Clinical Value of the Assessment of Changes in MEP Duration with XXXX .

@entity1 @entity64 @entity3520 @entity3500 @entity425 @entity15 @entity2472
Transcranial magnetic stimulation (TMS) gives rise to muscle responses, known as motor evoked potentials (MEP), through activation of the motor pathways. Voluntary contraction causes facilitation of MEPs, which consists of shortening MEP latency, increasing MEP amplitude and widening MEP duration. While an increase in excitability of alpha motorneurons and the corticospinal tract can easily explain latency shortening and amplitude increase, other mechanisms have to be accounted for to explain the increase in duration. We measured the increase in duration of the MEP during contraction with respect to rest in a group of healthy volunteers and retrospectively assessed this parameter in @entity1 who were examined in a standardized fashion during the past 5 years. We included 25 healthy subjects, 21 @entity1 with @entity15 , 33 @entity1 with @entity64 , 5 @entity1 with @entity3500 , and 5 @entity1 with signs suggesting @entity3520 paresis. We found already significant differences among groups in the MEP duration at rest, @entity1 with @entity15 had a significantly longer duration, and @entity1 with @entity64 had significantly shorter duration, than the other two groups. The increase in MEP duration during @entity2472 was different in @entity1 and in healthy subjects. It was significantly shorter in @entity15 and significantly longer in @entity64 @entity1 . It was absent in the five @entity1 with suspected @entity425 . In @entity1 with HSP, an abnormally increase in duration occurred only in leg muscles. Our results suggest that the increase in duration of the MEP during contraction may reveal the contribution of propriospinal interneurons to the activation of alpha motorneurons. This mechanism may be altered in some diseases and, therefore, the assessment proposed in this work may have clinical applicability for the differential diagnosis of @entity425 .
