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Frey J, Ramirez-Zamora A, Wagle Shukla A. Applications of Transcranial Magnetic Stimulation for Understanding and Treating Dystonia. ADVANCES IN NEUROBIOLOGY 2023; 31:119-139. [PMID: 37338699 DOI: 10.1007/978-3-031-26220-3_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Transcranial magnetic stimulation (TMS)-based studies have led to an advanced understanding of the pathophysiology of dystonia. This narrative review summarizes the TMS data contributed to the literature so far. Many studies have shown that increased motor cortex excitability, excessive sensorimotor plasticity, and abnormal sensorimotor integration are the core pathophysiological substrates for dystonia. However, an increasing body of evidence supports a more widespread network dysfunction involving many other brain regions. Repetitive TMS pulses (rTMS) in dystonia have therapeutic potential as they can induce local and network-wide effects through modulation of excitability and plasticity. The bulk of rTMS studies has targeted the premotor cortex with some promising results in focal hand dystonia. Some studies have targeted the cerebellum for cervical dystonia and the anterior cingulate cortex for blepharospasm. We believe that therapeutic potential could be leveraged better when rTMS is implemented in conjunction with standard-of-care pharmacological treatments. However, due to several limitations in the studies conducted to date, including small samples, heterogeneous populations, variability in the target sites, and inconsistencies in the study design and control arm, it is hard to draw a definite conclusion. Further studies are warranted to determine optimal targets and protocols yielding the most beneficial outcomes that will translate into meaningful clinical changes.
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Affiliation(s)
- Jessica Frey
- Department of Neurology, Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Adolfo Ramirez-Zamora
- Department of Neurology, Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Aparna Wagle Shukla
- Department of Neurology, Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA.
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2
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Somaa FA, de Graaf TA, Sack AT. Transcranial Magnetic Stimulation in the Treatment of Neurological Diseases. Front Neurol 2022; 13:793253. [PMID: 35669870 PMCID: PMC9163300 DOI: 10.3389/fneur.2022.793253] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 02/25/2022] [Indexed: 12/16/2022] Open
Abstract
Transcranial Magnetic Stimulation (TMS) has widespread use in research and clinical application. For psychiatric applications, such as depression or OCD, repetitive TMS protocols (rTMS) are an established and globally applied treatment option. While promising, rTMS is not yet as common in treating neurological diseases, except for neurorehabilitation after (motor) stroke and neuropathic pain treatment. This may soon change. New clinical studies testing the potential of rTMS in various other neurological conditions appear at a rapid pace. This can prove challenging for both practitioners and clinical researchers. Although most of these neurological applications have not yet received the same level of scientific/empirical scrutiny as motor stroke and neuropathic pain, the results are encouraging, opening new doors for TMS in neurology. We here review the latest clinical evidence for rTMS in pioneering neurological applications including movement disorders, Alzheimer's disease/mild cognitive impairment, epilepsy, multiple sclerosis, and disorders of consciousness.
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Affiliation(s)
- Fahad A. Somaa
- Department of Occupational Therapy, Faculty of Medical Rehabilitation, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Tom A. de Graaf
- Section Brain Stimulation and Cognition, Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
- Center of Integrative Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Alexander T. Sack
- Section Brain Stimulation and Cognition, Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
- Center of Integrative Neuroscience, Maastricht University, Maastricht, Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Brain + Nerve Centre, Maastricht University Medical Centre+, Maastricht, Netherlands
- *Correspondence: Alexander T. Sack
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3
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Ferrazzoli D, Ortelli P, Volpe D, Cucca A, Versace V, Nardone R, Saltuari L, Sebastianelli L. The Ties That Bind: Aberrant Plasticity and Networks Dysfunction in Movement Disorders-Implications for Rehabilitation. Brain Connect 2021; 11:278-296. [PMID: 33403893 DOI: 10.1089/brain.2020.0971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Movement disorders encompass various conditions affecting the nervous system. The pathological processes underlying movement disorders lead to aberrant synaptic plastic changes, which in turn alter the functioning of large-scale brain networks. Therefore, clinical phenomenology does not only entail motor symptoms but also cognitive and motivational disturbances. The result is the disruption of motor learning and motor behavior. Due to this complexity, the responsiveness to standard therapies could be disappointing. Specific forms of rehabilitation entailing goal-based practice, aerobic training, and the use of noninvasive brain stimulation techniques could "restore" neuroplasticity at motor-cognitive circuitries, leading to clinical gains. This is probably associated with modulations occurring at both molecular (synaptic) and circuitry levels (networks). Several gaps remain in our understanding of the relationships among plasticity and neural networks and how neurorehabilitation could promote clinical gains is still unclear. Purposes: In this review, we outline first the networks involved in motor learning and behavior and analyze which mechanisms link the pathological synaptic plastic changes with these networks' disruption in movement disorders. Therefore, we provide theoretical and practical bases to be applied for treatment in rehabilitation.
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Affiliation(s)
- Davide Ferrazzoli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy
| | - Paola Ortelli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy
| | - Daniele Volpe
- Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, Italy
| | - Alberto Cucca
- Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, Italy.,Department of Neurology, The Marlene & Paolo Fresco Institute for Parkinson's & Movement Disorders, NYU School of Medicine, New York, New York, USA.,Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Viviana Versace
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy
| | - Raffaele Nardone
- Department of Neurology, Franz Tappeiner Hospital (SABES-ASDAA), Merano-Meran, Italy.,Department of Neurology, Christian Doppler Medical Center, Paracelsus University Salzburg, Salzburg, Austria
| | - Leopold Saltuari
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy
| | - Luca Sebastianelli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy
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4
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Poydasheva AG, Semenova OV, Suponeva NA, Timerbaeva SL, Piradov MA. [Issues of diagnostic and therapeutic use of transcranial magnetic stimulation in patients with writing cramp]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 120:49-56. [PMID: 33459541 DOI: 10.17116/jnevro202012012149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To study diagnostic and therapeutic values of transcranial magnetic stimulation (TMS) in writing cramp (WC). MATERIAL AND METHODS Twelve right-handed patients with WC were enrolled in the study. All patients underwent low-frequency repetitive TMS (rTMS) of the premotor cortex of contralateral to affected hand hemisphere. The clinical efficacy was assessed using the Writer's Cramp Rating Scale (WCRS) and the Medical Outcomes Study-Short Form (MOS-SF-36). Before and after last rTMS session, motor mapping of Abductor pollicis brevis muscle (APB) was performed using navigated TMS (nTMS). Localization, area, and amplitude-weighted area of the APB muscle cortical representations were compared with the healthy controls. After the rTMS course, the dynamics of the studied parameters was assessed. RESULTS Ten sessions of low-frequency rTMS of premotor cortex reduced the severity of WS clinical symptoms with a duration of effect of at least 1 month (p<0.05). There was no statistically significant difference between the area and the weighted area of cortical muscle representations between patients and healthy controls or in patients before and after rTMS. When assessing the localization of cortical muscle representations, two trends were noted: in 4 patients, the localization remained stable, with a shift in the center of gravity of less than 4 mm; in the other 8 patients, a shift in the center of mass of more than 5 mm was noted. No significant correlation between the stability of the cortical muscle representations (the magnitude of the shift in the center of gravity) and the improvement on the WCRS were found. CONCLUSION The low-frequency rTMS of the premotor cortex of the contralateral to affected hand hemisphere can be used as an adjuvant therapy for WC. The TMS-motor mapping study did not show its diagnostic value.
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Affiliation(s)
| | - O V Semenova
- Vorokhobov City Clinical Hospital No. 67, Moscow, Russia
| | | | | | - M A Piradov
- Research Center of Neurology, Moscow, Russia
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5
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Poydasheva AG, Semenova OV, Suponeva NA, Timerbaeva SL, Piradov MA. [Diagnostic and therapeutic issues of using transcranial magnetic stimulation in patients with writer's cramp]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:22-29. [PMID: 31793539 DOI: 10.17116/jnevro201911910122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To assess diagnostic and therapeutic values of transcranial magnetic stimulation (TMS) in patients with writer's cramp (WC). MATERIAL AND METHODS Twelve right-handed patients with WC were enrolled in the study. All patients underwent low-frequency repetitive TMS (rTMS) over the premotor cortex of the hemisphere contralateral to the affected hand. The clinical efficacy was assessed using the Writer's Cramp Rating Scale (WCRS) and the Medical Outcomes Study-Short Form (MOS-SF-36). Before and after the last rTMS session, motor mapping of abductor pollicis brevis muscle (APB) was performed using navigated TMS (nTMS). Localization, area, and amplitude-weighted area of the APB muscle cortical representations were compared with the healthy controls. The dynamics of the mentioned above parameters after the rTMS course was assessed. RESULTS Ten sessions of low-frequency rTMS over premotor cortex reduced the severity of WC clinical symptoms, with a duration of effect of at least 1 month (p<0.05). There was no significant difference between the area and the weighted area of cortical muscle representations between patients and healthy controls or in patients before and after rTMS. When assessing the localization of cortical muscle representations, two trends were noted: in 4 patients, the localization remained stable, with a shift in the center of gravity of less than 4 mm; in the other 8 patients, a shift in the center of gravity of more than 5 mm was noted. No significant correlations between the stability of the cortical muscle representations (the magnitude of the shift in the center of gravity) and the improvement on the WCRS scale were found. CONCLUSION The low-frequency rTMS over the premotor cortex of the hemisphere contralateral to the affected hand can be used as an adjuvant therapy for WC. The TMS-motor mapping study did not show its diagnostic value.
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Affiliation(s)
| | - O V Semenova
- Vorokhobov City Clinical Hospital #67, Moscow, Russia
| | | | - S L Timerbaeva
- Federal State Hospital for Treatment and Rehabilitation, Moscow, Russia
| | - M A Piradov
- Research Center of Neurology, Moscow, Russia
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6
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Erro R, Tinazzi M, Morgante F, Bhatia KP. Non-invasive brain stimulation for dystonia: therapeutic implications. Eur J Neurol 2017; 24:1228-e64. [PMID: 28782903 DOI: 10.1111/ene.13363] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 06/01/2017] [Indexed: 11/28/2022]
Abstract
Dystonia is characterized by excessive muscle contractions giving rise to abnormal posture and involuntary twisting movements. Although dystonia syndromes are a heterogeneous group of disorders, certain pathophysiological mechanisms have been consistently identified across different forms. These pathophysiological mechanisms have subsequently been exploited for the development of non-invasive brain stimulation (NIBS) techniques able to modulate neural activity in one or more nodes of the putative network that is altered in dystonia, and the therapeutic role of NIBS has hence been suggested. Here all studies that applied such techniques as a therapeutic intervention in any forms of dystonia, including the few works performed in children, are reviewed and emerging concepts and pitfalls of NIBS are discussed.
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Affiliation(s)
- R Erro
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Neuroscience Section, University of Salerno, Salerno, Italy.,Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
| | - M Tinazzi
- Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Verona, Italy
| | - F Morgante
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.,Institute of Molecular and Clinical Sciences, St George's University of London, London, UK
| | - K P Bhatia
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
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7
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Quartarone A, Rizzo V, Terranova C, Cacciola A, Milardi D, Calamuneri A, Chillemi G, Girlanda P. Therapeutic Use of Non-invasive Brain Stimulation in Dystonia. Front Neurosci 2017; 11:423. [PMID: 28790883 PMCID: PMC5525337 DOI: 10.3389/fnins.2017.00423] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 07/06/2017] [Indexed: 12/16/2022] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are non-invasive methods for stimulating cortical neurons that have been increasingly used in the neurology realm and in the neurosciences applied to movement disorders. In addition, these tools have the potential to be delivered as clinically therapeutic approach. Despite several studies support this hypothesis, there are several limitations related to the extreme variability of the stimulation protocols, clinical enrolment and variability of rTMS and tDCS after effects that make clinical interpretation very difficult. Aim of the present study will be to critically discuss the state of art therapeutically applications of rTMS and tDCS in dystonia.
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Affiliation(s)
- Angelo Quartarone
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of MessinaMessina, Italy.,Centro Neurolesi Bonino Pulejo (IRCCS)Messina, Italy
| | - Vincenzo Rizzo
- Department of Clinical and Experimental Medicine, University of MessinaMessina, Italy
| | - Carmen Terranova
- Department of Clinical and Experimental Medicine, University of MessinaMessina, Italy
| | | | - Demetrio Milardi
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of MessinaMessina, Italy.,Centro Neurolesi Bonino Pulejo (IRCCS)Messina, Italy
| | - Alessandro Calamuneri
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of MessinaMessina, Italy
| | - Gaetana Chillemi
- Department of Clinical and Experimental Medicine, University of MessinaMessina, Italy
| | - Paolo Girlanda
- Department of Clinical and Experimental Medicine, University of MessinaMessina, Italy
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Lozeron P, Poujois A, Meppiel E, Masmoudi S, Magnan TP, Vicaut E, Houdart E, Guichard JP, Trocello JM, Woimant F, Kubis N. Inhibitory rTMS applied on somatosensory cortex in Wilson's disease patients with hand dystonia. J Neural Transm (Vienna) 2017; 124:1161-1170. [PMID: 28689295 DOI: 10.1007/s00702-017-1756-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 07/05/2017] [Indexed: 12/18/2022]
Abstract
Hand dystonia is a common complication of Wilson's disease (WD), responsible for handwriting difficulties and disability. Alteration of sensorimotor integration and overactivity of the somatosensory cortex have been demonstrated in dystonia. This study investigated the immediate after effect of an inhibitory repetitive transcranial magnetic stimulation (rTMS) applied over the somatosensory cortex on the writing function in WD patients with hand dystonia. We performed a pilot prospective randomized double-blind sham-controlled crossover rTMS study. A 20-min 1-Hz rTMS session, stereotaxically guided, was applied over the left somatosensory cortex in 13 WD patients with right dystonic writer's cramp. After 3 days, each patient was crossed-over to the alternative treatment. Patients were clinically evaluated before and immediately after each rTMS session with the Unified Wilson's Disease rating scale (UWDRS), the Writers' Cramp Rating Scale (WCRS), a specifically designed scale for handwriting difficulties in Wilson's disease patients (FAR, flow, accuracy, and rhythmicity evaluation), and a visual analog scale (VAS) for handwriting discomfort. No significant change in UWDRS, WCRS, VAS, or FAR scores was observed in patients treated with somatosensory inhibitory rTMS compared to the sham protocol. The FAR negatively correlated with UWDRS (r = -0.6; P = 0.02), but not with the WCRS score, disease duration, MRI diffusion lesions, or with atrophy scores. In our experimental conditions, a single inhibitory rTMS session applied over somatosensory cortex did not improve dystonic writer cramp in WD patients.
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Affiliation(s)
- Pierre Lozeron
- Service de Physiologie Clinique-Explorations Fonctionnelles, AP-HP, Hôpital Lariboisière, 2, rue Ambroise Paré, 75010, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, 75475, Paris, France.,INSERM UMR965, 75475, Paris, France
| | - Aurélia Poujois
- Service de Neurologie, AP-HP, Hôpital Lariboisière, Paris, France.,Centre de référence national de la maladie de Wilson, Hôpital Lariboisière, Paris, France
| | - Elodie Meppiel
- Service de Physiologie Clinique-Explorations Fonctionnelles, AP-HP, Hôpital Lariboisière, 2, rue Ambroise Paré, 75010, Paris, France
| | - Sana Masmoudi
- Service de Physiologie Clinique-Explorations Fonctionnelles, AP-HP, Hôpital Lariboisière, 2, rue Ambroise Paré, 75010, Paris, France
| | - Thierry Peron Magnan
- Centre de référence national de la maladie de Wilson, Hôpital Lariboisière, Paris, France
| | - Eric Vicaut
- Université Paris Diderot, Sorbonne Paris Cité, 75475, Paris, France.,Unité de Recherche Clinique, AP-HP, Hôpital Lariboisière, Paris, France
| | - Emmanuel Houdart
- Université Paris Diderot, Sorbonne Paris Cité, 75475, Paris, France.,Service de Neuroradiologie, AP-HP, Hôpital Lariboisière, Paris, France
| | | | - Jean-Marc Trocello
- Service de Neurologie, AP-HP, Hôpital Lariboisière, Paris, France.,Centre de référence national de la maladie de Wilson, Hôpital Lariboisière, Paris, France
| | - France Woimant
- Service de Neurologie, AP-HP, Hôpital Lariboisière, Paris, France.,Centre de référence national de la maladie de Wilson, Hôpital Lariboisière, Paris, France
| | - Nathalie Kubis
- Service de Physiologie Clinique-Explorations Fonctionnelles, AP-HP, Hôpital Lariboisière, 2, rue Ambroise Paré, 75010, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, 75475, Paris, France. .,INSERM UMR965, 75475, Paris, France.
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9
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Lozeron P, Poujois A, Richard A, Masmoudi S, Meppiel E, Woimant F, Kubis N. Contribution of TMS and rTMS in the Understanding of the Pathophysiology and in the Treatment of Dystonia. Front Neural Circuits 2016; 10:90. [PMID: 27891079 PMCID: PMC5102895 DOI: 10.3389/fncir.2016.00090] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 10/24/2016] [Indexed: 11/13/2022] Open
Abstract
Dystonias represent a heterogeneous group of movement disorders responsible for sustained muscle contraction, abnormal postures, and muscle twists. It can affect focal or segmental body parts or be generalized. Primary dystonia is the most common form of dystonia but it can also be secondary to metabolic or structural dysfunction, the consequence of a drug's side-effect or of genetic origin. The pathophysiology is still not elucidated. Based on lesion studies, dystonia has been regarded as a pure motor dysfunction of the basal ganglia loop. However, basal ganglia lesions do not consistently produce dystonia and lesions outside basal ganglia can lead to dystonia; mild sensory abnormalities have been reported in the dystonic limb and imaging studies have shown involvement of multiple other brain regions including the cerebellum and the cerebral motor, premotor and sensorimotor cortices. Transcranial magnetic stimulation (TMS) is a non-invasive technique of brain stimulation with a magnetic field applied over the cortex allowing investigation of cortical excitability. Hyperexcitability of contralateral motor cortex has been suggested to be the trigger of focal dystonia. High or low frequency repetitive TMS (rTMS) can induce excitatory or inhibitory lasting effects beyond the time of stimulation and protocols have been developed having either a positive or a negative effect on cortical excitability and associated with prevention of cell death, γ-aminobutyric acid (GABA) interneurons mediated inhibition and brain-derived neurotrophic factor modulation. rTMS studies as a therapeutic strategy of dystonia have been conducted to modulate the cerebral areas involved in the disease. Especially, when applied on the contralateral (pre)-motor cortex or supplementary motor area of brains of small cohorts of dystonic patients, rTMS has shown a beneficial transient clinical effect in association with restrained motor cortex excitability. TMS is currently a valuable tool to improve our understanding of the pathophysiology of dystonia but large controlled studies using sham stimulation are still necessary to delineate the place of rTMS in the therapeutic strategy of dystonia. In this review, we will focus successively on the use of TMS as a tool to better understand pathophysiology, and the use of rTMS as a therapeutic strategy.
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Affiliation(s)
- Pierre Lozeron
- Service de Physiologie Clinique-Explorations Fonctionnelles, AP-HP, Hôpital LariboisièreParis, France; INSERM UMR965Paris, France; Sorbonne Paris Cité - Université Paris DiderotParis, France
| | - Aurélia Poujois
- Service de Neurologie, AP-HP, Hôpital LariboisièreParis, France; Centre de Référence National de la Maladie de Wilson, Hôpital LariboisièreParis, France
| | - Alexandra Richard
- Service de Physiologie Clinique-Explorations Fonctionnelles, AP-HP, Hôpital LariboisièreParis, France; Sorbonne Paris Cité - Université Paris DiderotParis, France
| | - Sana Masmoudi
- Service de Physiologie Clinique-Explorations Fonctionnelles, AP-HP, Hôpital Lariboisière Paris, France
| | - Elodie Meppiel
- Service de Physiologie Clinique-Explorations Fonctionnelles, AP-HP, Hôpital LariboisièreParis, France; Sorbonne Paris Cité - Université Paris DiderotParis, France
| | - France Woimant
- Service de Neurologie, AP-HP, Hôpital LariboisièreParis, France; Centre de Référence National de la Maladie de Wilson, Hôpital LariboisièreParis, France
| | - Nathalie Kubis
- Service de Physiologie Clinique-Explorations Fonctionnelles, AP-HP, Hôpital LariboisièreParis, France; INSERM UMR965Paris, France; Sorbonne Paris Cité - Université Paris DiderotParis, France
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10
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Likhachev SA, Charnukha TN, Zabrodzets GV, Gleb OV. [Efficacy and safety of transcranial magnetic stimulation in the treatment of rare forms of muscular dystonia]. Zh Nevrol Psikhiatr Im S S Korsakova 2016; 116:29-33. [PMID: 27029444 DOI: 10.17116/jnevro20161162129-33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) for the treatment of patients with dystonia. MATERIAL AND METHODS Authors treated 66 patients with segmental and generalized forms of dystonia, writer's cramp and oromandibular dystonia. The degree of dystonia severity was assessed using the Burke--Fahn--Marsden scale. RESULTS AND CONCLUSION rTMS treatment of the motor cortex region decreased dystonic hyperkinesis severity. There was a significant decrease in scores on the Burke--Fahn--Marsden scale (p<0.05). This method was well-tolerated. No side-effects were observed, with the exception of one patient, who wished to discontinue treatment because of the twitching of facial muscles during rTMS. The results of the study allow to recommend wider adoption of this method in complex treatment and rehabilitation of patients with rare forms of dystonia.
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Affiliation(s)
- S A Likhachev
- Republican Research and Clinical Centre of Neurology and Neurosurgery, Minsk, Belarus
| | - T N Charnukha
- Republican Research and Clinical Centre of Neurology and Neurosurgery, Minsk, Belarus
| | - G V Zabrodzets
- Republican Research and Clinical Centre of Neurology and Neurosurgery, Minsk, Belarus
| | - O V Gleb
- Republican Research and Clinical Centre of Neurology and Neurosurgery, Minsk, Belarus
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11
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Obeso I, Cerasa A, Quattrone A. The Effectiveness of Transcranial Brain Stimulation in Improving Clinical Signs of Hyperkinetic Movement Disorders. Front Neurosci 2016; 9:486. [PMID: 26778947 PMCID: PMC4703824 DOI: 10.3389/fnins.2015.00486] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 12/07/2015] [Indexed: 01/21/2023] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a safe and painless method for stimulating cortical neurons. In neurological realm, rTMS has prevalently been applied to understand pathophysiological mechanisms underlying movement disorders. However, this tool has also the potential to be translated into a clinically applicable therapeutic use. Several available studies supported this hypothesis, but differences in protocols, clinical enrollment, and variability of rTMS effects across individuals complicate better understanding of efficient clinical protocols. The aim of this present review is to discuss to what extent the evidence provided by the therapeutic use of rTMS may be generalized. In particular, we attempted to define optimal cortical regions and stimulation protocols that have been demonstrated to maximize the effectiveness seen in the actual literature for the three most prevalent hyperkinetic movement disorders: Parkinson's disease (PD) with levodopa-induced dyskinesias (LIDs), essential tremor (ET) and dystonia. A total of 28 rTMS studies met our search criteria. Despite clinical and methodological differences, overall these studies demonstrated that therapeutic applications of rTMS to "normalize" pathologically decreased or increased levels of cortical activity have given moderate progress in patient's quality of life. Moreover, the present literature suggests that altered pathophysiology in hyperkinetic movement disorders establishes motor, premotor or cerebellar structures as candidate regions to reset cortico-subcortical pathways back to normal. Although rTMS has the potential to become a powerful tool for ameliorating the clinical outcome of hyperkinetic neurological patients, until now there is not a clear consensus on optimal protocols for these motor disorders. Well-controlled multicenter randomized clinical trials with high numbers of patients are urgently required.
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Affiliation(s)
- Ignacio Obeso
- Centro Integral en Neurociencias A. C. (CINAC), HM Hospitales – Puerta del Sur. MóstolesMadrid, Spain
- Center for Networked Biomedical Research on Neurodegenerative DiseasesMadrid, Spain
| | - Antonio Cerasa
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology - National Research CouncilGermaneto, Italy
| | - Aldo Quattrone
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology - National Research CouncilGermaneto, Italy
- Neurology Unit, Institute of Neurology, University “Magna Graecia”Catanzaro, Italy
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12
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Andrade DC, Borges I, Bravo GL, Bolognini N, Fregni F. Therapeutic time window of noninvasive brain stimulation for pain treatment: inhibition of maladaptive plasticity with early intervention. Expert Rev Med Devices 2014; 10:339-52. [PMID: 23668706 DOI: 10.1586/erd.12.90] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Neuromodulatory effects of noninvasive brain stimulation (NIBS) have been extensively studied in chronic disorders such as major depression, chronic pain and stroke. However, few studies have explored the use of these techniques in acute conditions. A possible use of NIBS in acute disorders is to prevent or reverse ongoing maladaptive plastic alterations, seemingly responsible for treatment refractoriness and detrimental behavioral changes. In this review, the authors discuss the potential role of NIBS in blocking maladaptive plasticity using the transition of acute to chronic pain in conditions such as postsurgical pain, central poststroke pain, pain after spinal cord injury and pain after traumatic brain injury as a model. The authors also present suggestions for clinical trial design using NIBS in the acute stage of illnesses.
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Affiliation(s)
- Dafne C Andrade
- Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, 125 Nashua Street 727, Boston, MA 02114, USA
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13
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Shprecher D. Sensory trick with metoclopramide-associated tardive tremor. BMJ Case Rep 2012; 2012:bcr-11-2011-5156. [PMID: 22962383 DOI: 10.1136/bcr-11-2011-5156] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Tardive tremor is a 3-5 Hz bilateral resting and action tremor, associated with the use of dopamine receptor blocking drugs, accompanied by other tardive movement disorders and responsive to tetrabenazine or clozapine. We describe a case of a sensory trick associated with tardive tremor which raises important points about semiology and management. First, the presence of a sensory trick with tardive limb tremor suggests that the disorder may be a form of dystonia. Second, further study of osteopathic manipulative therapy for treatment of dystonia or tardive tremor is supported by a symptomatic response observed in our case.
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Affiliation(s)
- David Shprecher
- Department of Neurology, University of Utah, Salt Lake City, Utah, USA.
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14
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Kim JY, Kim HJ, Park KI. Ameliorating effect of low frequency repetitive transcranial magnetic stimulation over the premotor cortex in a case of possible painless legs and moving toes syndrome. Parkinsonism Relat Disord 2012; 18:702-3. [PMID: 22445698 DOI: 10.1016/j.parkreldis.2012.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 02/09/2012] [Accepted: 02/12/2012] [Indexed: 11/24/2022]
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15
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Methods of therapeutic cortical stimulation. Neurophysiol Clin 2009; 39:1-14. [DOI: 10.1016/j.neucli.2008.11.001] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2008] [Revised: 10/09/2008] [Accepted: 11/09/2008] [Indexed: 02/07/2023] Open
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16
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Mylius V, Gerstner A, Peters M, Prokisch H, Leonhardt A, Hellwig D, Rosenow F. Low-frequency rTMS of the premotor cortex reduces complex movement patterns in a patient with pantothenate kinase-associated neurodegenerative disease (PKAN). Neurophysiol Clin 2009; 39:27-30. [DOI: 10.1016/j.neucli.2008.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2008] [Revised: 12/12/2008] [Accepted: 12/15/2008] [Indexed: 11/30/2022] Open
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