Changes in Cortical Circuits in Movement Disorders



Transcranial magnetic stimulation (TMS) can be used to investigate the intracortical circuits within the primary motor cortex (M1) and connections from other cortical areas to the M1. Repetitive TMS (rTMS) is able to modify the cortical excitability and can be used to test the cortical plasticity. In Parkinson’s disease (PD), there are impairments in intracortical circuits, indicating abnormal modulation of M1 excitability by intrahemispheric and interhemispheric inputs. Organic and psychogenic dystonia may have similar impairment in intracortical circuits but may have differences in cortical plasticity. Essential tremor and PD tremor respond differently to a resetting stimulus applied to different sites along the pathway for tremor generation and transmission, suggesting that they have different pathophysiological origins. Intracortical circuits may be impaired in Tourette’s syndrome but tend to normalize during task performance. Repeated applications of rTMS may induce long-term changes in cortical excitability. It is being developed as a potential treatment to normalize cortical excitability and intracortical circuits for movement disorders.


Dystonia Motor evoked potential Parkinson’s disease Tourett’s syndrome Transcranial magnetic stimulation Tremor 



Active motor threshold


Cerebellar inhibition


Central motor conduction time


Conditioning stimulus


Direct wave


Deep brain stimulation




Essential tremor


Gamma-aminobutyric acid


Indirect wave


Intracortical facilitation


Interstimulus interval


Long latency afferent inhibition


Long interval intracortical inhibition


Long latency interhemispheric inhibition


Primary motor cortex


Motor evoked potential


Paired associative stimulation


Parkinson’s disease


Rest motor threshold


Repetitive transcranial magnetic stimulation


Short latency afferent inhibition


Short interval intracortical facilitation


Short interval intracortical inhibition


Short latency interhemispheric inhibition


Silent period


Transcranial magnetic stimulation


Test stimulus


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Copyright information

© Springer Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Division of Neurology, Krembil Neuroscience Centre and Toronto Western Research InstituteUniversity Health Network, University of TorontoTorontoCanada
  2. 2.7MC-411, Toronto Western HospitalTorontoCanada

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