Prolonged postexcitatory inhibition after transcranial magnetic stimulation of the motor cortex in patients with cerebellar ataxia.
Postexcitatory inhibition after transcranial magnetic stimulation of the motor cortex (silent period, SP) is supposed to be predominantly mediated by the activation of inhibitory cortical interneurons. Cortical excitability seems to be reduced in patients with cerebellar ataxia. Motor threshold, central motor conduction time and the duration of the silent period after a single magnetic stimulus to the motor cortex on both sides were measured in five patients with cerebellar ataxia of different origin and 18 healthy controls. Duration of SP was highly significantly prolonged in patients compared with controls (P<0.001) while motor threshold and central motor conduction times were not different. Fifteen of 18 control subjects showed late EMG responses after magnetic stimulation but none of the patients did (P<0.001). These findings support the hypothesis that cerebellar lesions activate inhibitory cortical interneurons or cause a disruption of a normally tonic cerebellar excitation to the motor cortex. Silent period measurement appears to be a sensitive diagnostic tool in the neurophysiological examination of cerebellar diseases.
Oechsner
M
M
Neurologische Klinik Universitaetskrankenhaus Eppendorf, Martinistrasse 52, D-20246, Hamburg, Germany. m.oechsner@uke.uni-hamburg.de
Zangemeister
W H
WH
D000328:Adult; D002524:Cerebellar Ataxia / Q000503:physiopathology*; D004558:Electric Stimulation; D004576:Electromyography; D019054:Evoked Potentials, Motor / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology*; D009119:Muscle Contraction / Q000502:physiology; D009433:Neural Inhibition / Q000502:physiology*; D011930:Reaction Time / Q000502:physiology; D012684:Sensory Thresholds / Q000502:physiology; D013997:Time Factors; D050781:Transcranial Magnetic Stimulation