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. 2024 Sep;39(9):1523-1532.
doi: 10.1002/mds.29901. Epub 2024 Jun 24.

Mapping Motor Cortical Network Excitability and Connectivity Changes in De Novo Parkinson's Disease

Giorgio Leodori #  1   2 , Maria Ilenia De Bartolo #  2 , Claudia Piervincenzi  1 , Marco Mancuso  1 , Abhineet Ojha  1 , Matteo Costanzo  1 , Flavia Aiello  1 , Giorgio Vivacqua  3 , Giovanni Fabbrini  1   2 , Antonella Conte  1   2 , Patrizia Pantano  1   2 , Alfredo Berardelli #  1   2 , Daniele Belvisi  1   2
Affiliations

Mapping Motor Cortical Network Excitability and Connectivity Changes in De Novo Parkinson's Disease

Giorgio Leodori et al. Mov Disord. 2024 Sep.

Abstract

Background: Transcranial magnetic stimulation-electroencephalography (TMS-EEG) has demonstrated decreased excitability in the primary motor cortex (M1) and increased excitability in the pre-supplementary motor area (pre-SMA) in moderate-advanced Parkinson's disease (PD).

Objectives: The aim was to investigate whether these abnormalities are evident from the early stages of the disease, their behavioral correlates, and relationship to cortico-subcortical connections.

Methods: Twenty-eight early, drug-naive (de novo) PD patients and 28 healthy controls (HCs) underwent TMS-EEG to record TMS-evoked potentials (TEPs) from the primary motor cortex (M1) and the pre-SMA, kinematic recording of finger-tapping movements, and a 3T-MRI (magnetic resonance imaging) scan to obtain diffusion tensor imaging (DTI) reconstruction of white matter (WM) tracts connecting M1 to the ventral lateral anterior thalamic nucleus and pre-SMA to the anterior putamen.

Results: We found reduced M1 TEP P30 amplitude in de novo PD patients compared to HCs and similar pre-SMA TEP N40 amplitude between groups. PD patients exhibited smaller amplitude and slower velocity in finger-tapping movements and altered structural integrity in WM tracts of interest, although these changes did not correlate with TEPs.

Conclusions: M1 hypoexcitability is a characteristic of PD from early phases and may be a marker of the parkinsonian state. Pre-SMA hyperexcitability is not evident in early PD and possibly emerges at later stages of the disease. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Keywords: Parkinson's disease; diffusion tensor imaging; motor area; motor cortex; pre‐supplementary; transcranial magnetic stimulation‐electroencephalography.

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References

    1. Wichmann T. Changing views of the pathophysiology of parkinsonism. Mov Disord 2019;34(8):1130–1143.
    1. Underwood CF, Parr‐Brownlie LC. Primary motor cortex in Parkinson's disease: functional changes and opportunities for neurostimulation. Neurobiol Dis 2021;147:105159.
    1. Wichmann T, DeLong MR. Functional neuroanatomy of the basal ganglia in Parkinson's disease. Adv Neurol 2003;91:9–18.
    1. Berardelli A, Rothwell JC, Thompson PD, Hallett M. Pathophysiology of bradykinesia in Parkinson's disease. Brain 2001;124(Pt 11):2131–2146.
    1. Pasquereau B, DeLong MR, Turner RS. Primary motor cortex of the parkinsonian monkey: altered encoding of active movement. Brain 2016;139(Pt 1):127–143.

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