexcitability of the asymptomatic motor cortex in a case of Mills' syndrome

Cortical hyperexcitability in amyotrophic lateral sclerosis: from pathogenesis to diagnosis

Caffeine and cortical excitability, as measured with paired‐pulse transcranial magnetic stimulation

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