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Cortico‐motoneurone excitability in patients with obstructive sleep apnoea
Author(s) -
Civardi Carlo,
Naldi Paola,
Cantello Roberto
Publication year - 2004
Publication title -
journal of sleep research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.297
H-Index - 117
eISSN - 1365-2869
pISSN - 0962-1105
DOI - 10.1111/j.1365-2869.2004.00391.x
Subject(s) - transcranial magnetic stimulation , silent period , motor cortex , latency (audio) , psychology , neuroscience , wakefulness , abnormality , evoked potential , stimulation , medicine , anesthesia , audiology , electroencephalography , psychiatry , electrical engineering , engineering
Summary A disordered neuromotor control of pharynx muscles may play a role in the genesis of obstructive sleep apnoea syndrome (OSAS). This raises the possibility of a dysfunction of projections descending from the cortex to segmental nuclei. With single pulse transcranial magnetic stimulation (TMS) we studied the physiology of the corticospinal projection to hand muscles in seven OSAS patients. At first, we compared them with nine age‐ and sex‐matched normal controls in the wake state. The only abnormality was a lengthening of the central silent period ( P < 0.001). This supports a steady imbalance of motor cortical interneurone activities towards a state of enhanced inhibition. Then we looked at changes of the motor‐evoked potential (MEP) size and latency, according to whether patients were awake, or in a non‐rapid eye movement (REM) 2 sleep stage, or during a typical apnoea. During non‐REM 2 sleep, the average MEP amplitude was significantly ( P < 0.05) smaller than in the awake state. The MEP latency was, in turn, significantly longer ( P < 0.05). During apnoeas, the MEP size decreased, and the latency increased further ( P < 0.05), indicating an extra depression of the cortico‐motoneuronal activity. All TMS changes were detected outside the pharyngeal district, suggesting a widespread dysfunction of the cortico‐motoneuronal system in the OSAS, which is more evident during apnoeas.