Viviana Ponzo1, Silvia Picazio1, Alberto Benussi2, Francesco Di Lorenzo1, Livia Brusa3, Carlo Caltagirone1,4, Giacomo Koch1,5. 1. Non-invasive Brain Stimulation Unit, Santa Lucia Foundation, Rome, Italy. 2. Centre for Ageing Brain and Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy. 3. Neurology Department, S. Eugenio Hospital, Rome, Italy. 4. System Medicine Department, Tor Vergata University, Rome, Italy. 5. Stroke Unit, Department of Neuroscience, Policlinico Tor Vergata, Rome, Italy.
Abstract
BACKGROUND: Levodopa-induced dyskinesias are associated with thalamo-cortical disinhibition and frontal area overactivation. Neuroimaging and transcranial magnetic stimulation studies have highlighted the involvement of the right inferior frontal cortex in levodopa-induced dyskinesias. METHODS: Using transcranial magnetic stimulation, we tested connectivity between the inferior frontal and contralateral motor cortex in Parkinson's disease patients with and without levodopa-induced dyskinesias compared with age-matched controls. Furthermore, in dyskinetic patients, connectivity between the inferior frontal and contralateral motor cortex was assessed before and after a single session of continuous theta-burst stimulation applied over the inferior frontal cortex. RESULTS: Dyskinetic patients showed abnormal facilitatory connectivity between the inferior frontal and motor cortex when compared with the nondyskinetic group. Continuous theta-burst stimulation over the inferior frontal cortex eliminated such facilitatory connectivity and decreased the levodopa-induced dyskinesias that was induced by a supramaximal dose of levodopa. CONCLUSION: In dyskinetic patients, a weaker inhibitory cortico-cortical interaction between the inferior frontal and contralateral motor cortex could be involved in levodopa-induced dyskinesias and restored by continuous theta-burst stimulation over the inferior frontal cortex.
BACKGROUND:Levodopa-induced dyskinesias are associated with thalamo-cortical disinhibition and frontal area overactivation. Neuroimaging and transcranial magnetic stimulation studies have highlighted the involvement of the right inferior frontal cortex in levodopa-induced dyskinesias. METHODS: Using transcranial magnetic stimulation, we tested connectivity between the inferior frontal and contralateral motor cortex in Parkinson's diseasepatients with and without levodopa-induced dyskinesias compared with age-matched controls. Furthermore, in dyskineticpatients, connectivity between the inferior frontal and contralateral motor cortex was assessed before and after a single session of continuous theta-burst stimulation applied over the inferior frontal cortex. RESULTS:Dyskineticpatients showed abnormal facilitatory connectivity between the inferior frontal and motor cortex when compared with the nondyskinetic group. Continuous theta-burst stimulation over the inferior frontal cortex eliminated such facilitatory connectivity and decreased the levodopa-induced dyskinesias that was induced by a supramaximal dose of levodopa. CONCLUSION: In dyskineticpatients, a weaker inhibitory cortico-cortical interaction between the inferior frontal and contralateral motor cortex could be involved in levodopa-induced dyskinesias and restored by continuous theta-burst stimulation over the inferior frontal cortex.
Authors: Jin Ho Jung; Yae Ji Kim; Seok Jong Chung; Han Soo Yoo; Yang Hyun Lee; Kyoungwon Baik; Seong Ho Jeong; Young Gun Lee; Hye Sun Lee; Byoung Seok Ye; Young H Sohn; Yong Jeong; Phil Hyu Lee Journal: J Neurol Date: 2021-11-11 Impact factor: 6.682
Authors: Han Soo Yoo; Yong Ho Choi; Seok Jong Chung; Yang Hyun Lee; Byoung Seok Ye; Young H Sohn; Jong-Min Lee; Phil Hyu Lee Journal: Ann Clin Transl Neurol Date: 2019-10-23 Impact factor: 4.511