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Shah M, Suresh S, Paddick J, Mellow ML, Rees A, Berryman C, Stanton TR, Smith AE. Age-related changes in responsiveness to non-invasive brain stimulation neuroplasticity paradigms: A systematic review with meta-analysis. Clin Neurophysiol 2024; 162:53-67. [PMID: 38579515 DOI: 10.1016/j.clinph.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/27/2024] [Accepted: 03/06/2024] [Indexed: 04/07/2024]
Abstract
OBJECTIVES We aimed to summarise and critically appraise the available evidence for the effect of age on responsiveness to non-invasive brain stimulation (NBS) paradigms delivered to the primary motor cortex. METHODS Four databases (Medline, Embase, PsycINFO and Scopus) were searched from inception to February 7, 2023. Studies investigating age group comparisons and associations between age and neuroplasticity induction from NBS paradigms were included. Only studies delivering neuroplasticity paradigms to the primary motor cortex and responses measured via motor-evoked potentials (MEPs) in healthy adults were considered. RESULTS 39 studies, encompassing 40 experiments and eight NBS paradigms were included: paired associative stimulation (PAS; n = 12), repetitive transcranial magnetic stimulation (rTMS; n = 2), intermittent theta burst stimulation (iTBS; n = 8), continuous theta burst stimulation (cTBS; n = 7), transcranial direct and alternating current stimulation ((tDCS; n = 7; tACS; n = 2)), quadripulse stimulation (QPS; n = 1) and i-wave periodic transcranial magnetic stimulation (iTMS; n = 1). Pooled findings from PAS paradigms suggested older adults have reduced post-paradigm responses, although there was considerable heterogeneity. Mixed results were observed across all other NBS paradigms and post-paradigm timepoints. CONCLUSIONS/SIGNIFICANCE Whilst age-dependent reduction in corticospinal excitability is possible, there is extensive inter- and intra-individual variability both within and between studies, making it difficult to draw meaningful conclusions from pooled analyses.
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Affiliation(s)
- Mahima Shah
- Alliance for Research in Exercise, Nutrition and Activity (ARENA) Research Centre, Allied Health and Human Performance, University of South Australia, Adelaide 5000, Australia
| | - Suraj Suresh
- Brain Stimulation, Imaging and Cognition Laboratory, The University of Adelaide, South Australian Health and Medical Research Institute, Adelaide 5000, Australia
| | - Johanna Paddick
- Alliance for Research in Exercise, Nutrition and Activity (ARENA) Research Centre, Allied Health and Human Performance, University of South Australia, Adelaide 5000, Australia; Persistent Pain Research Group, Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI)
| | - Maddison L Mellow
- Alliance for Research in Exercise, Nutrition and Activity (ARENA) Research Centre, Allied Health and Human Performance, University of South Australia, Adelaide 5000, Australia
| | - Amy Rees
- Discipline of Physiology, School of Biomedicine. The University of Adelaide, Adelaide 5000, Australia
| | - Carolyn Berryman
- Brain Stimulation, Imaging and Cognition Laboratory, The University of Adelaide, South Australian Health and Medical Research Institute, Adelaide 5000, Australia; South Australian Health and Medical Research Institute (SAHMRI), North Tce, Adelaide 5000, Australia; IIMPACT in Health, University of South Australia, Adelaide 5000, Australia
| | - Tasha R Stanton
- Persistent Pain Research Group, Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI); IIMPACT in Health, University of South Australia, Adelaide 5000, Australia
| | - Ashleigh E Smith
- Alliance for Research in Exercise, Nutrition and Activity (ARENA) Research Centre, Allied Health and Human Performance, University of South Australia, Adelaide 5000, Australia.
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Curtin D, Cadwallader CJ, Taylor EM, Andrews SC, Stout JC, Hendrikse JJ, Chong TTJ, Coxon JP. Ageing attenuates exercise-enhanced motor cortical plasticity. J Physiol 2023; 601:5733-5750. [PMID: 37917116 DOI: 10.1113/jp285243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/18/2023] [Indexed: 11/03/2023] Open
Abstract
Cardiorespiratory exercise is known to modulate motor cortical plasticity in young adults, but the influence of ageing on this relationship is unknown. Here, we compared the effects of a single session of cardiorespiratory exercise on motor cortical plasticity in young and older adults. We acquired measures of cortical excitatory and inhibitory activity of the primary motor cortex using transcranial magnetic stimulation (TMS) from 20 young (mean ± SD = 25.30 ± 4.00 years, 14 females) and 20 older (mean ± SD = 64.10 ± 6.50 years, 11 females) healthy adults. Single- and paired-pulse TMS measurements were collected before and after a 20 min bout of high-intensity interval cycling exercise or an equivalent period of rest, and again after intermittent theta burst stimulation (iTBS). In both young (P = 0.027, Cohen's d = 0.87) and older adults (P = 0.006, Cohen's d = 0.85), there was an increase in glutamatergic excitation and a reduction in GABAergic inhibition from pre- to postexercise. However, in contrast to younger adults, older adults showed an attenuated plasticity response to iTBS following exercise (P = 0.011, Cohen's d = 0.85). These results demonstrate an age-dependent decline in cortical plasticity and indicate that a preceding bout of high-intensity interval exercise might be less effective for enhancing primary motor cortex plasticity in older adults. Our findings align with the hypothesis that the capacity for cortical plasticity is altered in older age. KEY POINTS: Exercise enhances motor cortical plasticity in young adults, but how ageing influences this effect is unknown. Here, we compared primary motor cortical plasticity responses in young and older adults before and after a bout of high-intensity interval exercise and again after a plasticity-inducing protocol, intermittent theta burst stimulation. In both young and older adults, exercise led to an increase in glutamatergic excitation and a reduction in GABAergic inhibition. Our key result was that older adults showed an attenuated plasticity response to theta burst stimulation following exercise, relative to younger adults. Our findings demonstrate an age-dependent decline in exercise-enhanced cortical plasticity and indicate that a preceding bout of high-intensity interval exercise might be less effective for enhancing primary motor cortex plasticity in older adults.
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Affiliation(s)
- Dylan Curtin
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Claire J Cadwallader
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Eleanor M Taylor
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Sophie C Andrews
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland, Australia
| | - Julie C Stout
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Joshua J Hendrikse
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Trevor T-J Chong
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Department of Neurology, Alfred Health, Melbourne, Victoria, Australia
- Department of Clinical Neurosciences, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - James P Coxon
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
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Acute effects of physical activity patterns on plasma cortisol and brain-derived neurotrophic factor in relation to corticospinal excitability. Behav Brain Res 2022; 430:113926. [PMID: 35568076 DOI: 10.1016/j.bbr.2022.113926] [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: 11/05/2021] [Revised: 05/02/2022] [Accepted: 05/09/2022] [Indexed: 11/20/2022]
Abstract
Brain-derived neurotrophic factor (BDNF) and cortisol are both capable of modulating synaptic plasticity, but it is unknown how physical activity-induced changes in their plasma levels relate to corticospinal plasticity in humans. Sixteen inactive middle-aged men and women participated in three separate interventions consisting of 3hours prolonged sitting (SIT); 3hours sitting interrupted every 30minutes with frequent short physical activity breaks (FPA); and 2.5hours prolonged sitting followed by 25minutes of moderate intensity exercise (EXE). These 3hour sessions were each followed by a 30min period of paired associative stimulation over the primary motor cortex (PAS). Blood samples were taken and corticospinal excitability measured at baseline, pre PAS, 5min and 30min post PAS. Here we report levels of plasma BDNF and cortisol over three activity conditions and relate these levels to previously published changes in corticospinal excitability of a non-activated thumb muscle. There was no interaction between time and condition in BDNF, but cortisol levels were significantly higher after EXE compared to after SIT and FPA. Higher cortisol levels at pre PAS predicted larger increases in corticospinal excitability from baseline to all subsequent time points in the FPA condition only, while levels of BDNF at pre PAS did not predict such changes in any of the conditions. Neither BDNF nor cortisol modified changes from pre PAS to the subsequent time points, suggesting that the increased corticospinal excitability was not mediated though an augmented effect of the PAS protocol. The relationship between cortisol and plasticity has been suggested to be U-shaped. This is possibly why the moderately high levels of cortisol seen in the FPA condition were positively associated with changes AURC, while the higher cortisol levels seen after EXE were not. A better understanding of the mechanisms for how feasible physical activity breaks affect neuroplasticity can inform the theoretical framework for how work environments and schedules should be designed. DATA AVAILABILITY: Data are available from the corresponding author upon reasonable request.
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Nuzum ND, Teo WP, Macpherson H, Loughman A, Szymlek-Gay EA, Hendy A. Inhibition, excitation and bilateral transfer following a unilateral complex finger-tapping task in young and older adults. Eur J Neurosci 2021; 54:6608-6617. [PMID: 34535926 DOI: 10.1111/ejn.15467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/09/2021] [Accepted: 09/11/2021] [Indexed: 11/29/2022]
Abstract
Neuroplasticity underpins motor learning, with abnormal neuroplasticity related to age-associated motor declines. Bilateral transfer of motor learning, through rehabilitation, may mitigate these declines; however, the magnitude of transfer may be reduced in older populations. This study investigated excitatory and inhibitory pathways in the trained and untrained hemispheres following unilateral training of a complex finger-tapping task across ageing. Fifteen young (26.2 ± 3.8 years) and 11 older adults (63.7 ± 15.4 years) received transcranial magnetic stimulation, although surface electromyography was recorded from the extensor digitorum communis (EDC) and abductor pollicis brevis (APB), before and after practicing a complex finger-tapping task with the dominant hand. Excitability, inhibition (expressed as percent change scores from pre- to post-training), motor task performance and bilateral transfer were assessed between groups. Investigation of hemispheric differences within each group was completed for measures that significantly differed between groups. There were no between-group differences in task performance or bilateral transfer, with task performance improving post-training irrespective of group for both hands (p < 0.05). Pre- to post-inhibition change scores of the untrained EDC muscle increased (p = 0.034) in older compared with younger adults, indicating reduced inhibition in older adults. Inhibition change scores significantly differed between hemispheres for the young group only (p = 0.037). Only the younger group presented with hemispheric lateralisation, providing some support for the Hemispheric Asymmetry Reduction in OLDer adults (HAROLD) hypothesis. Whether this reduction is evidence of de-differentiation or compensation will need to be confirmed with additional measures.
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Affiliation(s)
- Nathan D Nuzum
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Wei-Peng Teo
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.,Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Helen Macpherson
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Amy Loughman
- Food & Mood Centre, IMPACT Institute, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Ewa A Szymlek-Gay
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Ashlee Hendy
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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5
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Wittkopf PG, Larsen DB, Graven-Nielsen T. Protocols for inducing homeostatic plasticity reflected in the corticospinal excitability in healthy human participants: A systematic review and meta-analysis. Eur J Neurosci 2021; 54:5444-5461. [PMID: 34251703 DOI: 10.1111/ejn.15389] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 11/26/2022]
Abstract
Homeostatic plasticity complements synaptic plasticity by stabilising neural activity within a physiological range. In humans, homeostatic plasticity is investigated using two blocks of non-invasive brain stimulation (NIBS) with an interval without stimulation between blocks. The aim of this systematic review and meta-analysis was to investigate the effect of homeostatic plasticity induction protocols on motor evoked potentials (MEP) in healthy participants. Four databases were searched (Medline, Scopus, Embase and Cochrane library). Studies describing the application of two blocks of NIBS of the primary motor cortex with an interval of no stimulation between blocks reporting changes in corticospinal excitability by MEP amplitude were included. Thirty-seven reports with 55 experiments (700 participants) were included. Study quality was considered poor overall, with heterogeneity in study size, sample and designs. Two blocks of excitatory stimulation at the primary motor cortex produced a homeostatic response (decreased MEP) between 0 and 30 min post-protocols, when compared with a single stimulation block. Two blocks of inhibitory stimulation at the primary motor cortex using interval duration of 10 min or less produced a homeostatic response (increased MEP) between 0 and 30 min post-protocols, when compared with a single stimulation block. There were no differences in MEPs when compared with baseline MEPs. In conclusion, homeostatic plasticity induction using two blocks of NIBS with an interval of 10 min or less without stimulation between blocks produces a homeostatic response up to 30 min post-protocol. Improvements in participant selection, sample sizes and protocols of NIBS techniques are needed.
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Affiliation(s)
- Priscilla G Wittkopf
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Dennis B Larsen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Thomas Graven-Nielsen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Age-related changes in motor cortex plasticity assessed with non-invasive brain stimulation: an update and new perspectives. Exp Brain Res 2021; 239:2661-2678. [PMID: 34269850 DOI: 10.1007/s00221-021-06163-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/22/2021] [Indexed: 12/24/2022]
Abstract
It is commonly accepted that the brains capacity to change, known as plasticity, declines into old age. Recent studies have used a variety of non-invasive brain stimulation (NIBS) techniques to examine this age-related decline in plasticity in the primary motor cortex (M1), but the effects seem inconsistent and difficult to unravel. The purpose of this review is to provide an update on studies that have used different NIBS techniques to assess M1 plasticity with advancing age and offer some new perspective on NIBS strategies to boost plasticity in the ageing brain. We find that early studies show clear differences in M1 plasticity between young and older adults, but many recent studies with motor training show no decline in use-dependent M1 plasticity with age. For NIBS-induced plasticity in M1, some protocols show more convincing differences with advancing age than others. Therefore, our view from the NIBS literature is that it should not be automatically assumed that M1 plasticity declines with age. Instead, the effects of age are likely to depend on how M1 plasticity is measured, and the characteristics of the elderly population tested. We also suggest that NIBS performed concurrently with motor training is likely to be most effective at producing improvements in M1 plasticity and motor skill learning in older adults. Proposed NIBS techniques for future studies include combining multiple NIBS protocols in a co-stimulation approach, or NIBS strategies to modulate intracortical inhibitory mechanisms, in an effort to more effectively boost M1 plasticity and improve motor skill learning in older adults.
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Semmler JG, Opie GM. Boosting brain plasticity in older adults with non-invasive brain co-stimulation. Clin Neurophysiol 2021; 132:1334-1335. [PMID: 33832844 DOI: 10.1016/j.clinph.2021.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 03/12/2021] [Indexed: 10/21/2022]
Affiliation(s)
- John G Semmler
- Discipline of Physiology, Adelaide Medical School, The University of Adelaide, Adelaide, Australia.
| | - George M Opie
- Discipline of Physiology, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
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Guerra A, Rocchi L, Grego A, Berardi F, Luisi C, Ferreri F. Contribution of TMS and TMS-EEG to the Understanding of Mechanisms Underlying Physiological Brain Aging. Brain Sci 2021; 11:405. [PMID: 33810206 PMCID: PMC8004753 DOI: 10.3390/brainsci11030405] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/19/2021] [Accepted: 03/19/2021] [Indexed: 12/21/2022] Open
Abstract
In the human brain, aging is characterized by progressive neuronal loss, leading to disruption of synapses and to a degree of failure in neurotransmission. However, there is increasing evidence to support the notion that the aged brain has a remarkable ability to reorganize itself, with the aim of preserving its physiological activity. It is important to develop objective markers able to characterize the biological processes underlying brain aging in the intact human, and to distinguish them from brain degeneration associated with many neurological diseases. Transcranial magnetic stimulation (TMS), coupled with electromyography or electroencephalography (EEG), is particularly suited to this aim, due to the functional nature of the information provided, and thanks to the ease with which it can be integrated with behavioral manipulation. In this review, we aimed to provide up to date information about the role of TMS and TMS-EEG in the investigation of brain aging. In particular, we focused on data about cortical excitability, connectivity and plasticity, obtained by using readouts such as motor evoked potentials and transcranial evoked potentials. Overall, findings in the literature support an important potential contribution of TMS to the understanding of the mechanisms underlying normal brain aging. Further studies are needed to expand the current body of information and to assess the applicability of TMS findings in the clinical setting.
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Affiliation(s)
| | - Lorenzo Rocchi
- Department of Clinical and Movements Neurosciences, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK;
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Alberto Grego
- Department of Neuroscience, University of Padua, 35122 Padua, Italy; (A.G.); (F.B.); (C.L.)
| | - Francesca Berardi
- Department of Neuroscience, University of Padua, 35122 Padua, Italy; (A.G.); (F.B.); (C.L.)
| | - Concetta Luisi
- Department of Neuroscience, University of Padua, 35122 Padua, Italy; (A.G.); (F.B.); (C.L.)
| | - Florinda Ferreri
- Department of Neuroscience, University of Padua, 35122 Padua, Italy; (A.G.); (F.B.); (C.L.)
- Department of Clinical Neurophysiology, Kuopio University Hospital, University of Eastern Finland, 70210 Kuopio, Finland
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Guerra A, Asci F, Zampogna A, D'Onofrio V, Berardelli A, Suppa A. The effect of gamma oscillations in boosting primary motor cortex plasticity is greater in young than older adults. Clin Neurophysiol 2021; 132:1358-1366. [PMID: 33781703 DOI: 10.1016/j.clinph.2021.01.032] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/29/2020] [Accepted: 01/14/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVE In healthy subjects, the long-term potentiation (LTP)-like plasticity of the primary motor cortex (M1) induced by intermittent theta-burst stimulation (iTBS) can be boosted by modulating gamma (γ) oscillations through transcranial alternating current stimulation (tACS). γ-tACS also reduces short-interval intracortical inhibition (SICI). We tested whether the effects of γ-tACS differ between young (YA) and older adults (OA). METHODS Twenty YA (27.2 ± 2.7 years) and twenty OA (65.3 ± 9.5 years) underwent iTBS-γ tACS and iTBS-sham tACS in randomized sessions. In a separate session, we delivered γ-tACS alone and recorded SICI during stimulation. RESULTS iTBS-sham tACS produced comparable motor evoked potential (MEP) facilitation between groups. While iTBS-γ tACS boosted MEP facilitation in both the YA and OA groups, the magnitude of its effect was significantly lower in OA. Similarly, γ-tACS-induced modulation of GABA-A-ergic neurotransmission, as tested by SICI, was reduced in OA. The effect of iTBS-γ tACS negatively correlated with the age of OA subjects. CONCLUSIONS Mechanisms underlying the effects of γ oscillations on LTP-like plasticity become less efficient in older adults. This could reflect age-related changes in neural elements of M1 resonant to γ oscillations, including GABA-A-ergic interneurons. SIGNIFICANCE The beneficial effect of γ-tACS on iTBS-induced plasticity is reduced in older adults.
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Affiliation(s)
- Andrea Guerra
- IRCCS Neuromed, Via Atinense 18, 86077 Pozzilli, IS, Italy
| | - Francesco Asci
- IRCCS Neuromed, Via Atinense 18, 86077 Pozzilli, IS, Italy
| | - Alessandro Zampogna
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
| | - Valentina D'Onofrio
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
| | - Alfredo Berardelli
- IRCCS Neuromed, Via Atinense 18, 86077 Pozzilli, IS, Italy; Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy.
| | - Antonio Suppa
- IRCCS Neuromed, Via Atinense 18, 86077 Pozzilli, IS, Italy; Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
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Investigating the influence of paired-associative stimulation on multi-session skill acquisition and retention in older adults. Clin Neurophysiol 2020; 131:1497-1507. [DOI: 10.1016/j.clinph.2020.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 03/19/2020] [Accepted: 04/13/2020] [Indexed: 12/26/2022]
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Pourmajidian M, Lauber B, Sidhu SK. Preconditioning cathodal transcranial direct current stimulation facilitates the neuroplastic effect of subsequent anodal transcranial direct current stimulation applied during cycling in young adults. Neurosci Lett 2020; 714:134597. [PMID: 31689457 DOI: 10.1016/j.neulet.2019.134597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 10/11/2019] [Accepted: 10/28/2019] [Indexed: 01/30/2023]
Abstract
The study aimed to examine the effect of a pre-conditioning cathodal transcranial direct current stimulation (ctDCS) before subsequent anodal-tDCS (atDCS) was applied during low workload cycling exercise on the corticospinal responses in young healthy individuals. Eleven young subjects participated in two sessions receiving either conditioning ctDCS or sham stimulation, followed by atDCS while cycling (i.e. ctDCS-atDCS, sham-atDCS) at 1.2 times their body weight (84 ± 20 W) in a counterbalanced double-blind design. Corticospinal excitability was measured with motor evoked potentials (MEPs) elicited via transcranial magnetic stimulation with the intensity set to produce an MEP amplitude of 1 mV in a resting hand muscle at baseline (PRE), following pre-conditioning tDCS (POST-COND) and post atDCS combined with cycling exercise (POST-TEST). There was a significant interaction between time and intervention (P < 0.01) on MEPs. MEPs increased from PRE (1.0 ± 0.06 mV) to POST-TEST (1.3 ± 0.06 mV) during ctDCS-atDCS (P < 0.001) but did not change significantly across time during sham-atDCS (P > 0.7). Furthermore, MEPs were higher in ctDCS-atDCS compared to sham-atDCS (both P < 0.01) at POST-COND (ctDCS-atDCS: 1.1 ± 0.06 mV, sham-atDCS: 1.0 ± 0.06 mV) and POST-TEST (ctDCS-atDCS: 1.3 ± 0.06 mV, sham-atDCS: 1.0 ± 0.06 mV). These outcomes demonstrate that pre-conditioning cathodal tDCS can enhance subsequent corticospinal excitability changes induced by anodal tDCS applied in combination with cycling exercise. The findings have implications for the application of tDCS in combination with cycling exercise in rehabilitation and sporting contexts.
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Affiliation(s)
- Maryam Pourmajidian
- Discipline of Physiology, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Benedikt Lauber
- Department of Neuroscience and Movement Science, University of Fribourg, Fribourg, Switzerland
| | - Simranjit K Sidhu
- Discipline of Physiology, Adelaide Medical School, The University of Adelaide, Adelaide, Australia.
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Tang X, Huang P, Li Y, Lan J, Yang Z, Xu M, Yi W, Lu L, Wang L, Xu N. Age-Related Changes in the Plasticity of Neural Networks Assessed by Transcranial Magnetic Stimulation With Electromyography: A Systematic Review and Meta-Analysis. Front Cell Neurosci 2019; 13:469. [PMID: 31708744 PMCID: PMC6822534 DOI: 10.3389/fncel.2019.00469] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 10/01/2019] [Indexed: 01/03/2023] Open
Abstract
Objective: The excitability of cerebral cortical cells, neural pathway, and neural networks, as well as their plasticity, are key to our exploration of age-related changes in brain structure and function. The combination of transcranial magnetic stimulation (TMS) with electromyography (EMG) can be applied to the primary motor cortex; it activates the underlying neural group and passes through the corticospinal pathway, which can be quantified using EMG. This meta-analysis aimed to analyze changes in cortical excitability and plasticity in healthy elderly individuals vs. young individuals through TMS-EMG. Methods: The Cochrane Library, Medline, and EMBASE databases were searched to identify eligible trials published from database inception to June 3, 2019. The Cochrane Risk of Bias Tool and improved Jadad scale were used to assess the methodological quality. A meta-analysis of the comparative effects was conducted using the Review Manager 5.3 software and Stata 14.0 software. Results: The pooled results revealed that the resting motor threshold values in the elderly group were markedly higher than those reported in the young group (mean difference [MD]: −2.35; 95% confidence interval [CI]: −3.69 to −1.02]; p < (0.00001). The motor evoked potential amplitude significantly reduced in the elderly group vs. the young group (MD: 0.18; 95% CI: 0.09–0.27; p < 0.0001). Moreover, there was significantly longer motor evoked potential latency in the elderly group (MD: −1.07; 95% CI: −1.77 to −0.37]; p =(0.003). There was no significant difference observed in the active motor threshold between the elderly and young groups (MD: −1.52; 95% CI: −3.47 to −0.42]; p =(0.13). Meanwhile, only two studies reported the absence of adverse events. Conclusion: We found that the excitability of the cerebral cortex declined in elderly individuals vs. young individuals. The findings of the present analysis should be considered with caution owing to the methodological limitations in the included trials. Additional high-quality studies are warranted to validate our findings.
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Affiliation(s)
- Xiaorong Tang
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Peidong Huang
- Acupuncture and Massage Rehabilitation Institute, Yunnan University of Chinese Medicine, Kunming, China
| | - Yitong Li
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Juanchao Lan
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhonghua Yang
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Mindong Xu
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wei Yi
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Liming Lu
- Clinical Research Center, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lin Wang
- Clinical Research Center, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Nenggui Xu
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
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13
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Opie GM, Hand BJ, Coxon JP, Ridding MC, Ziemann U, Semmler JG. Visuomotor task acquisition is reduced by priming paired associative stimulation in older adults. Neurobiol Aging 2019; 81:67-76. [PMID: 31247460 DOI: 10.1016/j.neurobiolaging.2019.05.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 05/16/2019] [Accepted: 05/23/2019] [Indexed: 12/21/2022]
Abstract
Transcranial magnetic stimulation may represent an effective means for improving motor function in the elderly. The aim of this study was therefore to investigate the effects of paired associative stimulation (PAS; a plasticity-inducing transcranial magnetic stimulation paradigm) on acquisition of a novel visuomotor task in young and older adults. Fourteen young (20.4 ± 0.6 years) and 13 older (69.0 ± 1.6 years) adults participated in 3 experimental sessions during which training was preceded (primed) by PAS. Within each session, the interstimulus interval used for PAS was set at either the N20 latency plus 5 ms (PASLTP), the N20 latency minus 10 ms (PASLTD), or a constant 100 ms (PASControl). After training, the level of motor skill was not different between PAS conditions in young subjects (all p-values > 0.2), but was reduced by both PASLTP (p = 0.02) and PASLTD (p = 0.0001) in older subjects. Consequently, priming PAS was detrimental to skill acquisition in older adults, possibly suggesting a need for interventions that are optimized for use in elderly populations.
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Affiliation(s)
- George M Opie
- Discipline of Physiology, Adelaide Medical School, The University of Adelaide, Adelaide, Australia; Discipline of Obstetrics and Gynaecology, Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | - Brodie J Hand
- Discipline of Physiology, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - James P Coxon
- School of Psychological Sciences, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia
| | - Michael C Ridding
- Discipline of Obstetrics and Gynaecology, Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | - Ulf Ziemann
- Department of Neurology and Stroke, Hertie-Institute for Clinical Brain Research, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - John G Semmler
- Discipline of Physiology, Adelaide Medical School, The University of Adelaide, Adelaide, Australia.
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14
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A reappraisal of pain-paired associative stimulation suggesting motor inhibition at spinal level. Neurophysiol Clin 2018; 48:295-302. [DOI: 10.1016/j.neucli.2018.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 04/15/2018] [Accepted: 04/24/2018] [Indexed: 01/17/2023] Open
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15
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Apparent motion perception in lower limb amputees with phantom sensations: “obstacle shunning” and “obstacle tolerance”. Cortex 2018; 104:220-231. [DOI: 10.1016/j.cortex.2018.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 05/18/2017] [Accepted: 03/08/2018] [Indexed: 10/17/2022]
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16
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Opie GM, Cirillo J, Semmler JG. Age-related changes in late I-waves influence motor cortex plasticity induction in older adults. J Physiol 2018; 596:2597-2609. [PMID: 29667190 DOI: 10.1113/jp274641] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 04/16/2018] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS The response to neuroplasticity interventions using transcranial magnetic stimulation (TMS) is reduced in older adults, which may be due, in part, to age-related alterations in interneuronal (I-wave) circuitry. The current study investigated age-related changes in interneuronal characteristics and whether they influence motor cortical plasticity in older adults. While I-wave recruitment was unaffected by age, there was a shift in the temporal characteristics of the late, but not the early I-waves. Using I-wave periodicity repetitive TMS (iTMS), we showed that these differences in I-wave characteristics influence the induction of cortical plasticity in older adults. ABSTRACT Previous research shows that neuroplasticity assessed using transcranial magnetic stimulation (TMS) is reduced in older adults. While this deficit is often assumed to represent altered synaptic modification processes, age-related changes in the interneuronal circuits activated by TMS may also contribute. Here we assessed age-related differences in the characteristics of the corticospinal indirect (I) waves and how they influence plasticity induction in primary motor cortex. Twenty young (23.7 ± 3.4 years) and 19 older adults (70.6 ± 6.0 years) participated in these studies. I-wave recruitment was assessed by changing the direction of the current used to activate the motor cortex, whereas short-interval intracortical facilitation (SICF) was recorded to assess facilitatory I-wave interactions. In a separate study, I-wave periodicity TMS (iTMS) was used to examine the effect of I-wave latency on motor cortex plasticity. Data from the motor-evoked potential (MEP) onset latency produced using different coil orientations suggested that there were no age-related differences in preferential I-wave recruitment (P = 0.6). However, older adults demonstrated significant reductions in MEP facilitation at all 3 SICF peaks (all P values < 0.05) and a delayed latency of the second and third SICF peaks (all P values < 0.05). Using I-wave intervals that were optimal for young and older adults, these changes in the late I-waves were shown to influence the plasticity response in older adults after iTMS. These findings suggest that temporal characteristics are delayed for the late I-waves in older adults, and that optimising TMS interventions based on I-wave characteristics may improve the plasticity response in older adults.
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Affiliation(s)
- George M Opie
- Discipline of Physiology, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - John Cirillo
- Movement Neuroscience Laboratory, Department of Exercise Sciences, The University of Auckland, Auckland, New Zealand.,Centre for Brain Research, The University of Auckland, Auckland, New Zealand
| | - John G Semmler
- Discipline of Physiology, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
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17
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How different priming stimulations affect the corticospinal excitability induced by noninvasive brain stimulation techniques: a systematic review and meta-analysis. Rev Neurosci 2018; 29:883-899. [DOI: 10.1515/revneuro-2017-0111] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 01/12/2018] [Indexed: 11/15/2022]
Abstract
Abstract
Noninvasive brain stimulation (NIBS) techniques could induce changes in corticospinal excitability (CSE) and neuroplasticity. These changes could be affected by different factors, including having a session of stimulation called the ‘priming’ protocol before the main stimulation session called the ‘test’ protocol. Literature indicates that a priming protocol could affect the activity of postsynaptic neurons, form a neuronal history, and then modify the expected effects of the test protocol on CSE indicated by the amplitude of transcranial magnetic stimulation-induced motor-evoked potentials. This prior history affects a threshold to activate the necessary mechanism stabilizing the neuronal activity within a useful dynamic range. For studying the effects of this history and related metaplasticity mechanisms in the human primary motor cortex (M1), priming-test protocols are successfully employed. Thirty-two studies were included in this review to investigate how different priming protocols could affect the induced effects of a test protocol on CSE in healthy individuals. The results showed that if the history of synaptic activity were high or low enough to displace the threshold, the expected effects of the test protocol would be the reverse. This effect reversal is regulated by homeostatic mechanisms. On the contrary, the effects of the test protocol would not be the reverse, and at most we experience a prolongation of the lasting effects if the aforementioned history is not enough to displace the threshold. This effect prolongation is mediated by nonhomeostatic mechanisms. Therefore, based on the characteristics of priming-test protocols and the interval between them, the expected results of priming-test protocols would be different. Moreover, these findings could shed light on the different mechanisms of metaplasticity involved in NIBS. It helps us understand how we can improve the expected outcomes of these techniques in clinical approaches.
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18
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Sidhu SK, Pourmajidian M, Opie GM, Semmler JG. Increasing motor cortex plasticity with spaced paired associative stimulation at different intervals in older adults. Eur J Neurosci 2017; 46:2674-2683. [PMID: 28965371 DOI: 10.1111/ejn.13729] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 09/25/2017] [Accepted: 09/25/2017] [Indexed: 12/01/2022]
Abstract
The ability of priming non-invasive brain stimulation (NIBS) to modulate neuroplasticity induction (i.e. metaplasticity) within primary motor cortex (M1) may be altered in older adults. Previous studies in young subjects suggest that consecutive NIBS protocols interact in a time-dependent manner and involve homoeostatic metaplasticity mechanisms. This was investigated in older adults by assessing the response to consecutive blocks of paired-associative stimulation (PAS) separated by different inter-PAS intervals (IPIs). Fifteen older (62-82 years) subjects participated in four sessions, with each session involving two PAS blocks separated by IPIs of 10 (IPI10 ) or 30 (IPI30 ) mins. For each IPI, the first (priming) PAS block was either PASLTP (N20 latency + 2 ms) or PASLTD (N20 latency - 10 ms), while the second (test) PAS block was always PASLTP . Changes in M1 excitability were assessed by recording motor evoked potentials from a muscle of the right hand. For both IPIs, the response produced by PASLTD -primed PASLTP was significantly greater than the response produced by PASLTP -primed PASLTP . Furthermore, the effects of PASLTD priming on PASLTP were significantly greater for IPI30 . These findings suggest that priming PAS can increase plasticity induction in older adults, and this occurs through mechanisms involving homoeostatic metaplasticity. They also demonstrate that the timing between priming and test NIBS is a crucial determinant of this effect, with a 30-min interval being most effective. Providing a 30-min delay between priming NIBS and motor training may improve the efficacy of NIBS in augmenting motor performance and learning in the elderly.
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Affiliation(s)
- Simranjit K Sidhu
- Discipline of Physiology, Adelaide Medical School, The University of Adelaide, North Terrace Campus, Frome Road, Adelaide, SA 5005, Australia
| | - Maryam Pourmajidian
- Discipline of Physiology, Adelaide Medical School, The University of Adelaide, North Terrace Campus, Frome Road, Adelaide, SA 5005, Australia
| | - George M Opie
- Discipline of Physiology, Adelaide Medical School, The University of Adelaide, North Terrace Campus, Frome Road, Adelaide, SA 5005, Australia
| | - John G Semmler
- Discipline of Physiology, Adelaide Medical School, The University of Adelaide, North Terrace Campus, Frome Road, Adelaide, SA 5005, Australia
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