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Bardel B, Chalah MA, Bensais-Rueda R, Créange A, Lefaucheur JP, Ayache SS. Event-related desynchronization and synchronization in multiple sclerosis. Mult Scler Relat Disord 2024; 86:105601. [PMID: 38604003 DOI: 10.1016/j.msard.2024.105601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/04/2024] [Accepted: 03/31/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Motor preparation and execution can be impaired in patients with multiple sclerosis (pwMS). These neural processes can be assessed using electroencephalography (EEG). During a self-paced movement, EEG signal amplitude decreases before movement (event-related desynchronization, ERD) and increases after movement (event-related synchronization, ERS). OBJECTIVE To reappraise ERD/ERS changes in pwMS compared to healthy controls (HC). METHODS This single-center study included 13 pwMS and 10 sex/age-matched HC. 60-channel EEG was recorded during two self-paced movements of the right hand: a simple index finger extension task and a more complex finger tapping task. Clinical variables included MS type, sex, age, disease duration, disability, grip strength, fatigue and attentional performance. EEG variables included ERD and ERS onset latency, duration, and amplitude determined using two methods of signal analyses (based on visual or automated determination) in the alpha and beta frequency bands in five cortical regions: right and left frontocentral and centroparietal regions and a midline region. Neuroimaging variables included the volumes of four deep brain structures (thalamus, putamen, pallidum and caudate nucleus) and the relative lesion load. RESULTS ERD/ERS changes in pwMS compared to HC were observed only in the beta band. In pwMS, beta-ERD had a delayed onset in the midline and right parietocentral regions and a shortened duration or increased amplitude in the parietocentral region; beta-ERS had a shorter duration, delayed onset, or reduced amplitude in the left parieto/frontocentral region. In addition, pwMS with a more delayed beta-ERD in the midline region had less impaired executive functions but increased caudate nuclei volume, while pwMS with a more delayed beta-ERS in the parietocentral region contralateral to the movement had less fatigue but increased thalami volume. CONCLUSION This study confirms an alteration of movement preparation and execution in pwMS, mainly characterized by a delayed cortical activation (ERD) and a delayed and reduced post-movement inhibition (ERS) in the beta band. Compensatory mechanisms could be involved in these changes, associating more preserved clinical performance and overactivation of deep brain structures.
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Affiliation(s)
- Benjamin Bardel
- Univ Paris Est Créteil, Excitabilité Nerveuse et Thérapeutique (ENT), EA 4391, Créteil F-94010, France; Department of Clinical Neurophysiology, AP-HP, Henri Mondor University Hospital, DMU FIxIT, Creteil F-94010, France.
| | - Moussa A Chalah
- Univ Paris Est Créteil, Excitabilité Nerveuse et Thérapeutique (ENT), EA 4391, Créteil F-94010, France
| | - Ruben Bensais-Rueda
- Univ Paris Est Créteil, Excitabilité Nerveuse et Thérapeutique (ENT), EA 4391, Créteil F-94010, France
| | - Alain Créange
- Univ Paris Est Créteil, Excitabilité Nerveuse et Thérapeutique (ENT), EA 4391, Créteil F-94010, France; Centre de Ressources et de Compétences SEP Grand-Paris Est, Hôpital Universitaire Henri Mondor, Créteil, France; Department of Neurology, AP-HP, Henri Mondor University Hospital, DMU Médecine, Creteil F-94010, France
| | - Jean-Pascal Lefaucheur
- Univ Paris Est Créteil, Excitabilité Nerveuse et Thérapeutique (ENT), EA 4391, Créteil F-94010, France; Department of Clinical Neurophysiology, AP-HP, Henri Mondor University Hospital, DMU FIxIT, Creteil F-94010, France
| | - Samar S Ayache
- Univ Paris Est Créteil, Excitabilité Nerveuse et Thérapeutique (ENT), EA 4391, Créteil F-94010, France; Department of Clinical Neurophysiology, AP-HP, Henri Mondor University Hospital, DMU FIxIT, Creteil F-94010, France; Centre de Ressources et de Compétences SEP Grand-Paris Est, Hôpital Universitaire Henri Mondor, Créteil, France; Department of Neurology, AP-HP, Henri Mondor University Hospital, DMU Médecine, Creteil F-94010, France
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Seton KA, Espejo-Oltra JA, Giménez-Orenga K, Haagmans R, Ramadan DJ, Mehlsen J. Advancing Research and Treatment: An Overview of Clinical Trials in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Future Perspectives. J Clin Med 2024; 13:325. [PMID: 38256459 PMCID: PMC10816159 DOI: 10.3390/jcm13020325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/22/2023] [Accepted: 12/30/2023] [Indexed: 01/24/2024] Open
Abstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic, debilitating, and multi-faceted illness. Heterogenous onset and clinical presentation with additional comorbidities make it difficult to diagnose, characterize, and successfully treat. Current treatment guidelines focus on symptom management, but with no clear target or causative mechanism, remission rates are low, and fewer than 5% of patients return to their pre-morbid activity levels. Therefore, there is an urgent need to undertake robust clinical trials to identify effective treatments. This review synthesizes insights from clinical trials exploring pharmacological interventions and dietary supplements targeting immunological, metabolic, gastrointestinal, neurological, and neuroendocrine dysfunction in ME/CFS patients which require further exploration. Additionally, the trialling of alternative interventions in ME/CFS based on reported efficacy in the treatment of illnesses with overlapping symptomology is also discussed. Finally, we provide important considerations and make recommendations, focusing on outcome measures, to ensure the execution of future high-quality clinical trials to establish clinical efficacy of evidence-based interventions that are needed for adoption in clinical practice.
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Affiliation(s)
- Katharine A. Seton
- Quadram Institute Bioscience, Norwich Research Park, Norwich NR4 7UQ, UK;
| | - José A. Espejo-Oltra
- Max Delbrück Center for Molecular Medicine, Robert-Rössle-Straße 10, 13125 Berlin, Germany;
- Department of Pathology, School of Health Sciences, Universidad Católica de Valencia, San Vicente Mártir, 46001 Valencia, Spain
| | - Karen Giménez-Orenga
- Escuela de Doctorado, Universidad Católica de Valencia, San Vicente Mártir, 46001 Valencia, Spain;
| | - Rik Haagmans
- Quadram Institute Bioscience, Norwich Research Park, Norwich NR4 7UQ, UK;
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Donia J. Ramadan
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Kirkeveien 166, 0450 Oslo, Norway;
| | - Jesper Mehlsen
- Surgical Pathophysiology Unit, Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark;
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