Background: Motor impairment in Parkinson's disease (PD) reflects changes in the basal ganglia-thalamocortical circuit converging on the primary motor cortex (M1) and supplementary motor area (SMA). Previous studies assessed M1 excitability in PD using transcranial magnetic stimulation (TMS)-evoked electromyographic activity. TMS-evoked electroencephalographic activity may unveil broader motor cortical network changes in PD. Objective: The aim was to assess motor cortical network excitability in PD. Methods: We compared TMS-evoked cortical potentials (TEPs) from M1 and the pre-SMA between 20 PD patients tested off and on medication and 19 healthy controls (HCs) and investigated possible correlations with bradykinesia. Results: Off PD patients compared to HCs had smaller P30 responses from the M1s contralateral (M1+) and ipsilateral (M1-) to the most bradykinetic side and increased pre-SMA N40. Dopaminergic therapy normalized the amplitude of M1+ and M1- P30 as well as pre-SMA N40. We found a positive correlation between M1+ P30 amplitude and bradykinesia in off PD patients. Conclusions: Changes in M1 P30 and pre-SMA N40 in PD suggest that M1 excitability is reduced on both sides, whereas pre-SMA excitability is increased. The effect of dopaminergic therapy and the clinical correlation suggest that these cortical changes may reflect abnormal basal ganglia-thalamocortical activity. TMS electroencephalography provides novel insight into motor cortical network changes related to the pathophysiology of PD.

Motor Cortical Network Excitability in Parkinson's Disease / Leodori, Giorgio; De Bartolo, Maria Ilenia; Guerra, Andrea; Fabbrini, Andrea; Rocchi, Lorenzo; Latorre, Anna; Paparella, Giulia; Belvisi, Daniele; Conte, Antonella; Bhatia, Kailash P.; Rothwell, John C.; Berardelli, Alfredo. - In: MOVEMENT DISORDERS. - ISSN 0885-3185. - (2022). [10.1002/mds.28914]

Motor Cortical Network Excitability in Parkinson's Disease

Leodori, Giorgio;De Bartolo, Maria Ilenia;Guerra, Andrea;Fabbrini, Andrea;Paparella, Giulia;Belvisi, Daniele;Conte, Antonella;Berardelli, Alfredo
2022

Abstract

Background: Motor impairment in Parkinson's disease (PD) reflects changes in the basal ganglia-thalamocortical circuit converging on the primary motor cortex (M1) and supplementary motor area (SMA). Previous studies assessed M1 excitability in PD using transcranial magnetic stimulation (TMS)-evoked electromyographic activity. TMS-evoked electroencephalographic activity may unveil broader motor cortical network changes in PD. Objective: The aim was to assess motor cortical network excitability in PD. Methods: We compared TMS-evoked cortical potentials (TEPs) from M1 and the pre-SMA between 20 PD patients tested off and on medication and 19 healthy controls (HCs) and investigated possible correlations with bradykinesia. Results: Off PD patients compared to HCs had smaller P30 responses from the M1s contralateral (M1+) and ipsilateral (M1-) to the most bradykinetic side and increased pre-SMA N40. Dopaminergic therapy normalized the amplitude of M1+ and M1- P30 as well as pre-SMA N40. We found a positive correlation between M1+ P30 amplitude and bradykinesia in off PD patients. Conclusions: Changes in M1 P30 and pre-SMA N40 in PD suggest that M1 excitability is reduced on both sides, whereas pre-SMA excitability is increased. The effect of dopaminergic therapy and the clinical correlation suggest that these cortical changes may reflect abnormal basal ganglia-thalamocortical activity. TMS electroencephalography provides novel insight into motor cortical network changes related to the pathophysiology of PD.
Parkinson's disease; bradykinesia; motor cortex; supplementary motor area; transcranial magnetic stimulation-electroencephalography.
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Motor Cortical Network Excitability in Parkinson's Disease / Leodori, Giorgio; De Bartolo, Maria Ilenia; Guerra, Andrea; Fabbrini, Andrea; Rocchi, Lorenzo; Latorre, Anna; Paparella, Giulia; Belvisi, Daniele; Conte, Antonella; Bhatia, Kailash P.; Rothwell, John C.; Berardelli, Alfredo. - In: MOVEMENT DISORDERS. - ISSN 0885-3185. - (2022). [10.1002/mds.28914]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1601298
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