Nardone Raffaele, Golaszewski Stefan, Frey Vanessa, Brigo Francesco, Versace Viviana, Sebastianelli Luca, Saltuari Leopold, Höller Yvonne
Department of Neurology, Franz Tappeiner Hospital, Merano, Italy; Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Karl Landsteiner Institut für Neurorehabilitation und Raumfahrtneurologie, Salzburg, Austria.
Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Karl Landsteiner Institut für Neurorehabilitation und Raumfahrtneurologie, Salzburg, Austria.
Sleep Med. 2020 Aug;72:126-129. doi: 10.1016/j.sleep.2020.03.030. Epub 2020 Apr 5.
We aimed at evaluating the amplitude changes of the motor evoked potentials (MEPs) induced by of low-frequency (LF) repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex (M1) in10 patients with primary insomnia (PI) and in 10 age-matched healthy controls.
Median peak-to-peak MEP amplitudes were assessed in all subjects at three times: at baseline (T), after the first train of a single rTMS session (T), and after the whole rTMS procedure (T). This consists of 20 trains of 1 Hz stimulation with 50 stimuli per train and an intertrain interval of 30 s.
Resting motor threshold (RMT) and MEPs amplitude did not differ between the two groups at T. A reduction of MEP size was observed at both T and T in all subjects, but this was significantly less pronounced in patients than in control subjects.
The lack of MEP inhibition reflects an altered response to LF rTMS in patients with PI. These rTMS findings are indicative of an altered cortical plasticity in inhibitory circuits within M1 in PI. Subjects with PI exhibited an impairment of the LTD-like mechanisms induced by inhibitory rTMS, thus providing further support to the involvement of GABA neurotransmission in the pathophysiology of PI.
我们旨在评估10例原发性失眠（PI）患者和10例年龄匹配的健康对照者在初级运动皮层（M1）上进行低频（LF）重复经颅磁刺激（rTMS）所诱发的运动诱发电位（MEP）的幅度变化。
在所有受试者中，于三个时间点评估正中神经峰峰值MEP幅度：基线时（T0）、单次rTMS疗程的第一组刺激后（T1）以及整个rTMS程序结束后（T2）。该程序包括20组1Hz刺激，每组50次刺激，组间间隔30秒。
在T0时，两组之间的静息运动阈值（RMT）和MEP幅度无差异。在所有受试者的T1和T2时均观察到MEP大小降低，但患者的这种降低明显不如对照组明显。
MEP抑制的缺乏反映了PI患者对LF rTMS的反应改变。这些rTMS结果表明PI患者M1内抑制性回路的皮质可塑性发生改变。PI患者表现出抑制性rTMS诱导的类长时程抑制（LTD）机制受损，从而为γ-氨基丁酸（GABA）神经传递参与PI的病理生理学提供了进一步支持。
