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Moreno-Roco J, del Valle L, Jiménez D, Acosta I, Castillo JL, Dharmadasa T, Kiernan MC, Matamala JM. Diagnostic utility of transcranial magnetic stimulation for neurodegenerative disease: a critical review. Dement Neuropsychol 2024; 17:e20230048. [PMID: 38189033 PMCID: PMC10768644 DOI: 10.1590/1980-5764-dn-2023-0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/13/2023] [Accepted: 09/24/2023] [Indexed: 01/09/2024] Open
Abstract
Neurodegenerative diseases pose significant challenges due to their impact on brain structure, function, and cognition. As life expectancy rises, the prevalence of these disorders is rapidly increasing, resulting in substantial personal, familial, and societal burdens. Efforts have been made to optimize the diagnostic and therapeutic processes, primarily focusing on clinical, cognitive, and imaging characterization. However, the emergence of non-invasive brain stimulation techniques, specifically transcranial magnetic stimulation (TMS), offers unique functional insights and diagnostic potential. TMS allows direct evaluation of brain function, providing valuable information inaccessible through other methods. This review aims to summarize the current and potential diagnostic utility of TMS in investigating neurodegenerative diseases, highlighting its relevance to the field of cognitive neuroscience. The findings presented herein contribute to the growing body of research focused on improving our understanding and management of these debilitating conditions, particularly in regions with limited resources and a pressing need for innovative approaches.
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Affiliation(s)
- Javier Moreno-Roco
- Universidad de Chile, Facultad de Medicina, Laboratorio de Neurología y Neurofisiología Traslacional, Santiago, Chile
- Universidad de Chile, Facultad de Medicina, Centro de Investigación Clínica Avanzado (CICA) Oriente, Santiago, Chile
- Universidad de Chile, Facultad de Medicina, Departamento de Ciencias Neurológicas Oriente, Santiago, Chile
| | - Lucía del Valle
- Universidad de Chile, Facultad de Medicina, Laboratorio de Neurología y Neurofisiología Traslacional, Santiago, Chile
- Universidad de Chile, Facultad de Medicina, Centro de Investigación Clínica Avanzado (CICA) Oriente, Santiago, Chile
- Universidad de Chile, Facultad de Medicina, Departamento de Ciencias Neurológicas Oriente, Santiago, Chile
| | - Daniel Jiménez
- Universidad de Chile, Facultad de Medicina, Laboratorio de Neurología y Neurofisiología Traslacional, Santiago, Chile
- Universidad de Chile, Facultad de Medicina, Centro de Investigación Clínica Avanzado (CICA) Oriente, Santiago, Chile
- Universidad de Chile, Facultad de Medicina, Departamento de Ciencias Neurológicas Oriente, Santiago, Chile
- Hospital del Salvador, Servicio de Neurología, Santiago, Chile
| | - Ignacio Acosta
- Universidad de Chile, Facultad de Medicina, Laboratorio de Neurología y Neurofisiología Traslacional, Santiago, Chile
- Universidad de Chile, Facultad de Medicina, Centro de Investigación Clínica Avanzado (CICA) Oriente, Santiago, Chile
- Universidad de Chile, Facultad de Medicina, Departamento de Ciencias Neurológicas Oriente, Santiago, Chile
- Hospital del Salvador, Servicio de Neurología, Santiago, Chile
| | - José Luis Castillo
- Universidad de Chile, Facultad de Medicina, Laboratorio de Neurología y Neurofisiología Traslacional, Santiago, Chile
- Universidad de Chile, Facultad de Medicina, Departamento de Ciencias Neurológicas Oriente, Santiago, Chile
| | - Thanuja Dharmadasa
- University of Melbourne, The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
- The Royal Melbourne Hospital, Department of Neurology, Parkville, Victoria, Australia
- University of Sydney, Brain and Mind Centre, Sydney, Australia
| | - Matthew C. Kiernan
- University of Sydney, Brain and Mind Centre, Sydney, Australia
- Royal Prince Alfred Hospital, Department of Neurology, Sydney, AustraliaArgento
| | - José Manuel Matamala
- Universidad de Chile, Facultad de Medicina, Laboratorio de Neurología y Neurofisiología Traslacional, Santiago, Chile
- Universidad de Chile, Facultad de Medicina, Centro de Investigación Clínica Avanzado (CICA) Oriente, Santiago, Chile
- Universidad de Chile, Facultad de Medicina, Departamento de Ciencias Neurológicas Oriente, Santiago, Chile
- Universidad de Chile, Facultad de Medicina, Departamento de Neurociencias, Santiago, Chile
- Universidad de Chile, Facultad de Medicina, Instituto de Neurociencia Biomédica (BNI), Santiago, Chile
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2
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Transcranial magnetic stimulation and gait disturbances in Parkinson's disease: A systematic review. Neurophysiol Clin 2020; 50:213-225. [DOI: 10.1016/j.neucli.2020.05.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 05/14/2020] [Accepted: 05/14/2020] [Indexed: 12/11/2022] Open
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Lee YY, Li MH, Tai CH, Luh JJ. Corticomotor Excitability Changes Associated With Freezing of Gait in People With Parkinson Disease. Front Hum Neurosci 2020; 14:190. [PMID: 32508609 PMCID: PMC7253638 DOI: 10.3389/fnhum.2020.00190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 04/28/2020] [Indexed: 11/17/2022] Open
Abstract
Background and Purpose Freezing of gait (FOG) is a debilitating gait disorder in people with Parkinson’s disease (PD). While various neuroimaging techniques have been used to investigate the pathophysiology of FOG, changes in corticomotor excitability associated with FOG have yet to be determined. Research to date has not concluded if changes in corticomotor excitability are associated with gait disturbances in this patient population. This study aimed to use transcranial magnetic stimulation (TMS) to investigate corticomotor excitability changes associated with FOG. Furthermore, the relationship between corticomotor excitability and gait performances would be determined. Methods Eighteen participants with PD and FOG (PD + FOG), 15 without FOG (PD − FOG), and 15 non-disabled adults (Control) were recruited for this study. Single and paired-pulse TMS paradigms were used to assess corticospinal and intracortical excitability, respectively. Gait performance was measured by the 10-Meter-Walk test. Correlation analysis was performed to evaluate relationships between TMS outcomes and gait parameters. Results Compared with the Control group, the PD + FOG group showed a significantly lower resting motor threshold and reduced short intracortical inhibition (SICI). Correlation analysis revealed a relationship between resting motor evoked potential and step length, and between SICI and walking velocity in the Control group. While the silent period correlated with step length in the PD − FOG group, no significant relationship was observed in the PD + FOG group. Discussion and Conclusion Compared to the Control group, the PD + FOG group exhibited reduced corticomotor inhibition. Distinct correlations observed among the three groups suggest that the function of the corticomotor system plays an important role in mediating walking ability in non-disabled adults and people with PD − FOG, while people with PD + FOG may rely on neural networks other than the corticomotor system to control gait.
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Affiliation(s)
- Ya-Yun Lee
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Min-Hao Li
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Chun-Hwei Tai
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Jer-Junn Luh
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,College of Education, Fu-Jen Catholic University, Taipei, Taiwan
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4
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Bologna M, Paparella G, Fasano A, Hallett M, Berardelli A. Evolving concepts on bradykinesia. Brain 2020; 143:727-750. [PMID: 31834375 PMCID: PMC8205506 DOI: 10.1093/brain/awz344] [Citation(s) in RCA: 119] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/02/2019] [Accepted: 09/06/2019] [Indexed: 12/20/2022] Open
Abstract
Bradykinesia is one of the cardinal motor symptoms of Parkinson's disease and other parkinsonisms. The various clinical aspects related to bradykinesia and the pathophysiological mechanisms underlying bradykinesia are, however, still unclear. In this article, we review clinical and experimental studies on bradykinesia performed in patients with Parkinson's disease and atypical parkinsonism. We also review studies on animal experiments dealing with pathophysiological aspects of the parkinsonian state. In Parkinson's disease, bradykinesia is characterized by slowness, the reduced amplitude of movement, and sequence effect. These features are also present in atypical parkinsonisms, but the sequence effect is not common. Levodopa therapy improves bradykinesia, but treatment variably affects the bradykinesia features and does not significantly modify the sequence effect. Findings from animal and patients demonstrate the role of the basal ganglia and other interconnected structures, such as the primary motor cortex and cerebellum, as well as the contribution of abnormal sensorimotor processing. Bradykinesia should be interpreted as arising from network dysfunction. A better understanding of bradykinesia pathophysiology will serve as the new starting point for clinical and experimental purposes.
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Affiliation(s)
- Matteo Bologna
- Department of Human Neurosciences, Sapienza University of Rome, Italy
- IRCCS Neuromed, Pozzilli (IS), Italy
| | | | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, Ontario, Canada
- Division of Neurology, University of Toronto, Toronto, Ontario, Canada
- Krembil Brain Institute, Toronto, Ontario, Canada
- Center for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, ON, Canada
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Italy
- IRCCS Neuromed, Pozzilli (IS), Italy
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Fernández-Lago H, Bello O, Salgado AV, Fernandez-del-Olmo M. Acute kinematic and neurophysiological effects of treadmill and overground walking in Parkinson’s disease. NeuroRehabilitation 2019; 44:433-443. [DOI: 10.3233/nre-182638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Helena Fernández-Lago
- Faculty of Nursing and Physical Therapy, University of Lleida, Lleida, Spain
- Research Group of Health Care (GRECS), IRBLleida, Spain
| | - Olalla Bello
- Department of Physical Therapy, Faculty of Physical Therapy, University of A Coruña, A Coruña, Spain
| | - Antía Vidal Salgado
- Department of Physical Education, Faculty of Sciences of Sport and Physical Education, University of A Coruña, A Coruña, Spain
| | - Miguel Fernandez-del-Olmo
- Department of Physical Education, Faculty of Sciences of Sport and Physical Education, University of A Coruña, A Coruña, Spain
- Physical Education and Sports Area, University of Rey Juan Carlos, Madrid, Spain
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6
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Latorre A, Rocchi L, Berardelli A, Bhatia KP, Rothwell JC. The interindividual variability of transcranial magnetic stimulation effects: Implications for diagnostic use in movement disorders. Mov Disord 2019; 34:936-949. [DOI: 10.1002/mds.27736] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 05/09/2019] [Accepted: 05/16/2019] [Indexed: 11/08/2022] Open
Affiliation(s)
- Anna Latorre
- Department of Clinical and Movement NeurosciencesQueen Square Institute of Neurology University College London London United Kingdom
- Department of Neurology and Psychiatry, SapienzaUniversity of Rome Rome Italy
| | - Lorenzo Rocchi
- Department of Clinical and Movement NeurosciencesQueen Square Institute of Neurology University College London London United Kingdom
| | - Alfredo Berardelli
- Department of Neurology and Psychiatry, SapienzaUniversity of Rome Rome Italy
- Istituto di Ricovero e Cura a Carattere Scientifico Neuromed Pozzilli Isernia Italy
| | - Kailash P. Bhatia
- Department of Clinical and Movement NeurosciencesQueen Square Institute of Neurology University College London London United Kingdom
| | - John C. Rothwell
- Department of Clinical and Movement NeurosciencesQueen Square Institute of Neurology University College London London United Kingdom
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Segovia F, Górriz JM, Ramírez J, Martínez-Murcia FJ, Levin J, Schuberth M, Brendel M, Rominger A, Bötzel K, Garraux G, Phillips C. Multivariate Analysis of 18F-DMFP PET Data to Assist the Diagnosis of Parkinsonism. Front Neuroinform 2017; 11:23. [PMID: 28424607 PMCID: PMC5371594 DOI: 10.3389/fninf.2017.00023] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 03/14/2017] [Indexed: 02/03/2023] Open
Abstract
An early and differential diagnosis of parkinsonian syndromes still remains a challenge mainly due to the similarity of their symptoms during the onset of the disease. Recently, 18F-Desmethoxyfallypride (DMFP) has been suggested to increase the diagnostic precision as it is an effective radioligand that allows us to analyze post-synaptic dopamine D2/3 receptors. Nevertheless, the analysis of these data is still poorly covered and its use limited. In order to address this challenge, this paper shows a novel model to automatically distinguish idiopathic parkinsonism from non-idiopathic variants using DMFP data. The proposed method is based on a multiple kernel support vector machine and uses the linear version of this classifier to identify some regions of interest: the olfactory bulb, thalamus, and supplementary motor area. We evaluated the proposed model for both, the binary separation of idiopathic and non-idiopathic parkinsonism and the multigroup separation of parkinsonian variants. These systems achieved accuracy rates higher than 70%, outperforming DaTSCAN neuroimages for this purpose. In addition, a system that combined DaTSCAN and DMFP data was assessed.
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Affiliation(s)
- Fermín Segovia
- Department of Signal Theory, Networking and Communications, University of GranadaGranada, Spain.,Cyclotron Research Centre, University of LiègeLiège, Belgium
| | - Juan M Górriz
- Department of Signal Theory, Networking and Communications, University of GranadaGranada, Spain
| | - Javier Ramírez
- Department of Signal Theory, Networking and Communications, University of GranadaGranada, Spain
| | | | - Johannes Levin
- Department of Neurology, University of MunichMunich, Germany
| | | | - Matthias Brendel
- Department of Nuclear Medicine, University of MunichMunich, Germany
| | - Axel Rominger
- Department of Nuclear Medicine, University of MunichMunich, Germany
| | - Kai Bötzel
- Department of Neurology, University of MunichMunich, Germany
| | - Gaëtan Garraux
- Cyclotron Research Centre, University of LiègeLiège, Belgium
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8
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Bologna M, Suppa A, Conte A, Latorre A, Rothwell JC, Berardelli A. Are studies of motor cortex plasticity relevant in human patients with Parkinson’s disease? Clin Neurophysiol 2016; 127:50-59. [DOI: 10.1016/j.clinph.2015.02.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 02/08/2015] [Accepted: 02/11/2015] [Indexed: 10/23/2022]
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Bembenek JP, Kurczych K, Członkowska A. TMS-induced motor evoked potentials in Wilson's disease: a systematic literature review. Bioelectromagnetics 2015; 36:255-66. [PMID: 25808411 DOI: 10.1002/bem.21909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 02/22/2015] [Indexed: 12/18/2022]
Abstract
Wilson's disease (WD) is a metabolic brain disease resulting from improper copper metabolism. Although pyramidal symptoms are rarely observed, subclinical injury is highly possible as copper accumulates in all brain structures. The usefulness of motor evoked potentials (MEPs) in pyramidal tracts damage evaluation still appears to be somehow equivocal. We searched for original papers assessing the value of transcranial magnetic stimulation elicited MEPs with respect to motor function of upper and lower extremity in WD. We searched PubMed for original papers evaluating use of MEPs in WD using key words: "motor evoked potentials Wilson's disease" and "transcranial magnetic stimulation Wilson's disease." We found six articles using the above key words. One additional article and one case report were found while viewing the references lists. Therefore, we included eight studies. Number of patients in studies was low and their clinical characteristic was variable. There were also differences in methodology. Abnormal MEPs were confirmed in 20-70% of study participants. MEPs were not recorded in 7.6-66.7% of patients. Four studies reported significantly increased cortical excitability (up to 70% of patients). Prolonged central motor conduction time was observed in four studies (30-100% of patients). One study reported absent or prolonged central motor latency in 66.7% of patients. Although MEPs may be abnormal in WD, this has not been thoroughly assessed. Hence, further studies are indispensable to evaluate MEPs' usefulness in assessing pyramidal tract damage in WD.
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Affiliation(s)
- Jan P Bembenek
- 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
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10
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Leon-Sarmiento FE, Rizzo-Sierra CV, Leon-Ariza JS, Leon-Ariza DS, Sobota R, Prada DG. A new neurometric dissection of the area-under-curve-associated jiggle of the motor evoked potential induced by transcranial magnetic stimulation. Physiol Behav 2015; 141:111-9. [DOI: 10.1016/j.physbeh.2015.01.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 01/09/2015] [Accepted: 01/13/2015] [Indexed: 10/24/2022]
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11
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Kačar A, Filipović S, Kresojević N, Milanović S, Ljubisavljević M, Kostić V, Rothwell J. History of exposure to dopaminergic medication does not affect motor cortex plasticity and excitability in Parkinson’s disease. Clin Neurophysiol 2013; 124:697-707. [DOI: 10.1016/j.clinph.2012.09.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Revised: 09/04/2012] [Accepted: 09/06/2012] [Indexed: 10/27/2022]
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12
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Vonloh M, Chen R, Kluger B. Safety of transcranial magnetic stimulation in Parkinson's disease: a review of the literature. Parkinsonism Relat Disord 2013; 19:573-85. [PMID: 23473718 DOI: 10.1016/j.parkreldis.2013.01.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 12/18/2012] [Accepted: 01/13/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Transcranial magnetic stimulation (TMS) has been used in both physiological studies and, more recently, the therapy of Parkinson's disease (PD). Prior TMS studies in healthy subjects and other patient populations demonstrate a slight risk of seizures and other adverse events. Our goal was to estimate these risks and document other safety concerns specific to PD patients. METHODS We performed an English-Language literature search through PudMed to review all TMS studies involving PD patients. We documented any seizures or other adverse events associated with these studies. Crude risks were calculated per subject and per session of TMS. RESULTS We identified 84 single pulse (spTMS) and/or paired-pulse (ppTMS) TMS studies involving 1091 patients and 77 repetitive TMS (rTMS) studies involving 1137 patients. Risk of adverse events was low in all protocols. spTMS and ppTMS risk per patient for any adverse event was 0.0018 (95% CI: 0.0002-0.0066) per patient and no seizures were encountered. Risk of an adverse event from rTMS was 0.040 (95% CI: 0.029-0.053) per patient and no seizures were reported. Other adverse events included transient headaches, scalp pain, tinnitus, nausea, increase in pre-existing pain, and muscle jerks. Transient worsening of Parkinsonian symptoms was noted in one study involving rTMS of the supplementary motor area (SMA). CONCLUSION We conclude that current TMS and rTMS protocols do not pose significant risks to PD patients. We would recommend that TMS users in this population follow the most recent safety guidelines but do not warrant additional precautions.
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Affiliation(s)
- Matthew Vonloh
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA
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Busan P, D'Ausilio A, Borelli M, Monti F, Pelamatti G, Pizzolato G, Fadiga L. Motor excitability evaluation in developmental stuttering: A transcranial magnetic stimulation study. Cortex 2013; 49:781-92. [DOI: 10.1016/j.cortex.2011.12.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Revised: 07/15/2011] [Accepted: 12/07/2011] [Indexed: 11/16/2022]
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Corticomotor excitability in drug-naive patients with Parkinson disease. Neurol Neurochir Pol 2013; 47:109-15. [DOI: 10.5114/ninp.2013.34699] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kishore A, Popa T, Velayudhan B, Joseph T, Balachandran A, Meunier S. Acute dopamine boost has a negative effect on plasticity of the primary motor cortex in advanced Parkinson's disease. Brain 2012; 135:2074-88. [PMID: 22609619 DOI: 10.1093/brain/aws124] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Asha Kishore
- Department of Neurology, Comprehensive Care Centre for Movement Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvanathapuram, Kerala 695011, India.
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16
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Comparison of transcranial magnetic stimulation measures obtained at rest and under active conditions and their reliability. J Neurosci Methods 2012; 205:65-71. [DOI: 10.1016/j.jneumeth.2011.12.012] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 12/14/2011] [Accepted: 12/20/2011] [Indexed: 11/18/2022]
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