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Magnetic brain stimulation: central motor conduction studies in multiple sclerosis.
C W Hess1, K R Mills, N M Murray
1Department of Clinical Neurophysiology, National Hospital, London, United Kingdom.
Annals of Neurology
|December 1, 1987
Summary
Central motor conduction (CMC) testing effectively identifies central nervous system lesions in multiple sclerosis (MS) patients. This method is valuable for diagnosing motor pathway damage, particularly when clinical signs are unclear.
Area of Science:
- Neuroscience
- Neurology
- Clinical Neurophysiology
Background:
- Multiple sclerosis (MS) is a demyelinating disease affecting the central nervous system.
- Assessing central motor pathway integrity is crucial for MS diagnosis and management.
- Traditional methods like evoked potentials may not always detect subtle motor pathway lesions.
Purpose of the Study:
- To evaluate the utility of central motor conduction (CMC) time measurements in diagnosing multiple sclerosis.
- To correlate CMC abnormalities with clinical findings and other evoked potential data in MS patients.
Main Methods:
- Central motor conduction (CMC) time was measured in 32 healthy controls and 83 MS patients.
- Stimulation involved magnetic cortical and electrical C-7/T-1 interspace.
- Responses were recorded from the abductor digiti minimi muscle.
Main Results:
- Central motor conduction (CMC) was abnormal in 72% of multiple sclerosis patients.
- Abnormal CMC correlated significantly with brisk finger flexor jerks (p < 0.005).
- CMC abnormalities were detected even in MS patients with normal muscle strength (54%) and normal neurological exams (7 arms).
Conclusions:
- Central motor conduction (CMC) testing is a sensitive method for detecting central motor pathway lesions in multiple sclerosis.
- CMC is particularly useful when evoked potentials are normal or clinical signs are equivocal.
- This technique aids in documenting subclinical motor pathway involvement in MS.