title: Motor cortex excitability in chronic fatigue syndrome.
abstract: OBJECTIVE
  To use transcranial magnetic stimulation (TMS) to define motor cortical excitability in chronic fatigue syndrome (CFS) subjects during a repetitive, bilateral finger movement task.
  
  
  METHODS
  A total of 14 CFS patients were tested and compared with 14 age-matched healthy control subjects. TMS of the motor cortex (5% above threshold) was used to elicit motor evoked potentials (MEPs). Subjects performed regular (3-4/s) repetitive bilateral opening-closing movements of the index finger onto the thumb. MEPs of the first dorsal interosseus (FDI) were measured before, immediately following exercise periods of 30, 60 and 90 s, and after 15 min of rest.
  
  
  RESULTS
  Performance, defined by rate of movement, was significantly slower in CFS subjects (3.5/s) than in controls (4. 0/s) independent of the hand measured. The rate, however, was not significantly affected by the exercise duration for either group. The threshold of TMS to evoke MEPs from the FDI muscle was significantly higher in CFS than in control subjects, independent of the hemisphere tested. A transient post-exercise facilitation of MEP amplitudes immediately after the exercise periods was present in controls independent of the hemisphere tested, but was absent in CFS subjects. A delayed facilitation of MEPs after 15-30 min of rest was restricted to the non-dominant hemisphere in controls; delayed facilitation was absent in CFS subjects.
  
  
  CONCLUSIONS
  Individuals with CFS do not show the normal fluctuations of motor cortical excitability that accompany and follow non-fatiguing repetitive bimanual finger movements.
authors.affiliation: Department of Neurology, University of California, Irvine, CA 92697-4290, USA. astarr@uci.edu
authors.forename: A
authors.initials: A
authors.lastname: Starr
authors.forename: A
authors.initials: A
authors.lastname: Scalise
authors.forename: R
authors.initials: R
authors.lastname: Gordon
authors.forename: H J
authors.initials: HJ
authors.lastname: Michalewski
authors.forename: M D
authors.initials: MD
authors.lastname: Caramia
mesh_terms: D000328:Adult; D019054:Evoked Potentials, Motor / Q000502:physiology; D015673:Fatigue Syndrome, Chronic / Q000503:physiopathology*; D005260:Female; D005385:Fingers / Q000503:physiopathology; D006801:Humans; D008280:Magnetics; D008297:Male; D009044:Motor Cortex / Q000503:physiopathology*; D009068:Movement / Q000502:physiology