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Compared with the regular population, epilepsy is more common in people with intellectual disabilities. In addition, epilepsy is more difficult to diagnose and treat. It is striking how little is known about neuropsychiatric comorbidity, despite the fact that we know that this can have a major impact on the quality of life in this already vulnerable target group.This dissertation makes a start with the improvement of scientifically based considerations in the field of diagnostics, imaging and treatment options for this group. The results are clearly summarized in a graphical overview that can provide professionals with guidance when they encounter neuropsychiatric problems in their daily work. Factors within the intellectual disability itself seem to have more influence on this comorbidity than specific factors within epilepsy.

Contains fulltext : 130300.pdf (Publisher’s version ) (Open Access) The overall goal of the studies in this thesis was the use of non-invasive brain stimulation for measuring and modulating corticospinal excitability and to study the possibility of therapeutic modulation of excitability in some neurological disorders. Brain modulation to reduce the over-excitability of the primary motor cortex in ALS is the subject of the chapter 2 and chapter 3 in which transcranial direct current stimulation (tDCS) and theta burst stimulation (TBS), the latter as a specific form of repetitive transcranial magnetic stimulation (TMS), are used respectively. The effect of TBS over the cerebellum on freezing in patients with Parkinson’s disease is described in chapter 4. Chapter 5 reviews the first studies in literature using TMS as a biomarker in epilepsy. Chapter 6 shows that, in a brain computer interface mediated neurofeedback study, TMS can give “hard proof” on the effectiveness in changing brain excitability. The connectivity between the motor cortex and the muscular system is essential for several neurological disorders like the prediction of recovery after stroke. Any muscle response in a paralyzed muscle group after TMS signals the presence of a connection that might be relevant for the change of functional recovery. A guideline in optimization specifically the recording of electric muscle responses after TMS in the lower arm muscles is the subject of chapter 7. Radboud Universiteit Nijmegen, 03 oktober 2014 Promotor : Stegeman, D.F. Co-promotor : Schelhaas, H.J.

Contains fulltext : 108762.pdf (Publisher’s version ) (Open Access) Radboud Universiteit Nijmegen, 31 oktober 2012 Promotores : Stegeman, D.F., Bloem, B.R. Co-promotores : Schelhaas, H.J., Overeem, S.

Contains fulltext : 87188.pdf (Publisher’s version ) (Open Access) Radboud Universiteit Nijmegen, 06 juni 2011 Promotores : Zwarts, M.J., Stegeman, D.F. Co-promotores : Schelhaas, H.J., Opstal, A.J. van, Dekhuijzen, P.N.R., Hopman, M.T.E., Berg, L.H. van den, Koelman, J.H. 165 p.

Contains fulltext : 86659.pdf (Publisher’s version ) (Open Access) RU Radboud Universiteit Nijmegen, 04 juni 2010 Promotores : Zwarts, M.J., Stegeman, D.F. Co-promotores : Schaik, I.N. van, Schelhaas, H.J. 175 p.

Contains fulltext : 52347.pdf (Publisher’s version ) (Open Access) A muscle fibre can be excited by electrical stimulation using a needle electrode. Action potentials elicited this way will be conducted through the muscle fibre and can be recorded at some distance with a second needle electrode. This way, muscle fibre conduction velocity can be estimated. In the present study we have investigated the determinants of conduction velocity in healthy subjects and in patients with various neuromuscular disorders. Our main result was a linear relationship between conduction velocity and fibre diameter that we demonstrated in both groups, using data obtained from muscle biopsies. Furthermore, we evaluated the diagnostic value of the technique to measure muscle fibre conduction velocity with needle electrodes. Our findings showed that the diagnostic value was similar to those of the reference techniques, which were electromyography and muscle biopsy. In some myopathies, such as mitochondrial myopathies, channelopathies, and early motor neuron disease, our technique rendered superior results. In conclusion, this thesis contributes to the knowledge of muscle fibre physiology, and clarifies the use of an invasive technique to measure conduction velocity in electrodiagnosis. RU Radboud Universiteit Nijmegen, 14 december 2007 Promotores : Zwarts, M.J., Stegeman, D.F. Co-promotor : Schelhaas, H.J. 166 p.