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Ma K, Rothwell JC, Goetz SM. A revised calcium-dependent model of transcranial magnetic theta-burst stimulation. Clin Neurophysiol 2022; 144:41-49. [PMID: 36242947 DOI: 10.1016/j.clinph.2022.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/02/2022] [Accepted: 09/15/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Calcium dependency is presently an essential assumption in modelling the neuromodulatory effects of transcranial magnetic stimulation. Y.Z.Huang et al.developed the first neuromodulation model to explain the bidirectional effects of theta-burst stimulation (TBS) based on the postsynaptic intracellular calcium concentration elevation. However, we discover that the published computer code is not consistent with the model formulation, neither do the parameters and derived plots consequently match the formulations. Here we intend to fix the computer code and re-calibrate the model. METHODS We corrected the affected difference equations and re-calibrated the revised model with experimental data using non-convex optimisation based on a L2 penalty. RESULTS The revised model outperforms the initial model in characterising the relative motor-evoked potential levels of TBS-induced after-effects in various conditions. CONCLUSIONS We corrected the inconsistencies in the previous model and computer code and provided a complete calibration to support the research that is based on it. SIGNIFICANCE This work improves the accuracy and secures the scope of the model, which is necessary to retain a rich body of research resulting from the model. Furthermore, this model provides both a quantitative model for several parameters of TBS and a basic model foundation for future refinement.
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Affiliation(s)
- Ke Ma
- Department of Engineering, School of Technology, University of Cambridge, Cambridge, United Kingdom.
| | - John C Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London, United Kingdom
| | - Stephan M Goetz
- Department of Engineering, School of Technology, University of Cambridge, Cambridge, United Kingdom.
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2
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Zhang BBB, Kan RLD, Giron CG, Lin TTZ, Yau SY, Kranz GS. Dose-response relationship between iTBS and prefrontal activation during executive functioning: A fNIRS study. Front Psychiatry 2022; 13:1049130. [PMID: 36606127 PMCID: PMC9807664 DOI: 10.3389/fpsyt.2022.1049130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Intermittent theta-burst stimulation (iTBS) is a non-invasive brain stimulation paradigm that has demonstrated promising therapeutic benefits for a variety of neuropsychiatric disorders. It has recently garnered widespread favor among researchers and clinicians, owing to its comparable potentiation effects as conventional high-frequency repetitive transcranial magnetic stimulation (rTMS), but administered in a much shorter time frame. However, there is still a lack of agreement over the optimal stimulation intensity, particularly when targeting the prefrontal regions. The objective of this study was to systematically investigate the influence of different stimulation intensities of iTBS, applied over the left dorsolateral prefrontal cortex (DLPFC), on brain activity and executive function in healthy adults. METHODS Twenty young healthy adults were enrolled in this randomized cross-over experiment. All participants received a single session iTBS over the left DLPFC at intensities of 50, 70, or 100% of their individual resting motor threshold (RMT), each on separate visits. Functional near-infrared spectroscopy (fNIRS) was used to measure changes of hemoglobin concentrations in prefrontal areas during the verbal fluency task (VFT) before and after stimulation. RESULTS After stimulation, iTBS to the left DLPFC with 70% RMT maintained the concentration change of oxyhemoglobin (HbO) in the target area during the VFT. In contrast, 50% [t (17) = 2.203, P = 0.042, d = 0.523] and 100% iTBS [t (17) = 2.947, P = 0.009, d = 0.547] significantly decreased change of HbO concentration, indicating an inverse U-shape relationship between stimulation intensity and prefrontal hemodynamic response in healthy young adults. Notably, improved VFT performance was only observed after 70% RMT stimulation [t (17) = 2.511, P = 0.022, d = 0.592]. Moreover, a significant positive correlation was observed between task performance and the difference in HbO concentration change in the targeted area after 70% RMT stimulation (r = 0.496, P = 0.036) but not after 50 or 100% RMT stimulation. CONCLUSION The linear relationship between stimulation intensity and behavioral outcomes reported in previous conventional rTMS studies may not be translated to iTBS. Instead, iTBS at 70% RMT may be more efficacious than 100% RMT.
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Affiliation(s)
- Bella B B Zhang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Rebecca L D Kan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Cristian G Giron
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Tim T Z Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Suk-Yu Yau
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China.,Mental Health Research Center (MHRC), The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Georg S Kranz
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China.,Mental Health Research Center (MHRC), The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China.,Department of Psychiatry and Psychotherapy, Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Vienna, Austria.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hung Hom, Hong Kong SAR, China
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3
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Using Brain Imaging to Improve Spatial Targeting of Transcranial Magnetic Stimulation for Depression. Biol Psychiatry 2021; 90:689-700. [PMID: 32800379 DOI: 10.1016/j.biopsych.2020.05.033] [Citation(s) in RCA: 125] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 05/29/2020] [Accepted: 05/29/2020] [Indexed: 01/18/2023]
Abstract
Transcranial magnetic stimulation (TMS) is an effective treatment for depression but is limited in that the optimal therapeutic target remains unknown. Early TMS trials lacked a focal target and thus positioned the TMS coil over the prefrontal cortex using scalp measurements. Over time, it became clear that this method leads to variation in the stimulation site and that this could contribute to heterogeneity in antidepressant response. Newer methods allow for precise positioning of the TMS coil over a specific brain location, but leveraging these precise methods requires a more precise therapeutic target. We review how neuroimaging is being used to identify a more focal therapeutic target for depression. We highlight recent studies showing that more effective TMS targets in the frontal cortex are functionally connected to deep limbic regions such as the subgenual cingulate cortex. We review how connectivity might be used to identify an optimal TMS target for use in all patients and potentially even a personalized target for each individual patient. We address the clinical implications of this emerging field and highlight critical questions for future research.
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Chakraborty A, Tran TT, Silva AE, Giaschi D, Thompson B. Continuous theta burst TMS of area MT+ impairs attentive motion tracking. Eur J Neurosci 2021; 54:7289-7300. [PMID: 34591329 DOI: 10.1111/ejn.15480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 09/16/2021] [Accepted: 09/20/2021] [Indexed: 11/28/2022]
Abstract
Attentive motion tracking deficits measured using multiple object tracking (MOT) tasks have been identified in a number of neurodevelopmental disorders such as amblyopia and autism. These deficits are often attributed to the abnormal development of high-level attentional networks. However, neuroimaging evidence from amblyopia suggests that reduced MOT performance can be explained by impaired function in motion-sensitive area MT+ alone. To test the hypothesis that a subtle disruption of MT+ function could cause MOT impairment, we assessed whether continuous theta burst stimulation (cTBS) of MT+ influenced MOT task accuracy in individuals with normal vision. The MOT stimulus consisted of four target and four distractor dots and was presented at ±10° eccentricity (right/left hemifield). fMRI-guided cTBS was applied to left MT+. Participants (n = 13, age: 27 ± 3) attended separate active and sham cTBS sessions where the MOT task was completed before, 5-min post- and 30-min post-cTBS. Active cTBS significantly impaired MOT task accuracy relative to baseline for the right (stimulated) hemifield 5-min (10 ± 2% reduction) and 30-min (14 ± 3% reduction) post-stimulation. No impairment occurred within the left (control) hemifield after active cTBS or for either hemifield after sham cTBS. These results highlight the importance of lower level motion processing for MOT, suggesting that a minor disruption of MT+ function alone is sufficient to cause a deficit in MOT performance.
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Affiliation(s)
- Arijit Chakraborty
- School of Optometry and Vision Science, Faculty of Science, University of Waterloo, Waterloo, Ontario, Canada.,Chicago College of Optometry, Midwestern University, Downers Grove, Illinois, USA
| | - Tiffany T Tran
- School of Optometry and Vision Science, Faculty of Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Andrew E Silva
- School of Optometry and Vision Science, Faculty of Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Deborah Giaschi
- Department of Ophthalmology and Visual Sciences, University of British Columbia/B.C. Children's Hospital, Vancouver, British Columbia, Canada
| | - Benjamin Thompson
- School of Optometry and Vision Science, Faculty of Science, University of Waterloo, Waterloo, Ontario, Canada.,Centre for Eye and Vision Research (CEVR), Hong Kong, China.,Liggins Institute, University of Auckland, Auckland, New Zealand
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5
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Comparative Study of a Continuous Train of Theta-Burst Stimulation for a Duration of 20 s (cTBS 300) versus a Duration of 40 s (cTBS 600) in a Pre-Stimulation Relaxed Condition in Healthy Volunteers. Brain Sci 2021; 11:brainsci11060737. [PMID: 34205963 PMCID: PMC8230207 DOI: 10.3390/brainsci11060737] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 11/16/2022] Open
Abstract
As variable after effects have been observed following phasic muscle contraction prior to continuous theta-burst stimulation (cTBS), we here investigated two cTBS protocols (cTBS300 and cTBS600) in 20 healthy participants employing a pre-relaxed muscle condition including visual feedback on idle peripheral surface EMG activity. Furthermore, we assessed corticospinal excitability measures also from a pre-relaxed state to better understand the potential impact of these proposed contributors to TBS. Motor-evoked potential (MEP) magnitude changes were assessed for 30 min. The linear model computed across both experimental paradigms (cTBS300 and cTBS600) revealed a main effect of TIME COURSE (p = 0.044). Separate exploratory analysis for cTBS300 revealed a main effect of TIME COURSE (p = 0.031), which did not maintain significance after Greenhouse-Geisser correction (p = 0.073). For cTBS600, no main effects were observed. An exploratory analysis revealed a correlation between relative SICF at 2.0 ms (p = 0.006) and after effects (relative mean change) of cTBS600, which did not survive correction for multiple testing. Our findings thereby do not support the hypothesis of a specific excitability modulating effect of cTBS applied to the human motor-cortex in setups with pre-relaxed muscle conditions.
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6
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Merken L, Davare M, Janssen P, Romero MC. Behavioral effects of continuous theta-burst stimulation in macaque parietal cortex. Sci Rep 2021; 11:4511. [PMID: 33627702 PMCID: PMC7904760 DOI: 10.1038/s41598-021-83904-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 02/01/2021] [Indexed: 11/13/2022] Open
Abstract
The neural mechanisms underlying the effects of continuous Theta-Burst Stimulation (cTBS) in humans are poorly understood. Animal studies can clarify the effects of cTBS on individual neurons, but behavioral evidence is necessary to demonstrate the validity of the animal model. We investigated the behavioral effect of cTBS applied over parietal cortex in rhesus monkeys performing a visually-guided grasping task with two differently sized objects, which required either a power grip or a pad-to-side grip. We used Fitts' law, predicting shorter grasping times (GT) for large compared to small objects, to investigate cTBS effects on two different grip types. cTBS induced long-lasting object-specific and dose-dependent changes in GT that remained present for up to two hours. High-intensity cTBS increased GTs for a power grip, but shortened GTs for a pad-to-side grip. Thus, high-intensity stimulation strongly reduced the natural GT difference between objects (i.e. the Fitts' law effect). In contrast, low-intensity cTBS induced the opposite effects on GT. Modifying the coil orientation from the standard 45-degree to a 30-degree angle induced opposite cTBS effects on GT. These findings represent behavioral evidence for the validity of the nonhuman primate model to study the neural underpinnings of non-invasive brain stimulation.
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Affiliation(s)
- Lara Merken
- Laboratory for Neuro- and Psychophysiology, KU Leuven, 3000, Leuven, Belgium
- Leuven Brain Institute, KU Leuven, 3000, Leuven, Belgium
| | - Marco Davare
- College of Health and Life Sciences and Centre for Cognitive Neuroscience, Brunel University London, UxBridge, UB8 3PN, UK
| | - Peter Janssen
- Laboratory for Neuro- and Psychophysiology, KU Leuven, 3000, Leuven, Belgium
- Leuven Brain Institute, KU Leuven, 3000, Leuven, Belgium
| | - Maria C Romero
- Laboratory for Neuro- and Psychophysiology, KU Leuven, 3000, Leuven, Belgium.
- Leuven Brain Institute, KU Leuven, 3000, Leuven, Belgium.
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Lee H, Mun JS, Jung WR, Lee S, Kang J, Kang W, Kim S, Park SM, Na DL, Shon YM, Kim SJ. Long-Term Non Anesthetic Preclinical Study Available Extra-Cranial Brain Activator (ECBA) System for the Future Minimally Invasive Human Neuro Modulation. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2020; 14:1393-1406. [PMID: 33112749 DOI: 10.1109/tbcas.2020.3034444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In recent years, electroceuticals have been spotlighted as an emerging treatment for various severe chronic brain diseases, owing to their intrinsic advantage of electrical interaction with the brain, which is the most electrically active organ. However, the majority of research has verified only the short-term efficacy through acute studies in laboratory tests owing to the lack of a reliable miniaturized platform for long-term animal studies. The construction of a sufficient integrated system for such a platform is extremely difficult because it requires multi-disciplinary work using state-of-the-art technologies in a wide range of fields. In this study, we propose a complete system of an implantable platform for long-term preclinical brain studies. Our proposed system, the extra-cranial brain activator (ECBA), consists of a titanium-packaged implantable module and a helmet-type base station that powers the module wirelessly. The ECBA can also be controlled by a remote handheld device. Using the ECBA, we performed a long-term non-anesthetic study with multiple canine subjects, and the resulting PET-CT scans demonstrated remarkable enhancement in brain activity relating to memory and sensory skills. Furthermore, the histological analysis and high-temperature aging test confirmed the reliability of the system for up to 31 months. Hence, the proposed ECBA system is expected to lead a new paradigm of human neuromodulation studies in the near future.
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8
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Fujiki M, Kawasaki Y, Fudaba H. Continuous Theta-Burst Stimulation Intensity Dependently Facilitates Motor-Evoked Potentials Following Focal Electrical Stimulation of the Rat Motor Cortex. Front Neural Circuits 2020; 14:585624. [PMID: 33117132 PMCID: PMC7553073 DOI: 10.3389/fncir.2020.585624] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 08/31/2020] [Indexed: 01/28/2023] Open
Abstract
Although theta-burst stimulation (TBS) is known to differentially modify motor cortical excitability according to stimulus conditions in humans, whether similar effects can be seen in animals, in particular rats, remains to be defined. Given the importance of experimental rat models for humans, this study explored this stimulation paradigm in rats. Specifically, this study aimed to explore corticospinal excitability after TBS in anesthetized animals to confirm its comparability with human results. Both inhibition-facilitation configurations using paired electrical stimulation protocols and the effects of the TBS paradigm on motor-evoked potentials (MEPs) in rat descending motor pathways were assessed. Paired-stimulation MEPs showed inhibition [interstimulus interval (ISI): 3 ms] and facilitation (11 ms) patterns under medetomidine/midazolam/butorphanol (MMB) anesthesia. Furthermore, while ketamine and xylazine (K/X) anesthesia completely blocked facilitation at 11-ms ISI, inhibition at a 3-ms ISI was preserved. Continuous and intermittent TBS strongly facilitated MEPs depending on stimulus intensity, persisting for up to 25 min under both MMB and K/X anesthesia. These findings are similar to the intracortical inhibition and facilitation observed in the human motor cortex using paired-pulse magnetic stimulation, particularly the glutamate-mediated facilitation phase. However, different TBS facilitatory mechanisms occur in the rat motor cortex. These different TBS facilitatory mechanisms affect the comparability and interpretations of TBS between rat and human models.
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Affiliation(s)
- Minoru Fujiki
- Department of Neurosurgery, School of Medicine, Oita University, Oita, Japan
| | - Yukari Kawasaki
- Department of Neurosurgery, School of Medicine, Oita University, Oita, Japan
| | - Hirotaka Fudaba
- Department of Neurosurgery, School of Medicine, Oita University, Oita, Japan
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9
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Mosayebi-Samani M, Melo L, Agboada D, Nitsche MA, Kuo MF. Ca2+ channel dynamics explain the nonlinear neuroplasticity induction by cathodal transcranial direct current stimulation over the primary motor cortex. Eur Neuropsychopharmacol 2020; 38:63-72. [PMID: 32768154 DOI: 10.1016/j.euroneuro.2020.07.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 02/13/2020] [Accepted: 07/20/2020] [Indexed: 01/05/2023]
Abstract
Transcranial direct current stimulation (tDCS) induces polarity-dependent neuroplasticity: with conventional protocols, anodal tDCS results in excitability enhancement while cathodal stimulation reduces excitability. However, partially non-linear responses are observed with increased stimulation intensity and/or duration. Cathodal tDCS with 2 mA for 20 min reverses the excitability-diminishing plasticity induced by stimulation with 1 mA into excitation, while cathodal tDCS with 3 mA again results in excitability diminution. Since tDCS generates NMDA receptor-dependent neuroplasticity, such non-linearity could be explained by different levels of calcium concentration changes, which have been demonstrated in animal models to control for the directionality of plasticity. In this study, we tested the calcium dependency of non-linear cortical plasticity induced by cathodal tDCS in human subjects in a placebo controlled, double-blind and randomized design. The calcium channel blocker flunarizine was applied in low (2.5 mg), medium (5 mg) or high (10 mg) dosages before 20 min cathodal motor cortex tDCS with 3 mA in 12 young healthy subjects. After-effects of stimulation were monitored with TMS-induced motor evoked potentials (MEPs) until 2 h after stimulation. The results show that motor cortical excitability-diminishing after-effects of stimulation were unchanged, diminished, or converted to excitability enhancement with low, medium and high dosages of flunarizine. These results suggest a calcium-dependency of the directionality of tDCS-induced neuroplasticity, which may have relevant implications for future basic and clinical research.
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Affiliation(s)
- Mohsen Mosayebi-Samani
- Department Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Ardeystr. 67, 44139 Dortmund, Germany; Institute of Biomedical Engineering and Informatics, Ilmenau University of Technology, Ilmenau, Germany
| | - Lorena Melo
- Department Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Ardeystr. 67, 44139 Dortmund, Germany; International Graduate School of Neuroscience, IGSN, Ruhr University Bochum, Bochum, Germany
| | - Desmond Agboada
- Department Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Ardeystr. 67, 44139 Dortmund, Germany; International Graduate School of Neuroscience, IGSN, Ruhr University Bochum, Bochum, Germany
| | - Michael A Nitsche
- Department Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Ardeystr. 67, 44139 Dortmund, Germany; Department of Neurology, University Hospital Bergmannsheil, Bochum, Germany
| | - Min-Fang Kuo
- Department Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Ardeystr. 67, 44139 Dortmund, Germany.
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D'Amico JM, Dongés SC, Taylor JL. High-intensity, low-frequency repetitive transcranial magnetic stimulation enhances excitability of the human corticospinal pathway. J Neurophysiol 2020; 123:1969-1978. [PMID: 32292098 DOI: 10.1152/jn.00607.2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Paired corticospinal-motoneuronal stimulation (PCMS) is the repeated pairing of transcranial magnetic stimulation (TMS) with peripheral nerve stimulation to modify corticospinal synapses; however, it has yet to be determined whether PCMS modulates cortical excitability in a manner similar to paired-associative stimulation protocols. In this study, we first examined the effects of PCMS on adductor pollicis motor evoked potentials (MEPs). In experiment 1, on 2 separate days PCMS (repetitive, high-intensity TMS and ulnar nerve stimulation pairs; 1.5-ms interstimulus interval; 0.1 Hz) was compared with control conditioning of repetitive high-intensity TMS-only stimuli (0.1 Hz). Before and after conditioning, adductor pollicis MEPs were elicited using low-intensity TMS in three different coil orientations to preferentially activate corticospinal axons directly (thus bypassing cortical effects) or indirectly (cortical effects present). Unexpectedly, similar MEP increases were seen for all orientations on both PCMS (129 to 136% of baseline) and control days (108 to 129% of baseline). Given the common factor between conditioning protocols was repeated, high-intensity TMS, further experiments were performed to characterize this repetitive TMS (rTMS) protocol. In experiment 2, an intensity dependence of the rTMS protocol was revealed by a lack of change in MEPs elicited after repetitive low-intensity TMS (0.1 Hz; P = 0.37). In experiment 3, MEP recruitment curve and paired pulse analyses showed that the high-intensity rTMS protocol increased MEPs over a range of stimulus intensities but that effects were not accompanied by changes in intracortical inhibition or facilitation (P > 0.12). These experiments reveal a novel high-intensity, low-frequency rTMS protocol for enhancing corticospinal excitability.NEW & NOTEWORTHY In this study, we present a novel, intensity-dependent repetitive transcranial magnetic stimulation (rTMS) protocol that induces lasting, plastic changes within the corticospinal tract. High-intensity rTMS at a frequency of 0.1 Hz induces facilitation of motor evoked potentials (MEPs) lasting at least 35 min. Additionally, these changes are not limited only to small MEPs but occur throughout the recruitment curve. Finally, facilitation of MEPs following high-intensity rTMS does not appear to be due to changes in intracortical inhibition or facilitation.
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Affiliation(s)
| | | | - Janet L Taylor
- Neuroscience Research Australia, Sydney, Australia.,University of New South Wales, Sydney, Australia
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11
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Expanding the parameter space of anodal transcranial direct current stimulation of the primary motor cortex. Sci Rep 2019; 9:18185. [PMID: 31796827 PMCID: PMC6890804 DOI: 10.1038/s41598-019-54621-0] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 11/18/2019] [Indexed: 12/20/2022] Open
Abstract
Size and duration of the neuroplastic effects of tDCS depend on stimulation parameters, including stimulation duration and intensity of current. The impact of stimulation parameters on physiological effects is partially non-linear. To improve the utility of this intervention, it is critical to gather information about the impact of stimulation duration and intensity on neuroplasticity, while expanding the parameter space to improve efficacy. Anodal tDCS of 1–3 mA current intensity was applied for 15–30 minutes to study motor cortex plasticity. Sixteen healthy right-handed non-smoking volunteers participated in 10 sessions (intensity-duration pairs) of stimulation in a randomized cross-over design. Transcranial magnetic stimulation (TMS)-induced motor-evoked potentials (MEP) were recorded as outcome measures of tDCS effects until next evening after tDCS. All active stimulation conditions enhanced motor cortex excitability within the first 2 hours after stimulation. We observed no significant differences between the three stimulation intensities and durations on cortical excitability. A trend for larger cortical excitability enhancements was however observed for higher current intensities (1 vs 3 mA). These results add information about intensified tDCS protocols and suggest that the impact of anodal tDCS on neuroplasticity is relatively robust with respect to gradual alterations of stimulation intensity, and duration.
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12
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Edmond EC, Stagg CJ, Turner MR. Therapeutic non-invasive brain stimulation in amyotrophic lateral sclerosis: rationale, methods and experience. J Neurol Neurosurg Psychiatry 2019; 90:1131-1138. [PMID: 31072957 DOI: 10.1136/jnnp-2018-320213] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 03/29/2019] [Accepted: 04/08/2019] [Indexed: 01/24/2023]
Abstract
The neurodegenerative syndrome amyotrophic lateral sclerosis (ALS) is characterised by increased cortical excitability, thought to reflect pathological changes in the balance of local excitatory and inhibitory neuronal influences. Non-invasive brain stimulation (NIBS) has been shown to modulate cortical activity, with some protocols showing effects that outlast the stimulation by months. NIBS has been suggested as a potential therapeutic approach for disorders associated with changes in cortical neurophysiology, including ALS. This article reviews NIBS methodology, rationale for its application to ALS and progress to date.
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Affiliation(s)
- Evan C Edmond
- Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, UK.,Wellcome Centre for Integrative Neuroimaging, Oxford University, Oxford, UK.,Oxford Centre for Human Brain Activity (OHBA), Oxford University, Oxford, UK.,Oxford Centre for Functional MRI of the Brain (FMRIB), Oxford University, Oxford, UK
| | - Charlotte J Stagg
- Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, UK.,Wellcome Centre for Integrative Neuroimaging, Oxford University, Oxford, UK.,Oxford Centre for Human Brain Activity (OHBA), Oxford University, Oxford, UK.,Oxford Centre for Functional MRI of the Brain (FMRIB), Oxford University, Oxford, UK
| | - Martin R Turner
- Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, UK .,Wellcome Centre for Integrative Neuroimaging, Oxford University, Oxford, UK.,Oxford Centre for Human Brain Activity (OHBA), Oxford University, Oxford, UK.,Oxford Centre for Functional MRI of the Brain (FMRIB), Oxford University, Oxford, UK
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Ekhtiari H, Tavakoli H, Addolorato G, Baeken C, Bonci A, Campanella S, Castelo-Branco L, Challet-Bouju G, Clark VP, Claus E, Dannon PN, Del Felice A, den Uyl T, Diana M, di Giannantonio M, Fedota JR, Fitzgerald P, Gallimberti L, Grall-Bronnec M, Herremans SC, Herrmann MJ, Jamil A, Khedr E, Kouimtsidis C, Kozak K, Krupitsky E, Lamm C, Lechner WV, Madeo G, Malmir N, Martinotti G, McDonald WM, Montemitro C, Nakamura-Palacios EM, Nasehi M, Noël X, Nosratabadi M, Paulus M, Pettorruso M, Pradhan B, Praharaj SK, Rafferty H, Sahlem G, Salmeron BJ, Sauvaget A, Schluter RS, Sergiou C, Shahbabaie A, Sheffer C, Spagnolo PA, Steele VR, Yuan TF, van Dongen JDM, Van Waes V, Venkatasubramanian G, Verdejo-García A, Verveer I, Welsh JW, Wesley MJ, Witkiewitz K, Yavari F, Zarrindast MR, Zawertailo L, Zhang X, Cha YH, George TP, Frohlich F, Goudriaan AE, Fecteau S, Daughters SB, Stein EA, Fregni F, Nitsche MA, Zangen A, Bikson M, Hanlon CA. Transcranial electrical and magnetic stimulation (tES and TMS) for addiction medicine: A consensus paper on the present state of the science and the road ahead. Neurosci Biobehav Rev 2019; 104:118-140. [PMID: 31271802 PMCID: PMC7293143 DOI: 10.1016/j.neubiorev.2019.06.007] [Citation(s) in RCA: 169] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/30/2019] [Accepted: 06/08/2019] [Indexed: 12/21/2022]
Abstract
There is growing interest in non-invasive brain stimulation (NIBS) as a novel treatment option for substance-use disorders (SUDs). Recent momentum stems from a foundation of preclinical neuroscience demonstrating links between neural circuits and drug consuming behavior, as well as recent FDA-approval of NIBS treatments for mental health disorders that share overlapping pathology with SUDs. As with any emerging field, enthusiasm must be tempered by reason; lessons learned from the past should be prudently applied to future therapies. Here, an international ensemble of experts provides an overview of the state of transcranial-electrical (tES) and transcranial-magnetic (TMS) stimulation applied in SUDs. This consensus paper provides a systematic literature review on published data - emphasizing the heterogeneity of methods and outcome measures while suggesting strategies to help bridge knowledge gaps. The goal of this effort is to provide the community with guidelines for best practices in tES/TMS SUD research. We hope this will accelerate the speed at which the community translates basic neuroscience into advanced neuromodulation tools for clinical practice in addiction medicine.
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Affiliation(s)
| | - Hosna Tavakoli
- Institute for Cognitive Science Studies (ICSS), Iran; Iranian National Center for Addiction Studies (INCAS), Iran
| | - Giovanni Addolorato
- Alcohol Use Disorder Unit, Division of Internal Medicine, Gastroenterology and Hepatology Unit, Catholic University of Rome, A. Gemelli Hospital, Rome, Italy; Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Chris Baeken
- Department of Psychiatry and Medical Psychology, University Hospital Ghent, Ghent, Belgium
| | - Antonello Bonci
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA; Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | | | - Vincent P Clark
- University of New Mexico, USA; The Mind Research Network, USA
| | | | | | - Alessandra Del Felice
- University of Padova, Department of Neuroscience, Padova, Italy; Padova Neuroscience Center (PNC), University of Padova, Padova, Italy
| | | | - Marco Diana
- 'G. Minardi' Laboratory of Cognitive Neuroscience, Department of Chemistry and Pharmacy, University of Sassari, Italy
| | | | - John R Fedota
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | | | - Luigi Gallimberti
- Novella Fronda Foundation, Human Science and Brain Research, Padua, Italy
| | | | - Sarah C Herremans
- Department of Psychiatry and Medical Psychology, University Hospital Ghent, Ghent, Belgium
| | - Martin J Herrmann
- Center of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - Asif Jamil
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | | | | | - Karolina Kozak
- University of Toronto, Canada; Centre for Addiction and Mental Health (CAMH), Canada
| | - Evgeny Krupitsky
- V. M. Bekhterev National Medical Research Center for Psychiatry and Neurology, St.-Petersburg, Russia; St.-Petersburg First Pavlov State Medical University, Russia
| | - Claus Lamm
- Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Austria
| | | | - Graziella Madeo
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | | | | | - William M McDonald
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Chiara Montemitro
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA; University G.d'Annunzio of Chieti-Pescara, Italy
| | | | - Mohammad Nasehi
- Cognitive and Neuroscience Research Center (CNRC), Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Xavier Noël
- Université Libre de Bruxelles (ULB), Belgium
| | | | | | | | | | - Samir K Praharaj
- Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Haley Rafferty
- Spaulding Rehabilitation Hospital, Harvard Medical School, USA
| | | | - Betty Jo Salmeron
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | - Anne Sauvaget
- Laboratory «Movement, Interactions, Performance» (E.A. 4334), University of Nantes, 25 Bis Boulevard Guy Mollet, BP 72206, 44322, Nantes Cedex 3, France; CHU de Nantes Addictology and Liaison Psychiatry Department, University Hospital Nantes, Nantes Cedex 3, France
| | - Renée S Schluter
- Laureate Institute for Brain Research, USA; Institute for Cognitive Science Studies (ICSS), Iran
| | | | - Alireza Shahbabaie
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | | | | | - Vaughn R Steele
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Ti-Fei Yuan
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, China
| | | | - Vincent Van Waes
- Laboratoire de Neurosciences Intégratives et Cliniques EA481, Université Bourgogne Franche-Comté, Besançon, France
| | | | | | | | - Justine W Welsh
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | | | | | - Fatemeh Yavari
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Mohammad-Reza Zarrindast
- Department of Pharmacology School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Laurie Zawertailo
- University of Toronto, Canada; Centre for Addiction and Mental Health (CAMH), Canada
| | - Xiaochu Zhang
- University of Science and Technology of China, China
| | | | - Tony P George
- University of Toronto, Canada; Centre for Addiction and Mental Health (CAMH), Canada
| | | | - Anna E Goudriaan
- Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Arkin, Department of Research and Quality of Care, Amsterdam, The Netherlands
| | | | | | - Elliot A Stein
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Felipe Fregni
- Spaulding Rehabilitation Hospital, Harvard Medical School, USA
| | - Michael A Nitsche
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; University Medical Hospital Bergmannsheil, Dept. Neurology, Bochum, Germany
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Medium- and high-intensity rTMS reduces psychomotor agitation with distinct neurobiologic mechanisms. Transl Psychiatry 2018; 8:126. [PMID: 29976924 PMCID: PMC6033856 DOI: 10.1038/s41398-018-0129-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 12/20/2017] [Accepted: 02/18/2018] [Indexed: 12/21/2022] Open
Abstract
Definitive data are lacking on the mechanism of action and biomarkers of repetitive transcranial magnetic stimulation (rTMS) for the treatment of depression. Low-intensity rTMS (LI-rTMS) has demonstrated utility in preclinical models of rTMS treatments but the effects of LI-rTMS in murine models of depression are unknown. We examined the behavioral and neurobiologic changes in olfactory bulbectomy (OB) mice with medium-intensity rTMS (MI-rTMS) treatment and fluoxetine hydrochloride. We then compared 10-Hz rTMS sessions for 3 min at intensities (measured at the cortical surface) of 4 mT (LI-rTMS), 50 mT (medium-intensity rTMS [MI-rTMS]), or 1 T (high-intensity rTMS [HI-rTMS]) 5 days per week over 4 weeks in an OB model of agitated depression. Behavioral effects were assessed with forced swim test; neurobiologic effects were assessed with brain levels of 5-hydroxytryptamine, brain-derived neurotrophic factor (BDNF), and neurogenesis. Peripheral metabolomic changes induced by OB and rTMS were monitored through enzyme-linked immunosorbent assay and ultrapressure liquid chromatography-driven targeted metabolomics evaluated with ingenuity pathway analysis (IPA). MI-rTMS and HI-rTMS attenuated psychomotor agitation but only MI-rTMS increased BDNF and neurogenesis levels. HI-rTMS normalized the plasma concentration of α-amino-n-butyric acid and 3-methylhistidine. IPA revealed significant changes in glutamine processing and glutamate signaling in the OB model and following MI-rTMS and HI-rTMS treatment. The present findings suggest that MI-rTMS and HI-rTMS induce differential neurobiologic changes in a mouse model of agitated depression. Further, α-amino-n-butyric acid and 3-methylhistidine may have utility as biomarkers to objectively monitor the response to rTMS treatment of depression.
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Tse NY, Goldsworthy MR, Ridding MC, Coxon JP, Fitzgerald PB, Fornito A, Rogasch NC. The effect of stimulation interval on plasticity following repeated blocks of intermittent theta burst stimulation. Sci Rep 2018; 8:8526. [PMID: 29867191 PMCID: PMC5986739 DOI: 10.1038/s41598-018-26791-w] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 05/18/2018] [Indexed: 12/12/2022] Open
Abstract
This study assessed the effect of interval duration on the direction and magnitude of changes in cortical excitability and inhibition when applying repeated blocks of intermittent theta burst stimulation (iTBS) over motor cortex. 15 participants received three different iTBS conditions on separate days: single iTBS; repeated iTBS with a 5 minute interval (iTBS-5-iTBS); and with a 15 minute interval (iTBS-15-iTBS). Changes in cortical excitability and short-interval cortical inhibition (SICI) were assessed via motor-evoked potentials (MEPs) before and up to 60 mins following stimulation. iTBS-15-iTBS increased MEP amplitude for up to 60 mins post stimulation, whereas iTBS-5-iTBS decreased MEP amplitude. In contrast, MEP amplitude was not altered by single iTBS. Despite the group level findings, only 53% of individuals showed facilitated MEPs following iTBS-15-iTBS, and only 40% inhibited MEPs following iTBS-5-iTBS. Modulation of SICI did not differ between conditions. These results suggest interval duration between spaced iTBS plays an important role in determining the direction of plasticity on excitatory, but not inhibitory circuits in human motor cortex. While repeated iTBS can increase the magnitude of MEP facilitation/inhibition in some individuals compared to single iTBS, the response to repeated iTBS appears variable between individuals in this small sample.
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Affiliation(s)
- Nga Yan Tse
- Brain and Mental Health Research Hub, School of Psychological Sciences, Monash Institute of Cognitive and Clinical Neuroscience, and Monash Biomedical Imaging, Monash University, Melbourne, Australia
| | - Mitchell R Goldsworthy
- Neuromotor Plasticity and Development, Robinson Research Institute, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Michael C Ridding
- Neuromotor Plasticity and Development, Robinson Research Institute, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - James P Coxon
- School of Psychological Sciences, Monash Institute of Cognitive and Clinical Neuroscience, Monash University, Melbourne, Australia
| | - Paul B Fitzgerald
- Epworth Healthcare, The Epworth Clinic and Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University, Melbourne, Australia
| | - Alex Fornito
- Brain and Mental Health Research Hub, School of Psychological Sciences, Monash Institute of Cognitive and Clinical Neuroscience, and Monash Biomedical Imaging, Monash University, Melbourne, Australia
| | - Nigel C Rogasch
- Brain and Mental Health Research Hub, School of Psychological Sciences, Monash Institute of Cognitive and Clinical Neuroscience, and Monash Biomedical Imaging, Monash University, Melbourne, Australia.
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16
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Chung SW, Rogasch NC, Hoy KE, Sullivan CM, Cash RFH, Fitzgerald PB. Impact of different intensities of intermittent theta burst stimulation on the cortical properties during TMS-EEG and working memory performance. Hum Brain Mapp 2017; 39:783-802. [PMID: 29124791 DOI: 10.1002/hbm.23882] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/09/2017] [Accepted: 11/02/2017] [Indexed: 02/06/2023] Open
Abstract
Intermittent theta burst stimulation (iTBS) is a noninvasive brain stimulation technique capable of increasing cortical excitability beyond the stimulation period. Due to the rapid induction of modulatory effects, prefrontal application of iTBS is gaining popularity as a therapeutic tool for psychiatric disorders such as depression. In an attempt to increase efficacy, higher than conventional intensities are currently being applied. The assumption that this increases neuromodulatory may be mechanistically false for iTBS. This study examined the influence of intensity on the neurophysiological and behavioural effects of iTBS in the prefrontal cortex. Sixteen healthy participants received iTBS over prefrontal cortex at either 50, 75 or 100% resting motor threshold in separate sessions. Single-pulse TMS and concurrent electroencephalography (EEG) was used to assess changes in cortical reactivity measured as TMS-evoked potentials and oscillations. The n-back task was used to assess changes in working memory performance. The data can be summarised as an inverse U-shape relationship between intensity and iTBS plastic effects, where 75% iTBS yielded the largest neurophysiological changes. Improvement in reaction time in the 3-back task was supported by the change in alpha power, however, comparison between conditions revealed no significant differences. The assumption that higher intensity results in greater neuromodulatory effects may be false, at least in healthy individuals, and should be carefully considered for clinical populations. Neurophysiological changes associated with working memory following iTBS suggest functional relevance. However, the effects of different intensities on behavioural performance remain elusive in the present healthy sample.
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Affiliation(s)
- Sung Wook Chung
- Monash Alfred Psychiatry Research Centre, Monash University, Central Clinical School and The Alfred, Melbourne, Australia
| | - Nigel C Rogasch
- Brain and Mental Health Laboratory, School of Psychological Sciences and Monash Biomedical Imaging, Monash Institute of Cognitive and Clinical Neuroscience, Monash University, Melbourne, Australia
| | - Kate E Hoy
- Monash Alfred Psychiatry Research Centre, Monash University, Central Clinical School and The Alfred, Melbourne, Australia
| | - Caley M Sullivan
- Monash Alfred Psychiatry Research Centre, Monash University, Central Clinical School and The Alfred, Melbourne, Australia
| | - Robin F H Cash
- Monash Alfred Psychiatry Research Centre, Monash University, Central Clinical School and The Alfred, Melbourne, Australia
| | - Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Monash University, Central Clinical School and The Alfred, Melbourne, Australia.,Epworth Clinic, Epworth Healthcare, Camberwell, VIC, Australia
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17
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Rastogi A, Cash R, Dunlop K, Vesia M, Kucyi A, Ghahremani A, Downar J, Chen J, Chen R. Modulation of cognitive cerebello-cerebral functional connectivity by lateral cerebellar continuous theta burst stimulation. Neuroimage 2017; 158:48-57. [DOI: 10.1016/j.neuroimage.2017.06.048] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 05/27/2017] [Accepted: 06/20/2017] [Indexed: 11/17/2022] Open
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18
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Dissanayaka T, Zoghi M, Farrell M, Egan GF, Jaberzadeh S. Does transcranial electrical stimulation enhance corticospinal excitability of the motor cortex in healthy individuals? A systematic review and meta-analysis. Eur J Neurosci 2017; 46:1968-1990. [DOI: 10.1111/ejn.13640] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 07/03/2017] [Accepted: 07/04/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Thusharika Dissanayaka
- Department of Physiotherapy; School of Primary Health Care; Faculty of Medicine; Nursing and Health Sciences; Monash University; Melbourne Victoria Australia
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport; School of Allied Health; La Trobe University; Bundoora Victoria Australia
| | - Michael Farrell
- Monash Biomedical Imaging; Monash University; Melbourne Victoria Australia
- Biomedicine Discovery Institute and Department of Medical Imaging and Radiation Sciences; Monash University; Melbourne Victoria Australia
| | - Gary F. Egan
- Monash Biomedical Imaging; Monash University; Melbourne Victoria Australia
| | - Shapour Jaberzadeh
- Department of Physiotherapy; School of Primary Health Care; Faculty of Medicine; Nursing and Health Sciences; Monash University; Melbourne Victoria Australia
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19
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Cash RF, Dar A, Hui J, De Ruiter L, Baarbé J, Fettes P, Peters S, Fitzgerald PB, Downar J, Chen R. Influence of inter-train interval on the plastic effects of rTMS. Brain Stimul 2017; 10:630-636. [DOI: 10.1016/j.brs.2017.02.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 02/14/2017] [Accepted: 02/28/2017] [Indexed: 01/16/2023] Open
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20
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Selective TMS-induced modulation of functional connectivity correlates with changes in behavior. Neuroimage 2017; 149:361-378. [DOI: 10.1016/j.neuroimage.2017.01.076] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 01/06/2017] [Accepted: 01/30/2017] [Indexed: 11/19/2022] Open
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21
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Jamil A, Batsikadze G, Kuo H, Labruna L, Hasan A, Paulus W, Nitsche MA. Systematic evaluation of the impact of stimulation intensity on neuroplastic after-effects induced by transcranial direct current stimulation. J Physiol 2017; 595:1273-1288. [PMID: 27723104 PMCID: PMC5309387 DOI: 10.1113/jp272738] [Citation(s) in RCA: 246] [Impact Index Per Article: 35.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 10/04/2016] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS Applications of transcranial direct current stimulation to modulate human neuroplasticity have increased in research and clinical settings. However, the need for longer-lasting effects, combined with marked inter-individual variability, necessitates a deeper understanding of the relationship between stimulation parameters and physiological effects. We systematically investigated the full DC intensity range (0.5-2.0 mA) for both anodal and cathodal tDCS in a sham-controlled repeated measures design, monitoring changes in motor-cortical excitability via transcranial magnetic stimulation up to 2 h after stimulation. For both tDCS polarities, the excitability after-effects did not linearly correlate with increasing DC intensity; effects of lower intensities (0.5, 1.0 mA) showed equal, if not greater effects in motor-cortical excitability. Further, while intra-individual responses showed good reliability, inter-individual sensitivity to TMS accounted for a modest percentage of the variance in the early after-effects of 1.0 mA anodal tDCS, which may be of practical relevance for future optimizations. ABSTRACT Contemporary non-invasive neuromodulatory techniques, such as transcranial direct current stimulation (tDCS), have shown promising potential in both restituting impairments in cortical physiology in clinical settings, as well as modulating cognitive abilities in the healthy population. However, neuroplastic after-effects of tDCS are highly dependent on stimulation parameters, relatively short lasting, and not expectedly uniform between individuals. The present study systematically investigates the full range of current intensity between 0.5 and 2.0 mA on left primary motor cortex (M1) plasticity, as well as the impact of individual-level covariates on explaining inter-individual variability. Thirty-eight healthy subjects were divided into groups of anodal and cathodal tDCS. Five DC intensities (sham, 0.5, 1.0, 1.5 and 2.0 mA) were investigated in separate sessions. Using transcranial magnetic stimulation (TMS), 25 motor-evoked potentials (MEPs) were recorded before, and 10 time points up to 2 h following 15 min of tDCS. Repeated-measures ANOVAs indicated a main effect of intensity for both anodal and cathodal tDCS. With anodal tDCS, all active intensities resulted in equivalent facilitatory effects relative to sham while for cathodal tDCS, only 1.0 mA resulted in sustained excitability diminution. An additional experiment conducted to assess intra-individual variability revealed generally good reliability of 1.0 mA anodal tDCS (ICC(2,1) = 0.74 over the first 30 min). A post hoc analysis to discern sources of inter-individual variability confirmed a previous finding in which individual TMS SI1mV (stimulus intensity for 1 mV MEP amplitude) sensitivity correlated negatively with 1.0 mA anodal tDCS effects on excitability. Our study thus provides further insights on the extent of non-linear intensity-dependent neuroplastic after-effects of anodal and cathodal tDCS.
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Affiliation(s)
- Asif Jamil
- Department of Clinical NeurophysiologyUniversity Medical Center, University of Göttingen37075GöttingenGermany
- Leibniz Research Centre for Working Environment and Human Factors44139DortmundGermany
| | - Giorgi Batsikadze
- Department of Clinical NeurophysiologyUniversity Medical Center, University of Göttingen37075GöttingenGermany
| | - Hsiao‐I. Kuo
- Department of Clinical NeurophysiologyUniversity Medical Center, University of Göttingen37075GöttingenGermany
- Leibniz Research Centre for Working Environment and Human Factors44139DortmundGermany
| | - Ludovica Labruna
- Department of PsychologyUniversity of CaliforniaBerkeleyCA94720USA
| | - Alkomiet Hasan
- Department of Psychiatry and PsychotherapyKlinikum der Universität München80336MünchenGermany
| | - Walter Paulus
- Department of Clinical NeurophysiologyUniversity Medical Center, University of Göttingen37075GöttingenGermany
| | - Michael A. Nitsche
- Leibniz Research Centre for Working Environment and Human Factors44139DortmundGermany
- University Medical Hospital Bergmannsheil44789BochumGermany
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22
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Karabanov A, Ziemann U, Hamada M, George MS, Quartarone A, Classen J, Massimini M, Rothwell J, Siebner HR. Consensus Paper: Probing Homeostatic Plasticity of Human Cortex With Non-invasive Transcranial Brain Stimulation. Brain Stimul 2016; 8:993-1006. [PMID: 26598772 DOI: 10.1016/j.brs.2015.06.017] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Homeostatic plasticity is thought to stabilize neural activity around a set point within a physiologically reasonable dynamic range. Over the last ten years, a wide range of non-invasive transcranial brain stimulation (NTBS) techniques have been used to probe homeostatic control of cortical plasticity in the intact human brain. Here, we review different NTBS approaches to study homeostatic plasticity on a systems level and relate the findings to both, physiological evidence from in vitro studies and to a theoretical framework of homeostatic function. We highlight differences between homeostatic and other non-homeostatic forms of plasticity and we examine the contribution of sleep in restoring synaptic homeostasis. Finally, we discuss the growing number of studies showing that abnormal homeostatic plasticity may be associated to a range of neuropsychiatric diseases.
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23
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Chung SW, Hill AT, Rogasch NC, Hoy KE, Fitzgerald PB. Use of theta-burst stimulation in changing excitability of motor cortex: A systematic review and meta-analysis. Neurosci Biobehav Rev 2016; 63:43-64. [PMID: 26850210 DOI: 10.1016/j.neubiorev.2016.01.008] [Citation(s) in RCA: 163] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 12/30/2015] [Accepted: 01/26/2016] [Indexed: 12/13/2022]
Abstract
Noninvasive brain stimulation has been demonstrated to modulate cortical activity in humans. In particular, theta burst stimulation (TBS) has gained notable attention due to its ability to induce lasting physiological changes after short stimulation durations. The present study aimed to provide a comprehensive meta-analytic review of the efficacy of two TBS paradigms; intermittent (iTBS) and continuous (cTBS), on corticospinal excitability in healthy individuals. Literature searches yielded a total of 87 studies adhering to the inclusion criteria. iTBS yielded moderately large MEP increases lasting up to 30 min with a pooled SMD of 0.71 (p<0.00001). cTBS produced a reduction in MEP amplitudes lasting up to 60 min, with the largest effect size seen at 5 min post stimulation (SMD=-0.9, P<0.00001). The collected studies were of heterogeneous nature, and a series of tests conducted indicated a degree of publication bias. No significant change in SICI and ICF was observed, with exception to decrease in SICI with cTBS at the early time point (SMD=0.42, P=0.00036). The results also highlight several factors contributing to TBS efficacy, including the number of pulses, frequency of stimulation and BDNF polymorphisms. Further research investigating optimal TBS stimulation parameters, particularly for iTBS, is needed in order for these paradigms to be successfully translated into clinical settings.
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Affiliation(s)
- Sung Wook Chung
- Monash Alfred Psychiatry Research Centre, Central Clinical School, The Alfred and Monash University, Melbourne, Australia.
| | - Aron T Hill
- Monash Alfred Psychiatry Research Centre, Central Clinical School, The Alfred and Monash University, Melbourne, Australia
| | - Nigel C Rogasch
- Brain and Mental Health Laboratory, School of Psychological Sciences and Monash Biomedical Imaging, Monash University, Melbourne, Australia
| | - Kate E Hoy
- Monash Alfred Psychiatry Research Centre, Central Clinical School, The Alfred and Monash University, Melbourne, Australia
| | - Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Central Clinical School, The Alfred and Monash University, Melbourne, Australia
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24
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Opitz A, Fox MD, Craddock RC, Colcombe S, Milham MP. An integrated framework for targeting functional networks via transcranial magnetic stimulation. Neuroimage 2015; 127:86-96. [PMID: 26608241 DOI: 10.1016/j.neuroimage.2015.11.040] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 11/13/2015] [Accepted: 11/15/2015] [Indexed: 12/17/2022] Open
Abstract
Transcranial magnetic stimulation (TMS) is a powerful investigational tool for in vivo manipulation of regional or network activity, with a growing number of potential clinical applications. Unfortunately, the vast majority of targeting strategies remain limited by their reliance on non-realistic brain models and assumptions that anatomo-functional relationships are 1:1. Here, we present an integrated framework that combines anatomically realistic finite element models of the human head with resting functional MRI to predict functional networks targeted via TMS at a given coil location and orientation. Using data from the Human Connectome Project, we provide an example implementation focused on dorsolateral prefrontal cortex (DLPFC). Three distinct DLPFC stimulation zones were identified, differing with respect to the network to be affected (default, frontoparietal) and sensitivity to coil orientation. Network profiles generated for DLPFC targets previously published for treating depression revealed substantial variability across studies, highlighting a potentially critical technical issue.
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Affiliation(s)
- Alexander Opitz
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Center for the Developing Brain, Child Mind Institute, New York, NY, USA.
| | - Michael D Fox
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, MA, USA
| | - R Cameron Craddock
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Center for the Developing Brain, Child Mind Institute, New York, NY, USA
| | - Stan Colcombe
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Michael P Milham
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Center for the Developing Brain, Child Mind Institute, New York, NY, USA.
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Karabanov A, Ziemann U, Hamada M, George MS, Quartarone A, Classen J, Massimini M, Rothwell J, Siebner HR. Consensus Paper: Probing Homeostatic Plasticity of Human Cortex With Non-invasive Transcranial Brain Stimulation. Brain Stimul 2015; 8:442-54. [DOI: 10.1016/j.brs.2015.01.404] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 01/03/2015] [Accepted: 01/13/2015] [Indexed: 01/03/2023] Open
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Wischnewski M, Schutter DJLG. Efficacy and Time Course of Theta Burst Stimulation in Healthy Humans. Brain Stimul 2015; 8:685-92. [PMID: 26014214 DOI: 10.1016/j.brs.2015.03.004] [Citation(s) in RCA: 180] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 03/12/2015] [Accepted: 03/20/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND In the past decade research has shown that continuous (cTBS) and intermittent theta burst stimulation (iTBS) alter neuronal excitability levels in the primary motor cortex. OBJECTIVE Quantitatively review the magnitude and time course on cortical excitability of cTBS and iTBS. METHODS Sixty-four TBS studies published between January 2005 and October 2014 were retrieved from the scientific search engine PubMED and included for analyses. The main inclusion criteria involved stimulation of the primary motor cortex in healthy volunteers with no motor practice prior to intervention and motor evoked potentials as primary outcome measure. RESULTS ITBS applied for 190 s significantly increases cortical excitability up to 60 min with a mean maximum potentiation of 35.54 ± 3.32%. CTBS applied for 40 s decreases cortical excitability up to 50 min with a mean maximum depression of -22.81 ± 2.86%, while cTBS applied for 20 s decreases cortical excitability (mean maximum -27.84 ± 4.15%) for 20 min. CONCLUSION The present findings offer normative insights into the magnitude and time course of TBS-induced changes in cortical excitability levels.
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Affiliation(s)
- Miles Wischnewski
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, the Netherlands.
| | - Dennis J L G Schutter
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, the Netherlands
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Intensity sensitive modulation effect of theta burst form of median nerve stimulation on the monosynaptic spinal reflex. Neural Plast 2015; 2015:704849. [PMID: 25821603 PMCID: PMC4364050 DOI: 10.1155/2015/704849] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 02/22/2015] [Indexed: 01/05/2023] Open
Abstract
The effects of electrical stimulation of median nerve with a continuous theta burst pattern (EcTBS) on the spinal H-reflex were studied. Different intensities and durations of EcTBS were given to the median nerve to 11 healthy individuals. The amplitude ratio of the H-reflex to maximum M wave (H/M ratio), corticospinal excitability and inhibition measured using motor evoked potentials (MEPs), short-interval intracortical inhibition and facilitation (SICI/ICF), spinal reciprocal inhibition (RI), and postactivation depression (PAD) were measured before and after EcTBS. In result, the H/M ratio was reduced followed by EcTBS at 90% H-reflex threshold, and the effect lasted longer after 1200 pulses than after 600 pulses of EcTBS. In contrast, EcTBS at 110% threshold facilitated the H/M ratio, while at 80% threshold it had no effect. Maximum M wave, MEPs, SICI/ICF, RI, and PAD all remained unchanged after EcTBS. In conclusion, EcTBS produced lasting effects purely on the H-reflex, probably, through effects on postsynaptic plasticity. The effect of EcTBS depends on the intensity and duration of stimulation. EcTBS is beneficial to research on mechanisms of human plasticity. Moreover, its ability to modulate spinal excitability is expected to have therapeutic benefits on neurological disorders involving spinal cord dysfunction.
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Rossini PM, Burke D, Chen R, Cohen LG, Daskalakis Z, Di Iorio R, Di Lazzaro V, Ferreri F, Fitzgerald PB, George MS, Hallett M, Lefaucheur JP, Langguth B, Matsumoto H, Miniussi C, Nitsche MA, Pascual-Leone A, Paulus W, Rossi S, Rothwell JC, Siebner HR, Ugawa Y, Walsh V, Ziemann U. Non-invasive electrical and magnetic stimulation of the brain, spinal cord, roots and peripheral nerves: Basic principles and procedures for routine clinical and research application. An updated report from an I.F.C.N. Committee. Clin Neurophysiol 2015; 126:1071-1107. [PMID: 25797650 PMCID: PMC6350257 DOI: 10.1016/j.clinph.2015.02.001] [Citation(s) in RCA: 1726] [Impact Index Per Article: 191.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 01/22/2015] [Accepted: 02/01/2015] [Indexed: 12/14/2022]
Abstract
These guidelines provide an up-date of previous IFCN report on “Non-invasive electrical and magnetic stimulation of the brain, spinal cord and roots: basic principles and procedures for routine clinical application” (Rossini et al., 1994). A new Committee, composed of international experts, some of whom were in the panel of the 1994 “Report”, was selected to produce a current state-of-the-art review of non-invasive stimulation both for clinical application and research in neuroscience. Since 1994, the international scientific community has seen a rapid increase in non-invasive brain stimulation in studying cognition, brain–behavior relationship and pathophysiology of various neurologic and psychiatric disorders. New paradigms of stimulation and new techniques have been developed. Furthermore, a large number of studies and clinical trials have demonstrated potential therapeutic applications of non-invasive brain stimulation, especially for TMS. Recent guidelines can be found in the literature covering specific aspects of non-invasive brain stimulation, such as safety (Rossi et al., 2009), methodology (Groppa et al., 2012) and therapeutic applications (Lefaucheur et al., 2014). This up-dated review covers theoretical, physiological and practical aspects of non-invasive stimulation of brain, spinal cord, nerve roots and peripheral nerves in the light of more updated knowledge, and include some recent extensions and developments.
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Affiliation(s)
- P M Rossini
- Institute of Neurology, Department of Geriatrics, Neuroscience and Orthopedics, Catholic University, Policlinic A. Gemelli, Rome, Italy
| | - D Burke
- Department of Neurology, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia
| | - R Chen
- Division of Neurology, Toronto Western Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - L G Cohen
- Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA
| | - Z Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - R Di Iorio
- Institute of Neurology, Department of Geriatrics, Neuroscience and Orthopedics, Catholic University, Policlinic A. Gemelli, Rome, Italy.
| | - V Di Lazzaro
- Department of Neurology, University Campus Bio-medico, Rome, Italy
| | - F Ferreri
- Department of Neurology, University Campus Bio-medico, Rome, Italy; Department of Clinical Neurophysiology, University of Eastern Finland, Kuopio, Finland
| | - P B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and The Alfred, Melbourne, Australia
| | - M S George
- Medical University of South Carolina, Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - M Hallett
- Human Motor Control Section, Medical Neurology Branch, NINDS, NIH, Bethesda, MD, USA
| | - J P Lefaucheur
- Department of Physiology, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris, Créteil, France; EA 4391, Nerve Excitability and Therapeutic Team, Faculty of Medicine, Paris Est Créteil University, Créteil, France
| | - B Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - H Matsumoto
- Department of Neurology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - C Miniussi
- Department of Clinical and Experimental Sciences University of Brescia, Brescia, Italy; IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - M A Nitsche
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Georg-August-University, Göttingen, Germany
| | - A Pascual-Leone
- Berenson-Allen Center for Non-invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - W Paulus
- Department of Clinical Neurophysiology, Georg-August University, Göttingen, Germany
| | - S Rossi
- Brain Investigation & Neuromodulation Lab, Unit of Neurology and Clinical Neurophysiology, Department of Neuroscience, University of Siena, Siena, Italy
| | - J C Rothwell
- Institute of Neurology, University College London, London, United Kingdom
| | - H R Siebner
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Y Ugawa
- Department of Neurology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - V Walsh
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - U Ziemann
- Department of Neurology & Stroke, and Hertie Institute for Clinical Brain Research, Eberhard Karls University, Tübingen, Germany
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Opitz A, Legon W, Mueller J, Barbour A, Paulus W, Tyler WJ. Is sham cTBS real cTBS? The effect on EEG dynamics. Front Hum Neurosci 2015; 8:1043. [PMID: 25620925 PMCID: PMC4287020 DOI: 10.3389/fnhum.2014.01043] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 12/14/2014] [Indexed: 11/28/2022] Open
Abstract
Increasing sensitivity of modern evaluation tools allows for the study of weaker electric stimulation effects on neural populations. In the current study we examined the effects of sham continuous theta burst (cTBS) transcranial magnetic stimulation to the left dorsolateral prefrontal cortex (DLPFC) upon somatosensory evoked potentials (SEP) and frontal-parietal phase coupling of alpha and beta bands. Sham TMS results in an induced electric field amplitude roughly 5% that of real TMS with a similar spatial extent in cortex. Both real and sham cTBS reduced the amplitude of the frontal P14-N30 SEP and increased local phase coupling in the alpha-beta frequency bands of left frontal cortex. In addition, both sham and real cTBS increased frontal-parietal phase coupling in the alpha-beta bands concomitant with an increase in amplitude of parietal P50-N70 complex. These data suggest that weak electric fields from sham cTBS can affect both local and downstream neuronal circuits, though in a different manner than high strength TMS.
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Affiliation(s)
- Alexander Opitz
- Department of Clinical Neurophysiology, Georg-August-University Göttingen, Germany ; Center for Biomedical Imaging and Neuromodulation, Nathan Kline Institute for Psychiatric Research Orangeburg, NY, USA ; Center for the Developing Brain, Child Mind Institute New York, NY, USA
| | - Wynn Legon
- Department of Physical Medicine and Rehabilitation, University of Minnesota Minneapolis, MN, USA
| | - Jerel Mueller
- School of Biomedical Engineering and Sciences, Virginia Tech Blacksburg, VA, USA
| | - Aaron Barbour
- Virginia Tech Carilion Research Institute Roanoke, VA, USA
| | - Walter Paulus
- Department of Clinical Neurophysiology, Georg-August-University Göttingen, Germany
| | - William J Tyler
- School of Biological and Health Systems Engineering, Arizona State University Tempe, AZ, USA
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Lee NJ, Ahn HJ, Jung KI, Ohn SH, Hong J, Kim YJ, Yoo WK. Reduction of Continuous Theta Burst Stimulation-Induced Motor Plasticity in Healthy Elderly With COMT Val158Met Polymorphism. Ann Rehabil Med 2014; 38:658-64. [PMID: 25379495 PMCID: PMC4221394 DOI: 10.5535/arm.2014.38.5.658] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 07/10/2014] [Indexed: 01/08/2023] Open
Abstract
Objective To delineate whether cortical plasticity induced by continuous theta burst stimulation (cTBS) differed according to catechol-O-methyltransferase (COMT) gene polymorphism in healthy older adults. Methods Eighteen healthy older volunteers (mean age 73.78±5.04; 12 females and 6 males) were recruited. Volunteers randomly assigned in either a sham-first or real cTBS first group participated in two separate TMS visits with at least a 2-day wash-out period. Genotyping was carried out at baseline by a separate researcher who was blinded. cTBS was delivered in a hot spot over M1 at an active motor threshold of 80%. Motor evoked potentials (MEPs) were obtained at 120% of the resting motor threshold before and after sham/cTBS. Results The relative MEP to baseline was significantly decreased 0 and 10 minutes post-stimulation and increased 40 minutes post-stimulation, as compared with the sham condition. Immediately after cTBS, the Val/Val group had a significantly reduced relative MEP value, as compared with the MET carrier group. Conclusion In healthy older persons, cTBS-induced motor plasticity was reduced in the COMT Val/Val group as compared with the 158Met carrier group.
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Affiliation(s)
- Nam Jae Lee
- Department of Physical Medicine and Rehabilitation, Hallym University College of Medicine, Chooncheon, Korea
| | - Hyun Jung Ahn
- Hallym Institute of Translational Genomics & Bioinformatics, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Kwang-Ik Jung
- Department of Physical Medicine and Rehabilitation, Hallym University College of Medicine, Chooncheon, Korea
| | - Suk Hoon Ohn
- Department of Physical Medicine and Rehabilitation, Hallym University College of Medicine, Chooncheon, Korea
| | - Jeonghoon Hong
- ILSONG Institute of Life Science, Hallym University, Anyang, Korea
| | - Yun Joong Kim
- Hallym Institute of Translational Genomics & Bioinformatics, Hallym University Sacred Heart Hospital, Anyang, Korea. ; ILSONG Institute of Life Science, Hallym University, Anyang, Korea. ; Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Woo-Kyoung Yoo
- Department of Physical Medicine and Rehabilitation, Hallym University College of Medicine, Chooncheon, Korea. ; Hallym Institute of Translational Genomics & Bioinformatics, Hallym University Sacred Heart Hospital, Anyang, Korea
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Moliadze V, Schmanke T, Andreas S, Lyzhko E, Freitag CM, Siniatchkin M. Stimulation intensities of transcranial direct current stimulation have to be adjusted in children and adolescents. Clin Neurophysiol 2014; 126:1392-9. [PMID: 25468234 DOI: 10.1016/j.clinph.2014.10.142] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 10/02/2014] [Accepted: 10/15/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of the present study was to investigate the effect of the transcranial direct current stimulation (tDCS) on motor cortex excitability in healthy children and adolescents. METHODS We applied 1mA anodal or cathodal tDCS for 10min on the left primary motor cortex of 19 healthy children and adolescents (mean age 13.9±0.4years). In order to prove whether the effects of tDCS may be attributed to the stimulation intensity, 10 children and adolescents were studied again using 0.5mA anodal and cathodal tDCS. Sham stimulation was used as a control. RESULTS Compared with sham stimulation, both 1mA anodal and cathodal tDCS resulted in a significant increase of Motor evoked potentials (MEP) amplitudes which remained to be prominent even one hour after the end of stimulation. Interestingly, the 0.5mA cathodal tDCS decreased cortico-spinal excitability whereas the 0.5mA anodal stimulation did not result in any effect. CONCLUSION For the first time, the study demonstrates age-specific influences of tDCS on cortical excitability of the primary motor cortex. SIGNIFICANCE Thus, the stimulation protocols of the tDCS have to be optimized according to age by planning studies in pediatric population.
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Affiliation(s)
- Vera Moliadze
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe-University Frankfurt am Main, Deutschordenstr. 50, D-60528 Frankfurt am Main, Germany; Department of Medical Psychology and Medical Sociology, Schleswig-Holstein University Hospital (UK-SH), Campus Kiel, Schwanenweg 20, 24105 Kiel, Germany.
| | - Till Schmanke
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe-University Frankfurt am Main, Deutschordenstr. 50, D-60528 Frankfurt am Main, Germany
| | - Saskia Andreas
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe-University Frankfurt am Main, Deutschordenstr. 50, D-60528 Frankfurt am Main, Germany
| | - Ekaterina Lyzhko
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe-University Frankfurt am Main, Deutschordenstr. 50, D-60528 Frankfurt am Main, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe-University Frankfurt am Main, Deutschordenstr. 50, D-60528 Frankfurt am Main, Germany
| | - Michael Siniatchkin
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe-University Frankfurt am Main, Deutschordenstr. 50, D-60528 Frankfurt am Main, Germany; Department of Medical Psychology and Medical Sociology, Schleswig-Holstein University Hospital (UK-SH), Campus Kiel, Schwanenweg 20, 24105 Kiel, Germany
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Cash RFH, Murakami T, Chen R, Thickbroom GW, Ziemann U. Augmenting Plasticity Induction in Human Motor Cortex by Disinhibition Stimulation. Cereb Cortex 2014; 26:58-69. [PMID: 25100853 DOI: 10.1093/cercor/bhu176] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Cellular studies showed that disinhibition, evoked pharmacologically or by a suitably timed priming stimulus, can augment long-term plasticity (LTP) induction. We demonstrated previously that transcranial magnetic stimulation evokes a period of presumably GABA(B)ergic late cortical disinhibition (LCD) in human primary motor cortex (M1). Here, we hypothesized that, in keeping with cellular studies, LCD can augment LTP-like plasticity in humans. In Experiment 1, patterned repetitive TMS was applied to left M1, consisting of 6 trains (intertrain interval, 8 s) of 4 doublets (interpulse interval equal to individual peak I-wave facilitation, 1.3-1.5 ms) spaced by the individual peak LCD (interdoublet interval (IDI), 200-250 ms). This intervention (total of 48 pulses applied over ∼45 s) increased motor-evoked potential amplitude, a marker of corticospinal excitability, in a right hand muscle by 147% ± 4%. Control experiments showed that IDIs shorter or longer than LCD did not result in LTP-like plasticity. Experiment 2 indicated topographic specificity to the M1 hand region stimulated by TMS and duration of the LTP-like plasticity of 60 min. In conclusion, GABA(B)ergic LCD offers a powerful new approach for augmenting LTP-like plasticity induction in human cortex. We refer to this protocol as disinhibition stimulation (DIS).
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Affiliation(s)
- Robin F H Cash
- Australian Neuro-Muscular Research Institute and Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Perth, Australia Department of Neurology, Goethe-University of Frankfurt, Frankfurt, Germany Division of Brain, Imaging and Behaviour - Systems Neuroscience, Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Takenobu Murakami
- Department of Neurology, Goethe-University of Frankfurt, Frankfurt, Germany Department of Neurology, Fukushima Medical University, Fukushima, Japan
| | - Robert Chen
- Division of Brain, Imaging and Behaviour - Systems Neuroscience, Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Gary W Thickbroom
- Australian Neuro-Muscular Research Institute and Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Perth, Australia
| | - Ulf Ziemann
- Department of Neurology, Goethe-University of Frankfurt, Frankfurt, Germany Department of Neurology and Stroke, and Hertie Institute for Clinical Brain Research, Eberhard-Karls-University, Tübingen, Germany
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Hsieh TH, Huang YZ, Rotenberg A, Pascual-Leone A, Chiang YH, Wang JY, Chen JJJ. Functional Dopaminergic Neurons in Substantia Nigra are Required for Transcranial Magnetic Stimulation-Induced Motor Plasticity. Cereb Cortex 2014; 25:1806-14. [DOI: 10.1093/cercor/bht421] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Jacobs MF, Tsang P, Lee KGH, Asmussen MJ, Zapallow CM, Nelson AJ. 30 Hz theta-burst stimulation over primary somatosensory cortex modulates corticospinal output to the hand. Brain Stimul 2013; 7:269-74. [PMID: 24486137 DOI: 10.1016/j.brs.2013.12.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 11/20/2013] [Accepted: 12/15/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The primary somatosensory cortex (SI) is important for hand function and has direct connectivity with the primary motor cortex (M1). Much of our present knowledge of this connectivity and its relevance to hand function is based on animal research. In humans, less is known about the neural mechanisms by which SI influences motor circuitry that outputs to the muscles controlling the hand. OBJECTIVE The present study investigated the influence of SI on corticospinal excitability, and inhibitory and excitatory intracortical neural circuitry within M1 before and after continuous theta-burst stimulation (cTBS). Motor-evoked potentials (MEPs), short-latency intracortical inhibition (SICI) and intracortical facilitation (ICF) were recorded from the first dorsal interosseous (RFDI) muscle of the right hand following 30 Hz cTBS over left-hemisphere SI and M1 delivered in separate sessions. RESULTS cTBS over SI facilitated MEPs and did not alter ICF or SICI. cTBS delivered over M1 suppressed MEPs and ICF and did not alter SICI. CONCLUSIONS These findings indicate that SI influences corticospinal output to the hand, possibly via corticocortical projections, and may be one mechanism by which somatosensory information influences hand control.
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Affiliation(s)
- Mark F Jacobs
- Department of Kinesiology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Philemon Tsang
- Department of Kinesiology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Kevin G H Lee
- Department of Kinesiology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Michael J Asmussen
- Department of Kinesiology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Christopher M Zapallow
- Department of Kinesiology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Aimee J Nelson
- Department of Kinesiology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada.
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Lee KG, Jacobs MF, Asmussen MJ, Zapallow CM, Tommerdahl M, Nelson AJ. Continuous theta-burst stimulation modulates tactile synchronization. BMC Neurosci 2013; 14:89. [PMID: 23968301 PMCID: PMC3844444 DOI: 10.1186/1471-2202-14-89] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 08/21/2013] [Indexed: 11/22/2022] Open
Abstract
Background Temporal order judgement (TOJ) is the ability to detect the order of occurrence of two sequentially delivered stimuli. Previous research has shown that TOJ in the presence of synchronized periodic conditioning stimuli impairs TOJ performance, and this phenomenon is suggested to be mediated by GABAergic interneurons that cause perceptual binding across the two skin sites. Application of continuous theta-burst repetitive TMS (cTBS) over primary somatosensory cortex (SI) alters temporal and spatial tactile perception. The purpose of this study was to examine TOJ perception in the presence and absence of synchronized periodic conditioning stimuli before and after cTBS applied over left-hemisphere SI. A TOJ task was administered on the right index and middle finger (D2 and D3) in two separate sessions in the presence and absence of conditioning stimuli (a background low amplitude sinusoidal vibration). Results CTBS reduced the impact of the conditioning stimuli on TOJ performance for up to 18 minutes following stimulation while sham cTBS did not affect TOJ performance. In contrast, the TOJ task performed in the absence of synchronized conditioning stimulation was unaltered following cTBS. Conclusion We conclude that cTBS suppresses inhibitory networks in SI that mediate perceptual binding during TOJ synchronization. CTBS offers one method to suppress cortical excitability in the cortex and potentially benefit clinical populations with altered inhibitory cortical circuits. Additionally, TOJ measures with conditioning stimuli may provide an avenue to assess sensory processing in neurologically impaired patient populations.
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Affiliation(s)
- Kevin Gh Lee
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada.
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Vernet M, Bashir S, Yoo WK, Oberman L, Mizrahi I, Ifert-Miller F, Beck CJ, Pascual-Leone A. Reproducibility of the effects of theta burst stimulation on motor cortical plasticity in healthy participants. Clin Neurophysiol 2013; 125:320-6. [PMID: 23932365 DOI: 10.1016/j.clinph.2013.07.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Revised: 07/04/2013] [Accepted: 07/05/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Theta-burst stimulation (TBS) is a repetitive transcranial magnetic stimulation (TMS) protocol, capable of enhancing or suppressing the amplitude of contralateral motor-evoked potentials (MEP) for several minutes after stimulation over the primary motor cortex. Continuous TBS (cTBS) produces a long-term depression (LTD)-like reduction of cortical excitability. The purpose of this study was to assess the test-retest reproducibility of the effects of cTBS and to investigate which neurophysiologic markers of cTBS-induced plasticity are most reproducible. METHODS In ten healthy participants we evaluated in two different sessions the effects of cTBS (using AP-PA current direction, opposite to most commercial rTMS stimulators) on MEPs induced by single-pulse suprathreshold TMS (using AP-PA or PA current direction) over left motor cortex in the first dorsal interosseus (FDI) muscle. RESULTS Results demonstrate that the marker of cTBS induced-plasticity with highest within-subject reproducibility is the modulation of corticospinal excitability measured 5min after cTBS. CONCLUSION Overall the effects of cTBS modulation show limited test-retest reproducibility and some measures of the cTBS effects are more reproducible than others. SIGNIFICANCE Studies comparing cTBS effects in healthy subjects and patients need to proceed with care. Further characterization of the effects of TBS and identification of the best metrics warrant future studies.
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Affiliation(s)
- Marine Vernet
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue KS-158, Boston MA 02215, USA
| | - Shahid Bashir
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue KS-158, Boston MA 02215, USA
| | - Woo-Kyoung Yoo
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue KS-158, Boston MA 02215, USA
| | - Lindsay Oberman
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue KS-158, Boston MA 02215, USA
| | - Ilan Mizrahi
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue KS-158, Boston MA 02215, USA
| | - Frederick Ifert-Miller
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue KS-158, Boston MA 02215, USA
| | - Charles J Beck
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue KS-158, Boston MA 02215, USA
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue KS-158, Boston MA 02215, USA; Institut Universitari de Neurorehabilitació Guttmann, Universidad Autónoma de Barcelona, Barcelona, Spain.
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37
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Karabanov A, Siebner HR. Unravelling homeostatic interactions in inhibitory and excitatory networks in human motor cortex. J Physiol 2013; 590:5557-8. [PMID: 23154853 DOI: 10.1113/jphysiol.2012.244749] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Anke Karabanov
- Danish Research Center for Magnetic Resonance, Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Kettegaard Alle 30, DK-2650, Hvidovre, Denmark
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38
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Hulme SR, Jones OD, Abraham WC. Emerging roles of metaplasticity in behaviour and disease. Trends Neurosci 2013; 36:353-62. [PMID: 23602195 DOI: 10.1016/j.tins.2013.03.007] [Citation(s) in RCA: 137] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 03/19/2013] [Accepted: 03/19/2013] [Indexed: 12/01/2022]
Abstract
Since its initial conceptualisation, metaplasticity has come to encompass a wide variety of phenomena and mechanisms, creating the important challenge of understanding how they contribute to network function and behaviour. Here, we present a framework for considering potential roles of metaplasticity across three domains of function. First, metaplasticity appears ideally placed to prepare for subsequent learning by either enhancing learning ability generally or by preparing neuronal networks to encode specific content. Second, metaplasticity can homeostatically regulate synaptic plasticity, and this likely has important behavioural consequences by stabilising synaptic weights while ensuring the ongoing availability of synaptic plasticity. Finally, we discuss emerging evidence that metaplasticity mechanisms may play a role in disease causally and may serve as a potential therapeutic target.
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Affiliation(s)
- Sarah R Hulme
- Department of Psychology and Brain Health Research Centre, Box 56, University of Otago, Dunedin, 9054, New Zealand
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39
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Batsikadze G, Moliadze V, Paulus W, Kuo MF, Nitsche MA. Partially non-linear stimulation intensity-dependent effects of direct current stimulation on motor cortex excitability in humans. J Physiol 2013; 591:1987-2000. [PMID: 23339180 PMCID: PMC3624864 DOI: 10.1113/jphysiol.2012.249730] [Citation(s) in RCA: 689] [Impact Index Per Article: 62.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 01/18/2013] [Indexed: 11/08/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) of the human motor cortex at an intensity of 1 mA with an electrode size of 35 cm(2) has been shown to induce shifts of cortical excitability during and after stimulation. These shifts are polarity-specific with cathodal tDCS resulting in a decrease and anodal stimulation in an increase of cortical excitability. In clinical and cognitive studies, stronger stimulation intensities are used frequently, but their physiological effects on cortical excitability have not yet been explored. Therefore, here we aimed to explore the effects of 2 mA tDCS on cortical excitability. We applied 2 mA anodal or cathodal tDCS for 20 min on the left primary motor cortex of 14 healthy subjects. Cathodal tDCS at 1 mA and sham tDCS for 20 min was administered as control session in nine and eight healthy subjects, respectively. Motor cortical excitability was monitored by transcranial magnetic stimulation (TMS)-elicited motor-evoked potentials (MEPs) from the right first dorsal interosseous muscle. Global corticospinal excitability was explored via single TMS pulse-elicited MEP amplitudes, and motor thresholds. Intracortical effects of stimulation were obtained by cortical silent period (CSP), short latency intracortical inhibition (SICI) and facilitation (ICF), and I wave facilitation. The above-mentioned protocols were recorded both before and immediately after tDCS in randomized order. Additionally, single-pulse MEPs, motor thresholds, SICI and ICF were recorded every 30 min up to 2 h after stimulation end, evening of the same day, next morning, next noon and next evening. Anodal as well as cathodal tDCS at 2 mA resulted in a significant increase of MEP amplitudes, whereas 1 mA cathodal tDCS decreased corticospinal excitability. A significant shift of SICI and ICF towards excitability enhancement after both 2 mA cathodal and anodal tDCS was observed. At 1 mA, cathodal tDCS reduced single-pulse TMS-elicited MEP amplitudes and shifted SICI and ICF towards inhibition. No significant changes were observed in the other protocols. Sham tDCS did not induce significant MEP alterations. These results suggest that an enhancement of tDCS intensity does not necessarily increase efficacy of stimulation, but might also shift the direction of excitability alterations. This should be taken into account for applications of the stimulation technique using different intensities and durations in order to achieve stronger or longer lasting after-effects.
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Affiliation(s)
- G Batsikadze
- Department of Clinical Neurophysiology, University of Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany
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40
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Murakami T, Müller-Dahlhaus F, Lu MK, Ziemann U. Homeostatic metaplasticity of corticospinal excitatory and intracortical inhibitory neural circuits in human motor cortex. J Physiol 2012; 590:5765-81. [PMID: 22930265 DOI: 10.1113/jphysiol.2012.238519] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Homeostatic metaplasticity, a fundamental principle for maintaining overall synaptic weight in the physiological range in neuronal networks, was demonstrated at the cellular and systems level predominantly for excitatory synaptic neurotransmission. Although inhibitory networks are crucial for regulating excitability, it is largely unknown to what extent homeostatic metaplasticity of inhibition also exists. Here, we employed intermittent and continuous transcranial magnetic theta burst stimulation (iTBS, cTBS) of the primary motor cortex in healthy subjects for induction of long-term potentiation (LTP)-like and long-term depression (LTD)-like plasticity. We studied metaplasticity by testing the interactions of priming TBS with LTP/LTD-like plasticity induced by subsequent test TBS. Changes in excitatory neurotransmission were measured by the input-output curve of motor-evoked potentials (IO-MEP), and changes in GABA(A)ergic inhibitory neurotransmission by the IO of short-interval intracortical inhibition (IO-SICI, four conditioning stimulus intensities of 70-100% active motor threshold, interstimulus interval 2.0 ms). Non-primed iTBS increased IO-MEP, while non-primed cTBS decreased IO-MEP. Pairing of identical protocols (iTBSiTBS, cTBScTBS) resulted in suppression of the non-primed TBS effects on IO-MEP, and pairing of different protocols (cTBSiTBS, iTBScTBS) enhanced the test TBS effects on IO-MEP. While non-primed TBS did not result in significant changes of IO-SICI, iTBSiTBS resulted in IO-SICI decrease, and cTBScTBS in IO-SICI increase compared with the non-primed conditions. The changes in SICI induced by priming TBS correlated with the changes in MEP induced by subsequent test TBS. Findings demonstrate that plasticity in both excitatory and inhibitory circuits in the human motor cortex are regulated by homeostatic metaplasticity, and that priming effects on inhibition contribute to the homeostatic regulation of metaplasticity in excitatory circuits.
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Affiliation(s)
- Takenobu Murakami
- Department of Neurology, Goethe-University, Frankfurt am Main, Germany
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41
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Goldsworthy MR, Pitcher JB, Ridding MC. Neuroplastic modulation of inhibitory motor cortical networks by spaced theta burst stimulation protocols. Brain Stimul 2012; 6:340-5. [PMID: 22835528 DOI: 10.1016/j.brs.2012.06.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Revised: 06/19/2012] [Accepted: 06/19/2012] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Continuous theta burst stimulation (cTBS) suppresses the excitability of motor networks responsible for generating motor evoked potentials (MEPs), and may also modulates the excitability of inhibitory motor networks. However, its effects on intracortical inhibition are modest in comparison to the effects on MEPs. The repeated, spaced, application of cTBS protocols results in more MEP suppression than seen with a single cTBS protocol, but whether this approach is also effective at modulating intracortical inhibition has not been tested. OBJECTIVE To determine whether the paired application of cTBS effectively modulates the excitability of intracortical inhibitory motor networks. METHODS Single and paired-pulse transcranial magnetic stimulation (TMS) were used to assess resting motor threshold (RMT), MEP amplitude, short-interval intracortical inhibition (SICI), and long-interval intracortical inhibition (LICI) before and during two time periods (0-10 and 30-40 min) following application of either a single or paired cTBS protocols. RESULTS Both the single and paired cTBS conditions induced a significant reduction in both MEP amplitudes and the level of SICI. While paired cTBS produced a significantly greater MEP suppression than single cTBS, the effects on SICI were similar. Neither single nor paired cTBS had an effect on RMT or LICI. CONCLUSIONS Although the repeated application of cTBS protocols may be effective for enhancing modulation of the MEP-generating excitatory motor networks, these findings suggest that this approach offers little advantage when targeting intracortical inhibitory networks.
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Affiliation(s)
- Mitchell R Goldsworthy
- Neuromotor Plasticity and Development, The Robinson Institute, School of Paediatrics and Reproductive Health, The University of Adelaide, Adelaide, Australia
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Plasticity-inducing TMS protocols to investigate somatosensory control of hand function. Neural Plast 2012; 2012:350574. [PMID: 22666612 PMCID: PMC3362131 DOI: 10.1155/2012/350574] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Revised: 02/27/2012] [Accepted: 03/14/2012] [Indexed: 11/17/2022] Open
Abstract
Hand function depends on sensory feedback to direct an appropriate motor response. There is clear evidence that somatosensory cortices modulate motor behaviour and physiology within primary motor cortex. However, this information is mainly from research in animals and the bridge to human hand control is needed. Emerging evidence in humans supports the notion that somatosensory cortices modulate motor behaviour, physiology and sensory perception. Transcranial magnetic stimulation (TMS) allows for the investigation of primary and higher-order somatosensory cortices and their role in control of hand movement in humans. This review provides a summary of several TMS protocols in the investigation of hand control via the somatosensory cortices. TMS plasticity inducing protocols reviewed include paired associative stimulation, repetitive TMS, theta-burst stimulation as well as other techniques that aim to modulate cortical excitability in sensorimotor cortices. Although the discussed techniques may modulate cortical excitability, careful consideration of experimental design is needed to isolate factors that may interfere with desired results of the plasticity-inducing protocol, specifically events that may lead to metaplasticity within the targeted cortex.
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Paulus W. Transcranial static magnetic field stimulation in man: making things as simple as possible? J Physiol 2011; 589:5917-8. [PMID: 22025669 DOI: 10.1113/jphysiol.2011.221655] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Walter Paulus
- Department of Clinical Neurophysiology, University Hospital Göttingen, Göttingen, Germany.
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Modulation of cortical motor networks following primed θ burst transcranial magnetic stimulation. Exp Brain Res 2011; 215:199-206. [PMID: 21964890 DOI: 10.1007/s00221-011-2886-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Accepted: 09/21/2011] [Indexed: 10/17/2022]
Abstract
To investigate whether priming stimulation influences the responses of intracortical inhibitory and facilitatory motor circuits to a subsequent plasticity-inducing inhibitory theta burst TMS paradigm. Using standard transcranial magnetic stimulation (TMS) procedures, MEP amplitude, short-interval intracortical inhibition (SICI), and short-interval intracortical facilitation (SICF) were assessed at baseline and 5, 20 and 30 min following continuous theta burst stimulation (cTBS), intermittent TBS (iTBS), and iTBS-primed cTBS. SICI was assessed using paired-pulse TMS at inter-stimulus intervals (ISI) of 3 ms (SICI(3)) and the latency corresponding to the latency at which SICF was minimal in each individual. SICF was assessed at ISIs corresponding to Peak 1, Trough 1, Peak 2, and Peak 3 of each individual's SICF curve. When applied alone cTBS inhibited and iTBS facilitated MEP amplitudes. iTBS-primed cTBS resulted in greater MEP inhibition than cTBS alone. There were no changes in SICF and only marginal changes in SICI following any intervention. Synapses mediating MEP generation undergo modification following iTBS-primed cTBS, possibly through mechanisms related to metaplasticity or synaptic depotentiation. A lack of substantial changes in SICI and SICF under all experimental conditions suggests that the tested rTMS paradigms may be non-optimal for inducing robust modulation of the neural elements mediating SICI and SICF across subjects. Priming stimulation may provide an approach which facilitate neuroplastic change within the human motor cortex at least in circuits responsible for MEP generation.
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