title: Modulation of Cerebellar-Cortical Connections in Multiple System Atrophy Type C by Cerebellar Repetitive Transcranial Magnetic Stimulation.
abstract: OBJECTIVE
  This study aims at modulating the altered cerebellar-cortical interactions in patients with multiple system atrophy-cerebellar subtype (MSA-C) by using cerebellar repetitive transcranial magnetic stimulation (rTMS). We hypothesized that cerebellar modulation by low-frequency rTMS can resolve the abnormal cortical excitability in multiple system atrophy cerebellar subtype.
  
  
  METHODS
  We studied detailed effects of rTMS of the cerebellum on reaction time (RT) and short-latency afferent inhibition (SAI) response in MSA-C group, Alzheimer Disease (AD) group, and a control group of healthy individuals. The RT and SAI responses were measured before and after 1 Hz cerebellar rTMS in all groups. The study was conducted in the neurophysiology laboratory in Hacettepe University Hospital.
  
  
  RESULTS
  Our results indicated that motor cortex disinhibition was predominant in patients with AD and MSA-C. In AD and control groups, there were no changes in SAI after rTMS. However, after application of rTMS over the cerebellum in MSA-C patients, the pathological disinhibition and RT results showed an improvement compared to their previous results.
  
  
  CONCLUSIONS
  Our study highlights that cerebellar rTMS impairs abnormal cerebellar-cortical inhibitory connections in case of MSA-C.
authors.affiliation: Institute of Neurological Sciences and Psychiatry, Hacettepe University, Ankara, Turkey.|Department of Neurology, Hacettepe University Medical School, Ankara, Turkey.
authors.forename: F Gokcem
authors.initials: FG
authors.lastname: Yildiz
authors.affiliation: Department of Neurology, Hacettepe University Medical School, Ankara, Turkey.
authors.forename: Esen
authors.initials: E
authors.lastname: Saka
authors.affiliation: Department of Neurology, Hacettepe University Medical School, Ankara, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Elibol
authors.affiliation: Department of Neurology, Hacettepe University Medical School, Ankara, Turkey.
authors.forename: Cagri Mesut
authors.initials: CM
authors.lastname: Temucin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002531:Cerebellum / Q000502:physiology*; D002540:Cerebral Cortex / Q000502:physiology*; D003072:Cognition Disorders / Q000209:etiology / Q000628:therapy; D004576:Electromyography; D019054:Evoked Potentials, Motor / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000150:complications / Q000534:rehabilitation*; D009434:Neural Pathways / Q000502:physiology; D009483:Neuropsychological Tests; D011930:Reaction Time; D050781:Transcranial Magnetic Stimulation / Q000379:methods*
keywords: Cerebellar repetitive transcranial magnetic stimulation; cerebellum; multiple system atrophy type C; short-latency afferent inhibition; transcranial magnetic stimulation