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Y P O C T O Central Motor Conduction N Time (CMCT) O D E - PowerPoint PPT Presentation

Mar 06, 2023 •660 likes •841 views

Y P O C T O Central Motor Conduction N Time (CMCT) O D E S A Paula Davila Prez, MD E Berenson-Allen Center for Noninvasive Brain Stimulation L Beth Israel Deaconess Medical Center P Harvard Medical School Y P O Outline C

  1. Y P O C T O Central Motor Conduction N Time (CMCT) O D E S A Paula Davila Pérez, MD E Berenson-Allen Center for Noninvasive Brain Stimulation L Beth Israel Deaconess Medical Center P Harvard Medical School

  2. Y P O Outline C T • Physiological and technical aspects O N O • Clinical applications D E S • Hands-on! A E L P

  3. Y P O Definition of CMCT C T O N Time taken for neural impulses to travel through O central nervous system on their way to the D target muscle. E S A E L P

  4. Y P O C T O N O D E S A E L P

  5. Y P O C T O N O D E S A E L P

  6. Y P O C T O N O D E S A E L P

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  8. Y P O C T Método 1 O N O D E S A E Método 2 L F wave + M wave -1 P 2 Kobayashi and Pascual-Leone 2003

  9. Y P O • Stimulation of the roots: (TMS) C – Excites the roots at foramina T • Overestimation of CMCT O – Lower limbs may be difficult to assess N O • F-Waves method: D – Assumes conduction is normal at proximal E segments (Guillain-Barre S.) S – Proximal muscles or muscles with no F-waves A may be difficult E – More accurate L P – Needs 2 stimulators

  10. Y P • Longer conduction time O C • Dispersed and more attenuated responses T O • Low amplitude or no responses N O D E S A E L P Udupa & Chen. Handbook of Clinical Neurology. 2013

  11. Y P CMCT and Diseases O C T O N O D E S A E L P Udupa & Chen. Handbook of Clinical Neurology. 2013

  12. Y P O C T HANDS-ON ! O N O D E S A E L P

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  17. Y P Cortical Silent Period (cSP) O C T cSP Conditions: O • 120% of RMT N Amplitude (mV) • <50% of total muscle O contraction D TMS Pulse E S A Time (ms) E The Cortical Silent Period translates GABA B inhibitory cortical processes L The initial part of the cSP is thought to reflect spinal inhibition (≈50ms) P

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