皮质运动功能的神经生理学评估：方法的直接比较。

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology Pub Date : 2025-02-01 DOI:10.1016/j.clinph.2024.12.001

Steve Vucic , Nathan Pavey , Parvathi Menon , Michael Babayev , Anna Maslyukova , Anatoliy Muraviev , Matthew C. Kiernan

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引用次数: 0

摘要

目的：阈值跟踪经颅磁刺激（TT-TMS）评估皮质功能已经发展成为一种生物标志物，为疾病病理生理学提供信息，特别是在神经退行性疾病和痴呆中。目前还不存在完全集成的测试系统。为了促进临床应用，并简化软件设计以整合门诊诊断方法，本系列研究评估了改变诊断范式以测量间刺激间隔（ISI）的效果，包括连续上升[T-SICIs]和平行[T-SICIp]方法作为皮质运动功能的测量（MagXite软件）。方法：采用与先前建立的实验范式相比较的综合方法，用8字形线圈评估30名健康对照者的皮质兴奋性。运动诱发反应记录在对侧拇短外展肌。每个测试模式记录短间隔皮质内抑制（SICI），并在健康对照队列中进行验证。结果：该集成系统在ISI 1 ~ 7 ms（16.6±2.2%）之间确定了t - sici的稳健测量值，与先前建立的测试范式相当（P = 0.34），但高于T-SICIp (MagXite 10.7±1.5%,P = 0.016；悉尼TT-TMS 8.7±1.4%,P = 0.03)。两种方案在ISI 1和2.5 ~ 3 ms时都有明显的SICI峰。T-SICIs-MagXite平均值和t - sicp - magxite平均值之间存在显著相关性（R = 0.599， P）。结论：本系列研究验证了一种完全整合的运动皮质功能评估方法，提供了SICI的可重复性测量，使用序列升序方法评估时获得的皮质内抑制数据更为突出。意义：经颅磁刺激人体运动系统的集成系统已在临床实践中得到验证，适用于门诊神经系统疾病皮质功能的评估。

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Neurophysiological assessment of cortical motor function: A direct comparison of methodologies

Objective

Assessment of cortical function with threshold tracking transcranial magnetic stimulation (TT-TMS) has developed as a biomarker to inform disease pathophysiology, particularly in neurodegenerative disease and dementia. At present, a fully integrated testing system does not exist. To advance clinical utility, and to streamline software design to integrate with diagnostic approaches in an outpatient setting, the present series of studies assessed the effects of altering diagnostic paradigms to measure interstimulus interval (ISI) including serial ascending [T-SICIs] and parallel [T-SICIp] methodologies as measures of cortical motor function (the MagXite software).

Methods

Cortical excitability was assessed in 30 healthy controls with a figure-of-eight coil, using an integrated approach compared to previously established experimental paradigms. Motor evoked responses were recorded over the contralateral abductor pollicis brevis muscle. Short interval intracortical inhibition (SICI) was recorded with each testing paradigm and validated in a healthy control cohort.

Results

The integrated system determined a robust measure of T-SICIs between ISI 1-to-7 ms (16.6 ± 2.2 %) that was comparable to previously established testing paradigms (P = 0.34), but greater than T-SICIp (MagXite 10.7 ± 1.5 %, P = 0.016; Sydney TT-TMS 8.7 ± 1.4 %, P = 0.03). SICI peaks at ISI 1 and 2.5-to-3 ms were evident with both protocols. Significant correlations were evident between mean T-SICIs-_MagXite and T-SICIp-_MagXite (R = 0.599, P < 0.001).

Conclusion

The present series validates a fully integrated motor cortical functional assessment to provide reproducible measures of SICI, with data obtained for intracortical inhibition that is more prominent when assessed using the method of serial ascending order.

Significance

An integrated system for transcranial magnetic stimulation of the human motor system has been validated for clinical practice, suitable for the assessment of cortical function in neurological disease in an outpatient clinic setting.

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来源期刊

Clinical Neurophysiology 医学-临床神经学

CiteScore

8.70

自引率

6.40%

发文量

932

审稿时长

59 days

期刊介绍： As of January 1999, The journal Electroencephalography and Clinical Neurophysiology, and its two sections Electromyography and Motor Control and Evoked Potentials have amalgamated to become this journal - Clinical Neurophysiology. Clinical Neurophysiology is the official journal of the International Federation of Clinical Neurophysiology, the Brazilian Society of Clinical Neurophysiology, the Czech Society of Clinical Neurophysiology, the Italian Clinical Neurophysiology Society and the International Society of Intraoperative Neurophysiology.The journal is dedicated to fostering research and disseminating information on all aspects of both normal and abnormal functioning of the nervous system. The key aim of the publication is to disseminate scholarly reports on the pathophysiology underlying diseases of the central and peripheral nervous system of human patients. Clinical trials that use neurophysiological measures to document change are encouraged, as are manuscripts reporting data on integrated neuroimaging of central nervous function including, but not limited to, functional MRI, MEG, EEG, PET and other neuroimaging modalities.