The Effect of Repetitive Transcranial Magnetic Stimulation on Motor Symptoms in Hereditary Spastic Paraplegia

Table 1

Demographic and clinical data and TMS findings of recruited patients.

	Gender	Age at incl.	Diagnosis	Dis. d.	Pharmacotherapy for spasticity	MT left	MT right	CMCT	MEP ampl.	CSP
1	M	38	AMN	13	Baclofen, tizanidine	74%	62%	22.4 ↑	0.8/10%	107
2	M	56	AMN	3		68%	66%	18.4 ↑	1.0/11%	280
3	M	41	AMN	14	Clonazepam, baclofen, and Lorenzo’s oil	66%	78%	24.7 ↑	0.5/4%	122
4	F	42	Unspecified pure	8	Tizanidine	72%	69%	19.3 ↑	0.5/3%	119
5	M	38	Unspecified compl.	20		67% MHG	66% MHG	33 ↑	1.2/60%	129
6	M	29	HSP3A	26		57% AMT	53% AMT	14.7	1.4/10%	189
7	M	36	HSP7	8	Baclofen	No response	No response
8	F	62	AMN gene carrier	6	Baclofen	72%	65%	18 ↑	2.4/13%
9	M	54	Unspecified pure	17	Baclofen	57%	54%	16.8	0.6/7%	111
10	M	50	Unspecified pure	8		54%	50%	14.3	1.5/17%	229
11	M	53	Unspecified pure	8	Baclofen	50% AMT	50% AMT	12.8	0.4/7%	121
12	M	41	Unspecified pure	19		54% AMT	40% AMT	16.2	1.1/7%	132
13	F	46	AMN gene carrier	4		63%	67%	23.7 ↑	0.7/10%	93
14	F	48	AMN gene carrier	15	Baclofen	72%	72%	18.4 ↑	1.0/7%	119
15	F	22	Unspecified compl.	21		68%	76%	15	0.9/5%	109

F: female; M: male; age at incl.: age at inclusion; duration of sympt.: duration of symptoms (years); MT left: motor threshold of the left abductor hallucis (except subject 5) in % of the maximal stimulator output; MT right: motor threshold of the right abductor hallucis (except subject 5) in % of the maximal stimulator output; CMCT: central motor conduction time in milliseconds; MEP: motor-evoked potential (expressed in millivolts and as the percentage of the amplitude of respective peripheral response); CSP: cortical silent period (in milliseconds); AMN: adrenomyeloneuropathy; HSP: hereditary spastic paraplegia; MHG: medial head of gastrocnemius; compl.: complicated. The unusually high amplitude of MEP in relation to peripheral response in this patient may be explained by atrophy of MHG, which decreased the peripheral response more profoundly than MEP, because MEP amplitude was probably a summation of potentials generated by MHG and adjacent muscles innervated by the peroneal nerve, which were located—due to atrophy—close to the recording electrode. Patient no. 6 dropped out. CSP was not done in patient number 8. As the published normative data for MT were done using circular coil [24], we did not assess MT regarding its normality.