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Titolo:
Effect of multiple subpial transection on motor cortical excitability in cortical dysgenesis
Autore:
Shimizu, T; Maehara, T; Hino, T; Komori, T; Shimizu, H; Yagishita, A; Yokota, T; Hirai, S; Rossini, PM;
Indirizzi:
Tokyo Metropolitan Neurol Hosp, Dept Neurol, Fuchu, Tokyo 1830042, Japan Tokyo Metropolitan Neurol Hosp Fuchu Tokyo Japan 1830042 o 1830042, Japan Tokyo Metropolitan Neurol Hosp, Dept Neurosurg, Fuchu, Tokyo 1830042, Japan Tokyo Metropolitan Neurol Hosp Fuchu Tokyo Japan 1830042 o 1830042, Japan Tokyo Metropolitan Neurol Hosp, Dept Neuroradiol, Fuchu, Tokyo 1830042, Japan Tokyo Metropolitan Neurol Hosp Fuchu Tokyo Japan 1830042 o 1830042, Japan Tokyo Med & Dent Univ, Dept Neurol, Tokyo 113, Japan Tokyo Med & Dent Univ Tokyo Japan 113 niv, Dept Neurol, Tokyo 113, Japan Osped Fatebenefratelli, Div Neurol, AFaR, CRCCS, Rome, Italy Osped Fatebenefratelli Rome Italy Div Neurol, AFaR, CRCCS, Rome, Italy IRCCS Fatebenefratelli, Brescia, Italy IRCCS Fatebenefratelli Brescia Italy S Fatebenefratelli, Brescia, Italy
Titolo Testata:
BRAIN
, volume: 124, anno: 2001,
parte:, 7
pagine: 1336 - 1349
SICI:
0006-8950(200107)124:<1336:EOMSTO>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRANSCRANIAL MAGNETIC STIMULATION; GENERALIZED EPILEPSY; FOCAL EPILEPSY; EVOKED-POTENTIALS; SILENT PERIOD; HUMAN BRAIN; CORTEX; DYSPLASIA; INHIBITION; NEOCORTEX;
Keywords:
cortical dysgenesis; multiple subpial transection; transcranial magnetic stimulation; motor cortical excitability;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
57
Recensione:
Indirizzi per estratti:
Indirizzo: Shimizu, H Tokyo Metropolitan Neurol Hosp, Dept Neurol, 2-6-1 Musashidai, Fuchu, Tokyo 1830042, Japan Tokyo Metropolitan Neurol Hosp 2-6-1 MusashidaiFuchu Tokyo Japan 1830042
Citazione:
T. Shimizu et al., "Effect of multiple subpial transection on motor cortical excitability in cortical dysgenesis", BRAIN, 124, 2001, pp. 1336-1349

Abstract

We report here a 12-year-old patient with unilateral cortical dysgenesis and intractable simple partial seizure in his left arm, who underwent multiple subpial transection (MST) in the right cerebral cortex including the primary motor cortex, We investigated motor cortical excitability using multimodal transcranial magnetic stimulation (TMS) before and 1 month after MST, in which surgical cortical incisions were made with strokes 5 mm apart and 4 mm deep. Preoperative TMS studies showed hyperexcitability in the affected motor cortex as abnormally prolonged muscle responses to TMS with a wide cortical motor map, which were markedly reduced following the operation, The preoperative motor evoked potentials were large and polyphasic, and consisted of early and late components. The late component was completely abolished after MST, suggesting that this component might be due to activation ofthe corticospinal tract neurones by long recurrent axon branches of dysplastic excitatory pyramidal neurones, which were cut by MST, or by delayed, polysynaptic intracortical conduction with marked temporal dispersion. Intracortical inhibition in the affected motor cortex was also disrupted preoperatively and improved after MST. Postoperative recruitment order of muscle responses to TMS was bilaterally symmetrical, indicating that MST did not interfere with the function of the corticospinal tract neurones, The patient showed fair motor recovery and good seizure control after the operation, These results of TMS studies demonstrated the remarkable effectiveness of MSTnot only on intractable seizure but also on abnormal motor cortical organization and hyperexcitability in cortical dysgenesis.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/04/20 alle ore 23:58:32