dall'Hemicrania Continua alla SUNCT: descrizione di un caso clinico

Reduced cerebellar inhibition in migraine with aura: a transcarnial magnetic stimulation (TMS) study.

Neglect-like effects induced by tDCS modulation of posterior parietal cortices in healthy subjects

Background Repetitive transcranial magnetic stimulation (rTMS) over right posterior parietal cortex was shown to induce interference on visuospatial perception in healthy subjects. Transcranial direct current stimulation (tDCS) is another noninvasive brain stimulation technique that works modulating cortical activity. It is applied through easy to use, noncostly, and portable devices. Objective/Hypothesis The aim of the current study was to investigate if the novel approach of “dual” stimulation over parietal cortices compared with the unilateral (right) cathodal one is able to induce greater and/or longer-lasting neglect-like effects in normal subjects performing a computerized visuospatia…

Effects of cerebellar TMS on motor cortex of patients with focal dystonia

LOW-DOSAGE TOPIRAMATE IN PROPHYLAXIS OF MIGRAINE: RESULTS OF A RETROSPECTIVE STUDY IN 490 PATIENTS.

Ruolo del cervelletto nella percezione temporale: risultati di uno studio con rTMS a bassa frequenza in soggetti sani

Effects of transcranial direct current stimulation on esophageal motility in patients with gastroesophageal reflux disease

To evaluate the effects of transcranial direct current stimulation (tDCS) on esophageal peristalsis in patients with gastroesophageal reflux disease (GERD).Patients with GERD preliminary diagnosis were included in a randomized double-blind sham-controlled study. Esophageal manometry was performed before and during transcranial direct current stimulation (tDCS) of the right precentral cortex. Half of patients were randomly assigned to anodal, half to sham stimulation. Distal waves amplitude and pathological waves percentage were measured, after swallowing water boli, for ten subsequent times. Last, a 24h pH-bilimetry was done to diagnose non-erosive reflux disease (NERD) or functional heartb…

CEREBELLUM AND TIME PERCEPTION: A LOW-FREQUENCY STIMULATION STUDY IN HEALTHY SUBJECTS

Modulation of visual cortex excitability in migraine with aura: effects of valproate therapy.

We explored the effects of valproate treatment on visual cortex excitability changes in migraine with aura patients. Abnormal cortical excitability has been suggested to play an important role in the etiopathogenesis of migraine; in particular, it has been suggested a failure of inhibitory circuits in migraine with aura. Valproate acts as a central GABA agonist and it is reasonable suppose that VPA could modify cortical excitability state. Phosphene threshold (PT) was assessed at baseline and after 1 Hz rTMS before and after one month therapy. We found that low-frequency rTMS in drug-free migraineurs decreased PT, while the treatment with the GABA agonist valproate is able to revert the eff…

NOCICEPTIVE EVOKED POTENTIAL MODULATION BY CORTICAL rTMS: COMPARI-SON BETWEEN MOTOR AND DORSOLATERAL PREFRONTAL (DLPFC) CORTEX STIM-ULATION. JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM

EFFECTS OF TRANSCRANIAL DIRECT STIMULATION (tdcs) ON ESOPHAGEAL MOTILITY AND PATHOLOGICAL WAVES IN GASTROESOPHAGEAL REFLUX DISEASE (GERD) PATIENTS

Far Space Remapping by Tool Use: A rTMS Study Over the Right Posterior Parietal Cortex

Abstract Background In previous studies, rTMS has been successfully employed to interfere with the right posterior parietal cortex (rPPC) inducing neglect-like behavior in healthy subjects. Several studies have shown that the use of tools can modulate the boundaries between near and far space: indeed when far space is reached by the stick, far space can be remapped as near. Objective The aim of the present study was to investigate whether once that rTMS on the rPPC has selectively induced neglect-like bias in the near space (but not in the far space), neglect can appears also in the far space when the subjects used a tool to perform the task. Methods Fifteen right-handed healthy subjects ex…

Role of the cerebellum in time perception: A TMS study in normal subjects

The aim of this study was to investigate the role of the cerebellum in a temporal-discrimination task without movement production in healthy subjects. Ten healthy subjects underwent a time-perception task with somatosensory stimuli. Two pairs of electrical stimuli: the first considered the reference pair (rp) with a standard interval of 400 ms and the second, the test pair (tp), with variable intervals ranging from 300 to 500 ms, were applied by surface electrodes on the right forearm. Subjects were instructed to compare time intervals of rp and tp and to estimate whether the tp interval was shorter than, equal to, or longer than that of rp. The task was performed in baseline and after 1 Hz…

Effetti della modulazione cerebellare sulla corteccia motoria di pazienti con distonie focali

Impaired Glutamatergic Neurotransmission in Migraine With Aura? Evidence by an Input-Output Curves Transcranial Magnetic Stimulation Study

(Headache 2011;51:726-733) Objective.— An imbalance between activity of inhibitory and facilitatory intracortical circuits could play a central role in migraine etiology. We used input–output curves to achieve further information about intracortical excitability of motor cortex in migraine with aura. Methods.— Input–output curves were measured in the right abductor pollicis brevis muscle at rest in 12 patients suffering from migraine with aura and 8 healthy subjects. Stimuli were delivered at intensity ranging from 100% to 160% of resting motor threshold with 10-second inter-stimulus intervals. Seven patients were studied before and during treatment with levetiracetam. Results.— Results sho…

Impaired glutamatergic neurotransmission in migraine with aura? Evidence by an input-output curves transcranial magnetic stimulation study.

Objective: An imbalance between activity of inhibitory and facilitatory intracortical circuits could play a central role in migraine etiology. We used input-output curves to achieve further information about intracortical excitability of motor cortex in migraine with aura. METHODS: Input-output curves were measured in the right abductor pollicis brevis muscle at rest in 12 patients suffering from migraine with aura and 8 healthy subjects. Stimuli were delivered at intensity ranging from 100% to 160% of resting motor threshold with 10-second inter-stimulus intervals. Seven patients were studied before and during treatment with levetiracetam. RESULTS: Results showed a greater motor-evoked pot…

Different forms of trigeminal autonomic cephalalgias in the same patient: description of a case.

The trigeminal autonomic cephalalgias (TACs), including cluster headache, paroxysmal hemicrania and SUNCT, are characterized by the cardinal combination of short-lasting unilateral pain and autonomic phenomena affecting the head. Hemicrania continua (HC) shares many clinical characteristics with TACs, including unilateral pain and ipsilateral autonomic features. Nevertheless, HC is separately classified in the revised International Classification of Headache Disorders (ICHD-II). Here, we describe the case of a 45-year-old man presenting an unusual concurrence of different forms of primary headaches associated with autonomic signs, including subsequently ipsilateral cluster headache, SUNCT a…

Modulation of pain perception by transcranial magnetic stimulation of left prefrontal cortex.

Evidence by functional imaging studies suggests the role of left dorsolateral prefrontal cortex (DLPFC) in the inhibitory control of nociceptive transmission system. Repetitive transcranial magnetic stimulation (rTMS) is able to modulate pain response to capsaicin. In the present study, we evaluated the effect of DLPFC activation (through rTMS) on nociceptive control in a model of capsaicin-induced pain. The study was performed on healthy subjects that underwent capsaicin application on right or left hand. Subjects judged the pain induced by capsaicin through a 0–100 VAS scale before and after 5 Hz rTMS over left and right DLPFC at 10 or 20 min after capsaicin application in two separate gr…

Evidence Of Visual Cortical Hyperexcitability By Sound- Induced Flash Illusions In Migraine: Preliminary Results In 47 Patients

Effects of cerebellar TMS on motor cortex of patient with focal dystonia: a preliminary report

Recent evidence suggests a role for cerebellum in pathophysiology of dystonia. Here we explored, the cerebellar modulation of motor cortex in patients with focal upper limb dystonia. Eight patients and eight controls underwent a transcranial magnetic stimulation protocol to study the cerebellar-brain-inhibition (CBI): a conditioning cerebellar stimulus (CCS) was followed 5 ms after by the contralateral motor cortex stimulation (test stimulus: TS). We explored the effects of CBI on MEP amplitude, short intracortical inhibition (SICI) and intracortical facilitation (ICF) measures. At baseline no differences in TS-MEP amplitude, SICI or ICF were found between patients and controls. Cerebellar-…

Efficacy and tolerability of pregabalin in prophylaxis of chronic and refractory migraine.