Transcranial magnetic stimulation as a diagnostic and prognostic test in amyotrophic lateral sclerosis

Claus, D.; Brunhölzl, C.; Kerling, Frank; Henschel, S.

doi:10.1016/0022-510x(95)00056-8

Cited by 62 publications

(28 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…9,14,15,34,40,46,47 In agreement with Rösler et al, 42 we observed no instances of abnormal CMCT associated with normal TST in any of our ALS patients.…”

Section: Discussionsupporting

confidence: 94%

“…CMCT is reportedly not a sensitive variable for the diagnosis of ALS. 9,14,15,34,40,46,47 A decrease in SP duration 1,11,40,43,45 or an increase in RMT 47 seem to be sensitive variables for diagnosing ALS. By contrast, the amplitude of the MEP is not a reliable marker of UMN dysfunction; even in healthy subjects, MEPs are much smaller than the compound muscle action potentials (CMAPs) evoked by peripheral stimulation.…”

mentioning

confidence: 95%

See 1 more Smart Citation

Magnetic stimulation including the triple‐stimulation technique in amyotrophic lateral sclerosis

2007

View full text Add to dashboard Cite

To study the relative importance of upper motor neuron (UMN) dysfunction in the weakness of amyotrophic lateral sclerosis (ALS) and to compare the sensitivity of several transcranial magnetic stimulation (TMS) parameters as means of assessing UMN impairment in ALS, we used TMS to evaluate one upper limb of 63 patients. The triple-stimulation technique (TST) and silent period (SP) were found to be the most frequently abnormal parameters (55.6% and 47.6%, respectively), without significant difference in their diagnostic sensitivity. The SP was found to be a useful parameter in patients with suspected or possible ALS. A positive correlation was found between weakness and the TST amplitude ratio, indicating that weakness may partly be caused by UMN dysfunction. Thus, the TST provides a quantitative tool for assessing UMN conduction failure. When used in association with the SP, the TST provides a sensitive diagnostic tool for use on ALS patients.

show abstract

“…9,14,15,34,40,46,47 In agreement with Rösler et al, 42 we observed no instances of abnormal CMCT associated with normal TST in any of our ALS patients.…”

Section: Discussionsupporting

confidence: 94%

mentioning

confidence: 95%

Magnetic stimulation including the triple‐stimulation technique in amyotrophic lateral sclerosis

2007

View full text Add to dashboard Cite

show abstract

“…And, unfortunately, methods for assessing upper motor neuron dysfunction in the disease are decidedly limited. However, in the early 1990s, several studies showed that cortical excitability was altered in ALS by the use of transcranial magnetic stimulation (TMS) [69][70][71]. Many studies since then have been pursued, and a number of measures appear to be altered in ALS, including motor threshold (generally reduced early in the disease, supporting the presence of increased excitability), motor-evoked potential (generally also increased early in the disease), central motor conduction time (generally prolonged in the disease), and cortical silent period (reduced in the disease) [72].…”

Section: Transcranial Magnetic Stimulation Measuresmentioning

confidence: 99%

Clinical Measures of Disease Progression in Amyotrophic Lateral Sclerosis

Rutkove

2015

Neurotherapeutics

View full text Add to dashboard Cite

Progressive weakness remains the clinical hallmark of amyotrophic lateral sclerosis (ALS). Accordingly, a variety of tools has been developed to capture this disease feature, including questionnaires, such as the ALS-functional rating scale, strength testing, pulmonary function tests, electrophysiologic measures, including motor unit number estimation, and imaging techniques. Despite this plethora of approaches, there is little agreement as to what measures to use in a given clinical trial or in the clinic during routine patient care. Part of the reason for this uncertainty is that ALS is a remarkably protean disease. Some individuals progress rapidly, others slowly; some patients have considerable upper motor neuron dysfunction, whereas others have little; and there is considerable variation in the sequence of body regions affected, in some the disease beginning in the bulbar musculature and in others in one arm or one leg. Here, I present a variety of basic and more complex clinical measures for potential use in therapeutic trials with the aim of offering a balanced and practical set of recommendations, as well as considerations for future studies.

show abstract

“…Part of the SP shortening in ALS seems to reflect the reduced activation of cortical or spinal inhibitory networks by the abnormal corticospinal pathway. 4,5,19,33 In these studies, it was found that the resting motor threshold, size of motor evoked potentials (MEPs), and ratio between amplitude of MEP elicited by TMS and compound muscle action potential (CMAP) obtained by supramaximal electrical nerve stimulation are not very sensitive means of monitoring changes occurring in the course of the disease. Although the decrease in duration of the silent period (SP) is reportedly a sensitive variable for diagnosing ALS, 1,6,23,28 conflicting results have been published 19,33 about the time-related changes in this parameter.…”

mentioning

confidence: 99%

Covariation of corticospinal efficiency and silent period in motoneuron diseases

Attarian

Pouget

Schmied³

2006

Muscle and Nerve

View full text Add to dashboard Cite

For a better understanding of the changes affecting the cortically induced silent period (SP) in motoneuron disease, the excitatory and inhibitory effects of transcranial magnetic stimulation were explored repeatedly in 8 patients with amyotrophic lateral sclerosis (ALS), 3 patients with Kennedy's disease (KD), and 10 healthy subjects. In KD, the background electromyogram (EMG) and the motor evoked potential (MEP) area were both enhanced. However, neither the corticospinal efficiency (MEP gain, the ratio between MEP and background EMG) nor the duration of the SP differed from healthy subjects. In ALS patients, the MEP gain and the SP duration decreased conspicuously with time. We conclude that use of the MEP gain improves detection of corticospinal dysfunction in ALS patients. Part of the SP shortening in ALS seems to reflect the reduced activation of cortical or spinal inhibitory networks by the abnormal corticospinal pathway.

show abstract

Transcranial magnetic stimulation as a diagnostic and prognostic test in amyotrophic lateral sclerosis

Cited by 62 publications

References 16 publications

Magnetic stimulation including the triple‐stimulation technique in amyotrophic lateral sclerosis

Magnetic stimulation including the triple‐stimulation technique in amyotrophic lateral sclerosis

Clinical Measures of Disease Progression in Amyotrophic Lateral Sclerosis

Covariation of corticospinal efficiency and silent period in motoneuron diseases

Contact Info

Product

Resources

About