Mild cerebello-thalamo-cortical impairment in patients with normal dopaminergic scans (SWEDD)

Tommaso Schirinzi, Francesco Di Lorenzo, Viviana Ponzo, Maria Giuseppina Palmieri, Anna Rita Bentivoglio, Orazio Schillaci, Antonio Pisani, Giacomo Koch*

*Autore corrispondente per questo lavoro

Risultato della ricerca: Contributo in rivistaArticolo

13 Citazioni (Scopus)

Abstract

INTRODUCTION:\r\n\r\nPatients with Scans-Without-Evidence-of-Dopaminergic-Deficit (SWEDD) often present asymmetric rest tremor not responsive to levodopa. Although a dystonic origin of this tremor has been proposed, the underlying pathophysiology of such condition is still unclear. An abnormal activity in the Cerebello-Thalamo-Cortical circuit is involved in the pathogenesis of tremor and other movement disorders. Here we used different paradigms of cerebellar transcranial magnetic stimulation to evaluate the Cerebello-Thalamo-Cortical functioning in patients with normal scans.\r\nMETHODS:\r\n\r\nCerebello-Thalamo-Cortical circuit was investigated in 12 patients with normal scans, 8 patients with Parkinson's Disease (PD), 8 patients with adult-onset isolated dystonia and 9 healthy controls. We studied the effects of a single cerebellar magnetic pulse over the excitability of the contralateral primary motor cortex tested with Motor-Evoked-Potentials (Cerebellar-Inhibition) both at rest and during arm extension. Furthermore, we also tested the effects of cerebellar continuous-Theta-Burst-Stimulation on Motor-Evoked-Potentials amplitude.\r\nRESULTS:patients with normal scans compared to controls show a deficient Cerebellar-Inhibition at rest but not in arm extension; in both conditions they differ from PD but not from dystonic patients. Cerebellar Continuous-Theta-Burst-Stimulation induced the expected long-lasting cortical inhibition of Motor-Evoked-Potentials amplitude in patients with normal scans differently from PD and dystonic patients.\r\nCONCLUSIONS:\r\n\r\npatients with normal scans show a mild impairment in Cerebello-Thalamo-Cortical circuit that emerges only at rest. Such neurophysiological phenotype differs from the one observed in PD and dystonic patients, suggesting a distinct involvement of this pathway in the pathophysiology of these disorders.
Lingua originaleInglese
pagine (da-a)23-28
Numero di pagine6
RivistaParkinsonism and Related Disorders
Volume28
Numero di pubblicazionen/a
DOI
Stato di pubblicazionePubblicato - 2016

All Science Journal Classification (ASJC) codes

  • Neurologia
  • Geriatria e Gerontologia
  • Neurologia (clinica)

Keywords

  • Cerebello thalamo cortical
  • Dystonia
  • Parkinson's disease
  • SWEDD
  • Tremor

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