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01-05-2012 | Dementias - Original Article

Intra- and inter-cortical motor excitability in Alzheimer’s disease

Authors: Jacqueline Hoeppner, Martin Wegrzyn, Johannes Thome, Alexandra Bauer, Imke Oltmann, Johannes Buchmann, Stefan Teipel

Published in: Journal of Neural Transmission | Issue 5/2012

Abstract

Transcranial magnetic stimulation (TMS) provides evidence for facilitatory and inhibitory motor dysfunctions in Alzheimer’s disease (AD). The corpus callosum (CC) is affected in AD already at early stages consistent with the hypothesis that AD patients exhibit alterations in transcallosally mediated motor inhibition (ipsilateral silent period, iSP). Therefore, here we aimed at investigating the integrity not only of intra-, but also of inter-hemispheric mechanisms of cortical motor excitability in AD. We determined the iSP, the resting motor threshold (RMT), and the amplitude of motor evoked potentials (MEP) in 19 AD patients and 19 healthy controls using single-pulse TMS. Furthermore, we used paired-pulse TMS to study the intra-cortical inhibition (ICI) and intra-cortical facilitation (ICF). All subjects underwent comprehensive neuropsychologic, clinical, and laboratory testing, and neuroimaging to exclude significant co-morbidity. In AD patients, the RMT was significantly reduced (Oneway-ANOVA). An analysis of covariance (ANCOVA) revealed a strong group specific interaction of the inhibitory interstimulus intervals (p = 0.005) with a reduced ICI in AD. Furthermore, we found a significantly prolonged iSP-latency (p = 0.003) in AD compared to controls, whereas the iSP-duration was not different. The iSP-latency correlated significantly with the ICI (ANCOVA) (p = 0.02). The ICF did not differ significantly between groups. Our data suggest comprehensive but still subclinical dysfunctions of motor cortical inhibition in mild to moderate clinical stages of AD with strong interactions of intra- and inter-hemispheric inhibitory phenomena. Future studies are needed to show the potential prognostic relevance of these findings for the further course of the disease.

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Title: Intra- and inter-cortical motor excitability in Alzheimer’s disease
Authors: Jacqueline Hoeppner
Martin Wegrzyn
Johannes Thome
Alexandra Bauer
Imke Oltmann
Johannes Buchmann
Stefan Teipel
Publication date: 01-05-2012
Publisher: Springer Vienna
Published in: Journal of Neural Transmission / Issue 5/2012
Print ISSN: 0300-9564
Electronic ISSN: 1435-1463
DOI: https://doi.org/10.1007/s00702-011-0738-y

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Intra- and inter-cortical motor excitability in Alzheimer’s disease

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