Source:Sleep Medicine
Author(s): Giuseppe Lanza, Bartolo Lanuzza, Debora Aricò, Mariagiovanna Cantone, Filomena Irene Ilaria Cosentino, Rita Bella, Giovanni Pennisi, Raffaele Ferri, Manuela Pennisi
BackgroundPrevious studies showed an impairment of the LTP-like plasticity to TMS in Restless Legs Syndrome (RLS). Clinically, repetitive TMS (rTMS) was effective in alleviating the sensory-motor complaints of patients, although the effects induced by low-frequency (inhibitory) rTMS have not been investigated yet. An impaired LTD-like mechanism of cortical plasticity has been hypothesized, which we have directly assessed in this pilot study.MethodsMotor evoked potentials (MEPs) from the right first dorsal interosseus muscle were recorded at the stimulus intensity of 110% of the resting motor threshold (rMT) from 13 right-handed patients and 10 age-matched right-handed healthy controls. Median peak-to-peak amplitudes were calculated in all participants at baseline (T0), after the first train of a single evening session of low-frequency (1 Hz) rTMS over the left primary motor cortex (T1), and after the whole rTMS procedure (T2), which consists of 20 trains with 50 stimuli per train and intertrain interval of 30 s (1,000 stimuli in total).ResultsNo differences were found for rMT and MEPs size between the two groups at T0. Smaller MEPs amplitudes both at T1 and T2 were observed in all subjects, although this was significantly more pronounced in controls than in patients.Conclusionscompared to normal individuals, patients exhibited an impairment of the LTD-like mechanisms induced by inhibitory rTMS, adding support to the involvement of GABA in RLS pathophysiology. Although future studies with a larger population are needed, TMS is confirmed to be effetive in non-invasively probing of the neurophysiology and neurochemistry of RLS.
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