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Bernardino I, Dionísio A, Violante IR, Monteiro R, Castelo-Branco M. Motor Cortex Excitation/Inhibition Imbalance in Young Adults With Autism Spectrum Disorder: A MRS-TMS Approach. Front Psychiatry 2022; 13:860448. [PMID: 35492696 PMCID: PMC9046777 DOI: 10.3389/fpsyt.2022.860448] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 03/21/2022] [Indexed: 12/28/2022] Open
Abstract
Excitatory/inhibitory imbalance has been suggested as a neurobiological substrate of the cognitive symptomatology in Autism Spectrum Disorder (ASD). Studies using magnetic resonance spectroscopy (MRS) attempted to characterize GABA and Glutamate brain levels in ASD. However mixed findings have been reported. Here, we characterize both neurochemical and physiological aspects of GABA system in ASD by implementing a more comprehensive approach combining MRS and transcranial magnetic stimulation (TMS). A group of 16 young ASD adults and a group of 17 controls participated in this study. We employed one MRS session to assess motor cortex GABA+ and Glutamate+Glutamine (Glx) levels using MEGAPRESS and PRESS sequences, respectively. Additionally, a TMS experiment was implemented including paired-pulse (SICI, ICF and LICI), input-output curve and cortical silent period to probe cortical excitability. Our results showed a significantly increased Glx, with unchanged GABA+ levels in the ASD group compared with controls. Single TMS measures did not differ between groups, although exploratory within-group analysis showed impaired inhibition in SICI5ms, in ASD. Importantly, we observed a correlation between GABA levels and measures of the input-output TMS recruitment curve (slope and MEP amplitude) in the control group but not in ASD, as further demonstrated by direct between group comparisons. In this exploratory study, we found evidence of increased Glx levels which may contribute to ASD excitatory/inhibitory imbalance while highlighting the relevance of conducting further larger-scale studies to investigate the GABA system from complementary perspectives, using both MRS and TMS techniques.
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Affiliation(s)
- Inês Bernardino
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal.,Institute of Nuclear Sciences Applied to Health, University of Coimbra, Coimbra, Portugal
| | - Ana Dionísio
- Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal.,Institute of Nuclear Sciences Applied to Health, University of Coimbra, Coimbra, Portugal
| | - Inês R Violante
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Raquel Monteiro
- Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal.,Institute of Nuclear Sciences Applied to Health, University of Coimbra, Coimbra, Portugal
| | - Miguel Castelo-Branco
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal.,Institute of Nuclear Sciences Applied to Health, University of Coimbra, Coimbra, Portugal
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Chen L, Zhang J, Wang Z, Zhang X, Zhang L, Xu M, Liu S, Ming D. Effects of Transcutaneous Vagus Nerve Stimulation (tVNS) on Action Planning: A Behavioural and EEG study. IEEE Trans Neural Syst Rehabil Eng 2021; 30:1675-1683. [PMID: 34847035 DOI: 10.1109/tnsre.2021.3131497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Action planning is an important decision-making process, which can be specially affected by environment. Response selection during action planning has been demonstrated to be modulated by tVNS. Therefore, tVNS shows a great potential for modulating the action planning process. We aimed to explore the tVNS-induced effect on action planning in behavioural and electrophysiology. Twenty-eight participants were randomly divided into two groups (active group and sham group). A single-blind, sham-controlled between-subject design was applied to explore the effect of online-tVNS (i.e., tVNS overlapping with the task) on action planning paradigm. We measured and compared reaction time (RT) and movement-related cortical potentials (MRCPs) before and after tVNS between active and sham groups. As compared to sham group, for the ipsilateral hand/contralateral hemisphere relative to the stimulated side, active tVNS significantly reduced the reaction time and decreased the MRCP amplitude mainly in the challenging tasks. Our results indicate that tVNS can produce a lateralization effect on action planning, especially plays an important role in the more challenging tasks as reflected both in the behavioural and electrophysiological results.
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GABAergic Modulation in Movement Related Oscillatory Activity: A Review of the Effect Pharmacologically and with Aging. Tremor Other Hyperkinet Mov (N Y) 2021; 11:48. [PMID: 34824891 PMCID: PMC8588888 DOI: 10.5334/tohm.655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/26/2021] [Indexed: 11/20/2022] Open
Abstract
Gamma-aminobutyric acid (GABA) is a ubiquitous inhibitory neurotransmitter critical to the control of movement both cortically and subcortically. Modulation of GABA can alter the characteristic rest as well as movement-related oscillatory activity in the alpha (8-12 Hz), beta (13-30 Hz, and gamma (60-90 Hz) frequencies, but the specific mechanisms by which GABAergic modulation can modify these well-described changes remains unclear. Through pharmacologic GABAergic modulation and evaluation across the age spectrum, the contributions of GABA to these characteristic oscillatory activities are beginning to be understood. Here, we review how baseline GABA signaling plays a key role in motor networks and in cortical oscillations detected by scalp electroencephalography and magnetoencephalography. We also discuss the data showing specific alterations to baseline movement related oscillatory changes from pharmacologic intervention on GABAergic tone as well as with healthy aging. These data provide greater insight into the physiology of movement and may help improve future development of novel therapeutics for patients who suffer from movement disorders.
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Guerra A, Asci F, Zampogna A, D'Onofrio V, Suppa A, Fabbrini G, Berardelli A. Long-term changes in short-interval intracortical facilitation modulate motor cortex plasticity and L-dopa-induced dyskinesia in Parkinson's disease. Brain Stimul 2021; 15:99-108. [PMID: 34823038 DOI: 10.1016/j.brs.2021.11.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/19/2021] [Accepted: 11/20/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Abnormal glutamatergic neurotransmission in the primary motor cortex (M1) contributes to Parkinson's disease (PD) pathophysiology and is related to l-dopa-induced dyskinesia (LID). We previously showed that short-term treatment with safinamide, a monoamine oxidase type-B inhibitor with anti-glutamatergic properties, improves abnormally enhanced short-interval intracortical facilitation (SICF) in PD patients. OBJECTIVE To examine whether a long-term SICF modulation has beneficial effects on clinical measures, including LID severity, and whether these changes parallel improvement in cortical plasticity mechanisms in PD. METHODS We tested SICF in patients with and without LID before (S0) and after short- (14 days - S1) and long-term (12 months - S2) treatment with safinamide 100 mg/day. Possible changes in M1 plasticity were assessed using intermittent theta-burst stimulation (iTBS). Finally, we correlated safinamide-related neurophysiological changes with modifications in clinical scores. RESULTS SICF was enhanced at S0, and prominently in patients with LID. Safinamide normalized SICF at S1, and this effect persisted at S2. Impaired iTBS-induced plasticity was present at S0 and safinamide restored this alteration at S2. There was a significant correlation between the degree of SICF and the amount of iTBS-induced plasticity at S0 and S2. In patients with LID, the degree of SICF at S0 and S2 correlated with long-term changes in LID severity. CONCLUSIONS Altered SICF contributes to M1 plasticity impairment in PD. Both SICF and M1 plasticity improve after long-term treatment with safinamide. The abnormality in SICF-related glutamatergic circuits plays a role in LID pathophysiology, and its long-term modulation may prevent LID worsening over time.
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Affiliation(s)
| | | | | | | | - Antonio Suppa
- IRCCS Neuromed, Pozzilli, IS, Italy; Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - Giovanni Fabbrini
- IRCCS Neuromed, Pozzilli, IS, Italy; Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - Alfredo Berardelli
- IRCCS Neuromed, Pozzilli, IS, Italy; Department of Human Neurosciences, Sapienza University of Rome, Italy.
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Verstraelen S, Cuypers K, Maes C, Hehl M, Van Malderen S, Levin O, Mikkelsen M, Meesen RLJ, Swinnen SP. Neurophysiological modulations in the (pre)motor-motor network underlying age-related increases in reaction time and the role of GABA levels - a bimodal TMS-MRS study. Neuroimage 2021; 243:118500. [PMID: 34428570 PMCID: PMC8547554 DOI: 10.1016/j.neuroimage.2021.118500] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 08/17/2021] [Accepted: 08/20/2021] [Indexed: 01/10/2023] Open
Abstract
It has been argued that age-related changes in the neurochemical and neurophysiological properties of the GABAergic system may underlie increases in reaction time (RT) in older adults. However, the role of GABA levels within the sensorimotor cortices (SMC) in mediating interhemispheric interactions (IHi) during the processing stage of a fast motor response, as well as how both properties explain interindividual differences in RT, are not yet fully understood. In this study, edited magnetic resonance spectroscopy (MRS) was combined with dual-site transcranial magnetic stimulation (dsTMS) for probing GABA+ levels in bilateral SMC and task-related neurophysiological modulations in corticospinal excitability (CSE), and primary motor cortex (M1)-M1 and dorsal premotor cortex (PMd)-M1 IHi, respectively. Both CSE and IHi were assessed during the preparatory and premotor period of a delayed choice RT task. Data were collected from 25 young (aged 18-33 years) and 28 older (aged 60-74 years) healthy adults. Our results demonstrated that older as compared to younger adults exhibited a reduced bilateral CSE suppression, as well as a reduced magnitude of long latency M1-M1 and PMd-M1 disinhibition during the preparatory period, irrespective of the direction of the IHi. Importantly, in older adults, the GABA+ levels in bilateral SMC partially accounted for task-related neurophysiological modulations as well as individual differences in RT. In contrast, in young adults, neither task-related neurophysiological modulations, nor individual differences in RT were associated with SMC GABA+ levels. In conclusion, this study contributes to a comprehensive initial understanding of how age-related differences in neurochemical properties and neurophysiological processes are related to increases in RT.
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Affiliation(s)
- Stefanie Verstraelen
- Neuroplasticity and Movement Control Research Group, Rehabilitation Research Institute (REVAL), Hasselt University, 3590 Diepenbeek, Belgium
| | - Koen Cuypers
- Neuroplasticity and Movement Control Research Group, Rehabilitation Research Institute (REVAL), Hasselt University, 3590 Diepenbeek, Belgium; Movement Control & Neuroplasticity Research Group, Department of Movement Sciences, Group Biomedical Sciences, KU Leuven, 3001 Heverlee, Belgium.
| | - Celine Maes
- Movement Control & Neuroplasticity Research Group, Department of Movement Sciences, Group Biomedical Sciences, KU Leuven, 3001 Heverlee, Belgium; KU Leuven Brain Institute (LBI), Leuven, Belgium
| | - Melina Hehl
- Neuroplasticity and Movement Control Research Group, Rehabilitation Research Institute (REVAL), Hasselt University, 3590 Diepenbeek, Belgium; Movement Control & Neuroplasticity Research Group, Department of Movement Sciences, Group Biomedical Sciences, KU Leuven, 3001 Heverlee, Belgium
| | - Shanti Van Malderen
- Movement Control & Neuroplasticity Research Group, Department of Movement Sciences, Group Biomedical Sciences, KU Leuven, 3001 Heverlee, Belgium
| | - Oron Levin
- Movement Control & Neuroplasticity Research Group, Department of Movement Sciences, Group Biomedical Sciences, KU Leuven, 3001 Heverlee, Belgium
| | - Mark Mikkelsen
- Russel H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Raf L J Meesen
- Neuroplasticity and Movement Control Research Group, Rehabilitation Research Institute (REVAL), Hasselt University, 3590 Diepenbeek, Belgium; Movement Control & Neuroplasticity Research Group, Department of Movement Sciences, Group Biomedical Sciences, KU Leuven, 3001 Heverlee, Belgium
| | - Stephan P Swinnen
- Movement Control & Neuroplasticity Research Group, Department of Movement Sciences, Group Biomedical Sciences, KU Leuven, 3001 Heverlee, Belgium; KU Leuven Brain Institute (LBI), Leuven, Belgium
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56
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Petitet P, Spitz G, Emir UE, Johansen-Berg H, O'Shea J. Age-related decline in cortical inhibitory tone strengthens motor memory. Neuroimage 2021; 245:118681. [PMID: 34728243 PMCID: PMC8752967 DOI: 10.1016/j.neuroimage.2021.118681] [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: 05/19/2021] [Revised: 10/21/2021] [Accepted: 10/24/2021] [Indexed: 11/02/2022] Open
Abstract
Ageing disrupts the finely tuned excitation/inhibition balance (E:I) across cortex via a natural decline in inhibitory tone (γ-amino butyric acid, GABA), causing functional decrements. However, in young adults, experimentally lowering GABA in sensorimotor cortex enhances a specific domain of sensorimotor function: adaptation memory. Here, we tested the hypothesis that as sensorimotor cortical GABA declines naturally with age, adaptation memory would increase, and the former would explain the latter. Results confirmed this prediction. To probe causality, we used brain stimulation to further lower sensorimotor cortical GABA during adaptation. Across individuals, how stimulation changed memory depended on sensorimotor cortical E:I. In those with low E:I, stimulation increased memory; in those with high E:I stimulation reduced memory. Thus, we identified a form of motor memory that is naturally strengthened by age, depends causally on sensorimotor cortex neurochemistry, and may be a potent target for motor skill preservation strategies in healthy ageing and neurorehabilitation.
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Affiliation(s)
- Pierre Petitet
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences (NDCN), John Radcliffe Hospital, Headington, Oxford, United Kingdom; Centre de Recherche en Neurosciences de Lyon, Equipe Trajectoires, Inserm UMR-S 1028, CNRS UMR 5292, Université Lyon 1, Bron, France.
| | - Gershon Spitz
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences (NDCN), John Radcliffe Hospital, Headington, Oxford, United Kingdom; Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia.
| | - Uzay E Emir
- School of Health Sciences, Purdue University, West Lafayette, Indiana, USA; Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA.
| | - Heidi Johansen-Berg
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences (NDCN), John Radcliffe Hospital, Headington, Oxford, United Kingdom.
| | - Jacinta O'Shea
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences (NDCN), John Radcliffe Hospital, Headington, Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity (OHBA), University of Oxford Department of Psychiatry, Warneford Hospital, Warneford Lane, Oxford, United Kingdom.
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57
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Alvarez-Alvarado S, Boutzoukas EM, Kraft JN, O’Shea A, Indahlastari A, Albizu A, Nissim NR, Evangelista ND, Cohen R, Porges EC, Woods AJ. Impact of Transcranial Direct Current Stimulation and Cognitive Training on Frontal Lobe Neurotransmitter Concentrations. Front Aging Neurosci 2021; 13:761348. [PMID: 34744698 PMCID: PMC8568306 DOI: 10.3389/fnagi.2021.761348] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/04/2021] [Indexed: 11/30/2022] Open
Abstract
Objective: This study examines the impact of transcranial direct current stimulation (tDCS) combined with cognitive training on neurotransmitter concentrations in the prefrontal cortex. Materials and Methods: Twenty-three older adults were randomized to either active-tDCS or sham-tDCS in combination with cognitive training for 2 weeks. Active-tDCS was delivered over F3 (cathode) and F4 (anode) electrode placements for 20 min at 2 mA intensity. For each training session, 40-min of computerized cognitive training were applied with active or sham stimulation delivered during the first 20-min. Glutamine/glutamate (Glx) and gamma-aminobutyric acid (GABA) concentrations via proton magnetic resonance spectroscopy were evaluated at baseline and at the end of 2-week intervention. Results: Glx concentrations increased from pre- to post-intervention (p = 0.010) in the active versus sham group after controlling for age, number of intervention days, MoCA scores, and baseline Glx concentration. No difference in GABA concentration was detected between active and sham groups (p = 0.650) after 2-week intervention. Conclusion: Results provide preliminary evidence suggesting that combining cognitive training and tDCS over the prefrontal cortex elicits sustained increase in excitatory neurotransmitter concentrations. Findings support the combination of tDCS and cognitive training as a potential method for altering neurotransmitter concentrations in the frontal cortices, which may have implications for neuroplasticity in the aging brain.
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Affiliation(s)
- Stacey Alvarez-Alvarado
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Emanuel M. Boutzoukas
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Jessica N. Kraft
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Andrew O’Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Aprinda Indahlastari
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Alejandro Albizu
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Nicole R. Nissim
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Nicole D. Evangelista
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Eric C. Porges
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Adam J. Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
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58
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Test-Retest Reliability of Short-Interval Intracortical Inhibition Assessed by Threshold-Tracking and Automated Conventional Techniques. eNeuro 2021; 8:ENEURO.0103-21.2021. [PMID: 34561238 PMCID: PMC8528507 DOI: 10.1523/eneuro.0103-21.2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 08/09/2021] [Accepted: 08/20/2021] [Indexed: 11/21/2022] Open
Abstract
Two novel short-interval intracortical inhibition (SICI) protocols, assessing SICI across a range of interstimulus intervals (ISIs) using either parallel threshold-tracking transcranial magnetic stimulation (TT-TMS) or automated conventional TMS (cTMS), were recently introduced. However, the test-retest reliability of these protocols has not been investigated, which is important if they are to be introduced in the clinic. SICI was recorded in 18 healthy subjects using TT-TMS (T-SICI) and cTMS (A-SICI). All subjects were examined at four identical sessions, i.e., morning and afternoon sessions on 2 d, 5-7 d apart. Both SICI protocols were performed twice at each session by the same observer. In one of the sessions, another observer performed additional examinations. Neither intraobserver nor interobserver measures of SICI differed significantly between examinations, except for T-SICI at ISI 3 ms (p = 0.00035) and A-SICI at ISI 2.5 ms (p = 0.0103). Intraday reliability was poor-to-good for A-SICI and moderate-to-good for T-SICI. Interday and interobserver reliabilities of T-SICI and A-SICI were moderate-to-good. Although between-subject variation constituted most of the total variation, SICI repeatability in an individual subject was poor. The two SICI protocols showed no considerable systematic bias across sessions and had a comparable test-retest reliability profile. Findings from the present study suggest that both SICI protocols may be reliably and reproducibly employed in research studies, but should be used with caution for individual decision-making in clinical settings. Studies exploring reliability in patient cohorts are warranted to investigate the clinical utility of these two SICI protocols.
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Herrera-Melendez AL, Bajbouj M, Aust S. Application of Transcranial Direct Current Stimulation in Psychiatry. Neuropsychobiology 2021; 79:372-383. [PMID: 31340213 DOI: 10.1159/000501227] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 05/28/2019] [Indexed: 11/19/2022]
Abstract
Transcranial direct current stimulation (tDCS) is a neuromodulation technique, which noninvasively alters cortical excitability via weak polarizing currents between two electrodes placed on the scalp. Since it is comparably easy to handle, cheap to use and relatively well tolerated, tDCS has gained increasing interest in recent years. Based on well-known behavioral effects, a number of clinical studies have been performed in populations including patients with major depressive disorder followed by schizophrenia and substance use disorders, in sum with heterogeneous results with respect to efficacy. Nevertheless, the potential of tDCS must not be underestimated since it could be further improved by systematically investigating the various stimulation parameters to eventually increase clinical efficacy. The present article briefly explains the underlying physiology of tDCS, summarizes typical stimulation protocols and then reviews clinical efficacy for various psychiatric disorders as well as prevalent adverse effects. Future developments include combined and more complex interactions of tDCS with pharmacological or psychotherapeutic interventions. In particular, using computational models to individualize stimulation protocols, considering state dependency and applying closed-loop technologies will pave the way for tDCS-based personalized interventions as well as the development of home treatment settings promoting the role of tDCS as an effective treatment option for patients with mental health problems.
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Affiliation(s)
- Ana-Lucia Herrera-Melendez
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany,
| | - Malek Bajbouj
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Sabine Aust
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
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60
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GABAergic inhibition in the human visual cortex relates to eye dominance. Sci Rep 2021; 11:17022. [PMID: 34426611 PMCID: PMC8382755 DOI: 10.1038/s41598-021-95685-1] [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: 06/08/2021] [Accepted: 07/27/2021] [Indexed: 12/23/2022] Open
Abstract
Binocular vision is created by fusing the separate inputs arriving from the left and right eyes. 'Eye dominance' provides a measure of the perceptual dominance of one eye over the other. Theoretical models suggest that eye dominance is related to reciprocal inhibition between monocular units in the primary visual cortex, the first location where the binocular input is combined. As the specific inhibitory interactions in the binocular visual system critically depend on the presence of visual input, we sought to test the role of inhibition by measuring the inhibitory neurotransmitter GABA during monocular visual stimulation of the dominant and the non-dominant eye. GABA levels were measured in a single volume of interest in the early visual cortex, including V1 from both hemispheres, using a combined functional magnetic resonance imaging and magnetic resonance spectroscopy (combined fMRI-MRS) sequence on a 7-Tesla MRI scanner. Individuals with stronger eye dominance had a greater difference in GABAergic inhibition between the eyes. This relationship was present only when the visual system was actively processing sensory input and was not present at rest. We provide the first evidence that imbalances in GABA levels during ongoing sensory processing are related to eye dominance in the human visual cortex. Our finding supports the view that intracortical inhibition underlies normal eye dominance.
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61
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Gann MA, King BR, Dolfen N, Veldman MP, Chan KL, Puts NAJ, Edden RAE, Davare M, Swinnen SP, Mantini D, Robertson EM, Albouy G. Hippocampal and striatal responses during motor learning are modulated by prefrontal cortex stimulation. Neuroimage 2021; 237:118158. [PMID: 33991699 PMCID: PMC8351752 DOI: 10.1016/j.neuroimage.2021.118158] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/16/2021] [Accepted: 05/05/2021] [Indexed: 02/06/2023] Open
Abstract
While it is widely accepted that motor sequence learning (MSL) is supported by a prefrontal-mediated interaction between hippocampal and striatal networks, it remains unknown whether the functional responses of these networks can be modulated in humans with targeted experimental interventions. The present proof-of-concept study employed a multimodal neuroimaging approach, including functional magnetic resonance (MR) imaging and MR spectroscopy, to investigate whether individually-tailored theta-burst stimulation of the dorsolateral prefrontal cortex can modulate responses in the hippocampus and the basal ganglia during motor learning. Our results indicate that while stimulation did not modulate motor performance nor task-related brain activity, it influenced connectivity patterns within hippocampo-frontal and striatal networks. Stimulation also altered the relationship between the levels of gamma-aminobutyric acid (GABA) in the stimulated prefrontal cortex and learning-related changes in both activity and connectivity in fronto-striato-hippocampal networks. This study provides the first experimental evidence, to the best of our knowledge, that brain stimulation can alter motor learning-related functional responses in the striatum and hippocampus.
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Affiliation(s)
- Mareike A Gann
- Department of Movement Sciences, Movement Control and Neuroplasticity Research Group, KU Leuven, 3001 Leuven, Belgium; LBI - KU Leuven Brain Institute, KU Leuven, 3001 Leuven, Belgium
| | - Bradley R King
- Department of Movement Sciences, Movement Control and Neuroplasticity Research Group, KU Leuven, 3001 Leuven, Belgium; LBI - KU Leuven Brain Institute, KU Leuven, 3001 Leuven, Belgium
| | - Nina Dolfen
- Department of Movement Sciences, Movement Control and Neuroplasticity Research Group, KU Leuven, 3001 Leuven, Belgium; LBI - KU Leuven Brain Institute, KU Leuven, 3001 Leuven, Belgium
| | - Menno P Veldman
- Department of Movement Sciences, Movement Control and Neuroplasticity Research Group, KU Leuven, 3001 Leuven, Belgium; LBI - KU Leuven Brain Institute, KU Leuven, 3001 Leuven, Belgium
| | - Kimberly L Chan
- Advanced Imaging Research Center, University of Texas Southwestern, Dallas, TX 75390, USA
| | - Nicolaas A J Puts
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD 21205, USA; Department of Forensic and Neurodevelopmental Sciences and the Institute of Psychiatry, Psychology, and Neuroscience; King's College London, SE5 8AF London, United Kingdom
| | - Richard A E Edden
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD 21205, USA
| | - Marco Davare
- Department of Clinical Sciences, College of Health and Life Sciences, Brunel University London, UB8 3PN Uxbridge, United Kingdom
| | - Stephan P Swinnen
- Department of Movement Sciences, Movement Control and Neuroplasticity Research Group, KU Leuven, 3001 Leuven, Belgium; LBI - KU Leuven Brain Institute, KU Leuven, 3001 Leuven, Belgium
| | - Dante Mantini
- Department of Movement Sciences, Movement Control and Neuroplasticity Research Group, KU Leuven, 3001 Leuven, Belgium; Brain Imaging and Neural Dynamics Research Group, IRCCS San Camillo Hospital, 30126 Venice, Italy
| | - Edwin M Robertson
- Institute of Neuroscience and Psychology, University of Glasgow, G12 8QB Glasgow, United Kingdom
| | - Geneviève Albouy
- Department of Movement Sciences, Movement Control and Neuroplasticity Research Group, KU Leuven, 3001 Leuven, Belgium; LBI - KU Leuven Brain Institute, KU Leuven, 3001 Leuven, Belgium.
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Takeuchi H, Taki Y, Nouchi R, Yokoyama R, Kotozaki Y, Nakagawa S, Sekiguchi A, Iizuka K, Hanawa S, Araki T, Miyauchi CM, Sakaki K, Nozawa T, Ikeda S, Yokota S, Daniele M, Sassa Y, Kawashima R. Lead exposure is associated with functional and microstructural changes in the healthy human brain. Commun Biol 2021; 4:912. [PMID: 34312468 PMCID: PMC8313694 DOI: 10.1038/s42003-021-02435-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 07/06/2021] [Indexed: 02/07/2023] Open
Abstract
Lead is a toxin known to harm many organs in the body, particularly the central nervous system, across an individual's lifespan. To date, no study has yet investigated the associations between body lead level and the microstructural properties of gray matter areas, and brain activity during attention-demanding tasks. Here, utilizing data of diffusion tensor imaging, functional magnetic resonance imaging and cognitive measures among 920 typically developing young adults, we show greater hair lead levels are weakly but significantly associated with (a) increased working memory-related activity in the right premotor and pre-supplemental motor areas, (b) lower fractional anisotropy (FA) in white matter areas near the internal capsule, (c) lower mean diffusivity (MD) in the dopaminergic system in the left hemisphere and other widespread contingent areas, and (d) greater MD in the white matter area adjacent to the right fusiform gyrus. Higher lead levels were also weakly but significantly associated with lower performance in tests of high-order cognitive functions, such as the psychometric intelligence test, greater impulsivity measures, and higher novelty seeking and extraversion. These findings reflect the weak effect of daily lead level on the excitability and microstructural properties of the brain, particularly in the dopaminergic system.
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Affiliation(s)
- Hikaru Takeuchi
- grid.69566.3a0000 0001 2248 6943Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Yasuyuki Taki
- grid.69566.3a0000 0001 2248 6943Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan ,grid.69566.3a0000 0001 2248 6943Division of Medical Neuroimaging Analysis, Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan ,grid.69566.3a0000 0001 2248 6943Department of Radiology and Nuclear Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Rui Nouchi
- grid.69566.3a0000 0001 2248 6943Creative Interdisciplinary Research Division, Frontier Research Institute for Interdisciplinary Science, Tohoku University, Sendai, Japan ,grid.69566.3a0000 0001 2248 6943Human and Social Response Research Division, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan ,grid.69566.3a0000 0001 2248 6943Department of Advanced Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Ryoichi Yokoyama
- grid.31432.370000 0001 1092 3077School of Medicine, Kobe University, Kobe, Japan
| | - Yuka Kotozaki
- grid.411582.b0000 0001 1017 9540Division of Clinical research, Medical-Industry Translational Research Center, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Seishu Nakagawa
- grid.69566.3a0000 0001 2248 6943Department of Human Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan ,grid.412755.00000 0001 2166 7427Division of Psychiatry, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Atsushi Sekiguchi
- grid.69566.3a0000 0001 2248 6943Division of Medical Neuroimaging Analysis, Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan ,grid.419280.60000 0004 1763 8916Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kunio Iizuka
- grid.69566.3a0000 0001 2248 6943Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Sugiko Hanawa
- grid.69566.3a0000 0001 2248 6943Department of Human Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | | | - Carlos Makoto Miyauchi
- grid.69566.3a0000 0001 2248 6943Department of Advanced Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Kohei Sakaki
- grid.69566.3a0000 0001 2248 6943Department of Advanced Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Takayuki Nozawa
- grid.32197.3e0000 0001 2179 2105Research Institute for the Earth Inclusive Sensing, Tokyo Institute of Technology, Tokyo, Japan
| | - Shigeyuki Ikeda
- grid.69566.3a0000 0001 2248 6943Department of Ubiquitous Sensing, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Susum Yokota
- grid.177174.30000 0001 2242 4849Division for Experimental Natural Science, Faculty of Arts and Science, Kyushu University, Fukuoka, Japan
| | - Magistro Daniele
- grid.12361.370000 0001 0727 0669Department of Sport Science, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Yuko Sassa
- grid.69566.3a0000 0001 2248 6943Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Ryuta Kawashima
- grid.69566.3a0000 0001 2248 6943Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan ,grid.69566.3a0000 0001 2248 6943Department of Advanced Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan ,grid.69566.3a0000 0001 2248 6943Department of Human Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
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63
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Mooney RA, Bastian AJ, Celnik PA. Training at asymptote stabilizes motor memories by reducing intracortical excitation. Cortex 2021; 143:47-56. [PMID: 34375797 DOI: 10.1016/j.cortex.2021.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 10/20/2022]
Abstract
Learning similar motor skills in close succession is limited by interference, a phenomenon that takes place early after acquisition when motor memories are unstable. Interference can be bidirectional, as the first memory can be disrupted by the second (retrograde interference), or the second memory can be disrupted by the first (anterograde interference). The heightened plastic state of primary motor cortex after learning is thought to underlie interference, as unstable motor memories compete for neural resources. While time-dependent consolidation processes reduce interference, the passage of time (~6 h) required for memory stabilization limits our capacity to learn multiple motor skills at once. Here, we demonstrate in humans that prolonged training at asymptote of an initial motor skill reduces both retrograde and anterograde interference when a second motor skill is acquired in close succession. Neurophysiological assessments via transcranial magnetic stimulation reflect this online stabilization process. Specifically, excitatory neurotransmission in primary motor cortex increased after short training and decreased after prolonged training at performance asymptote. Of note, this reduction in intracortical excitation after prolonged training was proportional to better skill retention the following day. Importantly, these neurophysiological effects were not observed after motor practice without learning or after a temporal delay. Together, these findings indicate that prolonged training at asymptote improves the capacity to learn multiple motor skills in close succession, and that downregulation of excitatory neurotransmission in primary motor cortex may be a marker of online motor memory stabilization.
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Affiliation(s)
- Ronan A Mooney
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA
| | - Amy J Bastian
- Kennedy Krieger Institute, Baltimore, MD, USA; Department of Neuroscience, Johns Hopkins University, Baltimore, MD, USA
| | - Pablo A Celnik
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA.
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64
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Sasaki R, Watanabe H, Miyaguchi S, Otsuru N, Ohno K, Sakurai N, Kodama N, Onishi H. Contribution of the brain-derived neurotrophic factor and neurometabolites to the motor performance. Behav Brain Res 2021; 412:113433. [PMID: 34175359 DOI: 10.1016/j.bbr.2021.113433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 06/02/2021] [Accepted: 06/21/2021] [Indexed: 01/04/2023]
Abstract
Individual motor performance ability is affected by various factors. Although the key factor has not yet completely been elucidated, the brain-derived neurotrophic factor (BDNF) genotype as well as neurometabolites may become contibuting factors depending on the learning stage. We investigated the effects of the Met allele of the BDNF gene and those of the neurometabolites on visuomotor learning. In total, 43 healthy participants performed a visuomotor learning task consisting of 10 blocks using the right index finger (Val66Val, n = 15; Val66Met, n = 15; and Met66Met, n = 13). Glutamate plus glutamine (Glx) concentrations in the primary motor cortex, primary somatosensory cortex (S1), and cerebellum were evaluated using 3-T magnetic resonance spectroscopy in 19 participants who participated in the visuomotor learning task. For the learning stage, the task error (i.e., learning ability) was significantly smaller in the Met66Met group compared with that observed in the remaining groups, irrespective of the learning stage (all p values < 0.003). A significant difference was observed between the Val66Val and Met66Met groups in the learning slope (i.e., learning speed) in the early learning stage (p = 0.048) but not in the late learning stage (all p values> 0.54). Moreover, positive correlations were detected between the learning slope and Glx concentrations in S1 only in the early learning stage (r = 0.579, p = 0.009). The BDNF genotype and Glx concentrations in S1 partially contribute to interindividual variability on learning speed in the early learning stage.
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Affiliation(s)
- Ryoki Sasaki
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata, Japan; Discipline of Physiology, Adelaide Medical School, The University of Adelaide, Adelaide, Australia.
| | - Hiraku Watanabe
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata, Japan.
| | - Shota Miyaguchi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata, Japan; Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata, Japan.
| | - Naofumi Otsuru
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata, Japan; Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata, Japan.
| | - Ken Ohno
- Department of Radiological Technology, Niigata University of Health and Welfare, Niigata City, Niigata, Japan.
| | - Noriko Sakurai
- Department of Radiological Technology, Niigata University of Health and Welfare, Niigata City, Niigata, Japan.
| | - Naoki Kodama
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata, Japan; Department of Radiological Technology, Niigata University of Health and Welfare, Niigata City, Niigata, Japan.
| | - Hideaki Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata, Japan; Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata, Japan.
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Grigoras IF, Stagg CJ. Recent advances in the role of excitation-inhibition balance in motor recovery post-stroke. Fac Rev 2021; 10:58. [PMID: 34308424 PMCID: PMC8265564 DOI: 10.12703/r/10-58] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Stroke affects millions of people worldwide each year, and stroke survivors are often left with motor deficits. Current therapies to improve these functional deficits are limited, making it a priority to better understand the pathophysiology of stroke recovery and find novel adjuvant options. The excitation-inhibition balance undergoes significant changes post-stroke, and the inhibitory neurotransmitter γ-aminobutyric acid (GABA) appears to play an important role in stroke recovery. In this review, we summarise the most recent studies investigating GABAergic inhibition at different stages of stroke. We discuss the proposed role of GABA in counteracting glutamate-mediated excitotoxicity in hyperacute stroke as well as the evidence linking decreased GABAergic inhibition to increased neuronal plasticity in early stroke. Then, we discuss two types of interventions that aim to modulate the excitation-inhibition balance to improve functional outcomes in stroke survivors: non-invasive brain stimulation (NIBS) and pharmacological interventions. Finding the optimal NIBS administration or adjuvant pharmacological therapies would represent an important contribution to the currently scarce therapy options.
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Affiliation(s)
- Ioana-Florentina Grigoras
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford; Medical Research Council Brain Network Dynamics Unit, University of Oxford, Oxford, UK
| | - Charlotte J Stagg
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford; Medical Research Council Brain Network Dynamics Unit, University of Oxford, Oxford, UK
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66
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Transcutaneous vagus nerve stimulation in patients with attention-deficit/hyperactivity disorder: A viable option? PROGRESS IN BRAIN RESEARCH 2021; 264:171-190. [PMID: 34167655 DOI: 10.1016/bs.pbr.2021.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Individuals with attention-deficit/hyperactivity disorder (ADHD) suffer from a range of cognitive and behavioral problems that severely impair their educational and occupational attainment. ADHD symptoms have been linked to structural and functional changes within and between different brain regions, particularly the prefrontal cortex. At the system level, reduced availability of the neurotransmitters dopamine (DA) and norepinephrine (NE) but also γ-aminobutyric acid (GABA) have been repeatedly demonstrated. Recently, non-invasive brain stimulation (NIBS) techniques have been explored as treatment alternatives to alter dysfunctional activation patterns in specified brain areas or networks. In the current paper, we introduce transcutaneous vagus nerve stimulation (tVNS) as a systemic approach to directly affect NE and GABA neurotransmission. TVNS is a non-drug intervention with low risk and proven efficacy in improving cognitive particularly executive functions. It is easy to apply and therefore well-suited to provide home-based or mobile treatment options allowing a significant increase in treatment intensity and providing easier access to medical care for individuals who are unable to regularly visit a clinician. We describe in detail the underlying mechanisms of tVNS and current fields of application and discuss its potential as an adjuvant treatment for ADHD.
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67
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Turco CV, Nelson AJ. Transcranial Magnetic Stimulation to Assess Exercise-Induced Neuroplasticity. FRONTIERS IN NEUROERGONOMICS 2021; 2:679033. [PMID: 38235229 PMCID: PMC10790852 DOI: 10.3389/fnrgo.2021.679033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/06/2021] [Indexed: 01/19/2024]
Abstract
Aerobic exercise facilitates neuroplasticity and has been linked to improvements in cognitive and motor function. Transcranial magnetic stimulation (TMS) is a non-invasive technique that can be used to quantify changes in neurophysiology induced by exercise. The present review summarizes the single- and paired-pulse TMS paradigms that can be used to probe exercise-induced neuroplasticity, the optimal stimulation parameters and the current understanding of the neurophysiology underlying each paradigm. Further, this review amalgamates previous research exploring the modulation of these paradigms with exercise-induced neuroplasticity in healthy and clinical populations and highlights important considerations for future TMS-exercise research.
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Affiliation(s)
| | - Aimee J. Nelson
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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68
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Mohammad Mahdi Alavi S, Goetz SM, Saif M. Input-output slope curve estimation in neural stimulation based on optimal sampling principles . J Neural Eng 2021; 18:10.1088/1741-2552/abffe5. [PMID: 33975287 PMCID: PMC8384062 DOI: 10.1088/1741-2552/abffe5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/11/2021] [Indexed: 11/11/2022]
Abstract
This paper discusses some of the practical limitations and issues, which exist for the input-output (IO) slope curve estimation (SCE) in neural, brain and spinal, stimulation techniques. The drawbacks of the SCE techniques by using existing uniform sampling and Fisher-information-based optimal IO curve estimation (FO-IOCE) methods are elaborated. A novel IO SCE technique is proposed with a modified sampling strategy and stopping rule which improve the SCE performance compared to these methods. The effectiveness of the proposed IO SCE is tested on 1000 simulation runs in transcranial magnetic stimulation (TMS), with a realistic model of motor evoked potentials. The results show that the proposed IO SCE method successfully satisfies the stopping rule, before reaching the maximum number of TMS pulses in 79.5% of runs, while the estimation based on the uniform sampling technique never converges and satisfies the stopping rule. At the time of successful termination, the proposed IO SCE method decreases the 95th percentile (mean value in the parentheses) of the absolute relative estimation errors (AREs) of the slope curve parameters up to 7.45% (2.2%), with only 18 additional pulses on average compared to that of the FO-IOCE technique. It also decreases the 95th percentile (mean value in the parentheses) of the AREs of the IO slope curve parameters up to 59.33% (16.71%), compared to that of the uniform sampling method. The proposed IO SCE also identifies the peak slope with higher accuracy, with the 95th percentile (mean value in the parentheses) of AREs reduced by up to 9.96% (2.01%) compared to that of the FO-IOCE method, and by up to 46.29% (13.13%) compared to that of the uniform sampling method.
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Affiliation(s)
- Seyed Mohammad Mahdi Alavi
- Department of Applied Computing and Engineering, School of Technologies, Cardiff Metropolitan University, Llandaff Campus, Western Avenue, Cardiff CF5 2YB, United Kingdom
| | - Stefan M Goetz
- Departments of Psychiatry and Behavioral Sciences, Electrical and Computer Engineering, and Neurosurgery as well as the Duke Brain Initiative, Duke University, Durham, NC 27708, United States of America
- Department of Engineering, University of Cambridge, Cambridge CB2 1PZ, United Kingdom
| | - Mehrdad Saif
- Department of Electrical Engineering, University of Windsor, Windsor, ON N9B 3P4, Canada
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Guder S, Pasternak O, Gerloff C, Schulz R. Strengthened structure-function relationships of the corticospinal tract by free water correction after stroke. Brain Commun 2021; 3:fcab034. [PMID: 33959708 PMCID: PMC8088790 DOI: 10.1093/braincomms/fcab034] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/23/2020] [Accepted: 01/27/2021] [Indexed: 11/23/2022] Open
Abstract
The corticospinal tract is the most intensively investigated tract of the human motor system in stroke rehabilitative research. Diffusion-tensor-imaging gives insights into its microstructure, and transcranial magnetic stimulation assesses its excitability. Previous data on the interrelationship between both measures are contradictory. Correlative or predictive models which associate them with motor outcome are incomplete. Free water correction has been developed to enhance diffusion-tensor-imaging by eliminating partial volume with extracellular water, which could improve capturing stroke-related microstructural alterations, thereby also improving structure-function relationships in clinical cohorts. In the present cross-sectional study, data of 18 chronic stroke patients and 17 healthy controls, taken from a previous study on cortico-cerebellar motor tracts, were re-analysed: The data included diffusion-tensor-imaging data quantifying corticospinal tract microstructure with and without free water correction, transcranial magnetic stimulation data assessing recruitment curve properties of motor evoked potentials and detailed clinical data. Linear regression modelling was used to interrelate corticospinal tract microstructure, recruitment curves properties and clinical scores. The main finding of the present study was that free water correction substantially strengthens structure-function associations in stroke patients: Specifically, our data evidenced a significant association between fractional anisotropy of the ipsilesional corticospinal tract and its excitability (P = 0.001, adj. R2 = 0.54), with free water correction explaining additional 20% in recruitment curve variability. For clinical scores, only free water correction leads to the reliable detection of significant correlations between ipsilesional corticospinal tract fractional anisotropy and residual grip (P = 0.001, adj. R2 = 0.70) and pinch force (P < 0.001, adj. R2 = 0.72). Finally, multimodal models can be improved by free water correction as well. This study evidences that corticospinal tract microstructure directly relates to its excitability in stroke patients. It also shows that unexplained variance in motor outcome is considerably reduced by free water correction arguing that it might serve as a powerful tool to improve existing models of structure-function associations and potentially also outcome prediction after stroke.
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Affiliation(s)
- Stephanie Guder
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Ofer Pasternak
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Christian Gerloff
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Robert Schulz
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
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Keute M, Wienke C, Ruhnau P, Zaehle T. Effects of transcutaneous vagus nerve stimulation (tVNS) on beta and gamma brain oscillations. Cortex 2021; 140:222-231. [PMID: 34015727 DOI: 10.1016/j.cortex.2021.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/05/2021] [Accepted: 04/12/2021] [Indexed: 12/01/2022]
Abstract
Physiological and behavioral effects induced through transcutaneous vagus nerve stimulation (tVNS) are under scrutiny in a growing number of studies, yet its mechanisms of action remain poorly understood. One candidate mechanism is a modulation of γ-aminobutyric acid (GABA) transmission through tVNS. Two recent behavioral studies suggest that such a GABAergic effect might occur in a lateralized fashion, i.e., the GABA modulation might be stronger in the left than in the right brain hemisphere after tVNS applied to the left ear. Using magnetoencephalography (MEG), we tested for GABA-associated modulations in resting and event-related brain oscillations and for a lateralization of those effects in a sample of 41 healthy young adults. Our data provide substantial evidence against all hypotheses, i.e., we neither find effects of tVNS on oscillatory power nor a lateralization of effects.
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Affiliation(s)
- Marius Keute
- Department of Neurology, Otto-von Guericke-University, Magdeburg, Germany; Institute for Neuromodulation and Neurotechnology, University of Tübingen, Tübingen, Germany.
| | - Christian Wienke
- Department of Neurology, Otto-von Guericke-University, Magdeburg, Germany; Center for Behavioral Brain Sciences, Otto-von-Guericke University, Magdeburg
| | - Philipp Ruhnau
- Department of Neurology, Otto-von Guericke-University, Magdeburg, Germany; Center for Behavioral Brain Sciences, Otto-von-Guericke University, Magdeburg
| | - Tino Zaehle
- Department of Neurology, Otto-von Guericke-University, Magdeburg, Germany; Center for Behavioral Brain Sciences, Otto-von-Guericke University, Magdeburg
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71
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ACC Glu/GABA ratio is decreased in euthymic bipolar disorder I patients: possible in vivo neurometabolite explanation for mood stabilization. Eur Arch Psychiatry Clin Neurosci 2021; 271:537-547. [PMID: 31993746 DOI: 10.1007/s00406-020-01096-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 01/13/2020] [Indexed: 12/19/2022]
Abstract
Bipolar disorder (BD) is characterized by unstable mood states ranging from mania to depression. Although there is some evidence that mood instability may result from an imbalance between excitatory glutamatergic and inhibitory GABA-ergic neurotransmission, few proton magnetic resonance spectroscopy (1H-MRS) studies have measured these two neurometabolites simultaneously in BD. The enzyme glutamic acid decarboxylase (GAD1) catalyzes the decarboxylation of glutamate (Glu) to GABA, and its single nucleotide polymorphisms (SNPs) might influence Glu/GABA ratio. Thus, we investigated Glu/GABA ratio in the dorsal anterior cingulate cortex (dACC) of euthymic BD type I patients and healthy controls (HC), and assessed the influence of both mood stabilizers and GAD1 SNPs on this ratio. Eighty-eight subjects (50 euthymic BD type I patients and 38 HC) underwent 3T 1H-MRS in the dACC (2 × 2 × 4.5 cm3) using a two-dimensional JPRESS sequence and all subjects were genotyped for 4 SNPs in the GAD1 gene. BD patients had lower dACC Glu/GABA ratio compared to HC, where this was influenced by anticonvulsant and antipsychotic medications, but not lithium. The presence of GAD1 rs1978340 allele A was associated with higher Glu/GABA ratio in BD, while patients without this allele taking mood stabilizers had a lower Glu/GABA ratio. The lowering of dACC Glu/GABA could be one explanation for the mood stabilizing action of anticonvulsants and antipsychotics in BD type I euthymia. Therefore, this putative role of Glu/GABA ratio and the influence of GAD1 genotype interacting with mood stabilization medication should be confirmed by further studies involving larger samples and other mood states.ClincalTrials.gov registration: NCT01237158.
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72
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Austin T, Bani-Ahmed A, Cirstea MC. N-Acetylaspartate Biomarker of Stroke Recovery: A Case Series Study. FRONTIERS IN NEUROLOGY AND NEUROSCIENCE RESEARCH 2021; 2:100007. [PMID: 34296219 PMCID: PMC8294783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND PURPOSE Strong experimental neurobehavioral evidence suggests that intensive training improves arm motor disability after stroke. Yet, we still have only limited understanding why some patients recover more completely and others do not. This is in part due to our limited knowledge of the neurobiological principles of recovery from stroke. Mounting evidence suggests that functional and structural remapping of the primary motor cortex (M1) plays a major role in arm recovery after stroke. We used MR Spectroscopy to test the hypothesis that therapy-related arm improvement is associated with changes in levels of a putative marker of neuronal integrity (N-acetylaspartate, NAA) in M1 controlling the paretic arm (ipsilesional M1) in chronic stroke patients (n=5). METHODS Patients (1 female, age, mean ± SD, 58.4 ± 5.8 years) underwent 4-week arm-focused motor training (1080 repetitions of a reach-to-grasp task) at 13.6 ± 5.3 months after stroke onset. NAA levels in the ipsilesional M1 and arm impairment (Fugl-Meyer, FM, 66=normal; proximal FM, FMp, 30=normal) were assessed prior to and immediately after training. RESULTS At baseline, patients exhibited moderate-to-mild arm impairment (FM, 47.2 ± 18.8, FMp, 22.2 ± 8.6) and showed lower levels of NAA compared with age/sex-matched healthy controls (10.2 ± 0.9 mM in patients vs. 11.6 ± 1.6 mM in controls, p=0.03). After training, arm impairment improved (FM by 7%, 50.6 ± 17.5, p=0.01; FMp, by 5%, 23.4 ± 8.2, p=0.2) and NAA levels increased by 10.5% (11.2 ± 1.2 mM, p=0.1). Changes in NAA positively correlated with changes in FM (r=0.63, p=0.2) and FMp (r=0.93, p=0.03), suggesting that patients who show greater neuronal changes have a better chance of recovery. CONCLUSIONS Our data suggest the potential use of M1 NAA as a biomarker of motor recovery after stroke. However, because of our small sample, these preliminary results should be interpreted cautiously. Further work with larger sample sizes is warranted.
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Affiliation(s)
- Tyler Austin
- University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Ali Bani-Ahmed
- Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Physical Therapy & Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Ar-Ramtha, Jordan
| | - Mihaela Carmen Cirstea
- Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Physical Therapy & Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Physical Medicine & Rehabilitation, University of Missouri, Columbia, Missouri, USA
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Sasaki R, Otsuru N, Miyaguchi S, Kojima S, Watanabe H, Ohno K, Sakurai N, Kodama N, Sato D, Onishi H. Influence of Brain-Derived Neurotrophic Factor Genotype on Short-Latency Afferent Inhibition and Motor Cortex Metabolites. Brain Sci 2021; 11:brainsci11030395. [PMID: 33804682 PMCID: PMC8003639 DOI: 10.3390/brainsci11030395] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/01/2021] [Accepted: 03/18/2021] [Indexed: 12/11/2022] Open
Abstract
The Met allele of the brain-derived neurotrophic factor (BDNF) gene confers reduced cortical BDNF expression and associated neurobehavioral changes. BDNF signaling influences the survival, development, and synaptic function of cortical networks. Here, we compared gamma-aminobutyric acid (GABA)ergic network activity in the human primary motor cortex (M1) between the Met (Val/Met and Met/Met) and non-Met (Val/Val) genotype groups. Short- and long-interval intracortical inhibition, short-latency afferent inhibition (SAI), and long-latency afferent inhibition were measured using transcranial magnetic stimulation (TMS) as indices of GABAergic activity. Furthermore, the considerable inter-individual variability in inhibitory network activity typically measured by TMS may be affected not only by GABA but also by other pathways, including glutamatergic and cholinergic activities; therefore, we used 3-T magnetic resonance spectroscopy (MRS) to measure the dynamics of glutamate plus glutamine (Glx) and choline concentrations in the left M1, left somatosensory cortex, and right cerebellum. All inhibitory TMS conditions produced significantly smaller motor-evoked potentials than single-pulses. SAI was significantly stronger in the Met group than in the Val/Val group. Only the M1 Glx concentration was significantly lower in the Met group, while the BDNF genotype did not affect choline concentration in any region. Further, a positive correlation was observed between SAI and Glx concentrations only in M1. Our findings provide evidence that the BDNF genotype regulates both the inhibitory and excitatory circuits in human M1. In addition, lower Glx concentration in the M1 of Met carriers may alter specific inhibitory network on M1, thereby influencing the cortical signal processing required for neurobehavioral functions.
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Affiliation(s)
- Ryoki Sasaki
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan; (N.O.); (S.M.); (S.K.); (H.W.); (N.K.); (D.S.); (H.O.)
- Discipline of Physiology, Adelaide Medical School, The University of Adelaide, Adelaide 5000, Australia
- Correspondence: ; Tel.: +81-25-257-4445
| | - Naofumi Otsuru
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan; (N.O.); (S.M.); (S.K.); (H.W.); (N.K.); (D.S.); (H.O.)
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan
| | - Shota Miyaguchi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan; (N.O.); (S.M.); (S.K.); (H.W.); (N.K.); (D.S.); (H.O.)
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan
| | - Sho Kojima
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan; (N.O.); (S.M.); (S.K.); (H.W.); (N.K.); (D.S.); (H.O.)
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan
| | - Hiraku Watanabe
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan; (N.O.); (S.M.); (S.K.); (H.W.); (N.K.); (D.S.); (H.O.)
| | - Ken Ohno
- Department of Radiological Technology, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan; (K.O.); (N.S.)
| | - Noriko Sakurai
- Department of Radiological Technology, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan; (K.O.); (N.S.)
| | - Naoki Kodama
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan; (N.O.); (S.M.); (S.K.); (H.W.); (N.K.); (D.S.); (H.O.)
- Department of Radiological Technology, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan; (K.O.); (N.S.)
| | - Daisuke Sato
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan; (N.O.); (S.M.); (S.K.); (H.W.); (N.K.); (D.S.); (H.O.)
- Department of Health and Sports, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan
| | - Hideaki Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan; (N.O.); (S.M.); (S.K.); (H.W.); (N.K.); (D.S.); (H.O.)
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan
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Chaves AR, Snow NJ, Alcock LR, Ploughman M. Probing the Brain-Body Connection Using Transcranial Magnetic Stimulation (TMS): Validating a Promising Tool to Provide Biomarkers of Neuroplasticity and Central Nervous System Function. Brain Sci 2021; 11:384. [PMID: 33803028 PMCID: PMC8002717 DOI: 10.3390/brainsci11030384] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/09/2021] [Accepted: 03/12/2021] [Indexed: 01/18/2023] Open
Abstract
Transcranial magnetic stimulation (TMS) is a non-invasive method used to investigate neurophysiological integrity of the human neuromotor system. We describe in detail, the methodology of a single pulse TMS protocol that was performed in a large cohort of people (n = 110) with multiple sclerosis (MS). The aim was to establish and validate a core-set of TMS variables that predicted typical MS clinical outcomes: walking speed, hand dexterity, fatigue, and cognitive processing speed. We provide a brief and simple methodological pipeline to examine excitatory and inhibitory corticospinal mechanisms in MS that map to clinical status. Delayed and longer ipsilateral silent period (a measure of transcallosal inhibition; the influence of one brain hemisphere's activity over the other), longer cortical silent period (suggestive of greater corticospinal inhibition via GABA) and higher resting motor threshold (lower corticospinal excitability) most strongly related to clinical outcomes, especially when measured in the hemisphere corresponding to the weaker hand. Greater interhemispheric asymmetry (imbalance between hemispheres) correlated with poorer performance in the greatest number of clinical outcomes. We also show, not surprisingly, that TMS variables related more strongly to motor outcomes than non-motor outcomes. As it was validated in a large sample of patients with varying severities of central nervous system dysfunction, the protocol described herein can be used by investigators and clinicians alike to investigate the role of TMS as a biomarker in MS and other central nervous system disorders.
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Affiliation(s)
| | | | | | - Michelle Ploughman
- L.A. Miller Centre, Recovery and Performance Laboratory, Faculty of Medicine, Memorial University of Newfoundland, St. John’s, NL A1A 1E5, Canada; (A.R.C.); (N.J.S.); (L.R.A.)
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Harris AD, Gilbert DL, Horn PS, Crocetti D, Cecil KM, Edden RAE, Huddleston DA, Mostofsky SH, Puts NAJ. Relationship between GABA levels and task-dependent cortical excitability in children with attention-deficit/hyperactivity disorder. Clin Neurophysiol 2021; 132:1163-1172. [PMID: 33780723 DOI: 10.1016/j.clinph.2021.01.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 12/21/2020] [Accepted: 01/06/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Compared to typically developing (TD) peers, children with attention deficit hyperactivity disorder (ADHD) manifest reduced short interval cortical inhibition (SICI) in the dominant motor cortex measured with transcranial magnetic stimulation (TMS). This multimodal study investigates the inhibitory neurophysiology and neurochemistry by evaluating the relationship between SICI and γ-amino butyric acid (GABA+) levels, measured with magnetic resonance spectroscopy (MRS). METHODS Across two sites, 37 children with ADHD and 45 TD children, ages 8-12 years, participated. Single and paired pulse TMS to left motor cortex quantified SICI during REST and at times of action selection (GO) and inhibition (STOP) during a modified Slater-Hammel stop signal reaction task. MRS quantified GABA+ levels in the left sensorimotor cortex. Relationships between SICI and GABA+, as well as stopping efficiency and clinical symptoms, were analyzed with correlations and repeated-measure, mixed-models. RESULTS In both groups, higher GABA+ levels correlated with less SICI. In TD children only, higher GABA+ levels correlated with larger TMS motor evoked potentials (MEPs) at REST. In GO and STOP trials, higher GABA+ was associated with smaller MEP amplitudes, for both groups. Overall, GABA+ levels did not differ between groups or correlate with ADHD clinical symptoms. CONCLUSIONS In children with higher motor cortex GABA+, motor cortex is less responsive to inhibitory TMS (SICI). Comparing the relationships between MRS-GABA+ levels and responses to TMS at REST vs. GO/STOP trials suggests differences in inhibitory neurophysiology and neurotransmitters in children with ADHD. These differences are more prominent at rest than during response inhibition task engagement. SIGNIFICANCE Evaluating relationships between GABA+ and SICI may provide a biomarker useful for understanding behavioral diagnoses.
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Affiliation(s)
- Ashley D Harris
- Radiology, University of Calgary, Calgary, AB, Canada; Child and Adolescent Imaging Research Program, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
| | - Donald L Gilbert
- Division of Pediatric Neurology, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Paul S Horn
- Division of Pediatric Neurology, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Deana Crocetti
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Kim M Cecil
- Department of Radiology, Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati College of Medicine, OH, United States
| | - Richard A E Edden
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore, MD, United States; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States
| | - David A Huddleston
- Division of Pediatric Neurology, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Stewart H Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, United States; Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, United States; Department of Behavioral Science and Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Nicolaas A J Puts
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore, MD, United States; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States; Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
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Hynd M, Soh C, Rangel BO, Wessel JR. Paired-pulse TMS and scalp EEG reveal systematic relationship between inhibitory GABA a signaling in M1 and fronto-central cortical activity during action stopping. J Neurophysiol 2021; 125:648-660. [PMID: 33439759 DOI: 10.1152/jn.00571.2020] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
By stopping actions even after their initiation, humans can flexibly adapt ongoing behavior to changing circumstances. The neural processes underlying the inhibition of movement during action stopping are still controversial. In the 90s, a fronto-central event-related potential (ERP) was discovered in the human EEG response to stop signals in the classic stop-signal task, alongside a proposal that this "stop-signal P3" reflects an inhibitory process. Indeed, both amplitude and onset of the stop-signal P3 relate to overt behavior and movement-related EEG activity in ways predicted by the dominant models of action-stopping. However, neither EEG nor behavior allow direct inferences about the presence or absence of neurophysiological inhibition of the motor cortex, making it impossible to definitively relate the stop-signal P3 to inhibition. Here, we therefore present a multimethod investigation of the relationship between the stop-signal P3 and GABAergic signaling in primary motor cortex, as indexed by paired-pulse transcranial magnetic stimulation (TMS). In detail, we measured short-interval intracortical inhibition (SICI), a marker of inhibitory GABAa activity in M1, in a group of 41 human participants who also performed the stop-signal task while undergoing EEG recordings. In line with the P3-inhibition hypothesis, we found that subjects with stronger inhibitory GABA activity in M1 also showed both faster onsets and larger amplitudes of the stop-signal P3. This provides direct evidence linking the properties of this ERP to a true physiological index of motor system inhibition. We discuss these findings in the context of recent theoretical developments and empirical findings regarding the neural implementation of motor inhibition.NEW & NOTEWORTHY The neural mechanisms underlying rapid action stopping in humans are subject to intense debate, in part because recordings of neural signals purportedly reflecting inhibitory motor control are hard to directly relate to the true, physiological inhibition of motor cortex. For the first time, the current study combines EEG and transcranial magnetic stimulation (TMS) methods to demonstrate a direct correspondence between fronto-central control-related EEG activity following signals to cancel an action and the physiological inhibition of primary motor cortex.
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Affiliation(s)
- Megan Hynd
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa
| | - Cheol Soh
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa
| | - Benjamin O Rangel
- Interdisciplinary Graduate Program in Neuroscience, University of Iowa, Iowa City, Iowa
| | - Jan R Wessel
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa.,Interdisciplinary Graduate Program in Neuroscience, University of Iowa, Iowa City, Iowa.,Department of Neurology, University of Iowa Hospital and Clinics, Iowa City, Iowa
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Bell T, Stokoe M, Khaira A, Webb M, Noel M, Amoozegar F, Harris AD. GABA and glutamate in pediatric migraine. Pain 2021; 162:300-308. [PMID: 33326202 PMCID: PMC7737876 DOI: 10.1097/j.pain.0000000000002022] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/07/2020] [Accepted: 07/14/2020] [Indexed: 12/17/2022]
Abstract
Migraine is one of the top 5 most prevalent childhood diseases; however, effective treatment strategies for pediatric migraine are limited. For example, standard adult pharmaceutical therapies are less effective in children and can carry undesirable side effects. To develop more effective treatments, improved knowledge of the biology underlying pediatric migraine is necessary. One theory is that migraine results from an imbalance in cortical excitability. Magnetic resonance spectroscopy (MRS) studies show changes in GABA and glutamate levels (the primary inhibitory and excitatory neurotransmitters in the brain, respectively) in multiple brain regions in adults with migraine; however, they have yet to be assessed in children with migraine. Using MRS and GABA-edited MRS, we show that children (7-13 years) with migraine and aura had significantly lower glutamate levels in the visual cortex compared to controls, the opposite to results seen in adults. In addition, we found significant correlations between metabolite levels and migraine characteristics; higher GABA levels were associated with higher migraine burden. We also found that higher glutamate in the thalamus and higher GABA/Glx ratios in the sensorimotor cortex were associated with duration since diagnosis, i.e., having migraines longer. Lower GABA levels in the sensorimotor cortex were associated with being closer to their next migraine attack. Together, this indicates that GABA and glutamate disturbances occur early in migraine pathophysiology and emphasizes that evidence from adults with migraine cannot be immediately translated to pediatric sufferers. This highlights the need for further mechanistic studies of migraine in children, to aid in development of more effective treatments.
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Affiliation(s)
- Tiffany Bell
- Department of Radiology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Mehak Stokoe
- Department of Radiology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Akashroop Khaira
- Department of Radiology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Megan Webb
- Department of Radiology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Melanie Noel
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Farnaz Amoozegar
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Ashley D. Harris
- Department of Radiology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
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Abstract
OBJECTIVES The primary objective was to conduct a meta-analysis of studies comparing the GABA levels of schizophrenia patients (SZP) and healthy controls (HC) using proton magnetic resonance spectroscopy (1H-MRS) in the frontal cortex (FC) and its sub-regions. METHODS We included studies published in English language that used 1H-MRS from MRI scanners having at-least 3 Tesla (3 T) magnetic field strength to measure GABA levels in SZP (n = 699) and HC (n = 718) in FC and its sub-regions. The outcome measures were the means and standard deviations of GABA levels and outcome measure was calculated using a random-effect model. RESULTS In FC, medial prefrontal cortex (MPFC) and dorsolateral prefrontal cortex (DLPFC), there were no significant group differences. On excluding the outlier studies, the GABA levels were lower in patients with schizophrenia compared to healthy controls in FC (Hedges' g = -0.2; p = 0.02). In ACC, significant group difference was noted in GABA levels (Hedges' g = -0.25; p = 0.03) with patients values being lower that is more pronounced in the first episode schizophrenia patients (Hedges' g: -0.41; p = 0.003). CONCLUSIONS The available 1H-MRS studies suggest hypo-GABA ergia specifically in ACC and hint towards possible hypo GABA-ergic state in the FC. However, limitations of the analysis should be considered while interpreting the results.
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Affiliation(s)
- Vijay Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Bhavika Vajawat
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Naren P Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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Opie GM, Semmler JG. Preferential Activation of Unique Motor Cortical Networks With Transcranial Magnetic Stimulation: A Review of the Physiological, Functional, and Clinical Evidence. Neuromodulation 2020; 24:813-828. [PMID: 33295685 DOI: 10.1111/ner.13314] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/30/2020] [Accepted: 10/19/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The corticospinal volley produced by application of transcranial magnetic stimulation (TMS) over primary motor cortex consists of a number of waves generated by trans-synaptic input from interneuronal circuits. These indirect (I)-waves mediate the sensitivity of TMS to cortical plasticity and intracortical excitability and can be assessed by altering the direction of cortical current induced by TMS. While this methodological approach has been conventionally viewed as preferentially recruiting early or late I-wave inputs from a given populations of neurons, growing evidence suggests recruitment of different neuronal populations, and this would strongly influence interpretation and application of these measures. The aim of this review is therefore to consider the physiological, functional, and clinical evidence for the independence of the neuronal circuits activated by different current directions. MATERIALS AND METHODS To provide the relevant context, we begin with an overview of TMS methodology, focusing on the different techniques used to quantify I-waves. We then comprehensively review the literature that has used variations in coil orientation to investigate the I-wave circuits, grouping studies based on the neurophysiological, functional, and clinical relevance of their outcomes. RESULTS Review of the existing literature reveals significant evidence supporting the idea that varying current direction can recruit different neuronal populations having unique functionally and clinically relevant characteristics. CONCLUSIONS Further research providing greater characterization of the I-wave circuits activated with different current directions is required. This will facilitate the development of interventions that are able to modulate specific intracortical circuits, which will be an important application of TMS.
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Affiliation(s)
- George M Opie
- Discipline of Physiology, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - John G Semmler
- Discipline of Physiology, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
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Mostafa MM, Awad EM, Hazzou AM, Elewa MKA, Aziz TTA, Samy DM. Biochemical and structural magnetic resonance imaging in chronic stroke and the relationship with upper extremity motor function. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-00183-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Recovery of upper extremity (UE) motor function after stroke is variable from one to another due to heterogeneity of stroke pathology. Structural and biochemical magnetic resonance imaging of the primary motor cortex (M1) have been used to document reorganization of neural activity after stroke.
Objective
To assess cortical biochemical and structural causes of delayed recovery of UE motor function impairment in chronic subcortical ischemic stroke patients.
Methodology
A cross-sectional study with fifty patients were enrolled: thirty patients with chronic (> 6 months) subcortical ischemic stroke suffering from persistent UE motor function impairment (not improved group) and twenty patients with chronic subcortical ischemic stroke and improved UE motor function (improved group). We recruited a group of (16) age-matched healthy subjects. Single voxel proton magnetic resonance spectroscopy (1H-MRS) was performed to measure n-acetylaspartate (NAA) and glutamate+glutamine (Glx) ratios relative to creatine (Cr) in the precentral gyrus which represent M1of hand area in both ipsilesional and contralesional hemispheres. Brain magnetic resonance imaging (MRI) to measure precentral gyral thickness is representing the M1of hand area. UE motor function assessment is using the Fugl Meyer Assessment (FMA-UE) Scale.
Results
The current study found that ipslesional cortical thickness was significantly lower than contralesional cortical thickness among all stroke patients. Our study found that ipsilesional NAA/Cr ratio was lower than contralesional NAA/Cr among stroke patients. UE and hand motor function by FMA-UE showed highly statistically significant correlation with ipsilesional cortical thickness and ipsilesional NAA/Cr ratio, more powerful with NAA/Cr ratio.
Conclusion
We concluded that persistent motor impairment in individuals with chronic subcortical stroke may be at least in part related to ipsilesional structural and biochemical changes in motor areas remote from infarction in form of decreased cortical thickness and NAA/Cr ratio which had the strongest relationship with that impairment.
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Rafique SA, Steeves JKE. Assessing differential effects of single and accelerated low-frequency rTMS to the visual cortex on GABA and glutamate concentrations. Brain Behav 2020; 10:e01845. [PMID: 32964685 PMCID: PMC7749615 DOI: 10.1002/brb3.1845] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The application of repetitive transcranial magnetic stimulation (rTMS) for therapeutic use in visual-related disorders and its underlying mechanisms in the visual cortex is under-investigated. Additionally, there is little examination of rTMS adverse effects particularly with regards to visual and cognitive function. Neural plasticity is key in rehabilitation and recovery of function; thus, effective therapeutic strategies must be capable of modulating plasticity. Glutamate and γ-aminobutyric acid (GABA)-mediated changes in the balance between excitation and inhibition are prominent features in visual cortical plasticity. OBJECTIVES AND METHOD We investigated the effects of low-frequency (1 Hz) rTMS to the visual cortex on levels of neurotransmitters GABA and glutamate to determine the therapeutic potential of 1 Hz rTMS for visual-related disorders. Two rTMS regimes commonly used in clinical applications were investigated: participants received rTMS to the visual cortex either in a single 20-min session or five accelerated 20-min sessions (not previously investigated at the visual cortex). Proton (1H) magnetic resonance spectroscopy for in vivo quantification of GABA (assessed via GABA+) and glutamate (assessed via Glx) concentrations was performed pre- and post-rTMS. RESULTS GABA+ and Glx concentrations were unaltered following a single session of rTMS to the visual cortex. One day of accelerated rTMS significantly reduced GABA+ concentration for up to 24 hr, with levels returning to baseline by 1-week post-rTMS. Basic visual and cognitive function remained largely unchanged. CONCLUSION Accelerated 1 Hz rTMS to the visual cortex has greater potential for approaches targeting plasticity or in cases with altered GABAergic responses in visual disorders. Notably, these results provide preliminary insight into a critical window of plasticity with accelerated rTMS (e.g., 24 hr) in which adjunct therapies may offer better functional outcome. We describe detailed procedures to enable further exploration of these protocols.
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Affiliation(s)
- Sara A. Rafique
- Department of Psychology and Centre for Vision ResearchYork UniversityTorontoONCanada
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82
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Fomenko A, Chen KHS, Nankoo JF, Saravanamuttu J, Wang Y, El-Baba M, Xia X, Seerala SS, Hynynen K, Lozano AM, Chen R. Systematic examination of low-intensity ultrasound parameters on human motor cortex excitability and behavior. eLife 2020; 9:e54497. [PMID: 33236981 PMCID: PMC7728443 DOI: 10.7554/elife.54497] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 11/24/2020] [Indexed: 12/23/2022] Open
Abstract
Low-intensity transcranial ultrasound (TUS) can non-invasively modulate human neural activity. We investigated how different fundamental sonication parameters influence the effects of TUS on the motor cortex (M1) of 16 healthy subjects by probing cortico-cortical excitability and behavior. A low-intensity 500 kHz TUS transducer was coupled to a transcranial magnetic stimulation (TMS) coil. TMS was delivered 10 ms before the end of TUS to the left M1 hotspot of the first dorsal interosseous muscle. Varying acoustic parameters (pulse repetition frequency, duty cycle, and sonication duration) on motor-evoked potential amplitude were examined. Paired-pulse measures of cortical inhibition and facilitation, and performance on a visuomotor task was also assessed. TUS safely suppressed TMS-elicited motor cortical activity, with longer sonication durations and shorter duty cycles when delivered in a blocked paradigm. TUS increased GABAA-mediated short-interval intracortical inhibition and decreased reaction time on visuomotor task but not when controlled with TUS at near-somatosensory threshold intensity.
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Affiliation(s)
- Anton Fomenko
- Krembil Research Institute, University Health NetworkTorontoCanada
| | - Kai-Hsiang Stanley Chen
- Krembil Research Institute, University Health NetworkTorontoCanada
- Department of Neurology, National Taiwan University Hospital Hsin-Chu BranchHsin-ChuTaiwan
| | | | | | - Yanqiu Wang
- Krembil Research Institute, University Health NetworkTorontoCanada
| | - Mazen El-Baba
- Krembil Research Institute, University Health NetworkTorontoCanada
| | - Xue Xia
- Division of Neurology, Department of Medicine, University of TorontoTorontoCanada
| | | | | | - Andres M Lozano
- Krembil Research Institute, University Health NetworkTorontoCanada
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of TorontoTorontoCanada
| | - Robert Chen
- Krembil Research Institute, University Health NetworkTorontoCanada
- Division of Neurology, Department of Medicine, University of TorontoTorontoCanada
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83
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Ferland MC, Therrien-Blanchet JM, Proulx S, Klees-Themens G, Bacon BA, Dang Vu TT, Théoret H. Transcranial Magnetic Stimulation and H 1-Magnetic Resonance Spectroscopy Measures of Excitation and Inhibition Following Lorazepam Administration. Neuroscience 2020; 452:235-246. [PMID: 33246064 DOI: 10.1016/j.neuroscience.2020.11.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 10/16/2020] [Accepted: 11/09/2020] [Indexed: 12/21/2022]
Abstract
This study aimed at better understanding the neurochemistry underlying transcranial magnetic stimulation (TMS) and magnetic resonance spectroscopy (MRS) measurements as it pertains to GABAergic activity following administration of allosteric GABAA receptor agonist lorazepam. Seventeen healthy adults (8 females, 26.0 ± 5.4 years old) participated in a double-blind, crossover, placebo-controlled study, where participants underwent TMS and MRS two hours after drug intake (placebo or lorazepam; 2.5 mg). Neuronavigated TMS measures reflecting cortical inhibition and excitation were obtained in the left primary motor cortex. Sensorimotor cortex and occipital cortex MRS data were acquired using a 3T scanner with a MEGA-PRESS sequence, allowing water-referenced [GABA] and [Glx] (glutamate + glutamine) quantification. Lorazepam administration decreased occipital [GABA], decreased motor cortex excitability and increased GABAA-receptor mediated motor cortex inhibition (short intracortical inhibition (SICI)). Lorazepam intake did not modulate sensorimotor [GABA] and TMS measures of intra-cortical facilitation, long-interval cortical inhibition, cortical silent period, and resting motor threshold. Furthermore, higher sensorimotor [GABA] was associated with higher cortical inhibition (SICI) following lorazepam administration, suggesting that baseline sensorimotor [GABA] may be valuable in predicting pharmacological or neuromodulatory treatment response. Finally, the differential effects of lorazepam on MRS and TMS measures, with respect to GABA, support the idea that TMS measures of cortical inhibition reflect synaptic GABAergic phasic inhibitory activity while MRS reflects extrasynaptic GABA.
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Affiliation(s)
| | | | | | | | | | - Thien Thanh Dang Vu
- Center for Studies in Behavioral Neurobiology and Perform Center, Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC, Canada; Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Qc, Canada
| | - Hugo Théoret
- Département de psychologie, Université de Montréal, Québec, Canada; Centre de recherche du Centre Hospitalier Universitaire de l'Hôpital Sainte-Justine, Montréal, Québec, Canada.
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84
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Lea-Carnall CA, Williams SR, Sanaei-Nezhad F, Trujillo-Barreto NJ, Montemurro MA, El-Deredy W, Parkes LM. GABA Modulates Frequency-Dependent Plasticity in Humans. iScience 2020; 23:101657. [PMID: 33163932 PMCID: PMC7599432 DOI: 10.1016/j.isci.2020.101657] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/27/2020] [Accepted: 10/05/2020] [Indexed: 11/18/2022] Open
Abstract
Frequency-dependent reorganization of the primary somatosensory cortex, together with perceptual changes, arises following repetitive sensory stimulation. Here, we investigate the role of GABA in this process. We co-stimulated two finger tips and measured GABA and Glx using magnetic resonance (MR) spectroscopy at the beginning and end of the stimulation. Participants performed a perceptual learning task before and after stimulation. There were 2 sessions with stimulation frequency either at or above the resonance frequency of the primary somatosensory cortex (23 and 39 Hz, respectively). Perceptual learning occurred following above resonance stimulation only, while GABA reduced during this condition. Lower levels of early GABA were associated with greater perceptual learning. One possible mechanism underlying this finding is that cortical disinhibition “unmasks” lateral connections within the cortex to permit adaptation to the sensory environment. These results provide evidence in humans for a frequency-dependent inhibitory mechanism underlying learning and suggest a mechanism-based approach for optimizing neurostimulation frequency. In the context of repetitive sensory stimulation, GABA release is frequency dependent Stimulating above the resonance frequency of the somatosensory cortex reduces GABA Perceptual learning is associated with a reduction in GABA Early GABA reduction opens a window for plasticity and learning
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Affiliation(s)
- Caroline A. Lea-Carnall
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Corresponding author
| | - Stephen R. Williams
- Division of Informatics, Imaging and Data Science, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Faezeh Sanaei-Nezhad
- Division of Informatics, Imaging and Data Science, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Nelson J. Trujillo-Barreto
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Marcelo A. Montemurro
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Wael El-Deredy
- Centro de Investigación y Desarrollo en Ingeniería en Salud, Universidad de Valparaíso, Valparaíso, Chile
- Corresponding author
| | - Laura M. Parkes
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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85
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Giboin LS, Reunis T, Gruber M. Corticospinal properties are associated with sensorimotor performance in action video game players. Neuroimage 2020; 226:117576. [PMID: 33221450 DOI: 10.1016/j.neuroimage.2020.117576] [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: 08/10/2020] [Revised: 10/10/2020] [Accepted: 11/10/2020] [Indexed: 10/23/2022] Open
Abstract
Notwithstanding the apparent demands regarding fine motor skills that are required to perform in action video games, the motor nervous system of players has not been studied systematically. In the present study, we hypothesized to find differences in sensorimotor performance and corticospinal characteristics between action video game players (Players) and Controls. We tested sensorimotor performance in video games tasks and used transcranial magnetic stimulation (TMS) to measure motor map, input-output (IO) and short intra-cortical inhibition (SICI) curves in the first dorsal interosseous (FDI) muscle of Players (n = 18) and Control (n = 18). Players scored higher in performance tests and had stronger SICI and higher motor evoked potential (MEP) amplitudes. Multiple linear regressions showed that Players and Control differed with respect to their relation between reaction time and corticospinal excitability. However, we did not find different motor map topography or different IO curves for Players when compared to Controls. Action video game players showed an increased efficiency of motor cortical inhibitory and excitatory neural networks. Players also showed a different relation of MEPs with reaction time. The present study demonstrates the potential of action video game players as an ideal population to study the mechanisms underlying visuomotor performance and sensorimotor learning.
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Affiliation(s)
- Louis-Solal Giboin
- Sensorimotor Performance Lab, Human Performance Research Centre, Department of Sport Science, University of Konstanz, Germany.
| | - Tom Reunis
- Sensorimotor Performance Lab, Human Performance Research Centre, Department of Sport Science, University of Konstanz, Germany
| | - Markus Gruber
- Sensorimotor Performance Lab, Human Performance Research Centre, Department of Sport Science, University of Konstanz, Germany
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86
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Age-related GABAergic differences in the primary sensorimotor cortex: A multimodal approach combining PET, MRS and TMS. Neuroimage 2020; 226:117536. [PMID: 33186716 PMCID: PMC7894275 DOI: 10.1016/j.neuroimage.2020.117536] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 10/10/2020] [Accepted: 10/28/2020] [Indexed: 01/15/2023] Open
Abstract
Healthy aging is associated with mechanistic changes in gamma-aminobutyric acid (GABA), the most abundant inhibitory neurotransmitter in the human brain. While previous work mainly focused on magnetic resonance spectroscopy (MRS)-based GABA+ levels and transcranial magnetic stimulation (TMS)-based GABAA receptor (GABAAR) activity in the primary sensorimotor (SM1) cortex, the aim of the current study was to identify age-related differences in positron emission tomography (PET)-based GABAAR availability and its relationship with GABA+ levels (i.e. GABA with the contribution of macromolecules) and GABAAR activity. For this purpose, fifteen young (aged 20–28 years) and fifteen older (aged 65–80 years) participants were recruited. PET and MRS images were acquired using simultaneous time-of-flight PET/MR to evaluate age-related differences in GABAAR availability (distribution volume ratio with pons as reference region) and GABA+ levels. TMS was applied to identify age-related differences in GABAAR activity by measuring short-interval intracortical inhibition (SICI). Whereas GABAAR availability was significantly higher in the SM cortex of older as compared to young adults (18.5%), there were neither age-related differences in GABA+ levels nor SICI. A correlation analysis revealed no significant associations between GABAAR availability, GABAAR activity and GABA+ levels. Although the exact mechanisms need to be further elucidated, it is possible that a higher GABAAR availability in older adults is a compensatory mechanism to ensure optimal inhibitory functionality during the aging process.
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87
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Tankisi H, Cengiz B, Howells J, Samusyte G, Koltzenburg M, Bostock H. Short-interval intracortical inhibition as a function of inter-stimulus interval: Three methods compared. Brain Stimul 2020; 14:22-32. [PMID: 33166726 DOI: 10.1016/j.brs.2020.11.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 10/28/2020] [Accepted: 11/01/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Short-interval intracortical inhibition (SICI), as measured by threshold-tracking as a function of inter-stimulus interval (ISI), has been proposed as a useful biomarker for amyotrophic lateral sclerosis (ALS), but its relationship to conventional amplitude measurements has not been established. METHODS Serial tracking of SICI at increasing ISIs from 1 to 7 ms (T-SICIs) was compared in 50 healthy control subjects with the same ISIs tracked in parallel (T-SICIp), and with conventional amplitude measurements (A-SICI). For T-SICIp and A-SICI, pairs of conditioning and test stimuli with different ISIs were pseudo-randomised and interspersed with test-alone stimuli given at regular intervals. Thresholds were estimated by regression of log peak-to-peak amplitude on stimulus. RESULTS T-SICIp and A-SICI were closely related: a ten-fold reduction in amplitude corresponding to an approximately 18% increase in threshold. Threshold increases were greater for T-SICIs than for T-SICIp at 3.5-5 ms (P < 0.001). This divergence depended on the initial settings and whether ISIs were progressively increased or decreased, and was attributed to the limitations of the serial tracking protocol. SICI variability between subjects was greatest for T-SICIs estimates and least for A-SICI, and only A-SICI estimates revealed a significant decline in inhibition with age. CONCLUSIONS The serial tracking protocol did not accurately show the dependence of inhibition on ISI. Randomising ISIs gives corresponding SICI measures, whether tracking thresholds or measuring amplitude measurements. SICI variability suggested that A-SICI measurements may be the most sensitive to loss of inhibition.
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Affiliation(s)
- Hatice Tankisi
- Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark
| | - Bülent Cengiz
- Department of Neurology, Gazi University Faculty of Medicine, Beşevler, 06500, Ankara, Turkey
| | - James Howells
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Gintaute Samusyte
- Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Martin Koltzenburg
- Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, Queen Square, WC1N 3BG, London, United Kingdom; Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, Queen Square, WC1N 3BG, London, United Kingdom
| | - Hugh Bostock
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, Queen Square, WC1N 3BG, London, United Kingdom.
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88
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Steel A, Mikkelsen M, Edden RAE, Robertson CE. Regional balance between glutamate+glutamine and GABA+ in the resting human brain. Neuroimage 2020; 220:117112. [PMID: 32619710 PMCID: PMC9652611 DOI: 10.1016/j.neuroimage.2020.117112] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 06/17/2020] [Accepted: 06/27/2020] [Indexed: 12/04/2022] Open
Abstract
Models of healthy brain function and psychiatric conditions assume that excitatory and inhibitory activity are balanced in the human brain at multiple spatial and temporal scales. In human neuroimaging, concentrations of the major excitatory (glutamate) and inhibitory (γ-aminobutyric acid, GABA) neurotransmitters are measured in vivo using magnetic resonance spectroscopy (MRS). However, despite the central importance of E/I balance to theories of brain function, a relationship between regional glutamate and GABA levels in the human brain has not been shown. We addressed this question in a large corpus of edited MRS data collected at 19 different sites (n = 220). Consistent with the notion of E/I balance, we found that levels of glutamate+glutamine (Glx) and GABA+ were highly correlated (R = 0.52, p = 2.86 x 10−14). This relationship held when controlling for site, scanner vendor, and demographics. Controlling for neurochemicals associated with neuronal density and metabolism (i.e. N-acetylaspartate and creatine) significantly reduced the correlation between GABA+ and Glx, suggesting that the levels of GABA+ and Glx may be critically linked to regional metabolism. These results are consistent with the notion that excitation and inhibition are balanced in the human brain.
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Affiliation(s)
- Adam Steel
- Department of Psychology and Brain Sciences, Dartmouth College, Hanover, NH, USA.
| | - Mark Mikkelsen
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Richard A E Edden
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Caroline E Robertson
- Department of Psychology and Brain Sciences, Dartmouth College, Hanover, NH, USA
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89
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Hassanzahraee M, Nitsche MA, Zoghi M, Jaberzadeh S. Determination of anodal tDCS intensity threshold for reversal of corticospinal excitability: an investigation for induction of counter-regulatory mechanisms. Sci Rep 2020; 10:16108. [PMID: 32999375 PMCID: PMC7527486 DOI: 10.1038/s41598-020-72909-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/09/2020] [Indexed: 12/05/2022] Open
Abstract
Transcranial direct current stimulation is applied to modulate activity, and excitability of the brain. Basically, LTP-like plasticity is induced when anodal tDCS (a-tDCS) is applied over the primary motor cortex. However, it has been shown that specific parameters of a-tDCS can induce a plasticity reversal. We aimed to systematically assess the intensity threshold for reversal of the direction of plasticity induced by a-tDCS, monitored by corticospinal excitability (CSE), and explored mechanisms regulating this reversal. Fifteen healthy participants received a-tDCS in pseudo-random order for 26 min with four intensities of 0.3, 0.7, 1, and 1.5 mA. To measure CSE changes, single-pulse TMS was applied over the left M1, and motor evoked potentials of a contralateral hand muscle were recorded prior to a-tDCS, immediately and 30-min post-intervention. Paired-pulse TMS was used to evaluate intracortical excitation and inhibition. CSE increased significantly following a-tDCS with an intensity of 0.7 mA; however, the expected effect decreased and even reversed at intensities of 1 and 1.5 mA. ICF was significantly increased while SICI and LICI decreased at 0.7 mA. On the other hand, a significant decrease of ICF, but SICI and LICI enhancement was observed at intensities of 1, and 1.5 mA. The present findings show an intensity threshold of ≥ 1 mA for 26 min a-tDCS to reverse LTP- into LTD-like plasticity. It is suggested that increasing stimulation intensity, with constant stimulation duration, activates counter-regulatory mechanisms to prevent excessive brain excitation. Therefore, stimulation intensity and plasticity induced by a-tDCS might non-linearly correlate in scenarios with prolonged stimulation duration.
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Affiliation(s)
- Maryam Hassanzahraee
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia.
| | - Michael A Nitsche
- Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany.,Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, Discipline of Physiotherapy, La Trobe University, Melbourne, Australia
| | - Shapour Jaberzadeh
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
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90
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Cuypers K, Marsman A. Transcranial magnetic stimulation and magnetic resonance spectroscopy: Opportunities for a bimodal approach in human neuroscience. Neuroimage 2020; 224:117394. [PMID: 32987106 DOI: 10.1016/j.neuroimage.2020.117394] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 08/18/2020] [Accepted: 09/17/2020] [Indexed: 12/19/2022] Open
Abstract
Over the last decade, there has been an increasing number of studies combining transcranial magnetic stimulation (TMS) and magnetic resonance spectroscopy (MRS). MRS provides a manner to non-invasively investigate molecular concentrations in the living brain and thus identify metabolites involved in physiological and pathological processes. Particularly the MRS-detectable metabolites glutamate, the major excitatory neurotransmitter, and gamma-aminobutyric acid (GABA), the major inhibitory neurotransmitter, are of interest when combining TMS and MRS. TMS is a non-invasive brain stimulation technique that can be applied either as a neuromodulation or neurostimulation tool, specifically targeting glutamatergic and GABAergic mechanisms. The combination of TMS and MRS can be used to evaluate alterations in brain metabolite levels following an interventional TMS protocol such as repetitive TMS (rTMS) or paired associative stimulation (PAS). MRS can also be combined with a variety of non-interventional TMS protocols to identify the interplay between brain metabolite levels and measures of excitability or receptor-mediated inhibition and facilitation. In this review, we provide an overview of studies performed in healthy and patient populations combining MRS and TMS, both as a measurement tool and as an intervention. TMS and MRS may reveal complementary and comprehensive information on glutamatergic and GABAergic neurotransmission. Potentially, connectivity changes and dedicated network interactions can be probed using the combined TMS-MRS approach. Considering the ongoing technical developments in both fields, combined studies hold future promise for investigations of brain network interactions and neurotransmission.
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Affiliation(s)
- Koen Cuypers
- Department of Movement Sciences, Group Biomedical Sciences, Movement Control & Neuroplasticity Research Group, KU Leuven, 3001 Heverlee, Belgium; REVAL Research Institute, Hasselt University, Agoralaan, Building A, 3590 Diepenbeek, Belgium
| | - Anouk Marsman
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Section 714, Kettegård Allé 30, 26500 Hvidovre, Denmark.
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91
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Hoshino O, Kameno R, Kubo J, Watanabe K. Spatiotemporal regulation of GABA concentration in extracellular space by gliotransmission crucial for extrasynaptic receptor-mediated improvement of sensory tuning performance in schizophrenia. J Comput Neurosci 2020; 48:317-332. [PMID: 32761409 DOI: 10.1007/s10827-020-00755-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 06/14/2020] [Accepted: 07/07/2020] [Indexed: 10/23/2022]
Abstract
In schizophrenic patients, sensory tuning performance tends to be deteriorated (i.e., flattened sensory tuning), for which impaired intracortical tonic inhibition arising from a reduction in GABA concentration in extracellular space might be responsible. The δ subunit-containing GABAA receptor, located on extrasynaptic sites, is known to be involved in mediating tonic inhibitory currents in cortical pyramidal cells and is considered to be one of the beneficial therapeutic targets for the treatment of schizophrenia. The transporter GAT-1 in glial (astrocytic) membrane controls concentration of GABA molecules by removing them from extracellular space. We speculated that the upregulation of extrasynaptic receptors might compensate for the impaired tonic inhibition and thus improve their sensory tuning performance, in which the astrocytic GABA transporter might play an important role. To test our hypothesis, we simulated a schizophrenic neural network model with a GABAergic gliotransmission (i.e., GABA transport by transporters embedded in astrocytic membranes) mechanism that modulates local ambient (extracellular) GABA levels in a neuronal activity-dependent manner. Upregulating extrasynaptic GABA receptors compensated the impaired tonic inhibition and sharpened the sensory tuning, provided that ambient GABA molecules around stimulus-sensitive pyramidal cells were actively removed during sensory stimulation. We suggest that the upregulation of extrasynaptic GABA receptors can improve the performance of sensory tuning in schizophrenic patients, for which spatiotemporal regulation of ambient GABA concentration by gliotransmission may be crucial.
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Affiliation(s)
- Osamu Hoshino
- Department of Intelligent Systems Engineering, Ibaraki University, 4-12-1 Nakanarusawa, Hitachi, Ibaraki, 316-8511, Japan. .,Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital, 7-115 Yatsuyamada, Koriyama, Fukushima, 963-8563, Japan.
| | - Rikiya Kameno
- Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital, 7-115 Yatsuyamada, Koriyama, Fukushima, 963-8563, Japan
| | - Jin Kubo
- Department of Rehabilitation Medicine, International University of Health and Welfare, Ichikawa Hospital, 6-1-14 Konodai, Ichikawa, Chiba, 272-0827, Japan
| | - Kazuo Watanabe
- Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital, 7-115 Yatsuyamada, Koriyama, Fukushima, 963-8563, Japan
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92
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Droby A, Fleysher L, Petracca M, Podranski K, Xu J, Fabian M, Marjańska M, Inglese M. Lower cortical gamma-aminobutyric acid level contributes to increased connectivity in sensory-motor regions in progressive MS. Mult Scler Relat Disord 2020; 43:102183. [DOI: 10.1016/j.msard.2020.102183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 10/24/2022]
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93
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Puts NA, Ryan M, Oeltzschner G, Horska A, Edden RAE, Mahone EM. Reduced striatal GABA in unmedicated children with ADHD at 7T. Psychiatry Res Neuroimaging 2020; 301:111082. [PMID: 32438277 DOI: 10.1016/j.pscychresns.2020.111082] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 12/12/2022]
Abstract
Attention-deficit hyperactive disorder (ADHD) is characterized by inattention and increased impulsive and hypermotoric behaviors.Despite the high prevalence and impact of ADHD, little is known about the underlying neurophysiology of ADHD. The main inhibitory and excitatory neurotransmitters γ-aminobutyric acid (GABA) and glutamate are receiving increased attention in ADHD and can be measured using Magnetic Resonance Spectroscopy (MRS). However, MRS studies in ADHD are limited. We measured GABA and glutamate in young unmedicated participants, utilizing high magnetic field strength. Fifty unmedicated children (26 with ADHD, 24 controls) aged 5-9 years completed MRS at 7T and behavioral testing. GABA and glutamate were measured in dorsolateral prefrontal cortex (DLPFC), anterior cingulate cortex (ACC), premotor cortex (PMC), and striatum, and estimated using LCModel. Children with ADHD showed poorer inhibitory control and significantly reduced GABA/Cr in the striatum, but not in ACC, DLPFC, or PMC regions. There were no significant group differences for Glu/Cr levels, or correlations with behavioral manifestations of ADHD. The primary finding of this study is a reduction of striatal GABA levels in unmedicated children with ADHD at 7T. These findings provide guidance for future studies or interventions. Reduced striatal GABA may be a marker for specific GABA-related treatment for ADHD.
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Affiliation(s)
- Nicolaas A Puts
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, 600 N Wolfe St., Baltimore, MD 21287, United States; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, 707 N Broadway, Baltimore, MD 21205, United States; Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AB, United Kingdom.
| | - Matthew Ryan
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave., Baltimore, MD 21231 United States
| | - Georg Oeltzschner
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, 600 N Wolfe St., Baltimore, MD 21287, United States; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, 707 N Broadway, Baltimore, MD 21205, United States
| | - Alena Horska
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, 600 N Wolfe St., Baltimore, MD 21287, United States
| | - Richard A E Edden
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, 600 N Wolfe St., Baltimore, MD 21287, United States; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, 707 N Broadway, Baltimore, MD 21205, United States
| | - E Mark Mahone
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave., Baltimore, MD 21231 United States; Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, 600 N Wolfe St., Baltimore, MD 21287, United States
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94
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Dashtelei AA, Nitsche MA, Bakhtiari J, Habibi SA, Sepandi M, Khatoonabadi AR. The effects of spaced transcranial Direct Current Stimulation combined with conventional dysphagia therapy in Parkinson's disease: A case report. EXCLI JOURNAL 2020; 19:745-749. [PMID: 32636727 DOI: 10.17179/excli2020-1453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/29/2020] [Indexed: 11/10/2022]
Abstract
Parkinson's disease (PD) is a neurodegenerative disease of the central nervous system that is characterized by a set of motor and non-motor symptoms. Impaired swallowing or dysphagia is one relatively common motor symptom in patients with PD. We investigated whether neuroplasticity induction by spaced transcranial Direct Current Stimulation (tDCS) combined with conventional swallowing therapy leads to long-lasting effects on swallowing ability in patients with PD. We present a case of a 61-year-old male PD patient with dysphagia. Conventional Swallowing Therapy (CDT) combined with tDCS (bilateral anodal, 1 mA, 20 min, 10 online sessions, twice daily with a 20 min interval in between for five days over two weeks) was applied over the pharyngeal motor cortex. Our findings suggest that anodal tDCS combined with CDT is feasible, safe, and well-tolerated, and leads to a clinically relevant improvement of swallowing functions.
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Affiliation(s)
- Ali Akbar Dashtelei
- Speech Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Michael A Nitsche
- Department Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.,Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Jalal Bakhtiari
- Speech Therapy Department, Semnan University of Medical Sciences, Tehran, Iran
| | - Seyed Amirhassan Habibi
- Department of Neurology, Rasoul Akram Hospital, Iran University of Medical Science, Tehran, Iran
| | - Mojtaba Sepandi
- Department of Epidemiology and Biostatistics, Baqyiatallah University of Medical Science, Tehran, Iran.,Health Research Center, Life Style Institute, Baqyiatallah University of Medical Science, Tehran, Iran
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95
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Neige C, Grosprêtre S, Martin A, Lebon F. Influence of Voluntary Contraction Level, Test Stimulus Intensity and Normalization Procedures on the Evaluation of Short-Interval Intracortical Inhibition. Brain Sci 2020; 10:brainsci10070433. [PMID: 32650395 PMCID: PMC7407177 DOI: 10.3390/brainsci10070433] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/02/2020] [Accepted: 07/06/2020] [Indexed: 12/13/2022] Open
Abstract
Short-interval intracortical inhibition (SICI) represents an inhibitory phenomenon acting at the cortical level. However, SICI estimation is based on the amplitude of a motor-evoked potential (MEP), which depends on the discharge of spinal motoneurones and the generation of compound muscle action potential (M-wave). In this study, we underpin the importance of taking into account the proportion of spinal motoneurones that are activated or not when investigating the SICI of the right flexor carpi radialis (normalization with maximal M-wave (Mmax) and MEPtest, respectively), in 15 healthy subjects. We probed SICI changes according to various MEPtest amplitudes that were modulated actively (four levels of muscle contraction: rest, 10%, 20% and 30% of maximal voluntary contraction (MVC)) and passively (two intensities of test transcranial magnetic stimulation (TMS): 120 and 130% of motor thresholds). When normalized to MEPtest, SICI remained unchanged by stimulation intensity and only decreased at 30% of MVC when compared with rest. However, when normalized to Mmax, we provided the first evidence of a strong individual relationship between SICI and MEPtest, which was ultimately independent from experimental conditions (muscle states and TMS intensities). Under similar experimental conditions, it is thus possible to predict SICI individually from a specific level of corticospinal excitability in healthy subjects.
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Affiliation(s)
- Cécilia Neige
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, F-21078 Dijon, France; (A.M.); (F.L.)
- Correspondence: ; Tel.: +33-3-8039-6761
| | - Sidney Grosprêtre
- EA4660-C3S Laboratory—Culture, Sport, Health and Society, Université Bourgogne Franche-Comté, 25000 Besançon, France;
| | - Alain Martin
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, F-21078 Dijon, France; (A.M.); (F.L.)
| | - Florent Lebon
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, F-21078 Dijon, France; (A.M.); (F.L.)
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96
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King BR, Rumpf JJ, Verbaanderd E, Heise KF, Dolfen N, Sunaert S, Doyon J, Classen J, Mantini D, Puts NAJ, Edden RAE, Albouy G, Swinnen SP. Baseline sensorimotor GABA levels shape neuroplastic processes induced by motor learning in older adults. Hum Brain Mapp 2020; 41:3680-3695. [PMID: 32583940 PMCID: PMC7416055 DOI: 10.1002/hbm.25041] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 05/04/2020] [Accepted: 05/09/2020] [Indexed: 12/12/2022] Open
Abstract
Previous research in young adults has demonstrated that both motor learning and transcranial direct current stimulation (tDCS) trigger decreases in the levels of gamma-aminobutyric acid (GABA) in the sensorimotor cortex, and these decreases are linked to greater learning. Less is known about the role of GABA in motor learning in healthy older adults, a knowledge gap that is surprising given the established aging-related reductions in sensorimotor GABA. Here, we examined the effects of motor learning and subsequent tDCS on sensorimotor GABA levels and resting-state functional connectivity in the brains of healthy older participants. Thirty-six older men and women completed a motor sequence learning task before receiving anodal or sham tDCS to the sensorimotor cortex. GABA-edited magnetic resonance spectroscopy of the sensorimotor cortex and resting-state (RS) functional magnetic resonance imaging data were acquired before and after learning/stimulation. At the group level, neither learning nor anodal tDCS significantly modulated GABA levels or RS connectivity among task-relevant regions. However, changes in GABA levels from the baseline to post-learning session were significantly related to motor learning magnitude, age, and baseline GABA. Moreover, the change in functional connectivity between task-relevant regions, including bilateral motor cortices, was correlated with baseline GABA levels. These data collectively indicate that motor learning-related decreases in sensorimotor GABA levels and increases in functional connectivity are limited to those older adults with higher baseline GABA levels and who learn the most. Post-learning tDCS exerted no influence on GABA levels, functional connectivity or the relationships among these variables in older adults.
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Affiliation(s)
- Bradley R King
- Department of Movement Sciences, Movement Control and Neuroplasticity Research Group, KU Leuven, Leuven, Belgium.,LBI-KU Leuven Brain Institute, Leuven, Belgium
| | | | - Elvire Verbaanderd
- Department of Movement Sciences, Movement Control and Neuroplasticity Research Group, KU Leuven, Leuven, Belgium
| | - Kirstin F Heise
- Department of Movement Sciences, Movement Control and Neuroplasticity Research Group, KU Leuven, Leuven, Belgium.,LBI-KU Leuven Brain Institute, Leuven, Belgium
| | - Nina Dolfen
- Department of Movement Sciences, Movement Control and Neuroplasticity Research Group, KU Leuven, Leuven, Belgium.,LBI-KU Leuven Brain Institute, Leuven, Belgium
| | - Stefan Sunaert
- Department of Imaging and Pathology, KU Leuven and University Hospital Leuven (UZ Leuven), Leuven, Belgium
| | - Julien Doyon
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Joseph Classen
- Department of Neurology, University of Leipzig, Leipzig, Germany
| | - Dante Mantini
- Department of Movement Sciences, Movement Control and Neuroplasticity Research Group, KU Leuven, Leuven, Belgium.,LBI-KU Leuven Brain Institute, Leuven, Belgium.,Brain Imaging and Neural Dynamics Research Group, IRCCS San Camillo Hospital, Venice, Italy
| | - Nicolaas A J Puts
- 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.,Department of Forensic and Neurodevelopmental Sciences, The Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Richard A E Edden
- 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
| | - Geneviève Albouy
- Department of Movement Sciences, Movement Control and Neuroplasticity Research Group, KU Leuven, Leuven, Belgium.,LBI-KU Leuven Brain Institute, Leuven, Belgium
| | - Stephan P Swinnen
- Department of Movement Sciences, Movement Control and Neuroplasticity Research Group, KU Leuven, Leuven, Belgium.,LBI-KU Leuven Brain Institute, Leuven, Belgium
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97
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Neurotransmitter imbalance dysregulates brain dynamic fluidity in frontotemporal degeneration. Neurobiol Aging 2020; 94:176-184. [PMID: 32629312 DOI: 10.1016/j.neurobiolaging.2020.05.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 05/19/2020] [Accepted: 05/22/2020] [Indexed: 12/12/2022]
Abstract
Frontotemporal degeneration (FTD) is characterized by reduced global brain flexibility along with GABAergic/glutamatergic neurotransmitter deficits. We aimed to assess the relationship between dynamical properties of time-varying whole-brain network connectivity as well as static large-scale networks and neurotransmitter imbalance using resting-state functional MRI and transcranial magnetic stimulation (TMS) in sixty-six patients with FTD. We assessed GABAergic and glutamatergic neurotransmission by TMS, considering short- and long-interval intracortical inhibition and intracortical facilitation, and large-scale networks connectivity as well as four indexes of meta-state dynamic fluidity: (1) number of distinct meta-states, (2) number of switches from one meta-state to another, (3) span of the realized meta-states, and (4) total distance traveled in the state space. No significant correlations between TMS parameters and large-scale networks connectivity were observed. However, we observed a significant correlation between short-interval intracortical inhibition-intracortical facilitation and four meta-states (all indexes p < 0.02, false discovery rate-corrected). This study suggests that neurotransmitter imbalance dysregulates brain dynamic fluidity, linking microscopic and macroscopic changes in FTD.
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98
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Chaves AR, Devasahayam AJ, Riemenschneider M, Pretty RW, Ploughman M. Walking Training Enhances Corticospinal Excitability in Progressive Multiple Sclerosis-A Pilot Study. Front Neurol 2020; 11:422. [PMID: 32581998 PMCID: PMC7287174 DOI: 10.3389/fneur.2020.00422] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 04/22/2020] [Indexed: 12/16/2022] Open
Abstract
Background: Inflammatory lesions and neurodegeneration lead to motor, cognitive, and sensory impairments in people with multiple sclerosis (MS). Accumulation of disability is at least partially due to diminished capacity for neuroplasticity within the central nervous system. Aerobic exercise is a potentially important intervention to enhance neuroplasticity since it causes upregulation of neurotrophins and enhances corticospinal excitability, which can be probed using single-pulse transcranial magnetic stimulation (TMS). Whether people with progressive MS who have accumulated substantial disability could benefit from walking rehabilitative training to enhance neuroplasticity is not known. Objective: We aimed to determine whether 10 weeks of task-specific walking training would affect corticospinal excitability over time (pre, post, and 3-month follow-up) among people with progressive MS who required walking aids. Results: Eight people with progressive MS (seven female; 29–74 years old) with an Expanded Disability Status Scale of 6–6.5 underwent harness-supported treadmill walking training in a temperature controlled room at 16°C (10 weeks; three times/week; 40 min at 40–65% heart rate reserve). After training, there was significantly higher corticospinal excitability in both brain hemispheres, reductions in TMS active motor thresholds, and increases in motor-evoked potential amplitudes and slope of the recruitment curve (REC). Decreased intracortical inhibition (shorter cortical silent period) after training was noted in the hemisphere corresponding to the stronger hand only. These effects were not sustained at follow-up. There was a significant relationship between increases in corticospinal excitability (REC, area under the curve) in the hemisphere corresponding to the stronger hand and lessening of both intensity and impact of fatigue on activities of daily living (Fatigue Severity Scale and Modified Fatigue Impact Scale, respectively). Conclusion: Our pilot results support that vigorous treadmill training can potentially improve neuroplastic potential and mitigate symptoms of the disease even among people who have accumulated substantial disability due to MS.
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Affiliation(s)
- Arthur R Chaves
- Recovery and Performance Laboratory, Faculty of Medicine, L. A. Miller Centre, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Augustine J Devasahayam
- Recovery and Performance Laboratory, Faculty of Medicine, L. A. Miller Centre, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Morten Riemenschneider
- Section for Sports Science, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Ryan W Pretty
- Recovery and Performance Laboratory, Faculty of Medicine, L. A. Miller Centre, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Michelle Ploughman
- Recovery and Performance Laboratory, Faculty of Medicine, L. A. Miller Centre, Memorial University of Newfoundland, St. John's, NL, Canada
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99
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Dashtelei AA, Nitsche MA, Bakhtiari J, Habibi SA, Sepandi M, Khatoonabadi AR. The effects of spaced transcranial Direct Current Stimulation combined with conventional dysphagia therapy in Parkinson's disease: A case report. EXCLI JOURNAL 2020. [PMID: 32636727 PMCID: PMC7332806 DOI: 10.17179/excli2020-2434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Parkinson's disease (PD) is a neurodegenerative disease of the central nervous system that is characterized by a set of motor and non-motor symptoms. Impaired swallowing or dysphagia is one relatively common motor symptom in patients with PD. We investigated whether neuroplasticity induction by spaced transcranial Direct Current Stimulation (tDCS) combined with conventional swallowing therapy leads to long-lasting effects on swallowing ability in patients with PD. We present a case of a 61-year-old male PD patient with dysphagia. Conventional Swallowing Therapy (CDT) combined with tDCS (bilateral anodal, 1 mA, 20 min, 10 online sessions, twice daily with a 20 min interval in between for five days over two weeks) was applied over the pharyngeal motor cortex. Our findings suggest that anodal tDCS combined with CDT is feasible, safe, and well-tolerated, and leads to a clinically relevant improvement of swallowing functions.
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Affiliation(s)
- Ali Akbar Dashtelei
- Speech Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Michael A. Nitsche
- Department Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany,Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Jalal Bakhtiari
- Speech Therapy Department, Semnan University of Medical Sciences, Tehran, Iran
| | - Seyed Amirhassan Habibi
- Department of Neurology, Rasoul Akram Hospital, Iran University of Medical Science, Tehran, Iran
| | - Mojtaba Sepandi
- Department of Epidemiology and Biostatistics, Baqyiatallah University of Medical Science, Tehran, Iran,Health Research Center, Life Style Institute, Baqyiatallah University of Medical Science, Tehran, Iran
| | - Ahmad Reza Khatoonabadi
- Speech Therapy Department, Tehran University of Medical Sciences, Tehran, Iran,*To whom correspondence should be addressed: Ahmad Reza Khatoonabadi, Speech Therapy Department, Tehran University of Medical Sciences, Enghelab St., Piche-Shemiran, 11489-6514, Tehran, Iran, E-mail:
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100
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Kostova R, Cecere R, Thut G, Uhlhaas PJ. Targeting cognition in schizophrenia through transcranial direct current stimulation: A systematic review and perspective. Schizophr Res 2020; 220:300-310. [PMID: 32204971 DOI: 10.1016/j.schres.2020.03.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 02/28/2020] [Accepted: 03/02/2020] [Indexed: 01/03/2023]
Abstract
Cognitive deficits are a fundamental feature of schizophrenia for which currently no effective treatments exist. This paper examines the possibility to use transcranial direct current stimulation (tDCS) to target cognitive deficits in schizophrenia as evidence from studies in healthy participants suggests that tDCS may improve cognitive functions and associated neural processes. We carried out a systematic review with the following search terms: 'tDCS', 'electric brain stimulation', 'schizophrenia', 'cognitive', 'cognition' until March 2019. 659 records were identified initially, 612 of which were excluded after abstract screening. The remaining 47 articles were assessed for eligibility based on our criteria and 26 studies were excluded. In addition, we compared several variables, such as online vs. offline-stimulation protocols, stimulation type and intensity on mediating positive vs. negative study outcomes. The majority of studies (n = 21) identified significant behavioural and neural effects on a range of cognitive functions (versus n = 11 with null results), including working memory, attention and social cognition. However, we could not identify tDCS parameters (electrode montage, stimulation protocol, type and intensity) that clearly mediated effects on cognitive deficits. There is preliminary evidence for the possibility that tDCS may improve cognitive deficits in schizophrenia. We discuss the rationale and strength of evidence for using tDCS for targeting cognitive deficits in schizophrenia as well as methodological issues and potential mechanisms of action.
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Affiliation(s)
- R Kostova
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
| | - R Cecere
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
| | - G Thut
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
| | - Peter J Uhlhaas
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK; Department of Child and Adolescent Psychiatry, Charite Universitätsmedizin Berlin, Berlin, Germany.
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