Research articleThe role of magnetic stimulation as a quantifier of motor disability in patients with multiple sclerosis
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The use of transcranial magnetic stimulation in diagnosis, prognostication and treatment evaluation in multiple sclerosis
2015, Multiple Sclerosis and Related DisordersCitation Excerpt :A subgroup of 11 clinically stable patients were re-examined over the following 3 months, and a further 27 patients who suffered a clinical relapse were examined during and after steroid treatment. Despite small numbers, there was a statistically significant correlation between clinical findings and CMCT, in that patients who clinically responded to steroid treatment had a robust reduction in CMCT and non-improvers had no change; results from stable patients were unchanged across two readings (Kandler et al., 1991). Similar degrees of improvement in CMCT have also been documented with clinical improvement in response to physiotherapy (Kandler, 1990) and in patients who improve without treatment for a relapse (Sahota et al., 2005), making a specific effect of corticosteroids on neural excitability less likely.
Superficial brain stimulation in multiple sclerosis
2013, Handbook of Clinical NeurologyCitation Excerpt :In longitudinal studies changes in multimodal EP measures correlated with changes in EDSS (O’Connor et al., 1998; Fuhr et al., 2001; Jung et al., 2008; Schlaeger et al., 2012a). Serial measurements of CMCT and TST amplitude ratios thereby allowed for the detection of changes in both directions – not only worsening but also improvement – and also permitted monitoring of treatment responses to corticosteroids given as relapse treatment (Kandler et al., 1991; Salle et al., 1992; Fierro et al., 2002; Humm et al., 2006), and possibly also to interferon-β (Feuillet et al., 2007). The therapeutic response as measured by EP can even precede the clinically detectable response (Nuwer et al., 1987).
The clinical diagnostic utility of transcranial magnetic stimulation: Report of an IFCN committee
2008, Clinical NeurophysiologyCitation Excerpt :Most studies indicated a significant correlation between CMCT or TST abnormalities and clinical motor signs or motor disability (Ingram et al., 1988; Van Der Kamp et al., 1991; Britton et al., 1991; Jones et al., 1991; Facchetti et al., 1997; Kidd et al., 1998; Magistris et al., 1999). For example, prolonged CMCTs improve during a relapse treated by high-dose corticosteroids and this correlates with clinical improvement (Kandler et al., 1991a; Salle et al., 1992; La Mantia et al., 1994; Fierro et al., 2002). CMCT measures integrated into a multimodal evoked potential (EP) score revealed close correlations with the Expanded Disability Status Scale (EDSS) (Bednarik and Kadanka, 1992; O’Connor et al., 1998; Fuhr et al., 2001; Comi et al., 2001; Leocani et al., 2006).
Alteration of motor nerve recovery cycle in multiple sclerosis
2007, Clinical NeurophysiologyCitation Excerpt :Nerve excitability changes did not correlate with EDSS score or disease duration, as previously shown for nerve conduction abnormalities in MS patients (Antonini et al., 1995; Sarova-Pinhas et al., 1995; Zee et al., 1991). In contrast, MEP abnormalities, found in 55% of our patients, correlated with disability scores, as also previously shown (Fuhr et al., 2001; Ingram et al., 1988; Jones et al., 1991; Kandler et al., 1991; Schmierer et al., 2002). Nerve excitability changes, in particular regarding the supernormal period, are likely to impact clinically according to activity-dependent conduction failure rather than to rest alteration.
Use of Neurophysiologic Techniques in Clinical Trials
2005, Electrodiagnosis in Clinical Neurology: Expert Consult - Online and Print