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. 2022 Jun 28;12(7):842.
doi: 10.3390/brainsci12070842.

The Lateralization of Resting Motor Threshold to Predict Medication-Mediated Improvement in Parkinson's Disease

Tomoo Mano  1   2 , Kaoru Kinugawa  1 , Shigekazu Fujimura  2 , Kazuma Sugie  1
Affiliations

The Lateralization of Resting Motor Threshold to Predict Medication-Mediated Improvement in Parkinson's Disease

Tomoo Mano et al. Brain Sci. .

Abstract

Cortical stimulation patterns in patients with Parkinson's disease (PD) are asymmetric and get altered over time. This study examined cortical neurophysiological markers for PD and identified neurophysiological markers for lateralization in PD. We used transcranial magnetic stimulation (TMS) to study corticospinal and intracortical excitability in 21 patients with idiopathic PD. We used the Movement Disorder Society Unified Parkinson's Disease Rating Scale for examination during on and off periods and evaluated inhibitory and facilitatory process markers using TMS, including resting motor thresholds (RMT), active motor thresholds, and motor evoked potential amplitude. The RMT in the more affected cortex was significantly shorter than in the less affected cortex, and was strongly correlated with improved motor function following medication. Patients in the tremor group exhibited significantly lower RMT compared to those in the akinetic-rigid group. Cortical electrophysiological laterality observed in patients with PD may be a useful marker for guiding treatment and identifying underlying compensatory mechanisms.

Keywords: Parkinson’s disease; biomarker; cortical excitability; motor threshold; resting motor thresholds.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The comparison between more affected side and less affected side. (A,C) OFF period, (B,D) ON period. The levels of the RMT in the more affected side were significantly lower than those in the less affected side in OFF state (p < 0.01). Median values are represented by a thick black horizontal line within the box, and the box represents the upper and lower quartiles. The whiskers represent the maximum and minimum values, excluding outliers, which are shown as small circles, at least 1.5 times the interquartile range.
Figure 2
Figure 2
Correlation between the transcranial magnetic stimulation parameter and the motor symptoms as per the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) part 3. (A) Resting motor thresholds (RMTs) in the more affected cortex were correlated with the MDS-UPDRS part 3 in the OFF period. (B) RMT in the less affected cortex was not correlated with the MDS-UPDRS part 3 in the OFF period. (C,D) RMT was not correlated with the MDS-UPDRS part 3 in the ON period. (E–H) Active motor thresholds (AMT) in more and less affected cortex were not correlated in the ON and OFF periods.
Figure 3
Figure 3
The relationship between the change in RMT and the motor fluctuation between ON and OFF in Parkinson’s disease. (A–C): (A), more affected cortex, (B), less affected cortex, (C) mean RMT.
See this image and copyright information in PMC

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