Groiss Stefan J, Mochizuki Hitoshi, Hanajima Ritsuko, Trenado Carlos, Nakatani-Enomoto Setsu, Otani Koji, Ugawa Yoshikazu
a Department of Neurology, Faculty of Medicine , Fukushima Medical University , Fukushima , Japan.
b Department of Neurology & Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty , Heinrich-Heine-University , Düsseldorf , Germany.
Amyotroph Lateral Scler Frontotemporal Degener. 2017 Nov;18(7-8):604-610. doi: 10.1080/21678421.2017.1321676. Epub 2017 May 9.
The triad conditioned facilitation (TCF) technique has been shown to detect motor cortical intrinsic rhythms depending on the functioning of specific cortical layers by measuring motor evoked potential (MEP) enhancement after a triad of conditioning TMS pulses at a certain interval. However, the influence of cortical degeneration on TCF is still undetermined. We therefore studied TCF in patients with amyotrophic lateral sclerosis (ALS), a neurodegenerative disorder characterised by degeneration of the motor cortex.
Thirteen patients with ALS and 11 age-matched disease control patients with cervical myelopathy (CM) or radiculopathy (CR) participated in the study. We studied short-interval intracortical inhibition (SICI), intracortical facilitation (ICF) and TCF using the paired-pulse and triad conditioned TMS paradigm.
TCF was significantly reduced in ALS patients compared to CM/CR patients, who had normal TCF. SICI and ICF did not differ between groups.
The absence of TCF with preserved SICI and ICF suggests changes in the intrinsic rhythm generation within the motor cortex due to cortical neurodegeneration in ALS patients. In contrast, TCF was normal in patents with CM/CR in whom the motor cortical intrinsic circuits are not involved. This technique may be valuable to differentiate patients with ALS from those with CM/CR.
三联条件易化（TCF）技术已被证明可通过在一定间隔施加三联条件性经颅磁刺激（TMS）脉冲后测量运动诱发电位（MEP）增强来检测依赖于特定皮质层功能的运动皮质固有节律。然而，皮质变性对TCF的影响仍未确定。因此，我们对肌萎缩侧索硬化症（ALS）患者进行了TCF研究，ALS是一种以运动皮质变性为特征的神经退行性疾病。
13例ALS患者和11例年龄匹配的疾病对照患者（患有颈椎病（CM）或神经根病（CR））参与了本研究。我们使用配对脉冲和三联条件性TMS范式研究了短间隔皮质内抑制（SICI）、皮质内易化（ICF）和TCF。
与TCF正常的CM/CR患者相比，ALS患者的TCF显著降低。两组之间的SICI和ICF没有差异。
ALS患者存在SICI和ICF保留但TCF缺失的情况，这表明由于皮质神经变性，运动皮质内的固有节律产生发生了变化。相比之下，运动皮质固有回路未受累的CM/CR患者的TCF正常。该技术可能有助于区分ALS患者和CM/CR患者。
