Abnormal cortical and brain stem plasticity in Gilles de la Tourette syndrome
We investigated primary motor cortex and brain stem plasticity in patients with Gilles de la Tourette syndrome. The study group comprised 12 patients with Gilles de la Tourette syndrome and 24 healthy subjects. Patients were clinically evaluated using the Yale Global Tic Severity Scale. We tested co...
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| Published in | Movement disorders Vol. 26; no. 9; pp. 1703 - 1710 |
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| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Hoboken
Wiley Subscription Services, Inc., A Wiley Company
01.08.2011
Wiley |
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| Online Access | Get full text |
| ISSN | 0885-3185 1531-8257 1531-8257 |
| DOI | 10.1002/mds.23706 |
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| Abstract | We investigated primary motor cortex and brain stem plasticity in patients with Gilles de la Tourette syndrome. The study group comprised 12 patients with Gilles de la Tourette syndrome and 24 healthy subjects. Patients were clinically evaluated using the Yale Global Tic Severity Scale. We tested cortical plasticity by conditioning left primary motor cortex with intermittent or continuous theta‐burst stimulation in 2 separate sessions. Test stimulation consisted of 20 motor‐evoked potentials recorded from right first interosseous muscle before and after theta‐burst stimulation. We also tested brain stem plasticity by conditioning the right supraorbital nerve with facilitatory electric high‐frequency stimulation delivered at the same time as the late response of the blink reflex or inhibitory high‐frequency stimulation delivered before the late response on 2 separate sessions. Test stimulation consisted of 10 blink reflexes from the right orbicularis oculi muscle before and after high‐frequency stimulation. After intermittent theta‐burst stimulation, motor‐evoked potential amplitudes in healthy subjects increased significantly but remained unchanged in patients. Similarly, after continuous theta‐burst stimulation, motor‐evoked potential amplitudes decreased significantly in healthy subjects but did not in patients. After facilitatory high‐frequency stimulation, the blink reflex late response area in healthy subjects increased, whereas after inhibitory high‐frequency stimulation, it decreased. Conversely, in patients, both interventions left the blink reflex late response area unchanged. The lack of the expected inhibitory and facilitatory changes in motor‐evoked potential amplitudes and blink reflex late response area suggests that abnormal plasticity in the primary motor cortex and brain stem play a role in the pathophysiology of Gilles de la Tourette syndrome. © 2011 Movement Disorder Society |
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| AbstractList | We investigated primary motor cortex and brain stem plasticity in patients with Gilles de la Tourette syndrome. The study group comprised 12 patients with Gilles de la Tourette syndrome and 24 healthy subjects. Patients were clinically evaluated using the Yale Global Tic Severity Scale. We tested cortical plasticity by conditioning left primary motor cortex with intermittent or continuous theta-burst stimulation in 2 separate sessions. Test stimulation consisted of 20 motor-evoked potentials recorded from right first interosseous muscle before and after theta-burst stimulation. We also tested brain stem plasticity by conditioning the right supraorbital nerve with facilitatory electric high-frequency stimulation delivered at the same time as the late response of the blink reflex or inhibitory high-frequency stimulation delivered before the late response on 2 separate sessions. Test stimulation consisted of 10 blink reflexes from the right orbicularis oculi muscle before and after high-frequency stimulation. After intermittent theta-burst stimulation, motor-evoked potential amplitudes in healthy subjects increased significantly but remained unchanged in patients. Similarly, after continuous theta-burst stimulation, motor-evoked potential amplitudes decreased significantly in healthy subjects but did not in patients. After facilitatory high-frequency stimulation, the blink reflex late response area in healthy subjects increased, whereas after inhibitory high-frequency stimulation, it decreased. Conversely, in patients, both interventions left the blink reflex late response area unchanged. The lack of the expected inhibitory and facilitatory changes in motor-evoked potential amplitudes and blink reflex late response area suggests that abnormal plasticity in the primary motor cortex and brain stem play a role in the pathophysiology of Gilles de la Tourette syndrome. We investigated primary motor cortex and brain stem plasticity in patients with Gilles de la Tourette syndrome. The study group comprised 12 patients with Gilles de la Tourette syndrome and 24 healthy subjects. Patients were clinically evaluated using the Yale Global Tic Severity Scale. We tested cortical plasticity by conditioning left primary motor cortex with intermittent or continuous theta‐burst stimulation in 2 separate sessions. Test stimulation consisted of 20 motor‐evoked potentials recorded from right first interosseous muscle before and after theta‐burst stimulation. We also tested brain stem plasticity by conditioning the right supraorbital nerve with facilitatory electric high‐frequency stimulation delivered at the same time as the late response of the blink reflex or inhibitory high‐frequency stimulation delivered before the late response on 2 separate sessions. Test stimulation consisted of 10 blink reflexes from the right orbicularis oculi muscle before and after high‐frequency stimulation. After intermittent theta‐burst stimulation, motor‐evoked potential amplitudes in healthy subjects increased significantly but remained unchanged in patients. Similarly, after continuous theta‐burst stimulation, motor‐evoked potential amplitudes decreased significantly in healthy subjects but did not in patients. After facilitatory high‐frequency stimulation, the blink reflex late response area in healthy subjects increased, whereas after inhibitory high‐frequency stimulation, it decreased. Conversely, in patients, both interventions left the blink reflex late response area unchanged. The lack of the expected inhibitory and facilitatory changes in motor‐evoked potential amplitudes and blink reflex late response area suggests that abnormal plasticity in the primary motor cortex and brain stem play a role in the pathophysiology of Gilles de la Tourette syndrome. © 2011 Movement Disorder Society We investigated primary motor cortex and brain stem plasticity in patients with Gilles de la Tourette syndrome. The study group comprised 12 patients with Gilles de la Tourette syndrome and 24 healthy subjects. Patients were clinically evaluated using the Yale Global Tic Severity Scale. We tested cortical plasticity by conditioning left primary motor cortex with intermittent or continuous theta-burst stimulation in 2 separate sessions. Test stimulation consisted of 20 motor-evoked potentials recorded from right first interosseous muscle before and after theta-burst stimulation. We also tested brain stem plasticity by conditioning the right supraorbital nerve with facilitatory electric high-frequency stimulation delivered at the same time as the late response of the blink reflex or inhibitory high-frequency stimulation delivered before the late response on 2 separate sessions. Test stimulation consisted of 10 blink reflexes from the right orbicularis oculi muscle before and after high-frequency stimulation. After intermittent theta-burst stimulation, motor-evoked potential amplitudes in healthy subjects increased significantly but remained unchanged in patients. Similarly, after continuous theta-burst stimulation, motor-evoked potential amplitudes decreased significantly in healthy subjects but did not in patients. After facilitatory high-frequency stimulation, the blink reflex late response area in healthy subjects increased, whereas after inhibitory high-frequency stimulation, it decreased. Conversely, in patients, both interventions left the blink reflex late response area unchanged. The lack of the expected inhibitory and facilitatory changes in motor-evoked potential amplitudes and blink reflex late response area suggests that abnormal plasticity in the primary motor cortex and brain stem play a role in the pathophysiology of Gilles de la Tourette syndrome.We investigated primary motor cortex and brain stem plasticity in patients with Gilles de la Tourette syndrome. The study group comprised 12 patients with Gilles de la Tourette syndrome and 24 healthy subjects. Patients were clinically evaluated using the Yale Global Tic Severity Scale. We tested cortical plasticity by conditioning left primary motor cortex with intermittent or continuous theta-burst stimulation in 2 separate sessions. Test stimulation consisted of 20 motor-evoked potentials recorded from right first interosseous muscle before and after theta-burst stimulation. We also tested brain stem plasticity by conditioning the right supraorbital nerve with facilitatory electric high-frequency stimulation delivered at the same time as the late response of the blink reflex or inhibitory high-frequency stimulation delivered before the late response on 2 separate sessions. Test stimulation consisted of 10 blink reflexes from the right orbicularis oculi muscle before and after high-frequency stimulation. After intermittent theta-burst stimulation, motor-evoked potential amplitudes in healthy subjects increased significantly but remained unchanged in patients. Similarly, after continuous theta-burst stimulation, motor-evoked potential amplitudes decreased significantly in healthy subjects but did not in patients. After facilitatory high-frequency stimulation, the blink reflex late response area in healthy subjects increased, whereas after inhibitory high-frequency stimulation, it decreased. Conversely, in patients, both interventions left the blink reflex late response area unchanged. The lack of the expected inhibitory and facilitatory changes in motor-evoked potential amplitudes and blink reflex late response area suggests that abnormal plasticity in the primary motor cortex and brain stem play a role in the pathophysiology of Gilles de la Tourette syndrome. |
| Author | Belvisi, Daniele Berardelli, Isabella Marsili, Luca Suppa, Antonio Pasquini, Massimo Berardelli, Alfredo Bologna, Matteo Fabbrini, Giovanni Moretti, Germana |
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| Keywords | Nervous system diseases Motor pathway Brain stem Motor cortex Central nervous system disease Central nervous system Plasticity Gilles de la Tourette syndrome Degenerative disease Encephalon Cerebral disorder primary motor cortex |
| Language | English |
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| References_xml | – reference: Goodman WK, Price LH, Rasmussen SA, et al. The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry 1989; 46: 1006-1011. – reference: Orth M, Münchau A, Rothwell JC. Corticospinal system excitability at rest is associated with tic severity in Tourette syndrome. Biol Psychiatry 2008; 64: 248-251. – reference: Mantovani A, Lisanby SH, Pieraccini F, Ulivelli M, Castrogiovanni P, Rossi S. Repetitive transcranial magnetic stimulation (rTMS) in the treatment of obsessive-compulsive disorder (OCD) and Tourette's syndrome (TS). Int J Neuropsychopharmacol. 2006; 9: 95-100. – reference: Chae JH, Nahas Z, Wassermann E, et al. A pilot safety study of repetitive transcranial magnetic stimulation (rTMS) in Tourette's syndrome. Cogn Behav Neurol. 2004; 17: 109-117. – reference: Crupi D, Ghilardi MF, Mosiello C, Di Rocco A, Quartarone A, Battaglia F. Cortical and brainstem LTP-like plasticity in Huntington's disease. 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| SubjectTerms | Adolescent Adult Analysis of Variance Biological and medical sciences Biophysics brain stem Brain Stem - physiopathology Cerebral Cortex - physiopathology Electric Stimulation - methods Evoked Potentials, Motor - physiology Female Gilles de la Tourette syndrome Humans Long-Term Potentiation - physiology Long-Term Synaptic Depression - physiology Male Malformations of the nervous system Medical sciences Middle Aged Neurology Neuronal Plasticity - physiology plasticity primary motor cortex Statistics, Nonparametric Tourette Syndrome - pathology Young Adult |
| Title | Abnormal cortical and brain stem plasticity in Gilles de la Tourette syndrome |
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