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In vivo assessment of cortical circuitry in CADASIL – a novel biomarker?
  1. Vincenzo Di Lazzaro1,2
  1. 1Institute of Neurology, Campus Biomedico University, Rome, Italy
  2. 2Fondazione Alberto Sordi—Research Institute for Ageing, Rome, Italy
  1. Correspondence to Professor Vincenzo Di Lazzaro, Institute of Neurology, Campus Biomedico University, Via Alvaro del Portillo, 200, Rome 00128, Italy; v.dilazzaro{at}

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Non-invasive transcranial magnetic stimulation (TMS) of the human cerebral cortex, particularly the motor areas, has now been developed to the stage at which it is possible to evaluate in vivo glutamatergic, cholinergic and GABAergic circuits of the human brain.1 In addition, repetitive stimulation with TMS produces long-lasting changes in the excitability of central motor circuits that are thought to be caused by early stages of synaptic long-term potentiation/depression, thus providing for the first time the opportunity to explore plasticity in the conscious human brain.2 ,3 The TMS paradigm termed short latency afferent inhibition (SAI), based on coupling peripheral nerve stimulation with cortical TMS, provides information on central cholinergic circuits: SAI is abolished by anticholinergic drugs in healthy subjects,4 is reduced in cholinergic forms …

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