PMID- 15003779
OWN - NLM
STAT- MEDLINE
DCOM- 20040415
LR  - 20220408
IS  - 1388-2457 (Print)
IS  - 1388-2457 (Linking)
VI  - 115
IP  - 4
DP  - 2004 Apr
TI  - Brain excitability changes in the relapsing and remitting phases of multiple 
      sclerosis: a study with transcranial magnetic stimulation.
PG  - 956-65
AB  - OBJECTIVE: Recent functional and imaging studies have substantially contributed 
      to extend the concept of multiple sclerosis (MS), classically regarded as a 
      disease limited to the myelin axonal sheath. Several findings, in fact, point to 
      a parallel involvement of neuronal components of the central nervous system (CNS) 
      in the course of MS. In the present study, therefore, we explored, in MS 
      patients, some characteristics of central motor pathways related to changes of 
      neuronal excitability as measured using transcranial magnetic stimulation (TMS). 
      METHODS: Seventy-nine patients affected by relapsing-remitting (RR) MS were 
      examined using single and paired TMS in order to assess excitability changes in 
      the hand motor cortex occurring during relapse and/or remission of the disease. 
      The analyzed parameters were: motor-evoked potential (MEP) threshold, silent 
      period (SP), intracortical inhibition (ICI) with paired pulses from 1 to 6 ms 
      interstimulus intervals (ISIs), and central motor conduction time (CMCT). 
      RESULTS: The analysis of variance exhibited a strong correlation (P<0.001) 
      between the clinical phase and the type of excitability changes: 'relapsing' 
      patients showed increased threshold and reduced SP duration. 'Relapsing' patients 
      also displayed a significant lack of normal intracortical inhibition (ICI). By 
      contrast, 'remitting' patients showed a significant SP prolongation with normal 
      motor thresholds. CONCLUSIONS: The present findings reveal changes in cortical 
      excitability that might play a role in the pathophysiology of MS symptoms. In 
      particular, the relapsing phase of MS has been found to be associated with 
      cortical hyperexcitability irrespective of the site of clinical manifestation or 
      new plaque formation. These results might help to explain the puzzling picture of 
      neurological symptoms observed in MS patients during different phases of the 
      disease. SIGNIFICANCE: Alterations of neuronal components of the CNS play a role 
      in MS.
FAU - Caramia, M Donatella
AU  - Caramia MD
AD  - Dipartimento di Neuroscienze, Clinica Neurologica, Universita di Tor Vergata, and 
      Fondazione S Lucia, Rome, Italy. caramia@med.uniroma2.it
FAU - Palmieri, M Giuseppina
AU  - Palmieri MG
FAU - Desiato, M Teresa
AU  - Desiato MT
FAU - Boffa, Laura
AU  - Boffa L
FAU - Galizia, Pierluigi
AU  - Galizia P
FAU - Rossini, Paolo M
AU  - Rossini PM
FAU - Centonze, Diego
AU  - Centonze D
FAU - Bernardi, Giorgio
AU  - Bernardi G
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - Clin Neurophysiol
JT  - Clinical neurophysiology : official journal of the International Federation of 
      Clinical Neurophysiology
JID - 100883319
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Cerebral Cortex/physiology
MH  - Electric Stimulation
MH  - *Evoked Potentials, Motor
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multiple Sclerosis, Relapsing-Remitting/*physiopathology
MH  - *Transcranial Magnetic Stimulation
EDAT- 2004/03/09 05:00
MHDA- 2004/04/16 05:00
CRDT- 2004/03/09 05:00
PHST- 2003/11/17 00:00 [accepted]
PHST- 2004/03/09 05:00 [pubmed]
PHST- 2004/04/16 05:00 [medline]
PHST- 2004/03/09 05:00 [entrez]
AID - S1388245703004383 [pii]
AID - 10.1016/j.clinph.2003.11.024 [doi]
PST - ppublish
SO  - Clin Neurophysiol. 2004 Apr;115(4):956-65. doi: 10.1016/j.clinph.2003.11.024.