Transcranial magnetic stimulation and functional magnet resonance imaging evaluation of adductor spasmodic dysphonia during phonation

Mo Chen; Rebekah L.S. Summers; Cecília N. Prudente; George S. Goding; Sharyl Samargia-Grivette; Christy L. Ludlow; Teresa J. Kimberley

Brain Stimulation (May 2020)

Transcranial magnetic stimulation and functional magnet resonance imaging evaluation of adductor spasmodic dysphonia during phonation

Mo Chen,
Rebekah L.S. Summers,
Cecília N. Prudente,
George S. Goding,
Sharyl Samargia-Grivette,
Christy L. Ludlow,
Teresa J. Kimberley

Affiliations

Mo Chen: Divisions of Physical Therapy and Rehabilitation Science, Department of Rehabilitation Medicine, School of Medicine, University of Minnesota. 426 Church St. SE, Minneapolis, MN, 55455, USA; Non-invasive Neuromodulation Laboratory, MnDRIVE Initiative, University of Minnesota. 247, 717 Delaware St. SE, Minneapolis, MN, 55414, USA
Rebekah L.S. Summers: Divisions of Physical Therapy and Rehabilitation Science, Department of Rehabilitation Medicine, School of Medicine, University of Minnesota. 426 Church St. SE, Minneapolis, MN, 55455, USA; Department of Neurology, School of Medicine, University of Minnesota, 717 Delaware St., SE. Minneapolis, MN, 55414, USA
Cecília N. Prudente: Divisions of Physical Therapy and Rehabilitation Science, Department of Rehabilitation Medicine, School of Medicine, University of Minnesota. 426 Church St. SE, Minneapolis, MN, 55455, USA
George S. Goding: Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Phillips Wangensteen Building, 516 Delaware Street SE, Minneapolis, MN, 55455, USA
Sharyl Samargia-Grivette: Department of Communication Sciences and Disorders, University of Wisconsin River Falls Campus. 220 Wyman Teacher Education Bldg, 410 South Third Street, River Falls, WI, 54022, USA
Christy L. Ludlow: Department of Communication Sciences and Disorders, James Madison University, MSC 4304, MLK Drive, Harrisonburg, VA, 22807, USA
Teresa J. Kimberley: Divisions of Physical Therapy and Rehabilitation Science, Department of Rehabilitation Medicine, School of Medicine, University of Minnesota. 426 Church St. SE, Minneapolis, MN, 55455, USA; School of Health and Rehabilitation Sciences, Department of Physical Therapy, Massachusetts General Hospital, Institute of Health Professions, 36 First Ave, Boston, MA, 02129, USA; Corresponding author. 36 1st Avenue, Boston, MA, 02129, USA.

Journal volume & issue: Vol. 13, no. 3
pp. 908 – 915

Abstract

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Background: Reduced intracortical inhibition is a neurophysiologic finding in focal dystonia that suggests a broader problem of impaired cortical excitability within the brain. A robust understanding of the neurophysiology in dystonia is essential to elucidate the pathophysiology of the disorder and develop new treatments. The cortical silent period (cSP) is a reliable, non-invasive method to measure intracortical inhibition in the primary motor cortex associated with a muscle of interest. In adductor spasmodic dysphonia (AdSD), cSP of the laryngeal motor cortex (LMC) which directly corresponds to the affected musculature, the thyroarytenoid (TA), has not been examined. Objective: This work evaluated the cSP of the LMC and the relationship between cSP and functional magnetic resonance imaging (fMRI) blood-oxygen-level dependent (BOLD) activation in people with AdSD (n = 12) compared to healthy controls (CTL, n = 14). Results: Shortened LMC cSP were observed bilaterally in people with AdSD vs CTL (F(1, 99) = 19.5226, p CTL contrast as compared to CTL > AdSD contrast. Correlation analysis showed that people with AdSD have positive correlation of left LMC BOLD activation and the cSP. Further, the right LMC cSP lacks either positive or negative associations with BOLD activation. CTL individuals displayed both positive and negative correlations between cSP and BOLD activation in the left LMC. In CTL, the LMC cSP and BOLD activation showed exclusively negative correlations in both hemispheres. Conclusion: In AdSD, the cortical activation during phonation may not be efficiently or effectively associated with inhibitory processes, leading to muscular dysfunction. These findings may give insight into the maladaptive cortical control during phonation in people with AdSD.

Published in Brain Stimulation

ISSN: 1935-861X (Print); 1876-4754 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry
Website: https://www.journals.elsevier.com/brain-stimulation

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