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The Lateralization of Resting Motor Threshold to Predict Medication-Mediated Improvement in Parkinson’s Disease. Brain Sci 2022; 12:brainsci12070842. [PMID: 35884651 PMCID: PMC9313197 DOI: 10.3390/brainsci12070842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/15/2022] [Accepted: 06/27/2022] [Indexed: 12/10/2022] Open
Abstract
Cortical stimulation patterns in patients with Parkinson’s disease (PD) are asymmetric and get altered over time. This study examined cortical neurophysiological markers for PD and identified neurophysiological markers for lateralization in PD. We used transcranial magnetic stimulation (TMS) to study corticospinal and intracortical excitability in 21 patients with idiopathic PD. We used the Movement Disorder Society Unified Parkinson’s Disease Rating Scale for examination during on and off periods and evaluated inhibitory and facilitatory process markers using TMS, including resting motor thresholds (RMT), active motor thresholds, and motor evoked potential amplitude. The RMT in the more affected cortex was significantly shorter than in the less affected cortex, and was strongly correlated with improved motor function following medication. Patients in the tremor group exhibited significantly lower RMT compared to those in the akinetic-rigid group. Cortical electrophysiological laterality observed in patients with PD may be a useful marker for guiding treatment and identifying underlying compensatory mechanisms.
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Miyazawa A, Kanahara N, Shiko Y, Ozawa Y, Kawasaki Y, Komatsu H, Masumo Y, Nakata Y, Iyo M. The cortical silent period in schizophrenia: A systematic review and meta-analysis focusing on disease stage and antipsychotic medication. J Psychopharmacol 2022; 36:479-488. [PMID: 35475374 DOI: 10.1177/02698811221078751] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Although numerous studies reported some changes of cortical silent period (CSP), an indicator of gamma-aminobutyric acid (GABA) function in central nervous system, in schizophrenia patients, it has been unknown how the disease stage and antipsychotic medication affect CSP values. METHODS The present study conducted a systematic review of previous literature comparing CSP between schizophrenia patients and healthy subjects, and then performed meta-analysis on the effects of (1) the disease stage and (2) antipsychotics on CSP. RESULTS (1) In the comparison of the disease stage comprising a total of 17 reports, there was no significant difference in CSP between patients under drug-naïve first-episode psychoses and healthy controls, or between patients with antipsychotic medication and healthy controls. (2) In the comparison of the antipsychotic class, patients treated with clozapine were longer in CSP compared to healthy controls. Patients treated with olanzapine/quetiapine or with other type of antipsychotics were not different from healthy controls. Regarding other type of antipsychotics, the iteration analysis after leaving out one literature showed that patients were shorter in CSP than healthy controls. CONCLUSION The results showed that clozapine seems to surely prolong CSP, indicating the enhancement of GABA transmission via GABAB receptors, suggesting the possible relationship between the CSP prolongation by clozapine and its high efficacy in psychopathology. The finding of shorter CSP in patients with other type of antipsychotics was distinct from clozapine/olanzapine/quetiapine, but was difficult to interpret since this group included a variety of transcranial magnetic stimulation (TMS) methodologies and patients' background.
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Affiliation(s)
- Atsuhiro Miyazawa
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Nobuhisa Kanahara
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan.,Division of Medical Treatment and Rehabilitation, Center for Forensic Mental Health, Chiba University, Chiba, Japan
| | - Yuki Shiko
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yoshihito Ozawa
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yohei Kawasaki
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Hiroshi Komatsu
- Department of Psychiatry, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Yuto Masumo
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yusuke Nakata
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Masaomi Iyo
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
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Hassan WM, Al-Dbass A, Al-Ayadhi L, Bhat RS, El-Ansary A. Discriminant analysis and binary logistic regression enable more accurate prediction of autism spectrum disorder than principal component analysis. Sci Rep 2022; 12:3764. [PMID: 35260688 PMCID: PMC8904630 DOI: 10.1038/s41598-022-07829-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 01/31/2022] [Indexed: 12/04/2022] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impaired social interaction and restricted, repetitive behavior. Multiple studies have suggested mitochondrial dysfunction, glutamate excitotoxicity, and impaired detoxification mechanism as accepted etiological mechanisms of ASD that can be targeted for therapeutic intervention. In the current study, blood samples were collected from 40 people with autism and 40 control participants after informed consent and full approval from the Institutional Review Board of King Saud University. Sodium (Na+), Potassium (K+), lactate dehydrogenase (LDH), glutathione-s-transferase (GST), and mitochondrial respiratory chain complex I (MRC1) were measured in plasma of both groups. Predictive models were established to discriminate individuals with ASD from controls. The predictive power of these five variables, individually and in combination, was compared using the area under a ROC curve (AUC). We compared the performance of principal component analysis (PCA), discriminant analysis (DA), and binary logistic regression (BLR) as ways to combine single variables and create the predictive models. K+ had the highest AUC (0.801) of any single variable, followed by GST, LDH, Na+, and MRC1, respectively. Combining the five variables resulted in higher AUCs than those obtained using single variables across all models. Both DA and BLR were superior to PCA and comparable to each other. In our study, the combination of Na+, K+, LDH, GST, and MRC1 showed the highest promise in discriminating individuals with autism from controls. These results provide a platform that can potentially be used to verify the efficacy of our models with a larger sample size or evaluate other biomarkers.
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Affiliation(s)
- Wail M Hassan
- Department of Biomedical Sciences, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Abeer Al-Dbass
- Biochemistry Department, College of Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Laila Al-Ayadhi
- Department of Physiology, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia.,Autism Research and Treatment Center, Riyadh, Saudi Arabia
| | - Ramesa Shafi Bhat
- Biochemistry Department, College of Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Afaf El-Ansary
- Autism Research and Treatment Center, Riyadh, Saudi Arabia. .,Central Research Laboratory, Female Centre for Scientific and Medical Studies, King Saud University, Riyadh, Saudi Arabia.
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Howells FM, Hsieh JH, Temmingh HS, Baldwin DS, Stein DJ. Capacity for cortical excitation is reduced in psychotic disorders: An investigation of the TMS-EMG cortical silent period. Schizophr Res 2022; 240:73-77. [PMID: 34968895 DOI: 10.1016/j.schres.2021.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 12/07/2021] [Accepted: 12/09/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Fleur M Howells
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Neuroscience Institute, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - Jennifer H Hsieh
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Henk S Temmingh
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Valkenberg Hospital, Cape Town, Western Cape Province, South Africa
| | - David S Baldwin
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, United Kingdom
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Neuroscience Institute, Faculty of Health Sciences, University of Cape Town, South Africa; SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, South Africa
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di Hou M, Santoro V, Biondi A, Shergill SS, Premoli I. A systematic review of TMS and neurophysiological biometrics in patients with schizophrenia. J Psychiatry Neurosci 2021; 46:E675-E701. [PMID: 34933940 PMCID: PMC8695525 DOI: 10.1503/jpn.210006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 08/06/2021] [Accepted: 09/06/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Transcranial magnetic stimulation can be combined with electromyography (TMS-EMG) and electroencephalography (TMS-EEG) to evaluate the excitatory and inhibitory functions of the cerebral cortex in a standardized manner. It has been postulated that schizophrenia is a disorder of functional neural connectivity underpinned by a relative imbalance of excitation and inhibition. The aim of this review was to provide a comprehensive overview of TMS-EMG and TMS-EEG research in schizophrenia, focused on excitation or inhibition, connectivity, motor cortical plasticity and the effect of antipsychotic medications, symptom severity and illness duration on TMS-EMG and TMS-EEG indices. METHODS We searched PsycINFO, Embase and Medline, from database inception to April 2020, for studies that included TMS outcomes in patients with schizophrenia. We used the following combination of search terms: transcranial magnetic stimulation OR tms AND interneurons OR glutamic acid OR gamma aminobutyric acid OR neural inhibition OR pyramidal neurons OR excita* OR inhibit* OR GABA* OR glutam* OR E-I balance OR excitation-inhibition balance AND schizoaffective disorder* OR Schizophrenia OR schizophreni*. RESULTS TMS-EMG and TMS-EEG measurements revealed deficits in excitation or inhibition, functional connectivity and motor cortical plasticity in patients with schizophrenia. Increased duration of the cortical silent period (a TMS-EMG marker of γ-aminobutyric acid B receptor activity) with clozapine was a relatively consistent finding. LIMITATIONS Most of the studies used patients with chronic schizophrenia and medicated patients, employed cross-sectional group comparisons and had small sample sizes. CONCLUSION TMS-EMG and TMS-EEG offer an opportunity to develop a novel and improved understanding of the physiologic processes that underlie schizophrenia and to assess the therapeutic effect of antipsychotic medications. In the future, these techniques may also help predict disease progression and further our understanding of the excitatory/inhibitory balance and its implications for mechanisms that underlie treatment-resistant schizophrenia.
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Affiliation(s)
- Meng di Hou
- From the Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK (Hou, Shergill); the Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK (Santoro, Biondi, Premoli); and the Kent and Medway Medical School, Canterbury, UK (Shergill)
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Schecklmann M, Weidler C, Eichhammer P, Hajak G, Langguth B. Increased short-interval intracortical inhibition in un-medicated patients with schizophrenia. Brain Stimul 2018; 11:1080-1082. [PMID: 29776859 DOI: 10.1016/j.brs.2018.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 04/23/2018] [Accepted: 05/02/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Schizophrenia is associated with changes in inhibitory and facilitatory brain networks which can be assessed by motor cortex excitability. OBJECTIVE Here, we investigate differences between large cross-sectional samples of un-medicated and medicated patients with schizophrenia and healthy controls in single- and double-pulse transcranial magnetic stimulation parameters. METHODS We measured right abductor digiti minimi muscle activity in 71 un-medicated, 43 medicated patients and 131 healthy controls. To exclude sample bias analyses were repeated with groups comparable for age and gender (un-medicated: n = 43; medicated: n = 38; controls: n = 49). RESULTS Un-medicated patients showed increased short-interval intracortical inhibition (SICI) in contrast to medicated patients and healthy controls. No group differences were found for resting and active motor threshold, cortical silent period and intracortical facilitation. CONCLUSION Increases in SICI are in contrast to literature and highlight the necessity for large-scaled multi-centric studies with high methodological standards.
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Affiliation(s)
- Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University Regensburg, Germany.
| | - Carmen Weidler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany
| | | | - Göran Hajak
- Department of Psychiatry, Sozialstiftung Bamberg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University Regensburg, Germany
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