Transcranial Magnetic Stimulation for the Assessment of Neurodegenerative Disease
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- 作者：Steve Vucic ; Matthew C. Kiernan
- 关键词：Amyotrophic lateral sclerosis ; frontotemporal dementia ; neurodegeneration ; short interval intracortical inhibition ; transcranial magnetic stimulation
- 刊名：Neurotherapeutics
- 出版年：2017
- 出版时间：January 2017
- 年：2017
- 卷：14
- 期：1
- 页码：91-106
- 全文大小：
- 刊物主题：Neurosciences; Neurology; Neurosurgery; Neurobiology;
- 出版者：Springer US
- ISSN：1878-7479
- 卷排序：14
文摘
Transcranial magnetic stimulation (TMS) is a noninvasive technique that has provided important information about cortical function across an array of neurodegenerative disorders, including Alzheimer’s disease, frontotemporal dementia, Parkinson’s disease, and related extrapyramidal disorders. Application of TMS techniques in neurodegenerative diseases has provided important pathophysiological insights, leading to the development of pathogenic and diagnostic biomarkers that could be used in the clinical setting and therapeutic trials. Abnormalities of TMS outcome measures heralding cortical hyperexcitability, as evidenced by a reduction of short-interval intracortical inhibition and increased in motor-evoked potential amplitude, have been consistently identified as early and intrinsic features of amyotrophic lateral sclerosis (ALS), preceding and correlating with the ensuing neurodegeneration. Cortical hyperexcitability appears to form the pathogenic basis of ALS, mediated by trans-synaptic glutamate-mediated excitotoxic mechanisms. As a consequence of these research findings, TMS has been developed as a potential diagnostic biomarker, capable of identifying upper motor neuronal pathology, at earlier stages of the disease process, and thereby aiding in ALS diagnosis. Of further relevance, marked TMS abnormalities have been reported in other neurodegenerative diseases, which have varied from findings in ALS. With time and greater utilization by clinicians, TMS outcome measures may prove to be of utility in future therapeutic trial settings across the neurodegenerative disease spectrum, including the monitoring of neuroprotective, stem-cell, and genetic-based strategies, thereby enabling assessment of biological effectiveness at early stages of drug development.