METHODS: Cortical SDTC and rheobase were estimated from 17 ALS patients using a controllable pulse parameter transcranial magnetic stimulation (cTMS) device. Resting motor thresholds (RMTs) were determined at pulse widths (PW) of 30, 45, 60, 90 and 120 µs and M-ratio of 0.1, using a figure-of-eight coil applied to the primary motor cortex.
RESULTS: SDTC was significantly reduced in ALS patients (150.58 ± 9.98 µs; controls 205.94 ± 13.7 µs, P < 0.01). The reduced SDTC correlated with a rate of disease progression (Rho = -0.440, P < 0.05), ALS functional rating score (ALSFRS-R) score (Rho = 0.446, P < 0.05), and disease duration (R = 0.428, P < 0.05). The degree of change in SDTC was greater in patients with cognitive abnormalities as manifested by an abnormal total Edinburgh Cognitive ALS Screen score (140.5 ± 28.7 µs, P < 0.001) and ALS-specific subscore (141.7 ± 33.2 µs, P = 0.003).
CONCLUSIONS: Cortical SDTC reduction was associated with a more aggressive ALS phenotype, or with more prominent cognitive impairment.
CONCLUSIONS: An increase in transient Na+ conductances may account for the reduction in SDTC, linked to the pathogenesis of ALS.
方法:使用可控的脉冲参数经颅磁刺激(cTMS)装置从17名ALS患者中估算皮质SDTC和流变酶。在30、45、60、90和120µs的脉冲宽度(PW)和0.1的M比率下,使用应用于初级运动皮层的8字形线圈确定静息运动阈值(RMT)。
结果:ALS患者的SDTC显着降低(150.58±9.98µs;对照组205.94±13.7µs,P<0.01)。SDTC降低与疾病进展率相关(Rho=-0.440,P<0.05),ALS功能评分(ALSFRS-R)评分(Rho=0.446,P<0.05),病程(R=0.428,P<0.05)。在患有认知异常的患者中,SDTC的变化程度更大,表现为总爱丁堡认知ALSScreen评分异常(140.5±28.7µs,P<0.001)和ALS特异性子评分(141.7±33.2µs,P=0.003)。
结论:皮质SDTC降低与更具侵袭性的ALS表型相关,或更明显的认知障碍。
结论:瞬时Na+电导的增加可能是SDTC降低的原因,与ALS的发病机制有关。