TY - JOUR
T1 - Mild cerebello-thalamo-cortical impairment in patients with normal dopaminergic scans (SWEDD)
AU - Schirinzi, Tommaso
AU - Di Lorenzo, Francesco
AU - Ponzo, Viviana
AU - Palmieri, Maria Giuseppina
AU - Bentivoglio, Anna Rita
AU - Schillaci, Orazio
AU - Pisani, Antonio
AU - Koch, Giacomo
PY - 2016
Y1 - 2016
N2 - 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.
AB - 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.
KW - Cerebello thalamo cortical
KW - Dystonia
KW - Parkinson's disease
KW - SWEDD
KW - Tremor
KW - Cerebello thalamo cortical
KW - Dystonia
KW - Parkinson's disease
KW - SWEDD
KW - Tremor
UR - https://publicatt.unicatt.it/handle/10807/90663
UR - https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=84974800789&origin=inward
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84974800789&origin=inward
U2 - 10.1016/j.parkreldis.2016.03.023
DO - 10.1016/j.parkreldis.2016.03.023
M3 - Article
SN - 1353-8020
VL - 28
SP - 23
EP - 28
JO - Parkinsonism and Related Disorders
JF - Parkinsonism and Related Disorders
IS - n/a
ER -