Archival ReportIs Disturbed Intracortical Excitability a Stable Trait of Chronic Insomnia? A Study Using Transcranial Magnetic Stimulation Before and After Multimodal Sleep Therapy
Section snippets
Methods and Materials
All procedures complied with the declaration of Helsinki and approval was obtained from the medical ethical committee of the VU University Medical Centre.
Resting Motor Thresholds and Responses to Single-Pulse Stimulation
Insomnia patients and control participants did not differ in their resting motor threshold (51.8 ± 1.2 and 54.1 ± 2.3 of percent stimulator output, mean ± SEM, respectively; p = .35). They did, however, differ in their response to single-pulse suprathreshold stimuli, i.e., 120% of resting motor threshold: the area under the curve of the MEP for insomnia patients was 1511.4 ± 208.6 versus 790.0 ± 128.0 microvolts per millisecond for the control subjects (unpaired t test: p = .008). This
Discussion
Our study demonstrates that patients with chronic insomnia show an increase in excitability, as evidenced by larger MEP sizes to both single-pulse and paired-pulse TMS compared with control participants without sleep complaints. This indicates a stronger recruitment of the MEP, i.e., the increase of the MEP size when the stimulation intensity rises from 100% to 120% of resting motor threshold, which itself did not differ between the two groups. As the MEP size reflects the number of motor units
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