Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London, UK.
Department of Neurology, Ulm University Hospital, Ulm, Germany.
Mov Disord. 2018 Mar;33(3):440-448. doi: 10.1002/mds.27285. Epub 2018 Jan 22.
In Huntington's disease there is evidence of structural damage in the motor system, but it is still unclear how to link this to the behavioral disorder of movement. One feature of choreic movement is variable timing and coordination between sequences of actions. We postulate this results from desynchronization of neural activity in cortical motor areas.
The objective of this study was to explore the ability to synchronize activity in a motor network using transcranial magnetic stimulation and to relate this to timing of motor performance.
We examined synchronization in oscillatory activity of cortical motor areas in response to an external input produced by a pulse of transcranial magnetic stimulation. We combined this with EEG to compare the response of 16 presymptomatic Huntington's disease participants with 16 age-matched healthy volunteers to test whether the strength of synchronization relates to the variability of motor performance at the following 2 tasks: a grip force task and a speeded-tapping task.
Phase synchronization in response to M1 stimulation was lower in Huntington's disease than healthy volunteers (P < .01), resulting in a reduced cortical activity at global (P < .02) and local levels (P < .01). Participants who showed better timed motor performance also showed stronger oscillatory synchronization (r = -0.356; P < .05) and higher cortical activity (r = -0.393; P < .05).
Our data may model the ability of the motor command to respond to more subtle, physiological inputs from other brain areas. This novel insight indicates that impairments of the timing accuracy of synchronization and desynchronization could be a physiological basis for some key clinical features of Huntington's disease. © 2018 International Parkinson and Movement Disorder Society.
亨廷顿病患者的运动系统存在结构损伤的证据，但尚不清楚如何将其与运动障碍的运动行为联系起来。舞蹈运动的一个特征是动作序列之间的时间和协调变化。我们推测这是由于皮质运动区神经活动的去同步化所致。
本研究旨在探讨使用经颅磁刺激来协调运动网络活动的能力，并将其与运动表现的时间联系起来。
我们研究了皮质运动区对经颅磁刺激脉冲产生的外部输入的振荡活动的同步性，并结合脑电图比较了 16 名有症状前亨廷顿病患者和 16 名年龄匹配的健康志愿者的反应，以测试同步性的强度是否与以下 2 项任务的运动表现的可变性有关：握力任务和快速敲击任务。
亨廷顿病患者对 M1 刺激的相位同步性低于健康志愿者（P<0.01），导致全局（P<0.02）和局部水平（P<0.01）的皮质活动降低。表现出更好定时运动表现的参与者也表现出更强的振荡同步性（r=-0.356；P<0.05）和更高的皮质活动（r=-0.393；P<0.05）。
我们的数据可以模拟运动指令对来自其他脑区的更微妙的生理输入的响应能力。这一新的见解表明，同步和去同步的定时准确性的损伤可能是亨廷顿病一些关键临床特征的生理基础。© 2018 国际帕金森病和运动障碍协会。
