Cargando…

Regional motor cortex dysfunction in amyotrophic lateral sclerosis

OBJECTIVE: The pathophysiological processes underlying amyotrophic lateral sclerosis (ALS) need to be better understood, although cortical dysfunction has been implicated. Previous transcranial magnetic stimulation (TMS) studies have assessed cortical dysfunction from the hand. The aim of the presen...

Descripción completa

Detalles Bibliográficos
Autores principales: Menon, Parvathi, Yiannikas, Con, Kiernan, Matthew C., Vucic, Steve
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6689694/
https://www.ncbi.nlm.nih.gov/pubmed/31402622
http://dx.doi.org/10.1002/acn3.50819
_version_ 1783443074770272256
author Menon, Parvathi
Yiannikas, Con
Kiernan, Matthew C.
Vucic, Steve
author_facet Menon, Parvathi
Yiannikas, Con
Kiernan, Matthew C.
Vucic, Steve
author_sort Menon, Parvathi
collection PubMed
description OBJECTIVE: The pathophysiological processes underlying amyotrophic lateral sclerosis (ALS) need to be better understood, although cortical dysfunction has been implicated. Previous transcranial magnetic stimulation (TMS) studies have assessed cortical dysfunction from the hand. The aim of the present study was to determine whether cortical dysfunction was evident across representations of three body regions, and to relate these changes to clinical features of ALS. METHODS: In this cross‐sectional study, threshold tracking TMS was undertaken in 60 sporadic ALS patients, with motor evoked potential (MEP) responses recorded over the hand (abductor pollicis brevis), lower limb (tibialis anterior), and bulbar (trapezius) regions. The cross‐sectional findings were compared to 28 age‐ and gender‐matched controls. RESULTS: Cortical dysfunction was evident across the representation of the three body regions, although the degree and nature of the dysfunction varied. Cortical hyperexcitability, as heralded by reduced short interval intracortical inhibition (SICI), was evident in all cortical regions (hand, P < 0.01; leg, P < 0.05; bulbar, P < 0.05) in ALS patients when compared with healthy control subjects. Importantly, features of cortical hyperexcitability seemed more prominent in clinically affected body regions and correlated with functional disability and muscle weakness. Cortical inexcitability was more prominent in the leg (P < 0.001) and bulbar regions (P < 0.01) when compared with controls. INTERPRETATION: The nature of cortical dysfunction varied across the body regions in ALS, with cortical hyperexcitability being more prominent in the upper limbs while cortical inexcitability was more evident in the lower limbs and bulbar regions. The findings suggest a heterogeneity of cortical pathophysiological processes in ALS.
format Online
Article
Text
id pubmed-6689694
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-66896942019-08-15 Regional motor cortex dysfunction in amyotrophic lateral sclerosis Menon, Parvathi Yiannikas, Con Kiernan, Matthew C. Vucic, Steve Ann Clin Transl Neurol Research Articles OBJECTIVE: The pathophysiological processes underlying amyotrophic lateral sclerosis (ALS) need to be better understood, although cortical dysfunction has been implicated. Previous transcranial magnetic stimulation (TMS) studies have assessed cortical dysfunction from the hand. The aim of the present study was to determine whether cortical dysfunction was evident across representations of three body regions, and to relate these changes to clinical features of ALS. METHODS: In this cross‐sectional study, threshold tracking TMS was undertaken in 60 sporadic ALS patients, with motor evoked potential (MEP) responses recorded over the hand (abductor pollicis brevis), lower limb (tibialis anterior), and bulbar (trapezius) regions. The cross‐sectional findings were compared to 28 age‐ and gender‐matched controls. RESULTS: Cortical dysfunction was evident across the representation of the three body regions, although the degree and nature of the dysfunction varied. Cortical hyperexcitability, as heralded by reduced short interval intracortical inhibition (SICI), was evident in all cortical regions (hand, P < 0.01; leg, P < 0.05; bulbar, P < 0.05) in ALS patients when compared with healthy control subjects. Importantly, features of cortical hyperexcitability seemed more prominent in clinically affected body regions and correlated with functional disability and muscle weakness. Cortical inexcitability was more prominent in the leg (P < 0.001) and bulbar regions (P < 0.01) when compared with controls. INTERPRETATION: The nature of cortical dysfunction varied across the body regions in ALS, with cortical hyperexcitability being more prominent in the upper limbs while cortical inexcitability was more evident in the lower limbs and bulbar regions. The findings suggest a heterogeneity of cortical pathophysiological processes in ALS. John Wiley and Sons Inc. 2019-06-28 /pmc/articles/PMC6689694/ /pubmed/31402622 http://dx.doi.org/10.1002/acn3.50819 Text en © 2019 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals, Inc on behalf of American Neurological Association. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Research Articles
Menon, Parvathi
Yiannikas, Con
Kiernan, Matthew C.
Vucic, Steve
Regional motor cortex dysfunction in amyotrophic lateral sclerosis
title Regional motor cortex dysfunction in amyotrophic lateral sclerosis
title_full Regional motor cortex dysfunction in amyotrophic lateral sclerosis
title_fullStr Regional motor cortex dysfunction in amyotrophic lateral sclerosis
title_full_unstemmed Regional motor cortex dysfunction in amyotrophic lateral sclerosis
title_short Regional motor cortex dysfunction in amyotrophic lateral sclerosis
title_sort regional motor cortex dysfunction in amyotrophic lateral sclerosis
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6689694/
https://www.ncbi.nlm.nih.gov/pubmed/31402622
http://dx.doi.org/10.1002/acn3.50819
work_keys_str_mv AT menonparvathi regionalmotorcortexdysfunctioninamyotrophiclateralsclerosis
AT yiannikascon regionalmotorcortexdysfunctioninamyotrophiclateralsclerosis
AT kiernanmatthewc regionalmotorcortexdysfunctioninamyotrophiclateralsclerosis
AT vucicsteve regionalmotorcortexdysfunctioninamyotrophiclateralsclerosis