Motor Evoked Potential in Parkinson's Disease

Öz

Idiopathic Parkinson's Disease (PD) is the most common extrapyramidal syndrome encountered in the aging population. The major signs of Parkinson's disease are tremor, rigidity, akinesia, and postural instability. The diagnosis of PD remains a Clinical judgement without any confirmatory laboratory diagnostic procedure available or required. In this study we made transcranial cortical stimulation (TCCS) in 13 PD patients and motor evoked potential (MEP) recorded from soleus and anterior tibial muscle. In all patients three experimental paradigmas were performed; rest, voluntary dorsiflexion, voluntary plantar flexion.

Anahtar Kelimeler

• Parkinson's disease,motor evoked potential

Parkinson Hastalığında Motor Uyarılmış Potansiyeller

Öz

Parkinson Hastalığı (PH), ileri yaşlarda en sık karşımıza çıkan extrapiramidal sendromdur. Başlıca belirtileri, tremor, rijidite, akinezi ve postüral instabilitedir. Tanı herhangi bir laboratuvar desteği olmadan klinik bulgulara dayanır. Bu çalışmada Parkinson hastalığı olan 13 hastada transkranial kortikal stimulasyon (TCCS) ile motor uyarılmış potansiyeller (MEP) incelendi. İstirahat, dorsal fleksiyon ve plantar fleksiyon gibi 3 deneysel paradigma ile alt extremiteden soleus ve tibialis anterior kaslarından kayıtlanan motor uyarılmış potansiyeller incelendi.

Anahtar Kelimeler

• Parkinson hastalığı,motor uyarılmış potansiyeller

Kaynakça

1. Barker AT, Jalinous R. Freeston IL. Non-invasive magnetic stimulation of the human motor cortex. Lancet. 1985;1(8437):1106-1107. doi: 10.1016/s0140-6736(85)92413-4
2. Berardelli A, Inghilleri M, Cruccu G, Fornarelli M, Accornero N, Manfredi M. Stimulation of motor tracts in multiple sclerosis. J Neurol Neurosurg Psychiatry. 1988;51(5):677-683. doi: 10.1136/jnnp.51.5.677
3. Berardelli A, Inghilleri M, Cruccu G, Mercury B, Manfredi M. Electrical and magnetic transcranial stimulation in patients with corticospinal damage due to stroke or motor neuron disease. Electroencephalogr Clin Neurophysiol. 1991;81(5):389-396. doi: 10.1016/0168-5597(91)90028-v
4. Britton TC, Meyer BU, Benecke R. Variability of cortically evoked motor responses in multiple sclerosis. Electroencephalogr Clin Neurophysiol. 1991;81(3):186-194. doi: 10.1016/0168-5597(91)90071-5
5. Brouwer B, Ashby P. Corticospinal projections to upper and lower limb spinal motoneurons in man. Electroencephalogr Clin Neurophysiol. 1990;76(6):509-519. doi: 10.1016/0013-4694(90)90002-2
6. Claus D, Waddy HM, Harding AE, Murray NMF, Thomas PK. Hereditary motor and sensory neuropathies and hereditary spastic paraplegia: a magnetic stimulation study. Ann Neurol. 1990;28(1):43-49. doi: 10.1002/ana.410280109
7. Crone C, Hultborn H, Jespersen B, Nielsen J. Reciprocal I-A Inhibition between ankle flexors and extensors in man. J Physiol. 1987;389:163-185. doi: 10.1113/jphysiol.1987.sp016652
8. Ertekin C, Ertaş M, Efendi H, et al. A stable late soleus EMG response elicited by cortical stimulation during ankle dorsiflexion. Electroencephalogr Clin Neurophysiol. 1995;97(5):275-283. doi:10.1016/0013-4694(95)00038-z

9. Eisen A, Siejka S, Schulzer M, Calne D. Age-dependent decline in motor evoked potential (MEP) amplitude: with a comment on changes in Parkinson's disease. Electroencephalogr Clin Neurophysiol. 1991;81(3):209-215. doi: 10.1016/0168-5597(91)90074-8
10. Eisen AA, Shtybel WS. Clinical experience with transcranial magnetic stimulation. Muscle Nerve. 1990;13(11):995-1011. doi: 10.1002/mus.880131102
11. Ertekin C, Zileli M, Ertaş M. Motor Evoked Potansiyeller. 1. Baskı. İzmir: Klinik Nörofizyoloji Derneği Yayınları; 1992.
12. Ertaş M, Ertekin C, Efendi H, Uysal H. Contraversies in calculation of central motor delay. Muscle Nerve. 1994;17(10):1225-1226. doi: 10.1002/mus.880171018
13. Ghez C. The control of movement in: Principles of neural science. In: Kandel ER, Schwartz JH, Jessel TM, ed. 3rd Edition. Elsevier Science Publishing; 1991:534-547.
14. Hess CW, Mills KR, Murray NM, Schriefer TN. Magnetic brain stimulation: central motor conduction studies in multiple sclerosis. Ann Neurol. 1987;22(6):744-752. doi: 10.1002/ana.410220611
15. Homberg V, Stephan KM, Netz J. Transcranial stimulation of motor cortex in upper motor neuron motor disease: it is relation to the motor deficit. Electroencephalogr Clin Neurophysiol. 1991;81(5):377-388. doi: 10.1016/0168-5597(91)90027-u
16. Ingram DA, Thompson AJ, Swash M. Central motor conduction in multiple sclerosis: Evaluation of abnormalities revealed by transcutaneous magnetic stimulation of the brain. J Neurol Neurosurg Psychiatry. 1988;51(4):487-494. doi:10.1136/jnnp.51.4.487
17. Jaskolski DJ, Jarratt JA, Jakulbowski J. Magnetic stimulation in cervical spondylosis. Br J Neurosurg. 1989;3(5):541-548. doi: 10.3109/02688698909002845
18. Merton PA, Morton HB. Stimulation of the cerebral cortex in intact human. Nature. 1980;285(5762):227. doi: 10.1038/285227a0
19. Meunier S, Morin C. Changes in pre synaptic inhibition of I-A fiber's to soleus motoneurones during voluntary dorsiflexion of the foot. Exp Brain Res. 1989;76(3):510-518. doi: 10.1007/bf00248907
20. Golbe LI, Jage JI. Medical treatment of Parkinson's disease. In: Kurlan R, ed. Treatment of Movement Disorder. J.B. Lippincott Company; 1996:1-56.
21. Mills KR, Murray NM, Hess CW. Magnetic and electrical transcranial brain stimulation: Physiological mechanism and clinical applications. Neurosurgery. 1987;20(1):164-168. doi:10.1097/00006123-198701000-00033
22. Müller K, Homberg V, Aulich A, Lenard HG, Magnetoelectrical stimulation of motor cortex in children with motor disturbances. Electroencephalogr Clin Neurophysiol. 1992;85(2):86-94. doi: 10.1016/0168-5597(92)90073-k
23. Shindo M, Herayama H, Kando K, Yanagisawa N, Tanaka R. Changes in reciprocal I-A inhibition during voluntary contraction in man. Exp Brain Res. 1984;53(2):400-408. doi:10.1007/bf00238170
24. Tanaka R. Reciprocal I-A inhibitory pathway during voluntary performance in man. Brain Res. 1972;43:645-652.
25. Toygar A, Ertaş M, Selçuki D, Araç N, Ertekin C. ALS'de MEP ile longitudinal izlem. Nörofizyoloji Kongresi Kitabı. Ürgüp:1992.