特发性震颤的 TMS 兴奋性研究：通过静息期记录评估 GABA 能变化缺失。
TMS excitability study in essential tremor: Absence of gabaergic changes assessed by silent period recordings.
机构信息
Department of Neuropsychiatry, Faculty of Medicine, Assiut University, Assuit, Egypt; Department of Neuropsychiatry, Faculty of Medicine, Aswan University, Aswan, Egypt.
Department of Neuropsychiatry, Faculty of Medicine, Aswan University, Aswan, Egypt.
出版信息
Neurophysiol Clin. 2019 Sep;49(4):309-315. doi: 10.1016/j.neucli.2019.05.065. Epub 2019 Jun 2.
BACKGROUND
Essential tremor (ET) is thought to emerge from activity in a distributed cerebello-thalamo-cortical network. It has been proposed that the network goes into oscillation because of abnormal GABAergic inhibitory transmission.
OBJECTIVE
To test this idea by investigating GABAergic circuitry in motor cortex using transcranial magnetic stimulation (TMS).
METHODS
Motor cortex excitability was examined using TMS in 21 patients with essential tremor and in 20 control subjects. Resting and active motor threshold (RMT, AMT) and input-output curves examined corticospinal excitability. Contralateral silent period (cSP) at a different range of stimulation intensities, and the ipsilateral silent period (iSP) using a stimulus intensity of 150% RMT were used as measures of GABAergic function.
RESULTS
RMT and AMT were significantly lower in patients than controls and patients had a steeper I/O curve. However, there were no significant differences in either cSP at different intensities or in iSP.
CONCLUSION
We found no evidence in favour of the GABA hypothesis in ET.
背景
特发性震颤（ET）被认为源于小脑-丘脑-皮质网络的活动。有人提出，由于 GABA 能抑制性传递异常，网络会发生振荡。
目的
通过经颅磁刺激（TMS）研究运动皮层中的 GABA 能回路来验证这一观点。
方法
使用 TMS 检查 21 例 ET 患者和 20 例对照者的运动皮层兴奋性。静息和活动运动阈值（RMT、AMT）和输入-输出曲线检查皮质脊髓兴奋性。使用 150%RMT 的刺激强度测量不同刺激强度的对侧静息期（cSP）和同侧静息期（iSP），作为 GABA 能功能的指标。
结果
与对照组相比，患者的 RMT 和 AMT 明显降低，且患者的 I/O 曲线更陡。然而，在不同强度的 cSP 或 iSP 中，均未发现显著差异。
结论
我们没有发现支持 ET 中 GABA 假说的证据。
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