title: Cumulative effect of 5 daily sessions of θ burst stimulation on corticospinal excitability in amyotrophic lateral sclerosis.
abstract: BACKGROUND
  Excitotoxicity plays an important role in the pathogenesis of the preferential motor neuron death observed in amyotrophic lateral sclerosis (ALS). Continuous theta burst stimulation (cTBS) by transcranial magnetic stimulation has an inhibitory effect on corticospinal excitability (CSE). We characterized the neurophysiological changes induced by cTBS in ALS.
  
  
  METHODS
  The patients received 5 daily sessions of cTBS. CSE was assessed at baseline and after each session of cTBS.
  
  
  RESULTS
  The amplitude of a single pulse motor evoked potential was significantly decreased (34%) over the days. The amplitude returned to baseline a week after the last session. The resting motor threshold increased significantly, whereas intracortical inhibition and facilitation did not change over the sessions.
  
  
  CONCLUSIONS
  Daily cTBS has a cumulative depressing effect on CSE in patients with ALS. These results suggest that modulation of CSE in ALS is possible, but repetitive sessions are needed to maintain the effect.
authors: Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology/Clinical Neurophysiology, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
authors: Moniek A M
authors: MA
authors: Munneke
authors: Jan J
authors: JJ
authors: Rongen
authors: Sebastiaan
authors: S
authors: Overeem
authors: H Jurgen
authors: HJ
authors: Schelhaas
authors: Machiel J
authors: MJ
authors: Zwarts
authors: Dick F
authors: DF
authors: Stegeman
mesh_terms: D000690:Amyotrophic Lateral Sclerosis / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy*; D002540:Cerebral Cortex / Q000473:pathology / Q000503:physiopathology*; D004576:Electromyography; D019054:Evoked Potentials, Motor / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009433:Neural Inhibition / Q000502:physiology; D011712:Pyramidal Tracts / Q000473:pathology / Q000503:physiopathology*; D012684:Sensory Thresholds / Q000502:physiology; D013826:Theta Rhythm / Q000502:physiology*; D050781:Transcranial Magnetic Stimulation / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome
keywords: amyotrophic lateral sclerosis; continuous theta burst stimulation; corticospinal excitability; motor evoked potential; transcranial magnetic stimulation