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Modulation of the Disturbed Motor Network in Dystonia by Multisession Suppression of Premotor Cortex

Huang, Y-Z; Lu, C-S; Rothwell, JC; Lo, C-C; Chuang, W-L; Weng, Y-H; Lai, S-C; (2012) Modulation of the Disturbed Motor Network in Dystonia by Multisession Suppression of Premotor Cortex. PLOS ONE , 7 (10) , Article e47574. 10.1371/journal.pone.0047574. Green open access

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Abstract

Daily sessions of therapeutic transcranial brain stimulation are thought to prolong or amplify the effect of a single intervention. Here we show in patients with focal hand dystonia that additional, new effects build up progressively over time, making it difficult to predict the effect of long term interventions from shorter treatment sessions. In a sham-controlled study, real or sham continuous theta burst stimulation (cTBS) was given once daily for five consecutive days to dorsolateral premotor cortex (PMd). Five days of real, but not sham, premotor cTBS improved intracortical inhibition in primary motor cortex (M1) to a similar extent on day 1 and day 5. However 5 days of cTBS were required to restore the abnormal PMd-M1 interactions observed on day 1. Similarly, excessive M1 plasticity seen at baseline was also significantly reduced by five days of real premotor cTBS. There was only a marginal benefit on writing. The results show that additional, new effects, at sites distant from the point of stimulation, build up progressively over time, making it difficult to predict the effect of long term interventions from shorter treatment sessions. The results indicate that it may take many days of therapeutic intervention to rebalance activity in a complex network.

Type: Article
Title: Modulation of the Disturbed Motor Network in Dystonia by Multisession Suppression of Premotor Cortex
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.pone.0047574
Publisher version: http://dx.doi.org/10.1371/journal.pone.0047574
Language: English
Additional information: © Huang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. This work was supported by the National Science Council (NSC 100-2314-B-182A-001-MY2, http://web1.nsc.gov.tw/mp.aspx?mp=7); the National Health Research Institutes of Taiwan (NHRI-EX99-9913EC, http://english.nhri.org.tw/NHRI_WEB/nhri​w001Action.do); Chang Gung Memorial Hospital (CMRPG381281, http://www.cgmh.org.tw/eng2002/index.asp); the Royal Society of the UK (UK-Taiwan Joint Project Grant, http://royalsociety.org/); and the European Union grant REPLACES: Restorative Plasticity At Corticostriatal Excitatory Synapses: an FP7 Collaborative Project (222918, http://www.replaces-pd.org/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
UCL classification: UCL
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: https://discovery.ucl.ac.uk/id/eprint/1384021
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