Changes in the Cutaneous Silent Period Following Pallidal Deep Brain Stimulation in Patients with Cervical Dystonia
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Measuring Contralateral Silent Period Induced by Single-Pulse Transcranial Magnetic Stimulation to Investigate M1 Corticospinal Inhibition
Published on: August 23, 2022
Eiichirou Urasaki1, Yasushi Miyagi1
1Department of Neurosurgery, Fukuoka Mirai Hospital, Medical Co. LTA (Living Together Association), Fukuoka, Japan.
Background:
Dystonia is associated with impaired sensorimotor inhibition across distributed neural circuits; however, whether spinal inhibitory function changes following globus pallidus internus deep brain stimulation (GPi-DBS) remains unclear. This study aimed to examine perioperative changes in spinal inhibitory function in patients with cervical dystonia undergoing GPi-DBS.
Methods:
We investigated cutaneous silent period (CuSP) responses in 18 patients with cervical dystonia before and after bilateral GPi-DBS and compared them with those of 18 age- and sex-matched healthy controls.
Results:
At the early postoperative assessment during active GPi-DBS, CuSP end latency and duration were significantly increased compared with preoperative values, whereas onset latency remained unchanged. Neither preoperative nor postoperative end latency or duration differed significantly from healthy control values. Clinical severity improved after surgery; however, changes in CuSP parameters were not significantly correlated with improvements in Toronto Western Spasmodic Torticollis Rating Scale scores.
Discussion:
The significant early postoperative changes in CuSP end latency and duration suggest that the CuSP in patients with cervical dystonia is not a fixed phenomenon but may change dynamically during the early postoperative period while GPi-DBS is active, although neither preoperative nor postoperative values differed significantly from those of healthy controls.
Highlights:
CuSP duration and end latency increased at the early postoperative assessment during active GPi-DBS, suggesting that spinal inhibitory processing may change in association with perioperative modulation of the broader motor network.
