Session Time: 1:45pm-3:15pm
Location: Agora 3 West, Level 3
Objective: To evaluate the motor cortical excitability changes in PD patients with and without RBD.
Background: There has been an increase in the understanding of the pathophysiology of REM sleep behavior disorder (RBD) in patients with Parkinson’s disease (PD) due to recent advances in the neurophysiological techniques. Studies of the motor cortical excitability and central motor pathways have shown variable results in these patients. Therefore, our aim was to evaluate the motor cortical excitability changes in PD patients with and without RBD.
Method: The study included 16 PD with RBD (RBD+) and 16 PD without RBD (RBD-) patients. The study was conducted in the department of Neurology, NIMHANS, Bangalore. Detailed history, demographic details and clinical examination was recorded. RBD was evaluated using the RBD sleep questionnaire. All subjects underwent transcranial magnetic stimulation (TMS) with recording of resting motor threshold (RMT), central motor conduction time (CMCT), silent period (SP), short interval intracortical inhibition (SICI) and intracortical facilitation (ICF).
Results: The mean age of the RBD+ patients was 59.0±10.5 years and that of RBD- was 59.0±11.6 years. There was no significant difference in RMT (36.75±8.09%, 38.25±8.04%; p=0.31), CMCT (7.86±2.38msec, 7.28±1.55msec; p=0.22), contralateral SP (118.7±38.74msec, 125.28±44.91msec; p=0.34) and ipsilateral SP (44.6±11.8msec, 38.96±11.65msec, p=0.1) between the two groups. SICI was present in both the groups (0.19±0.009, 0.46±0.46; p=0.02) with significant inhibition observed in RBD+ patients. The ICF was not observed in RBD+ patients (0.21±0.11, 1.12±1.0; p<0.001).
Conclusion: TMS is a valuable method of evaluating the cortical excitability changes in RBD+ patients. These patients have absence of ICF and more of intracortical inhibition. This may suggest an imbalance between the GABAergic and glutaminergic pathways in the brain.
To cite this abstract in AMA style:A. Bhattacharya, N. Kamble, R. Yadav, PK Pal. Abnormal Intracortical Facilitation in patients of Parkinson’s disease with REM Sleep Behavior Disorder [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/abnormal-intracortical-facilitation-in-patients-of-parkinsons-disease-with-rem-sleep-behavior-disorder/. Accessed November 29, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/abnormal-intracortical-facilitation-in-patients-of-parkinsons-disease-with-rem-sleep-behavior-disorder/