Strauss Sebastian, Herr Thorsten, Nafz Christina, Seusing Nelly, Grothe Matthias
Department of Neurology, University Medicine of Greifswald, 17475 Greifswald, Germany.
Brain Sci. 2023 Dec 26;14(1):28. doi: 10.3390/brainsci14010028.
The cortical silent period (CSP), assessed with transcranial magnetic stimulation (TMS), provides insights into motor cortex excitability. Alterations in the CSP have been observed in multiple sclerosis (MS), although a comparison of the sometimes contradictory results is difficult due to methodological differences. The aim of this study is to provide a more profound neurophysiological understanding of fatigue's pathophysiology and its relationship to the CSP. Twenty-three patients with MS, along with a matched control group, underwent comprehensive CSP measurements at four intensities (125, 150, 175, and 200% resting motor threshold), while their fatigue levels were assessed using the Fatigue Scale for Motor and Cognitive Functions (FSMC) and its motor and cognitive subscore. MS patients exhibited a significantly increased CSP duration compared to controls ( = 0.02), but CSP duration was not associated with the total FSMC, or the motor or cognitive subscore. Our data suggest a systematic difference in MS patients compared to healthy controls in the CSP but no association with fatigue when measured with the FSMC. Based on these results, and considering the heterogeneous literature in the field, our study highlights the need for a more standardized approach to neurophysiological data collection and validation. This standardization is crucial for exploring the link between TMS and clinical impairments in diseases like MS.
通过经颅磁刺激（TMS）评估的皮质静息期（CSP），能为了解运动皮质兴奋性提供线索。在多发性硬化症（MS）中已观察到CSP的改变，不过由于方法学差异，有时难以对相互矛盾的结果进行比较。本研究的目的是更深入地从神经生理学角度理解疲劳的病理生理学及其与CSP的关系。23例MS患者以及一个匹配的对照组，在四种强度（125%、150%、175%和200%静息运动阈值）下接受了全面的CSP测量，同时使用运动和认知功能疲劳量表（FSMC）及其运动和认知子评分来评估他们的疲劳水平。与对照组相比，MS患者的CSP持续时间显著增加（P = 0.02），但CSP持续时间与FSMC总分、运动或认知子评分均无关联。我们的数据表明，与健康对照组相比，MS患者在CSP方面存在系统性差异，但用FSMC测量时与疲劳无关联。基于这些结果，并考虑到该领域文献的异质性，我们的研究强调需要一种更标准化的方法来进行神经生理学数据的收集和验证。这种标准化对于探索TMS与MS等疾病临床损伤之间的联系至关重要。
