Valeur pronostique des décréments mesurés lors de la stimulation nerveuse répétitive chez des patients souffrant de sclérose latérale amyotrophique

Conference (2002)

Changes in motor unit numbers in patients with ALS: a longitudinal study using the adapted multiple point stimulation method.

in Amyotrophic Lateral Sclerosis & Other Motor Neuron Disorders (2002), 3(1), 31-8

METHOD: The adapted multiple point stimulation (AMPS) method for calculating motor unit numbers (MUNE) was applied in 12 patients with amyotrophic lateral sclerosis (ALS) before riluzole therapy (T(0 ... [more ▼]

METHOD: The adapted multiple point stimulation (AMPS) method for calculating motor unit numbers (MUNE) was applied in 12 patients with amyotrophic lateral sclerosis (ALS) before riluzole therapy (T(0)) and again after 4, 8 and 12 months of treatment. RESULTS: Paired Student's t-test indicated a significant decrease of thenar MUNE and compound muscle action potential (CMAP) size at each 4-monthly interval, while average surface motor unit potential (SMUP) size did not change significantly over time. The rate of motor unit (MU) loss at month 4 was more than 20% in six patients (group 1) and less than 20% in six other patients (group 2). Comparison of groups 1 and 2 by Mann-Whitney U-testing indicated that percent changes in thenar MUNE and CMAP size compared to baseline were significantly different at months 4, 8 and 12, while no difference between the two groups was found for average SMUP size variations. In the group with a slow rate of MU loss, CMAP size remained stable, while in the group with a rapid rate of MU loss, there was a dramatic reduction in size of the CMAP. A positive correlation was found between percent change in thenar MUNE at T(4) and at T(12) (P < 0.001). CONCLUSION: AMPS is a useful technique to document MUNE, SMUP size and CMAP size changes over time in patients with ALS. [less ▲]

Reduced excitability of the motor cortex in untreated patients with de novo idiopathic “grand mal” seizures

in Journal of Neurology, Neurosurgery & Psychiatry (2001), 71(6), 772-776

OBJECTIVES: Transcranial magnetic stimulation (TMS) was used to investigate motor cortex excitability, intracortical excitatory, and inhibitory pathways in 18 patients having experienced a first "grand ... [more ▼]

OBJECTIVES: Transcranial magnetic stimulation (TMS) was used to investigate motor cortex excitability, intracortical excitatory, and inhibitory pathways in 18 patients having experienced a first "grand mal" seizure within 48 hours of the electrophysiological test. All had normal brain MRI, and were free of any treatment, drug, or alcohol misuse. Results were compared with those of 35 age matched normal volunteers. METHODS: The following parameters of responses to TMS were measured: motor thresholds at rest and with voluntary contraction, amplitudes of responses, cortical silent periods, and responses to paired pulse stimulation with interstimulus intervals of 1 to 20 ms. RESULTS: In patients, there were significantly increased motor thresholds with normal amplitudes of motor evoked potentials (MEPs), suggesting decreased cortical excitability. Cortical silent periods were not significantly different from those of normal subjects. Paired TMS with short interstimulus intervals (1-5 ms) induced normal inhibition of test MEPs, suggesting preserved function of GABAergic intracortical inhibitory interneurons. On the contrary, the subsequent period of MEP facilitation found in normal subjects (ISIs of 6-20 ms) was markedly reduced in patients. This suggests the existence of abnormally prolonged intracortical inhibition or deficient intracortical excitation. In nine patients retested 2 to 4 weeks after the initial seizure, these abnormalities persisted, although to a lesser extent. CONCLUSION: The present findings together with abnormally high motor thresholds could represent protective mechanisms against the spread or recurrence of seizures. [less ▲]

Prognostic value of decremental responses to repetitive nerve stimulation in ALS patients

in Neurology (2001)

Post-stroke reorganization of hand motor area: a 1 year longitudinal study with focal transcranial magnetic stimulation.

in Clinical Neurophysiology (2000), 111(Suppl. 1), 12517-06

Ipsilateral motor responses to focal transcranial magnetic stimulation in normal and stroke patients.

in Journal of Neurology, Neurosurgery & Psychiatry (2000), Neurosurgery and Psychiatry

Nombre et taille des unités motrices dans la sclérose latérale amyotrophique

in Magistris, Michel (Ed.) L’électroneuromyographie en l’an 2000 : mises au point (2000)

Dissections artérielles et manipulations cervicales

in Revue Neurologique (1999), 155(Supp 1), 160

AGE-RELATED CHANGES IN FASTEST AND SLOWEST CONDUCTING AXONS OF THENAR MOTOR UNITS.

in Muscle & Nerve (1999)

Posture et mouvement

in Held, Jean-Pierre; Dizien, Olivier (Eds.) Traité de Médecine Physique et de Réadaptation (1999)