Nantes Julia C, Zhong Jidan, Holmes Scott A, Whatley Benjamin, Narayanan Sridar, Lapierre Yves, Arnold Douglas L, Koski Lisa
Integrated Program in Neuroscience, McGill University, 3801 University Street, Room 141, Montreal, Que. H3A 2B4, Canada; Research Institute of the McGill University Health Centre, 2155 Guy Street, 5th Floor, Montreal, Que. H3H 2R9, Canada.
Research Institute of the McGill University Health Centre, 2155 Guy Street, 5th Floor, Montreal, Que. H3H 2R9, Canada; Department of Neurology and Neurosurgery, McGill University, 845 Rue Sherbrooke Ouest, Montréal, Que., Canada.
Clin Neurophysiol. 2016 Feb;127(2):1503-1511. doi: 10.1016/j.clinph.2015.08.011. Epub 2015 Aug 31.
The impact of inhibitory cortical activity on motor impairment of people with relapsing-remitting multiple sclerosis (RRMS) has not been fully elucidated despite its relevance to neurorehabilitation. The present study assessed the extent to which transcranial magnetic stimulation (TMS)-based metrics of intracortical inhibition are related to motor disability and brain damage.
Participants included forty-three persons with RRMS in the remitting phase and twenty-nine healthy controls. We stimulated the dominant hemisphere and recorded from the dominant hand to assess short-interval intracortical inhibition (SICI) and cortical silent period (CSP) duration. Disability was evaluated with the Multiple Sclerosis Functional Composite (MSFC). Regional cortical thickness and lesion volume were measured.
RRMS participants with dominant upper limb dexterity impairments had prolonged CSP, but equivalent SICI, compared to participants with preserved function. CSP was not related to walking or cognitive performance. Higher normalized lesion volume correlated with longer CSP duration. When adjusting for normalized lesion volume, longer CSP significantly predicted worse dominant upper extremity impairment.
High intracortical inhibition possibly contributes to (or prevents remission from) motor impairment. Lesions may be associated with intracortical inhibition shifts.
CSP duration and lesion burden should be considered when developing interventions aiming to mitigate motor impairment.
尽管抑制性皮质活动与神经康复相关，但其对复发缓解型多发性硬化症（RRMS）患者运动障碍的影响尚未完全阐明。本研究评估了基于经颅磁刺激（TMS）的皮质内抑制指标与运动残疾和脑损伤的相关程度。
参与者包括43名处于缓解期的RRMS患者和29名健康对照者。我们刺激优势半球并记录优势手的反应，以评估短间隔皮质内抑制（SICI）和皮质静息期（CSP）持续时间。使用多发性硬化症功能综合量表（MSFC）评估残疾情况。测量区域皮质厚度和病变体积。
与功能保留的参与者相比，优势上肢灵活性受损的RRMS参与者CSP延长，但SICI相当。CSP与步行或认知表现无关。较高的标准化病变体积与较长的CSP持续时间相关。在调整标准化病变体积后，较长的CSP显著预测优势上肢功能障碍更严重。
高皮质内抑制可能导致（或阻止缓解）运动障碍。病变可能与皮质内抑制转移有关。
在制定旨在减轻运动障碍的干预措施时，应考虑CSP持续时间和病变负担。
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