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Pathophysiological associations of transcallosal dysfunction in ALS
Author(s) -
Bos Mehdi A. J.,
Higashihara Mana,
Geevasinga Nimeshan,
Me Parvathi,
Kiernan Matthew C.,
Vucic Steve
Publication year - 2021
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.14653
Subject(s) - medicine , corpus callosum , amyotrophic lateral sclerosis , pathophysiology , transcranial magnetic stimulation , neuroscience , primary motor cortex , neurology , disease , psychology , pathology , stimulation , psychiatry
Aim Involvement of the corpus callosum has been identified as a feature of amyotrophic lateral sclerosis (ALS), particularly through neuropathological studies. The aim of the present study was to determine whether alteration in transcallosal function contributed to the development of ALS, disease progression and thereby functional disability. Methods Transcallosal function and motor cortex excitability were assessed in 17 ALS patients with results compared to healthy controls. Transcallosal inhibition (interstimulus intervals (ISI) of 8–40 ms), short interval intracortical facilitation (SICF) and inhibition (SICI) were assessed in both cerebral hemispheres. Patients were staged utilising clinical and neurophysiological staging assessments. Results In ALS, there was prominent reduction of transcallosal inhibition (TI) when recorded from the primary and secondary motor cortices compared to controls ( F = 23.255, p < 0.001). This reduction of TI was accompanied by features indicative of cortical hyperexcitability, including reduction of SICI and increase in SICF. There was a significant correlation between the reduction in TI and the rate of disease progression ( R = −0.825, p < 0.001) and reduction in muscle strength ( R = 0.54, p = 0.031). Conclusion The present study has established that dysfunction of transcallosal circuits was an important pathophysiological mechanism in ALS, correlating with greater disability and a faster rate of disease progression. Therapies aimed at restoring the function of transcallosal circuits may be considered for therapeutic approaches in ALS.