Ann Rehabil Med.  2016 Feb;40(1):81-87. 10.5535/arm.2016.40.1.81.

Usefulness of Transcranial Magnetic Stimulation to Assess Motor Function in Patients With Parkinsonism

• Park J
• Chang WH
• Cho JW
• Youn J
• Kim YK
• Kim SW
• Kim YH

• KMID: 2155169
• DOI: http://doi.org/10.5535/arm.2016.40.1.81

Abstract

OBJECTIVE
To investigate the clinical significance of upper and lower extremity transcranial magnetic stimulation (TMS)-induced motor evoked potentials (MEPs) in patients with parkinsonism.
METHODS
Twenty patients (14 men, 6 women; mean age 70.5±9.1 years) suffering from parkinsonism were included in this study. All participants underwent single-pulse TMS session to assess the corticospinal excitability of the upper and lower extremity motor cortex. The resting motor threshold (RMT) was defined as the lowest stimulus intensity able to evoke MEPs of an at least 50 µV peak-to-peak amplitude in 5 of 10 consecutive trials. Five sweeps of MEPs at 120% of the RMT were performed, and the mean amplitude and latency of the MEPs were calculated. Patients were also assessed using the Unified Parkinson's Disease Rating Scale part III (UPDRS-III) and the 5-meter Timed Up and Go (5m-TUG) test.
RESULTS
There was a significant positive correlation between the RMTs of MEPs in the upper and lower extremities (r=0.612, p=0.004) and between the amplitude of MEPs in the upper and lower extremities (r=0.579, p=0.007). The RMT of upper extremity MEPs showed a significant negative relationship with the UPDRS-III score (r=-0.516, p=0.020). In addition, RMTs of lower extremity MEPs exhibited a negative relationship with the UPDRS-III score, but the association was not statistically significant (r=-406, p=0.075).
CONCLUSION
These results indicated that the RMT of MEPs reflect the severity of motor dysfunction in patients with parkinsonism. MEP is a potential quantitative, electrodiagnostic method to assess motor function in patients with parkinsonism.

Keyword

Transcranial magnetic stimulation; Motor evoked potentials; Parkinsonian disorders; Motor disorders

MeSH Terms

Evoked Potentials, Motor
Female
Humans
Lower Extremity
Male
Motor Cortex
Parkinson Disease
Parkinsonian Disorders*
Transcranial Magnetic Stimulation*
Upper Extremity

Figure

• 

  Fig. 1 Correlations between motor evoked potentials (MEPs) in upper and lower extremities. (A) Resting motor threshold and (B) amplitude.

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