Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
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Randomized Controlled Trial Comparative Study Controlled Clinical Trial
Slow (1 Hz) repetitive transcranial magnetic stimulation (rTMS) induces a sustained change in cortical excitability in patients with Parkinson's disease.
Low-frequency (< or =1 Hz) rTMS (LF-rTMS) can reduce excitability in the underlying cortex and/or promote inhibition. In patients with Parkinson's disease (PD) several TMS elicited features of motor corticospinal physiology suggest presence of impaired inhibitory mechanisms. These include shortened silent period (SP) and slightly steeper input-output (I-O) curve of motor evoked potential (MEP) size than in normal controls. However, studies of LF-rTMS effects on inhibitory mechanisms in PD are scarce. In this companion paper to the clinical paper describing effects of four consecutive days of LF-rTMS on dyskinesia in PD (Filipović et al., 2009), we evaluate the delayed (24h) effects of the LF-rTMS treatment on physiological measures of excitability of the motor cortex in the same patients. There are very few studies of physiological follow up of daily rTMS treatments. ⋯ The results confirm the existence of a residual after-effect of consecutive daily applications of rTMS that might be relevant to the clinical effect that was observed in this group of patients and could be further exploited for potential therapeutic uses.
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Randomized Controlled Trial Comparative Study
A new clinical scale to grade the impairment of median nerve in carpal tunnel syndrome.
In carpal tunnel syndrome (CTS) distribution of paresthesias is related to the degree of the nerve impairment. To improve the clinical ability in detecting the damage severity, we have introduced the criteria "distribution of paresthesias" in a previous clinical scale: the historical-objective scale (Hi-Ob). ⋯ The new scale may be useful in routine examination and for scientific purposes.