rTMS induces brief events of muscle atonia in patients with narcolepsy

M. Hungs, F. M. Mottaghy, R. Sparing, Stephan L Zuchner, B. Boroojerdi, R. Töpper

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Study Objectives: To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) in patients with narcolepsy. Design: Using rTMS, three patients with narcolepsy and cataplexy were investigated with and without their anticataplectic medication. rTMS of the motor cortex was performed at an intensity of 110% of resting motor threshold, a frequency of 20 Hz, and a duration of 2s. EMG activity was recorded for both the right and left first dorsal interosseous muscle (FDI). Eight healthy controls were also investigated under the same conditions. Setting: The study was carried out in the sleep laboratory of the Neurology Department (University of Aachen). Patients: One female and two male patients with narcolepsy/cataplexy. Interventions: N/A. Measurements and Results: In three narcoleptic patients, after three days of not taking their usual anticataplectic medication, rTMS of the motorcortex induced an interruption of voluntary EMG activity in the FDI. EMG reduction lasted from 0.6 to 3.5s and was more pronounced in the hand contralateral to the stimulated hemisphere. This result was not observed in these patients when taking their regular medication nor in the normal controls. Stimulation of other cortical areas, as well as stimulation of the peripheral nervous system, did not induce muscle weakness episodes. Conclusions: We postulate that rTMS of the descending voluntary motor pathway triggers muscle atonia similar to cataplexy by indirectly activating the mechanisms responsible for the generation of muscle atonia during REM sleep and cataplexy. We conclude that rTMS, in the future, might prove to be a useful addition to the diagnostic repertoire for narcolepsy.

Original languageEnglish
Pages (from-to)1099-1104
Number of pages6
JournalSleep
Volume23
Issue number8
StatePublished - Dec 15 2000
Externally publishedYes

Fingerprint

Narcolepsy
Transcranial Magnetic Stimulation
Cataplexy
Muscles
Efferent Pathways
Muscle Weakness
REM Sleep
Peripheral Nervous System
Motor Cortex
Neurology
Sleep
Hand

Keywords

  • Cataplexy
  • Diagnosis
  • Muscle atonia
  • Narcolepsy
  • rTMS
  • Silent period
  • Sleep

ASJC Scopus subject areas

  • Physiology

Cite this

Hungs, M., Mottaghy, F. M., Sparing, R., Zuchner, S. L., Boroojerdi, B., & Töpper, R. (2000). rTMS induces brief events of muscle atonia in patients with narcolepsy. Sleep, 23(8), 1099-1104.

rTMS induces brief events of muscle atonia in patients with narcolepsy. / Hungs, M.; Mottaghy, F. M.; Sparing, R.; Zuchner, Stephan L; Boroojerdi, B.; Töpper, R.

In: Sleep, Vol. 23, No. 8, 15.12.2000, p. 1099-1104.

Research output: Contribution to journalArticle

Hungs, M, Mottaghy, FM, Sparing, R, Zuchner, SL, Boroojerdi, B & Töpper, R 2000, 'rTMS induces brief events of muscle atonia in patients with narcolepsy', Sleep, vol. 23, no. 8, pp. 1099-1104.
Hungs M, Mottaghy FM, Sparing R, Zuchner SL, Boroojerdi B, Töpper R. rTMS induces brief events of muscle atonia in patients with narcolepsy. Sleep. 2000 Dec 15;23(8):1099-1104.
Hungs, M. ; Mottaghy, F. M. ; Sparing, R. ; Zuchner, Stephan L ; Boroojerdi, B. ; Töpper, R. / rTMS induces brief events of muscle atonia in patients with narcolepsy. In: Sleep. 2000 ; Vol. 23, No. 8. pp. 1099-1104.
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