51
|
Revisiting the Rotational Field TMS Method for Neurostimulation. J Clin Med 2023; 12:jcm12030983. [PMID: 36769630 PMCID: PMC9917411 DOI: 10.3390/jcm12030983] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
Transcranial magnetic stimulation (TMS) is a non-invasive technique that has shown high efficacy in the treatment of major depressive disorder (MDD) and is increasingly utilized for various neuropsychiatric disorders. However, conventional TMS is limited to activating only a small fraction of neurons that have components parallel to the induced electric field. This likely contributes to the significant variability observed in clinical outcomes. A novel method termed rotational field TMS (rfTMS or TMS 360°) enables the activation of a greater number of neurons by reducing the sensitivity to orientation. Recruitment of a larger number of neurons offers the potential to enhance efficacy and reduce variability in the treatment of clinical indications for which neuronal recruitment and organization may play a significant role, such as MDD and stroke. The potential of the method remains to be validated in clinical trials. Here, we revisit and describe in detail the rfTMS method, its principles, mode of operation, effects on the brain, and potential benefits for clinical TMS.
Collapse
|
52
|
de Freitas Zanona A, Romeiro da Silva AC, Baltar do Rego Maciel A, Shirahige Gomes do Nascimento L, Bezerra da Silva A, Piscitelli D, Monte-Silva K. Sensory and motor cortical excitability changes induced by rTMS and sensory stimulation in stroke: A randomized clinical trial. Front Neurosci 2023; 16:985754. [PMID: 36760794 PMCID: PMC9907709 DOI: 10.3389/fnins.2022.985754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 12/29/2022] [Indexed: 01/26/2023] Open
Abstract
Background The ability to produce coordinated movement is dependent on dynamic interactions through transcallosal fibers between the two cerebral hemispheres of the brain. Although typically unilateral, stroke induces changes in functional and effective connectivity across hemispheres, which are related to sensorimotor impairment and stroke recovery. Previous studies have focused almost exclusively on interhemispheric interactions in the primary motor cortex (M1). Objective To identify the presence of interhemispheric asymmetry (ASY) of somatosensory cortex (S1) excitability and to investigate whether S1 repetitive transcranial magnetic stimulation (rTMS) combined with sensory stimulation (SS) changes excitability in S1 and M1, as well as S1 ASY, in individuals with subacute stroke. Methods A randomized clinical trial. Participants with a single episode of stroke, in the subacute phase, between 35 and 75 years old, were allocated, randomly and equally balanced, to four groups: rTMS/sham SS, sham rTMS/SS, rTMS/SS, and sham rTMS/Sham SS. Participants underwent 10 sessions of S1 rTMS of the lesioned hemisphere (10 Hz, 1,500 pulses) followed by SS. SS was applied to the paretic upper limb (UL) (active SS) or non-paretic UL (sham SS). TMS-induced motor evoked potentials (MEPs) of the paretic UL and somatosensory evoked potential (SSEP) of both ULs assessed M1 and S1 cortical excitability, respectively. The S1 ASY index was measured before and after intervention. Evaluator, participants and the statistician were blinded. Results Thirty-six participants divided equally into groups (nine participants per group). Seven patients were excluded from MEP analysis because of failure to produce consistent MEP. One participant was excluded in the SSEP analysis because no SSEP was detected. All somatosensory stimulation groups had decreased S1 ASY except for the sham rTMS/Sham SS group. When compared with baseline, M1 excitability increased only in the rTMS/SS group. Conclusion S1 rTMS and SS alone or in combination changed S1 excitability and decreased ASY, but it was only their combination that increased M1 excitability. Clinical trial registration clinicaltrials.gov, identifier (NCT03329807).
Collapse
Affiliation(s)
- Aristela de Freitas Zanona
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil,Occupational Therapy Department and Post-Graduate Program in Applied Health Sciences, Universidade Federal de Sergipe, São Cristóvão, Brazil
| | | | - Adriana Baltar do Rego Maciel
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | | | - Amanda Bezerra da Silva
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Daniele Piscitelli
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy,Department of Kinesiology, University of Connecticut, Storrs, CT, United States,*Correspondence: Daniele Piscitelli, ,
| | - Katia Monte-Silva
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| |
Collapse
|
53
|
Gebodh N, Miskovic V, Laszlo S, Datta A, Bikson M. A Scalable Framework for Closed-Loop Neuromodulation with Deep Learning. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.01.18.524615. [PMID: 36712027 PMCID: PMC9882307 DOI: 10.1101/2023.01.18.524615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Closed-loop neuromodulation measures dynamic neural or physiological activity to optimize interventions for clinical and nonclinical behavioral, cognitive, wellness, attentional, or general task performance enhancement. Conventional closed-loop stimulation approaches can contain biased biomarker detection (decoders and error-based triggering) and stimulation-type application. We present and verify a novel deep learning framework for designing and deploying flexible, data-driven, automated closed-loop neuromodulation that is scalable using diverse datasets, agnostic to stimulation technology (supporting multi-modal stimulation: tACS, tDCS, tFUS, TMS), and without the need for personalized ground-truth performance data. Our approach is based on identified periods of responsiveness - detected states that result in a change in performance when stimulation is applied compared to no stimulation. To demonstrate our framework, we acquire, analyze, and apply a data-driven approach to our open sourced GX dataset, which includes concurrent physiological (ECG, EOG) and neuronal (EEG) measures, paired with continuous vigilance/attention-fatigue tracking, and High-Definition transcranial electrical stimulation (HD-tES). Our framework's decision process for intervention application identified 88.26% of trials as correct applications, showed potential improvement with varying stimulation types, or missed opportunities to stimulate, whereas 11.25% of trials were predicted to stimulate at inopportune times. With emerging datasets and stimulation technologies, our unifying and integrative framework; leveraging deep learning (Convolutional Neural Networks - CNNs); demonstrates the adaptability and feasibility of automated multimodal neuromodulation for both clinical and nonclinical applications.
Collapse
Affiliation(s)
- Nigel Gebodh
- The Department of Biomedical Engineering, The City College of New York, The City University of New York, New York USA
| | | | | | | | - Marom Bikson
- The Department of Biomedical Engineering, The City College of New York, The City University of New York, New York USA
| |
Collapse
|
54
|
Koseki T, Kudo D, Yoshida K, Nito M, Takano K, Jin M, Tanabe S, Sato T, Katoh H, Yamaguchi T. Combined neuromuscular electrical stimulation and transcutaneous spinal direct current stimulation increases motor cortical plasticity in healthy humans. Front Neurosci 2023; 16:1034451. [PMID: 37091256 PMCID: PMC10115158 DOI: 10.3389/fnins.2022.1034451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/28/2022] [Indexed: 01/15/2023] Open
Abstract
IntroductionNeuromuscular electrical stimulation (NMES) induces neural plasticity of the central nervous system (CNS) and improves motor function in patients with CNS lesions. However, the extended stimulus duration of NMES reduces its clinical applicability. Transcutaneous spinal direct current stimulation (tsDCS), which increases afferent input, may enhance the effects and reduce the stimulus duration of NMES. This study investigated the excitability of the motor cortex, somatosensory cortex, and spinal motor neurons after the combined stimulation of NMES and tsDCS.MethodsAmong the 55 participants in this study, 24 were allocated to experiment 1, 15 to experiment 2, and 16 to experiment 3. They received intervention for 20 min on different days: (1) NMES combined with tsDCS (NMES + tsDCS), (2) NMES combined with sham tsDCS (NMES + sham tsDCS), and (3) sham NMES combined with tsDCS (sham NMES + tsDCS). NMES was delivered to the right common peroneal nerve at 25 Hz with the intensity at 120% of the motor threshold. For tsDCS, the cathodal electrode was positioned on the thoracic 10th–12th vertebral levels, and the anodal electrode was located on the right shoulder. The stimulus intensity was 2.5 mA. In experiment 1, motor evoked potentials (MEPs) and short-latency intracortical inhibition (SICI) were measured by transcranial magnetic stimulation up to 60 min after stimulation. The spinal motor neurons’ excitability was assessed by recording the posterior root muscle reflex (PRMR) induced via transcutaneous spinal cord stimulation in experiment 2, and the primary somatosensory cortex excitability was evaluated by recording the somatosensory evoked potentials (SEPs) in experiment 3 up to 15 min after stimulation.ResultsCompared to before the stimulation, NMES + tsDCS significantly increased MEP for 60 min or more, and significantly decreased SICI immediately after. Conversely contrast, the PRMR significantly decreased immediately after, and SEPs were unchanged.DiscussionThese results suggest that simultaneous afferent inputs from different stimulus positions critically induce primary motor cortex plasticity. The combined stimulation of NMES with tsDCS may facilitate the development of a new neurorehabilitation technique.
Collapse
Affiliation(s)
- Tadaki Koseki
- Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Daisuke Kudo
- Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
- Department of Physical Therapy, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Kaito Yoshida
- Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Mitsuhiro Nito
- Department of Anatomy and Structural Science, Yamagata University School of Medicine, Yamagata, Japan
| | - Keita Takano
- Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Masafumi Jin
- Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Shigeo Tanabe
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Toshiaki Sato
- Department of Occupational Therapy, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Hiroshi Katoh
- Department of Physical Therapy, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Tomofumi Yamaguchi
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan
- *Correspondence: Tomofumi Yamaguchi,
| |
Collapse
|
55
|
Kasten FH, Herrmann CS. The hidden brain-state dynamics of tACS aftereffects. Neuroimage 2022; 264:119713. [PMID: 36309333 DOI: 10.1016/j.neuroimage.2022.119713] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 10/11/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022] Open
Abstract
Non-invasive techniques to electrically stimulate the brain such as transcranial direct and alternating current stimulation (tDCS/tACS) are increasingly used in human neuroscience and offer potential new avenues to treat brain disorders. Previous research has shown that stimulation effects may depend on brain-states. However, this work mostly focused on experimentally induced brain-states over the course of several minutes. Besides such global, long-term changes in brain-states, previous research suggests, that the brain is likely to spontaneously alternate between states in sub-second ranges, which is much closer to the time scale at which it is generally believed to operate. Here, we utilized Hidden Markov Models (HMM) to decompose magnetoencephalography data obtained before and after tACS into spontaneous, transient brain-states with distinct spatial, spectral and connectivity profiles. Only one out of four spontaneous brain-states, likely reflecting default mode network activity, showed evidence for an effect of tACS on the power of spontaneous α-oscillations. The identified state appears to disproportionally drive the overall (non-state resolved) tACS effect. No or only marginal effects were found in the remaining states. We found no evidence that tACS influenced the time spent in each state. Although stimulation was applied continuously, our results indicate that spontaneous brain-states and their underlying functional networks differ in their susceptibility to tACS. Global stimulation aftereffects may be disproportionally driven by distinct time periods during which the susceptible state is active. Our results may pave the ground for future work to understand which features make a specific brain-state susceptible to electrical stimulation.
Collapse
Affiliation(s)
- Florian H Kasten
- Experimental Psychology Lab, Department of Psychology, European Medical School, Cluster of Excellence "Hearing4All", Carl von Ossietzky University, Oldenburg, Germany; Centre de Recherche Cerveau & Cognition, CNRS, Toulouse, France; Université Toulouse III Paul Sabatier, Toulouse, France
| | - Christoph S Herrmann
- Experimental Psychology Lab, Department of Psychology, European Medical School, Cluster of Excellence "Hearing4All", Carl von Ossietzky University, Oldenburg, Germany; Research Center Neurosensory Science, Carl von Ossietzky University, Oldenburg, Germany.
| |
Collapse
|
56
|
Ye H, Hendee J, Ruan J, Zhirova A, Ye J, Dima M. Neuron matters: neuromodulation with electromagnetic stimulation must consider neurons as dynamic identities. J Neuroeng Rehabil 2022; 19:116. [PMID: 36329492 PMCID: PMC9632094 DOI: 10.1186/s12984-022-01094-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 10/15/2022] [Indexed: 11/06/2022] Open
Abstract
Neuromodulation with electromagnetic stimulation is widely used for the control of abnormal neural activity, and has been proven to be a valuable alternative to pharmacological tools for the treatment of many neurological diseases. Tremendous efforts have been focused on the design of the stimulation apparatus (i.e., electrodes and magnetic coils) that delivers the electric current to the neural tissue, and the optimization of the stimulation parameters. Less attention has been given to the complicated, dynamic properties of the neurons, and their context-dependent impact on the stimulation effects. This review focuses on the neuronal factors that influence the outcomes of electromagnetic stimulation in neuromodulation. Evidence from multiple levels (tissue, cellular, and single ion channel) are reviewed. Properties of the neural elements and their dynamic changes play a significant role in the outcome of electromagnetic stimulation. This angle of understanding yields a comprehensive perspective of neural activity during electrical neuromodulation, and provides insights in the design and development of novel stimulation technology.
Collapse
Affiliation(s)
- Hui Ye
- grid.164971.c0000 0001 1089 6558Department of Biology, Quinlan Life Sciences Education and Research Center, Loyola University Chicago, 1032 W. Sheridan Rd., Chicago, IL 60660 USA
| | - Jenna Hendee
- grid.164971.c0000 0001 1089 6558Department of Biology, Quinlan Life Sciences Education and Research Center, Loyola University Chicago, 1032 W. Sheridan Rd., Chicago, IL 60660 USA
| | - Joyce Ruan
- grid.164971.c0000 0001 1089 6558Department of Biology, Quinlan Life Sciences Education and Research Center, Loyola University Chicago, 1032 W. Sheridan Rd., Chicago, IL 60660 USA
| | - Alena Zhirova
- grid.164971.c0000 0001 1089 6558Department of Biology, Quinlan Life Sciences Education and Research Center, Loyola University Chicago, 1032 W. Sheridan Rd., Chicago, IL 60660 USA
| | - Jayden Ye
- grid.164971.c0000 0001 1089 6558Department of Biology, Quinlan Life Sciences Education and Research Center, Loyola University Chicago, 1032 W. Sheridan Rd., Chicago, IL 60660 USA
| | - Maria Dima
- grid.164971.c0000 0001 1089 6558Department of Biology, Quinlan Life Sciences Education and Research Center, Loyola University Chicago, 1032 W. Sheridan Rd., Chicago, IL 60660 USA
| |
Collapse
|
57
|
Cai Z, Pellegrino G, Lina J, Benali H, Grova C. Hierarchical Bayesian modeling of the relationship between task-related hemodynamic responses and cortical excitability. Hum Brain Mapp 2022; 44:876-900. [PMID: 36250709 PMCID: PMC9875942 DOI: 10.1002/hbm.26107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/10/2022] [Accepted: 09/18/2022] [Indexed: 01/28/2023] Open
Abstract
Investigating the relationship between task-related hemodynamic responses and cortical excitability is challenging because it requires simultaneous measurement of hemodynamic responses while applying noninvasive brain stimulation. Moreover, cortical excitability and task-related hemodynamic responses are both associated with inter-/intra-subject variability. To reliably assess such a relationship, we applied hierarchical Bayesian modeling. This study involved 16 healthy subjects who underwent simultaneous Paired Associative Stimulation (PAS10, PAS25, Sham) while monitoring brain activity using functional Near-Infrared Spectroscopy (fNIRS), targeting the primary motor cortex (M1). Cortical excitability was measured by Motor Evoked Potentials (MEPs), and the motor task-related hemodynamic responses were measured using fNIRS 3D reconstructions. We constructed three models to investigate: (1) PAS effects on the M1 excitability, (2) PAS effects on fNIRS hemodynamic responses to a finger tapping task, and (3) the correlation between PAS effects on M1 excitability and PAS effects on task-related hemodynamic responses. Significant increase in cortical excitability was found following PAS25, whereas a small reduction of the cortical excitability was shown after PAS10 and a subtle increase occurred after sham. Both HbO and HbR absolute amplitudes increased after PAS25 and decreased after PAS10. The probability of the positive correlation between modulation of cortical excitability and hemodynamic activity was 0.77 for HbO and 0.79 for HbR. We demonstrated that PAS stimulation modulates task-related cortical hemodynamic responses in addition to M1 excitability. Moreover, the positive correlation between PAS modulations of excitability and hemodynamics brought insight into understanding the fundamental properties of cortical function and cortical excitability.
Collapse
Affiliation(s)
- Zhengchen Cai
- Multimodal Functional Imaging Lab, Department of PhysicsConcordia UniversityMontréalQuébecCanada,PERFORM CentreConcordia UniversityMontréalQuébecCanada
| | - Giovanni Pellegrino
- Epilepsy Program, Schulich School of Medicine and DentistryWestern UniversityLondonOntarioCanada,Multimodal Functional Imaging Lab, Biomedical Engineering DepartmentMcGill UniversityMontréalQuébecCanada
| | - Jean‐Marc Lina
- Département de Génie ElectriqueÉcole de Technologie SupérieureMontréalQuébecCanada,Centre De Recherches En MathématiquesMontréalQuébecCanada
| | - Habib Benali
- PERFORM CentreConcordia UniversityMontréalQuébecCanada,Centre De Recherches En MathématiquesMontréalQuébecCanada,Electrical and Computer Engineering Department, Concordia UniversityMontréalCanada
| | - Christophe Grova
- Multimodal Functional Imaging Lab, Department of PhysicsConcordia UniversityMontréalQuébecCanada,PERFORM CentreConcordia UniversityMontréalQuébecCanada,Multimodal Functional Imaging Lab, Biomedical Engineering DepartmentMcGill UniversityMontréalQuébecCanada,Centre De Recherches En MathématiquesMontréalQuébecCanada
| |
Collapse
|
58
|
Su B, Jia Y, Zhang L, Li D, Shen Q, Wang C, Chen Y, Gao F, Wei J, Huang G, Liu H, Wang L. Reliability of TMS measurements using conventional hand-hold method with different numbers of stimuli for tibialis anterior muscle in healthy adults. Front Neural Circuits 2022; 16:986669. [PMID: 36247728 PMCID: PMC9563236 DOI: 10.3389/fncir.2022.986669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/15/2022] [Indexed: 11/28/2022] Open
Abstract
Objective: The objective of this study was to determine the reliability of corticomotor excitability measurements using the conventional hand-hold transcranial magnetic stimulation (TMS) method for the tibialis anterior (TA) muscle in healthy adults and the number of stimuli required for reliable assessment. Methods: Forty healthy adults participated in three repeated sessions of corticomotor excitability assessment in terms of resting motor threshold (rMT), slope of recruitment curve (RC), peak motor evoked potential amplitude (pMEP), and MEP latency using conventional TMS method. The first two sessions were conducted with a rest interval of 1 h, and the last session was conducted 7–10 days afterward. With the exception of rMT, the other three outcomes measure elicited with the block of first 3–10 stimuli were analyzed respectively. The within-day (session 1 vs. 2) and between-day (session 1 vs. 3) reliability for all four outcome measures were assessed using intraclass correlation coefficient (ICC), standard error of measurement, and minimum detectable difference at 95% confidence interval. Results: Good to excellent within-day and between-day reliability was found for TMS-induced outcome measures examined using 10 stimuli (ICC ≥ 0.823), except in pMEP, which showed between-day reliability at moderate level (ICC = 0.730). The number of three stimuli was adequate to achieve minimum acceptable within-day reliability for all TMS-induced parameters and between-day reliability for MEP latency. With regard to between-day reliability of RC slope and pMEP, at least seven and nine stimuli were recommended respectively. Conclusion: Our findings indicated the high reliability of corticomotor excitability measurement by TMS with adequate number of stimuli for the TA muscle in healthy adults. This result should be interpreted with caveats for the specific methodological choices, equipment setting, and the characteristics of the sample in the current study. Clinical Trial Registration:http://www.chictr.org.cn, identifier ChiCTR2100045141.
Collapse
Affiliation(s)
- Bin Su
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation, Wuxi Central Rehabilitation Hospital, Wuxi, China
| | - Yanbing Jia
- School of Rehabilitation Medicine, Jiangsu Vocational College of Medicine, Yancheng, China
| | - Li Zhang
- Department of Rehabilitation, Wuxi Central Rehabilitation Hospital, Wuxi, China
| | - Duo Li
- Neuro-Rehabilitation Center, JORU Rehabilitation Hospital, Yixing, China
| | - Qianqian Shen
- Department of Rehabilitation, Wuxi Central Rehabilitation Hospital, Wuxi, China
| | - Chun Wang
- Neuro-Rehabilitation Center, JORU Rehabilitation Hospital, Yixing, China
| | - Yating Chen
- Department of Rehabilitation, Wuxi Central Rehabilitation Hospital, Wuxi, China
| | - Fanglan Gao
- Department of Rehabilitation, Wuxi Central Rehabilitation Hospital, Wuxi, China
| | - Jing Wei
- Neuro-Rehabilitation Center, JORU Rehabilitation Hospital, Yixing, China
| | - Guilan Huang
- Department of Rehabilitation, Wuxi Central Rehabilitation Hospital, Wuxi, China
| | - Hao Liu
- School of Rehabilitation Medicine, Jiangsu Vocational College of Medicine, Yancheng, China
- *Correspondence: Lin Wang Hao Liu
| | - Lin Wang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
- *Correspondence: Lin Wang Hao Liu
| |
Collapse
|
59
|
Gong F, Jin L, Song Q, Yang Z, Chen H, Wu J. Surgical techniques and function outcome for cingulate gyrus glioma, how we do it. Front Oncol 2022; 12:986387. [PMID: 36226056 PMCID: PMC9549335 DOI: 10.3389/fonc.2022.986387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveCingulate cortex and cingulum both play crucial roles in limbic system. The aim of study is to observe and analyze surgical outcomes of cingulate gyrus glioma through extents of resection (EORs), overall survival (OS), and postsurgical neurological outcome.MethodThe authors retrospectively studied 95 consecutive adult cases of primary cingulate gliomas that all underwent craniotomies and tumor resection. The patients were classified into unitary sub-region based on the four-division model. The information of clinical symptoms, pathology, EOR, postoperative neurological outcome and survival were analyzed through group comparison.ResultLow-grade gliomas (LGGs) were more prevalent (69.47%) for cingulate gyrus. Diffuse astrocytoma (40.00%) was most common histopathological diagnosis in total. Regarding sub-regions tumor involved in, midcingulate cortex (MCC) glioma was most prevalent (54.74%) followed by anterior cingulate cortex (ACC) glioma. Among all patients, 83 patients (87.37%) received EOR ≥ 90%. In LGG group, 58 patients (87.88%) received EOR ≥ 90%. The achievement of EOR significantly correlated with survival (P = 0.006). MCC cases were significantly associated with short-term morbidity in either language or motor function (P = 0.02). Majority of ACC cases (80.65%) escaped from any short-term deficits and nearly 90% free for permanent morbidity. Tumors in the dominant hemisphere were significantly associated with language dysfunction or cognition dysfunction, either short-term (P=0.0006) or long-term morbidity (P=0.0111). Age was the only postoperative susceptible predictor for all types of transient (P=0.021) and permanent (P=0.02) neurological deficit.ConclusionRegarding cingulate gyrus glioma, the management of surgical plans could be carried out into four sub-region level. In spite of short-term neurological dysfunction caused by surgical procedure, majority of transient dysfunction could be relieved or recovered in long-term. The necessary effort to prolong overall survival is still to achieve advisable EOR.
Collapse
Affiliation(s)
- Fangyuan Gong
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Lei Jin
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Qiuwei Song
- Department of Nursing, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhong Yang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Hong Chen
- Department of Pathology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jinsong Wu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
- *Correspondence: Jinsong Wu,
| |
Collapse
|
60
|
Kaminski E, Maudrich T, Bassler P, Ordnung M, Villringer A, Ragert P. tDCS over the primary motor cortex contralateral to the trained hand enhances cross-limb transfer in older adults. Front Aging Neurosci 2022; 14:935781. [PMID: 36204550 PMCID: PMC9530461 DOI: 10.3389/fnagi.2022.935781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022] Open
Abstract
Transferring a unimanual motor skill to the untrained hand, a phenomenon known as cross-limb transfer, was shown to deteriorate as a function of age. While transcranial direct current stimulation (tDCS) ipsilateral to the trained hand facilitated cross-limb transfer in older adults, little is known about the contribution of the contralateral hemisphere to cross-limb transfer. In the present study, we investigated whether tDCS facilitates cross-limb transfer in older adults when applied over the motor cortex (M1) contralateral to the trained hand. Furthermore, the study aimed at investigating short-term recovery of tDCS-associated cross-limb transfer. In a randomized, double-blinded, sham-controlled setting, 30 older adults (67.0 ± 4.6 years, 15 female) performed a short grooved-pegboard training using their left hand, while anodal (a-tDCS) or sham-tDCS (s-tDCS) was applied over right M1 for 20 min. Left (LHtrained) - and right-hand (RHuntrained) performance was tested before and after training and in three recovery measures 15, 30 and 45 min after training. LHtrained performance improved during both a-tDCS and s-tDCS and improvements persisted during recovery measures for at least 45 min. RHuntrained performance improved only following a-tDCS but not after s-tDCS and outlasted the stimulation period for at least 45 min. Together, these data indicate that tDCS over the M1 contralateral to the trained limb is capable of enhancing cross-limb transfer in older adults, thus showing that cross-limb transfer is mediated not only by increased bi-hemispheric activation.
Collapse
Affiliation(s)
- Elisabeth Kaminski
- Department of Movement Neuroscience, Faculty of Sport Science, Leipzig University, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- *Correspondence: Elisabeth Kaminski,
| | - Tom Maudrich
- Department of Movement Neuroscience, Faculty of Sport Science, Leipzig University, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Pauline Bassler
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Madeleine Ordnung
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
- Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Patrick Ragert
- Department of Movement Neuroscience, Faculty of Sport Science, Leipzig University, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| |
Collapse
|
61
|
Boosting psychological change: Combining non-invasive brain stimulation with psychotherapy. Neurosci Biobehav Rev 2022; 142:104867. [PMID: 36122739 DOI: 10.1016/j.neubiorev.2022.104867] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 09/01/2022] [Accepted: 09/07/2022] [Indexed: 11/21/2022]
Abstract
Mental health disorders and substance use disorders are a leading cause of morbidity and mortality worldwide, and one of the most important challenges for public health systems. While evidence-based psychotherapy is generally pursued to address mental health challenges, psychological change is often hampered by non-adherence to treatments, relapses, and practical barriers (e.g., time, cost). In recent decades, Non-invasive brain stimulation (NIBS) techniques have emerged as promising tools to directly target dysfunctional neural circuitry and promote long-lasting plastic changes. While the therapeutic efficacy of NIBS protocols for mental illnesses has been established, neuromodulatory interventions might also be employed to support the processes activated by psychotherapy. Indeed, combining psychotherapy with NIBS might help tailor the treatment to the patient's unique characteristics and therapeutic goal, and would allow more direct control of the neuronal changes induced by therapy. Herein, we overview emerging evidence on the use of NIBS to enhance the psychotherapeutic effect, while highlighting the next steps in advancing clinical and research methods toward personalized intervention approaches.
Collapse
|
62
|
Battisti A, Lazzaro G, Costanzo F, Varuzza C, Rossi S, Vicari S, Menghini D. Effects of a short and intensive transcranial direct current stimulation treatment in children and adolescents with developmental dyslexia: A crossover clinical trial. Front Psychol 2022; 13:986242. [PMID: 36160506 PMCID: PMC9500580 DOI: 10.3389/fpsyg.2022.986242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/23/2022] [Indexed: 12/02/2022] Open
Abstract
Developmental Dyslexia (DD) significantly interferes with children’s academic, personal, social, and emotional functioning. Nevertheless, therapeutic options need to be further validated and tested in randomized controlled clinical trials. The use of transcranial direct current stimulation (tDCS) has been gaining ground in recent years as a new intervention option for DD. However, there are still open questions regarding the most suitable tDCS protocol for young people with DD. The current crossover study tested the effectiveness of a short and intensive tDCS protocol, including the long-term effects, as well as the influence of age and neuropsychological processes at baseline on reading improvements. Twenty-four children and adolescents with DD were randomly assigned to receive active tDCS during the first slot and sham tDCS during the second slot or vice versa. Five consecutive daily sessions of left anodal/right cathodal tDCS set at 1 mA for 20 min were administered over the parieto-occipital regions. Reading measures (text, high frequency word, low frequency word, and non-word lists) and neuropsychological measures (visual-spatial and verbal working memory, phoneme blending, and rapid automatized naming tasks) were collected before, immediately after, 1 week and 1 month later the treatment. Our results showed that only the active tDCS condition improved non-word reading speed immediately after and 1 month later the end of the treatment compared with baseline. In addition, the improvement in non-word reading speed was significantly correlated with age and with neuropsychological measures (verbal working memory and phoneme blending) at baseline but only in the active tDCS condition. The current crossover study contributed to enforce previous effects of tDCS, including long-term effects, on non-word reading speed and to understand the effect of age and neuropsychological processes on reading outcomes. Our findings showed that tDCS could be a low-cost and easy-to-implement treatment option with long-term effects for children and adolescents with DD.
Collapse
Affiliation(s)
- Andrea Battisti
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Human Science, LUMSA University, Rome, Italy
| | - Giulia Lazzaro
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Floriana Costanzo
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Cristiana Varuzza
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Serena Rossi
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Life Science and Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - Deny Menghini
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- *Correspondence: Deny Menghini,
| |
Collapse
|
63
|
Neurochemical profiles of the anterior temporal lobe predict response of repetitive transcranial magnetic stimulation on semantic processing. Neuroimage 2022; 258:119386. [PMID: 35709948 DOI: 10.1016/j.neuroimage.2022.119386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/23/2022] [Accepted: 06/12/2022] [Indexed: 10/18/2022] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive technique used to modulate cortical excitability in the human brain. However, one major challenge with rTMS is that the responses to stimulation are highly variable across individuals. The underlying reasons why responses to rTMS are highly variable between individuals still remain unclear. Here, we investigated whether the response to continuous theta-burst stimulation (cTBS) - an effective rTMS protocol for decreasing cortical excitability - is related to individual differences in glutamate and GABA neurotransmission. We acquired resting-state magnetic resonance spectroscopy (MRS) and functional magnetic resonance imaging (fMRI) during semantic processing. Then, we applied cTBS over the anterior temporal lobe (ATL), a hub for semantic representation, to explore the relationship between the baseline neurochemical profiles in this region and the response to cTBS. We found that the baseline excitation-inhibition balance (glutamate + glutamine/GABA ratio) in the ATL was associated with individual cTBS responsiveness during semantic processing. Specifically, individuals with lower excitation-inhibition balance showed stronger inhibitory effect - poorer semantic performance. Our results revealed that non-responders (subjects who did not show an inhibitory effect of cTBS on subsequent semantic performance) had higher excitatory-inhibitory balance in the ATL, which led to up-regulated task-induced regional activity as well as increased ATL-connectivity with other semantic regions compared to responders. These results disclose that the baseline neurochemical state of a cortical region can be a significant factor in predicting responses to cTBS.
Collapse
|
64
|
Turrini S, Fiori F, Chiappini E, Santarnecchi E, Romei V, Avenanti A. Gradual enhancement of corticomotor excitability during cortico-cortical paired associative stimulation. Sci Rep 2022; 12:14670. [PMID: 36038605 PMCID: PMC9424198 DOI: 10.1038/s41598-022-18774-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/18/2022] [Indexed: 12/03/2022] Open
Abstract
Cortico-cortical paired associative stimulation (ccPAS) is an effective transcranial magnetic stimulation (TMS) method for inducing associative plasticity between interconnected brain areas in humans. Prior ccPAS studies have focused on protocol’s aftereffects. Here, we investigated physiological changes induced “online” during ccPAS administration. We tested 109 participants receiving ccPAS over left ventral premotor cortex (PMv) and primary motor cortex (M1) using a standard procedure (90 paired-pulses with 8-ms interstimulus interval, repeated at 0.1 Hz frequency). On each paired-pulse, we recorded a motor-evoked potential (MEP) to continuously trace the emergence of corticomotor changes. Participant receiving forward-ccPAS (on each pair, a first TMS pulse was administered over PMv, second over M1, i.e., PMv-to-M1) showed a gradual and linear increase in MEP size that did not reach a plateau at the end of the protocol and was greater in participants with low motor threshold. Participants receiving reverse-ccPAS (i.e., M1-to-PMv) showed a trend toward inhibition. Our study highlights the facilitatory and inhibitory modulations that occur during ccPAS administration and suggest that online MEP monitoring could provide insights into the malleability of the motor system and protocol’s effectiveness. Our findings open interesting prospects about ccPAS potential optimization in experimental and clinical settings.
Collapse
Affiliation(s)
- Sonia Turrini
- Centro Studi e Ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia, Alma Mater Studiorum - Università di Bologna, Campus di Cesena. Via Rasi Spinelli 176, 47521, Cesena, Italy.,Precision Neuroscience and Neuromodulation Program, Gordon Center for Medical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Francesca Fiori
- Centro Studi e Ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia, Alma Mater Studiorum - Università di Bologna, Campus di Cesena. Via Rasi Spinelli 176, 47521, Cesena, Italy.,NeXT: Unità di ricerca di Neurofisiologia e Neuroingegneria dell'Interazione Uomo-Tecnologia, Università Campus Bio-Medico, Rome, Italy
| | - Emilio Chiappini
- Centro Studi e Ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia, Alma Mater Studiorum - Università di Bologna, Campus di Cesena. Via Rasi Spinelli 176, 47521, Cesena, Italy.,Institut für Klinische und Gesundheitspsychologie, Universität Wien, Wien, Austria
| | - Emiliano Santarnecchi
- Precision Neuroscience and Neuromodulation Program, Gordon Center for Medical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Vincenzo Romei
- Centro Studi e Ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia, Alma Mater Studiorum - Università di Bologna, Campus di Cesena. Via Rasi Spinelli 176, 47521, Cesena, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Alessio Avenanti
- Centro Studi e Ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia, Alma Mater Studiorum - Università di Bologna, Campus di Cesena. Via Rasi Spinelli 176, 47521, Cesena, Italy. .,Centro de Investigación en Neuropsicología y Neurociencias Cognitivas, Universidad Católica del Maule, Talca, Chile.
| |
Collapse
|
65
|
Veldema J, Gharabaghi A. Non-invasive brain stimulation for improving gait, balance, and lower limbs motor function in stroke. J Neuroeng Rehabil 2022; 19:84. [PMID: 35922846 PMCID: PMC9351139 DOI: 10.1186/s12984-022-01062-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 07/21/2022] [Indexed: 11/27/2022] Open
Abstract
Objectives This systematic review and meta-analysis aim to summarize and analyze the available evidence of non-invasive brain stimulation/spinal cord stimulation on gait, balance and/or lower limb motor recovery in stroke patients. Methods The PubMed database was searched from its inception through to 31/03/2021 for randomized controlled trials investigating repetitive transcranial magnetic stimulation or transcranial/trans-spinal direct current/alternating current stimulation for improving gait, balance and/or lower limb motor function in stroke patients. Results Overall, 25 appropriate studies (including 657 stroke subjects) were found. The data indicates that non-invasive brain stimulation/spinal cord stimulation is effective in supporting recovery. However, the effects are inhomogeneous across studies: (1) transcranial/trans-spinal direct current/alternating current stimulation induce greater effects than repetitive transcranial magnetic stimulation, and (2) bilateral application of non-invasive brain stimulation is superior to unilateral stimulation. Conclusions The current evidence encourages further research and suggests that more individualized approaches are necessary for increasing effect sizes in stroke patients.
Collapse
Affiliation(s)
- Jitka Veldema
- Department of Sport Science, Bielefeld University, 33 501, Bielefeld, Germany. .,Institute for Neuromodulation and Neurotechnology, University Hospital and University of Tübingen, Tübingen, Germany.
| | - Alireza Gharabaghi
- Institute for Neuromodulation and Neurotechnology, University Hospital and University of Tübingen, Tübingen, Germany
| |
Collapse
|
66
|
Mittal N, Majdic BC, Peterson CL. Intermittent theta burst stimulation modulates biceps brachii corticomotor excitability in individuals with tetraplegia. J Neuroeng Rehabil 2022; 19:73. [PMID: 35843943 PMCID: PMC9290267 DOI: 10.1186/s12984-022-01049-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 07/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intermittent theta burst stimulation (iTBS) is a form of repetitive transcranial magnetic stimulation (TMS) that can increase corticomotor excitability of hand muscles in individuals with spinal cord injury (SCI). The objective of this study was to determine the effect of iTBS on the corticomotor excitability of the biceps brachii in individuals with tetraplegia. METHODS Ten individuals with low cervical SCI (C5-C8) and ten nonimpaired individuals completed three independent sessions. Motor evoked potentials (MEPs) served as our measure of corticomotor excitability and were collected before and after iTBS. MEPs were normalized by the electromyography corresponding to maximum voluntary contraction and analyzed using linear mixed effects models to determine the effect of iTBS (active or sham) on normalized MEPs (nMEPs). iTBS effects were compared to a ratio of active and resting motor thresholds as a measurement of corticomotor conductance potential. RESULTS Relative to sham, active iTBS increased nMEPs over time (p < 0.001) in individuals with SCI, but not nonimpaired individuals (p = 0.915). The amplitude of nMEPs were correlated with the biceps corticomotor conductance potential (p < 0.001), with nMEPs decreasing as the ratio increased at different rates after sham or active iTBS. CONCLUSIONS Preliminary results suggest that iTBS increases biceps corticomotor excitability in individuals with tetraplegia with effects that may be predicted by corticomotor conductance potential. Clinical trial registration NCT03277521 Registered on clinicaltrials.gov on August 24, 2017.
Collapse
Affiliation(s)
- Neil Mittal
- grid.224260.00000 0004 0458 8737Biomedical Engineering, College of Engineering, Rehabilitation Engineering to Advance Ability Lab, Virginia Commonwealth University, Biotech Eight, 737 N 5th Street, Richmond, VA 23219 USA
| | - Blaize C. Majdic
- grid.224260.00000 0004 0458 8737Biomedical Engineering, College of Engineering, Rehabilitation Engineering to Advance Ability Lab, Virginia Commonwealth University, Biotech Eight, 737 N 5th Street, Richmond, VA 23219 USA
| | - Carrie L. Peterson
- grid.224260.00000 0004 0458 8737Biomedical Engineering, College of Engineering, Rehabilitation Engineering to Advance Ability Lab, Virginia Commonwealth University, Biotech Eight, 737 N 5th Street, Richmond, VA 23219 USA
| |
Collapse
|
67
|
Cellular mechanisms underlying state-dependent neural inhibition with magnetic stimulation. Sci Rep 2022; 12:12131. [PMID: 35840656 PMCID: PMC9287388 DOI: 10.1038/s41598-022-16494-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 07/11/2022] [Indexed: 12/29/2022] Open
Abstract
Novel stimulation protocols for neuromodulation with magnetic fields are explored in clinical and laboratory settings. Recent evidence suggests that the activation state of the nervous system plays a significant role in the outcome of magnetic stimulation, but the underlying cellular and molecular mechanisms of state-dependency have not been completely investigated. We recently reported that high frequency magnetic stimulation could inhibit neural activity when the neuron was in a low active state. In this paper, we investigate state-dependent neural modulation by applying a magnetic field to single neurons, using the novel micro-coil technology. High frequency magnetic stimulation suppressed single neuron activity in a state-dependent manner. It inhibited neurons in slow-firing states, but spared neurons from fast-firing states, when the same magnetic stimuli were applied. Using a multi-compartment NEURON model, we found that dynamics of voltage-dependent sodium and potassium channels were significantly altered by the magnetic stimulation in the slow-firing neurons, but not in the fast-firing neurons. Variability in neural activity should be monitored and explored to optimize the outcome of magnetic stimulation in basic laboratory research and clinical practice. If selective stimulation can be programmed to match the appropriate neural state, prosthetic implants and brain-machine interfaces can be designed based on these concepts to achieve optimal results.
Collapse
|
68
|
Sale MV, Kuzovina A. Motor training is improved by concurrent application of slow oscillating transcranial alternating current stimulation to motor cortex. BMC Neurosci 2022; 23:45. [PMID: 35840886 PMCID: PMC9287859 DOI: 10.1186/s12868-022-00731-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/04/2022] [Indexed: 11/17/2022] Open
Abstract
Physical exercise and neurorehabilitation involve repetitive training that can induce changes in motor performance arising from neuroplasticity. Retention of these motor changes occurs via an encoding process, during which rapid neuroplastic changes occur in response to training. Previous studies show that transcranial alternating current stimulation (tACS), a form of non-invasive brain stimulation, can enhance encoding of a cognitive learning task during wakefulness. However, the effect of tACS on motor processes in the awake brain is unknown. In this study, forty-two healthy 18–35 year old participants received either 0.75 Hz (active) tACS (or sham stimulation) for 30 min during a ballistic thumb abduction motor training task. Training-related behavioural effects were quantified by assessing changes in thumb abduction acceleration, and neuroplastic changes were quantified by measuring motor evoked potential (MEP) amplitude of the abductor pollicis brevis muscle. These measures were reassessed immediately after the motor training task to quantify short-term changes, and then 24 h later to assess longer-term changes. Thumb abduction acceleration in both active and sham stimulation conditions increased immediately after the motor learning, consistent with effective training. Critically, participants in the active group maintained significantly higher thumb acceleration 24 h later (t40 = 2.810, P = 0.044). There were no significant changes or inter-group differences in MEPs for both conditions. The results suggest that 0.75 Hz tACS applied during motor training enhances the effectiveness of motor training, which manifests as enhancement in longer-term task benefits.
Collapse
Affiliation(s)
- Martin V Sale
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia.
| | - Anastasiia Kuzovina
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia
| |
Collapse
|
69
|
Adam O, Blay M, Brunoni AR, Chang HA, Gomes JS, Javitt DC, Jung DU, Kantrowitz JT, Koops S, Lindenmayer JP, Palm U, Smith RC, Sommer IE, Valiengo LDCL, Weickert TW, Brunelin J, Mondino M. Efficacy of Transcranial Direct Current Stimulation to Improve Insight in Patients With Schizophrenia: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Schizophr Bull 2022; 48:1284-1294. [PMID: 35820035 PMCID: PMC9673267 DOI: 10.1093/schbul/sbac078] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND HYPOTHESIS Impaired insight into the illness and its consequences is associated with poor outcomes in schizophrenia. While transcranial direct current stimulation (tDCS) may represent a potentially effective treatment strategy to relieve various symptoms of schizophrenia, its impact on insight remains unclear. To investigate whether tDCS would modulate insight in patients with schizophrenia, we undertook a meta-analysis based on results from previous RCTs that investigated the clinical efficacy of tDCS. We hypothesize that repeated sessions of tDCS will be associated with insight improvement among patients. STUDY DESIGN PubMed and ScienceDirect databases were systematically searched to identify RCTs that delivered at least 10 tDCS sessions in patients with schizophrenia. The primary outcome was the change in insight score, assessed by the Positive and Negative Syndrome Scale (PANSS) item G12 following active tDCS sessions as opposed to sham stimulation. Effect sizes were calculated for all studies and pooled using a random-effects model. Meta-regression and subgroup analyses were conducted. STUDY RESULTS Thirteen studies (587 patients with schizophrenia) were included. A significant pooled effect size (g) of -0.46 (95% CI [-0.78; -0.14]) in favor of active tDCS was observed. Age and G12 score at baseline were identified as significant moderators, while change in total PANSS score was not significant. CONCLUSIONS Ten sessions of active tDCS with either frontotemporoparietal or bifrontal montage may improve insight into the illness in patients with schizophrenia. The effect of this treatment could contribute to the beneficial outcomes observed in patients following stimulation.
Collapse
Affiliation(s)
- Ondine Adam
- Pôle Est, Centre Hospitalier Le Vinatier, Bron, France,INSERM U1028; CNRS UMR5292; PSYR2 Team; Lyon Neuroscience Research Center, Université Claude Bernard Lyon 1, Université Jean Monnet, Lyon, France
| | - Martin Blay
- Pôle Est, Centre Hospitalier Le Vinatier, Bron, France
| | - Andre R Brunoni
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Laboratório de Neurociências (LIM-27), Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil,Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, Serviço Interdisciplinar de Neuromodulação (SIN), Hospital das Clínicas HCFMUSP, São Paulo, Brazil
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - July S Gomes
- Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Daniel C Javitt
- Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA,Nathan Kline Institute, Orangeburg, NY, USA
| | - Do-Un Jung
- Department of Psychiatry, Busan Paik Hospital, Inje University, Busan, Republic of Korea
| | - Joshua T Kantrowitz
- Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA,Nathan Kline Institute, Orangeburg, NY, USA
| | - Sanne Koops
- Department of Biomedical Sciences of Cells and Systems, Cognitive Neurosciences, University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands
| | - Jean-Pierre Lindenmayer
- Nathan Kline Institute, Orangeburg, NY, USA,New York University School of Medicine, New York, NY, USA,Manhattan Psychiatric Center, New York, NY, USA
| | - Ulrich Palm
- Department of Psychiatry and Psychotherapy, Hospital of the University of Munich, Munich, Germany,Medical Park Chiemseeblick, Bernau-Felden, Germany
| | - Robert C Smith
- Nathan Kline Institute, Orangeburg, NY, USA,New York University School of Medicine, New York, NY, USA
| | - Iris E Sommer
- Department of Biomedical Sciences of Cells and Systems, Cognitive Neurosciences, University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands
| | - Leandro do Costa Lane Valiengo
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Laboratório de Neurociências (LIM-27), Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil,Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, Serviço Interdisciplinar de Neuromodulação (SIN), Hospital das Clínicas HCFMUSP, São Paulo, Brazil
| | - Thomas W Weickert
- Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA,School of Psychiatry, University of New South Wales, Sydney, NSW, Australia,Neuroscience Research Australia, Sydney, NSW, Australia
| | | | - Marine Mondino
- To whom correspondence should be addressed; PsyR2 team, Centre Hospitalier le Vinatier, batiment 416, 1st floor, 95 boulevard Pinel, 69678 Bron, Cedex BP 30039, France; tel: (+33)4 37 91 55 65, fax: (+33)4 37 91 55 49, e-mail:
| |
Collapse
|
70
|
Mittal N, Thakkar B, Hodges CB, Lewis C, Cho Y, Hadimani RL, Peterson CL. Effect of neuroanatomy on corticomotor excitability during and after transcranial magnetic stimulation and intermittent theta burst stimulation. Hum Brain Mapp 2022; 43:4492-4507. [PMID: 35678552 PMCID: PMC9435000 DOI: 10.1002/hbm.25968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 05/10/2022] [Accepted: 05/22/2022] [Indexed: 01/04/2023] Open
Abstract
Individual neuroanatomy can influence motor responses to transcranial magnetic stimulation (TMS) and corticomotor excitability after intermittent theta burst stimulation (iTBS). The purpose of this study was to examine the relationship between individual neuroanatomy and both TMS response measured using resting motor threshold (RMT) and iTBS measured using motor evoked potentials (MEPs) targeting the biceps brachii and first dorsal interosseus (FDI). Ten nonimpaired individuals completed sham‐controlled iTBS sessions and underwent MRI, from which anatomically accurate head models were generated. Neuroanatomical parameters established through fiber tractography were fiber tract surface area (FTSA), tract fiber count (TFC), and brain scalp distance (BSD) at the point of stimulation. Cortical magnetic field induced electric field strength (EFS) was obtained using finite element simulations. A linear mixed effects model was used to assess effects of these parameters on RMT and iTBS (post‐iTBS MEPs). FDI RMT was dependent on interactions between EFS and both FTSA and TFC. Biceps RMT was dependent on interactions between EFS and and both FTSA and BSD. There was no groupwide effect of iTBS on the FDI but individual changes in corticomotor excitability scaled with RMT, EFS, BSD, and FTSA. iTBS targeting the biceps was facilitatory, and dependent on FTSA and TFC. MRI‐based measures of neuroanatomy highlight how individual anatomy affects motor system responses to different TMS paradigms and may be useful for selecting appropriate motor targets when designing TMS based therapies.
Collapse
Affiliation(s)
- Neil Mittal
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia, USA.,College of Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Bhushan Thakkar
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Cooper B Hodges
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Connor Lewis
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia, USA.,College of Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Yeajin Cho
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia, USA.,College of Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Ravi L Hadimani
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia, USA.,College of Engineering, Virginia Commonwealth University, Richmond, Virginia, USA.,Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Carrie L Peterson
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia, USA.,College of Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
| |
Collapse
|
71
|
Chou YH, Sundman M, Ton That V, Green J, Trapani C. Cortical excitability and plasticity in Alzheimer's disease and mild cognitive impairment: A systematic review and meta-analysis of transcranial magnetic stimulation studies. Ageing Res Rev 2022; 79:101660. [PMID: 35680080 DOI: 10.1016/j.arr.2022.101660] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 05/13/2022] [Accepted: 05/30/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Transcranial magnetic stimulation (TMS) is a non-invasive neuromodulation technique. When stimulation is applied over the primary motor cortex and coupled with electromyography measures, TMS can probe functions of cortical excitability and plasticity in vivo. The purpose of this meta-analysis is to evaluate the utility of TMS-derived measures for differentiating patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI) from cognitively normal older adults (CN). METHODS Databases searched included PubMed, Embase, APA PsycInfo, Medline, and CINAHL Plus from inception to July 2021. RESULTS Sixty-one studies with a total of 2728 participants (1454 patients with AD, 163 patients with MCI, and 1111 CN) were included. Patients with AD showed significantly higher cortical excitability, lower cortical inhibition, and impaired cortical plasticity compared to the CN cohorts. Patients with MCI exhibited increased cortical excitability and reduced plasticity compared to the CN cohort. Additionally, lower cognitive performance was significantly associated with higher cortical excitability and lower inhibition. No seizure events due to TMS were reported, and the mild adverse response rate is approximately 3/1000 (i.e., 9/2728). CONCLUSIONS Findings of our meta-analysis demonstrate the potential of using TMS-derived cortical excitability and plasticity measures as diagnostic biomarkers and therapeutic targets for AD and MCI.
Collapse
Affiliation(s)
- Ying-Hui Chou
- Brain Imaging and TMS Laboratory, Department of Psychology, University of Arizona, Tucson, USA; Evelyn F McKnight Brain Institute, Arizona Center on Aging, and BIO5 Institute, University of Arizona, Tucson, USA.
| | - Mark Sundman
- Brain Imaging and TMS Laboratory, Department of Psychology, University of Arizona, Tucson, USA
| | - Viet Ton That
- Brain Imaging and TMS Laboratory, Department of Psychology, University of Arizona, Tucson, USA
| | - Jacob Green
- Brain Imaging and TMS Laboratory, Department of Psychology, University of Arizona, Tucson, USA
| | - Chrisopher Trapani
- Brain Imaging and TMS Laboratory, Department of Psychology, University of Arizona, Tucson, USA
| |
Collapse
|
72
|
King EM, Edwards LL, Borich MR. Short-term arm immobilization modulates excitability of inhibitory circuits within, and between, primary motor cortices. Physiol Rep 2022; 10:e15359. [PMID: 35757848 PMCID: PMC9234616 DOI: 10.14814/phy2.15359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 05/14/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023] Open
Abstract
Previous research has suggested that short-term immobilization of the arm may be a low-cost, non-invasive strategy to enhance the capacity for long-term potentiation (LTP)-like plasticity in primary motor cortex (M1). Short-term immobilization reduces corticospinal excitability (CSE) in the contralateral M1, and interhemispheric inhibition (IHI) from ipsi- onto contralateral M1 is increased. However, it is unclear whether reduced CSE and increased IHI are associated with changes in intracortical inhibition, which has been shown to be important for regulating neuroplasticity in M1. The current study used transcranial magnetic stimulation to evaluate the effects of short-term (6 h) arm immobilization on CSE, IHI, and intracortical inhibition measured bilaterally in 43 neurotypical young adults (23 immobilized). We replicated previous findings demonstrating that immobilization decreased CSE in, and increased IHI onto, the immobilized hemisphere, but a significant change in intracortical inhibition was not observed at the group level. Across individuals, decreased CSE was associated with a decreased short-interval intracortical inhibition, an index of GABAA -ergic inhibition, within the immobilized hemisphere only in the immobilization group. Previous research has demonstrated that decreases in GABAA -ergic inhibition are necessary for the induction of LTP-like plasticity in M1; therefore, decreased intracortical inhibition after short-term arm immobilization may provide a novel mechanism to enhance the capacity for LTP-like plasticity within M1 and may be a potential target for strategies to augment plasticity capacity to enhance motor learning in health and disease.
Collapse
Affiliation(s)
- Erin M. King
- Neuroscience Graduate ProgramGraduate Division of Biological and Biomedical SciencesEmory UniversityAtlantaGeorgiaUSA
- Department of Rehabilitation MedicineEmory UniversityAtlantaGeorgiaUSA
| | - Lauren L. Edwards
- Department of Rehabilitation MedicineEmory UniversityAtlantaGeorgiaUSA
| | - Michael R. Borich
- Department of Rehabilitation MedicineEmory UniversityAtlantaGeorgiaUSA
- Department of Biomedical EngineeringGeorgia Institute of TechnologyAtlantaGeorgiaUSA
| |
Collapse
|
73
|
Continuous but not intermittent theta burst stimulation decreases striatal dopamine release and cortical excitability. Exp Neurol 2022; 354:114106. [DOI: 10.1016/j.expneurol.2022.114106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/12/2022] [Accepted: 05/01/2022] [Indexed: 11/22/2022]
|
74
|
Niazi IK, Navid MS, Rashid U, Amjad I, Olsen S, Haavik H, Alder G, Kumari N, Signal N, Taylor D, Farina D, Jochumsen M. Associative cued asynchronous BCI induces cortical plasticity in stroke patients. Ann Clin Transl Neurol 2022; 9:722-733. [PMID: 35488791 PMCID: PMC9082379 DOI: 10.1002/acn3.51551] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/14/2022] [Accepted: 03/12/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE We propose a novel cue-based asynchronous brain-computer interface(BCI) for neuromodulation via the pairing of endogenous motor cortical activity with the activation of somatosensory pathways. METHODS The proposed BCI detects the intention to move from single-trial EEG signals in real time, but, contrary to classic asynchronous-BCI systems, the detection occurs only during time intervals when the patient is cued to move. This cue-based asynchronous-BCI was compared with two traditional BCI modes (asynchronous-BCI and offline synchronous-BCI) and a control intervention in chronic stroke patients. The patients performed ankle dorsiflexion movements of the paretic limb in each intervention while their brain signals were recorded. BCI interventions decoded the movement attempt and activated afferent pathways via electrical stimulation. Corticomotor excitability was assessed using motor-evoked potentials in the tibialis-anterior muscle induced by transcranial magnetic stimulation before, immediately after, and 30 min after the intervention. RESULTS The proposed cue-based asynchronous-BCI had significantly fewer false positives/min and false positives/true positives (%) as compared to the previously developed asynchronous-BCI. Linear-mixed-models showed that motor-evoked potential amplitudes increased following all BCI modes immediately after the intervention compared to the control condition (p <0.05). The proposed cue-based asynchronous-BCI resulted in the largest relative increase in peak-to-peak motor-evoked potential amplitudes(141% ± 33%) among all interventions and sustained it for 30 min(111% ± 33%). INTERPRETATION These findings prove the high performance of a newly proposed cue-based asynchronous-BCI intervention. In this paradigm, individuals receive precise instructions (cue) to promote engagement, while the timing of brain activity is accurately detected to establish a precise association with the delivery of sensory input for plasticity induction.
Collapse
Affiliation(s)
- Imran Khan Niazi
- Health and Rehabilitation Research Institute and BioDesign LabAuckland University of TechnologyAucklandNew Zealand
- SMI, Department of Health Science and TechnologyAalborg UniversityAalborgDenmark
- Centre for Chiropractic ResearchNew Zealand College of ChiropracticAucklandNew Zealand
| | - Muhammad Samran Navid
- Centre for Chiropractic ResearchNew Zealand College of ChiropracticAucklandNew Zealand
| | - Usman Rashid
- Health and Rehabilitation Research Institute and BioDesign LabAuckland University of TechnologyAucklandNew Zealand
| | - Imran Amjad
- Centre for Chiropractic ResearchNew Zealand College of ChiropracticAucklandNew Zealand
- Riphah International UniversityIslamabadPakistan
| | - Sharon Olsen
- Health and Rehabilitation Research Institute and BioDesign LabAuckland University of TechnologyAucklandNew Zealand
| | - Heidi Haavik
- Centre for Chiropractic ResearchNew Zealand College of ChiropracticAucklandNew Zealand
| | - Gemma Alder
- Health and Rehabilitation Research Institute and BioDesign LabAuckland University of TechnologyAucklandNew Zealand
| | - Nitika Kumari
- Health and Rehabilitation Research Institute and BioDesign LabAuckland University of TechnologyAucklandNew Zealand
- Centre for Chiropractic ResearchNew Zealand College of ChiropracticAucklandNew Zealand
| | - Nada Signal
- Health and Rehabilitation Research Institute and BioDesign LabAuckland University of TechnologyAucklandNew Zealand
| | - Denise Taylor
- Health and Rehabilitation Research Institute and BioDesign LabAuckland University of TechnologyAucklandNew Zealand
| | - Dario Farina
- Department of BioengineeringImperial College LondonLondonUK
| | - Mads Jochumsen
- SMI, Department of Health Science and TechnologyAalborg UniversityAalborgDenmark
| |
Collapse
|
75
|
Dell'Italia J, Sanguinetti JL, Monti MM, Bystritsky A, Reggente N. Current State of Potential Mechanisms Supporting Low Intensity Focused Ultrasound for Neuromodulation. Front Hum Neurosci 2022; 16:872639. [PMID: 35547195 PMCID: PMC9081930 DOI: 10.3389/fnhum.2022.872639] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/28/2022] [Indexed: 01/07/2023] Open
Abstract
Low intensity focused ultrasound (LIFU) has been gaining traction as a non-invasive neuromodulation technology due to its superior spatial specificity relative to transcranial electrical/magnetic stimulation. Despite a growing literature of LIFU-induced behavioral modifications, the mechanisms of action supporting LIFU's parameter-dependent excitatory and suppressive effects are not fully understood. This review provides a comprehensive introduction to the underlying mechanics of both acoustic energy and neuronal membranes, defining the primary variables for a subsequent review of the field's proposed mechanisms supporting LIFU's neuromodulatory effects. An exhaustive review of the empirical literature was also conducted and studies were grouped based on the sonication parameters used and behavioral effects observed, with the goal of linking empirical findings to the proposed theoretical mechanisms and evaluating which model best fits the existing data. A neuronal intramembrane cavitation excitation model, which accounts for differential effects as a function of cell-type, emerged as a possible explanation for the range of excitatory effects found in the literature. The suppressive and other findings need additional theoretical mechanisms and these theoretical mechanisms need to have established relationships to sonication parameters.
Collapse
Affiliation(s)
- John Dell'Italia
- Institute for Advanced Consciousness Studies, Santa Monica, CA, United States
- *Correspondence: John Dell'Italia
| | - Joseph L. Sanguinetti
- Department of Psychology, University of Arizona, Tuscon, AZ, United States
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Martin M. Monti
- Institute for Advanced Consciousness Studies, Santa Monica, CA, United States
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
- Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, United States
| | - Alexander Bystritsky
- Institute for Advanced Consciousness Studies, Santa Monica, CA, United States
- Tiny Blue Dot Foundation, Santa Monica, CA, United States
| | - Nicco Reggente
- Institute for Advanced Consciousness Studies, Santa Monica, CA, United States
- Tiny Blue Dot Foundation, Santa Monica, CA, United States
| |
Collapse
|
76
|
Inter-Individual Variability in tDCS Effects: A Narrative Review on the Contribution of Stable, Variable, and Contextual Factors. Brain Sci 2022; 12:brainsci12050522. [PMID: 35624908 PMCID: PMC9139102 DOI: 10.3390/brainsci12050522] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 04/08/2022] [Accepted: 04/14/2022] [Indexed: 01/27/2023] Open
Abstract
Due to its safety, portability, and cheapness, transcranial direct current stimulation (tDCS) use largely increased in research and clinical settings. Despite tDCS’s wide application, previous works pointed out inconsistent and low replicable results, sometimes leading to extreme conclusions about tDCS’s ineffectiveness in modulating behavioral performance across cognitive domains. Traditionally, this variability has been linked to significant differences in the stimulation protocols across studies, including stimulation parameters, target regions, and electrodes montage. Here, we reviewed and discussed evidence of heterogeneity emerging at the intra-study level, namely inter-individual differences that may influence the response to tDCS within each study. This source of variability has been largely neglected by literature, being results mainly analyzed at the group level. Previous research, however, highlighted that only a half—or less—of studies’ participants could be classified as responders, being affected by tDCS in the expected direction. Stable and variable inter-individual differences, such as morphological and genetic features vs. hormonal/exogenous substance consumption, partially account for this heterogeneity. Moreover, variability comes from experiments’ contextual elements, such as participants’ engagement/baseline capacity and individual task difficulty. We concluded that increasing knowledge on inter-dividual differences rather than undermining tDCS effectiveness could enhance protocols’ efficiency and reproducibility.
Collapse
|
77
|
Woldeamanuel GG, Frazer AK, Lee A, Avela J, Tallent J, Ahtiainen JP, Pearce AJ, Kidgell DJ. Determining the Corticospinal Responses and Cross-Transfer of Ballistic Motor Performance in Young and Older Adults: A Systematic Review and Meta-Analysis. J Mot Behav 2022; 54:763-786. [PMID: 35437124 DOI: 10.1080/00222895.2022.2061409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Ballistic motor training induces plasticity changes and imparts a cross-transfer effect. However, whether there are age-related differences in these changes remain unclear. Thus, the purpose of this study was to perform a meta-analysis to determine the corticospinal responses and cross-transfer of motor performance following ballistic motor training in young and older adults. Meta-analysis was performed using a random-effects model. A best evidence synthesis was performed for variables that had insufficient data for meta-analysis. There was strong evidence to suggest that young participants exhibited greater cross-transfer of ballistic motor performance than their older counterparts. This meta-analysis showed no significant age-related differences in motor-evoked potentials (MEPs), short-interval intracortical inhibition (SICI) and surface electromyography (sEMG) for both hands following ballistic motor training.
Collapse
Affiliation(s)
- Gashaw Garedew Woldeamanuel
- Faculty of Medicine, Nursing and Health Science, Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - Ashlyn K Frazer
- Faculty of Medicine, Nursing and Health Science, Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - Annemarie Lee
- Faculty of Medicine, Nursing and Health Science, Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - Janne Avela
- Faculty of Sport and Health Sciences, NeuroMuscular Research Center, University of Jyväskylä, Finland
| | - Jamie Tallent
- Faculty of Medicine, Nursing and Health Science, Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, Australia.,Faculty of Sport, Health and Applied Sciences, St Mary's University, Twickenham, UK
| | - Juha P Ahtiainen
- Faculty of Sport and Health Sciences, NeuroMuscular Research Center, University of Jyväskylä, Finland
| | - Alan J Pearce
- College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | - Dawson J Kidgell
- Faculty of Medicine, Nursing and Health Science, Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| |
Collapse
|
78
|
Brihmat N, Allexandre D, Saleh S, Zhong J, Yue GH, Forrest GF. Stimulation Parameters Used During Repetitive Transcranial Magnetic Stimulation for Motor Recovery and Corticospinal Excitability Modulation in SCI: A Scoping Review. Front Hum Neurosci 2022; 16:800349. [PMID: 35463922 PMCID: PMC9033167 DOI: 10.3389/fnhum.2022.800349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/24/2022] [Indexed: 12/28/2022] Open
Abstract
There is a growing interest in non-invasive stimulation interventions as treatment strategies to improve functional outcomes and recovery after spinal cord injury (SCI). Repetitive transcranial magnetic stimulation (rTMS) is a neuromodulatory intervention which has the potential to reinforce the residual spinal and supraspinal pathways and induce plasticity. Recent reviews have highlighted the therapeutic potential and the beneficial effects of rTMS on motor function, spasticity, and corticospinal excitability modulation in SCI individuals. For this scoping review, we focus on the stimulation parameters used in 20 rTMS protocols. We extracted the rTMS parameters from 16 published rTMS studies involving SCI individuals and were able to infer preliminary associations between specific parameters and the effects observed. Future investigations will need to consider timing, intervention duration and dosage (in terms of number of sessions and number of pulses) that may depend on the stage, the level, and the severity of the injury. There is a need for more real vs. sham rTMS studies, reporting similar designs with sufficient information for replication, to achieve a significant level of evidence regarding the use of rTMS in SCI.
Collapse
Affiliation(s)
- Nabila Brihmat
- Tim and Caroline Reynolds Center for Spinal Stimulation, Kessler Foundation, West Orange, NJ, United States
- Department of Physical Medicine and Rehabilitation, Rutgers—New Jersey Medical School, Newark, NJ, United States
| | - Didier Allexandre
- Department of Physical Medicine and Rehabilitation, Rutgers—New Jersey Medical School, Newark, NJ, United States
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, United States
| | - Soha Saleh
- Department of Physical Medicine and Rehabilitation, Rutgers—New Jersey Medical School, Newark, NJ, United States
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, United States
| | - Jian Zhong
- Burke Neurological Institute and Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, White Plains, NY, United States
| | - Guang H. Yue
- Department of Physical Medicine and Rehabilitation, Rutgers—New Jersey Medical School, Newark, NJ, United States
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, United States
| | - Gail F. Forrest
- Tim and Caroline Reynolds Center for Spinal Stimulation, Kessler Foundation, West Orange, NJ, United States
- Department of Physical Medicine and Rehabilitation, Rutgers—New Jersey Medical School, Newark, NJ, United States
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, United States
- *Correspondence: Gail F. Forrest
| |
Collapse
|
79
|
Directionality of the injected current targeting the P20/N20 source determines the efficacy of 140 Hz transcranial alternating current stimulation (tACS)-induced aftereffects in the somatosensory cortex. PLoS One 2022; 17:e0266107. [PMID: 35324989 PMCID: PMC8947130 DOI: 10.1371/journal.pone.0266107] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 03/14/2022] [Indexed: 11/19/2022] Open
Abstract
Interindividual anatomical differences in the human cortex can lead to suboptimal current directions and may result in response variability of transcranial electrical stimulation methods. These differences in brain anatomy require individualized electrode stimulation montages to induce an optimal current density in the targeted area of each individual subject. We aimed to explore the possible modulatory effects of 140 Hz transcranial alternating current stimulation (tACS) on the somatosensory cortex using personalized multi-electrode stimulation montages. In two randomized experiments using either tactile finger or median nerve stimulation, we measured by evoked potentials the plasticity aftereffects and oscillatory power changes after 140 Hz tACS at 1.0 mA as compared to sham stimulation (n = 17, male = 9). We found a decrease in the power of oscillatory mu-rhythms during and immediately after tactile discrimination tasks, indicating an engagement of the somatosensory system during stimulus encoding. On a group level both the oscillatory power and the evoked potential amplitudes were not modulated by tACS neither after tactile finger stimulation nor after median nerve stimulation as compared to sham stimulation. On an individual level we could however demonstrate that lower angular difference (i.e., differences between the injected current vector in the target region and the source orientation vector) is associated with significantly higher changes in both P20/N20 and N30/P30 source activities. Our findings suggest that the higher the directionality of the injected current correlates to the dipole orientation the greater the tACS-induced aftereffects are.
Collapse
|
80
|
Wischnewski M, Compen B. Effects of theta transcranial alternating current stimulation (tACS) on exploration and exploitation during uncertain decision-making. Behav Brain Res 2022; 426:113840. [PMID: 35325684 DOI: 10.1016/j.bbr.2022.113840] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 03/02/2022] [Accepted: 03/08/2022] [Indexed: 01/15/2023]
Abstract
Exploring ones surroundings may yield unexpected rewards, but is associated with uncertainty and risk. Alternatively, exploitation of certain outcomes is related to low risk, yet potentially better outcomes remain unexamined. As such, risk-taking behavior depends on perceived uncertainty and a trade-off between exploration-exploitation. Previously, it has been suggested that risk-taking may relate to theta activity in the prefrontal cortex. Furthermore, previous studies hinted at a relationship between a right-hemispheric bias in frontal theta asymmetry and risky behavior. In the present double-blind sham-controlled within-subject study, we applied bifrontal transcranial alternating current stimulation (tACS) at the theta frequency (5 Hz) on eighteen healthy volunteers during a gambling task. Two tACS montages with either left-right or posterior-anterior current flow were employed at an intensity of 1 mA. Results showed that, compared to sham, theta tACS increased perceived uncertainty irrespective of current flow direction. Despite this observation, no direct effect of tACS on exploration behavior and general risk-taking was observed. Furthermore, frontal theta asymmetry was more right-hemispherically biased after posterior-anterior tACS, compared to sham. Finally, we used electric field simulation to identify which regions were targeted by the tACS montages as an overlap in regions may explain why the two montages resulted in comparable outcomes. Our findings provide a first step towards understanding the relationship between frontal theta oscillations and different features of risk-taking.
Collapse
Affiliation(s)
- Miles Wischnewski
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, United States.
| | - Boukje Compen
- School of Health Professions Education, Maastricht University, Maastricht, the Netherlands
| |
Collapse
|
81
|
Ngetich R, Jin D, Li W, Song B, Zhang J, Jin Z, Li L. Enhancing Visuospatial Working Memory Performance Using Intermittent Theta-Burst Stimulation Over the Right Dorsolateral Prefrontal Cortex. Front Hum Neurosci 2022; 16:752519. [PMID: 35370586 PMCID: PMC8968997 DOI: 10.3389/fnhum.2022.752519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 02/24/2022] [Indexed: 11/13/2022] Open
Abstract
Noninvasive brain stimulation provides a promising approach for the treatment of neuropsychiatric conditions. Despite the increasing research on the facilitatory effects of this kind of stimulation on the cognitive processes, the majority of the studies have used the standard stimulation approaches such as the transcranial direct current stimulation and the conventional repetitive transcranial magnetic stimulation (rTMS) which seem to be limited in robustness and the duration of the transient effects. However, a recent specialized type of rTMS, theta-burst stimulation (TBS), patterned to mimic the natural cross-frequency coupling of the human brain, may induce robust and longer-lasting effects on cortical activity. Here, we aimed to investigate the effects of the intermittent TBS (iTBS), a facilitatory form of TBS, over the right DLPFC (rDLPFC), a brain area implicated in higher-order cognitive processes, on visuospatial working memory (VSWM) performance. Therefore, iTBS was applied over either the rDLPFC or the vertex of 24 healthy participants, in two separate sessions. We assessed VSWM performance using 2-back and 4-back visuospatial tasks before iTBS (at the baseline (BL), and after the iTBS. Our results indicate that the iTBS over the rDLPFC significantly enhanced VSWM performance in the 2-back task, as measured by the discriminability index and the reaction time. However, the 4-back task performance was not significantly modulated by iTBS. These findings demonstrate that the rDLPFC plays a critical role in VSWM and that iTBS is a safe and effective approach for investigating the causal role of the specific brain areas.
Collapse
|
82
|
Kimura I, Ugawa Y, Hayashi MJ, Amano K. Quadripulse stimulation: A replication study with a newly developed stimulator. Brain Stimul 2022; 15:579-581. [DOI: 10.1016/j.brs.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 03/27/2022] [Indexed: 11/02/2022] Open
|
83
|
Poh EZ, Green C, Agostinelli L, Penrose-Menz M, Karl AK, Harvey AR, Rodger J. Manipulating the Level of Sensorimotor Stimulation during LI-rTMS Can Improve Visual Circuit Reorganisation in Adult Ephrin-A2A5 -/- Mice. Int J Mol Sci 2022; 23:ijms23052418. [PMID: 35269561 PMCID: PMC8910719 DOI: 10.3390/ijms23052418] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 11/16/2022] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique that has the potential to treat a variety of neurologic and psychiatric disorders. The extent of rTMS-induced neuroplasticity may be dependent on a subject's brain state at the time of stimulation. Chronic low intensity rTMS (LI-rTMS) has previously been shown to induce beneficial structural and functional reorganisation within the abnormal visual circuits of ephrin-A2A5-/- mice in ambient lighting. Here, we administered chronic LI-rTMS in adult ephrin-A2A5-/- mice either in a dark environment or concurrently with voluntary locomotion. One day after the last stimulation session, optokinetic responses were assessed and fluorescent tracers were injected to map corticotectal and geniculocortical projections. We found that LI-rTMS in either treatment condition refined the geniculocortical map. Corticotectal projections were improved in locomotion+LI-rTMS subjects, but not in dark + LI-rTMS and sham groups. Visuomotor behaviour was not improved in any condition. Our results suggest that the beneficial reorganisation of abnormal visual circuits by rTMS can be significantly influenced by simultaneous, ambient visual input and is enhanced by concomitant physical exercise. Furthermore, the observed pathway-specific effects suggest that regional molecular changes and/or the relative proximity of terminals to the induced electric fields influence the outcomes of LI-rTMS on abnormal circuitry.
Collapse
Affiliation(s)
- Eugenia Z. Poh
- School of Biological Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (E.Z.P.); (M.P.-M.); (A.-K.K.)
- School of Human Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (C.G.); (L.A.); (A.R.H.)
- Perron Institute for Neurological and Translational Research, 8 Verdun St, Nedlands, WA 6009, Australia
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, 1105 BA Amsterdam, The Netherlands
| | - Courtney Green
- School of Human Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (C.G.); (L.A.); (A.R.H.)
| | - Luca Agostinelli
- School of Human Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (C.G.); (L.A.); (A.R.H.)
| | - Marissa Penrose-Menz
- School of Biological Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (E.Z.P.); (M.P.-M.); (A.-K.K.)
| | - Ann-Kathrin Karl
- School of Biological Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (E.Z.P.); (M.P.-M.); (A.-K.K.)
- Department of Neurology, University Hospital of Würzburg, Josef-Schneider-Strasse 11, 97080 Würzburg, Germany
| | - Alan R. Harvey
- School of Human Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (C.G.); (L.A.); (A.R.H.)
- Perron Institute for Neurological and Translational Research, 8 Verdun St, Nedlands, WA 6009, Australia
| | - Jennifer Rodger
- School of Biological Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (E.Z.P.); (M.P.-M.); (A.-K.K.)
- Perron Institute for Neurological and Translational Research, 8 Verdun St, Nedlands, WA 6009, Australia
- Correspondence: ; Tel.: +61-8-6488-2245
| |
Collapse
|
84
|
Diao X, Lu Q, Qiao L, Gong Y, Lu X, Feng M, Su P, Shen Y, Yuan TF, He C. Cortical Inhibition State-Dependent iTBS Induced Neural Plasticity. Front Neurosci 2022; 16:788538. [PMID: 35250445 PMCID: PMC8891511 DOI: 10.3389/fnins.2022.788538] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 01/11/2022] [Indexed: 11/13/2022] Open
Abstract
Background Intermittent theta burst stimulation (iTBS) is an effective stimulus for long-term potentiation (LTP)-like plasticity. However, iTBS-induced effects varied greatly between individuals. Ample evidence suggested that an initial decrease in local γ-aminobutyric acid (GABA) or enhancement in N-methyl-D-aspartate (NMDA) facilitation neurotransmission is of vital importance for allowing LTP-like plasticity to occur. Therefore, we aimed to investigate whether the individual level of GABA or NMDA receptor-mediated activity before stimulation is correlated with the after-effect in cortical excitability induced by iTBS. Methods Fifteen healthy volunteers were recruited for the present study. We measured short-interval intracortical inhibitory (SICI), long-interval intracortical inhibitory (LICI), and intracortical facilitation (ICF), which index GABAA receptor-, GABAB receptor-, and glutamate receptor-mediated activity, respectively, in the cortex before conducting iTBS. After iTBS intervention, the changes of motor-evoked potential (MEP) amplitude were taken as a measure for cortical excitability in response to iTBS protocol. Results There was a significant negative correlation between the amount of SICI measured before iTBS and the after-effect of iTBS-induced LTP-like plasticity at the time points of 5, 10, and 15 min after inducing iTBS. A multiple linear regression model indicated that SICI was a good predictor of the after-effect in cortical excitability induced by iTBS at 5, 10, and 15 min following stimulation. Conclusion The present study found that GABAA receptor-mediated activity measured before stimulation is negatively correlated with the after-effect of cortical excitability induced by iTBS. SICI, as the index of GABAA receptor-mediated activity measured before stimulation, might be a good predictor of iTBS-induced LTP-like plasticity for a period lasting 15 min following stimulation.
Collapse
Affiliation(s)
- Xiaoying Diao
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian Lu
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, China
| | - Lei Qiao
- Jiangsu Zhongshan Geriatric Rehabilitation Hospital, Nanjing, China
| | - Youhui Gong
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, China
| | - Xiao Lu
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, China
| | - Min Feng
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, China
| | - Panpan Su
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, China
| | - Ying Shen
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Ying Shen,
| | - Ti-Fei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Co-innovation Center of Neuroregeneration, Nantong University, Nantong, China
- Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
- Ti-Fei Yuan,
| | - Chuan He
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, China
- Chuan He,
| |
Collapse
|
85
|
Cotovio G, Rodrigues da Silva D, Real Lage E, Seybert C, Oliveira-Maia AJ. Hemispheric asymmetry of motor cortex excitability in mood disorders - Evidence from a systematic review and meta-analysis. Clin Neurophysiol 2022; 137:25-37. [PMID: 35240425 DOI: 10.1016/j.clinph.2022.01.137] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 12/31/2021] [Accepted: 01/31/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Mood disorders have been associated with lateralized brain dysfunction, on the left-side for depression and right-side for mania. Consistently, asymmetry of cortical excitability, as measured by transcranial magnetic stimulation (TMS) has been reported. Here, we reviewed and summarized work assessing such measures bilaterally in mood disorders. METHODS We performed a systematic review and extracted data to perform meta-analyses of interhemispheric asymmetry of motor cortex excitability, assessed with TMS, across different mood disorders and in healthy subjects. Additionally, potential predictors of interhemispheric asymmetry were explored. RESULTS Asymmetry of resting motor threshold (MT) among healthy volunteers was significant, favoring lower right relative to left-hemisphere excitability. MT was also significantly asymmetric in major depressive disorder (MDD), but with lower excitability of the left -hemisphere, when compared to the right, no longer observed in recovered patients. Findings on intracortical facilitation were similar. The few trials including bipolar depression revealed similar trends for imbalance, but with lower right hemisphere excitability, relative to the left. CONCLUSIONS There is interhemispheric asymmetry of motor cortical excitability in MDD, with lower excitability on left when compared to right-side. Interhemispheric asymmetry, with lower right relative to left-sided excitability, was found for bipolar depression and was also suggested for healthy volunteers, in a pattern that is clearly distinct from MDD. SIGNIFICANCE Mood disorders display asymmetric motor cortical excitability that is distinct from that found in healthy volunteers, supporting the presence of lateralized brain dysfunction in these disorders.
Collapse
Affiliation(s)
- Gonçalo Cotovio
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisboa, Portugal; NOVA Medical School, NMS , Universidade Nova de Lisboa, Lisboa, Portugal; Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | | | - Estela Real Lage
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisboa, Portugal; NOVA Medical School, NMS , Universidade Nova de Lisboa, Lisboa, Portugal
| | - Carolina Seybert
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisboa, Portugal
| | - Albino J Oliveira-Maia
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisboa, Portugal; NOVA Medical School, NMS , Universidade Nova de Lisboa, Lisboa, Portugal.
| |
Collapse
|
86
|
Al Qasem W, Abubaker M, Kvašňák E. Working Memory and Transcranial-Alternating Current Stimulation-State of the Art: Findings, Missing, and Challenges. Front Psychol 2022; 13:822545. [PMID: 35237214 PMCID: PMC8882605 DOI: 10.3389/fpsyg.2022.822545] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/19/2022] [Indexed: 12/06/2022] Open
Abstract
Working memory (WM) is a cognitive process that involves maintaining and manipulating information for a short period of time. WM is central to many cognitive processes and declines rapidly with age. Deficits in WM are seen in older adults and in patients with dementia, schizophrenia, major depression, mild cognitive impairment, Alzheimer's disease, etc. The frontal, parietal, and occipital cortices are significantly involved in WM processing and all brain oscillations are implicated in tackling WM tasks, particularly theta and gamma bands. The theta/gamma neural code hypothesis assumes that retained memory items are recorded via theta-nested gamma cycles. Neuronal oscillations can be manipulated by sensory, invasive- and non-invasive brain stimulations. Transcranial alternating-current stimulation (tACS) and repetitive transcranial magnetic stimulation (rTMS) are frequency-tuned non-invasive brain stimulation (NIBS) techniques that have been used to entrain endogenous oscillations in a frequency-specific manner. Compared to rTMS, tACS demonstrates superior cost, tolerability, portability, and safety profile, making it an attractive potential tool for improving cognitive performance. Although cognitive research with tACS is still in its infancy compared to rTMS, a number of studies have shown a promising WM enhancement effect, especially in the elderly and patients with cognitive deficits. This review focuses on the various methods and outcomes of tACS on WM in healthy and unhealthy human adults and highlights the established findings, unknowns, challenges, and perspectives important for translating laboratory tACS into realistic clinical settings. This will allow researchers to identify gaps in the literature and develop frequency-tuned tACS protocols with promising safety and efficacy outcomes. Therefore, research efforts in this direction should help to consider frequency-tuned tACS as a non-pharmacological tool of cognitive rehabilitation in physiological aging and patients with cognitive deficits.
Collapse
Affiliation(s)
- Wiam Al Qasem
- Department of Medical Biophysics and Medical Informatics, Third Faculty of Medicine, Charles University in Prague, Praha, Czechia
| | | | | |
Collapse
|
87
|
Rafique SA, Steeves JKE. Modulating intrinsic functional connectivity with visual cortex using low-frequency repetitive transcranial magnetic stimulation. Brain Behav 2022; 12:e2491. [PMID: 35049143 PMCID: PMC8865167 DOI: 10.1002/brb3.2491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 12/20/2021] [Accepted: 12/30/2021] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Intrinsic network connectivity becomes altered in pathophysiology. Noninvasive brain stimulation can modulate pathological functional networks in an attempt to restore the inherent response. To determine its usefulness for visual-related disorders, we developed procedures investigating repetitive transcranial magnetic stimulation (rTMS) protocols targeting the visual cortex on modulating connectivity associated with the visual network and default mode network (DMN). METHODS We compared two low-frequency (1 Hz) rTMS protocols to the visual cortex (V1)-a single 20 min session and five successive 20 min sessions (accelerated/within-session rTMS)-using multi-echo resting-state functional magnetic resonance whole-brain imaging and resting-state functional connectivity (rsFC). We also explored the relationship between rsFC and rTMS-induced changes in key inhibitory and excitatory neurotransmitters, γ-aminobutyric acid (GABA) and glutamate. GABA (GABA+) and glutamate (Glx) concentrations were measured in vivo using magnetic resonance spectroscopy. RESULTS Acute disruption with a single rTMS session caused widespread connectivity reconfiguration with nodes of interest. Changes were not evident immediately post-rTMS but were observed at 1 h post-rTMS. Accelerated sessions resulted in weak alterations in connectivity, producing a relatively homeostatic response. Changes in GABA+ and Glx concentrations with network connectivity were dependent on the rTMS protocol. CONCLUSIONS This proof-of-concept study offers new perspectives to assess stimulation-induced neural processes involved in intrinsic functional connectivity and the potential for rTMS to modulate nodes interconnected with the visual cortex. The differential effects of single-session and accelerated rTMS on physiological markers are crucial for furthering the advancement of treatment modalities in visual cortex related disorders.
Collapse
Affiliation(s)
- Sara A Rafique
- Department of Psychology and Centre for Vision Research, York University, Toronto, Canada
| | - Jennifer K E Steeves
- Department of Psychology and Centre for Vision Research, York University, Toronto, Canada
| |
Collapse
|
88
|
Stoby KS, Rafique SA, Oeltzschner G, Steeves JKE. Continuous and intermittent theta burst stimulation to the visual cortex do not alter GABA and glutamate concentrations measured by magnetic resonance spectroscopy. Brain Behav 2022; 12:e2478. [PMID: 35029058 PMCID: PMC8865152 DOI: 10.1002/brb3.2478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/07/2021] [Accepted: 12/14/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Theta burst stimulation (TBS), a form of repetitive transcranial magnetic stimulation (rTMS), uses repeated high-frequency bursts to non-invasively modulate neural processes in the brain. An intermittent TBS (iTBS) protocol is generally considered "excitatory," while continuous TBS (cTBS) is considered "inhibitory." However, the majority of work that has led to these effects being associated with the respective protocols has been done in the motor cortex, and it is well established that TMS can have variable effects across the brain. OBJECTIVES AND METHOD We investigated the effects of iTBS and cTBS to the primary visual cortex (V1) on composite levels of gamma-aminobutyric acid + co-edited macromolecules (GABA+) and glutamate + glutamine (Glx) since these are key inhibitory and excitatory neurotransmitters, respectively. Participants received a single session of cTBS, iTBS, or sham TBS to V1. GABA+ and Glx were quantified in vivo at the stimulation site using spectral-edited proton magnetic resonance spectroscopy (1 H-MRS) at 3T. Baseline pre-TBS GABA+ and Glx levels were compared to immediate post-TBS and 1 h post-TBS levels. RESULTS There were no significant changes in GABA+ or Glx following either of the TBS conditions. Visual cortical excitability, measured using phosphene thresholds, remained unchanged following both cTBS and iTBS conditions. There was no relationship between excitability thresholds and GABA+ or Glx levels. However, TBS did alter the relationship between GABA+ and Glx for up to 1 h following stimulation. CONCLUSIONS These findings demonstrate that a single session of TBS to the visual cortex can be used without significant effects on the tonic levels of these key neurotransmitters; and add to our understanding that TBS has differential effects at visual, motor, and frontal cortices.
Collapse
Affiliation(s)
- Karlene S Stoby
- Centre for Vision Research and Department of Psychology, York University, Toronto, ON, Canada
| | - Sara A Rafique
- Centre for Vision Research and Department of Psychology, York University, Toronto, ON, Canada
| | - Georg Oeltzschner
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Jennifer K E Steeves
- Centre for Vision Research and Department of Psychology, York University, Toronto, ON, Canada
| |
Collapse
|
89
|
The Effectiveness of Transcranial Magnetic Stimulation (TMS) Paradigms as Treatment Options for Recovery of Language Deficits in Chronic Poststroke Aphasia. Behav Neurol 2022; 2022:7274115. [PMID: 35069929 PMCID: PMC8767406 DOI: 10.1155/2022/7274115] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 12/18/2021] [Indexed: 11/29/2022] Open
Abstract
Background In an effort to boost aphasia recovery, modern rehabilitation, in addition to speech and language therapy (SALT), is increasingly incorporating noninvasive methods of brain stimulation. The present study is aimed at investigating the effectiveness of two paradigms of neuronavigated repetitive transcranial magnetic stimulation (rTMS): (i) 1 Hz rTMS and (ii) continuous theta burst stimulation (cTBS) each as a standalone treatment for chronic aphasia poststroke. Methods A single subject experimental design (SSED) trial was carried out in which six people with aphasia (PWA) were recruited, following a single left hemispheric stroke more than six months prior to the study. Three individuals were treated with 1 Hz rTMS, and the remaining three were treated with cTBS. In all cases, TMS was applied over the right pars triangularis (pTr). Language assessment, with standardized and functional measures, and cognitive evaluations were carried out at four time points: twice prior to treatment (baseline), one day immediately posttreatment, and at follow-up two months after treatment was terminated. Quality of life (QoL) was also assessed at baseline and two months posttreatment. In addition, one of the participants with severe global aphasia was followed up again one and two years posttherapy. Results For all participants, both rTMS paradigms (1 Hz rTMS and cTBS) generated trends towards improvement in several language skills (i.e., verbal receptive language, expressive language, and naming and reading) one day after treatment and/or two months after therapy. Rated QoL remained stable in three individuals, but for the other three, the communication scores of the QoL were reduced, while two of them also showed a decline in the psychological scores. The participant that was treated with cTBS and followed for up to two years showed that the significant improvement she had initially exhibited in comprehension and reading skills two months after TMS (1st follow-up) was sustained for at least up to two years. Conclusion From the current findings, it is suggested that inhibitory TMS over the right pTr has the potential to drive neuroplastic changes as a standalone treatment that facilitates language recovery in poststroke aphasia.
Collapse
|
90
|
BDNF Val66Met gene polymorphism modulates brain activity following rTMS-induced memory impairment. Sci Rep 2022; 12:176. [PMID: 34997117 PMCID: PMC8741781 DOI: 10.1038/s41598-021-04175-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 12/16/2021] [Indexed: 01/19/2023] Open
Abstract
The BDNF Val66Met gene polymorphism is a relevant factor explaining inter-individual differences to TMS responses in studies of the motor system. However, whether this variant also contributes to TMS-induced memory effects, as well as their underlying brain mechanisms, remains unexplored. In this investigation, we applied rTMS during encoding of a visual memory task either over the left frontal cortex (LFC; experimental condition) or the cranial vertex (control condition). Subsequently, individuals underwent a recognition memory phase during a functional MRI acquisition. We included 43 young volunteers and classified them as 19 Met allele carriers and 24 as Val/Val individuals. The results revealed that rTMS delivered over LFC compared to vertex stimulation resulted in reduced memory performance only amongst Val/Val allele carriers. This genetic group also exhibited greater fMRI brain activity during memory recognition, mainly over frontal regions, which was positively associated with cognitive performance. We concluded that BDNF Val66Met gene polymorphism, known to exert a significant effect on neuroplasticity, modulates the impact of rTMS both at the cognitive as well as at the associated brain networks expression levels. This data provides new insights on the brain mechanisms explaining cognitive inter-individual differences to TMS, and may inform future, more individually-tailored rTMS interventions.
Collapse
|
91
|
Esposito M, Ferrari C, Fracassi C, Miniussi C, Brignani D. Responsiveness to left-prefrontal tDCS varies according to arousal levels. Eur J Neurosci 2022; 55:762-777. [PMID: 34978110 PMCID: PMC9302688 DOI: 10.1111/ejn.15584] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 12/03/2021] [Accepted: 12/21/2021] [Indexed: 12/01/2022]
Abstract
Over the past two decades, the postulated modulatory effects of transcranial direct current stimulation (tDCS) on the human brain have been extensively investigated. However, recent concerns on reliability of tDCS effects have been raised, principally due to reduced replicability and to interindividual variability in response to tDCS. These inconsistencies are likely due to the interplay between the level of induced cortical excitability and unaccounted structural and state‐dependent functional factors. On these grounds, we aimed at verifying whether the behavioural effects induced by a common tDCS montage (F3‐rSOA) were influenced by the participants' arousal levels, as part of a broader mechanism of state‐dependency. Pupillary dynamics were recorded during an auditory oddball task while applying either a sham or real tDCS. The tDCS effects were evaluated as a function of subjective and physiological arousal predictors (STAI‐Y State scores and pre‐stimulus pupil size, respectively). We showed that prefrontal tDCS hindered task learning effects on response speed such that performance improvement occurred during sham, but not real stimulation. Moreover, both subjective and physiological arousal predictors significantly explained performance during real tDCS, with interaction effects showing performance improvement only with moderate arousal levels; likewise, pupil response was affected by real tDCS according to the ongoing levels of arousal, with reduced dilation during higher arousal trials. These findings highlight the potential role of arousal in shaping the neuromodulatory outcome, thus emphasizing a more careful interpretation of null or negative results while also encouraging more individually tailored tDCS applications based on arousal levels, especially in clinical populations.
Collapse
Affiliation(s)
- Marco Esposito
- Neurophysiology Lab, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Clarissa Ferrari
- Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Claudia Fracassi
- Neurophysiology Lab, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Carlo Miniussi
- Center for Mind/Brain Sciences CIMeC, University of Trento, Rovereto, Italy
| | - Debora Brignani
- Neurophysiology Lab, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| |
Collapse
|
92
|
Ghasemian-Shirvan E, Mosayebi-Samani M, Farnad L, Kuo MF, Meesen RL, Nitsche MA. Age-dependent non-linear neuroplastic effects of cathodal tDCS in the elderly population; a titration study. Brain Stimul 2022; 15:296-305. [DOI: 10.1016/j.brs.2022.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/27/2021] [Accepted: 01/16/2022] [Indexed: 11/16/2022] Open
|
93
|
Janssens SEW, Sack AT. Spontaneous Fluctuations in Oscillatory Brain State Cause Differences in Transcranial Magnetic Stimulation Effects Within and Between Individuals. Front Hum Neurosci 2021; 15:802244. [PMID: 34924982 PMCID: PMC8674306 DOI: 10.3389/fnhum.2021.802244] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 11/16/2021] [Indexed: 01/01/2023] Open
Abstract
Transcranial magnetic stimulation (TMS) can cause measurable effects on neural activity and behavioral performance in healthy volunteers. In addition, TMS is increasingly used in clinical practice for treating various neuropsychiatric disorders. Unfortunately, TMS-induced effects show large intra- and inter-subject variability, hindering its reliability, and efficacy. One possible source of this variability may be the spontaneous fluctuations of neuronal oscillations. We present recent studies using multimodal TMS including TMS-EMG (electromyography), TMS-tACS (transcranial alternating current stimulation), and concurrent TMS-EEG-fMRI (electroencephalography, functional magnetic resonance imaging), to evaluate how individual oscillatory brain state affects TMS signal propagation within targeted networks. We demonstrate how the spontaneous oscillatory state at the time of TMS influences both immediate and longer-lasting TMS effects. These findings indicate that at least part of the variability in TMS efficacy may be attributable to the current practice of ignoring (spontaneous) oscillatory fluctuations during TMS. Ignoring this state-dependent spread of activity may cause great individual variability which so far is poorly understood and has proven impossible to control. We therefore also compare two technical solutions to directly account for oscillatory state during TMS, namely, to use (a) tACS to externally control these oscillatory states and then apply TMS at the optimal (controlled) brain state, or (b) oscillatory state-triggered TMS (closed-loop TMS). The described multimodal TMS approaches are paramount for establishing more robust TMS effects, and to allow enhanced control over the individual outcome of TMS interventions aimed at modulating information flow in the brain to achieve desirable changes in cognition, mood, and behavior.
Collapse
Affiliation(s)
- Shanice E W Janssens
- Section Brain Stimulation and Cognition, Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.,Maastricht Brain Imaging Centre (MBIC), Maastricht, Netherlands
| | - Alexander T Sack
- Section Brain Stimulation and Cognition, Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.,Maastricht Brain Imaging Centre (MBIC), Maastricht, Netherlands.,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Brain + Nerve Centre, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands.,Centre for Integrative Neuroscience (CIN), Maastricht University, Maastricht, Netherlands
| |
Collapse
|
94
|
Behavioral and electrocortical effects of transcranial alternating current stimulation during advice-guided decision-making. NEUROIMAGE: REPORTS 2021. [DOI: 10.1016/j.ynirp.2021.100052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
95
|
Standard Non-Personalized Electric Field Modeling of Twenty Typical tDCS Electrode Configurations via the Computational Finite Element Method: Contributions and Limitations of Two Different Approaches. BIOLOGY 2021; 10:biology10121230. [PMID: 34943145 PMCID: PMC8698402 DOI: 10.3390/biology10121230] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 11/23/2021] [Indexed: 11/17/2022]
Abstract
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation procedure to modulate cortical excitability and related brain functions. tDCS can effectively alter multiple brain functions in healthy humans and is suggested as a therapeutic tool in several neurological and psychiatric diseases. However, variability of results is an important limitation of this method. This variability may be due to multiple factors, including age, head and brain anatomy (including skull, skin, CSF and meninges), cognitive reserve and baseline performance level, specific task demands, as well as comorbidities in clinical settings. Different electrode montages are a further source of variability between tDCS studies. A procedure to estimate the electric field generated by specific tDCS electrode configurations, which can be helpful to adapt stimulation protocols, is the computational finite element method. This approach is useful to provide a priori modeling of the current spread and electric field intensity that will be generated according to the implemented electrode montage. Here, we present standard, non-personalized model-based electric field simulations for motor, dorsolateral prefrontal, and posterior parietal cortex stimulation according to twenty typical tDCS electrode configurations using two different current flow modeling software packages. The resulting simulated maximum intensity of the electric field, focality, and current spread were similar, but not identical, between models. The advantages and limitations of both mathematical simulations of the electric field are presented and discussed systematically, including aspects that, at present, prevent more widespread application of respective simulation approaches in the field of non-invasive brain stimulation.
Collapse
|
96
|
The Role of Expectation and Beliefs on the Effects of Non-Invasive Brain Stimulation. Brain Sci 2021; 11:brainsci11111526. [PMID: 34827526 PMCID: PMC8615662 DOI: 10.3390/brainsci11111526] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/14/2021] [Accepted: 11/16/2021] [Indexed: 11/25/2022] Open
Abstract
Non-invasive brain stimulation (NIBS) techniques are used in clinical and cognitive neuroscience to induce a mild magnetic or electric field in the brain to modulate behavior and cortical activation. Despite the great body of literature demonstrating promising results, unexpected or even paradoxical outcomes are sometimes observed. This might be due either to technical and methodological issues (e.g., stimulation parameters, stimulated brain area), or to participants’ expectations and beliefs before and during the stimulation sessions. In this narrative review, we present some studies showing that placebo and nocebo effects, associated with positive and negative expectations, respectively, could be present in NIBS trials, both in experimental and in clinical settings. The lack of systematic evaluation of subjective expectations and beliefs before and after stimulation could represent a caveat that overshadows the potential contribution of placebo and nocebo effects in the outcome of NIBS trials.
Collapse
|
97
|
Lehmann SJ, Corneil BD. Completing the puzzle: Why studies in non-human primates are needed to better understand the effects of non-invasive brain stimulation. Neurosci Biobehav Rev 2021; 132:1074-1085. [PMID: 34742722 DOI: 10.1016/j.neubiorev.2021.10.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/29/2021] [Accepted: 10/31/2021] [Indexed: 11/27/2022]
Abstract
Brain stimulation is a core method in neuroscience. Numerous non-invasive brain stimulation (NIBS) techniques are currently in use in basic and clinical research, and recent advances promise the ability to non-invasively access deep brain structures. While encouraging, there is a surprising gap in our understanding of precisely how NIBS perturbs neural activity throughout an interconnected network, and how such perturbed neural activity ultimately links to behaviour. In this review, we will consider why non-human primate (NHP) models of NIBS are ideally situated to address this gap in knowledge, and why the oculomotor network that moves our line of sight offers a particularly valuable platform in which to empirically test hypothesis regarding NIBS-induced changes in brain and behaviour. NHP models of NIBS will enable investigation of the complex, dynamic effects of brain stimulation across multiple hierarchically interconnected brain areas, networks, and effectors. By establishing such links between brain and behavioural output, work in NHPs can help optimize experimental and therapeutic approaches, improve NIBS efficacy, and reduce side-effects of NIBS.
Collapse
Affiliation(s)
- Sebastian J Lehmann
- Department of Physiology and Pharmacology, Western University, London, Ontario, N6A 5B7, Canada.
| | - Brian D Corneil
- Department of Physiology and Pharmacology, Western University, London, Ontario, N6A 5B7, Canada; Department of Psychology, Western University, London, Ontario, N6A 5B7, Canada; Robarts Research Institute, London, Ontario, N6A 5B7, Canada.
| |
Collapse
|
98
|
Preconditioning with Cathodal High-Definition Transcranial Direct Current Stimulation Sensitizes the Primary Motor Cortex to Subsequent Intermittent Theta Burst Stimulation. Neural Plast 2021; 2021:8966584. [PMID: 34721571 PMCID: PMC8553444 DOI: 10.1155/2021/8966584] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/23/2021] [Accepted: 09/18/2021] [Indexed: 11/17/2022] Open
Abstract
Noninvasive brain stimulation techniques such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) can induce long-term potentiation-like facilitation, but whether the combination of TMS and tDCS has additive effects is unclear. To address this issue, in this randomized crossover study, we investigated the effect of preconditioning with cathodal high-definition (HD) tDCS on intermittent theta burst stimulation- (iTBS-) induced plasticity in the left motor cortex. A total of 24 healthy volunteers received preconditioning with cathodal HD-tDCS or sham intervention prior to iTBS in a random order with a washout period of 1 week. The amplitude of motor evoked potentials (MEPs) was measured at baseline and at several time points (5, 10, 15, and 30 min) after iTBS to determine the effects of the intervention on cortical plasticity. Preconditioning with cathodal HD-tDCS followed by iTBS showed a greater increase in MEP amplitude than sham cathodal HD-tDCS preconditioning and iTBS at each time postintervention point, with longer-lasting after-effects on cortical excitability. These results demonstrate that preintervention with cathodal HD-tDCS primes the motor cortex for long-term potentiation induced by iTBS and is a potential strategy for improving the clinical outcome to guide therapeutic decisions.
Collapse
|
99
|
Herrero JL, Smith A, Mishra A, Markowitz N, Mehta AD, Bickel S. Inducing neuroplasticity through intracranial θ-burst stimulation in the human sensorimotor cortex. J Neurophysiol 2021; 126:1723-1739. [PMID: 34644179 PMCID: PMC8782667 DOI: 10.1152/jn.00320.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/20/2021] [Accepted: 10/08/2021] [Indexed: 01/04/2023] Open
Abstract
The progress of therapeutic neuromodulation greatly depends on improving stimulation parameters to most efficiently induce neuroplasticity effects. Intermittent θ-burst stimulation (iTBS), a form of electrical stimulation that mimics natural brain activity patterns, has proved to efficiently induce such effects in animal studies and rhythmic transcranial magnetic stimulation studies in humans. However, little is known about the potential neuroplasticity effects of iTBS applied through intracranial electrodes in humans. This study characterizes the physiological effects of intracranial iTBS in humans and compare them with α-frequency stimulation, another frequently used neuromodulatory pattern. We applied these two stimulation patterns to well-defined regions in the sensorimotor cortex, which elicited contralateral hand muscle contractions during clinical mapping, in patients with epilepsy implanted with intracranial electrodes. Treatment effects were evaluated using oscillatory coherence across areas connected to the treatment site, as defined with corticocortical-evoked potentials. Our results show that iTBS increases coherence in the β-frequency band within the sensorimotor network indicating a potential neuroplasticity effect. The effect is specific to the sensorimotor system, the β band, and the stimulation pattern and outlasted the stimulation period by ∼3 min. The effect occurred in four out of seven subjects depending on the buildup of the effect during iTBS treatment and other patterns of oscillatory activity related to ceiling effects within the β band and to preexistent coherence within the α band. By characterizing the neurophysiological effects of iTBS within well-defined cortical networks, we hope to provide an electrophysiological framework that allows clinicians/researchers to optimize brain stimulation protocols which may have translational value.NEW & NOTEWORTHY θ-Burst stimulation (TBS) protocols in transcranial magnetic stimulation studies have shown improved treatment efficacy in a variety of neuropsychiatric disorders. The optimal protocol to induce neuroplasticity in invasive direct electrical stimulation approaches is not known. We report that intracranial TBS applied in human sensorimotor cortex increases local coherence of preexistent β rhythms. The effect is specific to the stimulation frequency and the stimulated network and outlasts the stimulation period by ∼3 min.
Collapse
Affiliation(s)
- Jose L Herrero
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York
- Department of Neurosurgery, Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York
| | - Alexander Smith
- Department of Neurosurgery, Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York
| | - Akash Mishra
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York
- Department of Neurosurgery, Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York
| | - Noah Markowitz
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York
- Department of Neurosurgery, Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York
| | - Ashesh D Mehta
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York
- Department of Neurosurgery, Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York
| | - Stephan Bickel
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York
- Department of Neurosurgery, Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York
- Department of Neurology, Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York
| |
Collapse
|
100
|
Mittal N, Majdic BC, Sima AP, Peterson CL. The effect of intermittent theta burst stimulation on corticomotor excitability of the biceps brachii in nonimpaired individuals. Neurosci Lett 2021; 764:136220. [PMID: 34499999 PMCID: PMC8572155 DOI: 10.1016/j.neulet.2021.136220] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/10/2021] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Abstract
Intermittent theta burst stimulation (iTBS) is a form of repetitive transcranial magnetic stimulation (TMS) that can increase corticomotor excitability in distal upper limb muscles, but the effect on the more proximal biceps is unknown. The study objective was to determine the effect of iTBS on corticomotor excitability of the biceps brachii in non-impaired individuals. Ten individuals completed three sessions, and an additional ten individuals completed one session in a secondary study; each session included sham and active iTBS. Resting and active motor thresholds (RMT, AMT) were determined prior to sham and active iTBS. Motor evoked potentials (MEPs) in response to single pulse TMS served as our measure of corticomotor excitability. In our primary cohort, MEPs were recorded with biphasic stimulation to accurately capture the same neurons affected by biphasic iTBS. MEPs were recorded at an intensity of 120% of RMT, or for instances of high RMTs, 100% of the maximum stimulator output (MSO), at baseline, and 10, 20, and 30 minutes after iTBS. MEPs were normalized by the maximum voluntary isometric muscle activity. In the secondary, MEPs were recorded with monophasic stimulation, which increased our ability to record MEPs at 120% of RMT. Linear mixed effects models were used to determine the effect of iTBS on normalized MEPs (nMEPs), with analyses to evaluate the interaction of the biceps AMT:RMT ratio as a measure of corticomotor conductance. Change in nMEPs from baseline did not differ for the active and sham conditions (p = 0.915 ) when MEPs were assessed with biphasic stimulation. With MEPs assessed by monophasic stimulation, there was an increase in biceps nMEPs after active iTBS, and no change in nMEPs after sham. Our results suggest that when RMTs are expected to be high when measured with biphasic stimulation, monophasic stimulation can better capture changes in MEPs induced by iTBS, and biphasic stimulation appears limited in its ability to capture changes in biceps MEPs in nonimpaired individuals. In both cohorts, increased corticomotor excitability after iTBS occurred when the biceps AMT:RMT ratio was high. Thus, the AMT:RMT ratio may be a predictive measure to evaluate the potential for iTBS to increase biceps corticomotor excitability.
Collapse
Affiliation(s)
- Neil Mittal
- Virginia Commonwealth University, Biomedical Engineering, College of Engineering, Virginia Commonwealth University, College of Engineering, Rehabilitation Engineering to Advance Ability Lab, Biotech Eight, 737 N 5(th) Street, Richmond, VA 23219, United States.
| | - Blaize C Majdic
- Virginia Commonwealth University, Biomedical Engineering, College of Engineering, Virginia Commonwealth University, College of Engineering, Rehabilitation Engineering to Advance Ability Lab, Biotech Eight, 737 N 5(th) Street, Richmond, VA 23219, United States
| | - Adam P Sima
- Virginia Commonwealth University, Department of Biostatistics, Virginia Commonwealth University, VCU School of Medicine, Department of Biostatistics, Box 980032, Richmond, VA 23298-0032, United States
| | - Carrie L Peterson
- Virginia Commonwealth University, Biomedical Engineering, College of Engineering, Virginia Commonwealth University, College of Engineering, Rehabilitation Engineering to Advance Ability Lab, Biotech Eight, 737 N 5(th) Street, Richmond, VA 23219, United States
| |
Collapse
|