Responses of masseter muscles to transcranial magnetic stimulation in patients with amyotrophic lateral sclerosis |
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| Affiliation: | 1. Depts. Orthodontics & Oral Health Sciences, University of Washington, School of Dentistry, Seattle, WA, USA;2. Dept. Pediatric Dentistry, Jacobi Medical Center, Bronx, NY, USA;3. Dept. Stomatology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong, University School of Medicine, Shanghai, China;1. Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan;2. Department of Neurology, Saiseikai Kumamoto Hospital, Japan;3. Department of Neurology, Minamata City General Hospital & Medical Center, Minamata, Japan;4. Department of Neurology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan;5. Department of Neurology, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan;6. Department of Neurology, Kumamoto City Hospital, Kumamoto, Japan;7. Department of Amyloidosis, Nagasaki International University, Sasebo, Japan;1. Doctor, Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China;2. Doctor, Department of Oral and Maxillofacial Surgery, Zhengzhou Stomatological Hospital, Zhengzhou, China;3. Department Head, Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China;4. Professor, Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China;6. Doctor, Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China;1. Laboratory of Neuromuscular Disorders and Department of Neurology, Qilu Hospital, Shandong University, Jinan, China;2. Department of Neurobiology, Yale School of Medicine, New Haven, CT 06510, USA;3. Key Laboratory for Experimental Teratology of the Ministry of Education, Brain Science Research Institute, Department of Neurology, Qilu Hospital, Shandong University, Jinan, China |
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| Abstract: | We recorded motor responses evoked by transcranial magnetic stimulation (TMS) in the masseter muscles of 30 patients with amyotrophic lateral sclerosis (ALS), 10 patients with cervical spondylotic myelopathy (CSM) and 22 age-matched normal controls. Responses to direct activation of the trigeminal motor root (R-MEPs) were normal both in ALS and CSM patients. Responses to activation of cortico-bulbar descending fibers (C-MEPs) were absent or delayed in 19 ALS patients (63.3%). Abnormalities of masseter C-MEPs were more frequent than abnormalities of limb MEPs and could be observed both in patients with (77.8%) and without (41.7%) clinical bulbar signs. Masseter C-MEPs were normal in all CSM patients. Recording masseter responses to TMS can reveal the frequent impairment of cortico-bulbar projections in ALS and can be useful in the differential diagnosis of spinal cord compression disorders mimicking ALS because of combination of upper and lower motor neuron signs. |
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