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Cortical Excitability and Interhemispheric Connectivity in Early Relapsing-Remitting Multiple Sclerosis Studied With TMS-EEG.
Front Neurosci 2018; 12:393FN

Abstract

Evoked potentials (EPs) are well established in clinical practice for diagnosis and prognosis in multiple sclerosis (MS). However, their value is limited to the assessment of their respective functional systems. Here, we used transcranial magnetic stimulation (TMS) coupled with electroencephalography (TMS-EEG) to investigate cortical excitability and spatiotemporal dynamics of TMS-evoked neural activity in MS patients. Thirteen patients with early relapsing-remitting MS (RRMS) with a median Expanded Disability Status Scale (EDSS) of 1.0 (range 0-2.5) and 16 age- and gender-matched healthy controls received single-pulse TMS of left and right primary motor cortex (L-M1 and R-M1), respectively. Resting motor threshold for L-M1 and R-M1 was increased in MS patients. Latencies and amplitudes of N45, P70, N100, P180, and N280 TMS-evoked EEG potentials (TEPs) were not different between groups, except a significantly increased amplitude of the N280 TEP in the MS group, both for L-M1 and R-M1 stimulation. Interhemispheric signal propagation (ISP), estimated from the area under the curve of TEPs in the non-stimulated vs. stimulated M1, also did not differ between groups. In summary, findings show that ISP and TEPs were preserved in early-stage RRMS, except for an exaggerated N280 amplitude. Our findings indicate that TMS-EEG is feasible in testing excitability and connectivity in cortical neural networks in MS patients, complementary to conventional EPs. However, relevance and pathophysiological correlates of the enhanced N280 will need further study.

Authors+Show Affiliations

Department of Neurology and Stroke, Hertie Institute for Clinical Brain Research, Eberhard Karls University of Tübingen, Tübingen, Germany.Department of Neurology and Stroke, Hertie Institute for Clinical Brain Research, Eberhard Karls University of Tübingen, Tübingen, Germany.Department of Neurology and Stroke, Hertie Institute for Clinical Brain Research, Eberhard Karls University of Tübingen, Tübingen, Germany.Nirakara: Instituto de Investigación y Formación en Ciencias Cognitivas, Madrid, Spain.Department of Education Science, Psychology and Communication Science, University of Bari Aldo Moro, Bari, Italy.Department of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany.Department of Neurology and Stroke, Hertie Institute for Clinical Brain Research, Eberhard Karls University of Tübingen, Tübingen, Germany. Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany.Department of Neurology and Stroke, Hertie Institute for Clinical Brain Research, Eberhard Karls University of Tübingen, Tübingen, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29937712

Citation

Zipser, Carl M., et al. "Cortical Excitability and Interhemispheric Connectivity in Early Relapsing-Remitting Multiple Sclerosis Studied With TMS-EEG." Frontiers in Neuroscience, vol. 12, 2018, p. 393.
Zipser CM, Premoli I, Belardinelli P, et al. Cortical Excitability and Interhemispheric Connectivity in Early Relapsing-Remitting Multiple Sclerosis Studied With TMS-EEG. Front Neurosci. 2018;12:393.
Zipser, C. M., Premoli, I., Belardinelli, P., Castellanos, N., Rivolta, D., Heidegger, T., ... Ziemann, U. (2018). Cortical Excitability and Interhemispheric Connectivity in Early Relapsing-Remitting Multiple Sclerosis Studied With TMS-EEG. Frontiers in Neuroscience, 12, p. 393. doi:10.3389/fnins.2018.00393.
Zipser CM, et al. Cortical Excitability and Interhemispheric Connectivity in Early Relapsing-Remitting Multiple Sclerosis Studied With TMS-EEG. Front Neurosci. 2018;12:393. PubMed PMID: 29937712.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cortical Excitability and Interhemispheric Connectivity in Early Relapsing-Remitting Multiple Sclerosis Studied With TMS-EEG. AU - Zipser,Carl M, AU - Premoli,Isabella, AU - Belardinelli,Paolo, AU - Castellanos,Nazareth, AU - Rivolta,Davide, AU - Heidegger,Tonio, AU - Müller-Dahlhaus,Florian, AU - Ziemann,Ulf, Y1 - 2018/06/08/ PY - 2018/01/31/received PY - 2018/05/22/accepted PY - 2018/6/26/entrez PY - 2018/6/26/pubmed PY - 2018/6/26/medline KW - TMS-EEG KW - connectivity KW - excitability KW - multiple sclerosis KW - relapsing–remitting KW - transcranial magnetic stimulation SP - 393 EP - 393 JF - Frontiers in neuroscience JO - Front Neurosci VL - 12 N2 - Evoked potentials (EPs) are well established in clinical practice for diagnosis and prognosis in multiple sclerosis (MS). However, their value is limited to the assessment of their respective functional systems. Here, we used transcranial magnetic stimulation (TMS) coupled with electroencephalography (TMS-EEG) to investigate cortical excitability and spatiotemporal dynamics of TMS-evoked neural activity in MS patients. Thirteen patients with early relapsing-remitting MS (RRMS) with a median Expanded Disability Status Scale (EDSS) of 1.0 (range 0-2.5) and 16 age- and gender-matched healthy controls received single-pulse TMS of left and right primary motor cortex (L-M1 and R-M1), respectively. Resting motor threshold for L-M1 and R-M1 was increased in MS patients. Latencies and amplitudes of N45, P70, N100, P180, and N280 TMS-evoked EEG potentials (TEPs) were not different between groups, except a significantly increased amplitude of the N280 TEP in the MS group, both for L-M1 and R-M1 stimulation. Interhemispheric signal propagation (ISP), estimated from the area under the curve of TEPs in the non-stimulated vs. stimulated M1, also did not differ between groups. In summary, findings show that ISP and TEPs were preserved in early-stage RRMS, except for an exaggerated N280 amplitude. Our findings indicate that TMS-EEG is feasible in testing excitability and connectivity in cortical neural networks in MS patients, complementary to conventional EPs. However, relevance and pathophysiological correlates of the enhanced N280 will need further study. SN - 1662-4548 UR - https://www.unboundmedicine.com/medline/citation/29937712/Cortical_Excitability_and_Interhemispheric_Connectivity_in_Early_Relapsing_Remitting_Multiple_Sclerosis_Studied_With_TMS_EEG_ L2 - https://doi.org/10.3389/fnins.2018.00393 DB - PRIME DP - Unbound Medicine ER -