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On the Use of TMS to Investigate the Pathophysiology of Neurodegenerative Diseases
Neurodegenerative diseases are a collection of disorders that result in the progressive degeneration and death of neurons. They are clinically heterogenous and can present as deficits in movement, cognition, executive function, memory, visuospatial awareness and language. Transcranial magnetic stimu...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7669623/ https://www.ncbi.nlm.nih.gov/pubmed/33224098 http://dx.doi.org/10.3389/fneur.2020.584664 |
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author | Rawji, Vishal Latorre, Anna Sharma, Nikhil Rothwell, John C. Rocchi, Lorenzo |
author_facet | Rawji, Vishal Latorre, Anna Sharma, Nikhil Rothwell, John C. Rocchi, Lorenzo |
author_sort | Rawji, Vishal |
collection | PubMed |
description | Neurodegenerative diseases are a collection of disorders that result in the progressive degeneration and death of neurons. They are clinically heterogenous and can present as deficits in movement, cognition, executive function, memory, visuospatial awareness and language. Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation tool that allows for the assessment of cortical function in vivo. We review how TMS has been used for the investigation of three neurodegenerative diseases that differ in their neuroanatomical axes: (1) Motor cortex—corticospinal tract (motor neuron diseases), (2) Non-motor cortical areas (dementias), and (3) Subcortical structures (parkinsonisms). We also make four recommendations that we hope will benefit the use of TMS in neurodegenerative diseases. Firstly, TMS has traditionally been limited by the lack of an objective output and so has been confined to stimulation of the motor cortex; this limitation can be overcome by the use of concurrent neuroimaging methods such as EEG. Given that neurodegenerative diseases progress over time, TMS measures should aim to track longitudinal changes, especially when the aim of the study is to look at disease progression and symptomatology. The lack of gold-standard diagnostic confirmation undermines the validity of findings in clinical populations. Consequently, diagnostic certainty should be maximized through a variety of methods including multiple, independent clinical assessments, imaging and fluids biomarkers, and post-mortem pathological confirmation where possible. There is great interest in understanding the mechanisms by which symptoms arise in neurodegenerative disorders. However, TMS assessments in patients are usually carried out during resting conditions, when the brain network engaged during these symptoms is not expressed. Rather, a context-appropriate form of TMS would be more suitable in probing the physiology driving clinical symptoms. In all, we hope that the recommendations made here will help to further understand the pathophysiology of neurodegenerative diseases. |
format | Online Article Text |
id | pubmed-7669623 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-76696232020-11-20 On the Use of TMS to Investigate the Pathophysiology of Neurodegenerative Diseases Rawji, Vishal Latorre, Anna Sharma, Nikhil Rothwell, John C. Rocchi, Lorenzo Front Neurol Neurology Neurodegenerative diseases are a collection of disorders that result in the progressive degeneration and death of neurons. They are clinically heterogenous and can present as deficits in movement, cognition, executive function, memory, visuospatial awareness and language. Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation tool that allows for the assessment of cortical function in vivo. We review how TMS has been used for the investigation of three neurodegenerative diseases that differ in their neuroanatomical axes: (1) Motor cortex—corticospinal tract (motor neuron diseases), (2) Non-motor cortical areas (dementias), and (3) Subcortical structures (parkinsonisms). We also make four recommendations that we hope will benefit the use of TMS in neurodegenerative diseases. Firstly, TMS has traditionally been limited by the lack of an objective output and so has been confined to stimulation of the motor cortex; this limitation can be overcome by the use of concurrent neuroimaging methods such as EEG. Given that neurodegenerative diseases progress over time, TMS measures should aim to track longitudinal changes, especially when the aim of the study is to look at disease progression and symptomatology. The lack of gold-standard diagnostic confirmation undermines the validity of findings in clinical populations. Consequently, diagnostic certainty should be maximized through a variety of methods including multiple, independent clinical assessments, imaging and fluids biomarkers, and post-mortem pathological confirmation where possible. There is great interest in understanding the mechanisms by which symptoms arise in neurodegenerative disorders. However, TMS assessments in patients are usually carried out during resting conditions, when the brain network engaged during these symptoms is not expressed. Rather, a context-appropriate form of TMS would be more suitable in probing the physiology driving clinical symptoms. In all, we hope that the recommendations made here will help to further understand the pathophysiology of neurodegenerative diseases. Frontiers Media S.A. 2020-11-03 /pmc/articles/PMC7669623/ /pubmed/33224098 http://dx.doi.org/10.3389/fneur.2020.584664 Text en Copyright © 2020 Rawji, Latorre, Sharma, Rothwell and Rocchi. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Rawji, Vishal Latorre, Anna Sharma, Nikhil Rothwell, John C. Rocchi, Lorenzo On the Use of TMS to Investigate the Pathophysiology of Neurodegenerative Diseases |
title | On the Use of TMS to Investigate the Pathophysiology of Neurodegenerative Diseases |
title_full | On the Use of TMS to Investigate the Pathophysiology of Neurodegenerative Diseases |
title_fullStr | On the Use of TMS to Investigate the Pathophysiology of Neurodegenerative Diseases |
title_full_unstemmed | On the Use of TMS to Investigate the Pathophysiology of Neurodegenerative Diseases |
title_short | On the Use of TMS to Investigate the Pathophysiology of Neurodegenerative Diseases |
title_sort | on the use of tms to investigate the pathophysiology of neurodegenerative diseases |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7669623/ https://www.ncbi.nlm.nih.gov/pubmed/33224098 http://dx.doi.org/10.3389/fneur.2020.584664 |
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