Alberto Benussi1, Valentina Dell'Era1, Valentina Cantoni2, Clarissa Ferrari3, Salvatore Caratozzolo1, Luca Rozzini1, Antonella Alberici1, Alessandro Padovani1, Barbara Borroni4. 1. Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. 2. Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Italy. 3. Statistics Service, IRCCS Centro San Giovanni di Dio - Fatebenefratelli, Brescia, Italy. 4. Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. Electronic address: bborroni@inwind.it.
Abstract
BACKGROUND: Differential diagnosis of atypical parkinsonian disorders, i.e. dementia with Lewy bodies (DLB), progressive supranuclear palsy (PSP) or corticobasal syndrome (CBS) still remains problematic. Furthermore, DLB may overlap with Alzheimer's disease (AD) in the early stages of disease. OBJECTIVE: To determine whether transcranial magnetic stimulation (TMS) can be used to classify atypical parkinsonian disorders and AD. METHODS: A paired-pulse TMS multi-paradigm approach assessing multiple intracortical circuits, as short interval intracortical inhibition-facilitation and short latency afferent inhibition, was used to model a decision tree analysis and determine diagnostic accuracy in classifying different neurodegenerative disorders. RESULTS: We observed a significant impairment in short latency afferent inhibition in AD and DLB and a significant impairment in short interval intracortical inhibition-facilitation in DLB, PSP and CBS patients. These parameters were used to model a decision tree analysis which yielded an overall diagnostic accuracy of 88.3%, with 90.5% for AD, 85.2% for DLB, 76.0% for CBS-PSP, and 94.9% for healthy controls. CONCLUSIONS: The assessment of intracortical connectivity with TMS may aid in the differential diagnosis of AD and the atypical parkinsonian disorders.
BACKGROUND: Differential diagnosis of atypical parkinsonian disorders, i.e. dementia with Lewy bodies (DLB), progressive supranuclear palsy (PSP) or corticobasal syndrome (CBS) still remains problematic. Furthermore, DLB may overlap with Alzheimer's disease (AD) in the early stages of disease. OBJECTIVE: To determine whether transcranial magnetic stimulation (TMS) can be used to classify atypical parkinsonian disorders and AD. METHODS: A paired-pulse TMS multi-paradigm approach assessing multiple intracortical circuits, as short interval intracortical inhibition-facilitation and short latency afferent inhibition, was used to model a decision tree analysis and determine diagnostic accuracy in classifying different neurodegenerative disorders. RESULTS: We observed a significant impairment in short latency afferent inhibition in AD and DLB and a significant impairment in short interval intracortical inhibition-facilitation in DLB, PSP and CBSpatients. These parameters were used to model a decision tree analysis which yielded an overall diagnostic accuracy of 88.3%, with 90.5% for AD, 85.2% for DLB, 76.0% for CBS-PSP, and 94.9% for healthy controls. CONCLUSIONS: The assessment of intracortical connectivity with TMS may aid in the differential diagnosis of AD and the atypical parkinsonian disorders.
Authors: Alberto Benussi; Valentina Cantoni; Jasmine Rivolta; Silvana Archetti; Anna Micheli; Nicholas Ashton; Henrik Zetterberg; Kaj Blennow; Barbara Borroni Journal: Alzheimers Res Ther Date: 2022-10-13 Impact factor: 8.823
Authors: Alberto Benussi; Maria S Cotelli; Valentina Cantoni; Valeria Bertasi; Marinella Turla; Andrea Dardis; Jessica Biasizzo; Rosa Manenti; Maria Cotelli; Alessandro Padovani; Barbara Borroni Journal: JIMD Rep Date: 2019-06-28
Authors: Alessandro Padovani; Alberto Benussi; Maria Sofia Cotelli; Clarissa Ferrari; Valentina Cantoni; Valentina Dell'Era; Rosanna Turrone; Barbara Paghera; Barbara Borroni Journal: Alzheimers Res Ther Date: 2019-12-01 Impact factor: 6.982