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Intracortical Inhibition Within the Primary Motor Cortex Can Be Modulated by Changing the Focus of Attention
Published on: September 11, 2017
Motor cortex disinhibition in normal-pressure hydrocephalus
Andrei V Chistyakov1, Hava Hafner, Alon Sinai
1Department of Neurosurgery, Rambam Health Care Campus, and B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. a_chistyakov@rambam.health.gov.il
Idiopathic normal-pressure hydrocephalus (iNPH) reduces motor cortex inhibition, impacting gait. Shunt surgery can restore this excitability and improve patient mobility, suggesting motor control deficits cause gait issues.
Area of Science:
- Neuroscience
- Neurology
- Motor Control
Background:
- Frontal lobe dysfunction and gait disturbance are linked in idiopathic normal-pressure hydrocephalus (iNPH).
- Corticospinal excitability modulation may underlie these impairments.
Purpose of the Study:
- To investigate if iNPH affects corticospinal excitability.
- To assess changes in corticospinal excitability post-ventricular shunt surgery and their relation to clinical outcomes.
Main Methods:
- Transcranial magnetic stimulation (TMS) assessed corticospinal excitability in 23 iNPH patients before and after shunt surgery.
- Compared iNPH patients with healthy volunteers and peripheral neuropathy patients.
Main Results:
- iNPH patients showed reduced short intracortical inhibition (SICI) and resting motor threshold (rMT) at baseline.
- Shunt surgery increased SICI and rMT in patients with significant clinical improvement.
Conclusions:
- iNPH causes motor cortex disinhibition, affecting corticospinal excitability.
- Improved excitability after shunt surgery correlates with better clinical outcomes in iNPH patients.
- Gait disturbances in iNPH are likely due to reduced motor output control.
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