4.6 Article

Effects of Two Weeks of Cerebellar Theta Burst Stimulation in Cervical Dystonia Patients

期刊

BRAIN STIMULATION
卷 7, 期 4, 页码 564-572

出版社

ELSEVIER SCIENCE INC
DOI: 10.1016/j.brs.2014.05.002

关键词

Cerebellar-thalamo-cortical circuits; Cervical dystonia cerebellar theta burst stimulation; Paired associative stimulation

资金

  1. Jacques and Gloria Goss-weiler Foundation (JGGF)
  2. Italian Ministry of Health [GR-2009-1591859]
  3. Ministerio de Economia y Competitividad de Espana [SAF2007-60700]
  4. Instituto de Salud Carlos III [PI10/01674, CP08/00174]
  5. Consejeria de Economia, Innovacion, Ciencia y Empleo de la Junta de Andalucia [CVI-02526, CTS-7685]
  6. Consejeria de Salud y Bienestar Social de la Junta de Andalucia [PI-0377/2007, PI-0741/2010, PI-0437-2012]
  7. SociedadAndaluza de Neurologia
  8. Fundacion Alicia Koplowitz

向作者/读者索取更多资源

Dystonia is generally regarded as a disorder of the basal ganglia and their efferent connections to the thalamus and brainstem, but an important role of cerebellar-thalamo-cortical (CTC) circuits in the pathophysiology of dystonia has been invoked. Here in a sham controlled trial, we tested the effects of two-weeks of cerebellar continuous theta burst stimulation (cTBS) in a sample of cervical dystonia (CD) patients. Clinical evaluations were performed by administering the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS). We used TMS to measure the inhibitory connectivity between the cerebellum and the contralateral motor cortex (cerebellar brain inhibition [CBI]), and the excitability of the contralateral primary motor cortex assessing intracortical inhibition (SICI), intracortical facilitation (ICF) and cortical silent period (CSP). Paired associative stimulation (PAS) was tested to evaluate the level and the topographical specificity of cortical plasticity, which is abnormally enhanced and non-focal in CD patients. Two weeks of cerebellar stimulation resulted in a small but significant clinical improvement as measured by the TWSTRS of approximately 15%. Cerebellar stimulation modified the CBI circuits and reduced the heterotopic PAS potentiation, leading to a normal pattern of topographic specific induced plasticity. These data provide novel evidence CTC circuits could be a potential target to partially control some dystonic symptoms in patients with cervical dystonia. (C) 2014 Elsevier Inc. All rights reserved.

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