1
|
Bonanno L, Cannuli A, Pignolo L, Marino S, Quartarone A, Calabrò RS, Cerasa A. Neural Plasticity Changes Induced by Motor Robotic Rehabilitation in Stroke Patients: The Contribution of Functional Neuroimaging. Bioengineering (Basel) 2023; 10:990. [PMID: 37627875 PMCID: PMC10451271 DOI: 10.3390/bioengineering10080990] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/07/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
Robotic rehabilitation is one of the most advanced treatments helping people with stroke to faster recovery from motor deficits. The clinical impact of this type of treatment has been widely defined and established using clinical scales. The neurofunctional indicators of motor recovery following conventional rehabilitation treatments have already been identified by previous meta-analytic investigations. However, a clear definition of the neural correlates associated with robotic neurorehabilitation treatment has never been performed. This systematic review assesses the neurofunctional correlates (fMRI, fNIRS) of cutting-edge robotic therapies in enhancing motor recovery of stroke populations in accordance with PRISMA standards. A total of 7, of the initial yield of 150 articles, have been included in this review. Lessons from these studies suggest that neural plasticity within the ipsilateral primary motor cortex, the contralateral sensorimotor cortex, and the premotor cortices are more sensitive to compensation strategies reflecting upper and lower limbs' motor recovery despite the high heterogeneity in robotic devices, clinical status, and neuroimaging procedures. Unfortunately, the paucity of RCT studies prevents us from understanding the neurobiological differences induced by robotic devices with respect to traditional rehabilitation approaches. Despite this technology dating to the early 1990s, there is a need to translate more functional neuroimaging markers in clinical settings since they provide a unique opportunity to examine, in-depth, the brain plasticity changes induced by robotic rehabilitation.
Collapse
Affiliation(s)
- Lilla Bonanno
- IRCCS Centro Neurolesi Bonino Pulejo, 98123 Messina, Italy; (L.B.); (A.C.); (S.M.); (A.Q.)
| | - Antonio Cannuli
- IRCCS Centro Neurolesi Bonino Pulejo, 98123 Messina, Italy; (L.B.); (A.C.); (S.M.); (A.Q.)
| | | | - Silvia Marino
- IRCCS Centro Neurolesi Bonino Pulejo, 98123 Messina, Italy; (L.B.); (A.C.); (S.M.); (A.Q.)
| | - Angelo Quartarone
- IRCCS Centro Neurolesi Bonino Pulejo, 98123 Messina, Italy; (L.B.); (A.C.); (S.M.); (A.Q.)
| | | | - Antonio Cerasa
- S’Anna Institute, 88900 Crotone, Italy;
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy
- Translational Pharmacology, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Rende, Italy
| |
Collapse
|
2
|
Pinardi M, Schuler AL, Arcara G, Ferreri F, Marinazzo D, Di Pino G, Pellegrino G. Reduced connectivity of primary auditory and motor cortices during exposure to auditory white noise. Neurosci Lett 2023; 804:137212. [PMID: 36966962 DOI: 10.1016/j.neulet.2023.137212] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/27/2023] [Accepted: 03/22/2023] [Indexed: 03/29/2023]
Abstract
Auditory white noise (WN) is widely used in daily life for inducing sleep, and in neuroscience to mask unwanted environmental noise and cues. However, WN was recently reported to influence corticospinal excitability and behavioral performance. Here, we expand previous preliminary findings on the influence of WN exposure on cortical functioning, and we hypothesize that it may modulate cortical connectivity. We tested our hypothesis by performing magnetoencephalography in 20 healthy subjects. WN reduces cortical connectivity of the primary auditory and motor regions with very distant cortical areas, showing a right lateralized connectivity reduction for primary motor cortex. The present results, together with previous finding concerning WN impact on corticospinal excitability and behavioral performance, further support the role of WN as a modulator of cortical function. This suggest avoiding its unrestricted use as a masking tool, while purposely designed and controlled WN application could be exploited to harness brain function and to treat neuropsychiatric conditions.
Collapse
|
3
|
Herzog R, Berger TM, Pauly MG, Xue H, Rueckert E, Münchau A, Bäumer T, Weissbach A. Cerebellar transcranial current stimulation – An intraindividual comparison of different techniques. Front Neurosci 2022; 16:987472. [PMID: 36188449 PMCID: PMC9521312 DOI: 10.3389/fnins.2022.987472] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
Transcranial current stimulation (tCS) techniques have been shown to induce cortical plasticity. As an important relay in the motor system, the cerebellum is an interesting target for plasticity induction using tCS, aiming to modulate its excitability and connectivity. However, until now it remains unclear, which is the most effective tCS method for inducing plasticity in the cerebellum. Thus, in this study, the effects of anodal transcranial direct current stimulation (tDCS), 50 Hz transcranial alternating current stimulation (50 Hz tACS), and high frequency transcranial random noise stimulation (tRNS) were compared with sham stimulation in 20 healthy subjects in a within-subject design. tCS was applied targeting the cerebellar lobe VIIIA using neuronavigation. We measured corticospinal excitability, short-interval intracortical inhibition (SICI), short-latency afferent inhibition (SAI), and cerebellar brain inhibition (CBI) and performed a sensor-based movement analysis at baseline and three times after the intervention (post1 = 15 min; post2 = 55 min; post3 = 95 min). Corticospinal excitability increased following cerebellar tACS and tRNS compared to sham stimulation. This effect was most pronounced directly after stimulation but lasted for at least 55 min after tACS. Cortico-cortical and cerebello-cortical conditioning protocols, as well as sensor-based movement analyses, did not change. Our findings suggest that cerebellar 50 Hz tACS is the most effective protocol to change corticospinal excitability.
Collapse
Affiliation(s)
- Rebecca Herzog
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
- Department of Neurology, University Hospital Schleswig Holstein, Lübeck, Germany
| | - Till M. Berger
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Martje G. Pauly
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
- Department of Neurology, University Hospital Schleswig Holstein, Lübeck, Germany
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Honghu Xue
- Institute for Robotics and Cognitive Systems, University of Lübeck, Lübeck, Germany
| | | | - Alexander Münchau
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Tobias Bäumer
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Anne Weissbach
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- *Correspondence: Anne Weissbach,
| |
Collapse
|
4
|
Chini G, Fiori L, Tatarelli A, Varrecchia T, Draicchio F, Ranavolo A. Indexes for motor performance assessment in job integration/reintegration of people with neuromuscular disorders: A systematic review. Front Neurol 2022; 13:968818. [PMID: 36158952 PMCID: PMC9493180 DOI: 10.3389/fneur.2022.968818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/08/2022] [Indexed: 11/28/2022] Open
Abstract
Individuals of working age affected by neuromuscular disorders frequently experience issues with their capacity to get employment, difficulty at work, and premature work interruption. Anyway, individuals with a disability could be able to return to work, thanks to targeted rehabilitation as well as ergonomic and training interventions. Biomechanical and physiological indexes are important for evaluating motor and muscle performance and determining the success of job integration initiatives. Therefore, it is necessary to determinate which indexes from the literature are the most appropriate to evaluate the effectiveness and efficiency of the return-to-work programs. To identify current and future valuable indexes, this study uses a systematic literature review methodology for selecting articles published from 2011 to March 30, 2021 from Scopus, Web of Science, and PubMed and for checking the eligibility and the potential bias risks. The most used indexes for motor performance assessment were identified, categorized, and analyzed. This review revealed a great potential for kinetic, kinematic, surface electromyography, postural, and other biomechanical and physiological indexes to be used for job integration/reintegration. Indeed, wearable miniaturized sensors, kinematic, kinetic, and sEMG-based indexes can be used to control collaborative robots, classify residual motor functions, and assess pre-post-rehabilitation and ergonomic therapies.
Collapse
Affiliation(s)
- Giorgia Chini
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL-Istituto Nazionale Assicurazione Infortuni sul Lavoro, Rome, Italy
| | - Lorenzo Fiori
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL-Istituto Nazionale Assicurazione Infortuni sul Lavoro, Rome, Italy
- Department of Physiology and Pharmacology and PhD Program in Behavioral Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Antonella Tatarelli
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL-Istituto Nazionale Assicurazione Infortuni sul Lavoro, Rome, Italy
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Tiwana Varrecchia
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL-Istituto Nazionale Assicurazione Infortuni sul Lavoro, Rome, Italy
| | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL-Istituto Nazionale Assicurazione Infortuni sul Lavoro, Rome, Italy
| | - Alberto Ranavolo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL-Istituto Nazionale Assicurazione Infortuni sul Lavoro, Rome, Italy
| |
Collapse
|
5
|
Stimulation with acoustic white noise enhances motor excitability and sensorimotor integration. Sci Rep 2022; 12:13108. [PMID: 35907889 PMCID: PMC9338990 DOI: 10.1038/s41598-022-17055-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 07/20/2022] [Indexed: 11/09/2022] Open
Abstract
Auditory white noise (WN) is widely used in neuroscience to mask unwanted environmental noise and cues, e.g. TMS clicks. However, to date there is no research on the influence of WN on corticospinal excitability and potentially associated sensorimotor integration itself. Here we tested the hypothesis, if WN induces M1 excitability changes and improves sensorimotor performance. M1 excitability (spTMS, SICI, ICF, I/O curve) and sensorimotor reaction-time performance were quantified before, during and after WN stimulation in a set of experiments performed in a cohort of 61 healthy subjects. WN enhanced M1 corticospinal excitability, not just during exposure, but also during silence periods intermingled with WN, and up to several minutes after the end of exposure. Two independent behavioural experiments highlighted that WN improved multimodal sensorimotor performance. The enduring excitability modulation combined with the effects on behaviour suggest that WN might induce neural plasticity. WN is thus a relevant modulator of corticospinal function; its neurobiological effects should not be neglected and could in fact be exploited in research applications.
Collapse
|
6
|
Yang QH, Zhang YH, Du SH, Wang YC, Fang Y, Wang XQ. Non-invasive Brain Stimulation for Central Neuropathic Pain. Front Mol Neurosci 2022; 15:879909. [PMID: 35663263 PMCID: PMC9162797 DOI: 10.3389/fnmol.2022.879909] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 05/04/2022] [Indexed: 12/15/2022] Open
Abstract
The research and clinical application of the noninvasive brain stimulation (NIBS) technique in the treatment of neuropathic pain (NP) are increasing. In this review article, we outline the effectiveness and limitations of the NIBS approach in treating common central neuropathic pain (CNP). This article summarizes the research progress of NIBS in the treatment of different CNPs and describes the effects and mechanisms of these methods on different CNPs. Repetitive transcranial magnetic stimulation (rTMS) analgesic research has been relatively mature and applied to a variety of CNP treatments. But the optimal stimulation targets, stimulation intensity, and stimulation time of transcranial direct current stimulation (tDCS) for each type of CNP are still difficult to identify. The analgesic mechanism of rTMS is similar to that of tDCS, both of which change cortical excitability and synaptic plasticity, regulate the release of related neurotransmitters and affect the structural and functional connections of brain regions associated with pain processing and regulation. Some deficiencies are found in current NIBS relevant studies, such as small sample size, difficulty to avoid placebo effect, and insufficient research on analgesia mechanism. Future research should gradually carry out large-scale, multicenter studies to test the stability and reliability of the analgesic effects of NIBS.
Collapse
Affiliation(s)
- Qi-Hao Yang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yong-Hui Zhang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Shu-Hao Du
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yu-Chen Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yu Fang
- School of Mechanical and Automotive Engineering, Shanghai University of Engineering Science, Shanghai, China
- *Correspondence: Yu Fang,
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
- Xue-Qiang Wang,
| |
Collapse
|
7
|
Dubbioso R, Bove M, Boccia D, D'Ambrosio V, Nolano M, Manganelli F, Iodice R. Neurophysiological and behavioural correlates of ocrelizumab therapy on manual dexterity in patients with primary progressive multiple sclerosis. J Neurol 2022; 269:4791-4801. [PMID: 35419681 PMCID: PMC9363320 DOI: 10.1007/s00415-022-11114-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 12/20/2022]
Abstract
Background Hand dexterity impairment is a key feature of disability in people with primary progressive multiple sclerosis (PPMS). So far, ocrelizumab, a recombinant humanized monoclonal antibody that selectively depletes CD20-expressing B cells, is the only therapy approved for PPMS and recent analysis reported its ability to reduce the risk of upper limb disability progression. However, the neural mechanisms underlying hand impairment in PPMS and the brain networks behind the effect of ocrelizumab on manual dexterity are not fully understood. Objective Main aims of our study were: (i) to investigate neurophysiological and behavioural correlates of hand function impairment in subjects with PPMS, and (ii) to use neurophysiologic and behavioural measures to track the effects of ocrelizumab therapy on manual dexterity. Methods Seventeen PPMS patients and 17 healthy-controls underwent routine neurophysiological protocols assessing the integrity of cortico-spinal and somatosensory pathways and advanced transcranial magnetic stimulation (TMS) protocols evaluating inhibitory (short and long interval intracortical inhibition, short-latency afferent inhibition) and facilitatory (motor thresholds, intracortical facilitation, short-interval intracortical facilitation) circuits in the primary motor cortex. All subjects also underwent behavioural analysis of hand dexterity by means of nine-hole peg test and finger movement analysis, and hand strength with handgrip and three-point pinch test. Neurophysiological and clinical assessments of hand functionality were also performed after 1 year of ocrelizumab therapy. Results At baseline PPMS patients displayed a significant impairment of hand dexterity and strength compared to healthy controls (all p < 0.03). Neurophysiological study disclosed prolonged latencies of standard somatosensory and motor evoked potentials (all p < 0.025) and an overall reduction of intracortical excitability at TMS protocols, involving both excitatory and inhibitory circuits. Importantly, hand dexterity impairment, indexed by delayed 9HPT, correlated with TMS protocols investigating cortical sensorimotor integration (short-latency afferent inhibition, SAI), p = 0.009. Both parameters, 9HPT (p = 0.01) and SAI (p = 0.01), displayed a significant improvement after 1 year of therapy with ocrelizumab. Conclusion Intracortical sensorimotor networks are involved in hand dexterity dysfunction of PPMS. Ocrelizumab therapy displays a beneficial effect on hand dexterity impairment most likely through intracortical networks implicated in fast sensorimotor integration.
Collapse
Affiliation(s)
- Raffaele Dubbioso
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Via Sergio Pansini, 5. 80131, Napoli, Italy.
| | - Marco Bove
- IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Section of Human Physiology, Department of Experimental Medicine, Università Degli Studi Di Genova, 16132, Genoa, Italy
| | - Daniele Boccia
- IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Neuroscience Genetics, Maternal and Child Health (DINOGMI)Center of Excellence for Biomedical Research (CEBR), University of Genoa, RehabilitationGenoa, Ophthalmology, Italy
| | - Vincenzo D'Ambrosio
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Maria Nolano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Via Sergio Pansini, 5. 80131, Napoli, Italy.,Department of Neurology, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, Italy
| | - Fiore Manganelli
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Via Sergio Pansini, 5. 80131, Napoli, Italy
| | - Rosa Iodice
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Via Sergio Pansini, 5. 80131, Napoli, Italy
| |
Collapse
|
8
|
Asan AS, McIntosh JR, Carmel JB. Targeting Sensory and Motor Integration for Recovery of Movement After CNS Injury. Front Neurosci 2022; 15:791824. [PMID: 35126040 PMCID: PMC8813971 DOI: 10.3389/fnins.2021.791824] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 12/27/2021] [Indexed: 12/18/2022] Open
Abstract
The central nervous system (CNS) integrates sensory and motor information to acquire skilled movements, known as sensory-motor integration (SMI). The reciprocal interaction of the sensory and motor systems is a prerequisite for learning and performing skilled movement. Injury to various nodes of the sensorimotor network causes impairment in movement execution and learning. Stimulation methods have been developed to directly recruit the sensorimotor system and modulate neural networks to restore movement after CNS injury. Part 1 reviews the main processes and anatomical interactions responsible for SMI in health. Part 2 details the effects of injury on sites critical for SMI, including the spinal cord, cerebellum, and cerebral cortex. Finally, Part 3 reviews the application of activity-dependent plasticity in ways that specifically target integration of sensory and motor systems. Understanding of each of these components is needed to advance strategies targeting SMI to improve rehabilitation in humans after injury.
Collapse
Affiliation(s)
| | | | - Jason B. Carmel
- Departments of Neurology and Orthopedics, Columbia University, New York, NY, United States
| |
Collapse
|
9
|
Ferrazzoli D, Ortelli P, Iansek R, Volpe D. Rehabilitation in movement disorders: From basic mechanisms to clinical strategies. HANDBOOK OF CLINICAL NEUROLOGY 2022; 184:341-355. [PMID: 35034747 DOI: 10.1016/b978-0-12-819410-2.00019-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Movement disorders encompass a variety of conditions affecting the nervous system at multiple levels. The pathologic processes underlying movement disorders alter the normal neural functions and could lead to aberrant neuroplastic changes and to clinical phenomenology that is not expressed only through mere motor symptoms. Given this complexity, the responsiveness to pharmacologic and surgical therapies is often disappointing. Growing evidence supports the efficacy of neurorehabilitation for the treatment of movement disorders. Specific form of training involving both goal-based practice and aerobic training could drive and modulate neuroplasticity in order to restore the circuitries dysfunctions and to achieve behavioral gains. This chapter provides an overview of the alterations expressed in some movement disorders in terms of clinical signs and symptoms and plasticity, and suggests which ones and why tailored rehabilitation strategies should be adopted for the management of the different movement disorders.
Collapse
Affiliation(s)
- Davide Ferrazzoli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy; Department of Parkinson's Disease, Fresco Parkinson Center, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital-Gravedona ed Uniti, Como, Italy
| | - Paola Ortelli
- Department of Parkinson's Disease, Fresco Parkinson Center, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital-Gravedona ed Uniti, Como, Italy; Department of Parkinson's Disease, Fresco Parkinson Center, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital-Gravedona ed Uniti, Como, Italy
| | - Robert Iansek
- Clinical Research Centre for Movement Disorders and Gait, National Parkinson Foundation Center of Excellence, Monash Health, Cheltenham, VIC, Australia; School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Daniele Volpe
- Department of Rehabilitation, Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, Italy
| |
Collapse
|
10
|
Cortese AM, Cacciante L, Schuler AL, Turolla A, Pellegrino G. Cortical Thickness of Brain Areas Beyond Stroke Lesions and Sensory-Motor Recovery: A Systematic Review. Front Neurosci 2021; 15:764671. [PMID: 34803596 PMCID: PMC8595399 DOI: 10.3389/fnins.2021.764671] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The clinical outcome of patients suffering from stroke is dependent on multiple factors. The features of the lesion itself play an important role but clinical recovery is remarkably influenced by the plasticity mechanisms triggered by the stroke and occurring at a distance from the lesion. The latter translate into functional and structural changes of which cortical thickness might be easy to quantify one of the main players. However, studies on the changes of cortical thickness in brain areas beyond stroke lesion and their relationship to sensory-motor recovery are sparse. Objectives: To evaluate the effects of cerebral stroke on cortical thickness (CT) beyond the stroke lesion and its association with sensory-motor recovery. Materials and Methods: Five electronic databases (PubMed, Embase, Web of Science, Scopus and the Cochrane Library) were searched. Methodological quality of the included studies was assessed with the Newcastle-Ottawa Scale for non-randomized controlled trials and the Risk of Bias Cochrane tool for randomized controlled trials. Results: The search strategy retrieved 821 records, 12 studies were included and risk of bias assessed. In most of the included studies, cortical thinning was seen at the ipsilesional motor area (M1). Cortical thinning can occur beyond the stroke lesion, typically in regions anatomically connected because of anterograde degeneration. Nonetheless, studies also reported cortical thickening of regions of the unaffected hemisphere, likely related to compensatory plasticity. Some studies revealed a significant correlation between changes in cortical thickness of M1 or somatosensory (S1) cortical areas and motor function recovery. Discussion and Conclusions: Following a stroke, changes in cortical thickness occur both in regions directly connected to the stroke lesion and in contralateral hemisphere areas as well as in the cerebellum. The underlying mechanisms leading to these changes in cortical thickness are still to be fully understood and further research in the field is needed. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020200539; PROSPERO 2020, identifier: CRD42020200539.
Collapse
Affiliation(s)
- Anna Maria Cortese
- Laboratory of Rehabilitation Technologies, San Camillo Istituto di Ricovero e Cura a Carattere Scientifico, Venice, Italy
| | - Luisa Cacciante
- Laboratory of Rehabilitation Technologies, San Camillo Istituto di Ricovero e Cura a Carattere Scientifico, Venice, Italy
| | - Anna-Lisa Schuler
- Laboratory of Clinical Imaging and Stimulation, San Camillo Istituto di Ricovero e Cura a Carattere Scientifico, Venice, Italy
| | - Andrea Turolla
- Laboratory of Rehabilitation Technologies, San Camillo Istituto di Ricovero e Cura a Carattere Scientifico, Venice, Italy
| | - Giovanni Pellegrino
- Laboratory of Clinical Imaging and Stimulation, San Camillo Istituto di Ricovero e Cura a Carattere Scientifico, Venice, Italy
| |
Collapse
|
11
|
Ferrazzoli D, Ortelli P, Volpe D, Cucca A, Versace V, Nardone R, Saltuari L, Sebastianelli L. The Ties That Bind: Aberrant Plasticity and Networks Dysfunction in Movement Disorders-Implications for Rehabilitation. Brain Connect 2021; 11:278-296. [PMID: 33403893 DOI: 10.1089/brain.2020.0971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Movement disorders encompass various conditions affecting the nervous system. The pathological processes underlying movement disorders lead to aberrant synaptic plastic changes, which in turn alter the functioning of large-scale brain networks. Therefore, clinical phenomenology does not only entail motor symptoms but also cognitive and motivational disturbances. The result is the disruption of motor learning and motor behavior. Due to this complexity, the responsiveness to standard therapies could be disappointing. Specific forms of rehabilitation entailing goal-based practice, aerobic training, and the use of noninvasive brain stimulation techniques could "restore" neuroplasticity at motor-cognitive circuitries, leading to clinical gains. This is probably associated with modulations occurring at both molecular (synaptic) and circuitry levels (networks). Several gaps remain in our understanding of the relationships among plasticity and neural networks and how neurorehabilitation could promote clinical gains is still unclear. Purposes: In this review, we outline first the networks involved in motor learning and behavior and analyze which mechanisms link the pathological synaptic plastic changes with these networks' disruption in movement disorders. Therefore, we provide theoretical and practical bases to be applied for treatment in rehabilitation.
Collapse
Affiliation(s)
- Davide Ferrazzoli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy
| | - Paola Ortelli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy
| | - Daniele Volpe
- Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, Italy
| | - Alberto Cucca
- Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, Italy.,Department of Neurology, The Marlene & Paolo Fresco Institute for Parkinson's & Movement Disorders, NYU School of Medicine, New York, New York, USA.,Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Viviana Versace
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy
| | - Raffaele Nardone
- Department of Neurology, Franz Tappeiner Hospital (SABES-ASDAA), Merano-Meran, Italy.,Department of Neurology, Christian Doppler Medical Center, Paracelsus University Salzburg, Salzburg, Austria
| | - Leopold Saltuari
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy
| | - Luca Sebastianelli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy
| |
Collapse
|
12
|
Ranavolo A, Serrao M, Varrecchia T, Casali C, Filla A, Roca A, Silvetti A, Marcotulli C, Rondinone BM, Iavicoli S, Draicchio F. The Working Life of People with Degenerative Cerebellar Ataxia. THE CEREBELLUM 2020; 18:910-921. [PMID: 31468336 DOI: 10.1007/s12311-019-01065-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The aim of the present study was to characterize and analyze the most important individual and organizational variables associated with job accommodation in subjects with degenerative cerebellar ataxia by administering a series of international and validated work activity-related scales. Twenty-four workers (W) and 58 non-workers (NW) were recruited: 34 with autosomal dominant ataxia and 48 with autosomal recessive ataxia (27 with Friedreich ataxia and 21 with sporadic adult-onset ataxia of unknown etiology). The severity of ataxia was rated using the Scale for the Assessment and Rating of Ataxia. Our results showed that the ataxic W were predominantly middle-aged (41-50 years), high school graduate, and married men with a permanent work contract, who had been working for more than 7 years. The W with ataxia exhibited a good level of residual working capacity, irrespective of gender, age range, and duration of the disease, and they were observed to have a low or average-to-low job stress-related risk. Supporting patients with ataxia to find an appropriate job is an important priority because about 78% of NW search for a job and W and NW have the same potential work abilities (no relevant differences were found in terms of disease characteristics, gender, and work resilience). In this view, introducing NW to work-life may have a potential rehabilitative aspect. Findings of this study highlight that equal job opportunities for subjects affected by cerebellar ataxia are recommended.
Collapse
Affiliation(s)
- A Ranavolo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida 1, Monte Porzio Catone, 00078, Rome, Italy.
| | - M Serrao
- Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Via Faggiana 34, 40100, Latina, Italy
- Rehabilitation Centre, Policlinico Italia, Rome, Italy
| | - T Varrecchia
- Department of Engineering, Roma TRE University, Via Vito Volterra 62, 00146, Rome, Italy
| | - C Casali
- Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Via Faggiana 34, 40100, Latina, Italy
| | - A Filla
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II, Naples, Italy
| | - A Roca
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II, Naples, Italy
| | - A Silvetti
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida 1, Monte Porzio Catone, 00078, Rome, Italy
| | - C Marcotulli
- Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Via Faggiana 34, 40100, Latina, Italy
| | - B M Rondinone
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida 1, Monte Porzio Catone, 00078, Rome, Italy
| | - S Iavicoli
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida 1, Monte Porzio Catone, 00078, Rome, Italy
| | - F Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida 1, Monte Porzio Catone, 00078, Rome, Italy
| |
Collapse
|
13
|
Iodice R, Ugga L, Aruta F, Iovino A, Ruggiero L. Facioscapulohumeral muscular dystrophy (FSHD) and multiple sclerosis: a case report. ACTA MYOLOGICA : MYOPATHIES AND CARDIOMYOPATHIES : OFFICIAL JOURNAL OF THE MEDITERRANEAN SOCIETY OF MYOLOGY 2020; 39:29-31. [PMID: 32607477 PMCID: PMC7315893 DOI: 10.36185/2532-1900-005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 03/05/2020] [Indexed: 11/23/2022]
Abstract
Facioscapulohumeral muscular dystrophy 1 (FSHD1) is an autosomal dominant neuromuscular disorder, associated with reduction of tandemly arrayed repetitive DNA elements D4Z4 (DRA), at 4q35. Few cases, especially carriers of 1-3 DRA show a syndromic form. Anecdotally the association of FSHD with multiple sclerosis (MS) is reported. Herein we report a 33 years old Caucasian with a molecular diagnosis of FSHD1 with classical phenotype (clinical category A2) and concomitant white matter lesions suggestive of MS. White matter lesions in patients with FSHD have often been described but rarely investigated in order to evaluate a possible diagnosis of MS. We think that MS and FSHD remain clearly distinct diseases, but growing evidences show a widespread and variable activation of the immune system in patients suffering from FSHD probably an hypotheses on a potential common pathogenetic mechanism between these two disorders could should be better investigated.
Collapse
Affiliation(s)
- Rosa Iodice
- Department of Neurosciences, Odontostomatology and Reproductive Sciences, University "Federico II", Naples, Italy
| | - Lorenzo Ugga
- Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy
| | - Francesco Aruta
- Department of Neurosciences, Odontostomatology and Reproductive Sciences, University "Federico II", Naples, Italy
| | - Aniello Iovino
- Department of Neurosciences, Odontostomatology and Reproductive Sciences, University "Federico II", Naples, Italy
| | - Lucia Ruggiero
- Department of Neurosciences, Odontostomatology and Reproductive Sciences, University "Federico II", Naples, Italy
| |
Collapse
|
14
|
Esposito M, Dubbioso R, Tozza S, Iodice R, Aiello M, Nicolai E, Cavaliere C, Salvatore M, Santoro L, Manganelli F. In vivo evidence of cortical amyloid deposition in the adult form of Niemann Pick type C. Heliyon 2019; 5:e02776. [PMID: 31844711 PMCID: PMC6895717 DOI: 10.1016/j.heliyon.2019.e02776] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 09/25/2019] [Accepted: 10/29/2019] [Indexed: 11/24/2022] Open
Abstract
Background Niemann Pick disease type C (NPC) is a lysosomal lipid storage disorder presenting visceral and neurological impairment with cognitive decline. Neurodegeneration in NPC is associated to deposition of amyloid-β and abnormal tau aggregations likewise Alzheimer disease (AD). Dementia is also related to intracortical circuiting abnormalities that can be detected by neurophysiological procedures both in NPC and in AD. Aim of this study is to find the in vivo evidence of amyloid deposition in NPC patients with cognitive impairment and to investigate the pathophysiology of dementia according to similarities with AD. Methods Two sisters affected by NPC and cognitive decline underwent neuropsychological tests, PET scans with 18F- Florbetaben and neurophysiological protocols to assess cortex excitability by means of transcranial magnetic stimulation (TMS), such as short-latency afferent inhibition (SAI), short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF). Results Both patients presented a multidomain cognitive impairment. 18F- Florbetaben uptake was detected in brain frontal areas, while SAI and SICI were abnormal in both patients. Discussion Cognitive impairment in NPC is associated to cortical amyloid deposition as revealed by 18F- Florbetaben PET scan. Amyloid imaging data, together with specific abnormalities found at TMS studies, suggest similar mechanisms underlying NPC and AD dementia.
Collapse
Affiliation(s)
- Marcello Esposito
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Italy
| | - Raffaele Dubbioso
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Italy
- Corresponding author.
| | - Stefano Tozza
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Italy
| | - Rosa Iodice
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Italy
| | - Marco Aiello
- IRCCS SDN, Via Emanuele Gianturco 113, 80143, Napoli, Italy
| | | | | | | | - Lucio Santoro
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Italy
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Italy
| |
Collapse
|
15
|
Dubbioso R, Ruggiero L, Esposito M, Tarantino P, De Angelis M, Aruta F, Pappatà S, Ugga L, Piperno A, Iorio R, Santoro L, Iodice R, Manganelli F. Different cortical excitability profiles in hereditary brain iron and copper accumulation. Neurol Sci 2019; 41:679-685. [PMID: 31773358 DOI: 10.1007/s10072-019-04147-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 11/08/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIM Neurodegeneration with brain iron accumulation (NBIA) and Wilson's disease (WD) is considered the prototype of neurodegenerative disorders characterised by the overloading of iron and copper in the central nervous system. Growing evidence has unveiled the involvement of these metals in brain cortical neurotransmission. Aim of this study was to assess cortical excitability profile due to copper and iron overload. METHODS Three patients affected by NBIA, namely two patients with a recessive hereditary parkinsonism (PARK9) and one patient with aceruloplasminemia and 7 patients with neurological WD underwent transcranial magnetic stimulation (TMS) protocols to assess cortical excitability. Specifically, we evaluated the motor thresholds that reflect membrane excitability related to the voltage-gated sodium channels in the neurons of the motor system and the ease of activation of motor cortex via glutamatergic networks, and ad hoc TMS protocols to probe inhibitory-GABAergic (short interval intracortical inhibition, SICI; short-latency afferent inhibition, SAI; cortical silent period, CSP) and excitatory intracortical circuitry (intracortical facilitation, ICF). RESULTS Patients with NBIA exhibited an abnormal prolongation of CSP respect to HC and WD patients. On the contrary, neurological WD displayed higher motor thresholds and reduced CSP and SICI. CONCLUSION Hereditary conditions due to overload of copper and iron exhibited peculiar cortical excitability profiles that can help during differential diagnosis between these conditions. Moreover, such results can give us more clues about the role of metals in acquired neurodegenerative disorders, such as Parkinson disease, Alzheimer disease, and multiple sclerosis.
Collapse
Affiliation(s)
- Raffaele Dubbioso
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy.
| | - Lucia Ruggiero
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Marcello Esposito
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Paola Tarantino
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Marcello De Angelis
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Francesco Aruta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Sabina Pappatà
- Institute of Biostructure and Bioimaging, National Council of Research, Via S. Pansini, 5 IT-80131, Napoli, Italy
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Alberto Piperno
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Raffaele Iorio
- Department of Translational Medical Sciences, Section of Pediatrics, University of Naples "Federico II", Naples, Italy
| | - Lucio Santoro
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Rosa Iodice
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Fiore Manganelli
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| |
Collapse
|
16
|
Yamazaki Y, Sato D, Yamashiro K, Nakano S, Onishi H, Maruyama A. Acute Low-Intensity Aerobic Exercise Modulates Intracortical Inhibitory and Excitatory Circuits in an Exercised and a Non-exercised Muscle in the Primary Motor Cortex. Front Physiol 2019; 10:1361. [PMID: 31787901 PMCID: PMC6853900 DOI: 10.3389/fphys.2019.01361] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 10/14/2019] [Indexed: 11/17/2022] Open
Abstract
Recent studies have reported that acute aerobic exercise modulates intracortical excitability in the primary motor cortex (M1). However, whether acute low-intensity aerobic exercise can also modulate M1 intracortical excitability, particularly intracortical excitatory circuits, remains unclear. In addition, no previous studies have investigated the effect of acute aerobic exercise on short-latency afferent inhibition (SAI). The aim of this study was to investigate whether acute low-intensity aerobic exercise modulates intracortical circuits in the M1 hand and leg areas. Intracortical excitability of M1 (Experiments 1, 2) and spinal excitability (Experiment 3) were measured before and after acute low-intensity aerobic exercise. In Experiment 3, skin temperature was also measured throughout the experiment. Transcranial magnetic stimulation was applied over the M1 non-exercised hand and exercised leg areas in Experiments 1, 2, respectively. Participants performed 30 min of low-intensity pedaling exercise or rested while sitting on the ergometer. Short- and long-interval intracortical inhibition (SICI and LICI), and SAI were measured to assess M1 inhibitory circuits. Intracortical facilitation (ICF) and short-interval intracortical facilitation (SICF) were measured to assess M1 excitatory circuits. We found that acute low-intensity aerobic exercise decreased SICI and SAI in the M1 hand and leg areas. After exercise, ICF in the M1 hand area was lower than in the control experiment, but was not significantly different to baseline. The single motor-evoked potential, resting motor threshold, LICI, SICF, and spinal excitability did not change following exercise. In conclusion, acute low-intensity pedaling modulates M1 intracortical circuits of both exercised and non-exercised areas, without affecting corticospinal and spinal excitability.
Collapse
Affiliation(s)
- Yudai Yamazaki
- Major in Health and Welfare, Niigata University of Health and Welfare, Niigata, Japan.,Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Daisuke Sato
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.,Department of Health and Sports, Niigata University of Health and Welfare, Niigata, Japan
| | - Koya Yamashiro
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.,Department of Health and Sports, Niigata University of Health and Welfare, Niigata, Japan
| | - Saki Nakano
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.,Field of Health and Sports, Major in Health and Science, Niigata University of Health and Welfare, Niigata, Japan
| | - Hideaki Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.,Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Atsuo Maruyama
- Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| |
Collapse
|
17
|
Dubbioso R, Manganelli F, Siebner HR, Di Lazzaro V. Fast Intracortical Sensory-Motor Integration: A Window Into the Pathophysiology of Parkinson's Disease. Front Hum Neurosci 2019; 13:111. [PMID: 31024277 PMCID: PMC6463734 DOI: 10.3389/fnhum.2019.00111] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 03/13/2019] [Indexed: 01/09/2023] Open
Abstract
Parkinson's Disease (PD) is a prototypical basal ganglia disorder. Nigrostriatal dopaminergic denervation leads to progressive dysfunction of the cortico-basal ganglia-thalamo-cortical sensorimotor loops, causing the classical motor symptoms. Although the basal ganglia do not receive direct sensory input, they are important for sensorimotor integration. Therefore, the basal ganglia dysfunction in PD may profoundly affect sensory-motor interaction in the cortex. Cortical sensorimotor integration can be probed with transcranial magnetic stimulation (TMS) using a well-established conditioning-test paradigm, called short-latency afferent inhibition (SAI). SAI probes the fast-inhibitory effect of a conditioning peripheral electrical stimulus on the motor response evoked by a TMS test pulse given to the contralateral primary motor cortex (M1). Since SAI occurs at latencies that match the peaks of early cortical somatosensory potentials, the cortical circuitry generating SAI may play an important role in rapid online adjustments of cortical motor output to changes in somatosensory inputs. Here we review the existing studies that have used SAI to examine how PD affects fast cortical sensory-motor integration. Studies of SAI in PD have yielded variable results, showing reduced, normal or even enhanced levels of SAI. This variability may be attributed to the fact that the strength of SAI is influenced by several factors, such as differences in dopaminergic treatment or the clinical phenotype of PD. Inter-individual differences in the expression of SAI has been shown to scale with individual motor impairment as revealed by UPDRS motor score and thus, may reflect the magnitude of dopaminergic neurodegeneration. The magnitude of SAI has also been linked to cognitive dysfunction, and it has been suggested that SAI also reflects cholinergic denervation at the cortical level. Together, the results indicate that SAI is a useful marker of disease-related alterations in fast cortical sensory-motor integration driven by subcortical changes in the dopaminergic and cholinergic system. Since a multitude of neurobiological factors contribute to the magnitude of inhibition, any mechanistic interpretation of SAI changes in PD needs to consider the group characteristics in terms of phenotypical spectrum, disease stage, and medication.
Collapse
Affiliation(s)
- Raffaele Dubbioso
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, Napoli, Italy
| | - Fiore Manganelli
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, Napoli, Italy
| | - Hartwig Roman Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark.,Institute for Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, University Campus Bio-Medico, Rome, Italy
| |
Collapse
|
18
|
Rodríguez-Labrada R, Velázquez-Pérez L, Ziemann U. Transcranial magnetic stimulation in hereditary ataxias: Diagnostic utility, pathophysiological insight and treatment. Clin Neurophysiol 2018; 129:1688-1698. [PMID: 29940480 DOI: 10.1016/j.clinph.2018.06.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 05/10/2018] [Accepted: 06/04/2018] [Indexed: 12/28/2022]
Abstract
Transcranial magnetic stimulation (TMS) is a valuable technique to assess and modulate human brain function in normal and pathological conditions. This critical review surveys the contributions of TMS to the diagnosis, insight into pathophysiology and treatment of genetically confirmed hereditary ataxias, a heterogeneous group of neurodegenerative disorders that can affect motor cortex and the corticospinal tract. Most studies were conducted on small sample sizes and focused on diagnostic approaches. The available data demonstrate early involvement of the corticospinal tract and motor cortex circuitry, and support the possible efficacy of cerebellar repetitive TMS (rTMS) as therapeutic approach. Further TMS-based studies are warranted, to establish biomarkers for early diagnosis and disease monitoring, explore the involvement of the cerebello-dentato-thalamo-cortical projection, study the effects of rTMS-induced plasticity, and utilize rTMS for treatment.
Collapse
Affiliation(s)
- Roberto Rodríguez-Labrada
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba; School of Physical Culture and Sport, University of Holguin, Holguin, Cuba
| | - Luis Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba; School of Physical Culture and Sport, University of Holguin, Holguin, Cuba; Cuban Academy of Science, Havana, Cuba.
| | - Ulf Ziemann
- Department of Neurology & Stroke, and Hertie Institute for Clinical Brain Research, University Tübingen, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany.
| |
Collapse
|
19
|
Iodice R, Manganelli F, Dubbioso R. The therapeutic use of non-invasive brain stimulation in multiple sclerosis - a review. Restor Neurol Neurosci 2018; 35:497-509. [PMID: 28984619 DOI: 10.3233/rnn-170735] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system and a leading cause of disability in young adults. Many disabling symptoms in MS, such as spasticity, pain, depression and cognitive deficits are not fully controlled by drug treatment. Non-invasive brain stimulation (NIBS) techniques can be used as tools for modulating altered cortical excitability and plasticity MS patients, providing an improvement in disabling symptoms affecting such patients. OBJECTIVE This review reported and summarized some of the most interesting and promising recent achievements regarding the therapeutic use of NIBS in MS patients. METHODS We reviewed the clinical application of transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), emphasizing their effect on clinical symptoms and signs that are commonly involved in MS patients. In addition, we shortly described new NIBS protocols, such as transcranial alternating current stimulation and transcranial focused ultrasound stimulation as potential and innovative therapeutic options to be applied in future studies in MS patients. RESULTS We reviewed twenty-one studies covering six main clinical domains. Most of such studies focused on fatigues (33.3%), motor performance (19%) and spasticity (19%), sparse results were about pain (9.5%), cognitive abilities (9.5%), sensory deficit (4.8%) and bladder function (4.8%). The most promising results have been published for the improvement of motor (i.e. hand dexterity) and cognitive performances (i.e. attention and working memory) by applying rTMS or tDCS alone or in association with motor/cognitive training, for pain's treatment by using tDCS. CONCLUSION There are still no official recommendations for the therapeutic use of tDCS or rTMS in MS. The huge inter-individual variability of NIBS efficacy is still a big challenge which needs to be solved. However, well-designed studies, deeper knowledge about pathomechanisms underlying MS, and the combination of such techniques with motor and cognitive rehabilitation might results in higher effectiveness of NIBS.
Collapse
Affiliation(s)
- Rosa Iodice
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, Italy
| | - Fiore Manganelli
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, Italy
| | - Raffaele Dubbioso
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, Italy
| |
Collapse
|
20
|
Long-term therapy with miglustat and cognitive decline in the adult form of Niemann-Pick disease type C: a case report. Neurol Sci 2018. [PMID: 29536386 DOI: 10.1007/s10072-018-3314-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Niemann-Pick disease type C (NPC) is a recessive lysosomal lipid storage disorder characterized by central nervous system involvement. Miglustat treatment might improve or stabilize neurological manifestations but there is still limited data on the long-term efficacy. The aim of our study was to report a four-year clinical, neuropsychological and electrophysiological follow-up of two sisters under treatment with miglustat. We report data at basal (T0) and after 4 years (T4) of treatment with miglustat from two sisters (P1 and P2) affected by NPC disease. During the follow-up period, P1 was not adherent to treatment. Both patients underwent neurological evaluation, neuropsychological assessment, nerve conduction study and motor (MEP), visual (VEP), somatosensory, and brainstem auditory evoked potentials. In the patient P2, neurological and electrophysiological evaluations at T4 were stable. Instead, the patient P1, with poor adherence to therapy, developed spasticity, psychiatric disturbances, and alterations of MEP and VEP. Neuropsychological examination showed in both patients a worsening of cognitive impairment. Our findings suggest that long-term therapy with miglustat does not arrest cognitive decline; otherwise, it stabilizes other neurological manifestations.
Collapse
|
21
|
Bilateral Transcranial Direct Current Stimulation Reshapes Resting-State Brain Networks: A Magnetoencephalography Assessment. Neural Plast 2018; 2018:2782804. [PMID: 29593782 PMCID: PMC5821992 DOI: 10.1155/2018/2782804] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 09/11/2017] [Accepted: 10/02/2017] [Indexed: 12/30/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) can noninvasively induce brain plasticity, and it is potentially useful to treat patients affected by neurological conditions. However, little is known about tDCS effects on resting-state brain networks, which are largely involved in brain physiological functions and in diseases. In this randomized, sham-controlled, double-blind study on healthy subjects, we have assessed the effect of bilateral tDCS applied over the sensorimotor cortices on brain and network activity using a whole-head magnetoencephalography system. Bilateral tDCS, with the cathode (−) centered over C4 and the anode (+) centered over C3, reshapes brain networks in a nonfocal fashion. Compared to sham stimulation, tDCS reduces left frontal alpha, beta, and gamma power and increases global connectivity, especially in delta, alpha, beta, and gamma frequencies. The increase of connectivity is consistent across bands and widespread. These results shed new light on the effects of tDCS and may be of help in personalizing treatments in neurological disorders.
Collapse
|
22
|
Suppa A, Quartarone A, Siebner H, Chen R, Di Lazzaro V, Del Giudice P, Paulus W, Rothwell J, Ziemann U, Classen J. The associative brain at work: Evidence from paired associative stimulation studies in humans. Clin Neurophysiol 2017; 128:2140-2164. [DOI: 10.1016/j.clinph.2017.08.003] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 07/20/2017] [Accepted: 08/03/2017] [Indexed: 12/25/2022]
|
23
|
Dubbioso R, Raffin E, Karabanov A, Thielscher A, Siebner HR. Centre-surround organization of fast sensorimotor integration in human motor hand area. Neuroimage 2017; 158:37-47. [DOI: 10.1016/j.neuroimage.2017.06.063] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 06/19/2017] [Accepted: 06/22/2017] [Indexed: 11/26/2022] Open
|
24
|
Lu MK, Chen JC, Chen CM, Duann JR, Ziemann U, Tsai CH. Impaired Cerebellum to Primary Motor Cortex Associative Plasticity in Parkinson's Disease and Spinocerebellar Ataxia Type 3. Front Neurol 2017; 8:445. [PMID: 28900413 PMCID: PMC5581840 DOI: 10.3389/fneur.2017.00445] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 08/14/2017] [Indexed: 12/26/2022] Open
Abstract
Background Functional perturbation of the cerebellum (CB)–motor cortex (M1) interactions may underlie pathophysiology of movement disorders, such as Parkinson’s disease (PD) and spinocerebellar ataxia type 3 (SCA3). Recently, M1 motor excitability can be bidirectionally modulated in young subjects by corticocortical paired associative stimulation (PAS) on CB and contralateral M1 with transcranial magnetic stimulation (TMS), probably through the cerebello–dentato–thalamo–cortical (CDTC) circuit. In this study, we investigated the CB to M1-associative plasticity in healthy elderly PD and SCA3. Methods Ten right-handed PD patients, nine gene-confirmed SCA3 patients, and 10 age-matched healthy controls (HC) were studied. One hundred and twenty pairs of TMS of the left M1 preceded by right lateral CB TMS at an interstimulus interval of 2 (CB → M1 PAS2ms) and 6 ms (CB → M1 PAS6ms) were, respectively, applied with at least 1-week interval. M1 excitability was assessed by motor-evoked potential (MEP) amplitude, short-interval intracortical inhibition (SICI), intracortical facilitation (ICF), and cerebellar inhibition (CBI) at the first dorsal interosseous muscle of the right hand before and after the CB → M1 PAS. Results The M1 excitability represented by MEP amplitude was significantly facilitated and suppressed in the HC group by CB → M1 PAS2ms and CB → M1 PAS6ms, respectively. The bidirectional modulation on MEP amplitude was absent in the PD and SCA3 groups. SICI and the baseline CBI were significantly reduced in the SCA3 group compared to those of the HC group irrespective of the CB → M1 PAS protocols. There was a significant reduction of CBI immediately and 60 min after the CB → M1 PAS protocols in the HC group but not in the patient groups. No significant change of ICF was found. Conclusion Corticocortical CB → M1 PAS can induce bidirectional motor cortical plasticity in M1 for healthy aged subjects. The modulation may be independent of the inhibitory neurocircuits, such as SICI and CBI, and the facilitatory mechanism like ICF. Both patients with PD and SCA3 showed impairment of such plasticity, suggesting significant functional perturbation of the CDTC circuit.
Collapse
Affiliation(s)
- Ming-Kuei Lu
- Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, Medical College, China Medical University, Taichung, Taiwan.,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Jui-Cheng Chen
- Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, Medical College, China Medical University, Taichung, Taiwan.,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Chun-Ming Chen
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.,Department of Radiology, China Medical University Hospital, Taichung, Taiwan
| | - Jeng-Ren Duann
- Institute of Cognitive Neuroscience, National Central University, Zhongli, Taiwan.,Institute for Neural Computation, University of California San Diego, San Diego, CA, United States
| | - Ulf Ziemann
- Department of Neurology and Stroke, Hertie Institute for Clinical Brain Research, Eberhard-Karls-University, Tübingen, Germany
| | - Chon-Haw Tsai
- Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, Medical College, China Medical University, Taichung, Taiwan.,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| |
Collapse
|
25
|
Abstract
Chorea-acanthocytosis (Ch-Ac) is an autosomal recessive neurodegenerative disorder characterized by adult-onset chorea, acanthocytes in the peripheral blood, and Huntington's disease-like neuropsychiatric symptoms. Animal studies have shown mutation-related dysregulated cortical gamma-aminobutyric acid (GABA)ergic inhibitory networks in its pathophysiology. Herein we found that in patients with Ch-Ac there is a striking alteration of intracortical inhibitory circuits detected by using paired pulse transcranial magnetic stimulation protocols. Our findings show in vivo the functional disruption of GABA(A)-mediated networks in humans with Ch-Ac supporting the existing data in mice models with this condition.
Collapse
|
26
|
Gramigna V, Pellegrino G, Cerasa A, Cutini S, Vasta R, Olivadese G, Martino I, Quattrone A. Near-Infrared Spectroscopy in Gait Disorders: Is It Time to Begin? Neurorehabil Neural Repair 2017; 31:402-412. [PMID: 28196453 DOI: 10.1177/1545968317693304] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Walking is a complex motor behavior with a special relevance in clinical neurology. Many neurological diseases, such as Parkinson's disease and stroke, are characterized by gait disorders whose neurofunctional correlates are poorly investigated. Indeed, the analysis of real walking with the standard neuroimaging techniques poses strong challenges, and only a few studies on motor imagery or walking observation have been performed so far. Functional near-infrared spectroscopy (fNIRS) is becoming an important research tool to assess functional activity in neurological populations or for special tasks, such as walking, because it allows investigating brain hemodynamic activity in an ecological setting, without strong immobility constraints. A systematic review following PRISMA guidelines was conducted on the fNIRS-based examination of gait disorders. Twelve of the initial yield of 489 articles have been included in this review. The lesson learnt from these studies suggest that oxy-hemoglobin levels within the prefrontal and premotor cortices are more sensitive to compensation strategies reflecting postural control and restoration of gait disorders. Although this field of study is in its relative infancy, the evidence provided encourages the translation of fNIRS in clinical practice, as it offers a unique opportunity to explore in depth the activity of the cortical motor system during real walking in neurological patients. We also discuss to what extent fNIRS may be applied for assessing the effectiveness of rehabilitation programs.
Collapse
Affiliation(s)
| | | | - Antonio Cerasa
- 1 University Magna Graecia, Catanzaro, Italy.,3 Istituto di Bioimmagini e Fisiologia Molecolare, National Research Council, Catanzaro, Italy
| | - Simone Cutini
- 4 Department of Developmental Psychology, University of Padova, Padova, Italy
| | | | - Giuseppe Olivadese
- 3 Istituto di Bioimmagini e Fisiologia Molecolare, National Research Council, Catanzaro, Italy
| | | | - Aldo Quattrone
- 1 University Magna Graecia, Catanzaro, Italy.,3 Istituto di Bioimmagini e Fisiologia Molecolare, National Research Council, Catanzaro, Italy
| |
Collapse
|
27
|
Motor cortex plasticity can indicate vulnerability to motor fluctuation and high L-DOPA need in drug-naïve Parkinson's disease. Parkinsonism Relat Disord 2017; 35:55-62. [DOI: 10.1016/j.parkreldis.2016.12.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 10/02/2016] [Accepted: 12/12/2016] [Indexed: 11/18/2022]
|
28
|
Tremblay S, Austin D, Hannah R, Rothwell JC. Non-invasive brain stimulation as a tool to study cerebellar-M1 interactions in humans. CEREBELLUM & ATAXIAS 2016; 3:19. [PMID: 27895926 PMCID: PMC5111316 DOI: 10.1186/s40673-016-0057-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 11/01/2016] [Indexed: 12/29/2022]
Abstract
The recent development of non-invasive brain stimulation techniques such as transcranial magnetic stimulation (TMS) has allowed the non-invasive assessment of cerebellar function in humans. Early studies showed that cerebellar activity, as reflected in the excitability of the dentate-thalamo-cortical pathway, can be assessed with paired stimulation of the cerebellum and the primary motor cortex (M1) (cerebellar inhibition of motor cortex, CBI). Following this, many attempts have been made, using techniques such as repetitive TMS and transcranial electrical stimulation (TES), to modulate the activity of the cerebellum and the dentate-thalamo-cortical output, and measure their impact on M1 activity. The present article reviews literature concerned with the impact of non-invasive stimulation of cerebellum on M1 measures of excitability and "plasticity" in both healthy and clinical populations. The main conclusion from the 27 reviewed articles is that the effects of cerebellar "plasticity" protocols on M1 activity are generally inconsistent. Nevertheless, two measurements showed relatively reproducible effects in healthy individuals: reduced response of M1 to sensorimotor "plasticity" (paired-associative stimulation, PAS) and reduced CBI following repetitive TMS and TES. We discuss current challenges, such as the low power of reviewed studies, variability in stimulation parameters employed and lack of understanding of physiological mechanisms underlying CBI.
Collapse
Affiliation(s)
- Sara Tremblay
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, WC1N 3BG UK
| | - Duncan Austin
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, WC1N 3BG UK
| | - Ricci Hannah
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, WC1N 3BG UK
| | - John C Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, WC1N 3BG UK
| |
Collapse
|
29
|
Hannah R, Rothwell JC. Pulse Duration as Well as Current Direction Determines the Specificity of Transcranial Magnetic Stimulation of Motor Cortex during Contraction. Brain Stimul 2016; 10:106-115. [PMID: 28029595 PMCID: PMC5282399 DOI: 10.1016/j.brs.2016.09.008] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 09/14/2016] [Accepted: 09/18/2016] [Indexed: 11/15/2022] Open
Abstract
Selective stimulation of inputs to corticospinal neurons may be achieved by manipulating current direction and pulse duration. Neural populations recruited by brief (30 μs) anterior–posterior currents exhibited the greatest sensitivity to somatosensory input. Pulse duration is an important determinant of what is activated with TMS in human motor cortex.
Background Previous research suggested that anterior–posterior (AP) directed currents induced by TMS in motor cortex (M1) activate interneuron circuits different from those activated by posterior–anterior currents (PA). The present experiments provide evidence that pulse duration also determines the activation of specific interneuron circuits. Objective To use single motor unit (SMU) recordings to confirm the difference in onset latencies of motor-evoked potentials (MEPs) evoked by different current directions and pulse durations: AP30, AP120, PA30 and PA120. To test whether the amplitude of the MEPs is differentially influenced by somatosensory inputs from the hand (short-latency afferent inhibition, SAI), and examine the sensitivity of SAI to changes in cerebellar excitability produced by direct current stimulation (tDCSCb). Methods Surface electromyograms and SMUs were recorded from the first dorsal interosseous muscle. SAI was tested with an electrical stimulus to median or digital nerves ~20–25 ms prior to TMS delivered over the M1 hand area via a controllable pulse parameter TMS (cTMS) device. SAI was also tested during the application of anodal or sham tDCSCb. Because TMS pulse specificity is greatest at low stimulus intensities, most experiments were conducted with weak voluntary contraction to reduce stimulus threshold. Results AP30 currents recruited the longest latency SMU and surface MEP responses. During contraction SAI was greater for AP30 responses versus all other pulses. Online anodal tDCSCb reduced SAI for the AP30 currents only. Conclusions AP30 currents activate an interneuron circuit with functional properties different from those activated by other pulse types. Pulse duration and current direction determine what is activated in M1 with TMS.
Collapse
Affiliation(s)
- Ricci Hannah
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK.
| | - John C Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
| |
Collapse
|
30
|
Oulad Ben Taib N, Manto M. The in vivo reduction of afferent facilitation induced by low frequency electrical stimulation of the motor cortex is antagonized by cathodal direct current stimulation of the cerebellum. CEREBELLUM & ATAXIAS 2016; 3:15. [PMID: 27579172 PMCID: PMC5004309 DOI: 10.1186/s40673-016-0053-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 08/25/2016] [Indexed: 12/03/2022]
Abstract
Background Low-frequency electrical stimulation to the motor cortex (LFSMC) depresses the excitability of motor circuits by long-term depression (LTD)-like effects. The interactions between LFSMC and cathodal direct current stimulation (cDCS) over the cerebellum are unknown. Methods We assessed the corticomotor responses and the afferent facilitation of corticomotor responses during a conditioning paradigm in anaesthetized rats. We applied LFSMC at a frequency of 1 Hz and a combination of LFSMC with cDCS. Results LFSMC significantly depressed both the corticomotor responses and the afferent facilitation of corticomotor responses. Simultaneous application of cDCS over the cerebellum antagonized the depression of corticomotor responses and cancelled the depression of the afferent facilitation. Conclusion Our results demonstrate that cDCS of the cerebellum is a potent modulator the inhibition of the motor circuits induced by LFSMC applied in vivo. These results expand our understanding of the effects of cerebellar DCS on motor commands and open novel applications for a cerebellar remote control of LFSMC-induced neuroplasticity. We suggest that the cerebellum acts as a neuronal machine supervising not only long-term potentiation (LTP)-like effects, but also LTD-like effects in the motor cortex, two mechanisms which underlie cerebello-cerebral interactions and the cerebellar control of remote plasticity. Implications for clinical ataxiology are discussed.
Collapse
Affiliation(s)
| | - Mario Manto
- Unité d'Etude du Mouvement (UEM), FNRS, Neurologie ULB-Erasme, 808 Route de Lennik, 1070 Bruxelles, Belgium ; Service des Neurosciences, Université de Mons, 7000 Mons, Belgium
| |
Collapse
|
31
|
Bailey AZ, Asmussen MJ, Nelson AJ. Short-latency afferent inhibition determined by the sensory afferent volley. J Neurophysiol 2016; 116:637-44. [PMID: 27226451 DOI: 10.1152/jn.00276.2016] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 05/25/2016] [Indexed: 01/07/2023] Open
Abstract
Short-latency afferent inhibition (SAI) is characterized by the suppression of the transcranial magnetic stimulation motor evoked potential (MEP) by the cortical arrival of a somatosensory afferent volley. It remains unknown whether the magnitude of SAI reflects changes in the sensory afferent volley, similar to that observed for somatosensory evoked potentials (SEPs). The present study investigated stimulus-response relationships between sensory nerve action potentials (SNAPs), SAI, and SEPs and their interrelatedness. Experiment 1 (n = 23, age 23 ± 1.5 yr) investigated the stimulus-response profile for SEPs and SAI in the flexor carpi radialis muscle after stimulation of the mixed median nerve at the wrist using ∼25%, 50%, 75%, and 100% of the maximum SNAP and at 1.2× and 2.4× motor threshold (the latter equated to 100% of the maximum SNAP). Experiment 2 (n = 20, age 23.1 ± 2 yr) probed SEPs and SAI stimulus-response relationships after stimulation of the cutaneous digital nerve at ∼25%, 50%, 75%, and 100% of the maximum SNAP recorded at the elbow. Results indicate that, for both nerve types, SAI magnitude is dependent on the volume of the sensory afferent volley and ceases to increase once all afferent fibers within the nerve are recruited. Furthermore, for both nerve types, the magnitudes of SAI and SEPs are related such that an increase in excitation within somatosensory cortex is associated with an increase in the magnitude of afferent-induced MEP inhibition.
Collapse
Affiliation(s)
- Aaron Z Bailey
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Michael J Asmussen
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Aimee J Nelson
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
32
|
Naro A, Leo A, Russo M, Cannavò A, Milardi D, Bramanti P, Calabrò RS. Does Transcranial Alternating Current Stimulation Induce Cerebellum Plasticity? Feasibility, Safety and Efficacy of a Novel Electrophysiological Approach. Brain Stimul 2016; 9:388-395. [PMID: 26946958 DOI: 10.1016/j.brs.2016.02.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 02/03/2016] [Accepted: 02/04/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Cerebellum-brain functional connectivity can be shaped through different non-invasive neurostimulation approaches. In this study, we propose a novel approach to perturb the cerebellum-brain functional connectivity by means of transcranial alternating current stimulation (tACS). METHODS Twenty-five healthy individuals underwent a cerebellar tACS protocol employing different frequencies (10, 50, and 300 Hz) and a sham-tACS over the right cerebellar hemisphere. We measured their after-effects on the motor evoked potential (MEP) amplitude, the cerebellum-brain inhibition (CBI), the long-latency intracortical inhibition (LICI), from the primary motor cortex of both the hemispheres. In addition, we assessed the functional adaptation to a right hand sequential tapping motor task. RESULTS None of the participants had any side-effect. Following 50 Hz-tACS, we observed a clear contralateral CBI weakening, paralleled by a MEP increase with a better adaptation to frequency variations during the sequential tapping. The 300 Hz-tACS induced a contralateral CBI strengthening, without significant MEP and kinematic after-effects. The 10 Hz-tACS conditioning was instead ineffective. CONCLUSIONS We may argue that tACS protocols could have interfered with the activity of CBI-sustaining Purkinje cell, affecting motor adaptation. Our safe approach seems promising in studying the cerebellum-brain functional connectivity, with possible implications in neurorehabilitative settings.
Collapse
Affiliation(s)
- Antonino Naro
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | - Antonino Leo
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | | | | | - Demetrio Milardi
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy; Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Italy
| | | | | |
Collapse
|