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06.05.2024 | Original Communication

Motor function in multiple sclerosis assessed by navigated transcranial magnetic stimulation mapping

verfasst von: Benjamin Bardel, Alain Créange, Nathalie Bonardet, Blanche Bapst, Mickael Zedet, Abir Wahab, Samar S. Ayache, Jean-Pascal Lefaucheur

Erschienen in: Journal of Neurology

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Abstract

Introduction

Impaired motor function is a major cause of disability in multiple sclerosis (MS), involving various neuroplasticity processes typically assessed by neuroimaging. This study aimed to determine whether navigated transcranial magnetic stimulation (nTMS) could also provide biomarkers of motor cortex plasticity in patients with MS (pwMS).

Methods

nTMS motor mapping was performed for hand and leg muscles bilaterally. nTMS variables included the amplitude and latency of motor evoked potentials (MEPs), corticospinal excitability measures, and the size of cortical motor maps (CMMs). Clinical assessment included disability (Expanded Disability Status Scale, EDSS), strength (MRC scale, pinch and grip), and dexterity (9-hole Pegboard Test).

Results

nTMS motor mapping was performed in 68 pwMS. PwMS with high disability (EDSS ≥ 3) had enlarged CMMs with less dense distribution of MEPs and various MEP parameter changes compared to pwMS with low disability (EDSS < 3). Patients with progressive MS had also various MEP parameter changes compared to pwMS with relapsing remitting form. MRC score correlated positively with MEP amplitude and negatively with MEP latency, pinch strength correlated negatively with CMM volume and dexterity with MEP latency.

Conclusions

This is the first study to perform 4-limb cortical motor mapping in pwMS using a dedicated nTMS procedure. By quantifying the cortical surface representation of a given muscle and the variability of MEP within this representation, nTMS can provide new biomarkers of motor function impairment in pwMS. Our study opens perspectives for the use of nTMS as an objective method for assessing pwMS disability in clinical practice.

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Titel: Motor function in multiple sclerosis assessed by navigated transcranial magnetic stimulation mapping
verfasst von: Benjamin Bardel
Alain Créange
Nathalie Bonardet
Blanche Bapst
Mickael Zedet
Abir Wahab
Samar S. Ayache
Jean-Pascal Lefaucheur
Publikationsdatum: 06.05.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Neurology
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-024-12398-x

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