Corticospinal excitability in idiopathic normal pressure hydrocephalus: a transcranial magnetic stimulation study.
Fluids Barriers CNS
; 17(1): 6, 2020 Feb 17.
Article
em En
| MEDLINE
| ID: mdl-32063230
ABSTRACT
BACKGROUND:
Idiopathic normal pressure hydrocephalus (iNPH) is a neurodegenerative disease with an unknown etiology. Disturbed corticospinal inhibition of the motor cortex has been reported in iNPH and can be evaluated in a noninvasive and painless manner using navigated transcranial magnetic stimulation (nTMS). This is the first study to characterize the immediate impact of cerebrospinal fluid (CSF) drainage on corticospinal excitability.METHODS:
Twenty patients with possible or probable iNPH (16 women and 4 men, mean age 74.4 years, range 67-84 years), presenting the classical symptom triad and radiological findings, were evaluated with motor function tests (10-m walk test, Grooved Pegboard and Box & Block test) and nTMS (silent period, SP, resting motor threshold, RMT and input-output curve, IO-curve). Evaluations were performed at baseline and repeated immediately after CSF drainage via lumbar puncture.RESULTS:
At baseline, iNPH patients presented shorter SPs (p < 0.001) and lower RMTs (p < 0.001) as compared to normative values. Positive correlation was detected between SP duration and Box & Block test (rho = 0.64, p = 0.002) in iNPH patients. CSF drainage led to an enhancement in gait velocity (p = 0.002) and a steeper IO-curve slope (p = 0.049).CONCLUSIONS:
Shorter SPs and lower RMTs in iNPH suggest impaired corticospinal inhibition and corticospinal hyperexcitability. The steeper IO-slope in patients who improve their gait velocity after CSF drainage may indicate a higher recovery potential. Corticospinal excitability correlated with the motor function of the upper limbs implying that the disturbance in motor performance in iNPH extends beyond the classically reported gait impairment.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tratos Piramidais
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Estimulação Magnética Transcraniana
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Fenômenos Eletrofisiológicos
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Hidrocefalia de Pressão Normal
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Atividade Motora
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Córtex Motor
Limite:
Aged
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Aged80
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Female
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Humans
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Male
Idioma:
En
Revista:
Fluids Barriers CNS
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Finlândia