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Hassan SS, Trenado C, Rageh TA, Schnitzler A, Groiss SJ. Effect of conditioning and test stimulus intensity on cortical excitability using triad-conditioning transcranial magnetic stimulation. Exp Brain Res 2020; 238:1305-1309. [PMID: 32322929 PMCID: PMC7237525 DOI: 10.1007/s00221-020-05812-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 04/13/2020] [Indexed: 01/17/2023]
Abstract
Cortical facilitation assessed with triad conditioning transcranial magnetic stimulation has been termed triad-conditioned facilitation (TCF). TCF has been supposed to reflect increased intracortical facilitation (ICF) at short interstimulus intervals (ISI) around 10 ms and an intrinsic rhythm of the motor cortex at longer ISI around 25 ms. To gain further insight into the pathophysiological mechanism of TCF, we systematically studied the effect of suprathreshold conditioning stimulus (CS) and test stimulus (TS) intensity on TCF. Various CS intensities and TS intensities were used in a triad-conditioning paradigm that was applied to 11 healthy subjects. ISI between pulses were studied between 5 and 200 ms. TCF at 10 ms ISI enhanced with increasing CS intensity but decreased with increasing TS intensity. The duration of facilitation was longer with higher CS intensity. However, TCF at 25 ms ISI could not be elicited with none of the CS and TS intensities addressed here. Our results are consistent with the notion of TCF at short ISI reflecting ICF. The enhanced and prolonged facilitation with increase of CS without additional isolated facilitation at longer ISI suggest a prolongation of ICF.
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Affiliation(s)
- Shady Safwat Hassan
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- Department of Neurology, Assiut University Hospital, Assiut, Egypt
| | - Carlos Trenado
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- Translational Neuromodulation Unit, Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Dortmund, Germany
| | - Tarek Ali Rageh
- Department of Neurology, Assiut University Hospital, Assiut, Egypt
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- Department of Neurology, Medical Faculty, Heinrich Heine University, Moorenstr 5, 40225, Düsseldorf, Germany
| | - Stefan Jun Groiss
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.
- Department of Neurology, Medical Faculty, Heinrich Heine University, Moorenstr 5, 40225, Düsseldorf, Germany.
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Abstract
Usually, cortical rhythmic activities are studied with local field potentials. To overcome small amplitude of EEGs easily disturbed by several factors, we developed a new method to study motor cortical rhythm using Motor evoked potentials (MEPs) to transcranial magnetic stimulation (TMS). We, here, review triad-conditioning TMS technique for investigating the intrinsic rhythm of the human primary motor cortex (M1). MEP was recorded from the first dorsal interosseous muscle (FDI). TMS was applied over the M1 to study its frequency dependency. In the intervention condition, the subthreshold, same intensity three conditioning stimuli separated by a certain interval were given prior to the supra-threshold test stimulus. In the control condition, the test stimulus was given alone. MEPs were compared between the two conditions. In healthy volunteers, triad-conditioning stimulus (TCS) at an interval of 25 ms induced MEP facilitation, whereas the other intervals TCS induced no facilitation. This frequency dependent facilitation may reflect some intrinsic rhythm of M1 (25 ms, i.e. 40 Hz). In cortical myoclonus, the 40 ms TCS induced facilitation whereas 25 ms TCS induced no facilitation, which is consistent with abnormal rhythm of M1 at 25 Hz (40 ms interval) reported previously. In Parkinson's disease (PD), 25 ms TCS evoked no facilitation. Triad-conditioning TMS may enable us to investigate the intrinsic rhythmic activity of M1 and its abnormality.
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Nardone R, Versace V, Höller Y, Sebastianelli L, Brigo F, Lochner P, Golaszewski S, Saltuari L, Trinka E. Transcranial magnetic stimulation in myoclonus of different aetiologies. Brain Res Bull 2018; 140:258-269. [DOI: 10.1016/j.brainresbull.2018.05.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 05/12/2018] [Accepted: 05/18/2018] [Indexed: 12/29/2022]
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Groiss SJ, Mochizuki H, Hanajima R, Trenado C, Nakatani-Enomoto S, Otani K, Ugawa Y. Impairment of triad conditioned facilitation in amyotrophic lateral sclerosis. Amyotroph Lateral Scler Frontotemporal Degener 2017; 18:604-610. [PMID: 28485644 DOI: 10.1080/21678421.2017.1321676] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The triad conditioned facilitation (TCF) technique has been shown to detect motor cortical intrinsic rhythms depending on the functioning of specific cortical layers by measuring motor evoked potential (MEP) enhancement after a triad of conditioning TMS pulses at a certain interval. However, the influence of cortical degeneration on TCF is still undetermined. We therefore studied TCF in patients with amyotrophic lateral sclerosis (ALS), a neurodegenerative disorder characterised by degeneration of the motor cortex. METHODS Thirteen patients with ALS and 11 age-matched disease control patients with cervical myelopathy (CM) or radiculopathy (CR) participated in the study. We studied short-interval intracortical inhibition (SICI), intracortical facilitation (ICF) and TCF using the paired-pulse and triad conditioned TMS paradigm. RESULTS TCF was significantly reduced in ALS patients compared to CM/CR patients, who had normal TCF. SICI and ICF did not differ between groups. CONCLUSION The absence of TCF with preserved SICI and ICF suggests changes in the intrinsic rhythm generation within the motor cortex due to cortical neurodegeneration in ALS patients. In contrast, TCF was normal in patents with CM/CR in whom the motor cortical intrinsic circuits are not involved. This technique may be valuable to differentiate patients with ALS from those with CM/CR.
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Affiliation(s)
- Stefan J Groiss
- a Department of Neurology, Faculty of Medicine , Fukushima Medical University , Fukushima , Japan.,b Department of Neurology & Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty , Heinrich-Heine-University , Düsseldorf , Germany
| | - Hitoshi Mochizuki
- a Department of Neurology, Faculty of Medicine , Fukushima Medical University , Fukushima , Japan.,c Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine , University of Miyazaki , Miyazaki , Japan
| | - Ritsuko Hanajima
- d Department of Neurology , Kitasato University School of Medicine , Sagamihara , Japan
| | - Carlos Trenado
- b Department of Neurology & Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty , Heinrich-Heine-University , Düsseldorf , Germany
| | - Setsu Nakatani-Enomoto
- a Department of Neurology, Faculty of Medicine , Fukushima Medical University , Fukushima , Japan
| | - Koji Otani
- e Department of Orthopedic Surgery, Faculty of Medicine , Fukushima Medical University , Fukushima , Japan , and
| | - Yoshikazu Ugawa
- a Department of Neurology, Faculty of Medicine , Fukushima Medical University , Fukushima , Japan.,f Neurology , Fukushima Global Medical Science Center, Advanced Clinical Research Center, Fukushima Medical University , Fukushima , Japan
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Nakatani-Enomoto S, Hanajima R, Hamada M, Terao Y, Matsumoto H, Shirota Y, Ohminami S, Okabe S, Hirose M, Nakamura K, Furubayashi T, Groiss SJ, Kobayashi S, Mochizuki H, Enomoto H, Ugawa Y. Somatosensory-evoked potential modulation by quadripulse transcranial magnetic stimulation in patients with benign myoclonus epilepsy. Clin Neurophysiol 2016; 127:1560-1567. [DOI: 10.1016/j.clinph.2015.07.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 07/22/2015] [Accepted: 07/24/2015] [Indexed: 10/23/2022]
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Hanajima R, Terao Y, Shirota Y, Ohminami S, Tsutsumi R, Shimizu T, Tanaka N, Okabe S, Tsuji S, Ugawa Y. Triad-conditioning transcranial magnetic stimulation in Parkinson's disease. Brain Stimul 2013; 7:74-9. [PMID: 24183477 DOI: 10.1016/j.brs.2013.09.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 09/26/2013] [Accepted: 09/26/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Transcranial magnetic stimulation (TMS) has been used to reveal excitability changes of the primary motor cortex (M1) in Parkinson's disease (PD). Abnormal rhythmic neural activities are considered to play pathophysiological roles in the motor symptoms of PD. The cortical responses to external rhythmic stimulation have not been studied in PD. We recently reported a new method of triad-conditioning TMS to detect the excitability changes after rhythmic conditioning stimuli, which induce facilitation by 40-Hz stimulation in healthy volunteers. OBJECTIVE We applied a triad-conditioning TMS to PD patients to reveal the motor cortical response characteristics to rhythmic TMS. METHODS The subjects included 13 PD patients and 14 healthy volunteers. Three conditioning stimuli over M1 at an intensity of 110% active motor threshold preceded the test TMS at various inter-stimulus intervals corresponding to 10-200 Hz. RESULTS The triad-conditioning TMS at 40 Hz induced no MEP enhancement in PD patients in either the On or Off state, in contrast to the facilitation observed in the normal subjects. Triad-conditioning TMS at 20-33 Hz in the beta frequency elicited significant MEP suppression in PD patients. The amount of suppression at 20 Hz positively correlated with the UPDRS III score. CONCLUSION We observed abnormal M1 responses to rhythmic TMS in PD. The suppression induced by beta frequency stimulation and no facilitation by 40-Hz stimulation may be related to abnormal beta and gamma band activities within the cortical-basal ganglia network in PD patients. The motor cortical response to rhythmic TMS may be an additional method to detect physiological changes in humans.
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Affiliation(s)
- Ritsuko Hanajima
- Department of Neurology, University of Tokyo Hospital, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
| | - Yasuo Terao
- Department of Neurology, University of Tokyo Hospital, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Division of Neuroscience, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuichiro Shirota
- Department of Neurology, University of Tokyo Hospital, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Shinya Ohminami
- Division of Neuroscience, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryosuke Tsutsumi
- Division of Neuroscience, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takahiro Shimizu
- Division of Neuroscience, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nobuyuki Tanaka
- Division of Neuroscience, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shingo Okabe
- Department of Neurology, University of Tokyo Hospital, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Shoji Tsuji
- Department of Neurology, University of Tokyo Hospital, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Division of Neuroscience, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshikazu Ugawa
- Department of Neurology, Fukushima Medical University, Fukushima, Japan
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