Functionally matched domains in parietal-frontal cortex of monkeys project to overlapping regions of the striatum

Projections of small regions (domains) of primary motor cortex (M1), premotor cortex (PMC) and posterior parietal cortex (PPC) to the striatum of squirrel monkeys were revealed by restricted injections of anterograde tracers. As many as 8 classes of action-specific domains can be identified in PPC, as well as in PMC and M1, and some have been identified for injections by the action evoked by 0.5 s trains of electrical microstimulation. Injections of domains in all three cortical regions labeled dense patches of terminations in the matrix of the ipsilateral putamen, while providing sparse or no projections to corresponding regions of the contralateral putamen. When two or three of these domains were injected with different tracers, projection fields in the putamen were highly overlapped for injections in functionally matched domains across cortical areas, but were highly segregated for injections placed in functionally mismatched domains. While not all classes of domains were studied, the results suggest that the striatum potentially has separate representations of eight or more classes of actions that receive inputs from domains in three or more cortical regions in sensorimotor cortex. The overlap/segregation of cortico-striatal projections correlates with the strength of cortico-cortical connections between injected motor areas.

Electrical Cortical Stimulation: Mapping for Function and Seizures

Surgical procedures for the treatment of epilepsy and brain tumors can involve resection of regions closed or merged to functionally eloquent cortical areas. Removal of language, primary motor, or sensory areas can be associated with transient or permanent functional deficits, which should be avoided if possible. Functional electrical cortical stimulation is a reliable technique to prevent or minimize motor, sensory and language deficits and has been used in humans since the 1950s to identify functional cortex, and it can also localize epileptogenic regions. This article discusses functional electrical stimulation in adults and children for different functional modalities.

A limited range of vagus nerve stimulation intensities produce motor cortex reorganization when delivered during training

Pairing vagus nerve stimulation (VNS) with rehabilitation has emerged as a potential strategy to improve recovery after neurological injury, an effect ascribed to VNS-dependent enhancement of synaptic plasticity. Previous studies demonstrate that pairing VNS with forelimb training increases forelimb movement representations in motor cortex. However, it is not known whether VNS-dependent enhancement of plasticity is restricted to forelimb training or whether VNS paired with other movements could induce plasticity of other motor representations. We tested the hypothesis that VNS paired with orofacial movements associated with chewing during an unskilled task would drive a specific increase in jaw representation in motor cortex compared to equivalent behavioral experience without VNS. Rats performed a behavioral task in which VNS at a specified intensity between 0 and 1.2 mA was paired with chewing 200 times per day for five days. Intracortical microstimulation (ICMS) was then used to document movement representations in motor cortex. VNS paired with chewing at 0.8 mA significantly increased motor cortex jaw representation compared to equivalent behavioral training without stimulation (Bonferroni-corrected unpaired t-test, p < 0.01). Higher and lower intensities failed to alter cortical plasticity. No changes in other movement representations or total motor cortex area were observed between groups. These results demonstrate that 0.8 mA VNS paired with training drives robust plasticity specific to the paired movement, is not restricted to forelimb representations, and occurs with training on an unskilled task. This suggests that moderate intensity VNS may be a useful adjuvant to enhance plasticity and support benefits of rehabilitative therapies targeting functions beyond upper limb movement.

Using transcranial magnetic stimulation to map the cortical representation of lower-limb muscles

Objective

To evaluate the extent to which transcranial magnetic stimulation (TMS) can identify discrete cortical representation of lower-limb muscles in healthy individuals.

Methods

Motor evoked potentials were recorded from resting vastus medialis, rectus femoris, vastus lateralis, medial and lateral hamstring, and medial and lateral gastrocnemius muscles on the right leg of 16 young healthy adults using bipolar surface electrodes. TMS was delivered through a 110-mm double-cone coil at 63 sites over the left hemisphere. Location and size of cortical representation and number of discrete peaks were quantified.

Results

Within the quadriceps group there was a main effect of muscle on anterior-posterior centre of gravity (p = 0.010), but the magnitude of the difference was small. There was also a main effect of muscle on medial-lateral hotspot (p = 0.027) and map volume (p = 0.047), but no post-hoc tests were significant. The topography of each lower-limb muscle was complex and variable across individuals.

Conclusions

TMS delivered with a 110-mm double-cone coil could not reliably identify discrete cortical representations of resting lower-limb muscles when responses were measured using bipolar surface electromyography.

Significance

The characteristics of the cortical representation provide a basis against which to evaluate cortical reorganisation in clinical populations.

Influence of RehaCom Therapy on the Improvement of Manual Skills in Multiple Sclerosis Subjects

Objective

To assess the influence of cognitive therapy, in combination with cognitive software, on manual dexterity in individuals with multiple sclerosis (MS).

Methods

The Nine-Hole Peg Test (NHPT) was used to establish the eligibility of individuals with MS for testing and to assess their upper limb performance. In addition to standard upper limb rehabilitation, 20 participants received RehaCom-based visual-motor therapy, administered three times a week in 20-minute routines.

Results

A significant relationship was found between the use of manual therapy that utilized the cognitive function platform and the improvement of the non-dominant hand (p=0.037). Compared to controls, the experimental group scored higher on the NHPT, when using the dominant hand (p=0.007). All members of the experimental group, aged ≤60 years, needed considerably less time to do the NHPT with the dominant hand (p=0.008).

Conclusion

Application of manual therapy using the cognitive function platform improves performance of the hand. However, further research is needed to analyze the correlation between cognitive function and motor performance in patients with MS.

Rotational field TMS: Comparison with conventional TMS based on motor evoked potentials and thresholds in the hand and leg motor cortices

BACKGROUND

Transcranial magnetic stimulation (TMS) is a rapidly expanding technology utilized in research and neuropsychiatric treatments. Yet, conventional TMS configurations affect primarily neurons that are aligned parallel to the induced electric field by a fixed coil, making the activation orientation-specific. A novel method termed rotational field TMS (rfTMS), where two orthogonal coils are operated with a 90° phase shift, produces rotation of the electric field vector over almost a complete cycle, and may stimulate larger portion of the neuronal population within a given brain area.

OBJECTIVE

To compare the physiological effects of rfTMS and conventional unidirectional TMS (udTMS) in the motor cortex.

METHODS

Hand and leg resting motor thresholds (rMT), and motor evoked potential (MEP) amplitudes and latencies (at 120% of rMT), were measured using a dual-coil array based on the H7-coil, in 8 healthy volunteers following stimulation at different orientations of either udTMS or rfTMS.

RESULTS

For both target areas rfTMS produced significantly lower rMTs and much higher MEPs than those induced by udTMS, for comparable induced electric field amplitude. Both hand and leg rMTs were orientation-dependent.

CONCLUSIONS

rfTMS induces stronger physiologic effects in targeted brain regions at significantly lower intensities. Importantly, given the activation of a much larger population of neurons within a certain brain area, repeated application of rfTMS may induce different neuroplastic effects in neural networks, opening novel research and clinical opportunities.

Altered speech-related cortical network in frontotemporal dementia

BACKGROUND

In healthy subjects (HS), transcranial magnetic stimulation (TMS) demonstrated an increase in motor-evoked potential (MEP) amplitudes during specific linguistic tasks. This finding indicates functional connections between speech-related cortical areas and the dominant primary motor cortex (M1).

OBJECTIVE

To investigate M1 function with TMS and the speech-related cortical network with neuroimaging measures in frontotemporal dementia (FTD), including the non-fluent variant of primary progressive aphasia (nfv-PPA) and the behavioral variant of FTD (bv-FTD).

METHODS

M1 excitability changes during specific linguistc tasks were examined using TMS in 24 patients (15 with nfv-PPA and 9 with bv-FTD) and in 18 age-matched HS. In the same patients neuroimaging was used to assess changes in specific white matter (WM) bundles and grey matter (GM) regions involved in language processing, with diffusion tensor imaging (DTI) and voxel-based morphometry (VBM).

RESULTS

During the linguistic task, M1 excitability increased in HS, whereas in FTD patients it did not. M1 excitability changes were comparable in nfv-PPA and bv-FTD. DTI revealed decreased fractional anisotropy in the superior and inferior longitudinal and uncinate fasciculi. Moreover, VBM disclosed GM volume loss in the left frontal operculum though not in the parietal operculum or precentral gyrus. Furthermore, WM and GM changes were comparable in nfv-PPA and bv-FTD. There was no correlation between neurophysiological and neuroimaging changes in FTD. Atrophy in the left frontal operculum correlated with linguistic dysfunction, assessed by semantic and phonemic fluency tests.

CONCLUSION

We provide converging neurophysiological and neuroimaging evidence of abnormal speech-related cortical network activation in FTD.

Cerebellar outputs contribute to spontaneous and movement-related activity in the motor cortex of monkeys

Cerebellar outputs originate from the dentate nucleus (DN), project to the primary motor cortex (M1) via the motor thalamus, control M1 activity, and play an essential role in coordinated movements. However, it is unclear when and how the cerebellar outputs contribute to M1 activity. To address this question, we examined the response of M1 neurons to electrical stimulation of the DN and M1 activity during performance of arm-reaching tasks. Based on response patterns to DN stimulation, M1 neurons were classified into facilitation-, suppression-, and no-response-types. During tasks, not only facilitation- and suppression-type M1 neurons, but also no response-type M1 neurons increased or decreased their firing rates in relation to arm reaching movements. However, the firing rates of facilitation- and suppression-type neurons were higher than those of no-response-type neurons during both inter-trial intervals and arm reaching movements. These results imply that cerebellar outputs contribute to both spontaneous and movement-related activity in the M1, which help to maintain muscle tones and execute coordinated movements, although other inputs also contribute to movement-related activity. Pharmacological inactivation of the DN supports this notion, in that DN inactivation reduced both spontaneous firing rates and movement-related activity in the M1.

Visual feedback therapy for restoration of upper limb function of stroke patients

Objective

To investigate the effects of mirror neuron theory-based visual feedback therapy (VFT) on restoration of upper limb function of stroke patients and motor-related cortical function using functional magnetic resonance imaging (fMRI).

Methods

Hemiplegic stroke patients were randomly divided into two groups: a VFT group and a control (CTL) group. Sixteen patients in the VFT group received conventional rehabilitation (CR) and VFT for 8 weeks, while 15 patients in the CTL group received only CR. The Barthel Index (BI) was used to assess the activities of daily living at baseline and the 8^th week of the recovery training period. The Fugl–Meyer assessment (FMA) scale, somatosensory evoked potential (SEP), and fMRI were used to evaluate the recovery effect of the training therapies. The latencies and amplitudes of N9 and N20 were measured. Before recovery training, fMRI was performed for all patients in the VFT and CTL groups. In addition, 17 patients (9 in the VFT group and 8 in the CTL group) underwent fMRI for follow-up 2 months after treatment. Qualitative data were analyzed using the χ² test. The independent sample t-test was used to compare normally distributed data among different groups, the paired sample t-test was used to compare data between groups, and the non-parametric test was used to comparing data without normal distribution among groups.

Results

There were no significant differences between the VFT and CTL group in all indexes. However, after 8 weeks of recovery training, these indexes were all significantly improved (P < 0.05). As compared with the CTL group, the FMA scores, BI, and N9/N20 latencies and amplitudes of SEP in the VFT group were significantly improved (P < 0.05). Two months after recovery training, fMRI showed that the degree of activation of the bilateral central anterior gyrus, parietal lobe, and auxiliary motor areas was significantly higher in the VFT group than the CTL group (P < 0.05).

Conclusions

VFT based on mirror neuron theory is an effective approach to improve upper extremity motor function and daily activity performance of stroke patients. The therapeutic mechanism promotes motor relearning by activating the mirror neuron system and motor cortex. SEP amplitudes increased only for patients who participated in visual feedback. VFT promotes sensory-motor plasticity and behavioral changes in both the motor and sensory domains.

Determination of anodal tDCS duration threshold for reversal of corticospinal excitability: An investigation for induction of counter-regulatory mechanisms

BACKGROUND

Transcranial direct current stimulation (tDCS) is used to induce neuroplasticity in the human brain. Within certain limits of stimulation duration, anodal tDCS (a-tDCS) over the primary motor cortex induces long term potentiation- (LTP) like plasticity. A reversal of the direction of plasticity has however been described with prolonged a-tDCS protocols.

OBJECTIVE

We aimed to systematically investigate the intervention duration threshold for reversal of a-tDCS-induced effects on corticospinal excitability (CSE) and to determine the probable mechanisms involved in these changes.

METHODS

Fifteen healthy participants received a-tDCS of 1 mA for five different durations in pseudo-random session order. Transcranial magnetic stimulation (TMS) was delivered over the left M1, and motor evoked potentials (MEPs) of a contralateral hand muscle were recorded before, immediately and 30 min following intervention to measure CSE changes. Short-interval intracortical inhibition (SICI), intracortical facilitation (ICF), and long interval facilitation (LIF) were assessed via paired-pulse TMS protocols.

RESULTS

A-tDCS significantly increased CSE as expected at stimulation durations of 22 and 24 min. However, this effect of a-tDCS on CSE decreased and even reversed when stimulation duration increased to 26, 28, and 30 min. Respective alterations of ICF, LIF, and SICI indicate the involvement of glutamatergic, and GABAergic systems in these effects.

CONCLUSIONS

These results confirm a duration threshold for reversal of the excitability-enhancing effect of a-tDCS with stimulation durations ≥ 26 min. Counter-regulatory mechanisms are discussed as a mechanistic foundation for these effects, which might prevent excessive brain activation.

DNA damage accumulates and responses are engaged in human ALS brain and spinal motor neurons and DNA repair is activatable in iPSC-derived motor neurons with SOD1 mutations

DNA damage is implicated in the pathogenesis of amyotrophic lateral sclerosis (ALS). However, relationships between DNA damage accumulation, DNA damage response (DDR), and upper and lower motor neuron vulnerability in human ALS are unclear; furthermore, it is unknown whether epigenetic silencing of DNA repair pathways contributes to ALS pathogenesis. We tested the hypotheses that DNA damage accumulates in ALS motor neurons along with diminished DDR, and that DNA repair genes undergo hypermethylation. Human postmortem CNS tissue was obtained from ALS cases (N = 34) and age-matched controls without neurologic disease (N = 15). Compared to age-matched controls, abasic sites accumulated in genomic DNA of ALS motor cortex and laser capture microdissection-acquired spinal motor neurons but not in motor neuron mitochondrial DNA. By immunohistochemistry, DNA damage accumulated significantly in upper and lower motor neurons in ALS cases as single-stranded DNA and 8-hydroxy-deoxyguanosine (OHdG) compared to age-matched controls. Significant DDR was engaged in ALS motor neurons as evidenced by accumulation of c-Abl, nuclear BRCA1, and ATM activation. DNA damage and DDR were present in motor neurons at pre-attritional stages and throughout the somatodendritic attritional stages of neurodegeneration. Motor neurons with DNA damage were also positive for activated p53 and cleaved caspase-3. Gene-specific promoter DNA methylation pyrosequencing identified the DNA repair genes Ogg1, Apex1, Pnkp and Aptx as hypomethylated in ALS. In human induced-pluripotent stem cell (iPSC)-derived motor neurons with familial ALS SOD1 mutations, DNA repair capacity was similar to isogenic control motor neurons. Our results show that vulnerable neurons in human ALS accumulate DNA damage, and contrary to our hypothesis, strongly activate and mobilize response effectors and DNA repair genes. This DDR in ALS motor neurons involves recruitment of c-Abl and BRCA1 to the nucleus in vivo, and repair of DNA double-strand breaks in human ALS motor neurons with SOD1 mutations in cell culture.

Imaging neuronal activity in the central and peripheral nervous systems using new Thy1.2-GCaMP6 transgenic mouse lines

BACKGROUND

The genetically encoded calcium (Ca2+) sensor GCaMP6 has been widely used for imaging Ca2+ transients in neuronal somata, dendrites, and synapses.

NEW METHOD

Here we describe five new transgenic mouse lines expressing GCaMP6F (fast) or GCaMP6S (slow) in the central and peripheral nervous system under the control of theThy1.2 promoter.

RESULTS

These transgenic lines exhibit stable and layer-specific expression of GCaMP6 in multiple brain regions. They have several unique features compared to existing Thy1.2-GCaMP6 mice, including sparse expression of GCaMP6 in layer V pyramidal neurons of the cerebral cortex, motor neurons in the spinal cord, as well as sensory neurons in dorsal root ganglia (DRG). We further demonstrate that these mouse lines allow for robust detection of Ca2+ transients in neuronal somata and apical dendrites in the cerebral cortex of both anesthetized and awake behaving mice, as well as in DRG neurons.

COMPARISON WITH EXISTING METHOD(S)

These transgenic lines allows Ca2+ imaging of dendrites and somas of pyramidal neurons in specific cortical layers that is difficult to achieve with existing methods.

CONCLUSIONS

These GCaMP6 transgenic lines thus provide useful tools for functional analysis of neuronal circuits in both central and peripheral nervous systems.

Action processing in the motor system: Transcranial Magnetic Stimulation (TMS) evidence of shared mechanisms in the visual and linguistic modalities

In two experiments, we compared the dynamics of corticospinal excitability when processing visually or linguistically presented tool-oriented hand actions in native speakers and sequential bilinguals. In a third experiment we used the same procedure to test non-motor, low-level stimuli, i.e. scrambled images and pseudo-words. Stimuli were presented in sequence: pictures (tool + tool-oriented hand action or their scrambled counterpart) and words (tool noun + tool-action verb or pseudo-words). Experiment 1 presented German linguistic stimuli to native speakers, while Experiment 2 presented English stimuli to non-natives. Experiment 3 tested Italian native speakers. Single-pulse trascranial magnetic stimulation (spTMS) was applied to the left motor cortex at five different timings: baseline, 200 ms after tool/noun onset, 150, 350 and 500 ms after hand/verb onset with motor-evoked potentials (MEPs) recorded from the first dorsal interosseous (FDI) and abductor digiti minimi (ADM) muscles. We report strong similarities in the dynamics of corticospinal excitability across the visual and linguistic modalities. MEPs' suppression started as early as 150 ms and lasted for the duration of stimulus presentation (500 ms). Moreover, we show that this modulation is absent for stimuli with no motor content. Overall, our study supports the notion of a core, overarching system of action semantics shared by different modalities.

Specific motor cortex hypoexcitability and hypoactivation in COPD patients with peripheral muscle weakness

Background

Peripheral muscle weakness can be caused by both peripheral muscle and neural alterations. Although peripheral alterations cannot totally explain peripheral muscle weakness in COPD, the existence of an activation deficit remains controversial. The heterogeneity of muscle weakness (between 32 and 57% of COPD patients) is generally not controlled in studies and could explain this discrepancy. This study aimed to specifically compare voluntary and stimulated activation levels in COPD patients with and without muscle weakness.

Methods

Twenty-two patients with quadriceps weakness (COPD_MW), 18 patients with preserved quadriceps strength (COPD_NoMW) and 20 controls were recruited. Voluntary activation was measured through peripheral nerve (VA_peripheral) and transcranial magnetic (VA_cortical) stimulation. Corticospinal and spinal excitability (MEP/Mmax and Hmax/Mmax) and corticospinal inhibition (silent period duration) were assessed during maximal voluntary quadriceps contractions.

Results

COPD_MW exhibited lower VA_cortical and lower MEP/Mmax compared with COPD_NoMW (p < 0.05). Hmax/Mmax was not significantly different between groups (p = 0.25). Silent period duration was longer in the two groups of COPD patients compared with controls (p < 0.01). Interestingly, there were no significant differences between all COPD patients taken together and controls regarding VA_cortical and MEP/Mmax.

Conclusions

COPD patients with muscle weakness have reduced voluntary activation without altered spinal excitability. Corticospinal inhibition is higher in COPD regardless of muscle weakness. Therefore, reduced cortical excitability and a voluntary activation deficit from the motor cortex are the most likely cortical mechanisms implicated in COPD muscle weakness. The mechanisms responsible for cortical impairment and possible therapeutic interventions need to be addressed.

Circuits generating secondarily generalized seizures

Mapping the circuits underlying the generation and propagation of seizures is critically important for understanding their pathophysiology. We review evidence to suggest that circuits engaged in secondarily generalized seizures are likely to be more complex than those currently proposed. Focal seizures have been proposed to engage canonical thalamocortical circuits that mediate primarily generalized absence seizures, leading to secondarily generalized tonic-clonic seizures. In addition to traveling through the canonical thalamocortical circuits, secondarily generalized seizures could also travel through the striatum, globus pallidus, substantia nigra reticulata, and corpus callosum to the contralateral hemisphere. Recruitment of principal neurons in superficial layers 2/3 of the cortex can play a critical role in corticocortical seizure spread. Understanding the neuronal structures engaged in generating secondarily generalized seizures could provide novel targets for neuromodulation for the treatment of seizures. Furthermore, these sites may be loci of neuronal plasticity facilitating epileptogenesis. This article is part of the Special Issue "Proceedings of the 7th London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures".

Application of anodal tDCS at primary motor cortex immediately after practice of a motor sequence does not improve offline gain

Tecchio et al. (J Neurophysiology 104: 1134-1140, 2010) reported that the application of anodal tDCS at primary motor cortex (M1) immediately after practice of a procedural motor skill enhanced consolidation, which in turn improved offline gain. Tecchio et al. noted, however, that this study did not account for known after-effects associated with this form of non-invasive stimulation. The present study was designed to explicitly reevaluate Tecchio et al.'s claim. As in the original study, individuals experienced either anodal or sham stimulation at M1 after practice of a serial reaction time task (SRTT) followed by test trials 15-min later. Two additional novel conditions experienced the test trials after 120-min rather than 15-min thus allowing potential stimulation after-effects to dissipate. The expectation was that if anodal stimulation influences post-practice consolidation leading to offline gain, this effect would be present not only at 15-min but also after 120-min. In agreement with the working hypothesis, findings revealed offline gain at both 15-min and the longer 2-h time period. Unexpectedly, we found no interaction between real and sham conditions. The lack of difference between Real and Sham effects weakens confidence in the potential of post-practice tDCS for consolidation enhancement, while it is more consistent with other claims that decoupling practice and anodal tDCS stimulation in time can reduce the effectiveness of exogenous stimulation for procedural skill gain.

Longitudinal assessment of 1H-MRS (GABA and Glx) and TMS measures of cortical inhibition and facilitation in the sensorimotor cortex

The purpose of the present study was to investigate the long-term stability of water-referenced GABA and Glx neurometabolite concentrations in the sensorimotor cortex using MRS and to assess the long-term stability of GABA- and glutamate-related intracortical excitability using transcranial magnetic stimulation (TMS). Healthy individuals underwent two sessions of MRS and TMS at a 3-month interval. A MEGA-PRESS sequence was used at 3 T to acquire MRS signals in the sensorimotor cortex. Metabolites were quantified by basis spectra fitting and metabolite concentrations were derived using unsuppressed water reference scans accounting for relaxation and partial volume effects. TMS was performed using published standards. After performing stability and reliability analyses for MRS and TMS, reliable change indexes were computed for all measures with a statistically significant test-retest correlation. No significant effect of time was found for GABA, Glx and TMS measures. There was an excellent ICC and a strong correlation across time for GABA and Glx. Analysis of TMS measure stability revealed an excellent ICC for rMT CSP and %MSO and a fair ICC for 2 ms SICI. There was no significant correlation between MRS and TMS measures at any time point. This study shows that MRS-GABA and MRS-Glx of the sensorimotor cortex have good stability over a 3-month period, with variability across time comparable to that reported in other brain areas. While resting motor threshold, %MSO and CSP were found to be stable and reliable, other TMS measures had greater variability and lesser reliability.

Reducing variability in motor cortex activity at a resting state by extracellular GABA for reliable perceptual decision-making

Interaction between sensory and motor cortices is crucial for perceptual decision-making, in which intracortical inhibition might have an important role. We simulated a neural network model consisting of a sensory network (N_S) and a motor network (N_M) to elucidate the significance of their interaction in perceptual decision-making in association with the level of GABA in extracellular space: extracellular GABA concentration. Extracellular GABA molecules acted on extrasynaptic receptors embedded in membranes of pyramidal cells and suppressed them. A reduction in extracellular GABA concentration either in N_S or N_M increased the rate of errors in perceptual decision-making, for which an increase in ongoing-spontaneous fluctuations in subthreshold neuronal activity in N_M prior to sensory stimulation was responsible. Feedback (N_M-to-N_S) signaling enhanced selective neuronal responses in N_S, which in turn increased stimulus-evoked neuronal activity in N_M. We suggest that GABA in extracellular space contributes to reducing variability in motor cortex activity at a resting state and thereby the motor cortex can respond correctly to a subsequent sensory stimulus. Feedback signaling from the motor cortex improves the selective responsiveness of the sensory cortex, which ensures the fidelity of information transmission to the motor cortex, leading to reliable perceptual decision-making.

The effect of coil placement and orientation on the assessment of focal excitability in motor mapping with navigated transcranial magnetic stimulation

BACKGROUND

Navigated transcranial magnetic stimulation (nTMS) is used for mapping muscle representations in the primary motor cortex. We used sulcus-aligned mapping and electric field (E-field) modeling to investigate the excitability of the motor hand area for further understanding the methodological limitations of nTMS.

NEW METHOD

We studied 10 healthy volunteers to locate the cortical target eliciting the largest responses (the hotspot) in the first dorsal interosseous (FDI) muscle. Six additional targets were placed along the central sulcus at 5-mm distances. Resting motor thresholds (rMTs) and optimal coil orientations were determined at all targets, and a conventional motor mapping was conducted. The cortical E-fields, induced by stimulating the targets with rMT intensities and optimal coil orientations, were modeled in a realistic head geometry to estimate the activated cortical sites.

RESULTS

The rMTs increased with increasing distance from the hotspot (p < 0.001). The greatest motor-evoked potential (MEP) amplitudes occurred with the coil perpendicular to the sulcus and with the coil pointing towards the hotspot or the center of gravity of the motor map. The E-field strengths at the hotspot (99±26 V/m) remained above previously estimated thresholds for activation.

COMPARISON WITH EXISTING METHODS

Depending on the target location, optimal coil orientations may deviate significantly from the conventional perpendicular-to-sulcus angle, which is often assumed optimal. These orientations seem to maintain the E-field stable in the hand knob, regardless of the sulcal shape near the stimulated target.

CONCLUSIONS

The coil orientation is crucial for the accuracy of motor mapping, and the apparent motor map may extend due to remote hotspot activation.

Low-intensity contralesional electrical theta burst stimulation modulates ipsilesional excitability and enhances stroke recovery

Targeting interhemispheric inhibition using brain stimulation has shown potential for enhancing stroke recovery. Following stroke, increased inhibition originating from the contralesional hemisphere impairs motor activation in ipsilesional areas. We have previously reported that low-intensity electrical theta burst stimulation (TBS) applied to an implanted electrode in the contralesional rat motor cortex reduces interhemispheric inhibition, and improves functional recovery when commenced three days after cortical injury. Here we apply this approach at more clinically relevant later time points and measure recovery from photothrombotic stroke, following three weeks of low-intensity intermittent TBS (iTBS), continuous TBS (cTBS) or sham stimulation applied to the contralesional motor cortex. Interhemispheric inhibition and cellular excitability were measured in the same rats from single pyramidal neurons in the peri-infarct area, using in vivo intracellular recording. A minimal dose of iTBS did not enhance motor function when applied beginning one month after stroke. However both a high and a low dose of iTBS improved recovery to a similar degree when applied 10 days after stroke, with the degree of recovery positively correlated with ipsilesional excitability. The final level of interhemispheric inhibition was negatively correlated with excitability, but did not independently correlate with functional recovery. In contrast, contralesional cTBS left recovery unaltered, but decreased ipsilesional excitability. These data support focal contralesional iTBS and not cTBS as an intervention for enhancing stroke recovery and suggest that there is a complex relationship between functional recovery and interhemispheric inhibition, with both independently associated with ipsilesional excitability.

Static magnetic field stimulation of the supplementary motor area modulates resting-state activity and motor behavior

Focal application of a strong static magnetic field over the human scalp induces measurable local changes in brain function. Whether it also induces distant effects across the brain and how these local and distant effects collectively affect motor behavior remains unclear. Here we applied transcranial static magnetic field stimulation (tSMS) over the supplementary motor area (SMA) in healthy subjects. At a behavioral level, tSMS increased the time to initiate movement while decreasing errors in choice reaction-time tasks. At a functional level, tSMS increased SMA resting-state fMRI activity and bilateral functional connectivity between the SMA and both the paracentral lobule and the lateral frontotemporal cortex, including the inferior frontal gyrus. These results suggest that tSMS over the SMA can induce behavioral aftereffects associated with modulation of both local and distant functionally-connected cortical circuits involved in the control of speed-accuracy tradeoffs, thus offering a promising protocol for cognitive and clinical research.

Motor cortex somatotopic presentation after restriction of neck movement in rats

[Purpose] In this study, we aimed to investigate the effects of neck movement restriction on somatotopic mapping of the motor cortex. We restricted cervical extension for two weeks and investigated the effects on motor cortex somatic representation in rats. [Subjects and Methods] We placed six Wistar rats into each of three groups: (i) the experimental group, in which cervical extension was restricted; (ii) the sham group, in which cervical movement was not restricted, but a splint was placed in the shoulder girdle; and (iii) the control group. After cervical immobilization for two weeks, we evaluated the motor cortex somatic representation using intra-cortical micro-stimulation. [Results] In the experimental group, the areas of the cervical and vibrissal domains of the motor cortex decreased by approximately 50%, and the forelimb domain showed slight reduction. In addition, a trunk domain formed at the locus of the vibrissal area. There were no differences between the sham and control groups. [Conclusion] Restriction of cervical extension for two weeks resulted in changes in motor cortex somatic representation. Reversible changes occurred in cortical areas that controlled the neck and parts of the body involved in cervical movement.

Simulation of transcranial magnetic stimulation in head model with morphologically-realistic cortical neurons

BACKGROUND

Transcranial magnetic stimulation (TMS) enables non-invasive modulation of brain activity with both clinical and research applications, but fundamental questions remain about the neural types and elements TMS activates and how stimulation parameters affect the neural response.

OBJECTIVE

To develop a multi-scale computational model to quantify the effect of TMS parameters on the direct response of individual neurons.

METHODS

We integrated morphologically-realistic neuronal models with TMS-induced electric fields computed in a finite element model of a human head to quantify the cortical response to TMS with several combinations of pulse waveforms and current directions.

RESULTS

TMS activated with lowest intensity intracortical axonal terminations in the superficial gyral crown and lip regions. Layer 5 pyramidal cells had the lowest thresholds, but layer 2/3 pyramidal cells and inhibitory basket cells were also activated at most intensities. Direct activation of layers 1 and 6 was unlikely. Neural activation was largely driven by the field magnitude, rather than the field component normal to the cortical surface. Varying the induced current direction caused a waveform-dependent shift in the activation site and provided a potential mechanism for experimentally observed differences in thresholds and latencies of muscle responses.

CONCLUSIONS

This biophysically-based simulation provides a novel method to elucidate mechanisms and inform parameter selection of TMS and other cortical stimulation modalities. It also serves as a foundation for more detailed network models of the response to TMS, which may include endogenous activity, synaptic connectivity, inputs from intrinsic and extrinsic axonal projections, and corticofugal axons in white matter.

Short-term Effects of Transcranial Near-Infrared Photobiomodulation on Motor Performance in Healthy Human Subjects: An Experimental SingleBlind Randomized Clinical Trial

Introduction: Transcranial near-infrared photobiomodulation (NIR-PBM) is a new noninvasive procedure which transcranially applies a near-infrared wavelength to the scalp with a laser or a light-emitting diode (LED) source. Improvement in the neurological or psychological symptoms has been reported following light irradiation. However, to our knowledge, there is no study to investigate the effects of transcranial NIR-PBM on motor performance directly. Therefore, the objective of this study was to investigate the short-term effects of transcranial NIR-PBM on motor performance in healthy human subjects. Methods: In this experimental single-blind randomized clinical trial study, 56 right-handed healthy participants, whose ages ranged from 18 to 30, were randomly assigned to (1) Real transcranial NIR-PBMC3 group (n=14), (2) Sham transcranial NIR-PBMC3 group (n=14), (3) Real transcranial NIR-PBMC4 group (n=14), and (4) Sham transcranial NIR-PBMC4 group (n=14). We applied the 808 nm laser with irradiation energy density of 60 J/cm² and power density of 200 mw/cm² to the C3 or C4 points of the scalp. The number of finger taps as an indicator of motor performance was assessed by the finger-tapping test (FTT) before and after irradiation of transcranial NIR-PBM on the corresponding points of the scalp for 5 minutes. Results: The results showed that the number of finger taps in both right and left hands following the use of transcranial NIR-PBM in the real transcranial NIR-PBMC3 group significantly increased (P<0.05). Conclusion: We concluded that using transcranial NIR-PBM with a laser source on C3 point of the motor cortex in right-handed healthy people can increase the number of finger taps in both hands as an indicator of motor performance improvement.