PMID- 32821185
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220416
IS  - 1179-1608 (Print)
IS  - 1179-1608 (Electronic)
IS  - 1179-1608 (Linking)
VI  - 12
DP  - 2020
TI  - Obstructive Sleep Apnea Syndrome: A Preliminary Navigated Transcranial Magnetic 
      Stimulation Study.
PG  - 563-574
LID - 10.2147/NSS.S253281 [doi]
AB  - PURPOSE: An increase in resting motor threshold (RMT), prolonged cortical silent 
      period duration (CSP), and reduced short-latency afferent inhibition (SAI), 
      confirmed with previous transcranial magnetic stimulation (TMS), suggest 
      decreased cortical excitability in obstructive sleep apnea syndrome (OSAS). The 
      present study included MRI of OSAS patients for navigated TMS assessment of the 
      RMT, as an index of the threshold for corticospinal activation at rest, and SAI 
      as an index of cholinergic neurotransmission. We hypothesize to confirm findings 
      on SAI and RMT with adding precision in the targeting of motor cortex in OSAS. 
      SUBJECTS AND METHODS: After acquiring head MRIs for 17 severe right-handed OSAS 
      and 12 healthy subjects, the motor cortex was mapped with nTMS to assess the RMT 
      and SAI, with motor evoked potentials (MEPs) recorded from the abductor-pollicis 
      brevis (APB) muscle. The 120%RMT intensity was used for the SAI by a paired-pulse 
      paradigm in which the electrical stimulation to the median nerve is followed by 
      magnetic stimulation of the motor cortex at inter-stimulus intervals (ISIs) of 
      18-28 ms (ISIs(18-28)). The SAI control condition included a recording of MEPs 
      without peripheral stimulation. Latency and amplitude of MEP at RMT at 120%RMT 
      for eleven different at ISIs(18-28) were analyzed. RESULTS: The study showed a 
      significantly lower percentage deviation of MEP amplitude at ISIs((18-28ms)) from 
      the control condition between OSAS and healthy subjects (U=44.0, p=0.01). The 
      intensity of stimulation at RMT was significantly higher in OSAS subjects 
      (U=55.0, p=0.04*). Correlation analysis showed that BMI significantly negatively 
      correlated (rho=-0.47) with MEP amplitude percentage deviation in OSAS patients. 
      CONCLUSION: The nTMS study results in increased RMT, and reduced cortical 
      afferent inhibition in OSAS patients for SAI at ISIs(18-28), confirming previous 
      findings of impaired cortical afferent inhibition in OSAS. Future nTMS studies 
      are desirable to elucidate the role of RMT and SAI in diagnostics and treatment 
      of OSAS, and to elucidate the usefulness of nTMS in OSAS research.
CI  - (c) 2020 Rogic Vidakovic et al.
FAU - Rogic Vidakovic, Maja
AU  - Rogic Vidakovic M
AUID- ORCID: 0000-0001-8516-9718
AD  - University of Split, School of Medicine, Department of Neuroscience, Laboratory 
      for Human and Experimental Neurophysiology (LAHEN), Split, Croatia.
FAU - Soda, Josko
AU  - Soda J
AUID- ORCID: 0000-0002-5825-8026
AD  - University of Split, Faculty of Maritime Studies, Signal Processing, Analysis and 
      Advanced Diagnostics Research and Education Laboratory (SPAADREL), Split, 
      Croatia.
FAU - Jerkovic, Ana
AU  - Jerkovic A
AD  - University of Split, School of Medicine, Department of Neuroscience, Laboratory 
      for Human and Experimental Neurophysiology (LAHEN), Split, Croatia.
FAU - Benzon, Benjamin
AU  - Benzon B
AD  - University of Split, School of Medicine, Department of Neuroscience, Laboratory 
      for Human and Experimental Neurophysiology (LAHEN), Split, Croatia.
FAU - Bakrac, Karla
AU  - Bakrac K
AD  - University of Split, School of Medicine, Department of Neuroscience, Laboratory 
      for Human and Experimental Neurophysiology (LAHEN), Split, Croatia.
FAU - Duzevic, Silvia
AU  - Duzevic S
AD  - University of Split, School of Medicine, Department of Neuroscience, Laboratory 
      for Human and Experimental Neurophysiology (LAHEN), Split, Croatia.
FAU - Vujovic, Igor
AU  - Vujovic I
AUID- ORCID: 0000-0001-6649-1461
AD  - University of Split, Faculty of Maritime Studies, Signal Processing, Analysis and 
      Advanced Diagnostics Research and Education Laboratory (SPAADREL), Split, 
      Croatia.
FAU - Mihalj, Mario
AU  - Mihalj M
AUID- ORCID: 0000-0001-5609-4868
AD  - University Hospital Split, Department of Neurology, Laboratory of 
      Electromyoneurography, Split, Croatia.
FAU - Pecotic, Renata
AU  - Pecotic R
AUID- ORCID: 0000-0003-3519-2201
AD  - University of Split, School of Medicine, Department of Neuroscience, Laboratory 
      for Human and Experimental Neurophysiology (LAHEN), Split, Croatia.
AD  - University of Split, Split Sleep Medical Center, Split 21000, Croatia.
FAU - Valic, Maja
AU  - Valic M
AUID- ORCID: 0000-0001-9001-3718
AD  - University of Split, School of Medicine, Department of Neuroscience, Laboratory 
      for Human and Experimental Neurophysiology (LAHEN), Split, Croatia.
AD  - University of Split, Split Sleep Medical Center, Split 21000, Croatia.
FAU - Mastelic, Angela
AU  - Mastelic A
AD  - University of Split, School of Medicine, Department of Medical Chemistry and 
      Biochemistry, Split, Croatia.
FAU - Hagelien, Maximilian Vincent
AU  - Hagelien MV
AD  - University of Split, School of Medicine, Department of Neuroscience, Laboratory 
      for Human and Experimental Neurophysiology (LAHEN), Split, Croatia.
FAU - Zmajevic Schonwald, Marina
AU  - Zmajevic Schonwald M
AD  - Clinical Medical Centre "Sisters Of Mercy", Department of Neurosurgery, Clinical 
      Unit for Intraoperative Neurophysiologic Monitoring, Zagreb, Croatia.
FAU - Dogas, Zoran
AU  - Dogas Z
AD  - University of Split, School of Medicine, Department of Neuroscience, Laboratory 
      for Human and Experimental Neurophysiology (LAHEN), Split, Croatia.
AD  - University of Split, Split Sleep Medical Center, Split 21000, Croatia.
LA  - eng
PT  - Journal Article
DEP - 20200806
PL  - New Zealand
TA  - Nat Sci Sleep
JT  - Nature and science of sleep
JID - 101537767
PMC - PMC7418161
OTO - NOTNLM
OT  - motor evoked potentials
OT  - obstructive sleep apnea
OT  - primary motor cortex
OT  - short-latency afferent inhibition
OT  - transcranial magnetic stimulation
OT  - transcutaneous electrical nerve stimulation
COIS- Part of the results of this paper was presented at the 7th Croatian Neuroscience 
      Congress in Zadar, September 12th, 2019, to September 15th, 2019. The abstract is 
      cited as: Maja Rogic Vidakovic, Ana Jerkovic, Josko Soda et al Short latency 
      afferent cortical inhibition in obstructive sleep apnea syndrome: a TMS study 
      (PP71 - Book of abstracts: 
      http://www.hiim.unizg.hr/images/ostalo/VII_CNsC_Book_of_Abstracts.pdf). The 
      authors declare they have no conflict of interest. All authors have seen and 
      approved the final version of the manuscript. No competing interests were 
      reported by the authors for any financial interests or commercial associations 
      held by the authors or their family members.
EDAT- 2020/08/22 06:00
MHDA- 2020/08/22 06:01
PMCR- 2020/08/06
CRDT- 2020/08/22 06:00
PHST- 2020/03/23 00:00 [received]
PHST- 2020/06/25 00:00 [accepted]
PHST- 2020/08/22 06:00 [entrez]
PHST- 2020/08/22 06:00 [pubmed]
PHST- 2020/08/22 06:01 [medline]
PHST- 2020/08/06 00:00 [pmc-release]
AID - 253281 [pii]
AID - 10.2147/NSS.S253281 [doi]
PST - epublish
SO  - Nat Sci Sleep. 2020 Aug 6;12:563-574. doi: 10.2147/NSS.S253281. eCollection 2020.