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Harquel S, Cadic-Melchior A, Morishita T, Fleury L, Witon A, Ceroni M, Brügger J, Meyer NH, Evangelista GG, Egger P, Beanato E, Menoud P, Van de Ville D, Micera S, Blanke O, Léger B, Adolphsen J, Jagella C, Constantin C, Alvarez V, Vuadens P, Turlan JL, Mühl A, Bonvin C, Koch PJ, Wessel MJ, Hummel FC. Stroke Recovery-Related Changes in Cortical Reactivity Based on Modulation of Intracortical Inhibition. Stroke 2024; 55:1629-1640. [PMID: 38639087 DOI: 10.1161/strokeaha.123.045174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 02/29/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Cortical excitation/inhibition dynamics have been suggested as a key mechanism occurring after stroke. Their supportive or maladaptive role in the course of recovery is still not completely understood. Here, we used transcranial magnetic stimulation (TMS)-electroencephalography coupling to study cortical reactivity and intracortical GABAergic inhibition, as well as their relationship to residual motor function and recovery longitudinally in patients with stroke. METHODS Electroencephalography responses evoked by TMS applied to the ipsilesional motor cortex were acquired in patients with stroke with upper limb motor deficit in the acute (1 week), early (3 weeks), and late subacute (3 months) stages. Readouts of cortical reactivity, intracortical inhibition, and complexity of the evoked dynamics were drawn from TMS-evoked potentials induced by single-pulse and paired-pulse TMS (short-interval intracortical inhibition). Residual motor function was quantified through a detailed motor evaluation. RESULTS From 76 patients enrolled, 66 were included (68.2±13.2 years old, 18 females), with a Fugl-Meyer score of the upper extremity of 46.8±19. The comparison with TMS-evoked potentials of healthy older revealed that most affected patients exhibited larger and simpler brain reactivity patterns (Pcluster<0.05). Bayesian ANCOVA statistical evidence for a link between abnormally high motor cortical excitability and impairment level. A decrease in excitability in the following months was significantly correlated with better motor recovery in the whole cohort and the subgroup of recovering patients. Investigation of the intracortical GABAergic inhibitory system revealed the presence of beneficial disinhibition in the acute stage, followed by a normalization of inhibitory activity. This was supported by significant correlations between motor scores and the contrast of local mean field power and readouts of signal dynamics. CONCLUSIONS The present results revealed an abnormal motor cortical reactivity in patients with stroke, which was driven by perturbations and longitudinal changes within the intracortical inhibition system. They support the view that disinhibition in the ipsilesional motor cortex during the first-week poststroke is beneficial and promotes neuronal plasticity and recovery.
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Affiliation(s)
- Sylvain Harquel
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
- Defitech Chair of Clinical Neuroengineering, INX, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
| | - Andéol Cadic-Melchior
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
- Defitech Chair of Clinical Neuroengineering, INX, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
| | - Takuya Morishita
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
- Defitech Chair of Clinical Neuroengineering, INX, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
| | - Lisa Fleury
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
- Defitech Chair of Clinical Neuroengineering, INX, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
| | - Adrien Witon
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
- Defitech Chair of Clinical Neuroengineering, INX, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
- Health-IT, Centre de Service, Hôpital du Valais, Switzerland (A.W.)
| | - Martino Ceroni
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
- Defitech Chair of Clinical Neuroengineering, INX, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
| | - Julia Brügger
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
- Defitech Chair of Clinical Neuroengineering, INX, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
| | - Nathalie H Meyer
- Laboratory of Cognitive Neuroscience, INX and BMI, EPFL, Geneva, Switzerland (N.H.M., O.B.)
| | - Giorgia G Evangelista
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
- Defitech Chair of Clinical Neuroengineering, INX, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
| | - Philip Egger
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
- Defitech Chair of Clinical Neuroengineering, INX, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
| | - Elena Beanato
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
- Defitech Chair of Clinical Neuroengineering, INX, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
| | - Pauline Menoud
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
- Defitech Chair of Clinical Neuroengineering, INX, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
| | - Dimitri Van de Ville
- Medical Image Processing Laboratory, INX, EPFL, Geneva, Switzerland (D.V.V.)
- Department of Radiology and Medical Informatics, University of Geneva (UNIGE), Switzerland (D.V.d.V.)
| | - Silvestro Micera
- The Biorobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy (S.M.)
- Bertarelli Foundation Chair in Translational Neuroengineering, INX and Institute of Bioengineering, School of Engineering, Ecole Polytechnique Fédérale de Lausanne (S.M.)
| | - Olaf Blanke
- Laboratory of Cognitive Neuroscience, INX and BMI, EPFL, Geneva, Switzerland (N.H.M., O.B.)
- Department of Neurology, Geneva University Hospital (HUG), Switzerland (O.B.)
| | - Bertrand Léger
- Clinique Romande de Réadaptation, Sion, Switzerland (B.L., P.V., J.-L.T., A.M.)
| | | | | | | | - Vincent Alvarez
- Department of Neurology, Hôpital du Valais, Sion, Switzerland (C.C., V.A., C.B.)
| | - Philippes Vuadens
- Clinique Romande de Réadaptation, Sion, Switzerland (B.L., P.V., J.-L.T., A.M.)
| | - Jean-Luc Turlan
- Clinique Romande de Réadaptation, Sion, Switzerland (B.L., P.V., J.-L.T., A.M.)
| | - Andreas Mühl
- Clinique Romande de Réadaptation, Sion, Switzerland (B.L., P.V., J.-L.T., A.M.)
| | - Christophe Bonvin
- Department of Neurology, Hôpital du Valais, Sion, Switzerland (C.C., V.A., C.B.)
| | - Philipp J Koch
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
- Defitech Chair of Clinical Neuroengineering, INX, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
- Department of Neurology, University of Lübeck, Germany (P.J.K.)
| | - Maximilian J Wessel
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
- Defitech Chair of Clinical Neuroengineering, INX, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
- Department of Neurology, Julius-Maximilians-University Würzburg, Germany (M.J.W.)
| | - Friedhelm C Hummel
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
- Defitech Chair of Clinical Neuroengineering, INX, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland (S.H., A.C.-M., T.M., L.F., A.W., M.C., J.B., G.G.E., P.E., E.B., P.M., P.J.K., M.J.W., F.C.H.)
- Clinical Neuroscience, Geneva University Hospital, Switzerland (F.C.H.)
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Bigoni C, Pagnamenta S, Cadic-Melchior A, Bevilacqua M, Harquel S, Raffin E, Hummel FC. MEP and TEP features variability: is it just the brain-state? J Neural Eng 2024; 21:016011. [PMID: 38211341 DOI: 10.1088/1741-2552/ad1dc2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/11/2024] [Indexed: 01/13/2024]
Abstract
Objective.The literature investigating the effects of alpha oscillations on corticospinal excitability is divergent. We believe inconsistency in the findings may arise, among others, from the electroencephalography (EEG) processing for brain-state determination. Here, we provide further insights in the effects of the brain-state on cortical and corticospinal excitability and quantify the impact of different EEG processing.Approach.Corticospinal excitability was measured using motor evoked potential (MEP) peak-to-peak amplitudes elicited with transcranial magnetic stimulation (TMS); cortical responses were studied through TMS-evoked potentials' TEPs features. A TMS-EEG-electromyography (EMG) dataset of 18 young healthy subjects who received 180 single-pulse (SP) and 180 paired pulses (PP) to determine short-intracortical inhibition (SICI) was investigated. To study the effect of different EEG processing, we compared the brain-state estimation deriving from three published methods. The influence of presence of neural oscillations was also investigated. To evaluate the effect of the brain-state on MEP and TEP features variability, we defined the brain-state based on specific EEG phase and power combinations, only in trials where neural oscillations were present. The relationship between TEPs and MEPs was further evaluated.Main results.The presence of neural oscillations resulted in more consistent results regardless of the EEG processing approach. Nonetheless, the latter still critically affected the outcomes, making conclusive claims complex. With our approach, the MEP amplitude was positively modulated by the alpha power and phase, with stronger responses during the trough phase and high power. Power and phase also affected TEP features. Importantly, similar effects were observed in both TMS conditions.Significance.These findings support the view that the brain state of alpha oscillations is associated with the variability observed in cortical and corticospinal responses to TMS, with a tight correlation between the two. The results further highlight the importance of closed-loop stimulation approaches while underlining that care is needed in designing experiments and choosing the analytical approaches, which should be based on knowledge from offline studies to control for the heterogeneity originating from different EEG processing strategies.
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Affiliation(s)
- Claudia Bigoni
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva 1202, Switzerland
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL Valais), Sion 1951, Switzerland
| | - Sara Pagnamenta
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva 1202, Switzerland
| | - Andéol Cadic-Melchior
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva 1202, Switzerland
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL Valais), Sion 1951, Switzerland
| | - Michele Bevilacqua
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva 1202, Switzerland
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL Valais), Sion 1951, Switzerland
| | - Sylvain Harquel
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva 1202, Switzerland
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL Valais), Sion 1951, Switzerland
| | - Estelle Raffin
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva 1202, Switzerland
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL Valais), Sion 1951, Switzerland
| | - Friedhelm C Hummel
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva 1202, Switzerland
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL Valais), Sion 1951, Switzerland
- Clinical Neuroscience, University of Geneva Medical School, 1202 Geneva, Switzerland
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Song Y, Gordon PC, Metsomaa J, Rostami M, Belardinelli P, Ziemann U. Evoked EEG Responses to TMS Targeting Regions Outside the Primary Motor Cortex and Their Test-Retest Reliability. Brain Topogr 2024; 37:19-36. [PMID: 37996562 PMCID: PMC10771591 DOI: 10.1007/s10548-023-01018-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/25/2023] [Indexed: 11/25/2023]
Abstract
Transcranial magnetic stimulation (TMS)-evoked electroencephalography (EEG) potentials (TEPs) provide unique insights into cortical excitability and connectivity. However, confounding EEG signals from auditory and somatosensory co-stimulation complicate TEP interpretation. Our optimized sham procedure established with TMS of primary motor cortex (Gordon in JAMA 245:118708, 2021) differentiates direct cortical EEG responses to TMS from those caused by peripheral sensory inputs. Using this approach, this study aimed to investigate TEPs and their test-retest reliability when targeting regions outside the primary motor cortex, specifically the left angular gyrus, supplementary motor area, and medial prefrontal cortex. We conducted three identical TMS-EEG sessions one week apart involving 24 healthy participants. In each session, we targeted the three areas separately using a figure-of-eight TMS coil for active TMS, while a second coil away from the head produced auditory input for sham TMS. Masking noise and electric scalp stimulation were applied in both conditions to achieve matched EEG responses to peripheral sensory inputs. High test-retest reliability was observed in both conditions. However, reliability declined for the 'cleaned' TEPs, resulting from the subtraction of evoked EEG response to the sham TMS from those to the active, particularly for latencies > 100 ms following the TMS pulse. Significant EEG differences were found between active and sham TMS at latencies < 90 ms for all targeted areas, exhibiting distinct spatiotemporal characteristics specific to each target. In conclusion, our optimized sham procedure effectively reveals EEG responses to direct cortical activation by TMS in brain areas outside primary motor cortex. Moreover, we demonstrate the impact of peripheral sensory inputs on test-retest reliability of TMS-EEG responses.
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Affiliation(s)
- Yufei Song
- Department of Neurology and Stroke, University of Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Pedro C Gordon
- Department of Neurology and Stroke, University of Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Johanna Metsomaa
- Department of Neurology and Stroke, University of Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
| | - Maryam Rostami
- Faculty of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
| | - Paolo Belardinelli
- Department of Neurology and Stroke, University of Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Center for Mind/Brain Sciences, CIMeC, University of Trento, Trento, Italy
| | - Ulf Ziemann
- Department of Neurology and Stroke, University of Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany.
- Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
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Tik M, Vasileiadi M, Woletz M, Linhardt D, Schuler AL, Williams N, Windischberger C. Concurrent TMS/fMRI reveals individual DLPFC dose-response pattern. Neuroimage 2023; 282:120394. [PMID: 37805020 DOI: 10.1016/j.neuroimage.2023.120394] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 09/04/2023] [Accepted: 09/25/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND TMS is a valuable tool in both research and clinical settings, playing a crucial role in understanding brain-behavior relationships and providing treatment for various neurological and psychiatric conditions. Importantly, TMS over left DLPFC is an FDA approved treatment for MDD. Despite its potential, response variability to TMS remains a challenge, with stimulation parameters, particularly the stimulation intensity, being a primary contributor to these differences. OBJECTIVE The objective of this study was to establish dose-response relationships of TMS stimulation in DLPFC by means of concurrent TMS/fMRI. METHODS Here, we stimulated 15 subjects at different stimulation intensities of 80, 90, 100 and 110 % relative to the motor threshold during concurrent TMS/fMRI. The experiment comprised two sessions: one session to collect anatomical data in order to perform neuronavigation and one session dedicated to dose-response mapping. We calculated GLMs for each intensity level and each subject, as well as at a group-level per intensity. RESULTS On a group level, we show that the strongest BOLD-response was at 100 % stimulation. However, investigating individual dose response-relationships showed differences in response patterns across the group: subjects that responded to subthreshold stimulation, subjects that required above threshold stimulation in order to show a significant BOLD-response and atypical responders. CONCLUSIONS We observed qualitative inter-subject variability in terms of dose-response relationship to TMS over left DLPFC, which hints towards the motor threshold not being directly transferable to the excitability of the DLPFC. Concurrent TMS/fMRI might have the potential to improve response rates to rTMS applications. As such, it may be valuable in the future to consider implementing this approach prior to clinical TMS or validating more cost-effective methods to determine dose and target with respect to changes in clinical symptoms.
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Affiliation(s)
- Martin Tik
- MR Center of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Lazarettgasse 14, Vienna 1090, Austria; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Maria Vasileiadi
- MR Center of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Lazarettgasse 14, Vienna 1090, Austria
| | - Michael Woletz
- MR Center of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Lazarettgasse 14, Vienna 1090, Austria
| | - David Linhardt
- MR Center of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Lazarettgasse 14, Vienna 1090, Austria
| | - Anna-Lisa Schuler
- MR Center of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Lazarettgasse 14, Vienna 1090, Austria
| | - Nolan Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Christian Windischberger
- MR Center of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Lazarettgasse 14, Vienna 1090, Austria.
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Krile L, Ensafi E, Cole J, Noor M, Protzner AB, McGirr A. A dose-response characterization of transcranial magnetic stimulation intensity and evoked potential amplitude in the dorsolateral prefrontal cortex. Sci Rep 2023; 13:18650. [PMID: 37903906 PMCID: PMC10616119 DOI: 10.1038/s41598-023-45730-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 10/23/2023] [Indexed: 11/01/2023] Open
Abstract
By combining transcranial magnetic stimulation (TMS) with electroencephalography, human cortical circuits can be directly interrogated. The resulting electrical trace contains TMS-evoked potential (TEP) components, and it is not known whether the amplitudes of these components are stimulus intensity dependent. We examined this in the left dorsolateral prefrontal cortex in nineteen healthy adult participants and extracted TEP amplitudes for the N40, P60, N120, and P200 components at 110%, 120%, and 130% of resting motor threshold (RMT). To probe plasticity of putative stimulus intensity dose-response relationships, this was repeated after participants received intermittent theta burst stimulation (iTBS; 600 pulses, 80% RMT). The amplitude of the N120 and P200 components exhibited a stimulus intensity dose-response relationship, however the N40 and P60 components did not. After iTBS, the N40 and P60 components continued to exhibit a lack of stimulus intensity dose-dependency, and the P200 dose-response was unchanged. In the N120 component, however, we saw evidence of change within the stimulus intensity dose-dependent relationship characterized by a decrease in absolute peak amplitudes at lower stimulus intensities. These data suggest that TEP components have heterogeneous dose-response relationships, with implications for standardizing and harmonizing methods across experiments. Moreover, the selective modification of the N120 dose-response relationship may provide a novel marker for iTBS plasticity in health and disease.
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Affiliation(s)
- Louisa Krile
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Elnaz Ensafi
- Department of Psychiatry, University of Calgary, 3280 Hospital Drive NW, TRW-4D68, Calgary, AB, T2N 4Z6, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada
| | - Jaeden Cole
- Department of Psychiatry, University of Calgary, 3280 Hospital Drive NW, TRW-4D68, Calgary, AB, T2N 4Z6, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada
| | - Mah Noor
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Andrea B Protzner
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada
| | - Alexander McGirr
- Department of Psychiatry, University of Calgary, 3280 Hospital Drive NW, TRW-4D68, Calgary, AB, T2N 4Z6, Canada.
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
- Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada.
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6
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Schmidgen J, Konrad K, Roessner V, Bender S. The external evocation and movement-related modulation of motor cortex inhibition in children and adolescents with Tourette syndrome - a TMS/EEG study. Front Neurosci 2023; 17:1209801. [PMID: 37928740 PMCID: PMC10620315 DOI: 10.3389/fnins.2023.1209801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 09/26/2023] [Indexed: 11/07/2023] Open
Abstract
Objective This study tested the reactivity of motor cortex inhibition to different intensities of external stimulation by transcranial magnetic stimulation (TMS) and its internal modulation during different motor states in children and adolescents with Tourette syndrome. Methods TMS-evoked N100 served as an indirect measure of GABAB receptor function which is related to cortical inhibition. Combined TMS/EEG was used to analyze the TMS-evoked N100 component evoked by different stimulation intensities as well as during resting condition, movement preparation (contingent negative variation task) and movement execution. The study included 18 early adolescents with Tourette syndrome and 15 typically developing control subjects. Results TMS-evoked N100 showed a less steep increase with increasing TMS intensity in Tourette syndrome together with less modulation (disinhibition) over the primary motor cortex during the motor states movement preparation and movement execution. Children with Tourette syndrome showed equally high N100 amplitudes at 110% resting motor threshold (RMT) intensity during resting condition and a parallel decline of RMT and N100 amplitude with increasing age as control subjects. Conclusion Our study yields preliminary evidence that modulation of motor cortical inhibitory circuits, during external direct stimulation by different TMS intensities and during volitional movement preparation and execution is different in children and adolescents with Tourette syndrome compared to controls. These results suggest that a reduced resting motor cortical inhibitory "reserve" could contribute to the production of unwanted movements. Our findings are compatible with increased regulation of motor cortex excitability by perception-action binding in Tourette syndrome instead of top-down / motor regulation and need to be replicated in further studies.
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Affiliation(s)
- Julia Schmidgen
- Department of Child and Adolescent Psychiatry, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany
| | - Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, RWTH Aachen, Aachen, Germany
- JARA-BRAIN Institute II, Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Jülich, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Custav Carus, TU, Dresden, Germany
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany
- Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Custav Carus, TU, Dresden, Germany
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7
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Bigoni C, Beanato E, Harquel S, Hervé J, Oflar M, Crema A, Espinosa A, Evangelista GG, Koch P, Bonvin C, Turlan JL, Guggisberg A, Morishita T, Wessel MJ, Zandvliet SB, Hummel FC. Novel personalized treatment strategy for patients with chronic stroke with severe upper-extremity impairment: The first patient of the AVANCER trial. MED 2023; 4:591-599.e3. [PMID: 37437575 DOI: 10.1016/j.medj.2023.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/12/2023] [Accepted: 06/15/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Around 25% of patients who have had a stroke suffer from severe upper-limb impairment and lack effective rehabilitation strategies. The AVANCER proof-of-concept clinical trial (NCT04448483) tackles this issue through an intensive and personalized-dosage cumulative intervention that combines multiple non-invasive neurotechnologies. METHODS The therapy consists of two sequential interventions, lasting until the patient shows no further motor improvement, for a minimum of 11 sessions each. The first phase involves a brain-computer interface governing an exoskeleton and multi-channel functional electrical stimulation enabling full upper-limb movements. The second phase adds anodal transcranial direct current stimulation of the motor cortex of the lesioned hemisphere. Clinical, electrophysiological, and neuroimaging examinations are performed before, between, and after the two interventions (T0, T1, and T2). This case report presents the results from the first patient of the study. FINDINGS The primary outcome (i.e., 4-point improvement in the Fugl-Meyer assessment of the upper extremity) was met in the first patient, with an increase from 6 to 11 points between T0 and T2. This improvement was paralleled by changes in motor-network structure and function. Resting-state and transcranial magnetic stimulation-evoked electroencephalography revealed brain functional changes, and magnetic resonance imaging (MRI) measures detected structural and task-related functional changes. CONCLUSIONS These first results are promising, pointing to feasibility, safety, and potential efficacy of this personalized approach acting synergistically on the nervous and musculoskeletal systems. Integrating multi-modal data may provide valuable insights into underlying mechanisms driving the improvements and providing predictive information regarding treatment response and outcomes. FUNDING This work was funded by the Wyss-Center for Bio and Neuro Engineering (WCP-030), the Defitech Foundation, PHRT-#2017-205, ERA-NET-NEURON (Discover), and SNSF (320030L_197899, NiBS-iCog).
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Affiliation(s)
- Claudia Bigoni
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland; Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne Valais (EPFL Valais), Clinique Romande de Réadaptation, 1951 Sion, Switzerland
| | - Elena Beanato
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland; Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne Valais (EPFL Valais), Clinique Romande de Réadaptation, 1951 Sion, Switzerland
| | - Sylvain Harquel
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland; Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne Valais (EPFL Valais), Clinique Romande de Réadaptation, 1951 Sion, Switzerland
| | - Julie Hervé
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland; Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne Valais (EPFL Valais), Clinique Romande de Réadaptation, 1951 Sion, Switzerland
| | - Meltem Oflar
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland; Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne Valais (EPFL Valais), Clinique Romande de Réadaptation, 1951 Sion, Switzerland
| | - Andrea Crema
- Clinical Neuroscience, University of Geneva Medical School, 1202 Geneva, Switzerland; Bertarelli Foundation Chair in Translational Neuroengineering, Neuro-X Institute (INX) and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Arnau Espinosa
- Wyss Center for Bio and Neuroengineering, Chemin des Mines 9, 1202 Geneva, Switzerland
| | - Giorgia G Evangelista
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland; Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne Valais (EPFL Valais), Clinique Romande de Réadaptation, 1951 Sion, Switzerland
| | - Philipp Koch
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany; Center of Brain, Behavior and Metabolism (CBBM), University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | | | - Jean-Luc Turlan
- Department of Neurological Rehabilitation, Clinique Romande de Réadaptation SUVA, 1951 Sion, Switzerland
| | - Adrian Guggisberg
- Universitäre Neurorehabilitation, Universitätsklinik für Neurologie, Inselspital, University Hospital Berne, Bern, Switzerland
| | - Takuya Morishita
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland; Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne Valais (EPFL Valais), Clinique Romande de Réadaptation, 1951 Sion, Switzerland
| | - Maximilian J Wessel
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland; Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne Valais (EPFL Valais), Clinique Romande de Réadaptation, 1951 Sion, Switzerland
| | - Sarah B Zandvliet
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland; Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne Valais (EPFL Valais), Clinique Romande de Réadaptation, 1951 Sion, Switzerland; Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Friedhelm C Hummel
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland; Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne Valais (EPFL Valais), Clinique Romande de Réadaptation, 1951 Sion, Switzerland; Clinical Neuroscience, University of Geneva Medical School, 1202 Geneva, Switzerland.
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8
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Schuler AL, Brkić D, Ferrazzi G, Arcara G, Marinazzo D, Pellegrino G. Auditory white noise exposure results in intrinsic cortical excitability changes. iScience 2023; 26:107387. [PMID: 37575186 PMCID: PMC10415920 DOI: 10.1016/j.isci.2023.107387] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/23/2023] [Accepted: 07/11/2023] [Indexed: 08/15/2023] Open
Abstract
Cortical excitability is commonly measured by applying magnetic stimulation in combination with measuring behavioral response. This measure has, however, some shortcomings including spatial limitation to the primary motor cortex and not accounting for intrinsic excitability fluctuations. Here, we use a measure for intrinsic excitability based on phase synchronization previously validated for epilepsy. We apply this measure in 30 healthy participants' magnetoencephalography (MEG) recordings during the exposure of auditory white noise, a stimulus that has been suggested to modify cortical excitability. Using cortical parcellation of the MEG source data, we could find a specific pattern of increased and decreased excitability while participants are exposed to white noise vs. silence. Specifically, excitability during white noise exposure decreases in the frontal lobe and increases in the temporal lobe. This study thus adds to the understanding of cortical excitability changes due to specific environmental stimuli as well as the spatial extent of these effects.
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Affiliation(s)
- Anna-Lisa Schuler
- IRCCS San Camillo Hospital, Venice, Italy
- Lise Meitner Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | | | | | | | - Daniele Marinazzo
- Department of Data Analysis, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Giovanni Pellegrino
- Epilepsy Program, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
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9
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Cruciani A, Mancuso M, Sveva V, Maccarrone D, Todisco A, Motolese F, Santoro F, Pilato F, Spampinato DA, Rocchi L, Di Lazzaro V, Capone F. Using TMS-EEG to assess the effects of neuromodulation techniques: a narrative review. Front Hum Neurosci 2023; 17:1247104. [PMID: 37645690 PMCID: PMC10461063 DOI: 10.3389/fnhum.2023.1247104] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 08/01/2023] [Indexed: 08/31/2023] Open
Abstract
Over the past decades, among all the non-invasive brain stimulation (NIBS) techniques, those aiming for neuromodulatory protocols have gained special attention. The traditional neurophysiological outcome to estimate the neuromodulatory effect is the motor evoked potential (MEP), the impact of NIBS techniques is commonly estimated as the change in MEP amplitude. This approach has several limitations: first, the use of MEP limits the evaluation of stimulation to the motor cortex excluding all the other brain areas. Second, MEP is an indirect measure of brain activity and is influenced by several factors. To overcome these limitations several studies have used new outcomes to measure brain changes after neuromodulation techniques with the concurrent use of transcranial magnetic stimulation (TMS) and electroencephalogram (EEG). In the present review, we examine studies that use TMS-EEG before and after a single session of neuromodulatory TMS. Then, we focused our literature research on the description of the different metrics derived from TMS-EEG to measure the effect of neuromodulation.
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Affiliation(s)
- Alessandro Cruciani
- Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Università Campus Bio-Medico di Roma, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Marco Mancuso
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Valerio Sveva
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, Rome, Italy
| | - Davide Maccarrone
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Antonio Todisco
- Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Università Campus Bio-Medico di Roma, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Francesco Motolese
- Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Università Campus Bio-Medico di Roma, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Francesca Santoro
- Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Università Campus Bio-Medico di Roma, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Fabio Pilato
- Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Università Campus Bio-Medico di Roma, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | | | - Lorenzo Rocchi
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Vincenzo Di Lazzaro
- Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Università Campus Bio-Medico di Roma, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Fioravante Capone
- Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Università Campus Bio-Medico di Roma, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
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10
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Parmigiani S, Ross JM, Cline CC, Minasi CB, Gogulski J, Keller CJ. Reliability and Validity of Transcranial Magnetic Stimulation-Electroencephalography Biomarkers. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:805-814. [PMID: 36894435 PMCID: PMC10276171 DOI: 10.1016/j.bpsc.2022.12.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/15/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022]
Abstract
Noninvasive brain stimulation and neuroimaging have revolutionized human neuroscience with a multitude of applications, including diagnostic subtyping, treatment optimization, and relapse prediction. It is therefore particularly relevant to identify robust and clinically valuable brain biomarkers linking symptoms to their underlying neural mechanisms. Brain biomarkers must be reproducible (i.e., have internal reliability) across similar experiments within a laboratory and be generalizable (i.e., have external reliability) across experimental setups, laboratories, brain regions, and disease states. However, reliability (internal and external) is not alone sufficient; biomarkers also must have validity. Validity describes closeness to a true measure of the underlying neural signal or disease state. We propose that these metrics, reliability and validity, should be evaluated and optimized before any biomarker is used to inform treatment decisions. Here, we discuss these metrics with respect to causal brain connectivity biomarkers from coupling transcranial magnetic stimulation (TMS) with electroencephalography (EEG). We discuss controversies around TMS-EEG stemming from the multiple large off-target components (noise) and relatively weak genuine brain responses (signal), as is unfortunately often the case in noninvasive human neuroscience. We review the current state of TMS-EEG recordings, which consist of a mix of reliable noise and unreliable signal. We describe methods for evaluating TMS-EEG biomarkers, including how to assess internal and external reliability across facilities, cognitive states, brain networks, and disorders and how to validate these biomarkers using invasive neural recordings or treatment response. We provide recommendations to increase reliability and validity, discuss lessons learned, and suggest future directions for the field.
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Affiliation(s)
- Sara Parmigiani
- Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Stanford, California; Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center, Palo Alto, California; Wu Tsai Neuroscience Institute, Stanford, California
| | - Jessica M Ross
- Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Stanford, California; Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center, Palo Alto, California; Wu Tsai Neuroscience Institute, Stanford, California
| | - Christopher C Cline
- Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Stanford, California; Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center, Palo Alto, California; Wu Tsai Neuroscience Institute, Stanford, California
| | - Christopher B Minasi
- Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Stanford, California; Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center, Palo Alto, California; Wu Tsai Neuroscience Institute, Stanford, California
| | - Juha Gogulski
- Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Stanford, California; Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center, Palo Alto, California; Wu Tsai Neuroscience Institute, Stanford, California; Department of Clinical Neurophysiology, HUS Diagnostic Center, Clinical Neurosciences, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Corey J Keller
- Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Stanford, California; Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center, Palo Alto, California; Wu Tsai Neuroscience Institute, Stanford, California.
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11
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Passera B, Harquel S, Chauvin A, Gérard P, Lai L, Moro E, Meoni S, Fraix V, David O, Raffin E. Multi-scale and cross-dimensional TMS mapping: A proof of principle in patients with Parkinson's disease and deep brain stimulation. Front Neurosci 2023; 17:1004763. [PMID: 37214390 PMCID: PMC10192635 DOI: 10.3389/fnins.2023.1004763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 03/29/2023] [Indexed: 05/24/2023] Open
Abstract
Introduction Transcranial magnetic stimulation (TMS) mapping has become a critical tool for exploratory studies of the human corticomotor (M1) organization. Here, we propose to gather existing cutting-edge TMS-EMG and TMS-EEG approaches into a combined multi-dimensional TMS mapping that considers local and whole-brain excitability changes as well as state and time-specific changes in cortical activity. We applied this multi-dimensional TMS mapping approach to patients with Parkinson's disease (PD) with Deep brain stimulation (DBS) of the sub-thalamic nucleus (STN) ON and OFF. Our goal was to identifying one or several TMS mapping-derived markers that could provide unprecedent new insights onto the mechanisms of DBS in movement disorders. Methods Six PD patients (1 female, mean age: 62.5 yo [59-65]) implanted with DBS-STN for 1 year, underwent a robotized sulcus-shaped TMS motor mapping to measure changes in muscle-specific corticomotor representations and a movement initiation task to probe state-dependent modulations of corticospinal excitability in the ON (using clinically relevant DBS parameters) and OFF DBS states. Cortical excitability and evoked dynamics of three cortical areas involved in the neural control of voluntary movements (M1, pre-supplementary motor area - preSMA and inferior frontal gyrus - IFG) were then mapped using TMS-EEG coupling in the ON and OFF state. Lastly, we investigated the timing and nature of the STN-to-M1 inputs using a paired pulse DBS-TMS-EEG protocol. Results In our sample of patients, DBS appeared to induce fast within-area somatotopic re-arrangements of motor finger representations in M1, as revealed by mediolateral shifts of corticomuscle representations. STN-DBS improved reaction times while up-regulating corticospinal excitability, especially during endogenous motor preparation. Evoked dynamics revealed marked increases in inhibitory circuits in the IFG and M1 with DBS ON. Finally, inhibitory conditioning effects of STN single pulses on corticomotor activity were found at timings relevant for the activation of inhibitory GABAergic receptors (4 and 20 ms). Conclusion Taken together, these results suggest a predominant role of some markers in explaining beneficial DBS effects, such as a context-dependent modulation of corticospinal excitability and the recruitment of distinct inhibitory circuits, involving long-range projections from higher level motor centers and local GABAergic neuronal populations. These combined measures might help to identify discriminative features of DBS mechanisms towards deep clinical phenotyping of DBS effects in Parkinson's Disease and in other pathological conditions.
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Affiliation(s)
- Brice Passera
- CNRS UMR 5105, Laboratoire Psychologie et Neurocognition, LPNC, Grenoble, France
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
| | - Sylvain Harquel
- CNRS UMR 5105, Laboratoire Psychologie et Neurocognition, LPNC, Grenoble, France
- CNRS, INSERM, IRMaGe, Grenoble, France
- Defitech Chair in Clinical Neuroengineering, Neuro-X Institute and Brain Mind Institute, EPFL, Geneva, Switzerland
| | - Alan Chauvin
- CNRS UMR 5105, Laboratoire Psychologie et Neurocognition, LPNC, Grenoble, France
| | - Pauline Gérard
- CNRS UMR 5105, Laboratoire Psychologie et Neurocognition, LPNC, Grenoble, France
| | - Lisa Lai
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
| | - Elena Moro
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
| | - Sara Meoni
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
| | - Valerie Fraix
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
| | - Olivier David
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
- Aix Marseille Univ, Inserm, U1106, INS, Institut de Neurosciences des Systèmes, Marseille, France
| | - Estelle Raffin
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
- Defitech Chair in Clinical Neuroengineering, Neuro-X Institute and Brain Mind Institute, EPFL, Geneva, Switzerland
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12
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Helling RM, Perenboom MJL, Bauer PR, Carpay JA, Sander JW, Ferrari MD, Visser GH, Tolner EA. TMS-evoked EEG potentials demonstrate altered cortical excitability in migraine with aura. Brain Topogr 2023; 36:269-281. [PMID: 36781512 PMCID: PMC10014725 DOI: 10.1007/s10548-023-00943-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 01/25/2023] [Indexed: 02/15/2023]
Abstract
Migraine is associated with altered sensory processing, that may be evident as changes in cortical responsivity due to altered excitability, especially in migraine with aura. Cortical excitability can be directly assessed by combining transcranial magnetic stimulation with electroencephalography (TMS-EEG). We measured TMS evoked potential (TEP) amplitude and response consistency as these measures have been linked to cortical excitability but were not yet reported in migraine.We recorded 64-channel EEG during single-pulse TMS on the vertex interictally in 10 people with migraine with aura and 10 healthy controls matched for age, sex and resting motor threshold. On average 160 pulses around resting motor threshold were delivered through a circular coil in clockwise and counterclockwise direction. Trial-averaged TEP responses, frequency spectra and phase clustering (over the entire scalp as well as in frontal, central and occipital midline electrode clusters) were compared between groups, including comparison to sham-stimulation evoked responses.Migraine and control groups had a similar distribution of TEP waveforms over the scalp. In migraine with aura, TEP responses showed reduced amplitude around the frontal and occipital N100 peaks. For the migraine and control groups, responses over the scalp were affected by current direction for the primary motor cortex, somatosensory cortex and sensory association areas, but not for frontal, central or occipital midline clusters.This study provides evidence of altered TEP responses in-between attacks in migraine with aura. Decreased TEP responses around the N100 peak may be indicative of reduced cortical GABA-mediated inhibition and expand observations on enhanced cortical excitability from earlier migraine studies using more indirect measurements.
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Affiliation(s)
- Robert M Helling
- Stichting Epilepsie Instellingen Nederland (SEIN), Achterweg 5, 2103 SW, Heemstede, The Netherlands
| | - Matthijs J L Perenboom
- Department of Neurology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Prisca R Bauer
- Department of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, University of Freiburg, Hauptstraße 8, 79104, Freiburg, Germany
| | - Johannes A Carpay
- Department of Neurology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.,Department of Neurology, Tergooi Hospitals, Van Riebeeckweg 212, 1213 XZ, Hilversum, The Netherlands
| | - Josemir W Sander
- Stichting Epilepsie Instellingen Nederland (SEIN), Achterweg 5, 2103 SW, Heemstede, The Netherlands.,Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, Queen Square, WC1N 3BG, London, UK
| | - Michel D Ferrari
- Department of Neurology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Gerhard H Visser
- Stichting Epilepsie Instellingen Nederland (SEIN), Achterweg 5, 2103 SW, Heemstede, The Netherlands
| | - Else A Tolner
- Department of Neurology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. .,Department of Human Genetics, Leiden University Medical Centre, Postal Zone S4-P, PO Box 9600, Leiden, The Netherlands.
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13
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Hernandez-Pavon JC, Veniero D, Bergmann TO, Belardinelli P, Bortoletto M, Casarotto S, Casula EP, Farzan F, Fecchio M, Julkunen P, Kallioniemi E, Lioumis P, Metsomaa J, Miniussi C, Mutanen TP, Rocchi L, Rogasch NC, Shafi MM, Siebner HR, Thut G, Zrenner C, Ziemann U, Ilmoniemi RJ. TMS combined with EEG: Recommendations and open issues for data collection and analysis. Brain Stimul 2023; 16:567-593. [PMID: 36828303 DOI: 10.1016/j.brs.2023.02.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 02/10/2023] [Accepted: 02/19/2023] [Indexed: 02/25/2023] Open
Abstract
Transcranial magnetic stimulation (TMS) evokes neuronal activity in the targeted cortex and connected brain regions. The evoked brain response can be measured with electroencephalography (EEG). TMS combined with simultaneous EEG (TMS-EEG) is widely used for studying cortical reactivity and connectivity at high spatiotemporal resolution. Methodologically, the combination of TMS with EEG is challenging, and there are many open questions in the field. Different TMS-EEG equipment and approaches for data collection and analysis are used. The lack of standardization may affect reproducibility and limit the comparability of results produced in different research laboratories. In addition, there is controversy about the extent to which auditory and somatosensory inputs contribute to transcranially evoked EEG. This review provides a guide for researchers who wish to use TMS-EEG to study the reactivity of the human cortex. A worldwide panel of experts working on TMS-EEG covered all aspects that should be considered in TMS-EEG experiments, providing methodological recommendations (when possible) for effective TMS-EEG recordings and analysis. The panel identified and discussed the challenges of the technique, particularly regarding recording procedures, artifact correction, analysis, and interpretation of the transcranial evoked potentials (TEPs). Therefore, this work offers an extensive overview of TMS-EEG methodology and thus may promote standardization of experimental and computational procedures across groups.
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Affiliation(s)
- Julio C Hernandez-Pavon
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Legs + Walking Lab, Shirley Ryan AbilityLab, Chicago, IL, USA; Center for Brain Stimulation, Shirley Ryan AbilityLab, Chicago, IL, USA.
| | | | - Til Ole Bergmann
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Germany; Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Paolo Belardinelli
- Center for Mind/Brain Sciences - CIMeC, University of Trento, Rovereto, TN, Italy; Department of Neurology & Stroke, University of Tübingen, Tübingen, Germany
| | - Marta Bortoletto
- Neurophysiology Lab, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Silvia Casarotto
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy; IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Elias P Casula
- Department of Systems Medicine, University of Tor Vergata, Rome, Italy
| | - Faranak Farzan
- Simon Fraser University, School of Mechatronic Systems Engineering, Surrey, British Columbia, Canada
| | - Matteo Fecchio
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Petro Julkunen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland; Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland
| | - Elisa Kallioniemi
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA
| | - Pantelis Lioumis
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, Helsinki University Hospital, Helsinki University and Aalto University School of Science, Helsinki, Finland
| | - Johanna Metsomaa
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, Helsinki University Hospital, Helsinki University and Aalto University School of Science, Helsinki, Finland
| | - Carlo Miniussi
- Center for Mind/Brain Sciences - CIMeC, University of Trento, Rovereto, TN, Italy
| | - Tuomas P Mutanen
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, Helsinki University Hospital, Helsinki University and Aalto University School of Science, Helsinki, Finland
| | - Lorenzo Rocchi
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Nigel C Rogasch
- University of Adelaide, Adelaide, Australia; South Australian Health and Medical Research Institute, Adelaide, Australia; Monash University, Melbourne, Australia
| | - Mouhsin M Shafi
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Hartwig R Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark; Department of Neurology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gregor Thut
- School of Psychology and Neuroscience, University of Glasgow, United Kingdom
| | - Christoph Zrenner
- Department of Neurology & Stroke, University of Tübingen, Tübingen, Germany; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Canada; Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Ulf Ziemann
- Department of Neurology & Stroke, University of Tübingen, Tübingen, Germany; Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Risto J Ilmoniemi
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, Helsinki University Hospital, Helsinki University and Aalto University School of Science, Helsinki, Finland
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14
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Fleury L, Koch PJ, Wessel MJ, Bonvin C, San Millan D, Constantin C, Vuadens P, Adolphsen J, Cadic Melchior A, Brügger J, Beanato E, Ceroni M, Menoud P, De Leon Rodriguez D, Zufferey V, Meyer NH, Egger P, Harquel S, Popa T, Raffin E, Girard G, Thiran JP, Vaney C, Alvarez V, Turlan JL, Mühl A, Léger B, Morishita T, Micera S, Blanke O, Van De Ville D, Hummel FC. Toward individualized medicine in stroke—The TiMeS project: Protocol of longitudinal, multi-modal, multi-domain study in stroke. Front Neurol 2022; 13:939640. [PMID: 36226086 PMCID: PMC9549862 DOI: 10.3389/fneur.2022.939640] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022] Open
Abstract
Despite recent improvements, complete motor recovery occurs in <15% of stroke patients. To improve the therapeutic outcomes, there is a strong need to tailor treatments to each individual patient. However, there is a lack of knowledge concerning the precise neuronal mechanisms underlying the degree and course of motor recovery and its individual differences, especially in the view of brain network properties despite the fact that it became more and more clear that stroke is a network disorder. The TiMeS project is a longitudinal exploratory study aiming at characterizing stroke phenotypes of a large, representative stroke cohort through an extensive, multi-modal and multi-domain evaluation. The ultimate goal of the study is to identify prognostic biomarkers allowing to predict the individual degree and course of motor recovery and its underlying neuronal mechanisms paving the way for novel interventions and treatment stratification for the individual patients. A total of up to 100 patients will be assessed at 4 timepoints over the first year after the stroke: during the first (T1) and third (T2) week, then three (T3) and twelve (T4) months after stroke onset. To assess underlying mechanisms of recovery with a focus on network analyses and brain connectivity, we will apply synergistic state-of-the-art systems neuroscience methods including functional, diffusion, and structural magnetic resonance imaging (MRI), and electrophysiological evaluation based on transcranial magnetic stimulation (TMS) coupled with electroencephalography (EEG) and electromyography (EMG). In addition, an extensive, multi-domain neuropsychological evaluation will be performed at each timepoint, covering all sensorimotor and cognitive domains. This project will significantly add to the understanding of underlying mechanisms of motor recovery with a strong focus on the interactions between the motor and other cognitive domains and multimodal network analyses. The population-based, multi-dimensional dataset will serve as a basis to develop biomarkers to predict outcome and promote personalized stratification toward individually tailored treatment concepts using neuro-technologies, thus paving the way toward personalized precision medicine approaches in stroke rehabilitation.
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Affiliation(s)
- Lisa Fleury
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), EPFL, Campus Biotech, Geneva, Switzerland
- Defitech Chair of Clinical Neuroengineering, INX and BMI, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland
| | - Philipp J. Koch
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), EPFL, Campus Biotech, Geneva, Switzerland
- Defitech Chair of Clinical Neuroengineering, INX and BMI, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Maximilian J. Wessel
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), EPFL, Campus Biotech, Geneva, Switzerland
- Defitech Chair of Clinical Neuroengineering, INX and BMI, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland
- Department of Neurology, University Hospital and Julius-Maximilians-University, Wuerzburg, Germany
| | | | | | | | | | | | - Andéol Cadic Melchior
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), EPFL, Campus Biotech, Geneva, Switzerland
- Defitech Chair of Clinical Neuroengineering, INX and BMI, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland
| | - Julia Brügger
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), EPFL, Campus Biotech, Geneva, Switzerland
- Defitech Chair of Clinical Neuroengineering, INX and BMI, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland
| | - Elena Beanato
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), EPFL, Campus Biotech, Geneva, Switzerland
- Defitech Chair of Clinical Neuroengineering, INX and BMI, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland
| | - Martino Ceroni
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), EPFL, Campus Biotech, Geneva, Switzerland
- Defitech Chair of Clinical Neuroengineering, INX and BMI, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland
| | - Pauline Menoud
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), EPFL, Campus Biotech, Geneva, Switzerland
- Defitech Chair of Clinical Neuroengineering, INX and BMI, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland
| | - Diego De Leon Rodriguez
- Defitech Chair of Clinical Neuroengineering, INX and BMI, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland
| | - Valérie Zufferey
- Defitech Chair of Clinical Neuroengineering, INX and BMI, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland
| | - Nathalie H. Meyer
- Laboratory of Cognitive Neuroscience, INX and BMI, EPFL, Campus Biotech, Geneva, Switzerland
| | - Philip Egger
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), EPFL, Campus Biotech, Geneva, Switzerland
- Defitech Chair of Clinical Neuroengineering, INX and BMI, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland
| | - Sylvain Harquel
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), EPFL, Campus Biotech, Geneva, Switzerland
- Defitech Chair of Clinical Neuroengineering, INX and BMI, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland
| | - Traian Popa
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), EPFL, Campus Biotech, Geneva, Switzerland
- Defitech Chair of Clinical Neuroengineering, INX and BMI, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland
| | - Estelle Raffin
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), EPFL, Campus Biotech, Geneva, Switzerland
- Defitech Chair of Clinical Neuroengineering, INX and BMI, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland
| | - Gabriel Girard
- CIBM Center for Biomedical Imaging, Lausanne, Switzerland
- Department of Radiology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
- Signal Processing Laboratory (LTS5), EPFL, Lausanne, Switzerland
| | - Jean-Philippe Thiran
- CIBM Center for Biomedical Imaging, Lausanne, Switzerland
- Department of Radiology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
- Signal Processing Laboratory (LTS5), EPFL, Lausanne, Switzerland
| | | | | | | | - Andreas Mühl
- Clinique Romande de Réadaptation, Sion, Switzerland
| | | | - Takuya Morishita
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), EPFL, Campus Biotech, Geneva, Switzerland
- Defitech Chair of Clinical Neuroengineering, INX and BMI, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland
| | - Silvestro Micera
- The Biorobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
- Bertarelli Foundation Chair in Translational Neuroengineering, Centre for Neuroprosthetics and Institute of Bioengineering, School of Engineering, EPFL, Lausanne, Switzerland
| | - Olaf Blanke
- Laboratory of Cognitive Neuroscience, INX and BMI, EPFL, Campus Biotech, Geneva, Switzerland
- Department of Clinical Neurosciences, University of Geneva (UNIGE), Geneva, Switzerland
| | - Dimitri Van De Ville
- CIBM Center for Biomedical Imaging, Lausanne, Switzerland
- Medical Image Processing Lab, Center for Neuroprosthetics, Institute of Bioengineering, EPFL, Lausanne, Switzerland
- Department of Radiology and Medical Informatics, University of Geneva (UNIGE), Geneva, Switzerland
| | - Friedhelm C. Hummel
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), EPFL, Campus Biotech, Geneva, Switzerland
- Defitech Chair of Clinical Neuroengineering, INX and BMI, EPFL Valais, Clinique Romande de Réadaptation, Sion, Switzerland
- Clinical Neuroscience, Geneva University Hospital, Geneva, Switzerland
- *Correspondence: Friedhelm C. Hummel
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15
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Wu Y, Yang Z, Cui S. Update Research Advances in the Application of Transcranial Magnetic Stimulation in the Treatment of Schizophrenia. SCANNING 2022; 2022:5415775. [PMID: 36160325 PMCID: PMC9484979 DOI: 10.1155/2022/5415775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/01/2022] [Indexed: 06/16/2023]
Abstract
Schizophrenia presents a chronic progressive course and requires long-term treatment. The current treatment of schizophrenia is mainly based on antipsychotic drugs, but drugs are ineffective for the negative symptoms and cognitive dysfunction of schizophrenia, and long-term medication may increase the burden on the endocrine and circulatory systems of patients. Repetitive transcranial magnetic stimulation is a noninvasive, painless, safe, efficacious, and economical physical therapy measure that has achieved good results in the treatment of schizophrenia. This paper reviews the progress of research on the clinical application of transcranial magnetic stimulation in the treatment of schizophrenia.
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Affiliation(s)
- Yanhai Wu
- The Third People's Hospital of Fuyang, Fuyang 236000, China
| | - Zucheng Yang
- Anhui Province Veterans Hospital, Bengbu 233000, China
| | - Shu Cui
- The Third People's Hospital of Fuyang, Fuyang 236000, China
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16
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Lioumis P, Rosanova M. The role of neuronavigation in TMS-EEG studies: current applications and future perspectives. J Neurosci Methods 2022; 380:109677. [PMID: 35872153 DOI: 10.1016/j.jneumeth.2022.109677] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 07/12/2022] [Accepted: 07/19/2022] [Indexed: 11/28/2022]
Abstract
Transcranial magnetic stimulation combined with electroencephalography (TMS-EEG) allows measuring non-invasively the electrical response of the human cerebral cortex to a direct perturbation. Complementing TMS-EEG with a structural neuronavigation tool (nTMS-EEG) is key for accurately selecting cortical areas, targeting them, and adjusting the stimulation parameters based on some relevant anatomical priors. This step, together with the employment of visualization tools designed to perform a quality check of TMS-evoked potentials (TEPs) in real-time during acquisition, is key for maximizing the impact of the TMS pulse on the cortex and in ensuring highly reproducible measurements within sessions and across subjects. Moreover, storing stimulation parameters in the neuronavigation system can help in reproducing the stimulation parameters within and across experimental sessions and sharing them across research centers. Finally, the systematic employment of neuronavigation in TMS-EEG studies is also key to standardize measurements in clinical populations in search for reliable diagnostic and prognostic TMS-EEG-based biomarkers for neurological and psychiatric disorders.
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Affiliation(s)
- Pantelis Lioumis
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; BioMag Laboratory, HUS Diagnostic Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Mario Rosanova
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
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17
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Rostami M, Zomorrodi R, Rostami R, Hosseinzadeh GA. Impact of methodological variability on EEG responses evoked by transcranial magnetic stimulation: a meta-analysis. Clin Neurophysiol 2022; 142:154-180. [DOI: 10.1016/j.clinph.2022.07.495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 07/12/2022] [Accepted: 07/15/2022] [Indexed: 12/01/2022]
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18
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Passera B, Chauvin A, Raffin E, Bougerol T, David O, Harquel S. Exploring the spatial resolution of TMS-EEG coupling on the sensorimotor region. Neuroimage 2022; 259:119419. [PMID: 35777633 DOI: 10.1016/j.neuroimage.2022.119419] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 04/12/2022] [Accepted: 06/27/2022] [Indexed: 02/06/2023] Open
Abstract
The use of TMS-EEG coupling as a neuroimaging tool for the functional exploration of the human brain recently gained strong interest. If this tool directly inherits the fine temporal resolution from EEG, its spatial counterpart remains unknown. In this study, we explored the spatial resolution of TMS-EEG coupling by evaluating the minimal distance between two stimulated cortical sites that would significantly evoke different response dynamics. TMS evoked responses were mapped on the sensorimotor region in twenty participants. The stimulation grid was composed of nine targets separated between 10 and 15 mm on average. The dynamical signatures of TMS evoked activity were extracted and compared between sites using both local and remote linear regression scores and spatial generalized mixed models. We found a significant effect of the distance between stimulated sites on their dynamical signatures, neighboring sites showing differentiable response dynamics. Besides, common dynamical signatures were also found between sites up to 25-30 mm from each other. This overlap in dynamical properties decreased with distance and was stronger between sites within the same Brodmann area. Our results suggest that the spatial resolution of TMS-EEG coupling might be at least as high as 10 mm. Furthermore, our results reveal an anisotropic spatial resolution that was higher across than within the same Brodmann areas, in accordance with the TMS induced E-field modeling. Common cytoarchitectonic leading to shared dynamical properties within the same Brodmann area could also explain this anisotropy. Overall, these findings suggest that TMS-EEG benefits from the spatial resolution of TMS, which makes it an accurate technique for meso-scale brain mapping.
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Affiliation(s)
- Brice Passera
- Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France; Univ. Grenoble Alpes, CNRS, UMR5105, Laboratoire Psychologie et NeuroCognition, LPNC, F-38000 Grenoble, France; Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Alan Chauvin
- Univ. Grenoble Alpes, CNRS, UMR5105, Laboratoire Psychologie et NeuroCognition, LPNC, F-38000 Grenoble, France
| | - Estelle Raffin
- Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France; Defitech Chair of Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland; Defitech Chair of Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL Valais), Clinique Romande de Réadaptation, Sion, Switzerland
| | - Thierry Bougerol
- Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France; Centre Hospitalier Univ. Grenoble Alpes, Service de Psychiatrie, F-38000 Grenoble, France
| | - Olivier David
- Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France; Aix Marseille Univ, Inserm, U1106, INS, Institut de Neurosciences des Systèmes, Marseille, France
| | - Sylvain Harquel
- Univ. Grenoble Alpes, CNRS, UMR5105, Laboratoire Psychologie et NeuroCognition, LPNC, F-38000 Grenoble, France; Defitech Chair of Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland; Defitech Chair of Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL Valais), Clinique Romande de Réadaptation, Sion, Switzerland.
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19
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Wang C, Chen S, Huang L, Yu L. Prediction and control of focal seizure spread: Random walk with restart on heterogeneous brain networks. Phys Rev E 2022; 105:064412. [PMID: 35854502 DOI: 10.1103/physreve.105.064412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 05/25/2022] [Indexed: 06/15/2023]
Abstract
Whole-brain models offer a promising method of predicting seizure spread, which is critical for successful surgical treatment of focal epilepsy. Existing methods are largely based on structural connectome, which ignores the effects of heterogeneity within the regional excitability of brains. In this study we used a whole-brain model to show that heterogeneity in nodal excitability had a significant impact on seizure propagation in the networks and compromised the prediction accuracy with structural connections. We then addressed this problem with an algorithm based on random walk with restart on graphs. We demonstrated that by establishing a relationship between the restarting probability and the excitability for each node, this algorithm could significantly improve the seizure spread prediction accuracy in heterogeneous networks and was more robust against the extent of heterogeneity. We also strategized surgical seizure control as a process to identify and remove the key nodes (connections) responsible for the early spread of seizures from the focal region. Compared to strategies based on structural connections, virtual surgery with a strategy based on a modified random walk with extended restart generated outcomes with a high success rate while maintaining low damage to the brain by removing fewer anatomical connections. These findings may have potential applications in developing personalized surgery strategies for epilepsy.
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Affiliation(s)
- Chen Wang
- School of Physical Science and Technology, Lanzhou University, Lanzhou 730000, China
| | - Sida Chen
- School of Physical Science and Technology, Lanzhou University, Lanzhou 730000, China
| | - Liang Huang
- School of Physical Science and Technology, Lanzhou University, Lanzhou 730000, China
- Lanzhou Center for Theoretical Physics, Key Laboratory of Theoretical Physics of Gansu Province, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Lianchun Yu
- School of Physical Science and Technology, Lanzhou University, Lanzhou 730000, China
- Lanzhou Center for Theoretical Physics, Key Laboratory of Theoretical Physics of Gansu Province, Lanzhou University, Lanzhou, Gansu 730000, China
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20
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Sasaki R, Semmler JG, Opie GM. Threshold Tracked Short-Interval Intracortical Inhibition More Closely Predicts the Cortical Response to Transcranial Magnetic Stimulation. Neuromodulation 2022; 25:614-623. [DOI: 10.1016/j.neurom.2021.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/19/2021] [Accepted: 10/26/2021] [Indexed: 01/14/2023]
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21
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Identifying novel biomarkers with TMS-EEG - Methodological possibilities and challenges. J Neurosci Methods 2022; 377:109631. [PMID: 35623474 DOI: 10.1016/j.jneumeth.2022.109631] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 05/09/2022] [Accepted: 05/21/2022] [Indexed: 12/17/2022]
Abstract
Biomarkers are essential for understanding the underlying pathologies in brain disorders and for developing effective treatments. Combined transcranial magnetic stimulation and electroencephalography (TMS-EEG) is an emerging neurophysiological tool that can be used for biomarker development. This method can identify biomarkers associated with the function and dynamics of the inhibitory and excitatory neurotransmitter systems and effective connectivity between brain areas. In this review, we outline the current state of the TMS-EEG biomarker field by summarizing the existing protocols and the possibilities and challenges associated with this methodology.
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22
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Nazarova M, Asmolova A. Towards more reliable TMS studies - How fast can we probe cortical excitability? Clin Neurophysiol Pract 2021; 7:21-22. [PMID: 35036660 PMCID: PMC8752992 DOI: 10.1016/j.cnp.2021.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 11/23/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Maria Nazarova
- Center for Cognition and Decision Making, Institute for Cognitive Neuroscience, National Research University Higher School of Economics, 101000, Krivokolenny per. 3 Entrance 2, Moscow, Russian Federation
- Federal State Budgetary Institution Federal Center for Brain Research and Neurotechnologies of the Federal Medical Biological Agency, 117513 Ostrovityanova Street 1/10, Russian Federation
| | - Anastasia Asmolova
- Center for Cognition and Decision Making, Institute for Cognitive Neuroscience, National Research University Higher School of Economics, 101000, Krivokolenny per. 3 Entrance 2, Moscow, Russian Federation
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Gordon PC, Jovellar DB, Song Y, Zrenner C, Belardinelli P, Siebner HR, Ziemann U. Recording brain responses to TMS of primary motor cortex by EEG - utility of an optimized sham procedure. Neuroimage 2021; 245:118708. [PMID: 34743050 PMCID: PMC8752966 DOI: 10.1016/j.neuroimage.2021.118708] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 10/31/2021] [Accepted: 11/02/2021] [Indexed: 11/30/2022] Open
Abstract
Optimized sham TMS-EEG is introduced and tested. Sham combined auditory and supramaximal electrical somatosensory stimulation. Subjects reported equal sensory perception during sham and real TMS. Subtraction revealed evoked EEG potentials and beta-band power specific to real TMS. The optimized sham procedure is relevant in research and therapeutic settings.
Introduction Electroencephalography (EEG) is increasingly used to investigate brain responses to transcranial magnetic stimulation (TMS). A relevant issue is that TMS is associated with considerable auditory and somatosensory stimulation, causing peripherally evoked potentials (PEPs) in the EEG, which contaminate the direct cortical responses to TMS (TEPs). All previous attempts to control for PEPs suffer from significant limitations. Objective/Hypothesis To design an optimized sham procedure to control all sensory input generated by subthreshold real TMS targeting the hand area of the primary motor cortex (M1), enabling reliable separation of TEPs from PEPs. Methods In 23 healthy (16 female) subjects, we recorded EEG activity evoked by an optimized sham TMS condition which masks and matches auditory and somatosensory co-stimulation during the real TMS condition: auditory control was achieved by noise masking and by using a second TMS coil that was placed on top of the real TMS coil and produced a calibrated sound pressure level. Somatosensory control was obtained by electric stimulation (ES) of the scalp with intensities sufficient to saturate somatosensory input. ES was applied in both the sham and real TMS conditions. Perception of auditory and somatosensory inputs in the sham and real TMS conditions were compared by psychophysical testing. Transcranially evoked EEG signal changes were identified by subtraction of EEG activity in the sham condition from EEG activity in the real TMS condition. Results Perception of auditory and somatosensory inputs in the sham vs. real TMS conditions was comparable. Both sham and real TMS evoked a series of similar EEG signal deflections and induced broadband power increase in oscillatory activity. Notably, the present procedure revealed EEG potentials and a transient increase in beta band power at the site of stimulation that were only present in the real TMS condition. Discussion The results validate the effectiveness of our optimized sham approach. Despite the presence of typical responses attributable to sensory input, the procedure provided evidence for direct cortical activation by subthreshold TMS of M1. The findings are relevant for future TMS-EEG experiments that aim at measuring regional brain target engagement controlled by an optimized sham procedure.
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Affiliation(s)
- Pedro C Gordon
- Department of Neurology & Stroke, University of Tübingen, Hoppe-Seyler-Straße 3, Tübingen 72076, Germany; Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
| | - D Blair Jovellar
- Department of Neurology & Stroke, University of Tübingen, Hoppe-Seyler-Straße 3, Tübingen 72076, Germany; Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
| | - YuFei Song
- Department of Neurology & Stroke, University of Tübingen, Hoppe-Seyler-Straße 3, Tübingen 72076, Germany; Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
| | - Christoph Zrenner
- Department of Neurology & Stroke, University of Tübingen, Hoppe-Seyler-Straße 3, Tübingen 72076, Germany; Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
| | - Paolo Belardinelli
- Department of Neurology & Stroke, University of Tübingen, Hoppe-Seyler-Straße 3, Tübingen 72076, Germany; Hertie Institute for Clinical Brain Research, University of Tübingen, Germany; CIMeC, Center for Mind/Brain Sciences, University of Trento, Italy
| | - Hartwig Roman Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Department of Neurology, Copenhagen University Hospital - Bispebjerg and Fredriksberg, Copenhagen, Denmark
| | - Ulf Ziemann
- Department of Neurology & Stroke, University of Tübingen, Hoppe-Seyler-Straße 3, Tübingen 72076, Germany; Hertie Institute for Clinical Brain Research, University of Tübingen, Germany.
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Hortobágyi T, Granacher U, Fernandez-Del-Olmo M, Howatson G, Manca A, Deriu F, Taube W, Gruber M, Márquez G, Lundbye-Jensen J, Colomer-Poveda D. Functional relevance of resistance training-induced neuroplasticity in health and disease. Neurosci Biobehav Rev 2020; 122:79-91. [PMID: 33383071 DOI: 10.1016/j.neubiorev.2020.12.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 12/18/2020] [Accepted: 12/19/2020] [Indexed: 01/13/2023]
Abstract
Repetitive, monotonic, and effortful voluntary muscle contractions performed for just a few weeks, i.e., resistance training, can substantially increase maximal voluntary force in the practiced task and can also increase gross motor performance. The increase in motor performance is often accompanied by neuroplastic adaptations in the central nervous system. While historical data assigned functional relevance to such adaptations induced by resistance training, this claim has not yet been systematically and critically examined in the context of motor performance across the lifespan in health and disease. A review of muscle activation, brain and peripheral nerve stimulation, and imaging data revealed that increases in motor performance and neuroplasticity tend to be uncoupled, making a mechanistic link between neuroplasticity and motor performance inconclusive. We recommend new approaches, including causal mediation analytical and hypothesis-driven models to substantiate the functional relevance of resistance training-induced neuroplasticity in the improvements of gross motor function across the lifespan in health and disease.
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Affiliation(s)
- Tibor Hortobágyi
- Center for Human Movement Sciences, University of Groningen, University Medical CenterGroningen, Groningen, Netherlands.
| | - Urs Granacher
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
| | - Miguel Fernandez-Del-Olmo
- Area of Sport Sciences, Faculty of Sports Sciences and Physical Education, Center for Sport Studies, King Juan Carlos University, Madrid, Spain
| | - Glyn Howatson
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, UK; Water Research Group, North West University, Potchefstroom, South Africa
| | - Andrea Manca
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Wolfgang Taube
- Department of Neurosciences and Movement Sciences, University of Fribourg, Fribourg, Switzerland
| | - Markus Gruber
- Human Performance Research Centre, Department of Sport Science, University of Konstanz, Konstanz, Germany
| | - Gonzalo Márquez
- Department of Physical Education and Sport, Faculty of Sports Sciences and Physical Education, University of A Coruña, A Coruña, Spain
| | - Jesper Lundbye-Jensen
- Movement & Neuroscience, Department of Nutrition, Exercise & Sports Department of Neuroscience, University of Copenhagenk, Faculty of Health Science, Universidad Isabel I, Burgos, Spain
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25
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Hannah R, Muralidharan V, Sundby KK, Aron AR. Temporally-precise disruption of prefrontal cortex informed by the timing of beta bursts impairs human action-stopping. Neuroimage 2020; 222:117222. [PMID: 32768628 PMCID: PMC7736218 DOI: 10.1016/j.neuroimage.2020.117222] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 06/18/2020] [Accepted: 07/30/2020] [Indexed: 01/29/2023] Open
Abstract
Human action-stopping is thought to rely on a prefronto-basal ganglia-thalamocortical network, with right inferior frontal cortex (rIFC) posited to play a critical role in the early stage of implementation. Here we sought causal evidence for this idea in experiments involving healthy human participants. We first show that action-stopping is preceded by bursts of electroencephalographic activity in the beta band over prefrontal electrodes, putatively rIFC, and that the timing of these bursts correlates with the latency of stopping at a single-trial level: earlier bursts are associated with faster stopping. From this we reasoned that the integrity of rIFC at the time of beta bursts might be critical to successful stopping. We then used fMRI-guided transcranial magnetic stimulation (TMS) to disrupt rIFC at the approximate time of beta bursting. Stimulation prolonged stopping latencies and, moreover, the prolongation was most pronounced in individuals for whom the pulse appeared closer to the presumed time of beta bursting. These results help validate a model of the neural architecture and temporal dynamics of action-stopping. They also highlight the usefulness of prefrontal beta bursts to index an apparently important sub-process of stopping, the timing of which might help explain within- and between-individual variation in impulse control.
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Affiliation(s)
- Ricci Hannah
- Department of Psychology, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Vignesh Muralidharan
- Department of Psychology, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Kelsey K Sundby
- Department of Psychology, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Adam R Aron
- Department of Psychology, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
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26
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Raffin E, Harquel S, Passera B, Chauvin A, Bougerol T, David O. Probing regional cortical excitability via input-output properties using transcranial magnetic stimulation and electroencephalography coupling. Hum Brain Mapp 2020; 41:2741-2761. [PMID: 32379389 PMCID: PMC7294059 DOI: 10.1002/hbm.24975] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 02/04/2020] [Accepted: 02/23/2020] [Indexed: 01/28/2023] Open
Abstract
The modular organization of the cortex refers to subsets of highly interconnected nodes, sharing specific cytoarchitectural and dynamical properties. These properties condition the level of excitability of local pools of neurons. In this study, we described TMS evoked potentials (TEP) input-output properties to provide new insights into regional cortical excitability. We combined robotized TMS with EEG to disentangle region-specific TEP from threshold to saturation and describe their oscillatory contents. Twenty-two young healthy participants received robotized TMS pulses over the right primary motor cortex (M1), the right dorsolateral prefrontal cortex (DLPFC) and the right superior occipital lobe (SOL) at five stimulation intensities (40, 60, 80, 100, and 120% resting motor threshold) and one short-interval intracortical inhibition condition during EEG recordings. Ten additional subjects underwent the same experiment with a realistic sham TMS procedure. The results revealed interregional differences in the TEPs input-output functions as well as in the responses to paired-pulse conditioning protocols, when considering early local components (<80 ms). Each intensity in the three regions was associated with complex patterns of oscillatory activities. The quality of the regression of TEPs over stimulation intensity was used to derive a new readout for cortical excitability and dynamical properties, revealing lower excitability in the DLPFC, followed by SOL and M1. The realistic sham experiment confirmed that these early local components were not contaminated by multisensory stimulations. This study provides an entirely new analytic framework to characterize input-output relations throughout the cortex, paving the way to a more accurate definition of local cortical excitability.
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Affiliation(s)
- Estelle Raffin
- University of Grenoble Alpes, Inserm, U1216, Grenoble Institut NeurosciencesGrenobleFrance
- Defitech Chair of Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL)GenevaSwitzerland
- Defitech Chair of Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL Valais), Clinique Romande de RéadaptationSionSwitzerland
| | - Sylvain Harquel
- CNRS, UMR5105, Laboratoire Psychologie et NeuroCognition, LPNCUniversity of Grenoble AlpesGrenobleFrance
- University of Grenoble‐Alpes, CNRS, CHU Grenoble Alpes, INSERM, CNRS, IRMaGeGrenobleFrance
| | - Brice Passera
- University of Grenoble Alpes, Inserm, U1216, Grenoble Institut NeurosciencesGrenobleFrance
- CNRS, UMR5105, Laboratoire Psychologie et NeuroCognition, LPNCUniversity of Grenoble AlpesGrenobleFrance
| | - Alan Chauvin
- CNRS, UMR5105, Laboratoire Psychologie et NeuroCognition, LPNCUniversity of Grenoble AlpesGrenobleFrance
- University of Grenoble‐Alpes, CNRS, CHU Grenoble Alpes, INSERM, CNRS, IRMaGeGrenobleFrance
| | - Thierry Bougerol
- University of Grenoble Alpes, Inserm, U1216, Grenoble Institut NeurosciencesGrenobleFrance
- CNRS, UMR5105, Laboratoire Psychologie et NeuroCognition, LPNCUniversity of Grenoble AlpesGrenobleFrance
| | - Olivier David
- University of Grenoble Alpes, Inserm, U1216, Grenoble Institut NeurosciencesGrenobleFrance
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