Diagnostic value of motor evoked potential parameters in patients with Parkinson’s disease stage II
DOI:
https://doi.org/10.14739/2310-1237.2022.1.246660Keywords:
Parkinson disease, motor symptoms, motor evoked potentials, transcranial magnetic stimulationAbstract
The aim of our study was to identify the most informative parameters of motor evoked potential (MEP) based on clinical and neurophysiological comparisons in patients with Parkinson’s disease (PD) stage II.
Materials and methods. The study included 90 patients aged 45 to 75 years with stage II PD according to Hoehn–Yahr. Examination of patients was performed according to the following scheme: clinical and neurological examination with MDS UPDRS scale and neurophysiological examination to determine the latency, amplitude and duration of MEP after 4 tests with a gradual increase of magnetic field induction. Our study involved patients with predominantly right and left-sided motor symptoms, so for correct statistical analysis, the dominant side was considered as the debut side or the side with more pronounced motor symptoms, the subdominant side was considered as the opposite one.
Results. In cases of patients with stage II PD the MEP latency significantly decreased, and the amplitude and duration of MEP significantly increased in samples with increasing magnetic field induction in the right and left hemispheres of the brain. It was found significant positive moderate correlation between UPDRS part III total score and MEP latency in the ipsilateral premotor cortex to the dominant side of motor symptoms with samples of magnetic induction (1.1 Tl – r = 0.34, P < 0.05; 1.32 Tl – r = 0.32, P < 0.05; 1.76 Tl – r = 0.31, P < 0.05). Also positive mild correlation was found between MEP latency in the ipsilateral premotor cortex to the subdominant side of motor symptoms and UPDRS part III total score (1.54 Tl – r = 0.22, P < 0.05; 1.76 Tl – r = 0.29, P < 0.05). Mild positive correlation (r = 0.29, P < 0.05) was found between MEP duration of ipsilateral premotor cortex to the subdominant side of motor symptoms and UPDRS part III total score in sample with 1.54 Tl magnetic induction. No significant correlations were found to the amplitude parameter and the severity of clinical symptoms in investigated patients with PD stage II.
Conclusions. The most informative neurophysiological indicators in patients with PD stage II are the MEP latencies. The MEP latencies of the premotor cortex, which is ipsilateral to the side with more pronounced motor symptoms, have a particularly close relationship with UPDRS part III total score in the samples with 1.10–1.76 Tl magnetic inductions (r = 0.31–0.34, P ˂ 0.05). The MEP duration of premotor cortex, which is ipsilateral to the side with less pronounced motor symptoms, is most closely associated with the severity of motor manifestations on the subdominant side in patients with PD stage II (r = 0.27, P ˂ 0.05).
References
Anzak, A., Tan, H., Pogosyan, A., Khan, S., Javed, S., Gill, S. S., Ashkan, K., Akram, H., Foltynie, T., Limousin, P., Zrinzo, L., Green, A. L., Aziz, T., & Brown, P. (2016). Subcortical evoked activity and motor enhancement in Parkinson's disease. Experimental neurology, 277, 19-26. https://doi.org/10.1016/j.expneurol.2015.12.004
Bologna, M., Guerra, A., Paparella, G., Giordo, L., Alunni Fegatelli, D., Vestri, A. R., Rothwell, J. C., & Berardelli, A. (2018). Neurophysiological correlates of bradykinesia in Parkinson's disease. Brain, 141(8), 2432-2444. https://doi.org/10.1093/brain/awy155
Casarotto, S., Turco, F., Comanducci, A., Perretti, A., Marotta, G., Pezzoli, G., Rosanova, M., & Isaias, I. U. (2019). Excitability of the supplementary motor area in Parkinson's disease depends on subcortical damage. Brain stimulation, 12(1), 152-160. https://doi.org/10.1016/j.brs.2018.10.011
Dagan, M., Herman, T., Mirelman, A., Giladi, N., & Hausdorff, J. M. (2017). The role of the prefrontal cortex in freezing of gait in Parkinson's disease: insights from a deep repetitive transcranial magnetic stimulation exploratory study. Experimental brain research, 235(8), 2463-2472. https://doi.org/10.1007/s00221-017-4981-9
Dileone, M., Carrasco-López, M. C., Segundo-Rodriguez, J. C., Mordillo-Mateos, L., López-Ariztegui, N., Alonso-Frech, F., Catalan-Alonso, M. J., Obeso, J. A., Oliviero, A., & Foffani, G. (2017). Dopamine-dependent changes of cortical excitability induced by transcranial static magnetic field stimulation in Parkinson's disease. Scientific reports, 7(1), 4329. https://doi.org/10.1038/s41598-017-04254-y
Fisicaro, F., Lanza, G., Cantone, M., Ferri, R., Pennisi, G., Nicoletti, A., Zappia, M., Bella, R., & Pennisi, M. (2020). Clinical and Electrophysiological Hints to TMS in De Novo Patients with Parkinson's Disease and Progressive Supranuclear Palsy. Journal of personalized medicine, 10(4), 274. https://doi.org/10.3390/jpm10040274
Kojovic, M., Kassavetis, P., Bologna, M., Pareés, I., Rubio-Agusti, I., Berardelli, A., Edwards, M. J., Rothwell, J. C., & Bhatia, K. P. (2015). Transcranial magnetic stimulation follow-up study in early Parkinson's disease: A decline in compensation with disease progression?. Movement disorders, 30(8), 1098-1106. https://doi.org/10.1002/mds.26167
Kolmancic, K., Perellón-Alfonso, R., Pirtosek, Z., Rothwell, J. C., Bhatia, K., & Kojovic, M. (2019). Sex differences in Parkinson's disease: A transcranial magnetic stimulation study. Movement disorders, 34(12), 1873-1881. https://doi.org/10.1002/mds.27870
Lee, Y. Y., Li, M. H., Tai, C. H., & Luh, J. J. (2020). Corticomotor Excitability Changes Associated With Freezing of Gait in People With Parkinson Disease. Frontiers in human neuroscience, 14, 190. https://doi.org/10.3389/fnhum.2020.00190
Van den Noort, M., Bosch, P., Yeo, S., & Lim, S. (2015). Transcranial Magnetic Stimulation for Parkinson's Disease. Movement disorders, 30(14), 1973. https://doi.org/10.1002/mds.26439
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeThe Effect of Open Access).
