Motor cortex plasticity can indicate vulnerability to motor fluctuation and high L-DOPA need in drug-naïve Parkinson's disease.
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Date
2016-12
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Parkinsonism Relat Disord.
Abstract
Introduction: Motor cortex plasticity is reported to be decreased in Parkinson's disease in studies which
pooled patients in various stages of the disease. Whether the early decrease in plasticity is related to the
motor signs or is linked to the future development of motor complications of treatment is unclear. The
aim of the study was to test if motor cortex plasticity and its cerebellar modulation are impaired in
treatment-naïve Parkinson's disease, are related to the motor signs of the disease and predict occurrence
of motor complications of treatment.
Methods: Twenty-nine denovo patients with Parkinson's disease were longitudinally assessed for motor
complications for four years. Using transcranial magnetic stimulation, the plasticity of the motor cortex
and its cerebellar modulation were measured (response to paired-associative stimulation alone or preceded
by 2 active cerebellar stimulation protocols), both in the untreated state and after a single dose of
L-DOPA. Twenty-six matched, healthy volunteers were tested, only without L-DOPA.
Results: Patients and healthy controls had similar proportions of responders and non-responders to
plasticity induction. In the untreated state, the more efficient was the cerebellar modulation of motor
cortex plasticity, the lower were the bradykinesia and rigidity scores. The extent of the individual plastic
response to paired associative stimulation could indicate a vulnerability to develop early motor fluctuation
but not dyskinesia.
Conclusions: Measuring motor cortex plasticity in denovo Parkinson's disease could be a neurophysiological
parameter that may help identify patients with greater propensity for early motor fluctuations.
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Citation
A. Kishore, et al., Motor cortex plasticity can indicate vulnerability to motor fluctuation and high L-DOPA need in drug-naïve Parkinson's disease, Parkinsonism and Related Disorders (2016), http://dx.doi.org/10.1016/j.parkreldis.2016.12.005