Multifocal Noninvasive Magnetic Stimulation of the Primary Motor Cortex in Type 1 Myotonic Dystrophy –A Proof of Concept Pilot Study
| Autor: | Blessy John, Santosh A. Helekar, Jason R. Thonhoff, David B. Rosenfield, Ericka P Greene |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment 0206 medical engineering Pilot Projects Stimulation 02 engineering and technology Electromyography Proof of Concept Study 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Double-Blind Method Tibialis anterior muscle medicine Humans Myotonic Dystrophy Muscle Strength Muscle Skeletal Aged medicine.diagnostic_test business.industry Motor Cortex Magnetic resonance imaging Middle Aged Hand Magnetic Resonance Imaging Transcranial Magnetic Stimulation 020601 biomedical engineering Compound muscle action potential Transcranial magnetic stimulation Neurology Female Neurology (clinical) Primary motor cortex Trapezius muscle business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Neuromuscular Diseases. 8:963-972 |
| ISSN: | 2214-3602 2214-3599 |
| DOI: | 10.3233/jnd-210690 |
| Popis: | Background: Repeated neuromuscular electrical stimulation in type 1 Myotonic Dystrophy (DM1) has previously been shown to cause an increase in strength and a decrease in hyperexcitability of the tibialis anterior muscle. Objective: In this proof-of-principle study our objective was to test the hypothesis that noninvasive repetitive transcranial magnetic stimulation of the primary motor cortex (M1) with a new portable wearable multifocal stimulator causes improvement in muscle function in DM1 patients. Methods: We performed repetitive stimulation of M1, localized by magnetic resonance imaging, with a newly developed Transcranial Rotating Permanent Magnet Stimulator (TRPMS). Using a randomized within-patient placebo-controlled double-blind TRPMS protocol, we performed unilateral active stimulation along with contralateral sham stimulation every weekday for two weeks in 6 adults. Methods for evaluation of muscle function involved electromyography (EMG), hand dynamometry and clinical assessment using the Medical Research Council scale. Results: All participants tolerated the treatment well. While there were no significant changes clinically, EMG showed significant improvement in nerve stimulus-evoked compound muscle action potential amplitude of the first dorsal interosseous muscle and a similar but non-significant trend in the trapezius muscle, after a short exercise test, with active but not sham stimulation. Conclusions: We conclude that two-week repeated multifocal cortical stimulation with a new wearable transcranial magnetic stimulator can be safely conducted in DM1 patients to investigate potential improvement of muscle strength and activity. The results obtained, if confirmed and extended by future safety and efficacy trials with larger patient samples, could offer a potential supportive TRPMS treatment in DM1. |
| Databáze: | OpenAIRE |
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