Corticomotor Excitability in Two Kinds of Motor Neuron Diseases: A Study on the Patients With Amyotrophic Lateral Sclerosis and Poliomyelitis Survivors.


Sirin N. G. , Erbas B., Oguz-Akarsu E. , Gula G., Kocasoy-Orhan E., Dede H. O. , ...More

Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society, vol.38, pp.448-455, 2021 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 38
  • Publication Date: 2021
  • Doi Number: 10.1097/wnp.0000000000000707
  • Title of Journal : Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society
  • Page Numbers: pp.448-455
  • Keywords: Amyotrophic lateral sclerosis, Poliomyelitis, Postpoliomyelitis syndrome, Transcranial magnetic stimulation, Triple-stimulation technique, Cortical excitability, TRANSCRANIAL MAGNETIC STIMULATION, CORTICAL EXCITABILITY, MUSCLE PERFORMANCE, POSTPOLIO SYNDROME, ASSESSMENTS, PATHOPHYSIOLOGY, INHIBITION, ACTIVATION, MANAGEMENT, DIAGNOSIS

Abstract

Purpose: To examine upper motor neuron functions comparatively in patients with amyotrophic lateral sclerosis (ALS) and poliomyelitis survivors using transcranial magnetic stimulation (TMS) methods. Methods: Single- and paired-pulse TMS with conventional methods and the triple-stimulation technique were performed by recording from the abductor digiti minimi and abductor pollicis brevis muscles in 31 patients with ALS, 18 patients with poliomyelitis survivors, and 21 controls. Nine patients were diagnosed as having postpoliomyelitis syndrome after a 6-month follow-up. Results: Triple-stimulation technique and some of conventional TMS studies were able to distinguish ALS from both poliomyelitis survivors and controls. A reduced ipsilateral silent period in abductor pollicis brevis muscles was the only parameter to show a significant difference when comparing thenar and hypothenar muscles in ALS. No significant difference was present in any TMS parameters between the postpoliomyelitis syndrome and non-postpoliomyelitis syndrome groups. Conclusions: Conventional TMS and particularly triple-stimulation technique studies are helpful in disclosing upper motor neuron dysfunction in ALS. The results of this study might favor the cortical hypothesis for split hand in ALS, but they revealed no significant indication for upper motor neuron dysfunction in postpoliomyelitis syndrome.