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- Caliandro, Pietro, et al.
(författare)
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Jitter of Corticospinal Neurons During Repetitive Transcranial Magnetic Stimulation : Method and Possible Clinical Implications
- 2014
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Ingår i: Brain Stimulation. - : Elsevier BV. - 1935-861X .- 1876-4754. ; 7:4, s. 580-586
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Tidskriftsartikel (refereegranskat)abstract
- Background: Repetitive transcranial magnetic stimulation (rTMS) of the motor cortex activates corticospinal neurons mainly through the depolarization of cortico-cortical axons belonging to interneurons of superficial layers. Objective: We used single-fiber electromyography (SFEMG) to estimate the "central jitter" of activation latency of interneural pools from one pulse of TMS to another. Methods: We evaluated 10 healthy subjects and one patient with multiple sclerosis. By recording SFEMG evoked activity from the left first dorsal interosseous (FDI), we first used a standard repetitive electrical 3 Hz stimulation of the ulnar nerve at the wrist to calculate the mean consecutive difference from at least 10 different potentials. The same procedure was applied during 3 Hz repetitive TMS of the contralateral motor cortex. The corticospinal monosynaptic connection of the FDI and the selectivity of SFEMG recording physiologically justified the subtraction of the "peripheral jitter" from the whole cortico-muscular jitter, obtaining an estimation of the actual "central jitter." Results: All subjects completed the study. The peripheral jitter was 28 mu s +/- 6 and the cortico-muscular jitter was 344 mu s +/- 97. The estimated central jitter was 343 +/- 97 mu s. In the patient the central jitter was 846 mu s, a value more than twice the central jitter in healthy subjects. Conclusion: Current results demonstrate that the evaluation of the central component of the cumulative cortico-muscular latency variability in healthy subjects is feasible with a minimally invasive approach. We present and discuss this methodology and provide a "proof of concept" of its potential clinical applicability in a patient with multiple sclerosis.
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- Padua, Luca, et al.
(författare)
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Single-fiber conduction velocity test allows earlier detection of abnormalities in diabetes
- 2011
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Ingår i: Muscle and Nerve. - : Wiley. - 0148-639X .- 1097-4598. ; 43:5, s. 652-656
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The purpose of this study was to determine whether single-fiber conduction velocity (SF-CV) of a small number of axons increases sensitivity for identification of motor nerve conduction alterations in patients with diabetes. Methods: Twenty-one consecutive diabetic patients in good metabolic control were studied. For each patient, conventional (C-CV) and SF-CV results were correlated with the presence of neuropathic symptoms. Results: Nine of 21 patients reported symptoms suggestive of mild nerve impairment. Three patients had abnormal sural nerve CV, 1 of whom also had abnormal motor nerve conduction. Eighteen patients had normal findings on conventional tests, 3 of whom had slowing of SF-CV. Conclusions: SF-CV is able to detect mild myelin damage with higher sensitivity than conventional tests. The use of SF-CV may be a helpful tool in the early identification of diabetic polyneuropathy, and it may be useful for tailoring an approach to diabetic polyneuropathy.
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- Padula, Luca, et al.
(författare)
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A novel approach to the measurement of motor conduction velocity using a single fibre EMG electrode
- 2007
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Ingår i: Clinical Neurophysiology. - : Elsevier BV. - 1388-2457 .- 1872-8952. ; 118:9, s. 1985-1990
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate whether, for patients with suspected myelin impairment, the sensitivity of motor nerve conduction studies can be increased by using an SFEMG electrode which makes it possible to study conduction velocity in a small number of axons (SF-CV). METHODS: We studied 22 consecutive patients with suspected neuropathy through conventional motor conduction study and through SF-CV. For each patient we selected a nerve that was normal at conventional neurography and studied it through SF-CV. Also, we performed SF-CV in 15 healthy subjects. We considered 36 m/s as the low limit of normal SF-CV (the normal value commonly accepted in the literature for the slowest alpha motor axons). RESULTS: In the healthy subjects we never observed abnormal SF-CV values. Of the 22 patients, in 18 the conventional tests showed abnormal findings suggestive of neuropathy. The remaining 4 patients were completely normal at the conventional tests. Through SF-CV we studied 22 nerves that were normal at the conventional tests. Fourteen of 22 (64%) nerves presented pathological SF-CV test. Half of the patients with normal findings at the conventional tests showed pathological SF-CV test. CONCLUSIONS: SF-CV evaluation may be useful in detecting early, mild, or partial myelin damage, because it makes it possible to detect nerve conduction slowing when conventional tests are normal. SIGNIFICANCE: Increasing sensitivity of motor conduction evaluation.
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