Fisicaro Francesco, Lanza Giuseppe, Cantone Mariagiovanna, Ferri Raffaele, Pennisi Giovanni, Nicoletti Alessandra, Zappia Mario, Bella Rita, Pennisi Manuela
Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia, 97-95123 Catania, Italy.
Department of Surgery and Medical-Surgical Specialties, University of Catania, Via Santa Sofia, 78-95123 Catania, Italy.
J Pers Med. 2020 Dec 12;10(4):274. doi: 10.3390/jpm10040274.
Transcranial magnetic stimulation (TMS) can non-invasively probe cortical excitability in movement disorders, although clinical significance is still controversial, especially at early stages. We compare single-pulse TMS in two prototypic synucleinopathy and tauopathy-i.e., Parkinson's disease (PD) and Progressive Supranuclear Palsy (PSP), respectively-to find neurophysiological differences and identify early measures associated with cognitive impairment.
28 PD and 23 PSP de novo patients were age-matched with 28 healthy controls, all right-handed and drug-free. Amplitude and latency of motor evoked potentials (MEP), central motor conduction time, resting motor threshold (rMT), and cortical silent period (CSP) were recorded through a figure-of-eight coil from the First Dorsal Interosseous muscle (FDI), bilaterally.
Mini Mental Examination and Frontal Assessment Battery (FAB) scored worse in PSP; PD had worse FAB than controls. Higher MEP amplitude from right FDI in PD and PSP than controls was found, without difference between them. CSP was bilaterally longer in patients than controls, but similar between patient groups. A positive correlation between FAB and rMT was observed in PSP, bilaterally.
Despite the small sample size, PD and PSP might share, at early stage, a similar global electrocortical asset. rMT might detect and possibly predict cognitive deterioration in PSP.
经颅磁刺激（TMS）可无创地探测运动障碍中的皮质兴奋性，尽管其临床意义仍存在争议，尤其是在疾病早期。我们比较了两种典型的突触核蛋白病和tau蛋白病（分别为帕金森病（PD）和进行性核上性麻痹（PSP））中的单脉冲TMS，以发现神经生理学差异并确定与认知障碍相关的早期指标。
28例新发PD患者和23例新发PSP患者与28名健康对照者进行年龄匹配，均为右利手且未用药。通过八字形线圈从双侧第一背侧骨间肌（FDI）记录运动诱发电位（MEP）的波幅和潜伏期、中枢运动传导时间、静息运动阈值（rMT）和皮质静息期（CSP）。
PSP患者的简易精神状态检查和额叶评估量表（FAB）评分较差；PD患者的FAB评分比对照组差。发现PD和PSP患者右侧FDI的MEP波幅高于对照组，但两者之间无差异。患者的双侧CSP均比对照组更长，但两组患者之间相似。在PSP患者双侧，观察到FAB与rMT之间呈正相关。
尽管样本量较小，但PD和PSP在疾病早期可能具有相似的整体皮质电活动特征。rMT可能检测并预测PSP患者的认知衰退。
