Diagnostic and therapeutic issues of using transcranial magnetic stimulation in patients with writer’s cramp

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Objective. To assess diagnostic and therapeutic values of transcranial magnetic stimulation (TMS) in patients with writer’s cramp (WC). Material and methods. Twelve right-handed patients with WC were enrolled in the study. All patients underwent low-frequency repetitive TMS (rTMS) over the premotor cortex of the hemisphere contralateral to the affected hand. The clinical efficacy was assessed using the Writer’s Cramp Rating Scale (WCRS) and the Medical Outcomes Study-Short Form (MOS-SF-36). Before and after the last rTMS session, motor mapping of abductor pollicis brevis muscle (APB) was performed using navigated TMS (nTMS). Localization, area, and amplitude-weighted area of the APB muscle cortical representations were compared with the healthy controls. The dynamics of the mentioned above parameters after the rTMS course was assessed. Results. Ten sessions of low-frequency rTMS over premotor cortex reduced the severity of WC clinical symptoms, with a duration of effect of at least 1 month (p<0.05). There was no significant difference between the area and the weighted area of cortical muscle representations between patients and healthy controls or in patients before and after rTMS. When assessing the localization of cortical muscle representations, two trends were noted: in 4 patients, the localization remained stable, with a shift in the center of gravity of less than 4 mm; in the other 8 patients, a shift in the center of gravity of more than 5 mm was noted. No significant correlations between the stability of the cortical muscle representations (the magnitude of the shift in the center of gravity) and the improvement on the WCRS scale were found. Conclusion. The low-frequency rTMS over the premotor cortex of the hemisphere contralateral to the affected hand can be used as an adjuvant therapy for WC. The TMS-motor mapping study did not show its diagnostic value.

Keywords:

writing cramp

repetitive transcranial magnetic stimulation

non-invasive brain stimulation

nTMS mapping

Authors:

Poydasheva A.G.

Research Center of Neurology, Moscow

Semenova O.V.

Vorokhobov City Clinical Hospital #67, Moscow, Russia

Suponeva N.A.

Nauchnyĭ tsentr nevrologii RAMN, Moskva

SPIN RSCI: 3223-6006
Scopus AuthorID: 35773598900
ResearcherID: B-4686-2012
ORCID: 0000-0003-3956-6362

Timerbaeva S.L.

Research Center of Neurology, Moscow, Russia

Piradov M.A.

Federal State budgetary scientific Institution «Research Centre of Neurology», Moscow

SPIN RSCI: 2860-1689
Scopus AuthorID: 7003731802
ResearcherID: B-4407-2012
ORCID: 0000-0002-6338-0392

List of references:

Epidemiology Study of Dystonia in Europe (EDSE) Collaborative Group. A prevalence study of primary dystonia in eight European countries. J Neurol. 2000;247(10):787-792. https://doi.org/10.1007/s004150070094
Gordon NS. Focal dystonia, with special reference to writer’s cramp. Int J Clin Pract. 2005;59(9):1088-1090. https://doi.org/10.1111/j.1742-1241.2005.00603.x
Rhoad RC, Stern PJ. Writer’s cramp-A focal dystonia: Etiology, diagnosis, and treatment. Journal of Hand Surgery. 1993;18:541-544. https://doi.org/10.1016/0363-5023(93)90109-g
Albanese A, Bhatia K, Bressman SB, Delong MR, Fahn S, Fung VS, Hallett M, Jankovic J, Jinnah HA, Klein C, Lang AE, Mink JW, Teller JK. Phenomenology and classification of dystonia: A consensus update. Mov Disord. 2013;28(7):863-873. https://doi.org/10.1002/mds.25475
Marsden CD, Sheehy MP. Writer’s cramp. Trends Neurosci. 1990;13(4):148-153. https://doi.org/10.1016/0166-2236(90)90007-w
Shavlovskaya OA. Patogenez pischego spazma. Nervnye Bolezni. 2016;1:8-15. (In Russ.)
Garraux G, Bauer A, Hanakawa T, Wu T, Kansaku K, Hallett M. Changes in Brain Anatomy in Focal Hand Dystonia. Ann Neurol. 2004;55(5):736-739. https://doi.org/10.1002/ana.20113
Kamble N, Netravathi M, Pal PK. Therapeutic applications of repetitive transcranial magnetic stimulation (rTMS) in movement disorders: A review. Parkinsonism Relat Disord. 2014;20(7):695-707. https://doi.org/10.1016/j.parkreldis.2014.03.018
Zoons E, Booij J, Nederveen AJ, Dijk JM TM. Structural, functional and molecular imaging of the brain in primary focal dystonia — a review. Neuroimage. 2011;56(3):1011-1020. https://doi.org/10.1016/j.neuroimage.2011.02.045
Wilson BK, Hess EJ. Animal models for dystonia. Mov Disord. 2013;28(7):982-989. https://doi.org/10.1002/mds.25526
Pappas SS, Leventhal DK, Albin RL, Dauer WT. Mouse models of neurodevelopmental disease of the basal ganglia and associated circuits. Curr Top Dev Biol. 2014;109:97-169. https://doi.org/10.1016/b978-0-12-397920-9.00001-9
Betty S, Spoto A, Castielo U, Sartori L. Testing rTMS-Induced Neuroplasticity: A Single Case Study of Focal Hand Dystonia. Neural Plast. 2018;6464896. https://doi.org/10.1155/2018/6464896
Chervyakov AV, Piradov MA, Nazarova MA, Savitskaya NG, Chernikova LA, Konovalov RN. Cortical mapping of m. abductor pollicis brevis motor area in healthy volunteers using navigation transcranial magnetic stimulation. Annaly Klinicheskoi i Eksperimental’noi Nevrologii. 2012;6(3):37-42. (In Russ.)
Byrnes ML, Thickbroom GW, Wilson SA, Sacco P, Shipman JM, Stell R, Mastaglia FL. The corticomotor representation of upper limb muscles in writer’s cramp and changes following botulinum toxin injection. Brain. 1998;121(5):977-988. https://doi.org/10.1093/brain/121.5.977
Schabrun SM, Stinear CM, Byblow WD, Ridding MC. Normalizing motor cortex representations in focal hand dystonia. Cereb Cortex. 2009;19(9):1968-1977. https://doi.org/10.1093/cercor/bhn224
Bara-Jimenez W, Catalan MJ, Hallett M, Gerloff C. Abnormal somatosensory homunculus in dystonia of the hand. Ann Neurol. 1998;44(5):828-831. https://doi.org/10.1002/ana.410440520
Ridding MC, Sheean G, Rothwell JC, Inzelberg R KT. Changes in the balance between motor cortical excitation and inhibition in focal, task specific dystonia. J Neurol Neurosurg Psychiatry. 1995;59:493-498. https://doi.org/10.1136/jnnp.59.5.493
Stinear CM, Byblow WD. Impaired Modulation of Intracortical Inhibition in Focal Hand Dystonia. Cereb Cortex. 2004;14(5):555-561. https://doi.org/10.1093/cercor/bhh017
Bütefiscch CM, Boroojerdi B, Chen R, Battaglia F, Hallet M. Task-dependent intracortical inhibition is impaired in focal hand dystonia. Mov Disord. 2005;20(5):545-551. https://doi.org/10.1002/mds.20367
Chen R, Classen J, Gerloff C, Celnik P, Wassermann EM, Hallett M, Cohen LG.. Depression of motor cortex excitability by low-frequency transcranial magnetic stimulation. Neurology. 1997;48(5):1398-1403. https://doi.org/10.1212/wnl.48.5.1398
Hallett M. Neurophysiology of dystonia: The role of inhibition. Neurobiol Dis. 2011;42(2):177-184. https://doi.org/10.1016/j.nbd.2010.08.025
Molloy FM, Carr TD, Zeuner KE, Dambrosia JM, Hallett M. Abnormalities of spatial discrimination in focal and generalized dystonia. Brain. 2003;126(10):2175-2182. https://doi.org/10.1093/brain/awg219
Sommer M, Ruge D, Tergau F, Beuche W, Altenmüller EPW. Intracortical excitability in the hand motor representation in hand dystonia and blepharospasm. Mov Disord. 2002;17(5):1017-1025. https://doi.org/10.1002/mds.10205
Orlova OR, Timerbaeva SL, Khat’kova SE, Kotliarov VV, Korenko LA, Zalialova ZA, Fal’kovskiĭ IV, Shperling LP, Antipova LN, Antipenko EA, Mingazova LR, Soĭkher MI, Krasavina DA. Focal dystonias and their treatment with dysport (botulinum toxin type A). Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova. 2012;112(5):81-89. (In Russ.)
Dressler D, Altenmueller E, Bhidayasiri R, Bohlega S, Chana P, Chung TM, Frucht S, Garcia-Ruiz PJ, Kaelin A, Kaji R, Kanovsky P, Laskawi R, Micheli F, Orlova O, Relja M, Rosales R, Slawek J, Timerbaeva S, Warner TT, Saberi FA. Strategies for treatment of dystonia. J Neural Transm (Vienna). 2016;123(3):251-258. https://doi.org/10.1007/s00702-015-1453-x
Albanese A, Lalli S. Update on dystonia. Curr Opin Neurol. 2012;25(4):483-490. https://doi.org/10.1097/wco.0b013e3283550c22
Cogiamanian F, Barbieri S, Priori A. Novel nonpharmacologic perspectives for the treatment of task-specific focal hand dystonia. J Hand Ther. 2009;22(2):156-161. https://doi.org/10.1016/j.jht.2008.11.008
Quartarone A. Transcranial magnetic stimulation in dystonia. Handb Clin Neurol. 2013;116:543-553. https://doi.org/10.1016/b978-0-444-53497-2.00043-7
Quartarone A, Classen J, Morgante F, Rosenkranz K, Hallett M. Consensus paper: Use of transcranial magnetic stimulation to probe motor cortex plasticity in dystonia and levodopa-induced dyskinesia. Brain Stimul. 2009;2(2):108-17. https://doi.org/10.1016/j.brs.2008.09.010
Quartarone A, Rizzo V, Terranova C, Cacciola A, Milardi D, Calamuneri A, Chillemi G, Girlanda P. Therapeutic use of non-invasive brain stimulation in dystonia. Front Neurosci. 2017;11:423. https://doi.org/10.3389/fnins.2017.00423
Chervyakov AV, Poydasheva AG, Korzhova YuE, Suponeva NA, Chernikova LA, Piradov MA. Repetitive transcranial magnetic stimulation in neurology and psychiatry. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova. 2015;115(12):7-18. (In Russ.) https://doi.org/10.17116/jnevro20151151127-18
Poydasheva AG, Bakulin IS, Chernyavskiy AYu, Suponeva NA, Piradov MA. Motor cortex mapping with navigated transcranial magnetic stimulation and its clinical application. Meditsinskii Alfavit. 2017;2(22):21-25. (In Russ.)
Rossi S, Hallett M, Rossini PM, Pascual-Leone A. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol. 2009;120(12):2008-2039. https://doi.org/10.1016/j.clinph.2009.08.016
Suponeva NA, Bakulin IS, Poydasheva AG, Piradov MA. Safety of transcranial magnetic stimulation: Review of international guidelines and new findings. Neuromuscular Diseases. 2017;7(2):21-36. (In Russ.) https://doi.org/10.17650/2222-8721-2017-7-2-21-36
Wassermann EM. Risk and safety of repetitive transcranial magnetic stimulation: report and suggested guidelines from the International Workshop on the Safety of Repetitive Transcranial Magnetic Stimulation, June 5—7, 1996. Electroencephalogr Clin Neurophysiol. 1998;108(1):1-16. https://doi.org/10.1016/s0168-5597(97)00096-8
Quartarone A, Rizzo V, Terranova C, Morgante F, Schneider S, Ibrahim N, Girlanda P, Bhatia KP, Rothwell JC. Abnormal sensorimotor plasticity in organic but not in psychogenic dystonia. Brain. 2009;132(10):2871-2877. https://doi.org/10.1093/brain/awp213
Schneider SA, Pleger B, Draganski B, Cordivari C, Rothwell JC, Bhatia KP DR. Modulatory effects of 5Hz rTMS over the primary somatosensory cortex in focal dystonia — an fMRI-TMS study. Mov Disord. 2010;25(1):76-83. https://doi.org/10.1002/mds.22825
Monte-Silva K, Kuo M-F, Hessenthaler S, Fresnoza S, Liebetanz D, Paulus W, Nitsche M. Induction of late LTP-like plasticity in the human motor cortex by repeated non-invasive brain stimulation. Brain Stimul. 2013;6(3):424-432. https://doi.org/10.1016/j.brs.2012.04.011
Chervyakov AV, Chernyavsky AY, Sinitsyn DO, Piradov MA. Possible Mechanisms Underlying the Therapeutic Effects of Transcranial Magnetic Stimulation. Front Hum Neurosci. 2015;9:303. https://doi.org/10.3389/fnhum.2015.00303
Chervyakov AV, Poydasheva AG, Korzhova YuE, Suponeva NA, Chernikova LA, Piradov MA. Sovremennye terapevticheskie vozmozhnosti ritmicheskoi transkranial’noi magnitnoi stimulyatsii v lechenii zabolevanii nervnoi sistemy. RMZh. 2014;22:1567-1572. (In Russ.)
Lerner A, Shill H, Hanakawa T, Bushara K, Goldfine A, Hallett M. Regional cerebral blood flow correlates of the severity of writer’s cramp symptoms. Neuroimage. 2004;21(3):904-913. https://doi.org/10.1016/j.neuroimage.2003.10.019
Asanuma K, Carbon-Correll M, Eidelberg D. Neuroimaging in human dystonia. J Med Invest. 2005;52(suppl):272-279. https://doi.org/10.2152/jmi.52.272
Tyvaert L, Houdayer E, Devanne H, Monaca C, Cassim F DP. The effect of repetitive transcranial magnetic stimulation on dystonia: a clinical and pathophysiological approach. Neurophysiol Clin. 2006;36(3):135-143. https://doi.org/10.1016/j.neucli.2006.08.007
Bharath RD, Biswal BB, Bhaskar MV, Gohel S, Jhunjhunwala K, Panda R, George L, Gupta AK PP. Repetitive transcranial magnetic stimulation induced modulations of resting state motor connectivity in writer’s cramp. Eur J Neurol. 2015;22(5):796-805. https://doi.org/10.1111/ene.12653
Erro R, Tinazzi M, Morgante F, Bhatia KP. Non-invasive brain stimulation for dystonia: therapeutic implications. Eur J Neurol. 2017;24(10):1228-1264. https://doi.org/10.1111/ene.13363
Siebner HR, Tormos JM, Ceballos-Baumann AO, Auer C, Catala MD, Conrad B, et al. Low-frequency repetitive transcranial magnetic stimulation of the motor cortex in writer’s cramp. Neurology. 1999;52(3):529-537. https://doi.org/10.1212/wnl.52.3.529
Murase N, Rothwell JC, Kaji R, Urushihara R, Nakamura K, Murayama N, Igasaki T, Sakata-Igasaki M, Mima T, Ikeda A, Shibasaki H. Subthreshold low-frequency repetitive transcranial magnetic stimulation over the premotor cortex modulates writer’s cramp. Brain. 2005;128(1):104-115. https://doi.org/10.1093/brain/awh315
Siebner HR, Filipovic SR, Rowe JB, Cordivari C, Gerschlager W, Rothwell JC, Frackowiak RS, Bhatia KP. Patients with focal arm dystonia have increased sensitivity to slow-frequency repetitive TMS of the dorsal premotor cortex. Brain. 2003;126(12):2710-2725. https://doi.org/10.1093/brain/awg282
Borich M, Arora S, Kimberley TJ. Lasting effects of repeated rTMS application in focal hand dystonia. Restor Neurol Neurosci. 2009;27(1):55-65. https://doi.org/10.3233/RNN-2009-0461
Kimberley TJ, Borich MR, Arora S SH. Multiple sessions of low-frequency repetitive transcranial magnetic stimulation in focal hand dystonia: clinical and physiological effects. Restor Neurol Neurosci. 2013;31(5):533-542. https://doi.org/10.3233/RNN-120259
Kimberley TJ, Schmidt RLS, Chen M, Dykstra DD, Buetefisch CM. Mixed effectiveness of rTMS and retraining in the treatment of focal hand dystonia. Front Hum Neurosci. 2015;9:385. https://doi.org/10.3389/fnhum.2015.00385
Huang YZ, Lu CS, Rothwell JC, Lo CC, Chuang WL, Weng YH, et al. Modulation of the Disturbed Motor Network in Dystonia by Multisession Suppression of Premotor Cortex. PLoS One. 2012;7(10):e47574. https://doi.org/10.1371/journal.pone.0047574
Havrankova P, Jech R, Walker ND, Operto G, Tauchmanova J, Vymazal J, Dusek P, Hromcik M, Ruzicka E. Repetitive TMS of the somatosensory cortex improves writer’s cramp and enhances cortical activity. Neuroendocrinol Lett. 2010;31(1):73-86.
Lefaucheur J-PP, Andre-Obadia N, Antal A, Ayache SS, Baeken C, Benninger DH, et al. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS). Clin Neurophysiol. 2014;125(11):2150-2206. https://doi.org/10.1016/j.clinph.2014.05.021
Krieg SM, Lioumis P, Mäkelä JP, Wilenius J, Karhu J, Hannula H, et al. Protocol for motor and language mapping by navigated TMS in patients and healthy volunteers; workshop report. Acta Neurochir (Wien). 2017;159(7):1187-1195. https://doi.org/10.1007/s00701-017-3187-z
Ahdab R, Ayache SS, Brugières P, Goujon C, Lefaucheur J-P. Comparison of «standard» and «navigated» procedures of TMS coil positioning over motor, premotor and prefrontal targets in patients with chronic pain and depression. Neurophysiol Clin. 2010;40(1):27-36. https://doi.org/10.1016/j.neucli.2010.01.001
Fitzgerald PB, Hoy K, McQueen S, Maller JJ, Herring S, Segrave R, et al. A randomized trial of rTMS targeted with MRI based neuro-navigation in treatment-resistant depression. Neuropsychopharmacology. 2009;34(5):1255-1262. https://doi.org/10.1038/npp.2008.233
Farzan F, Barr MS, Hoppenbrouwers SS, Fitzgerald PB, Chen R, Pascual-Leone A, et al. The EEG correlates of the TMS-induced EMG silent period in humans. Neuroimage. 2013;83:120-134. https://doi.org/10.1016/j.clinph.2013.04.271
Paillère Martinot ML, Galinowski A, Ringuenet D, Gallarda T, Lefaucheur JP, Bellivier F, et al. Influence of prefrontal target region on the efficacy of repetitive transcranial magnetic stimulation in patients with medication-resistant depression: A [18F]-fluorodeoxyglucose PET and MRI study. Int J Neuropsychopharmacol. 2010;13(1):45-59. https://doi.org/10.1017/s146114570900008x
Poydasheva AG, Aziatskaya GA, Chernyavskiy A, Lyukmanov RX, Mokienko OA, Chernikova LA, et al. The dynamics of the m. extensor digitorum communis cortical representation after motor imagery training sessions using brain-computer interface: Controlled study. Neuroscience and Behavioral Physiology. 2018;48(9):1106-1113. https://doi.org/10.1007/s11055-018-0674-5

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