Alberto Benussi1, Valentina Dell'Era1, Valentina Cantoni2, Rosanna Turrone3, Andrea Pilotto4, Antonella Alberici3, Maria Sofia Cotelli5, Cristina Rizzetti6, Alessandro Padovani1, Barbara Borroni7. 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. Neurology Unit, Spedali Civili di Brescia, Brescia, Italy. 4. Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Parkinson's Disease Rehabilitation Centre FERB ONLUS S. Isidoro Hospital, Trescore Balneario, Italy. 5. Neurology Unit, Valle Camonica Hospital, Brescia, Italy. 6. Parkinson's Disease Rehabilitation Centre FERB ONLUS S. Isidoro Hospital, Trescore Balneario, Italy. 7. Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. Electronic address: bborroni@inwind.it.
Abstract
OBJECTIVE: To determine whether motor cortex inhibition by stimulation over the cerebellum with a figure-of eight coil (MISC8) may be reduced in patients with Progressive Supranuclear Palsy (PSP). METHODS: Paired pulse TMS was used to evaluate MISC8, in patients with different forms of parkinsonism and dementia. The primary outcome measures were sensitivity and specificity of motor cortex inhibition, derived from receiver operator curve analysis, in discriminating PSP from other neurodegenerative disorders. RESULTS: A total of 150 participants met inclusion criteria. According to clinical criteria, the study population included 19 PSP, 26 Parkinson's disease, 25 dementia with Lewy bodies, 15 corticobasal syndrome, 25 frontotemporal dementia and 15 Alzheimer's disease patients, and 25 healthy controls. PSP patients were characterized by a specific impairment of MISC8 (0.99 ± 0.08) compared to the healthy control group and to other neurodegenerative disorders (mean range = 0.63-0.80, all p-values<0.001). Using the best cut-off index, MISC8 differentiated PSP from other diagnoses with an overall sensitivity of 100%, a specificity of 94%, and an accuracy of 97%. CONCLUSIONS: TMS is a non-invasive procedure which reliably distinguishes PSP from other neurodegenerative disorders. MISC8 could represent a useful additional diagnostic tool to be used in clinical practice.
OBJECTIVE: To determine whether motor cortex inhibition by stimulation over the cerebellum with a figure-of eight coil (MISC8) may be reduced in patients with Progressive Supranuclear Palsy (PSP). METHODS: Paired pulse TMS was used to evaluate MISC8, in patients with different forms of parkinsonism and dementia. The primary outcome measures were sensitivity and specificity of motor cortex inhibition, derived from receiver operator curve analysis, in discriminating PSP from other neurodegenerative disorders. RESULTS: A total of 150 participants met inclusion criteria. According to clinical criteria, the study population included 19 PSP, 26 Parkinson's disease, 25 dementia with Lewy bodies, 15 corticobasal syndrome, 25 frontotemporal dementia and 15 Alzheimer's diseasepatients, and 25 healthy controls. PSPpatients were characterized by a specific impairment of MISC8 (0.99 ± 0.08) compared to the healthy control group and to other neurodegenerative disorders (mean range = 0.63-0.80, all p-values<0.001). Using the best cut-off index, MISC8 differentiated PSP from other diagnoses with an overall sensitivity of 100%, a specificity of 94%, and an accuracy of 97%. CONCLUSIONS: TMS is a non-invasive procedure which reliably distinguishes PSP from other neurodegenerative disorders. MISC8 could represent a useful additional diagnostic tool to be used in clinical practice.
Authors: Rebecca Herzog; Till M Berger; Martje G Pauly; Honghu Xue; Elmar Rueckert; Alexander Münchau; Tobias Bäumer; Anne Weissbach Journal: Front Neurosci Date: 2022-09-15 Impact factor: 5.152