Marsili L, Suppa A, Di Stasio F, Belvisi D, Upadhyay N, Berardelli I, Pasquini M, Petrucci S, Ginevrino M, Fabbrini G, Cardona F, Defazio G, Berardelli A
Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy.
IRCCS Neuromed Institute, Pozzilli, IS, Italy.
Exp Brain Res. 2017 Mar;235(3):841-850. doi: 10.1007/s00221-016-4847-6. Epub 2016 Nov 30.
Gilles de la Tourette syndrome (GTS) is characterized by motor and vocal tics and often associated with obsessive-compulsive disorder (OCD). Responses to intermittent/continuous theta-burst stimulation (iTBS/cTBS), which probe long-term potentiation (LTP)-/depression (LTD)-like plasticity in the primary motor cortex (M1), are reduced in GTS. ITBS-/cTBS-induced M1 plasticity can be affected by brain-derived neurotrophic factor (BDNF) polymorphism. We investigated whether the BDNF polymorphism influences iTBS-/cTBS-induced LTP-/LTD-like M1 plasticity in 50 GTS patients and in 50 age- and sex-matched healthy subjects. In GTS patients, motor and psychiatric (OCD) symptom severity was rated using the Yale Global Tic Severity Scale (YGTSS) and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). We compared M1 iTBS-/cTBS-induced plasticity in healthy subjects and in patients with GTS. We also compared responses to TBS according to BDNF polymorphism (Val/Val vs Met carriers) in patients and controls. Fourteen healthy subjects and 13 GTS patients were Met carriers. When considering the whole group of controls, as expected, iTBS increased whereas cTBS decreased MEPs. Differently, iTBS/cTBS failed to induce LTP-/LTD-like plasticity in patients with GTS. When comparing responses to TBS according to BDNF polymorphism, in healthy subjects, Met carriers showed reduced MEP changes compared with Val/Val individuals. Conversely, in patients with GTS, responses to iTBS/cTBS were comparable in Val/Val individuals and Met carriers. YGTSS and Y-BOCS scores were comparable in Met carriers and in Val/Val subjects. We conclude that iTBS and cTBS failed to induce LTP-/LTD-like plasticity in patients with GTS, and this was not affected by BDNF genotype.
Gilles de la Tourette综合征（GTS）的特征是运动和发声抽动，且常与强迫症（OCD）相关。GTS患者对间歇性/连续性theta爆发刺激（iTBS/cTBS）的反应降低，这种刺激可探测初级运动皮层（M1）中类似长时程增强（LTP）/长时程抑制（LTD）的可塑性。ITBS-/cTBS诱导的M1可塑性可能受脑源性神经营养因子（BDNF）多态性的影响。我们调查了BDNF多态性是否影响50例GTS患者以及50例年龄和性别匹配的健康受试者中iTBS-/cTBS诱导的类似LTP/LTD的M1可塑性。在GTS患者中，使用耶鲁全球抽动严重程度量表（YGTSS）和耶鲁-布朗强迫症量表（Y-BOCS）对运动和精神（OCD）症状严重程度进行评分。我们比较了健康受试者和GTS患者中M1的iTBS-/cTBS诱导的可塑性。我们还比较了患者和对照组中根据BDNF多态性（Val/Val与Met携带者）对TBS的反应。14名健康受试者和13名GTS患者为Met携带者。在考虑整个对照组时，正如预期的那样，iTBS使运动诱发电位（MEP）增加，而cTBS使其降低。不同的是，iTBS/cTBS未能在GTS患者中诱导出类似LTP/LTD的可塑性。在根据BDNF多态性比较对TBS的反应时，在健康受试者中，Met携带者与Val/Val个体相比，MEP变化较小。相反，在GTS患者中，Val/Val个体和Met携带者对iTBS/cTBS的反应相当。Met携带者和Val/Val受试者的YGTSS和Y-BOCS评分相当。我们得出结论，iTBS和cTBS未能在GTS患者中诱导出类似LTP/LTD的可塑性，且这不受BDNF基因型的影响。
