Altered response to repetitive transcranial magnetic stimulation in patients with chronic primary insomnia

Raffaele Nardone; Stefan Golaszewski; Vanessa Frey; Francesco Brigo; Viviana Versace; Luca Sebastianelli; Leopold Saltuari; Yvonne Höller

doi:10.1016/j.sleep.2020.03.030

Altered response to repetitive transcranial magnetic stimulation in patients with chronic primary insomnia

Raffaele Nardone^*, Stefan Golaszewski, Vanessa Frey, Francesco Brigo, Viviana Versace, Luca Sebastianelli, Leopold Saltuari, Yvonne Höller

^*Corresponding author for this work

School of Humanities and Social Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

Background: We aimed at evaluating the amplitude changes of the motor evoked potentials (MEPs) induced by of low-frequency (LF) repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex (M1) in10 patients with primary insomnia (PI) and in 10 age-matched healthy controls. Methods: Median peak-to-peak MEP amplitudes were assessed in all subjects at three times: at baseline (T₀), after the first train of a single rTMS session (T₁), and after the whole rTMS procedure (T₂). This consists of 20 trains of 1 Hz stimulation with 50 stimuli per train and an intertrain interval of 30 s. Results: Resting motor threshold (RMT) and MEPs amplitude did not differ between the two groups at T₀. A reduction of MEP size was observed at both T₁ and T₂ in all subjects, but this was significantly less pronounced in patients than in control subjects. Conclusions: The lack of MEP inhibition reflects an altered response to LF rTMS in patients with PI. These rTMS findings are indicative of an altered cortical plasticity in inhibitory circuits within M1 in PI. Subjects with PI exhibited an impairment of the LTD-like mechanisms induced by inhibitory rTMS, thus providing further support to the involvement of GABA neurotransmission in the pathophysiology of PI.

Original language	English
Pages (from-to)	126-129
Number of pages	4
Journal	Sleep Medicine
Volume	72
DOIs	https://doi.org/10.1016/j.sleep.2020.03.030
Publication status	Published - Aug 2020

Bibliographical note

Publisher Copyright:
© 2020 Elsevier B.V.

Other keywords

GABA
Motor evoked potentials
Primary insomnia
Repetitive transcranial magnetic stimulation

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10.1016/j.sleep.2020.03.030

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title = "Altered response to repetitive transcranial magnetic stimulation in patients with chronic primary insomnia",

abstract = "Background: We aimed at evaluating the amplitude changes of the motor evoked potentials (MEPs) induced by of low-frequency (LF) repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex (M1) in10 patients with primary insomnia (PI) and in 10 age-matched healthy controls. Methods: Median peak-to-peak MEP amplitudes were assessed in all subjects at three times: at baseline (T0), after the first train of a single rTMS session (T1), and after the whole rTMS procedure (T2). This consists of 20 trains of 1 Hz stimulation with 50 stimuli per train and an intertrain interval of 30 s. Results: Resting motor threshold (RMT) and MEPs amplitude did not differ between the two groups at T0. A reduction of MEP size was observed at both T1 and T2 in all subjects, but this was significantly less pronounced in patients than in control subjects. Conclusions: The lack of MEP inhibition reflects an altered response to LF rTMS in patients with PI. These rTMS findings are indicative of an altered cortical plasticity in inhibitory circuits within M1 in PI. Subjects with PI exhibited an impairment of the LTD-like mechanisms induced by inhibitory rTMS, thus providing further support to the involvement of GABA neurotransmission in the pathophysiology of PI.",

keywords = "GABA, Motor evoked potentials, Primary insomnia, Repetitive transcranial magnetic stimulation",

author = "Raffaele Nardone and Stefan Golaszewski and Vanessa Frey and Francesco Brigo and Viviana Versace and Luca Sebastianelli and Leopold Saltuari and Yvonne H{\"o}ller",

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year = "2020",

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doi = "10.1016/j.sleep.2020.03.030",

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AU - Nardone, Raffaele

AU - Golaszewski, Stefan

AU - Frey, Vanessa

AU - Brigo, Francesco

AU - Versace, Viviana

AU - Sebastianelli, Luca

AU - Saltuari, Leopold

AU - Höller, Yvonne

PY - 2020/8

Y1 - 2020/8

N2 - Background: We aimed at evaluating the amplitude changes of the motor evoked potentials (MEPs) induced by of low-frequency (LF) repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex (M1) in10 patients with primary insomnia (PI) and in 10 age-matched healthy controls. Methods: Median peak-to-peak MEP amplitudes were assessed in all subjects at three times: at baseline (T0), after the first train of a single rTMS session (T1), and after the whole rTMS procedure (T2). This consists of 20 trains of 1 Hz stimulation with 50 stimuli per train and an intertrain interval of 30 s. Results: Resting motor threshold (RMT) and MEPs amplitude did not differ between the two groups at T0. A reduction of MEP size was observed at both T1 and T2 in all subjects, but this was significantly less pronounced in patients than in control subjects. Conclusions: The lack of MEP inhibition reflects an altered response to LF rTMS in patients with PI. These rTMS findings are indicative of an altered cortical plasticity in inhibitory circuits within M1 in PI. Subjects with PI exhibited an impairment of the LTD-like mechanisms induced by inhibitory rTMS, thus providing further support to the involvement of GABA neurotransmission in the pathophysiology of PI.

AB - Background: We aimed at evaluating the amplitude changes of the motor evoked potentials (MEPs) induced by of low-frequency (LF) repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex (M1) in10 patients with primary insomnia (PI) and in 10 age-matched healthy controls. Methods: Median peak-to-peak MEP amplitudes were assessed in all subjects at three times: at baseline (T0), after the first train of a single rTMS session (T1), and after the whole rTMS procedure (T2). This consists of 20 trains of 1 Hz stimulation with 50 stimuli per train and an intertrain interval of 30 s. Results: Resting motor threshold (RMT) and MEPs amplitude did not differ between the two groups at T0. A reduction of MEP size was observed at both T1 and T2 in all subjects, but this was significantly less pronounced in patients than in control subjects. Conclusions: The lack of MEP inhibition reflects an altered response to LF rTMS in patients with PI. These rTMS findings are indicative of an altered cortical plasticity in inhibitory circuits within M1 in PI. Subjects with PI exhibited an impairment of the LTD-like mechanisms induced by inhibitory rTMS, thus providing further support to the involvement of GABA neurotransmission in the pathophysiology of PI.

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ER -

Altered response to repetitive transcranial magnetic stimulation in patients with chronic primary insomnia

Abstract

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Other keywords

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