{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T05:35:11Z","timestamp":1761975311153,"version":"build-2065373602"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,2,11]],"date-time":"2013-02-11T00:00:00Z","timestamp":1360540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Our previous work showed a beneficial therapeutic effect on blepharospasm using slow repetitive transcranial magnetic stimulation, which produces a long\u2010term depression (<jats:styled-content style=\"fixed-case\">LTD<\/jats:styled-content>)\u2010like effect. High\u2010frequency supraorbital electrical stimulation, asynchronous with the R2 component of the blink reflex, can also induce <jats:styled-content style=\"fixed-case\">LTD<\/jats:styled-content>\u2010like effects on the blink reflex circuit in healthy subjects. Patients with blepharospasm have reduced inhibition of their blink recovery curves; therefore, a LTD\u2010like intervention might normalize the blink reflex recovery (<jats:styled-content style=\"fixed-case\">BRR<\/jats:styled-content>) and have a favorable therapeutic effect. This is a randomized, sham\u2010controlled, observer\u2010blinded prospective study. In 14 blepharospasm patients, we evaluated the effects of high\u2010frequency supraorbital stimulation on three separate treatment days. We applied 28 trains of nine stimuli, 400 Hz, either before or after the R2 or used sham stimulation. The primary outcome was the blink rate, number of spasms rated by a blinded physician and patient rating before, immediately after and 1 hour after stimulation while resting, reading, and talking; secondary outcome was the <jats:styled-content style=\"fixed-case\">BRR<\/jats:styled-content>. Stimulation \u201cbefore\u201d and \u201cafter\u201d the R2 both showed a similar improvement as sham stimulation in physician rating, but patients felt significantly better with the before condition. Improvement in recovery of the blink reflex was noted only in the before condition. Clinical symptoms differed in the three baseline conditions (resting, reading, and talking). Stimulation before R2 increased inhibition in trigeminal blink reflex circuits in blepharospasm toward normal values and produced subjective, but not objective, improvement. Inhibition of the blink reflex pathway by itself appeared to be insufficient for a useful therapeutic effect. \u00a9 2013 <jats:italic>Movement<\/jats:italic> Disorder Society<\/jats:p>","DOI":"10.1002\/mds.25329","type":"journal-article","created":{"date-parts":[[2013,2,11]],"date-time":"2013-02-11T09:34:42Z","timestamp":1360575282000},"page":"498-503","source":"Crossref","is-referenced-by-count":7,"title":["Long\u2010term depression\u2010like plasticity of the blink reflex for the treatment of blepharospasm"],"prefix":"10.1002","volume":"28","author":[{"given":"Gottfried","family":"Kranz","sequence":"first","affiliation":[{"name":"Human Motor Control Section National Institute of Neurological Disorders and Stroke, National Institutes of Health Bethesda Maryland USA"},{"name":"Department of Neurology Medical University of Vienna Wien Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ejaz A.","family":"Shamim","sequence":"additional","affiliation":[{"name":"Human Motor Control Section National Institute of Neurological Disorders and Stroke, National Institutes of Health Bethesda Maryland USA"},{"name":"Department of Neurology Mid\u2010Atlantic Permanente Research Institute of the Mid\u2010Atlantic Permanente Medical Group Rockville Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter T.","family":"Lin","sequence":"additional","affiliation":[{"name":"Human Motor Control Section National Institute of Neurological Disorders and Stroke, National Institutes of Health Bethesda Maryland USA"},{"name":"Department of Neurology Santa Clara Valley Medical Center San Jose California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George S.","family":"Kranz","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Hallett","sequence":"additional","affiliation":[{"name":"Human Motor Control Section National Institute of Neurological Disorders and Stroke, National Institutes of Health Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,2,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000327601.46315.85"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.48.5.1398"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181c5b42d"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh315"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181f8814d"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870080414"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.58.6.692"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-4598(199601)19:1<10::AID-MUS2>3.0.CO;2-B"},{"key":"e_1_2_8_10_1","doi-asserted-by":"crossref","first-page":"RC151","DOI":"10.1523\/JNEUROSCI.21-12-j0002.2001","article-title":"Long\u2010term 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