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Author Kishore, A. ♦ Joseph, Thomas ♦ Velayudhan, Balu ♦ Popa, T. ♦ Meunier, S.
Source Sree Chitra Tirunal Institute for Medical Sciences & Technology
Content type Text
Publisher Clinical Neurophysiology
File Format PDF
Language English
Subject Domain (in DDC) Technology ♦ Medicine & health ♦ Diseases
Subject Domain (in MeSH) Nervous System Diseases ♦ Diseases
Subject Keyword Neurology
Abstract Objective: To test the plasticity of bilateral motor cortices (M1) in treatment-nave (de novo) Parkinson's disease (PD) patients and its response to single dose of L-DOPA.Methods: Twenty-one de novo PD patients with only unilateral motor symptoms were recruited to eliminate the effects of advanced disease and chronic treatment and were tested with intermittent (n = 10) and continuous theta burst stimulation (iTBS and cTBS) (n = 11) protocols to induce LTP and LTD-like plasticity on both M1 cortices. They were compared with two groups of 10 each, age-matched, healthy volunteers (HV). Severity of motor signs and effectiveness of TBS were measured bilaterally in the untreated state and after a uniform dose of L-DOPA in all patients.Results: iTBS and cTBS induced significant LTP and LTD-like plasticity in M1 of HV. In de novo patients, there was no plasticity in both M1. Acute L-DOPA challenge did not improve plasticity in either M1 cortices, though motor signs of PD improved. There was no correlation of motor signs with M1 plasticity.Conclusion: The early, severe and bilateral loss of plasticity in M1 in de novo PD patients is a primary disease-related cortical dysfunction. The contrasting L-DOPA response of motor signs and M1 plasticity could arise from differences in neural circuits mediating them or differing effects of acute dopamine replacement on circuits recruited by specific plasticity-induction techniques, particularly in treatment nave PD.Significance: M1 plasticity defect occurs early in PD and might affect motor learning. Acute vs. chronic dopamine replacement could have different effects on plasticity in PD or in the networks recruited by a specific plasticity induction technique. (C) 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
Education Level UG and PG
Learning Resource Type Article
Educational Framework Medical Council of India (MCI)
Journal Clinical Neurophysiology
Volume Number 123
Issue Number 4
Page Count 7
Starting Page 822
Ending Page 828