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Franco-Rosado P, Callejón MA, Reina-Tosina J, Roa LM, Martin-Rodriguez JF, Mir P. Addressing the sources of inter-subject variability in E-field parameters in anodal tDCS stimulation over motor cortical network. Phys Med Biol 2024; 69:145013. [PMID: 38917834 DOI: 10.1088/1361-6560/ad5bb9] [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: 10/31/2023] [Accepted: 06/25/2024] [Indexed: 06/27/2024]
Abstract
Objetive: .Although transcranial direct current stimulation constitutes a non-invasive neuromodulation technique with promising results in a great variety of applications, its clinical implementation is compromised by the high inter-subject variability reported. This study aims to analyze the inter-subject variability in electric fields (E-fields) over regions of the cortical motor network under two electrode montages: the classical C3Fp2 and an alternative P3F3, which confines more the E-field over this region.Approach.Computational models of the head of 98 healthy subjects were developed to simulate the E-field under both montages. E-field parameters such as magnitude, focality and orientation were calculated over three regions of interest (ROI): M1S1, supplementary motor area (SMA) and preSMA. The role of anatomical characteristics as a source of inter-subject variability on E-field parameters and individualized stimulation intensity were addressed using linear mixed-effect models.Main results.P3F3 showed a more confined E-field distribution over M1S1 than C3Fp2; the latter elicited higher E-fields over supplementary motor areas. Both montages showed high inter-subject variability, especially for the normal component over C3Fp2. Skin, bone and CSF ROI volumes showed a negative association with E-field magnitude irrespective of montage. Grey matter volume and montage were the main sources of variability for focality. The curvature of gyri was found to be significantly associated with the variability of normal E-fields.Significance.Computational modeling proves useful in the assessment of E-field variability. Our simulations predict significant differences in E-field magnitude and focality for C3Fp2 and P3F3. However, anatomical characteristics were also found to be significant sources of E-field variability irrespective of electrode montage. The normal E-field component better captured the individual variability and low rate of responder subjects observed in experimental studies.
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Affiliation(s)
- Pablo Franco-Rosado
- Unidad de Trastornos del Movimiento, Servicio de Neurología, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
- Grupo de Ingeniería Biomédica, Departamento de Teoría de la Señal y Comunicaciones, Universidad de Sevilla, Sevilla, Spain
- Departamento de Psicología Experimental, Universidad de Sevilla, Sevilla, Spain
| | - M Amparo Callejón
- Grupo de Ingeniería Biomédica, Departamento de Teoría de la Señal y Comunicaciones, Universidad de Sevilla, Sevilla, Spain
- Servicio de Otorrinolaringología, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Javier Reina-Tosina
- Grupo de Ingeniería Biomédica, Departamento de Teoría de la Señal y Comunicaciones, Universidad de Sevilla, Sevilla, Spain
| | - Laura M Roa
- Grupo de Ingeniería Biomédica, Departamento de Teoría de la Señal y Comunicaciones, Universidad de Sevilla, Sevilla, Spain
| | - Juan F Martin-Rodriguez
- Unidad de Trastornos del Movimiento, Servicio de Neurología, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Psicología Experimental, Universidad de Sevilla, Sevilla, Spain
| | - Pablo Mir
- Unidad de Trastornos del Movimiento, Servicio de Neurología, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Medicina, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain
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Leodori G, De Bartolo MI, Piervincenzi C, Mancuso M, Ojha A, Costanzo M, Aiello F, Vivacqua G, Fabbrini G, Conte A, Pantano P, Berardelli A, Belvisi D. Mapping Motor Cortical Network Excitability and Connectivity Changes in De Novo Parkinson's Disease. Mov Disord 2024. [PMID: 38924157 DOI: 10.1002/mds.29901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/07/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Transcranial magnetic stimulation-electroencephalography (TMS-EEG) has demonstrated decreased excitability in the primary motor cortex (M1) and increased excitability in the pre-supplementary motor area (pre-SMA) in moderate-advanced Parkinson's disease (PD). OBJECTIVES The aim was to investigate whether these abnormalities are evident from the early stages of the disease, their behavioral correlates, and relationship to cortico-subcortical connections. METHODS Twenty-eight early, drug-naive (de novo) PD patients and 28 healthy controls (HCs) underwent TMS-EEG to record TMS-evoked potentials (TEPs) from the primary motor cortex (M1) and the pre-SMA, kinematic recording of finger-tapping movements, and a 3T-MRI (magnetic resonance imaging) scan to obtain diffusion tensor imaging (DTI) reconstruction of white matter (WM) tracts connecting M1 to the ventral lateral anterior thalamic nucleus and pre-SMA to the anterior putamen. RESULTS We found reduced M1 TEP P30 amplitude in de novo PD patients compared to HCs and similar pre-SMA TEP N40 amplitude between groups. PD patients exhibited smaller amplitude and slower velocity in finger-tapping movements and altered structural integrity in WM tracts of interest, although these changes did not correlate with TEPs. CONCLUSIONS M1 hypoexcitability is a characteristic of PD from early phases and may be a marker of the parkinsonian state. Pre-SMA hyperexcitability is not evident in early PD and possibly emerges at later stages of the disease. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Giorgio Leodori
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | | | | | - Marco Mancuso
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Abhineet Ojha
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Matteo Costanzo
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Flavia Aiello
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Giorgio Vivacqua
- Unit of Microscopic and Ultrastructural Anatomy, Campus Bio-Medico University of Rome, Rome, Italy
| | - Giovanni Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - Patrizia Pantano
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - Daniele Belvisi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
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Fong PY, Rothwell JC, Rocchi L. The Past, Current and Future Research in Cerebellar TMS Evoked Responses-A Narrative Review. Brain Sci 2024; 14:432. [PMID: 38790411 PMCID: PMC11118133 DOI: 10.3390/brainsci14050432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/26/2024] Open
Abstract
Transcranial magnetic stimulation coupled with electroencephalography (TMS-EEG) is a novel technique to investigate cortical physiology in health and disease. The cerebellum has recently gained attention as a possible new hotspot in the field of TMS-EEG, with several reports published recently. However, EEG responses obtained by cerebellar stimulation vary considerably across the literature, possibly due to different experimental methods. Compared to conventional TMS-EEG, which involves stimulation of the cortex, cerebellar TMS-EEG presents some technical difficulties, including strong muscle twitches in the neck area and a loud TMS click when double-cone coils are used, resulting in contamination of responses by electromyographic activity and sensory potentials. Understanding technical difficulties and limitations is essential for the development of cerebellar TMS-EEG research. In this review, we summarize findings of cerebellar TMS-EEG studies, highlighting limitations in experimental design and potential issues that can result in discrepancies between experimental outcomes. Lastly, we propose a possible direction for academic and clinical research with cerebellar TMS-EEG.
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Affiliation(s)
- Po-Yu Fong
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK; (J.C.R.)
- Division of Movement Disorders, Department of Neurology and Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
- Medical School, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - John C. Rothwell
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK; (J.C.R.)
| | - Lorenzo Rocchi
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK; (J.C.R.)
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
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Mancuso M, Cruciani A, Sveva V, Casula E, Brown KE, Di Lazzaro V, Rothwell JC, Rocchi L. Changes in Cortical Activation by Transcranial Magnetic Stimulation Due to Coil Rotation Are Not Attributable to Cranial Muscle Activation. Brain Sci 2024; 14:332. [PMID: 38671984 PMCID: PMC11048461 DOI: 10.3390/brainsci14040332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
Transcranial magnetic stimulation coupled with electroencephalography (TMS-EEG) allows for the study of brain dynamics in health and disease. Cranial muscle activation can decrease the interpretability of TMS-EEG signals by masking genuine EEG responses and increasing the reliance on preprocessing methods but can be at least partly prevented by coil rotation coupled with the online monitoring of signals; however, the extent to which changing coil rotation may affect TMS-EEG signals is not fully understood. Our objective was to compare TMS-EEG data obtained with an optimal coil rotation to induce motor evoked potentials (M1standard) while rotating the coil to minimize cranial muscle activation (M1emg). TMS-evoked potentials (TEPs), TMS-related spectral perturbation (TRSP), and intertrial phase clustering (ITPC) were calculated in both conditions using two different preprocessing pipelines based on independent component analysis (ICA) or signal-space projection with source-informed reconstruction (SSP-SIR). Comparisons were performed with cluster-based correction. The concordance correlation coefficient was computed to measure the similarity between M1standard and M1emg TMS-EEG signals. TEPs, TRSP, and ITPC were significantly larger in M1standard than in M1emg conditions; a lower CCC than expected was also found. These results were similar across the preprocessing pipelines. While rotating the coil may be advantageous to reduce cranial muscle activation, it may result in changes in TMS-EEG signals; therefore, this solution should be tailored to the specific experimental context.
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Affiliation(s)
- Marco Mancuso
- Department of Human Neuroscience, University of Rome “Sapienza”, Viale dell’Università 30, 00185 Rome, Italy;
| | - Alessandro Cruciani
- Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Rome, Italy; (A.C.); (V.D.L.)
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Valerio Sveva
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, University of Rome “Sapienza”, Piazzale Aldo Moro 5, 00185 Rome, Italy;
| | - Elias Casula
- Department of System Medicine, “Tor Vergata” University of Rome, Via Montpellier 1, 00133 Rome, Italy;
| | - Katlyn E. Brown
- Department of Kinesiology, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G5, Canada;
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Rome, Italy; (A.C.); (V.D.L.)
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - John C. Rothwell
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK;
| | - Lorenzo Rocchi
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK;
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria di Monserrato, Blocco I S.S. 554 bivio per Sestu, Monserrato, 09042 Cagliari, Italy
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Bevacqua N, Turrini S, Fiori F, Saracini C, Lucero B, Candidi M, Avenanti A. Cortico-cortical paired associative stimulation highlights asymmetrical communication between rostral premotor cortices and primary motor cortex. Brain Stimul 2024; 17:89-91. [PMID: 38191092 DOI: 10.1016/j.brs.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 01/02/2024] [Indexed: 01/10/2024] Open
Affiliation(s)
- Naomi Bevacqua
- Centro Studi e Ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia "Renzo Canestrari", Campus di Cesena, Alma Mater Studiorum Università di Bologna, 47521, Cesena, Italy; Dipartimento di Psicologia, Sapienza Università di Roma, 00185, Rome, Italy
| | - Sonia Turrini
- Centro Studi e Ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia "Renzo Canestrari", Campus di Cesena, Alma Mater Studiorum Università di Bologna, 47521, Cesena, Italy
| | - Francesca Fiori
- Centro Studi e Ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia "Renzo Canestrari", Campus di Cesena, Alma Mater Studiorum Università di Bologna, 47521, Cesena, Italy; Neurophysiology and Neuroengineering of Human-Technology Interaction Unit (NeXT Lab), Università Campus Bio-Medico di Roma, 00128, Rome, Italy
| | - Chiara Saracini
- Centro de Investigación en Neuropsicología y Neurosciencias Cognitivas (CINPSI Neurocog), Universidad Católica Del Maule, 3460000, Talca, Chile
| | - Boris Lucero
- Centro de Investigación en Neuropsicología y Neurosciencias Cognitivas (CINPSI Neurocog), Universidad Católica Del Maule, 3460000, Talca, Chile
| | - Matteo Candidi
- Dipartimento di Psicologia, Sapienza Università di Roma, 00185, Rome, Italy
| | - Alessio Avenanti
- Centro Studi e Ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia "Renzo Canestrari", Campus di Cesena, Alma Mater Studiorum Università di Bologna, 47521, Cesena, Italy; Centro de Investigación en Neuropsicología y Neurosciencias Cognitivas (CINPSI Neurocog), Universidad Católica Del Maule, 3460000, Talca, Chile.
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Leodori G, Fabbrini A, Suppa A, Mancuso M, Tikoo S, Belvisi D, Conte A, Fabbrini G, Berardelli A. Effective connectivity abnormalities in Lewy body disease with visual hallucinations. Clin Neurophysiol 2023; 156:156-165. [PMID: 37952445 DOI: 10.1016/j.clinph.2023.10.009] [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: 03/23/2023] [Revised: 09/14/2023] [Accepted: 10/19/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVE To assess the changes in effective connectivity of important regions of the visual network (VIS) and dorsal attention network (DAN) underlying visual hallucinations (VHs) in Dementia with Lewy Bodies (DLB), Parkinson's Disease (PD) and Parkinson's Disease Dementia (PDD), as measured by a transcranial magnetic stimulation-electroencephalographic technique (TMS-EEG). METHODS We stimulated the right visual cortex (V1/V2), the right intraparietal sulcus and the right frontal eye fields, two key regions of the DAN, and measured TMS-evoked cortical activation within the VIS and the DAN. We compared 11 patients with VHs and 15 patients without VHs. RESULTS Patients with VHs showed lower TMS-evoked cortical activation within the DAN following intraparietal sulcus and frontal eye fields stimulation than patients without VHs. No difference was found between patients with and without cognitive impairment. Also, when considering only patients with cognitive impairment, VHs were associated with lower TMS-evoked cortical activation following intraparietal sulcus stimulation. CONCLUSIONS DLB, PD, and PDD patients with VHs had less effective connectivity of the right intraparietal sulcus within the DAN than patients without VHs. SIGNIFICANCE We provided the first evidence that VHs are associated with specific intraparietal sulcus dysfunction within the DAN in patients with PDD, PD, and DLB.
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Affiliation(s)
- Giorgio Leodori
- IRCCS Neuromed, Pozzilli, Italy; Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Andrea Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Antonio Suppa
- IRCCS Neuromed, Pozzilli, Italy; Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Marco Mancuso
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Sankalp Tikoo
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, and Imaging, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Daniele Belvisi
- IRCCS Neuromed, Pozzilli, Italy; Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Antonella Conte
- IRCCS Neuromed, Pozzilli, Italy; Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Giovanni Fabbrini
- IRCCS Neuromed, Pozzilli, Italy; Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Alfredo Berardelli
- IRCCS Neuromed, Pozzilli, Italy; Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
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Mancuso M, Cruciani A, Sveva V, Casula EP, Brown K, Rothwell JC, Di Lazzaro V, Koch G, Rocchi L. Somatosensory input in the context of transcranial magnetic stimulation coupled with electroencephalography: An evidence-based overview. Neurosci Biobehav Rev 2023; 155:105434. [PMID: 37890602 DOI: 10.1016/j.neubiorev.2023.105434] [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: 06/18/2023] [Revised: 10/11/2023] [Accepted: 10/22/2023] [Indexed: 10/29/2023]
Abstract
The transcranial evoked potential (TEP) is a powerful technique to investigate brain dynamics, but some methodological issues limit its interpretation. A possible contamination of the TEP by electroencephalographic (EEG) responses evoked by the somatosensory input generated by transcranial magnetic stimulation (TMS) has been postulated; nonetheless, a characterization of these responses is lacking. The aim of this work was to review current evidence about possible somatosensory evoked potentials (SEP) induced by sources of somatosensory input in the craniofacial region. Among these, only contraction of craniofacial muscle and stimulation of free cutaneous nerve endings may be able to induce EEG responses, but direct evidence is lacking due to experimental difficulties in isolating these inputs. Notably, EEG evoked activity in this context is represented by a N100/P200 complex, reflecting a saliency-related multimodal response, rather than specific activation of the primary somatosensory cortex. Strategies to minimize or remove these responses by EEG processing still yield uncertain results; therefore, data inspection is of paramount importance to judge a possible contamination of the TEP by multimodal potentials caused by somatosensory input.
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Affiliation(s)
- M Mancuso
- Department of Human Neurosciences, University of Rome "Sapienza", Viale dell'Università 30, 00185 Rome, Italy
| | - A Cruciani
- Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Rome, Italy; Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - V Sveva
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, University of Rome "Sapienza", Piazzale Aldo Moro, 5, 00185 Rome, Italy
| | - E P Casula
- Department of System Medicine, "Tor Vergata" University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - K Brown
- Department of Kinesiology, University of Waterloo, 200 University Ave W, N2L 3G5 Waterloo, ON, Canada
| | - J C Rothwell
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, WC1N 3BG London, United Kingdom
| | - V Di Lazzaro
- Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Rome, Italy; Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - G Koch
- Non-Invasive Brain Stimulation Unit, IRCCS Santa Lucia Foundation, Via Ardeatina, 306/354, 00179 Rome, Italy
| | - L Rocchi
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria di Monserrato Blocco I S.S, 554 bivio per Sestu 09042, Monserrato, Cagliari, Italy.
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Wang J, Wang X, Li H, Shi L, Song N, Xie J. Updates on brain regions and neuronal circuits of movement disorders in Parkinson's disease. Ageing Res Rev 2023; 92:102097. [PMID: 38511877 DOI: 10.1016/j.arr.2023.102097] [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: 07/28/2023] [Revised: 10/17/2023] [Accepted: 10/23/2023] [Indexed: 03/22/2024]
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disease with a global burden that affects more often in the elderly. The basal ganglia (BG) is believed to account for movement disorders in PD. More recently, new findings in the original regions in BG involved in motor control, as well as the new circuits or new nucleuses previously not specifically considered were explored. In the present review, we provide up-to-date information related to movement disorders and modulations in PD, especially from the perspectives of brain regions and neuronal circuits. Meanwhile, there are updates in deep brain stimulation (DBS) and other factors for the motor improvement in PD. Comprehensive understandings of brain regions and neuronal circuits involved in motor control could benefit the development of novel therapeutical strategies in PD.
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Affiliation(s)
- Juan Wang
- Institute of Brain Science and Disease, School of Basic Medicine, Qingdao University, Qingdao, Shandong, China; Shandong Provincial Collaborative Innovation Center for Neurodegenerative Disorders, Qingdao University, Qingdao, Shandong, China; Shandong Provincial Key Laboratory of Pathogenesis and Prevention of Neurological Disorders, Qingdao University, Qingdao, Shandong, China
| | - Xiaoting Wang
- Institute of Brain Science and Disease, School of Basic Medicine, Qingdao University, Qingdao, Shandong, China; Shandong Provincial Collaborative Innovation Center for Neurodegenerative Disorders, Qingdao University, Qingdao, Shandong, China; Shandong Provincial Key Laboratory of Pathogenesis and Prevention of Neurological Disorders, Qingdao University, Qingdao, Shandong, China
| | - Hui Li
- Institute of Brain Science and Disease, School of Basic Medicine, Qingdao University, Qingdao, Shandong, China; Shandong Provincial Collaborative Innovation Center for Neurodegenerative Disorders, Qingdao University, Qingdao, Shandong, China; Shandong Provincial Key Laboratory of Pathogenesis and Prevention of Neurological Disorders, Qingdao University, Qingdao, Shandong, China
| | - Limin Shi
- Institute of Brain Science and Disease, School of Basic Medicine, Qingdao University, Qingdao, Shandong, China; Shandong Provincial Collaborative Innovation Center for Neurodegenerative Disorders, Qingdao University, Qingdao, Shandong, China; Shandong Provincial Key Laboratory of Pathogenesis and Prevention of Neurological Disorders, Qingdao University, Qingdao, Shandong, China
| | - Ning Song
- Institute of Brain Science and Disease, School of Basic Medicine, Qingdao University, Qingdao, Shandong, China; Shandong Provincial Collaborative Innovation Center for Neurodegenerative Disorders, Qingdao University, Qingdao, Shandong, China; Shandong Provincial Key Laboratory of Pathogenesis and Prevention of Neurological Disorders, Qingdao University, Qingdao, Shandong, China.
| | - Junxia Xie
- Institute of Brain Science and Disease, School of Basic Medicine, Qingdao University, Qingdao, Shandong, China; Shandong Provincial Collaborative Innovation Center for Neurodegenerative Disorders, Qingdao University, Qingdao, Shandong, China; Shandong Provincial Key Laboratory of Pathogenesis and Prevention of Neurological Disorders, Qingdao University, Qingdao, Shandong, China.
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9
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Wei YX, Tu LD, He L, Qiu YT, Su W, Zhang L, Ma RT, Gao Q. Research hotspots and trends of transcranial magnetic stimulation in Parkinson's disease: a bibliometric analysis. Front Neurosci 2023; 17:1280180. [PMID: 37928722 PMCID: PMC10620724 DOI: 10.3389/fnins.2023.1280180] [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: 08/19/2023] [Accepted: 10/05/2023] [Indexed: 11/07/2023] Open
Abstract
Background Transcranial magnetic stimulation (TMS), as a non-invasive neuromodulation technique, has been widely used in the treatment of Parkinson's disease (PD). The increasing application of TMS has promoted an increasing number of clinical studies. In this paper, a bibliometric analysis of existing studies was conducted to reveal current research hotspots and guide future research directions. Method Relevant articles and reviews were obtained from the Science Citation Index Expanded of Web of Science Core Collection database. Data related to publications, countries, institutions, authors, journals, citations, and keywords in the studies included in the review were systematically analyzed using VOSviewer 1.6.18 and Citespace 6.2.4 software. Result A total of 1,894 papers on the topic of TMS in PD between 1991 and 2022 were analyzed and visualized to identify research hotspots and trends in the field. The number of annual publications in this field of study has increased gradually over the past 30 years, with the number of annual publications peaking in 2022 (n = 150). In terms of publications and total citations, countries, institutions, and authors from North America and Western Europe were found to make significant contributions to the field. The current hotspot focuses on the effectiveness of TMS for PD in different stimulation modes or different stimulated brain regions. The keyword analysis indicates that the latest research is oriented to the mechanism study of TMS for motor symptoms in PD, and the non-motor symptoms are also receiving more attention. Conclusion Our study offers insights into the current hotspots and emerging trends of TMS in the rehabilitation of PD. These findings may serve as a guide for future research and the application of TMS for PD.
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Affiliation(s)
- Yi-Xin Wei
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Liang-Dan Tu
- Neurology Department, West China Hospital, Sichuan University, Chengdu, China
| | - Lin He
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Yi-Tong Qiu
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Su
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Li Zhang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Run-Ting Ma
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Gao
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
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10
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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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11
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Spampinato DA, Ibanez J, Rocchi L, Rothwell J. Motor potentials evoked by transcranial magnetic stimulation: interpreting a simple measure of a complex system. J Physiol 2023; 601:2827-2851. [PMID: 37254441 PMCID: PMC10952180 DOI: 10.1113/jp281885] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 05/18/2023] [Indexed: 06/01/2023] Open
Abstract
Transcranial magnetic stimulation (TMS) is a non-invasive technique that is increasingly used to study the human brain. One of the principal outcome measures is the motor-evoked potential (MEP) elicited in a muscle following TMS over the primary motor cortex (M1), where it is used to estimate changes in corticospinal excitability. However, multiple elements play a role in MEP generation, so even apparently simple measures such as peak-to-peak amplitude have a complex interpretation. Here, we summarize what is currently known regarding the neural pathways and circuits that contribute to the MEP and discuss the factors that should be considered when interpreting MEP amplitude measured at rest in the context of motor processing and patients with neurological conditions. In the last part of this work, we also discuss how emerging technological approaches can be combined with TMS to improve our understanding of neural substrates that can influence MEPs. Overall, this review aims to highlight the capabilities and limitations of TMS that are important to recognize when attempting to disentangle sources that contribute to the physiological state-related changes in corticomotor excitability.
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Affiliation(s)
- Danny Adrian Spampinato
- Department of Clinical and Movement NeurosciencesUniversity College LondonLondonUK
- Department of Human NeurosciencesSapienza University of RomeRomeItaly
- Department of Clinical and Behavioral NeurologyIRCCS Santa Lucia FoundationRomeItaly
| | - Jaime Ibanez
- Department of Clinical and Movement NeurosciencesUniversity College LondonLondonUK
- BSICoS group, I3A Institute and IIS AragónUniversity of ZaragozaZaragozaSpain
- Department of Bioengineering, Centre for NeurotechnologiesImperial College LondonLondonUK
| | - Lorenzo Rocchi
- Department of Clinical and Movement NeurosciencesUniversity College LondonLondonUK
- Department of Medical Sciences and Public HealthUniversity of CagliariCagliariItaly
| | - John Rothwell
- Department of Clinical and Movement NeurosciencesUniversity College LondonLondonUK
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12
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Costanzo M, Leodori G, Cutrona C, Marchet F, De Bartolo MI, Mancuso M, Belvisi D, Conte A, Berardelli A, Fabbrini G. Motor Cortical Correlates of Paired Associative Stimulation Induced Plasticity: A TMS-EEG Study. Brain Sci 2023; 13:921. [PMID: 37371399 DOI: 10.3390/brainsci13060921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 05/31/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
Paired associative stimulation (PAS) is a non-invasive brain stimulation technique that modulates synaptic plasticity in the human motor cortex (M1). Since previous studies have primarily used motor-evoked potentials (MEPs) as outcome measure, cortical correlates of PAS-induced plasticity remain unknown. Therefore, the aim of this observational study was to investigate cortical correlates of a standard PAS induced plasticity in the primary motor cortex by using a combined TMS-EEG approach in a cohort of eighteen healthy subjects. In addition to the expected long-lasting facilitatory modulation of MEPs amplitude, PAS intervention also induced a significant increase in transcranial magnetic stimulation-evoked potentials (TEPs) P30 and P60 amplitude. No significant correlation between the magnitude of PAS-induced changes in TEP components and MEP amplitude were observed. However, the linear regression analysis revealed that the combined changes in P30 and P60 component amplitudes significantly predicted the MEP facilitation after PAS. The findings of our study offer novel insight into the neurophysiological changes associated with PAS-induced plasticity at M1 cortical level and suggest a complex relationship between TEPs and MEPs changes following PAS.
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Affiliation(s)
| | - Giorgio Leodori
- IRCCS Neuromed, 86077 Pozzilli, Italy
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
| | | | - Francesco Marchet
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
| | | | - Marco Mancuso
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
| | - Daniele Belvisi
- IRCCS Neuromed, 86077 Pozzilli, Italy
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
| | - Antonella Conte
- IRCCS Neuromed, 86077 Pozzilli, Italy
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
| | - Alfredo Berardelli
- IRCCS Neuromed, 86077 Pozzilli, Italy
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
| | - Giovanni Fabbrini
- IRCCS Neuromed, 86077 Pozzilli, Italy
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
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13
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Vucic S, Stanley Chen KH, Kiernan MC, Hallett M, Benninger DH, Di Lazzaro V, Rossini PM, Benussi A, Berardelli A, Currà A, Krieg SM, Lefaucheur JP, Long Lo Y, Macdonell RA, Massimini M, Rosanova M, Picht T, Stinear CM, Paulus W, Ugawa Y, Ziemann U, Chen R. Clinical diagnostic utility of transcranial magnetic stimulation in neurological disorders. Updated report of an IFCN committee. Clin Neurophysiol 2023; 150:131-175. [PMID: 37068329 PMCID: PMC10192339 DOI: 10.1016/j.clinph.2023.03.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/28/2023] [Accepted: 03/09/2023] [Indexed: 03/31/2023]
Abstract
The review provides a comprehensive update (previous report: Chen R, Cros D, Curra A, Di Lazzaro V, Lefaucheur JP, Magistris MR, et al. The clinical diagnostic utility of transcranial magnetic stimulation: report of an IFCN committee. Clin Neurophysiol 2008;119(3):504-32) on clinical diagnostic utility of transcranial magnetic stimulation (TMS) in neurological diseases. Most TMS measures rely on stimulation of motor cortex and recording of motor evoked potentials. Paired-pulse TMS techniques, incorporating conventional amplitude-based and threshold tracking, have established clinical utility in neurodegenerative, movement, episodic (epilepsy, migraines), chronic pain and functional diseases. Cortical hyperexcitability has emerged as a diagnostic aid in amyotrophic lateral sclerosis. Single-pulse TMS measures are of utility in stroke, and myelopathy even in the absence of radiological changes. Short-latency afferent inhibition, related to central cholinergic transmission, is reduced in Alzheimer's disease. The triple stimulation technique (TST) may enhance diagnostic utility of conventional TMS measures to detect upper motor neuron involvement. The recording of motor evoked potentials can be used to perform functional mapping of the motor cortex or in preoperative assessment of eloquent brain regions before surgical resection of brain tumors. TMS exhibits utility in assessing lumbosacral/cervical nerve root function, especially in demyelinating neuropathies, and may be of utility in localizing the site of facial nerve palsies. TMS measures also have high sensitivity in detecting subclinical corticospinal lesions in multiple sclerosis. Abnormalities in central motor conduction time or TST correlate with motor impairment and disability in MS. Cerebellar stimulation may detect lesions in the cerebellum or cerebello-dentato-thalamo-motor cortical pathways. Combining TMS with electroencephalography, provides a novel method to measure parameters altered in neurological disorders, including cortical excitability, effective connectivity, and response complexity.
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Affiliation(s)
- Steve Vucic
- Brain, Nerve Research Center, The University of Sydney, Sydney, Australia.
| | - Kai-Hsiang Stanley Chen
- Department of Neurology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Matthew C Kiernan
- Brain and Mind Centre, The University of Sydney; and Department of Neurology, Royal Prince Alfred Hospital, Australia
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health, Bethesda, Maryland, United States
| | - David H Benninger
- Department of Neurology, University Hospital of Lausanne (CHUV), Switzerland
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, University Campus Bio-Medico of Rome, Rome, Italy
| | - Paolo M Rossini
- Department of Neurosci & Neurorehab IRCCS San Raffaele-Rome, Italy
| | - Alberto Benussi
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Alfredo Berardelli
- IRCCS Neuromed, Pozzilli; Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Antonio Currà
- Department of Medico-Surgical Sciences and Biotechnologies, Alfredo Fiorini Hospital, Sapienza University of Rome, Terracina, LT, Italy
| | - Sandro M Krieg
- Department of Neurosurgery, Technical University Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Jean-Pascal Lefaucheur
- Univ Paris Est Creteil, EA4391, ENT, Créteil, France; Clinical Neurophysiology Unit, Henri Mondor Hospital, AP-HP, Créteil, France
| | - Yew Long Lo
- Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore, and Duke-NUS Medical School, Singapore
| | | | - Marcello Massimini
- Dipartimento di Scienze Biomediche e Cliniche, Università degli Studi di Milano, Milan, Italy; Istituto Di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Mario Rosanova
- Department of Biomedical and Clinical Sciences University of Milan, Milan, Italy
| | - Thomas Picht
- Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Cluster of Excellence: "Matters of Activity. Image Space Material," Humboldt University, Berlin Simulation and Training Center (BeST), Charité-Universitätsmedizin Berlin, Germany
| | - Cathy M Stinear
- Department of Medicine Waipapa Taumata Rau, University of Auckland, Auckland, Aotearoa, New Zealand
| | - Walter Paulus
- Department of Neurology, Ludwig-Maximilians-Universität München, München, Germany
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, School of Medicine, Fukushima Medical University, Japan
| | - Ulf Ziemann
- Department of Neurology and Stroke, Eberhard Karls University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany; Hertie Institute for Clinical Brain Research, Eberhard Karls University of Tübingen, Otfried-Müller-Straße 27, 72076 Tübingen, Germany
| | - Robert Chen
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital-UHN, Division of Neurology-University of Toronto, Toronto Canada
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14
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Cristofari A, De Santis M, Lucidi S, Rothwell J, Casula EP, Rocchi L. Machine Learning-Based Classification to Disentangle EEG Responses to TMS and Auditory Input. Brain Sci 2023; 13:866. [PMID: 37371346 DOI: 10.3390/brainsci13060866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 05/21/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
The combination of transcranial magnetic stimulation (TMS) and electroencephalography (EEG) offers an unparalleled opportunity to study cortical physiology by characterizing brain electrical responses to external perturbation, called transcranial-evoked potentials (TEPs). Although these reflect cortical post-synaptic potentials, they can be contaminated by auditory evoked potentials (AEPs) due to the TMS click, which partly show a similar spatial and temporal scalp distribution. Therefore, TEPs and AEPs can be difficult to disentangle by common statistical methods, especially in conditions of suboptimal AEP suppression. In this work, we explored the ability of machine learning algorithms to distinguish TEPs recorded with masking of the TMS click, AEPs and non-masked TEPs in a sample of healthy subjects. Overall, our classifier provided reliable results at the single-subject level, even for signals where differences were not shown in previous works. Classification accuracy (CA) was lower at the group level, when different subjects were used for training and test phases, and when three stimulation conditions instead of two were compared. Lastly, CA was higher when average, rather than single-trial TEPs, were used. In conclusion, this proof-of-concept study proposes machine learning as a promising tool to separate pure TEPs from those contaminated by sensory input.
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Affiliation(s)
- Andrea Cristofari
- Department of Civil Engineering and Computer Science Engineering, "Tor Vergata" University of Rome, 00133 Rome, Italy
| | - Marianna De Santis
- Department of Computer, Automatic and Management Engineering, "Sapienza" University of Rome, 00185 Rome, Italy
| | - Stefano Lucidi
- Department of Computer, Automatic and Management Engineering, "Sapienza" University of Rome, 00185 Rome, Italy
| | - John Rothwell
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Elias P Casula
- Department of System Medicine, "Tor Vergata" University of Rome, 00133 Rome, Italy
| | - Lorenzo Rocchi
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria di Monserrato, 09042 Cagliari, Italy
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15
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Neural bases of motor fatigue in multiple sclerosis: A multimodal approach using neuromuscular assessment and TMS-EEG. Neurobiol Dis 2023; 180:106073. [PMID: 36906073 DOI: 10.1016/j.nbd.2023.106073] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/28/2023] [Accepted: 03/07/2023] [Indexed: 03/11/2023] Open
Abstract
Motor fatigue is one of the most common symptoms in multiple sclerosis (MS) patients. Previous studies suggested that increased motor fatigue in MS may arise at the central nervous system level. However, the mechanisms underlying central motor fatigue in MS are still unclear. This paper investigated whether central motor fatigue in MS reflects impaired corticospinal transmission or suboptimal primary motor cortex (M1) output (supraspinal fatigue). Furthermore, we sought to identify whether central motor fatigue is associated with abnormal M1 excitability and connectivity within the sensorimotor network. Twenty-two patients affected by relapsing-remitting MS and 15 healthy controls (HCs) performed repeated blocks of contraction at different percentages of maximal voluntary contraction with the right first dorsal interosseus muscle until exhaustion. Peripheral, central, and supraspinal components of motor fatigue were quantified by a neuromuscular assessment based on the superimposed twitch evoked by peripheral nerve and transcranial magnetic stimulation (TMS). Corticospinal transmission, excitability and inhibition during the task were tested by measurement of motor evoked potential (MEP) latency, amplitude, and cortical silent period (CSP). M1 excitability and connectivity was measured by TMS-evoked electroencephalography (EEG) potentials (TEPs) elicited by M1 stimulation before and after the task. Patients completed fewer blocks of contraction and showed higher values of central and supraspinal fatigue than HCs. We found no MEP or CSP differences between MS patients and HCs. Patients showed a post-fatigue increase in TEPs propagation from M1 to the rest of the cortex and in source-reconstructed activity within the sensorimotor network, in contrast to the reduction observed in HCs. Post-fatigue increase in source-reconstructed TEPs correlated with supraspinal fatigue values. To conclude, MS-related motor fatigue is caused by central mechanisms related explicitly to suboptimal M1 output rather than impaired corticospinal transmission. Furthermore, by adopting a TMS-EEG approach, we proved that suboptimal M1 output in MS patients is associated with abnormal task-related modulation of M1 connectivity within the sensorimotor network. Our findings shed new light on the central mechanisms of motor fatigue in MS by highlighting a possible role of abnormal sensorimotor network dynamics. These novel results may point to new therapeutical targets for fatigue in MS.
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16
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Chen X, Huang Z, Lin W, Li M, Ye Z, Qiu Y, Xia X, Chen N, Hu J, Gan S, Chen Q. Altered brain white matter structural motor network in spinocerebellar ataxia type 3. Ann Clin Transl Neurol 2022; 10:225-236. [PMID: 36479904 PMCID: PMC9930426 DOI: 10.1002/acn3.51713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/07/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Spinocerebellar ataxia type 3 is a disorder within the brain network. However, the relationship between the brain network and disease severity is still unclear. This study aims to investigate changes in the white matter (WM) structural motor network, both in preclinical and ataxic stages, and its relationship with disease severity. METHODS For this study, 20 ataxic, 20 preclinical SCA3 patients, and 20 healthy controls were recruited and received MRI scans. Disease severity was quantified using the SARA and ICARS scores. The WM motor structural network was created using probabilistic fiber tracking and was analyzed using graph theory and network-based statistics at global, nodal, and edge levels. In addition, the correlations between network topological measures and disease duration or clinical scores were analyzed. RESULTS Preclinical patients showed increasing assortativity of the motor network, altered subnetwork including 12 edges of 11 nodes, and 5 brain regions presenting reduced nodal strength. In ataxic patients assortativity of the motor network also increased, but global efficiency, global strength, and transitivity decreased. Ataxic patients showed a wider altered subnetwork and a higher number of reduced nodal strengths. A negative correlation between the transitivity of the motor network and SARA and ICARS scores was observed in ataxic patients. INTERPRETATION Changes to the WM motor network in SCA3 start before ataxia onset, and WM motor network involvement increases with disease progression. Global network topological measures of the WM motor network appear to be a promising image biomarker for disease severity. This study provides new insights into the pathophysiology of disease in SCA3/MJD.
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Affiliation(s)
- Xin‐Yuan Chen
- Department of Rehabilitation MedicineThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Zi‐Qiang Huang
- Department of RadiologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Wei Lin
- Department of NeurologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Meng‐Cheng Li
- Department of RadiologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Zhi‐Xian Ye
- Department of NeurologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Yu‐Sen Qiu
- Department of NeurologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Xiao‐Yue Xia
- Department of RadiologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Na‐Ping Chen
- Department of RadiologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Jian‐Ping Hu
- Department of RadiologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Shi‐Rui Gan
- Department of NeurologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Qun‐Lin Chen
- Department of RadiologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
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17
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Wilhelm E, Quoilin C, Derosiere G, Paço S, Jeanjean A, Duque J. Corticospinal Suppression Underlying Intact Movement Preparation Fades in Parkinson's Disease. Mov Disord 2022; 37:2396-2406. [PMID: 36121426 DOI: 10.1002/mds.29214] [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: 04/14/2022] [Revised: 08/11/2022] [Accepted: 08/17/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND In Parkinson's disease (PD), neurophysiological abnormalities within the primary motor cortex (M1) have been shown to contribute to bradykinesia, but exact modalities are still uncertain. We propose that such motor slowness could involve alterations in mechanisms underlying movement preparation, especially the suppression of corticospinal excitability-called "preparatory suppression"-which is considered to propel movement execution by increasing motor neural gain in healthy individuals. METHODS On two consecutive days, 29 PD patients (on and off medication) and 29 matched healthy controls (HCs) underwent transcranial magnetic stimulation over M1, eliciting motor-evoked potentials (MEPs) in targeted hand muscles, while they were either at rest or preparing a left- or right-hand response in an instructed-delay choice reaction time task. Preparatory suppression was assessed by expressing MEP amplitudes during movement preparation relative to rest. RESULTS Contrary to HCs, PD patients showed a lack of preparatory suppression when the side of the responding hand was analyzed, especially when the latter was the most affected one. This deficit, which did not depend on dopamine medication, increased with disease duration and also tended to correlate with motor impairment, as measured by the Movement Disorder Society Unified Parkinson's Disease Rating Scale, Part III (both total and bradykinesia scores). CONCLUSIONS Our novel findings indicate that preparatory suppression fades in PD, in parallel with worsening motor symptoms, including bradykinesia. Such results suggest that an alteration in this marker of intact movement preparation could indeed cause motor slowness and support its use in future studies on the relation between M1 alterations and motor impairment in PD. © 2022 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Emmanuelle Wilhelm
- CoActions Lab, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium.,Department of Adult Neurology, Saint-Luc University Hospital, Brussels, Belgium
| | - Caroline Quoilin
- CoActions Lab, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Gerard Derosiere
- CoActions Lab, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Susana Paço
- NOVA IMS, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Anne Jeanjean
- Department of Adult Neurology, Saint-Luc University Hospital, Brussels, Belgium
| | - Julie Duque
- CoActions Lab, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
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18
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Pei G, Liu X, Huang Q, Shi Z, Wang L, Suo D, Funahashi S, Wu J, Zhang J, Fang B. Characterizing cortical responses to short-term multidisciplinary intensive rehabilitation treatment in patients with Parkinson’s disease: A transcranial magnetic stimulation and electroencephalography study. Front Aging Neurosci 2022; 14:1045073. [PMID: 36408100 PMCID: PMC9669794 DOI: 10.3389/fnagi.2022.1045073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
Combined transcranial magnetic stimulation and electroencephalography (TMS-EEG) is a powerful non-invasive tool for qualifying the neurophysiological effects of interventions by recording TMS-induced cortical activation with high temporal resolution and generates reproducible and reliable waves of activity without participant cooperation. Cortical dysfunction contributes to the pathogenesis of the clinical symptoms of Parkinson’s disease (PD). Here, we examined changes in cortical activity in patients with PD following multidisciplinary intensive rehabilitation treatment (MIRT). Forty-eight patients with PD received 2 weeks of MIRT. The cortical response was examined following single-pulse TMS over the primary motor cortex by 64-channel EEG, and clinical symptoms were assessed before and after MIRT. TMS-evoked potentials were quantified by the global mean field power, as well as oscillatory power in theta, alpha, beta, and gamma bands, and their clinical correlations were calculated. After MIRT, motor and non-motor symptoms improved in 22 responders, and only non-motor function was enhanced in 26 non-responders. Primary motor cortex stimulation reduced global mean field power amplitudes in responders but not significantly in non-responders. Oscillations exhibited attenuated power in the theta, beta, and gamma bands in responders but only reduced gamma power in non-responders. Associations were observed between beta oscillations and motor function and between gamma oscillations and non-motor symptoms. Our results suggest that motor function enhancement by MIRT may be due to beta oscillatory power modulation and that alterations in cortical plasticity in the primary motor cortex contribute to PD recovery.
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Affiliation(s)
- Guangying Pei
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Xinting Liu
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Qiwei Huang
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Zhongyan Shi
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Li Wang
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Dingjie Suo
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Shintaro Funahashi
- Advanced Research Institute of Multidisciplinary Science, Beijing Institute of Technology, Beijing, China
| | - Jinglong Wu
- School of Medical Technology, Beijing Institute of Technology, Beijing, China
| | - Jian Zhang
- School of Mechatronical Engineering, Beijing Institute of Technology, Beijing, China
- Jian Zhang,
| | - Boyan Fang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
- *Correspondence: Boyan Fang,
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Leodori G, Rocchi L, Mancuso M, De Bartolo MI, Baione V, Costanzo M, Belvisi D, Conte A, Defazio G, Berardelli A. The effect of stimulation frequency on transcranial evoked potentials. Transl Neurosci 2022; 13:211-217. [PMID: 35990553 PMCID: PMC9356286 DOI: 10.1515/tnsci-2022-0235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/26/2022] [Accepted: 07/05/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction Transcranial magnetic stimulation-evoked electroencephalography potentials (TEPs) have been used to study motor cortical excitability in healthy subjects and several neurological conditions. However, optimal recording parameters for TEPs are still debated. Stimulation rates could affect TEP amplitude due to plasticity effects, thus confounding the assessment of cortical excitability. We tested whether short interpulse intervals (IPIs) affect TEP amplitude. Methods We investigated possible changes in TEP amplitude and global mean field amplitude (GMFA) obtained with stimulation of the primary motor cortex at IPIs of 1.1-1.4 s in a group of healthy subjects. Results We found no differences in TEP amplitude or GMFA between the first, second and last third of trials. Discussion Short IPIs do not affect TEP size and can be used without the risk of confounding effects due to short-term plasticity.
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Affiliation(s)
- Giorgio Leodori
- IRCCS Neuromed, 86077 Pozzilli (IS), Italy.,Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome (RM), Italy
| | - Lorenzo Rocchi
- Department of Medical Sciences and Public Health, University of Cagliari, SS 554 bivio Sestu - 09042 Monserrato, 09124 Cagliari (CA), Italy.,Institute of Neurology, University Hospital of Cagliari, Cagliari, Italy
| | - Marco Mancuso
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome (RM), Italy
| | | | - Viola Baione
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome (RM), Italy
| | - Matteo Costanzo
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome (RM), Italy
| | - Daniele Belvisi
- IRCCS Neuromed, 86077 Pozzilli (IS), Italy.,Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome (RM), Italy
| | - Antonella Conte
- IRCCS Neuromed, 86077 Pozzilli (IS), Italy.,Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome (RM), Italy
| | - Giovanni Defazio
- Department of Medical Sciences and Public Health, University of Cagliari, SS 554 bivio Sestu - 09042 Monserrato, 09124 Cagliari (CA), Italy.,Institute of Neurology, University Hospital of Cagliari, Cagliari, Italy
| | - Alfredo Berardelli
- IRCCS Neuromed, 86077 Pozzilli (IS), Italy.,Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome (RM), Italy
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