Motor cortex excitability in Alzheimer's disease: A transcranial magnetic stimulation study

Florinda Ferreri, Flavia Pauri, Patrizio Pasqualetti, Rita Fini, Gloria Dal Forno, Paolo Maria Rossini

Research output: Contribution to journalArticle

132 Citations (Scopus)

Abstract

Motor deficits affect patients with Alzheimer's disease only at later stages. Recent studies demonstrate that the primary motor cortex is affected by neuronal degeneration accompanied by the formation of amyloid plaques and neurofibrillary tangles. It is conceivable that neuronal loss is compensated by reorganization of the neural circuitries occurring along the natural course of the disease, thereby maintaining motor performances in daily living. Cortical motor output to upper limbs was tested via motor-evoked potentials from forearm and hand muscles elicited by transcranial magnetic stimulation of motor cortex in 16 patients with mild Alzheimer's disease without motor deficits. Motor cortex excitability was increased, and the center of gravity of motor cortical output, as represented by excitable scalp sites, showed a frontal and medial shift, without correlated changes in the site of maximal excitability (hot-spot). This may indicate functional reorganization, possibly after the neuronal loss in motor areas. Hyperexcitability might be caused by a dysregulation of the intracortical GABAergic inhibitory circuitries and selective alteration of glutamatergic neurotransmission. Such findings suggest that motor cortex hyperexcitability and reorganization allows prolonged preservation of motor function during the clinical course of Alzheimer's disease.

Original languageEnglish
Pages (from-to)102-108
Number of pages7
JournalAnnals of Neurology
Volume53
Issue number1
DOIs
Publication statusPublished - Jan 1 2003

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Transcranial Magnetic Stimulation
Motor Cortex
Alzheimer Disease
Hypergravity
Motor Evoked Potentials
Neurofibrillary Tangles
Amyloid Plaques
Scalp
Forearm
Upper Extremity
Synaptic Transmission
Hand
Muscles

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Motor cortex excitability in Alzheimer's disease : A transcranial magnetic stimulation study. / Ferreri, Florinda; Pauri, Flavia; Pasqualetti, Patrizio; Fini, Rita; Dal Forno, Gloria; Rossini, Paolo Maria.

In: Annals of Neurology, Vol. 53, No. 1, 01.01.2003, p. 102-108.

Research output: Contribution to journalArticle

Ferreri, Florinda ; Pauri, Flavia ; Pasqualetti, Patrizio ; Fini, Rita ; Dal Forno, Gloria ; Rossini, Paolo Maria. / Motor cortex excitability in Alzheimer's disease : A transcranial magnetic stimulation study. In: Annals of Neurology. 2003 ; Vol. 53, No. 1. pp. 102-108.
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