| Chapter 1:Study of motor evoked potential in idiopathic Parkinson's disease and multiple system atrophy.ObjectiveTo investigate the difference in motor evoked potentials(MEP)between idiopathic Parkinson's disease(PD)patients with long course and newly-diagnosed idiopathic PD patients and explore its prognostic value,and evaluate the difference in MEP between patients with idiopathic PD and multiple system atrophy(MSA),explore its value of differential diagnosis.Materials and methods(1)We performed single-pulsed transcranial magnetic stimulation(s TMS)-MEP examinations in both 7 idiopathic PD patients with more than 8 years of disease course and 7 sex/age-mathed newly-diagnosed idiopathic PD patients.Both motor functions with unified Parkinson disease rating scale-3rd part(UPDRS-III)and MEP parameters were compared in the more affected side and the less affected side between groups of patients and between the two sides of each patient,and the correlation was assessed between parameters and UPDRS-III;?s TMS-MEP examinations were performed in 13 patients with MSA and 13 sex/age-matched idiopathic PD patients.MEP parameters were compared between two groups of patients.ROC curves were made to screen the parameters suitable for differential diagnosis.ResultsThe differences of motor threshold,MEP amplitude and central motor conduction time(CMCT)were not observed between long course PD and newly-diagnosed PD patients,between the more affected side and the less affected in both groups or between idiopathic PD and MSA patients(P>0.05).There was a positive correlation between CMCT and UPDRS-III(P<0.05).However,the waveform of MEP differs significantly between idiopathic PD and MSA patients(P<0.01).The MEP duration showed a trend of prolonging in MSA patients than in idiopathic PD patients(P<0.1).ConclusionsCMCT correlates with disease severity in PD patients and may be available for prognositc evaluation.Additonally,both duration and waveform of MEP may help the differential diagnosis of MSA from idiopathic PD.Chapter2:The impact of high frequency repetitive transcranial magnetic stimulation on cognitive function in amnestic mild cognitive impairment patientsObjectiveTo investigate the impact of high frequency repetitive transcranial magnetic stimulation(r TMS)on cognitive function in amnesic mild cognitive impairment(a MCI)patients.Materials and methodsTwelve a MCI patients were randomly assigned into real-stimulation group and sham-stimulation group,and then received 10 consective working days of 10 Hz high frequency r TMS over right dorsolateral prefrontal cortex(DLPFC)for 1500 stimuli each day or sham stimulation.Neuropsychological tests,automatic speech recognition software evaluation,cortical excitability and functional magnetic resonance imaging(f MRI)were performed before and after the intervention,respectively.ResultsThe language part of Addenbrooke's cognitive examination 3rd edition(ACE-III),ACE-III total score and short delay recall of Audio Verbal Learning Test improved after intervention in the real-stimulation group(P<0.05),but not significant compared to sham-stimulation group(P>0.05).The parameters of automatic speech,cortical excitability and f MRI did not change after intervention in both groups(P>0.05).ConclusionsHigh frequency r TMS over right DLPFC has a trend of improving both language and memory ability of aMCI patients. |
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