Low-frequency repetitive transcranial magnetic stimulation of the motor cortex in writer's cramp.
Siebner HR; Tormos JM; Ceballos-Baumann AO; Auer C; Catala MD; Conrad B; Pascual-Leone A
Neurology 1999 Feb;52(3):529-37

ABSTRACT:
OBJECTIVE: To Study The Short-term Effects Of Slow Repetitive
Transcranial Magnetic Stimulation (rTMS) Of The Motor Cortex On
Cortical Excitability And Handwriting In Patients With Writer's
Cramp. BACKGROUND: Cortical Excitability Of The Primary
Motor Cortex Is Abnormally Enhanced In Patients With Writer's
Cramp. Therefore, Reducing Cortical Excitability By Low-frequency
RTMS Of The Motor Cortex Might Result In Beneficial Effects On
Handwriting In Writer's Cramp. DESIGN/METHODS: We
Studied The Effects Of Subthreshold 1-Hz RTMS On Motor
Threshold And Cortico-cortical Excitability Using The Paired-pulse
Technique In Seven Patients And Seven Controls. In Another 16
Patients And 11 Age-matched Controls We Evaluated Changes In
Cortical Excitability By Measuring The Stimulus-response Curve
And The Postexcitatory Silent Period Before And After
Subthreshold 1-Hz RTMS. In Addition, We Analyzed The
Handwriting Before And 20 Minutes After 1-Hz RTMS. RESULTS:
In The First Experiment, Low-frequency RTMS Resulted In A
Normalization Of The Deficient Cortico-cortical Inhibition In The
Patients Without Affecting Motor Threshold. In The Second
Experiment, 1-Hz RTMS Resulted In A Significant Prolongation Of
The Postexcitatory Silent Period Without Affecting The
Stimulus-response Curve In The Patient Group. Moreover, The
Dystonic Patients Showed A Significant Reduction Of Mean Writing
Pressure After Subthreshold 1-Hz RTMS That Was Associated With
Clear But Transient Improvement In Six Patients.
CONCLUSIONS: In Some Patients 1-Hz RTMS Can Reinforce
Deficient Intracortical Inhibition And May Improve Handwriting
Temporarily. Our Data Support The Notion That Reduced
Intracortical Inhibition Plays A Part In The Pathophysiology Of
Focal Dystonia.
MAIN MESH
HEADINGS:
*Handwriting
*Magnetics
Motor Cortex/*physiopathology
Muscle Cramp/*physiopathology
ADDITIONAL
MESH HEADINGS:
Adult
Analysis Of Variance
Evoked Potentials, Motor/physiology
Human
Middle Age
Support, Non-U.S. Gov't
1999/02
1999/20 03:12
PUBLICATION
TYPES:
JOURNAL ARTICLE
LANGUAGES:
Eng

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Eletromagnetismo

Bioeletricidade
em Psiquiatría