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Macerollo A, Chen JC, Parees I, Sadnicka A, Kassavetis P, Bhatia KP, Kilner JM, Rothwell JC, Edwards MJ. Abnormal movement‐related suppression of sensory evoked potentials in upper limb dystonia. Eur J Neurol 2016; 23:562-8. [DOI: 10.1111/ene.12890] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 09/02/2015] [Indexed: 12/11/2022]
Affiliation(s)
- A. Macerollo
- Sobell Department of Motor Neuroscience and Movement Disorders UCL Institute of Neurology London UK
- Department of Neuroscience and Sense Organs Aldo Moro University of Bari Bari Italy
| | - J. C. Chen
- Sobell Department of Motor Neuroscience and Movement Disorders UCL Institute of Neurology London UK
- Neuroscience Laboratory, Department of Neurology China Medical University Hospital Taichung Taiwan
- School of Medicine China Medical University Taichung Taiwan
| | - I. Parees
- Sobell Department of Motor Neuroscience and Movement Disorders UCL Institute of Neurology London UK
| | - A. Sadnicka
- Sobell Department of Motor Neuroscience and Movement Disorders UCL Institute of Neurology London UK
| | - P. Kassavetis
- Sobell Department of Motor Neuroscience and Movement Disorders UCL Institute of Neurology London UK
| | - K. P. Bhatia
- Sobell Department of Motor Neuroscience and Movement Disorders UCL Institute of Neurology London UK
| | - J. M. Kilner
- Sobell Department of Motor Neuroscience and Movement Disorders UCL Institute of Neurology London UK
| | - J. C. Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders UCL Institute of Neurology London UK
| | - M. J. Edwards
- Sobell Department of Motor Neuroscience and Movement Disorders UCL Institute of Neurology London UK
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Macerollo A, Chen JC, Parees I, Kassavetis P, Kilner J, Edwards MJ. SENSORY ATTENUATION ASSESSED BY SENSORY EVOKED POTENTIALS IN FUNCTIONAL MOVEMENT DISORDERS. J Neurol Psychiatry 2015. [DOI: 10.1136/jnnp-2015-311750.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Macerollo A, Batla A, Kassavetis P, Parees I, Bhatia KP, Edwards MJ. Using reaction time and co-contraction to differentiate acquired (secondary) from functional 'fixed' dystonia. J Neurol Neurosurg Psychiatry 2015; 86:933-4. [PMID: 25433034 PMCID: PMC4516003 DOI: 10.1136/jnnp-2014-309040] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Accepted: 11/10/2014] [Indexed: 11/04/2022]
Affiliation(s)
- A Macerollo
- Sobell Department of Motor Neuroscience and Movement Disorders, The National Hospital of Neurology and Neurosurgery, Institute of Neurology, University College London, London, UK Department of Basic Medical Sciences, Neuroscience and Sense Organs, Aldo Moro University of Bari, Bari, Italy
| | - A Batla
- Sobell Department of Motor Neuroscience and Movement Disorders, The National Hospital of Neurology and Neurosurgery, Institute of Neurology, University College London, London, UK
| | - P Kassavetis
- Sobell Department of Motor Neuroscience and Movement Disorders, The National Hospital of Neurology and Neurosurgery, Institute of Neurology, University College London, London, UK
| | - I Parees
- Sobell Department of Motor Neuroscience and Movement Disorders, The National Hospital of Neurology and Neurosurgery, Institute of Neurology, University College London, London, UK
| | - K P Bhatia
- Sobell Department of Motor Neuroscience and Movement Disorders, The National Hospital of Neurology and Neurosurgery, Institute of Neurology, University College London, London, UK
| | - M J Edwards
- Sobell Department of Motor Neuroscience and Movement Disorders, The National Hospital of Neurology and Neurosurgery, Institute of Neurology, University College London, London, UK
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Grimaldi G, Argyropoulos GP, Boehringer A, Celnik P, Edwards MJ, Ferrucci R, Galea JM, Groiss SJ, Hiraoka K, Kassavetis P, Lesage E, Manto M, Miall RC, Priori A, Sadnicka A, Ugawa Y, Ziemann U. Non-invasive cerebellar stimulation--a consensus paper. Cerebellum 2014; 13:121-38. [PMID: 23943521 DOI: 10.1007/s12311-013-0514-7] [Citation(s) in RCA: 195] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The field of neurostimulation of the cerebellum either with transcranial magnetic stimulation (TMS; single pulse or repetitive (rTMS)) or transcranial direct current stimulation (tDCS; anodal or cathodal) is gaining popularity in the scientific community, in particular because these stimulation techniques are non-invasive and provide novel information on cerebellar functions. There is a consensus amongst the panel of experts that both TMS and tDCS can effectively influence cerebellar functions, not only in the motor domain, with effects on visually guided tracking tasks, motor surround inhibition, motor adaptation and learning, but also for the cognitive and affective operations handled by the cerebro-cerebellar circuits. Verbal working memory, semantic associations and predictive language processing are amongst these operations. Both TMS and tDCS modulate the connectivity between the cerebellum and the primary motor cortex, tuning cerebellar excitability. Cerebellar TMS is an effective and valuable method to evaluate the cerebello-thalamo-cortical loop functions and for the study of the pathophysiology of ataxia. In most circumstances, DCS induces a polarity-dependent site-specific modulation of cerebellar activity. Paired associative stimulation of the cerebello-dentato-thalamo-M1 pathway can induce bidirectional long-term spike-timing-dependent plasticity-like changes of corticospinal excitability. However, the panel of experts considers that several important issues still remain unresolved and require further research. In particular, the role of TMS in promoting cerebellar plasticity is not established. Moreover, the exact positioning of electrode stimulation and the duration of the after effects of tDCS remain unclear. Future studies are required to better define how DCS over particular regions of the cerebellum affects individual cerebellar symptoms, given the topographical organization of cerebellar symptoms. The long-term neural consequences of non-invasive cerebellar modulation are also unclear. Although there is an agreement that the clinical applications in cerebellar disorders are likely numerous, it is emphasized that rigorous large-scale clinical trials are missing. Further studies should be encouraged to better clarify the role of using non-invasive neurostimulation techniques over the cerebellum in motor, cognitive and psychiatric rehabilitation strategies.
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Affiliation(s)
- G Grimaldi
- Unité d'Etude du Mouvement, Hôpital Erasme-ULB, 808 Route de Lennik, 1070, Brussels, Belgium,
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Sadnicka A, Teo JT, Kojovic M, Pareés I, Saifee TA, Kassavetis P, Schwingenschuh P, Katschnig-Winter P, Stamelou M, Mencacci NE, Rothwell JC, Edwards MJ, Bhatia KP. All in the blink of an eye: new insight into cerebellar and brainstem function in DYT1 and DYT6 dystonia. Eur J Neurol 2014; 22:762-7. [PMID: 25039324 DOI: 10.1111/ene.12521] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [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: 02/25/2014] [Accepted: 05/26/2014] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND PURPOSE Traditionally dystonia has been considered a disorder of basal ganglia dysfunction. However, recent research has advocated a more complex neuroanatomical network. In particular, there is increasing interest in the pathophysiological role of the cerebellum. Patients with cervical and focal hand dystonia have impaired cerebellar associative learning using the paradigm eyeblink conditioning. This is perhaps the most direct evidence to date that the cerebellum is implicated in patients. METHODS Eleven patients with DYT1 dystonia and five patients with DYT6 dystonia were examined and rates of eyeblink conditioning were compared with age-matched controls. A marker of brainstem excitability, the blink reflex recovery, was also studied in the same groups. RESULTS Patients with DYT1 and DYT6 dystonia have a normal ability to acquire conditioned responses. Blink reflex recovery was enhanced in DYT1 but this effect was not seen in DYT6. CONCLUSIONS If the cerebellum is an important driver in DYT1 and DYT6 dystonia our data suggest that there is specific cerebellar dysfunction such that the circuits essential for conditioning function normally. Our data are contrary to observations in focal dystonia and suggest that the cerebellum may have a distinct role in different subsets of dystonia. Evidence of enhanced blink reflex recovery in all patients with dystonia was not found and recent studies calling for the blink recovery reflex to be used as a diagnostic test for dystonic tremor may require further corroboration.
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Affiliation(s)
- A Sadnicka
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
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Hoffland BS, Kassavetis P, Bologna M, Teo JTH, Bhatia KP, Rothwell JC, Edwards MJ, van de Warrenburg BP. Cerebellum-dependent associative learning deficits in primary dystonia are normalized by rTMS and practice. Eur J Neurosci 2013; 38:2166-71. [DOI: 10.1111/ejn.12186] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 02/13/2013] [Indexed: 11/29/2022]
Affiliation(s)
| | - P. Kassavetis
- Sobell Department of Motor Neuroscience and Movement Disorders; UCL Institute of Neurology; UCL; Queen Square; London; WC1N 3BG; UK
| | - M. Bologna
- Neuromed Institute (IRCCS); Pozzilli (IS); Italy
| | - J. T. H. Teo
- Sobell Department of Motor Neuroscience and Movement Disorders; UCL Institute of Neurology; UCL; Queen Square; London; WC1N 3BG; UK
| | - K. P. Bhatia
- Sobell Department of Motor Neuroscience and Movement Disorders; UCL Institute of Neurology; UCL; Queen Square; London; WC1N 3BG; UK
| | - J. C. Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders; UCL Institute of Neurology; UCL; Queen Square; London; WC1N 3BG; UK
| | - M. J. Edwards
- Sobell Department of Motor Neuroscience and Movement Disorders; UCL Institute of Neurology; UCL; Queen Square; London; WC1N 3BG; UK
| | - B. P. van de Warrenburg
- Department of Neurology; Donders Centre for Neuroscience; Radboud University Nijmegen Medical Centre; Nijmegen; The Netherlands
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Saifee TA, Kassavetis P, Pareés I, Kojovic M, Fisher L, Morton L, Foong J, Price G, Joyce EM, Edwards MJ. Inpatient treatment of functional motor symptoms: a long-term follow-up study. J Neurol 2012; 259:1958-63. [DOI: 10.1007/s00415-012-6530-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 04/16/2012] [Accepted: 04/18/2012] [Indexed: 10/28/2022]
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Kojovic M, Kassavetis P, Bologna M, Berardelli A, Rothwell J, Edwards M, Bhatia K. Functional Reorganisation in Sensorimotor Cortex Is a Compensatory Mechanism in Early Parkinson's Disease: A Six Months Follow-Up Study (PD4.011). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.pd4.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Kojovic M, Kassavetis P, Bologna M, Berardelli A, Rothwell J, Edwards M, Bhatia K. Functional Reorganisation in Sensorimotor Cortex Is a Compensatory Mechanism in Early Parkinson's Disease: A Six Months Follow-Up Study (IN6-2.002). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.in6-2.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Kojovic M, Bologna M, Kassavetis P, Murase N, Palomar FJ, Berardelli A, Rothwell JC, Edwards MJ, Bhatia KP. Functional reorganization of sensorimotor cortex in early Parkinson disease. Neurology 2012; 78:1441-8. [PMID: 22517098 DOI: 10.1212/wnl.0b013e318253d5dd] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Compensatory reorganization of the nigrostriatal system is thought to delay the onset of symptoms in early Parkinson disease (PD). Here we sought evidence that compensation may be a part of a more widespread functional reorganization in sensorimotor networks, including primary motor cortex. METHODS Several neurophysiologic measures known to be abnormal in the motor cortex (M1) of patients with advanced PD were tested on the more and less affected side of 16 newly diagnosed and drug-naive patients with PD and compared with 16 age-matched healthy participants. LTP-like effects were probed using a paired associative stimulation protocol. We also measured short interval intracortical inhibition, intracortical facilitation, cortical silent period, and input/output curves. RESULTS The less affected side in patients with PD had preserved intracortical inhibition and a larger response to the plasticity protocol compared to healthy participants. On the more affected side, there was no response to the plasticity protocol and inhibition was reduced. There was no difference in input/output curves between sides or between patients with PD and healthy participants. CONCLUSIONS Increased motor cortical plasticity on the less affected side is consistent with a functional reorganization of sensorimotor cortex and may represent a compensatory change that contributes to delaying onset of clinical symptoms. Alternatively, it may reflect a maladaptive plasticity that provokes symptom onset. Plasticity deteriorates as the symptoms progress, as seen on the more affected side. The rate of change in paired associative stimulation response over time could be developed into a surrogate marker of disease progression in PD.
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Affiliation(s)
- M Kojovic
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London, UK
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Kassavetis P, Hoffland B, Saifee T, Bhatia K, van de Warrenburg B, Rothwell J, Edwards M. PTMS3 Cerebellar brain inhibition is decreased in active and surround muscles at the onset of voluntary movement. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60656-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Saifee T, Pareés I, Kassavetis P, Reilly M, Kaski D, Bronstein A, Rothwell J, Edwards M. P46 Tremor in Charcot-Marie-Tooth disease. Neuromuscul Disord 2011. [DOI: 10.1016/s0960-8966(11)70065-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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