High-density electroencephalography as an innovative tool to explore sleep physiology and sleep related disorders.

High density EEG represents a promising tool to achieve new insights regarding sleep physiology and pathology. It combines the advantages of an EEG technique as an optimal temporal resolution with the spatial resolution of the neuroimaging. So far its application in sleep research contributed to better characterize some of the peculiar microstructural figures of sleep such as spindles and K-complexes, and to understand the fundamental relationships between sleep and synaptic plasticity, learning and consciousness. Its application is not limited to neurophysiology, being recently also applied to study some sleep related psychiatric and neurological disorders such as depression, schizophrenia, attention-deficit hyperactivity disorder, and stroke. adding some interesting new pieces in the pathophysiological puzzle of these diseases. Due to its non-invasive, repetitive and reliable tempo-spatial resolution it is reasonable that the field of application of this tool will be soon enlarged to other areas of neuroscience. The present review aims to offer a complete overview regarding the use of high density EEG over the last decade in sleep research and sleep medicine, including its possible future perspective.

Improvement of hand dexterity following motor cortex rTMS in multiple sclerosis patients with cerebellar impairment.

We tested the effects of 5-Hz repetitive transcranial magnetic stimulation (rTMS) over the motor cortex in multiple sclerosis (MS) subjects with cerebellar symptoms. rTMS improved hand dexterity in cerebellar patients (n=8) but not in healthy subjects (n=7), as detected by a significant transient reduction of the time required to complete the nine-hole pegboard task. rTMS of the motor cortex may be a useful approach to treat cerebellar impairment in MS patients.

Effects of motor cortex rTMS on lower urinary tract dysfunction in multiple sclerosis.

We tested the effects of 5-Hz rTMS over the motor cortex in multiple sclerosis (MS) subjects complaining of lower urinary tract symptoms either in the filling or voiding phase. Our data show that motor cortex stimulation for five consecutive days over two weeks ameliorates the voiding phase of the micturition cycle, suggesting that enhancing corticospinal tract excitability might be useful to ameliorate detrusor contraction and/or urethral sphincter relaxation in MS patients with bladder dysfunction.

Repetitive transcranial magnetic stimulation of the motor cortex ameliorates spasticity in multiple sclerosis.

OBJECTIVE: To investigate whether repetitive transcranial magnetic stimulation (rTMS) can modify spasticity. METHODS: We used high-frequency (5 Hz) and low-frequency (1 Hz) rTMS protocols in 19 remitting patients with relapsing-remitting multiple sclerosis and lower limb spasticity. RESULTS: A single session of 1 Hz rTMS over the leg primary motor cortex increased H/M amplitude ratio of the soleus H reflex, a reliable neurophysiologic measure of stretch reflex. Five hertz rTMS decreased H/M amplitude ratio of the soleus H reflex and increased corticospinal excitability. Single sessions did not induce any effect on spasticity. A significant improvement of lower limb spasticity was observed when rTMS applications were repeated during a 2-week period. Clinical improvement was long-lasting (at least 7 days after the end of treatment) when the patients underwent 5 Hz rTMS treatment during a 2-week protocol. No effect was obtained after a 2-week sham stimulation. CONCLUSIONS: Repetitive transcranial magnetic stimulation may improve spasticity in multiple sclerosis.

Deficits of glutamate transmission in the striatum of experimental hemiballism.

Hemiballism (HB) is a quite rare disorder, generally secondary to stroke, neoplasms or demyelinating plaques, classically considered as almost pathognomonic of a lesion in the subthalamic nucleus (STN). This alteration causes involuntary movements in the chorea-ballism spectrum. One theory is that the output nuclei of the basal ganglia are overinhibited in HB, while little is known about the physiological state of the striatum, the major input structure of the basal ganglia. In the present study, we recorded spontaneous and miniature excitatory and inhibitory postsynaptic currents (sEPSCs, mEPSCs, sIPSCs, mIPSCs) from projection neurons of the striatum of experimental HB. We found a selective reduction of striatal sEPSC and mEPSC frequency following chemical lesion of the STN of the rat, suggesting that reduced synaptic excitation of the input structure of the basal ganglia represents a physiological correlate of HB.