Abstract
Objective
The corpus callosum (CC) is commonly affected in multiple sclerosis (MS). The ipsilateral
silent period (iSP) is a putative electrophysiological marker of callosal demyelination.
The purpose of this study was to re-assess, under recently established optimised protocol
conditions [Jung P., Ziemann U. Differences of the ipsilateral silent period in small
hand muscles. Muscle Nerve in press.], its diagnostic sensitivity in MS, about which
conflicting results were reported in previous studies.
Methods
ISP measurements (onset, duration, and depth) were obtained in the abductor pollicis
brevis (APB) muscle of either hand in 49 patients with early relapsing–remitting MS
(RRMS) (mean EDSS, 1.3). Standard central motor conduction times to the APB (CMCTAPB) and tibial anterior muscles (CMCTTA), and magnetic resonance images (MRI) were also obtained.
Results
ISP measurements showed a similar diagnostic sensitivity (28.6%) as CMCTAPB (24.5%), while diagnostic sensitivities of CMCTTA (69.4%) and MRI of the CC (78.6%) were much higher. Prolongation of iSP duration
was the most sensitive single iSP measure. ISP prolongation occurred more frequently
when CMCTAPB to the same hand was also prolonged (40.0% vs. 8.4%, p<0.0001). The correlation between iSP duration and CMCTAPB was significant (Pearson's r=0.24, p<0.02), suggesting that iSP duration can be contaminated by demyelination of the contralateral
corticospinal tract. ISP duration did not correlate with MRI abnormalities of the
CC.
Conclusions
ISP measures are neither a sensitive nor a specific marker of callosal conduction
abnormality in early RRMS.
Keywords
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Article info
Publication history
Accepted:
August 16,
2006
Received in revised form:
August 16,
2006
Received:
May 8,
2006
Identification
Copyright
© 2006 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
