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      Multiple measures of corticospinal excitability are associated with clinical features of multiple sclerosis

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          Abstract

          In individuals with multiple sclerosis (MS), transcranial magnetic stimulation (TMS) may be employed to assess the integrity of corticospinal system and provides a potential surrogate biomarker of disability. The purpose of this study was to provide a comprehensive examination of the relationship between multiple measures corticospinal excitability and clinical disability in MS (expanded disability status scale (EDSS)). Bilateral corticospinal excitability was assessed using motor evoked potential (MEP) input–output (IO) curves, cortical silent period (CSP), short-interval intracortical inhibition (SICI), intracortical facilitation (ICF) and transcallosal inhibition (TCI) in 26 individuals with MS and 11 healthy controls. Measures of corticospinal excitability were compared between individuals with MS and controls. We evaluated the relationship(s) between age and clinical demographics such as age at MS onset (AO), disease duration (DD) and clinical disability (EDSS) with measures of corticospinal excitability. Corticospinal excitability thresholds were higher, MEP latency and CSP onset delayed and MEP durations prolonged in individuals with MS compared to controls. Age, DD and EDSS correlated with corticospinal excitability thresholds. Also, TCI duration and the linear slope of the MEP amplitude IO curve correlated with EDSS. Hierarchical regression modeling demonstrated that combining multiple TMS-based measures of corticospinal excitability accounted for unique variance in clinical disability (EDSS) beyond that of clinical demographics (AO, DD). Our results indicate that multiple TMS-based measures of corticospinal and interhemispheric excitability provide insights into the potential neural mechanisms associated with clinical disability in MS. These findings may aid in the clinical evaluation, disease monitoring and prediction of disability in MS.

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          Author and article information

          Journal
          8004872
          1436
          Behav Brain Res
          Behav. Brain Res.
          Behavioural brain research
          0166-4328
          1872-7549
          2 June 2016
          20 October 2015
          15 January 2016
          15 January 2017
          : 297
          : 187-195
          Affiliations
          [a ]Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
          [b ]Division of Physical Therapy, Department of Rehabilitation Medicine, School of Medicine, Emory University, Atlanta, GA, USA
          [c ]Department of Radiology, The University of British Columbia, Vancouver, BC, Canada
          [d ]Department of Pathology & Laboratory Medicine, The University of British Columbia, Vancouver, BC, Canada
          [e ]Division of Neurology, Department of Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
          [f ]Department of Physics & Astronomy, The University of British Columbia, Vancouver, BC, Canada
          Author notes
          [* ]Corresponding author at: Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Department of Physical Therapy, 212-2177 Westbrook Mall, Vancouver, BC V6T 1Z3, Canada. Fax: +1 604 822 1870. jason.neva@ 123456ubc.ca (J.L. Neva)
          Article
          PMC4904787 PMC4904787 4904787 nihpa791243
          10.1016/j.bbr.2015.10.015
          4904787
          26467603
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