Trial reportNeurology2009
Blepharospasm and the modulation of cortical excitability in primary and secondary motor areas.
Trial report in Neurology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 37 citations in OpenAlex.
- Long-term depression-like plasticity of the blink reflex for the treatment of blepharospasm.Movement disorders : official journal of the Movement Disorder Society · 2013Trial
- Transcranial magnetic brain stimulation modulates blepharospasm: a randomized controlled study.Neurology · 2010Trial
- Noninvasive transcranial brain stimulation for eye diseases and visual dysfunctions: A systematic review of RCTs.iScience · 2025Article
- Efficacy and safety of combination of frankincense and botulinum toxin in the treatment of blepharospasm: a protocol for a single-centre, open-label, randomized, controlled trial.Frontiers in neurology · 2025Article
- Abnormal inter-hemispheric functional cooperation in blepharospasm.Frontiers in neurology · 2025Article
- Transcranial alternating current stimulation can modulate the blink reflex excitability. Effects of a 10- and 20-Hz tACS session on the blink reflex recovery cycle in healthy subjects.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Applications of Transcranial Magnetic Stimulation for Understanding and Treating Dystonia.Advances in neurobiology · 2023Review
- Article
- Effects of non-invasive brain stimulation in dystonia: a systematic review and meta-analysis.Therapeutic advances in neurological disorders · 2022Article
- Comparing Brain Functional Activities in Patients With Blepharospasm and Dry Eye Disease Measured With Resting-State fMRI.Frontiers in neurology · 2021Article
- Blepharospasm, Oromandibular Dystonia, and Meige Syndrome: Clinical and Genetic Update.Frontiers in neurology · 2021Review
- Transcranial Magnetic Stimulation in Tremor Syndromes: Pathophysiologic Insights and Therapeutic Role.Frontiers in neurology · 2021Review
- Blepharospasm 40 years later.Movement disorders : official journal of the Movement Disorder Society · 2017Review
- Multiple Neural Networks Malfunction in Primary Blepharospasm: An Independent Components Analysis.Frontiers in human neuroscience · 2017Article
- Transcranial direct current stimulation for patients with benign essential blepharospasm: a case report.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2017Article
- Therapeutic Use of Non-invasive Brain Stimulation in Dystonia.Frontiers in neuroscience · 2017Review
- Article
- Contribution of TMS and rTMS in the Understanding of the Pathophysiology and in the Treatment of Dystonia.Frontiers in neural circuits · 2016Review
- Non-Invasive Brain Stimulation to Enhance Post-Stroke Recovery.Frontiers in neural circuits · 2016Review
- Prefrontal Hemodynamic Functions during a Verbal Fluency Task in Blepharospasm Using Multi-Channel NIRS.PloS one · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundTraditionally, benign essential blepharospasm (BEB) is considered a disorder caused by basal ganglia dysfunction. Electrophysiologic and brain imaging studies suggest pathologic changes in excitability in the primary motor cortex (MC), anterior cingulate (AC), and secondary motor areas, such as premotor (PMC) and supplementary motor cortices (SMA).
methodsIn this pilot study of 7 patients with BEB, we experimentally reduced cortical excitability of 4 areas: MC (first dorsal interosseus area), PMC, SMA, and AC, each with 3 noninvasive techniques: low-frequency repetitive transcranial magnetic stimulation (lfrTMS), continuous theta burst stimulation (cTBS), and cathodal transcranial direct current stimulation (tDCS). Primary outcome was the clinical effects on blepharospasm (blink rate observation by an investigator blinded to the intervention and subjective rating by the patient); secondary outcome was the blink reflex recovery curve (BRR).
resultslfrTMS resulted in a significant improvement over all 4 brain areas for physician rating, patient rating, and BRR, whereas cTBS and tDCS showed only trends for improvement in physician rating, but no improvements for patient rating and BRR. lfrTMS had a significantly higher effect over AC than MC for physician rating, but no differences were seen for other pairwise comparisons of stimulated brain areas.
conclusionsElectrophysiologic and clinical improvements by functional inhibition of the medial frontal areas using low-frequency repetitive transcranial magnetic stimulation suggests that hypersensitivity of the anterior cingulate is directly or indirectly involved in the pathophysiology of benign essential blepharospasm. Inhibition of these areas using low-frequency repetitive transcranial magnetic stimulation could provide a therapeutic tool and is worthy of a larger study.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.