Obstructive Sleep Apnea Syndrome: A Preliminary Navigated Transcranial Magnetic Stimulation Study
| Autor: | Maximilian Vincent Hagelien, Benjamin Benzon, Renata Pecotić, Mario Mihalj, Maja Valić, Silvia Dužević, Angela Mastelić, Marina Zmajević Schőnwald, Zoran Đogaš, Ana Jerković, Joško Šoda, Igor Vujović, Karla Bakrač, Maja Rogić Vidaković |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Poison control Stimulation medicine.disease Transcutaneous electrical nerve stimulation law.invention Obstructive sleep apnea Transcranial magnetic stimulation 03 medical and health sciences Behavioral Neuroscience 0302 clinical medicine medicine.anatomical_structure 030228 respiratory system law Internal medicine medicine Cardiology Silent period Primary motor cortex business 030217 neurology & neurosurgery Applied Psychology Motor cortex |
| Zdroj: | Nature and Science of Sleep. 12:563-574 |
| ISSN: | 1179-1608 |
| Popis: | Purpose An increase in resting motor threshold (RMT), prolonged cortical silent period duration (CSP), and reduced short-latency afferent inhibition (SAI), confirmed with previous transcranial magnetic stimulation (TMS), suggest decreased cortical excitability in obstructive sleep apnea syndrome (OSAS). The present study included MRI of OSAS patients for navigated TMS assessment of the RMT, as an index of the threshold for corticospinal activation at rest, and SAI as an index of cholinergic neurotransmission. We hypothesize to confirm findings on SAI and RMT with adding precision in the targeting of motor cortex in OSAS. Subjects and methods After acquiring head MRIs for 17 severe right-handed OSAS and 12 healthy subjects, the motor cortex was mapped with nTMS to assess the RMT and SAI, with motor evoked potentials (MEPs) recorded from the abductor-pollicis brevis (APB) muscle. The 120%RMT intensity was used for the SAI by a paired-pulse paradigm in which the electrical stimulation to the median nerve is followed by magnetic stimulation of the motor cortex at inter-stimulus intervals (ISIs) of 18-28 ms (ISIs18-28). The SAI control condition included a recording of MEPs without peripheral stimulation. Latency and amplitude of MEP at RMT at 120%RMT for eleven different at ISIs18-28 were analyzed. Results The study showed a significantly lower percentage deviation of MEP amplitude at ISIs(18-28ms) from the control condition between OSAS and healthy subjects (U=44.0, p=0.01). The intensity of stimulation at RMT was significantly higher in OSAS subjects (U=55.0, p=0.04*). Correlation analysis showed that BMI significantly negatively correlated (ρ=-0.47) with MEP amplitude percentage deviation in OSAS patients. Conclusion The nTMS study results in increased RMT, and reduced cortical afferent inhibition in OSAS patients for SAI at ISIs18-28, confirming previous findings of impaired cortical afferent inhibition in OSAS. Future nTMS studies are desirable to elucidate the role of RMT and SAI in diagnostics and treatment of OSAS, and to elucidate the usefulness of nTMS in OSAS research. |
| Databáze: | OpenAIRE |
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