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Interrogating cortical function with transcranial magnetic stimulation: insights from neurodegenerative disease and stroke

Agarwal, S; Koch, G; Hillis, AE; Huynh, W; Ward, NS; Vucic, S; Kiernan, MC; (2018) Interrogating cortical function with transcranial magnetic stimulation: insights from neurodegenerative disease and stroke. Journal of Neurology, Neurosurgery, and Psychiatry 10.1136/jnnp-2017-317371. Green open access

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Abstract

Transcranial magnetic stimulation (TMS) is an accessible, non-invasive technique to study cortical function in vivo. TMS studies have provided important pathophysiological insights across a range of neurodegenerative disorders and enhanced our understanding of brain reorganisation after stroke. In neurodegenerative disease, TMS has provided novel insights into the function of cortical output cells and the related intracortical interneuronal networks. Characterisation of cortical hyperexcitability in amyotrophic lateral sclerosis and altered motor cortical function in frontotemporal dementia, demonstration of cholinergic deficits in Alzheimer's disease and Parkinson's disease are key examples where TMS has led to advances in understanding of disease pathophysiology and potential mechanisms of propagation, with the potential for diagnostic applications. In stroke, TMS methodology has facilitated the understanding of cortical reorganisation that underlie functional recovery. These insights are critical to the development of effective and targeted rehabilitation strategies in stroke. The present review will provide an overview of cortical function measures obtained using TMS and how such measures may provide insight into brain function. Through an improved understanding of cortical function across a range of neurodegenerative disorders, and identification of changes in neural structure and function associated with stroke that underlie clinical recovery, more targeted therapeutic approaches may now be developed in an evolving era of precision medicine.

Type: Article
Title: Interrogating cortical function with transcranial magnetic stimulation: insights from neurodegenerative disease and stroke
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/jnnp-2017-317371
Publisher version: http://dx.doi.org/10.1136/jnnp-2017-317371
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: dementia, magnetic stimulation, motor neuron disease, parkinson’s disease, stroke
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Movement Neurosciences
URI: http://discovery.ucl.ac.uk/id/eprint/10054108
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