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Ehrenbrusthoff K, Ryan CG, Martin DJ, Milnik V, Dinse HR, Grüneberg C. Low test–retest reliability of a protocol for assessing somatosensory cortex excitability generated from sensory nerves of the lower back. Front Hum Neurosci 2022; 16:898759. [PMID: 36082228 PMCID: PMC9445117 DOI: 10.3389/fnhum.2022.898759] [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: 03/17/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
In people with chronic low back pain (CLBP), maladaptive structural and functional changes on a cortical level have been identified. On a functional level, somatosensory cortical excitability has been shown to be reduced in chronic pain conditions, resulting in cortical disinhibition. The occurrence of structural and/or functional maladaptive cortical changes in people with CLBP could play a role in maintaining the pain. There is currently no measurement protocol for cortical excitability that employs stimulation directly to the lower back. We developed a protocol for the measurement of single pulse somatosensory evoked potential (SEP) waveforms and paired-pulse behavior (PPB) generated from sensory nerves of the lower back and quantified its test–retest reliability in a sample of 30 healthy individuals to gain insights into the normal variability of cortical responses, which could then be compared to results from people with CLBP. We investigated cortical excitability by measuring SEPs and PPB. PPB was defined as the ratio of the amplitude of the second cortical response (A2s) divided by the first cortical response (A1). A2s was determined by subtracting the response to single-pulse stimuli from the paired pulse stimuli response to account for linear superposition effects. The test–retest reliability of the protocol was very poor with no evidence of systematic bias but a high amount of random variability between sessions. There was no significant difference in the right side PPB for session 1 (Mean ratio A2s/A1 = 0.66, SD = 0.54) and session 2 (Mean ratio A2s/A1 = 0.94, SD = 1.56); mean session difference [(95% CI) = −0.44 (−1.23 to 0.34); t (22) = −1.17, p = 0.26]. The ICC3.1 (absolute agreement) for the outlier-removed right side PPB were 0.19 (95% CI: −0.84 to 0.66) and 0.43 for left side PPB (95% CI: −0.37 to 0.76). This finding potentially has wider implications for PPB protocols. If these findings were replicated in other groups and other nerves, it would question the validity of this measure more generally. However, these findings are restricted to healthy people and sensory nerves of the lower back and may not be generalizable.
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Affiliation(s)
- Katja Ehrenbrusthoff
- Department of Applied Health Sciences, Hochschule für Gesundheit, Bochum, Germany
- *Correspondence: Katja Ehrenbrusthoff,
| | - Cormac G. Ryan
- School of Health & Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Denis J. Martin
- School of Health & Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | | | - Hubert R. Dinse
- Department of Neurology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Ruhr-University Bochum, Bochum, Germany
- Institute for Neuroinformatics, Neural Plasticity Lab, Ruhr-University of Bochum, Bochum, Germany
| | - Christian Grüneberg
- Department of Applied Health Sciences, Hochschule für Gesundheit, Bochum, Germany
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MEG-Derived Symptom-Sensitive Biomarkers with Long-Term Test-Retest Reliability. Diagnostics (Basel) 2021; 12:diagnostics12010084. [PMID: 35054252 PMCID: PMC8775104 DOI: 10.3390/diagnostics12010084] [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: 11/29/2021] [Revised: 12/20/2021] [Accepted: 12/23/2021] [Indexed: 11/17/2022] Open
Abstract
Neuroelectric measures derived from human magnetoencephalographic (MEG) recordings hold promise as aides to diagnosis and treatment monitoring and targeting for chronic sequelae of traumatic brain injury (TBI). This study tests novel MEG-derived regional brain measures of tonic neuroelectric activation for long-term test-retest reliability and sensitivity to symptoms. Resting state MEG recordings were obtained from a normative cohort (CamCAN, baseline: n = 613; mean 16-month follow-up: n = 245) and a chronic symptomatic TBI cohort (TEAM-TBI, baseline: n = 62; mean 6-month follow-up: n = 40). The MEG-derived neuroelectric measures were corrected for the empty-room contribution using a random forest classifier. The mean 16-month correlation between baseline and 16-month follow-up CamCAN measures was 0.67; test-retest reliability was markedly improved in this study compared with previous work. The TEAM-TBI cohort was screened for depression, somatization, and anxiety with the Brief Symptom Inventory and for insomnia with the Insomnia Severity Index and was assessed via adjudication for six clinical syndromes: chronic pain, psychological health, and oculomotor, vestibular, cognitive, and sleep dysfunction. Linear classifiers constructed from the 136 regional measures from each TEAM-TBI cohort member distinguished those with and without each symptom, p < 0.0003 for each, i.e., the tonic regional neuroelectric measures of activation are sensitive to the presence/absence of these symptoms and clinical syndromes. The novel regional MEG-derived neuroelectric measures obtained and tested in this study demonstrate the necessary and sufficient properties to be clinically useful, i.e., good test-retest reliability, sensitivity to symptoms in each individual, and obtainable using automatic processing without human judgement or intervention.
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Watanabe H, Kojima S, Nagasaka K, Ohno K, Sakurai N, Kodama N, Otsuru N, Onishi H. Gray Matter Volume Variability in Young Healthy Adults: Influence of Gender Difference and Brain-Derived Neurotrophic Factor Genotype. Cereb Cortex 2021; 32:2635-2643. [PMID: 34635909 PMCID: PMC9201594 DOI: 10.1093/cercor/bhab370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 11/26/2022] Open
Abstract
Although brain gray matter (GM) plastically changes during short-term training, it is still unclear whether brain structures are stable for short periods (several months). Therefore, this study aimed to re-test the short-term variability of GM volumes and to clarify the effect of factors (gender and BDNF-genotype) expected to contribute to such variability. The subjects comprised 41 young healthy adults. T1-weighted images were acquired twice with an interval of approximately 4 months using a 3 T-MRI scanner. Voxel-based morphometry (VBM) was used to calculate GM volumes in 47 regions. The intraclass correlation coefficient (ICC) and Test–retest variability (%TRV) were used as indices of variability. As a result, the ICCs in 43 regions were excellent (ICC > 0.90) and those in 3 regions were good (ICC > 0.80), whereas the ICC in the thalamus was moderate (ICC = 0.694). Women had a higher %TRV than men in 5 regions, and %TRV of the Val66Val group was higher than that of the Met carrier group in 2 regions. Moreover, the Female-Val66Val group had a higher %TRV than the Male-Met carrier group in 3 regions. These results indicate that although the short-term variability of GM volumes is small, it is affected by within-subject factors.
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Affiliation(s)
- Hiraku Watanabe
- Address correspondence to Hiraku Watanabe, Graduate School, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata-City, Niigata 950-3198, Japan. Tel: +81-25-257-4445; Fax: +81-25-257-4445.
| | - Sho Kojima
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Niigata, 950-3198, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan
| | - Kazuaki Nagasaka
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Niigata, 950-3198, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan
| | - Ken Ohno
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Niigata, 950-3198, Japan
- Department of Radiological Technology, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan
| | - Noriko Sakurai
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Niigata, 950-3198, Japan
- Department of Radiological Technology, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan
| | - Naoki Kodama
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Niigata, 950-3198, Japan
- Department of Radiological Technology, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan
| | - Naofumi Otsuru
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Niigata, 950-3198, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan
| | - Hideaki Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Niigata, 950-3198, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan
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Krieger D, Shepard P, Soose R, Puccio AM, Beers S, Schneider W, Kontos AP, Collins MW, Okonkwo DO. Symptom-Dependent Changes in MEG-Derived Neuroelectric Brain Activity in Traumatic Brain Injury Patients with Chronic Symptoms. Med Sci (Basel) 2021; 9:medsci9020020. [PMID: 33806153 PMCID: PMC8103254 DOI: 10.3390/medsci9020020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/23/2021] [Accepted: 03/17/2021] [Indexed: 01/11/2023] Open
Abstract
Neuroelectric measures derived from human magnetoencephalographic (MEG) recordings hold promise as aides to diagnosis and treatment monitoring and targeting for chronic sequelae of traumatic brain injury (TBI). This study tests novel MEG-derived regional brain measures of tonic neuroelectric activation for long-term test-retest reliability and sensitivity to symptoms. Resting state MEG recordings were obtained from a normative cohort, Cambridge Centre for Ageing and Neuroscience (CamCAN), baseline: n = 619; mean 16-month follow-up: n = 253) and a chronic symptomatic TBI cohort, Targeted Evaluation, Action and Monitoring of Traumatic Brain Injury (TEAM-TBI), baseline: n = 64; mean 6-month follow-up: n = 39). For the CamCAN cohort, MEG-derived neuroelectric measures showed good long-term test-retest reliability for most of the 103 automatically identified stereotypic regions. The TEAM-TBI cohort was screened for depression, somatization, and anxiety with the Brief Symptom Inventory and for insomnia with the Insomnia Severity Index. Linear classifiers constructed from the 103 regional measures from each TEAM-TBI cohort member distinguished those with and without each symptom, with p < 0.01 for each-i.e., the tonic regional neuroelectric measures of activation are sensitive to the presence/absence of these symptoms. The novel regional MEG-derived neuroelectric measures obtained and tested in this study demonstrate the necessary and sufficient properties to be clinically useful-i.e., good test-retest reliability, sensitivity to symptoms in each individual, and obtainable using automatic processing without human judgement or intervention.
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Affiliation(s)
- Don Krieger
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15232, USA; (A.M.P.); (D.O.O.)
- Correspondence:
| | - Paul Shepard
- Department of Physics and Astronomy, University of Pittsburgh, Pittsburgh, PA 15232, USA;
| | - Ryan Soose
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA 15232, USA;
| | - Ava M. Puccio
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15232, USA; (A.M.P.); (D.O.O.)
| | - Sue Beers
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15232, USA;
| | - Walter Schneider
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15232, USA;
| | - Anthony P. Kontos
- Department of Sports Medicine, University of Pittsburgh, Pittsburgh, PA 15232, USA; (A.P.K.); (M.W.C.)
| | - Michael W. Collins
- Department of Sports Medicine, University of Pittsburgh, Pittsburgh, PA 15232, USA; (A.P.K.); (M.W.C.)
| | - David O. Okonkwo
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15232, USA; (A.M.P.); (D.O.O.)
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Sasaki R, Otsuru N, Miyaguchi S, Kojima S, Watanabe H, Ohno K, Sakurai N, Kodama N, Sato D, Onishi H. Influence of Brain-Derived Neurotrophic Factor Genotype on Short-Latency Afferent Inhibition and Motor Cortex Metabolites. Brain Sci 2021; 11:brainsci11030395. [PMID: 33804682 PMCID: PMC8003639 DOI: 10.3390/brainsci11030395] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/01/2021] [Accepted: 03/18/2021] [Indexed: 12/11/2022] Open
Abstract
The Met allele of the brain-derived neurotrophic factor (BDNF) gene confers reduced cortical BDNF expression and associated neurobehavioral changes. BDNF signaling influences the survival, development, and synaptic function of cortical networks. Here, we compared gamma-aminobutyric acid (GABA)ergic network activity in the human primary motor cortex (M1) between the Met (Val/Met and Met/Met) and non-Met (Val/Val) genotype groups. Short- and long-interval intracortical inhibition, short-latency afferent inhibition (SAI), and long-latency afferent inhibition were measured using transcranial magnetic stimulation (TMS) as indices of GABAergic activity. Furthermore, the considerable inter-individual variability in inhibitory network activity typically measured by TMS may be affected not only by GABA but also by other pathways, including glutamatergic and cholinergic activities; therefore, we used 3-T magnetic resonance spectroscopy (MRS) to measure the dynamics of glutamate plus glutamine (Glx) and choline concentrations in the left M1, left somatosensory cortex, and right cerebellum. All inhibitory TMS conditions produced significantly smaller motor-evoked potentials than single-pulses. SAI was significantly stronger in the Met group than in the Val/Val group. Only the M1 Glx concentration was significantly lower in the Met group, while the BDNF genotype did not affect choline concentration in any region. Further, a positive correlation was observed between SAI and Glx concentrations only in M1. Our findings provide evidence that the BDNF genotype regulates both the inhibitory and excitatory circuits in human M1. In addition, lower Glx concentration in the M1 of Met carriers may alter specific inhibitory network on M1, thereby influencing the cortical signal processing required for neurobehavioral functions.
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Affiliation(s)
- Ryoki Sasaki
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan; (N.O.); (S.M.); (S.K.); (H.W.); (N.K.); (D.S.); (H.O.)
- Discipline of Physiology, Adelaide Medical School, The University of Adelaide, Adelaide 5000, Australia
- Correspondence: ; Tel.: +81-25-257-4445
| | - Naofumi Otsuru
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan; (N.O.); (S.M.); (S.K.); (H.W.); (N.K.); (D.S.); (H.O.)
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan
| | - Shota Miyaguchi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan; (N.O.); (S.M.); (S.K.); (H.W.); (N.K.); (D.S.); (H.O.)
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan
| | - Sho Kojima
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan; (N.O.); (S.M.); (S.K.); (H.W.); (N.K.); (D.S.); (H.O.)
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan
| | - Hiraku Watanabe
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan; (N.O.); (S.M.); (S.K.); (H.W.); (N.K.); (D.S.); (H.O.)
| | - Ken Ohno
- Department of Radiological Technology, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan; (K.O.); (N.S.)
| | - Noriko Sakurai
- Department of Radiological Technology, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan; (K.O.); (N.S.)
| | - Naoki Kodama
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan; (N.O.); (S.M.); (S.K.); (H.W.); (N.K.); (D.S.); (H.O.)
- Department of Radiological Technology, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan; (K.O.); (N.S.)
| | - Daisuke Sato
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan; (N.O.); (S.M.); (S.K.); (H.W.); (N.K.); (D.S.); (H.O.)
- Department of Health and Sports, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan
| | - Hideaki Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan; (N.O.); (S.M.); (S.K.); (H.W.); (N.K.); (D.S.); (H.O.)
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata City, Niigata 950-3198, Japan
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