Format

Send to

Choose Destination
J Neural Transm (Vienna). 2017 Oct;124(10):1161-1170. doi: 10.1007/s00702-017-1756-1. Epub 2017 Jul 8.

Inhibitory rTMS applied on somatosensory cortex in Wilson's disease patients with hand dystonia.

Author information

1
Service de Physiologie Clinique-Explorations Fonctionnelles, AP-HP, Hôpital Lariboisière, 2, rue Ambroise Paré, 75010, Paris, France.
2
Université Paris Diderot, Sorbonne Paris Cité, 75475, Paris, France.
3
INSERM UMR965, 75475, Paris, France.
4
Service de Neurologie, AP-HP, Hôpital Lariboisière, Paris, France.
5
Centre de référence national de la maladie de Wilson, Hôpital Lariboisière, Paris, France.
6
Unité de Recherche Clinique, AP-HP, Hôpital Lariboisière, Paris, France.
7
Service de Neuroradiologie, AP-HP, Hôpital Lariboisière, Paris, France.
8
Service de Physiologie Clinique-Explorations Fonctionnelles, AP-HP, Hôpital Lariboisière, 2, rue Ambroise Paré, 75010, Paris, France. nathalie.kubis@aphp.fr.
9
Université Paris Diderot, Sorbonne Paris Cité, 75475, Paris, France. nathalie.kubis@aphp.fr.
10
INSERM UMR965, 75475, Paris, France. nathalie.kubis@aphp.fr.

Abstract

Hand dystonia is a common complication of Wilson's disease (WD), responsible for handwriting difficulties and disability. Alteration of sensorimotor integration and overactivity of the somatosensory cortex have been demonstrated in dystonia. This study investigated the immediate after effect of an inhibitory repetitive transcranial magnetic stimulation (rTMS) applied over the somatosensory cortex on the writing function in WD patients with hand dystonia. We performed a pilot prospective randomized double-blind sham-controlled crossover rTMS study. A 20-min 1-Hz rTMS session, stereotaxically guided, was applied over the left somatosensory cortex in 13 WD patients with right dystonic writer's cramp. After 3 days, each patient was crossed-over to the alternative treatment. Patients were clinically evaluated before and immediately after each rTMS session with the Unified Wilson's Disease rating scale (UWDRS), the Writers' Cramp Rating Scale (WCRS), a specifically designed scale for handwriting difficulties in Wilson's disease patients (FAR, flow, accuracy, and rhythmicity evaluation), and a visual analog scale (VAS) for handwriting discomfort. No significant change in UWDRS, WCRS, VAS, or FAR scores was observed in patients treated with somatosensory inhibitory rTMS compared to the sham protocol. The FAR negatively correlated with UWDRS (r = -0.6; P = 0.02), but not with the WCRS score, disease duration, MRI diffusion lesions, or with atrophy scores. In our experimental conditions, a single inhibitory rTMS session applied over somatosensory cortex did not improve dystonic writer cramp in WD patients.

KEYWORDS:

Dystonia; Plasticity; Somatosensory cortex; Wilson’s disease; rTMS

PMID:
28689295
DOI:
10.1007/s00702-017-1756-1
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center