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Moslemi Z, Toledo-Aldana EA, Baldwin B, Donkers SJ, Eng JJ, Mondal P, de Zepetnek JOT, Buttigieg J, Levin MC, Mang CS. Task-oriented exercise effects on walking and corticospinal excitability in multiple sclerosis: protocol for a randomized controlled trial. BMC Sports Sci Med Rehabil 2023; 15:175. [PMID: 38129896 PMCID: PMC10734154 DOI: 10.1186/s13102-023-00790-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) is a degenerative disease of the central nervous system (CNS) that disrupts walking function and results in other debilitating symptoms. This study compares the effects of 'task-oriented exercise' against 'generalized resistance and aerobic exercise' and a 'stretching control' on walking and CNS function in people with MS (PwMS). We hypothesize that task-oriented exercise will enhance walking speed and related neural changes to a greater extent than other exercise approaches. METHODS This study is a single-blinded, three-arm randomized controlled trial conducted in Saskatchewan, Canada. Eligible participants are those older than 18 years of age with a diagnosis of MS and an expanded Patient-Determined Disease Steps (PDDS) score between 3 ('gait disability') and 6 ('bilateral support'). Exercise interventions are delivered for 12 weeks (3 × 60-min per week) in-person under the supervision of a qualified exercise professional. Interventions differ in exercise approach, such that task-oriented exercise involves weight-bearing, walking-specific activities, while generalized resistance and aerobic exercise uses seated machine-based resistance training of major upper and lower body muscle groups and recumbent cycling, and the stretching control exercise involves seated flexibility and relaxation activities. Participants are allocated to interventions using blocked randomization that stratifies by PDDS (mild: 3-4; moderate: 5-6). Assessments are conducted at baseline, post-intervention, and at a six-week retention time point. The primary and secondary outcome measures are the Timed 25-Foot Walk Test and corticospinal excitability for the tibialis anterior muscles determined using transcranial magnetic stimulation (TMS), respectively. Tertiary outcomes include assessments of balance, additional TMS measures, blood biomarkers of neural health and inflammation, and measures of cardiorespiratory and musculoskeletal fitness. DISCUSSION A paradigm shift in MS healthcare towards the use of "exercise as medicine" was recently proposed to improve outcomes and alleviate the economic burden of MS. Findings will support this shift by informing the development of specialized exercise programming that targets walking and changes in corticospinal excitability in PwMS. TRIAL REGISTRATION ClinicalTrials.gov, NCT05496881, Registered August 11, 2022. https://classic. CLINICALTRIALS gov/ct2/show/NCT05496881 . Protocol amendment number: 01; Issue date: August 1, 2023; Primary reason for amendment: Expand eligibility to include people with all forms of MS rather than progressive forms of MS only.
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Affiliation(s)
- Zahra Moslemi
- Faculty of Kinesiology and Health Studies, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A1, Canada
| | - Eduardo A Toledo-Aldana
- Faculty of Kinesiology and Health Studies, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A1, Canada
| | - Bruce Baldwin
- Faculty of Kinesiology and Health Studies, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A1, Canada
| | - Sarah J Donkers
- School of Rehabilitation Sciences, College of Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada
| | - Janice J Eng
- Centre for Aging SMART at Vancouver Coastal Health, Department of Physical Therapy, University of British Columbia, 2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Prosanta Mondal
- Clinical Research Support Unit, University of Saskatchewan, 3200 Health Science E-wing, Saskatoon, SK, S7N 5B5, Canada
| | - Julia O Totosy de Zepetnek
- Faculty of Kinesiology and Health Studies, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A1, Canada
| | - Josef Buttigieg
- Department of Biology, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A1, Canada
| | - Michael C Levin
- Department of Neurology and Anatomy and Cell Biology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Cameron S Mang
- Faculty of Kinesiology and Health Studies, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A1, Canada.
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Maiella M, Casula EP, Borghi I, Assogna M, D’Acunto A, Pezzopane V, Mencarelli L, Rocchi L, Pellicciari MC, Koch G. Simultaneous transcranial electrical and magnetic stimulation boost gamma oscillations in the dorsolateral prefrontal cortex. Sci Rep 2022; 12:19391. [PMID: 36371451 PMCID: PMC9653481 DOI: 10.1038/s41598-022-23040-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 10/25/2022] [Indexed: 11/13/2022] Open
Abstract
Neural oscillations in the gamma frequency band have been identified as a fundament for synaptic plasticity dynamics and their alterations are central in various psychiatric and neurological conditions. Transcranial magnetic stimulation (TMS) and alternating electrical stimulation (tACS) may have a strong therapeutic potential by promoting gamma oscillations expression and plasticity. Here we applied intermittent theta-burst stimulation (iTBS), an established TMS protocol known to induce LTP-like cortical plasticity, simultaneously with transcranial alternating current stimulation (tACS) at either theta (θtACS) or gamma (γtACS) frequency on the dorsolateral prefrontal cortex (DLPFC). We used TMS in combination with electroencephalography (EEG) to evaluate changes in cortical activity on both left/right DLPFC and over the vertex. We found that simultaneous iTBS with γtACS but not with θtACS resulted in an enhancement of spectral gamma power, a trend in shift of individual peak frequency towards faster oscillations and an increase of local connectivity in the gamma band. Furthermore, the response to the neuromodulatory protocol, in terms of gamma oscillations and connectivity, were directly correlated with the initial level of cortical excitability. These results were specific to the DLPFC and confined locally to the site of stimulation, not being detectable in the contralateral DLPFC. We argue that the results described here could promote a new and effective method able to induce long-lasting changes in brain plasticity useful to be clinically applied to several psychiatric and neurological conditions.
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Affiliation(s)
- Michele Maiella
- grid.417778.a0000 0001 0692 3437Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, 00179 Rome, Italy
| | - Elias Paolo Casula
- grid.417778.a0000 0001 0692 3437Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, 00179 Rome, Italy ,grid.7841.aDepartment of Psychology, La Sapienza University, Rome, Italy
| | - Ilaria Borghi
- grid.417778.a0000 0001 0692 3437Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, 00179 Rome, Italy ,grid.25786.3e0000 0004 1764 2907Center for Translational Neurophysiology of Speech and Communication, Istituto Italiano di Tecnologia (IIT), Ferrara, Italy
| | - Martina Assogna
- grid.417778.a0000 0001 0692 3437Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, 00179 Rome, Italy
| | - Alessia D’Acunto
- grid.417778.a0000 0001 0692 3437Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, 00179 Rome, Italy
| | - Valentina Pezzopane
- grid.417778.a0000 0001 0692 3437Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, 00179 Rome, Italy
| | - Lucia Mencarelli
- grid.417778.a0000 0001 0692 3437Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, 00179 Rome, Italy
| | - Lorenzo Rocchi
- grid.7763.50000 0004 1755 3242Department of Medical Sciences and Public Health, Institute of Neurology, University of Cagliari, Cagliari, Italy
| | - Maria Concetta Pellicciari
- grid.417778.a0000 0001 0692 3437Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, 00179 Rome, Italy
| | - Giacomo Koch
- grid.417778.a0000 0001 0692 3437Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, 00179 Rome, Italy ,grid.8484.00000 0004 1757 2064Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
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Cortical mechanisms underlying variability in intermittent theta-burst stimulation-induced plasticity: A TMS-EEG study. Clin Neurophysiol 2021; 132:2519-2531. [PMID: 34454281 DOI: 10.1016/j.clinph.2021.06.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/10/2021] [Accepted: 06/22/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To test the hypothesis that intermittent theta burst stimulation (iTBS) variability depends on the ability to engage specific neurons in the primary motor cortex (M1). METHODS In a sham-controlled interventional study on 31 healthy volunteers, we used concomitant transcranial magnetic stimulation (TMS) and electroencephalography (EEG). We compared baseline motor evoked potentials (MEPs), M1 iTBS-evoked EEG oscillations, and resting-state EEG (rsEEG) between subjects who did and did not show MEP facilitation following iTBS. We also investigated whether baseline MEP and iTBS-evoked EEG oscillations could explain inter and intraindividual variability in iTBS aftereffects. RESULTS The facilitation group had smaller baseline MEPs than the no-facilitation group and showed more iTBS-evoked EEG oscillation synchronization in the alpha and beta frequency bands. Resting-state EEG power was similar between groups and iTBS had a similar non-significant effect on rsEEG in both groups. Baseline MEP amplitude and beta iTBS-evoked EEG oscillation power explained both inter and intraindividual variability in MEP modulation following iTBS. CONCLUSIONS The results show that variability in iTBS-associated plasticity depends on baseline corticospinal excitability and on the ability of iTBS to engage M1 beta oscillations. SIGNIFICANCE These observations can be used to optimize iTBS investigational and therapeutic applications.
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Determining the optimal pulse number for theta burst induced change in cortical excitability. Sci Rep 2021; 11:8726. [PMID: 33888752 PMCID: PMC8062542 DOI: 10.1038/s41598-021-87916-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 04/06/2021] [Indexed: 12/19/2022] Open
Abstract
Theta-burst stimulation (TBS) is a form of non-invasive neuromodulation which is delivered in an intermittent (iTBS) or continuous (cTBS) manner. Although 600 pulses is the most common dose, the goal of these experiments was to evaluate the effect of higher per-dose pulse numbers on cortical excitability. Sixty individuals were recruited for 2 experiments. In Experiment 1, participants received 600, 1200, 1800, or sham (600) iTBS (4 visits, counterbalanced, left motor cortex, 80% active threshold). In Experiment 2, participants received 600, 1200, 1800, 3600, or sham (600) cTBS (5 visits, counterbalanced). Motor evoked potentials (MEP) were measured in 10-min increments for 60 min. For iTBS, there was a significant interaction between dose and time (F = 3.8296, p = 0.01), driven by iTBS (1200) which decreased excitability for up to 50 min (t = 3.1267, p = 0.001). For cTBS, there was no overall interaction between dose and time (F = 1.1513, p = 0.33). Relative to sham, cTBS (3600) increased excitability for up to 60 min (t = 2.0880, p = 0.04). There were no other significant effects of dose relative to sham in either experiment. Secondary analyses revealed high within and between subject variability. These results suggest that iTBS (1200) and cTBS (3600) are, respectively, the most effective doses for decreasing and increasing cortical excitability.
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Dai W, Nakagawa K, Nakajima T, Kanosue K. Determinants of Neural Plastic Changes Induced by Motor Practice. Front Hum Neurosci 2021; 15:613867. [PMID: 33584230 PMCID: PMC7875877 DOI: 10.3389/fnhum.2021.613867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 01/04/2021] [Indexed: 11/29/2022] Open
Abstract
Short-term motor practice leads to plasticity in the primary motor cortex (M1). The purpose of this study is to investigate the factors that determine the increase in corticospinal tract (CST) excitability after motor practice, with special focus on two factors; “the level of muscle activity” and “the presence/absence of a goal of keeping the activity level constant.” Fifteen healthy subjects performed four types of rapid thumb adduction in separate sessions. In the “comfortable task” (C) and “forceful task” (F), the subjects adducted their thumb using comfortable and strong forces. In the “comfortable with a goal task” (CG) and “forceful with a goal task” (FG), subjects controlled the muscle activity at the same level as in the C and F, respectively, by adjusting the peak electromyographic amplitude within the target ranges. Paired associative stimulation (PAS), which combines peripheral nerve (median nerve) stimulation and transcranial magnetic stimulation (TMS), with an inter-stimulus interval of 25 ms (PAS25) was also done. Before and after the motor tasks and PAS25, TMS was applied to the M1. None of the four tasks showed any temporary changes in behavior, meaning no learning occurred. Motor-evoked potential (MEP) amplitude increased only after the FG and it exhibited a positive correlation with the MEP increase after PAS25, suggesting that FG and PAS25 share at least similar plasticity mechanisms in the M1. Resting motor threshold (RMT) decreased only after FG, suggesting that FG would also be associated with the membrane depolarization of M1 neurons. These results suggest task-dependent plasticity from the synergistic effect of forceful muscle activity and of setting a goal of keeping the activity level constant.
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Affiliation(s)
- Wen Dai
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Kento Nakagawa
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Tsuyoshi Nakajima
- Department of Integrative Physiology, Kyorin University School of Medicine, Tokyo, Japan
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Whife CJ, Vallence AM, Edgar DW, Wood FM. Decreased neuroplasticity in minor burn injury survivors compared to non-injured adults: A pilot study in burn injury survivors aged 45 years and older. Burns 2020; 47:327-337. [PMID: 33288329 DOI: 10.1016/j.burns.2020.10.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 10/22/2020] [Accepted: 10/29/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Neuroplasticity is the capacity of the brain to change or adapt with experience: brain changes occur with use, disuse, and injury. Repetitive transcranial magnetic stimulation (rTMS) can be used to induce neuroplasticity in the human brain. Here, we examined rTMS-induced neuroplasticity in the primary motor cortex in burns survivors and controls without injury, and whether neuroplasticity is associated with functional recovery in burns survivors. METHODS Sixteen burn injury survivors (total body surface area of burn injury <15%) and 13 non-injured control participants were tested. Repetitive TMS (specifically, spaced continuous theta-burst stimulation[cTBS]) was applied to induce neuroplasticity 6 and 12 weeks after injury in burn survivors and in two sessions separated by 6 weeks in controls. Motor evoked potentials (MEPs) elicited by single-pulse TMS were measured before and after rTMS to measure neuroplasticity. Burns survivors completed a functional assessment 12 weeks after injury. RESULTS Non-injured controls showed decreased MEP amplitude 15-30 min after spaced cTBS in both experimental sessions. Burn survivors showed a smaller change in MEP amplitude after spaced cTBS compared to controls 6 weeks after burn injury but no difference compared to controls 12 weeks after burn injury. In burn survivors, there was a significant positive association between general health outcome (Short-Form Health Survey) and the change in MEP amplitude after spaced cTBS 12 weeks after injury (r=.73, p = .01). CONCLUSIONS The current findings suggest that burn survivors have a reduced capacity for neuroplasticity early in the recovery period (6 weeks after injury), which normalizes later in the recovery period (12 weeks after injury). Furthermore, the results provide preliminary evidence to suggest that burn survivors with normalized neuroplasticity 12 weeks after injury recover faster after burn injury.
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Affiliation(s)
- Casey J Whife
- Burn Injury Research Unit, School of Surgery, University of Western Australia, Crawley, Western Australia, Australia
| | - Ann-Maree Vallence
- Psychology, Murdoch University, Western Australia, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Western Australia, Australia; Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Western Australia, Australia.
| | - Dale W Edgar
- Burn Injury Research Unit, School of Surgery, University of Western Australia, Crawley, Western Australia, Australia; Burn Injury Research Node, The University of Notre Dame Australia, Fremantle, Western Australia, Australia; Burns Service of Western Australia, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Fiona M Wood
- Burn Injury Research Unit, School of Surgery, University of Western Australia, Crawley, Western Australia, Australia; Burns Service of Western Australia, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
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Pellegrini M, Zoghi M, Jaberzadeh S. A Checklist to Reduce Response Variability in Studies Using Transcranial Magnetic Stimulation for Assessment of Corticospinal Excitability: A Systematic Review of the Literature. Brain Connect 2020; 10:53-71. [PMID: 32093486 DOI: 10.1089/brain.2019.0715] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Response variability between individuals (interindividual variability) and within individuals (intraindividual variability) is an important issue in the transcranial magnetic stimulation (TMS) literature. This has raised questions of the validity of TMS to assess changes in corticospinal excitability (CSE) in a predictable and reliable manner. Several participant-specific factors contribute to this observed response variability with a current lack of consensus on the degree each factor contributes. This highlights a need for consistency and structure in reporting study designs and methodologies. Currently, there is no summarized review of the participant-specific factors that can be controlled and may contribute to response variability. This systematic review aimed to develop a checklist of methodological measures taken by previously published research to increase the homogeneity of participant selection criteria, preparation of participants before experimental testing, participant scheduling, and the instructions given to participants throughout experimental testing to minimize their effect on response variability. Seven databases were searched in full. Studies were included if CSE was measured via TMS and included methodological measures to increase the homogeneity of the participants. Eighty-four studies were included. Twenty-three included measures to increase participant selection homogeneity, 21 included measures to increase participant preparation homogeneity, while 61 included measures to increase participant scheduling and instructions during experimental testing homogeneity. These methodological measures were summarized into a user-friendly checklist with considerations, suggestions, and rationale/justification for their inclusion. This may provide the framework for further insights into ways to reduce response variability in TMS research.
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Affiliation(s)
- Michael Pellegrini
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, Discipline of Physiotherapy, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - Shapour Jaberzadeh
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia
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Cavaleri R, Chipchase LS, Massé-Alarie H, Schabrun SM, Shraim MA, Hodges PW. Corticomotor reorganization during short-term visuomotor training in the lower back: A randomized controlled study. Brain Behav 2020; 10:e01702. [PMID: 32633899 PMCID: PMC7428511 DOI: 10.1002/brb3.1702] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 04/29/2020] [Accepted: 05/17/2020] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Accumulating evidence suggests that motor skill training is associated with structural and functional reorganization of the primary motor cortex. However, previous studies have focussed primarily upon the upper limb, and it is unclear whether comparable reorganization occurs following training of other regions, such as the lower back. Although this holds important implications for rehabilitation, no studies have examined corticomotor adaptations following short-term motor training in the lower back. METHOD The aims of this study were to (a) determine whether a short-term lumbopelvic tilt visuomotor task induced reorganization of the corticomotor representations of lower back muscles, (b) quantify the variability of corticomotor responses to motor training, and (c) determine whether any improvements in task performance were correlated with corticomotor reorganization. Participants were allocated randomly to perform a lumbopelvic tilt motor training task (n = 15) or a finger abduction control task involving no lumbopelvic movement (n = 15). Transcranial magnetic stimulation was used to map corticomotor representations of the lumbar erector spinae before, during, and after repeated performance of the allocated task. RESULTS No relationship between corticomotor reorganization and improved task performance was identified. Substantial variability was observed in terms of corticomotor responses to motor training, with approximately 50% of participants showing no corticomotor reorganization despite significant improvements in task performance. CONCLUSION These findings suggest that short-term improvements in lower back visuomotor task performance may be driven by changes in remote subcortical and/or spinal networks rather than adaptations in corticomotor pathways. However, further research using tasks of varying complexities and durations is required to confirm this hypothesis.
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Affiliation(s)
- Rocco Cavaleri
- School of Health Sciences, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Lucy S Chipchase
- School of Health Sciences, Western Sydney University, Campbelltown, New South Wales, Australia.,College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Hugo Massé-Alarie
- CIRRIS Research Centre, Department of Rehabilitation, Laval University, Quebec, Canada.,Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | | | - Muath A Shraim
- Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Paul W Hodges
- Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
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Vleugels LWE, Swinnen SP, Hardwick RM. Skill acquisition is enhanced by reducing trial-to-trial repetition. J Neurophysiol 2020; 123:1460-1471. [PMID: 32049588 DOI: 10.1152/jn.00741.2019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Developing approaches to improve motor skill learning is of considerable interest across multiple disciplines. Previous research has typically shown that repeating the same action on consecutive trials enhances short-term performance but has detrimental effects on longer term skill acquisition. However, most prior research has contrasted the effects of repetition only at the block level; in the current study we examined the effects of repeating individual trials embedded in a larger randomized block, a feature that is often overlooked when random trial orders are generated in learning tasks. With 4 days of practice, a "Minimal Repeats" group, who rarely experienced repeating stimuli on consecutive trials during training, improved to a greater extent than a "Frequent Repeats" group, who were frequently presented with repeating stimuli on consecutive trials during training. Our results extend the previous finding of the beneficial effects of random compared with blocked practice on performance, showing that reduced trial-to-trial repetition during training is favorable with regard to skill learning. This research highlights that limiting the number of repeats on consecutive trials is a simple behavioral manipulation that can enhance the process of skill learning. Data/analysis code and Supplemental Material are available at https://osf.io/p3278/.NEW & NOTEWORTHY Numerous studies have shown that performing different subtasks across consecutive blocks of trials enhances learning. We examined whether the same effect would occur on a trial-to-trial level. Our Minimal Repeats group, who primarily responded to different stimuli on consecutive trials, learned more than our Frequent Repeats group, who frequently responded to the same stimulus on consecutive trials. This shows that minimizing trial-to-trial repetition is a simple and easily applicable manipulation that can enhance learning.
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Affiliation(s)
- Lore W E Vleugels
- Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, KU Leuven, Belgium.,Cognition and Systems Neuroscience Division, Institute of Neurosciences, UC Louvain, Belgium
| | - Stephan P Swinnen
- Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, KU Leuven, Belgium.,Leuven Brain Institute, KU Leuven, Belgium
| | - Robert M Hardwick
- Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, KU Leuven, Belgium.,Cognition and Systems Neuroscience Division, Institute of Neurosciences, UC Louvain, Belgium
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Cortical Excitability, Synaptic Plasticity, and Cognition in Benign Epilepsy With Centrotemporal Spikes: A Pilot TMS-EMG-EEG Study. J Clin Neurophysiol 2020; 37:170-180. [PMID: 32142025 DOI: 10.1097/wnp.0000000000000662] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Children with benign epilepsy with centrotemporal spikes have rare seizures emerging from the motor cortex, which they outgrow in adolescence, and additionally may have language deficits of unclear etiology. We piloted the use of transcranial magnetic stimulation paired with EMG and EEG (TMS-EMG, TMS-EEG) to test the hypotheses that net cortical excitability decreases with age and that use-dependent plasticity predicts learning. METHODS We assessed language and motor learning in 14 right-handed children with benign epilepsy with centrotemporal spikes. We quantified two TMS metrics of left motor cortex excitability: the resting motor threshold (measure of neuronal membrane excitability) and amplitude of the N100-evoked potential (an EEG measure of GABAergic tone). To test plasticity, we applied 1 Hz repetitive TMS to the motor cortex to induce long-term depression-like changes in EMG- and EEG-evoked potentials. RESULTS Children with benign epilepsy with centrotemporal spikes tolerate TMS; no seizures were provoked. Resting motor threshold decreases with age but is elevated above maximal stimulator output for half the group. N100 amplitude decreases with age after controlling for resting motor threshold. Motor cortex plasticity correlates significantly with language learning and at a trend level with motor learning. CONCLUSIONS Transcranial magnetic stimulation is safe and feasible for children with benign epilepsy with centrotemporal spikes, and TMS-EEG provides more reliable outcome measures than TMS-EMG in this group because many children have unmeasurably high resting motor thresholds. Net cortical excitability decreases with age, and motor cortex plasticity predicts not only motor learning but also language learning, suggesting a mechanism by which motor cortex seizures may interact with language development.
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Galaro JK, Celnik P, Chib VS. Motor Cortex Excitability Reflects the Subjective Value of Reward and Mediates Its Effects on Incentive-Motivated Performance. J Neurosci 2019; 39:1236-1248. [PMID: 30552182 PMCID: PMC6381239 DOI: 10.1523/jneurosci.1254-18.2018] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 11/30/2018] [Accepted: 12/04/2018] [Indexed: 01/03/2023] Open
Abstract
Performance-based incentives tend to increase an individual's motivation, resulting in enhancements in behavioral output. While much work has focused on understanding how the brain's reward circuitry influences incentive-motivated performance, fewer studies have investigated how such reward representations act on the motor system. Here we measured motor cortical excitability with transcranial magnetic stimulation while female and male human participants performed a motoric incentive motivation task for prospective monetary gains and losses. We found that individuals' performance increased for increasing prospective gains and losses. While motor cortical excitability appeared insensitive to prospective loss, temporal features of motor cortical excitability for prospective gains were modulated by an independent measure of an individual's subjective preferences for incentive (i.e., loss aversion). Those individuals that were more loss averse had a greater motor cortical sensitivity to prospective gain, closer to movement onset. Critically, behavioral sensitivity to incentive and motor cortical sensitivity to prospective gains were both predicted by loss aversion. Furthermore, causal modeling indicated that motor cortical sensitivity to incentive mediated the relationship between subjective preferences for incentive and behavioral sensitivity to incentive. Together, our findings suggest that motor cortical activity integrates information about the subjective value of reward to invigorate incentive-motivated performance.SIGNIFICANCE STATEMENT Increasing incentives tend to increase motivation and effort. Using a motoric incentive motivation task and transcranial magnetic stimulation, we studied the motor cortical mechanisms responsible for incentive-motivated motor performance. We provide experimental evidence that motor cortical sensitivity to incentive mediates the relationship between subjective preferences for incentive and incentive-motivated performance. These results indicate that, rather than simply being a reflection of motor output, motor cortical physiology integrates information about reward value to motivate performance.
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Affiliation(s)
- Joseph K Galaro
- Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, Maryland 21205
| | - Pablo Celnik
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland 21287, and
| | - Vikram S Chib
- Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, Maryland 21205,
- Kennedy Krieger Institute, Baltimore, Maryland 21205
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12
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Palmer JA, Halter A, Gray W, Wolf SL, Borich MR. Modulatory Effects of Motor State During Paired Associative Stimulation on Motor Cortex Excitability and Motor Skill Learning. Front Hum Neurosci 2019; 13:8. [PMID: 30760990 PMCID: PMC6361855 DOI: 10.3389/fnhum.2019.00008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 01/08/2019] [Indexed: 01/06/2023] Open
Abstract
Repeated pairing of electrical stimulation of a peripheral nerve with transcranial magnetic stimulation (TMS) over the primary motor cortex (M1) representation for a target muscle can induce neuroplastic adaptations in the human brain related to motor learning. The extent to which the motor state during this form of paired associative stimulation (PAS) influences the degree and mechanisms of neuroplasticity or motor learning is unclear. Here, we investigated the effect of volitional muscle contraction during PAS on: (1) measures of general corticomotor excitability and intracortical circuit excitability; and (2) motor performance and learning. We assessed measures of corticomotor excitability using TMS and motor skill performance during a serial reaction time task (SRTT) at baseline and at 0, 30, 60 min post-PAS. Participants completed a SRTT retention test 1 week following the first two PAS sessions. Following the PAS intervention where the hand muscle maintained an active muscle contraction (PASACTIVE), there was lower short interval intracortical inhibition compared to PAS during a resting motor state (PASREST) and a sham PAS condition (PASCONTROL). SRTT performance improved within the session regardless of PAS condition. SRTT retention was greater following both PASACTIVE and PASREST after 1 week compared to PASCONTROL. These findings suggest that PAS may enhance motor learning retention and that motor state may be used to target different neural mechanisms of intracortical excitation and inhibition during PAS. This observation may be important to consider for the use of therapeutic noninvasive brain stimulation in neurologic patient populations.
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Affiliation(s)
- Jacqueline A Palmer
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University, Atlanta, GA, United States
| | - Alice Halter
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University, Atlanta, GA, United States
| | - Whitney Gray
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University, Atlanta, GA, United States
| | - Steven L Wolf
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University, Atlanta, GA, United States.,Atlanta VA Health Care System Visual and Neurocognitive Center of Excellence, Decatur, GA, United States
| | - Michael R Borich
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University, Atlanta, GA, United States
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13
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Lopez-Alonso V, Liew SL, Fernández Del Olmo M, Cheeran B, Sandrini M, Abe M, Cohen LG. A Preliminary Comparison of Motor Learning Across Different Non-invasive Brain Stimulation Paradigms Shows No Consistent Modulations. Front Neurosci 2018; 12:253. [PMID: 29740271 PMCID: PMC5924807 DOI: 10.3389/fnins.2018.00253] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 04/03/2018] [Indexed: 12/13/2022] Open
Abstract
Non-invasive brain stimulation (NIBS) has been widely explored as a way to safely modulate brain activity and alter human performance for nearly three decades. Research using NIBS has grown exponentially within the last decade with promising results across a variety of clinical and healthy populations. However, recent work has shown high inter-individual variability and a lack of reproducibility of previous results. Here, we conducted a small preliminary study to explore the effects of three of the most commonly used excitatory NIBS paradigms over the primary motor cortex (M1) on motor learning (Sequential Visuomotor Isometric Pinch Force Tracking Task) and secondarily relate changes in motor learning to changes in cortical excitability (MEP amplitude and SICI). We compared anodal transcranial direct current stimulation (tDCS), paired associative stimulation (PAS25), and intermittent theta burst stimulation (iTBS), along with a sham tDCS control condition. Stimulation was applied prior to motor learning. Participants (n = 28) were randomized into one of the four groups and were trained on a skilled motor task. Motor learning was measured immediately after training (online), 1 day after training (consolidation), and 1 week after training (retention). We did not find consistent differential effects on motor learning or cortical excitability across groups. Within the boundaries of our small sample sizes, we then assessed effect sizes across the NIBS groups that could help power future studies. These results, which require replication with larger samples, are consistent with previous reports of small and variable effect sizes of these interventions on motor learning.
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Affiliation(s)
- Virginia Lopez-Alonso
- Human Cortical Physiology and Neurorehabilitation Section, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health, Bethesda, MD, United States.,Department of Physical Activity and Sport Sciences, "Center of Higher Education Alberta Giménez (CESAG)" Comillas Pontifical University, Palma, Spain.,Department of Physical Education, Faculty of Sciences of Sport and Physical Education, University of A Coruña, A Coruña, Spain
| | - Sook-Lei Liew
- Human Cortical Physiology and Neurorehabilitation Section, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health, Bethesda, MD, United States.,Departments of Occupational Therapy, Biokinesiology, and Neurology, Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, United States
| | - Miguel Fernández Del Olmo
- Department of Physical Education, Faculty of Sciences of Sport and Physical Education, University of A Coruña, A Coruña, Spain
| | - Binith Cheeran
- Molecular and Clinical Sciences Institute, St. George's, University of London, London, United Kingdom.,The London Clinic, London, United Kingdom
| | - Marco Sandrini
- Department of Psychology, University of Roehampton, London, United Kingdom
| | - Mitsunari Abe
- Faculty of Medicine, Center for Neurological Disorders, Fukushima Medical University, Fukushima, Japan
| | - Leonardo G Cohen
- Human Cortical Physiology and Neurorehabilitation Section, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health, Bethesda, MD, United States
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14
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van de Ruit M, Grey MJ. Interindividual Variability in Use-Dependent Plasticity Following Visuomotor Learning: The Effect of Handedness and Muscle Trained. J Mot Behav 2018; 51:171-184. [PMID: 29611783 DOI: 10.1080/00222895.2018.1446125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Motor learning has been linked with increases in corticospinal excitability (CSE). However, the robustness of this link is unclear. In this study, changes in CSE associated with learning a visuomotor tracking task were mapped using transcranial magnetic stimulation (TMS). TMS maps were obtained before and after training with the first dorsal interosseous (FDI) of the dominant and nondominant hand, and for a distal (FDI) and proximal (biceps brachii) muscle. Tracking performance improved following 20 min of visuomotor training, while map area was unaffected. Large individual differences were observed with 18%-36% of the participants revealing an increase in TMS map area. This result highlights the complex relationship between motor learning and use-dependent plasticity of the motor cortex.
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Affiliation(s)
- Mark van de Ruit
- a Department of Biomechanical Engineering , Delft University of Technology , Delft , The Netherlands
| | - Michael J Grey
- b Acquired Brain Injury Rehabilitation Alliance, School of Health Sciences, University of East Anglia , Norwich , United Kingdom
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15
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Suppa A, Quartarone A, Siebner H, Chen R, Di Lazzaro V, Del Giudice P, Paulus W, Rothwell J, Ziemann U, Classen J. The associative brain at work: Evidence from paired associative stimulation studies in humans. Clin Neurophysiol 2017; 128:2140-2164. [DOI: 10.1016/j.clinph.2017.08.003] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 07/20/2017] [Accepted: 08/03/2017] [Indexed: 12/25/2022]
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16
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Variability in neural excitability and plasticity induction in the human cortex: A brain stimulation study. Brain Stimul 2017; 10:588-595. [DOI: 10.1016/j.brs.2016.12.001] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 11/09/2016] [Accepted: 12/03/2016] [Indexed: 11/21/2022] Open
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17
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Priming theta burst stimulation enhances motor cortex plasticity in young but not old adults. Brain Stimul 2017; 10:298-304. [PMID: 28089653 DOI: 10.1016/j.brs.2017.01.003] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 01/03/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Primary motor cortex neuroplasticity is reduced in old adults, which may contribute to the motor deficits commonly observed in the elderly. Previous research in young subjects suggests that the neuroplastic response can be enhanced using non-invasive brain stimulation (NIBS), with a larger plastic response observed following priming with both long-term potentiation (LTP) and depression (LTD)-like protocols. However, it is not known if priming stimulation can also modulate plasticity in older adults. OBJECTIVE To investigate if priming NIBS can be used to modulate motor cortical plasticity in old subjects. METHODS In 16 young (22.3 ± 1.0 years) and 16 old (70.2 ± 1.7 years) subjects, we investigated the response to intermittent theta burst stimulation (iTBS; LTP-like) when applied 10 min after sham stimulation, continuous TBS (cTBS; LTD-like) or an identical block of iTBS. Corticospinal plasticity was assessed by recording changes in motor evoked potential (MEP) amplitude. RESULTS In young subjects, priming with cTBS (cTBS + iTBS) resulted in larger MEPs than priming with either iTBS (iTBS + iTBS; P = 0.001) or sham (sham + iTBS; P < 0.0001), while larger MEPs were seen following iTBS + iTBS than sham + iTBS (P < 0.0001). In old subjects, the response to iTBS + iTBS was not different to sham + iTBS (P > 0.9), whereas the response to cTBS + iTBS was reduced relative to iTBS + iTBS (P = 0.02) and sham + iTBS (P = 0.04). CONCLUSIONS Priming TBS is ineffective for modifying M1 plasticity in older adults, which may limit the therapeutic use of priming stimulation in neurological conditions common in the elderly.
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18
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Opie GM, Vosnakis E, Ridding MC, Ziemann U, Semmler JG. WITHDRAWN: Priming theta burst stimulation enhances motor cortex plasticity in young but not old adults. Brain Stimul 2016:S1935-861X(16)30311-4. [PMID: 27888026 DOI: 10.1016/j.brs.2016.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 11/16/2016] [Indexed: 10/20/2022] Open
Affiliation(s)
- George M Opie
- Discipline of Physiology, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Eleni Vosnakis
- Discipline of Physiology, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Michael C Ridding
- Robinson Research Institute, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Ulf Ziemann
- Department of Neurology & 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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19
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Short-term immobilization influences use-dependent cortical plasticity and fine motor performance. Neuroscience 2016; 330:247-56. [DOI: 10.1016/j.neuroscience.2016.06.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 06/02/2016] [Accepted: 06/02/2016] [Indexed: 12/21/2022]
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20
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Facilitatory non-invasive brain stimulation in older adults: the effect of stimulation type and duration on the induction of motor cortex plasticity. Exp Brain Res 2016; 234:3411-3423. [DOI: 10.1007/s00221-016-4740-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 07/19/2016] [Indexed: 10/21/2022]
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21
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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: 165] [Impact Index Per Article: 20.6] [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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22
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Goldsworthy MR, Vallence AM, Yang R, Pitcher JB, Ridding MC. Combined transcranial alternating current stimulation and continuous theta burst stimulation: a novel approach for neuroplasticity induction. Eur J Neurosci 2016; 43:572-9. [DOI: 10.1111/ejn.13142] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 11/28/2015] [Accepted: 12/01/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Mitchell R. Goldsworthy
- The Robinson Research Institute; School of Medicine; University of Adelaide; Adelaide 5005 Australia
| | - Ann-Maree Vallence
- The Robinson Research Institute; School of Medicine; University of Adelaide; Adelaide 5005 Australia
- School of Psychology and Exercise Science; Murdoch University; Perth WA Australia
| | - Ruiting Yang
- The Robinson Research Institute; School of Medicine; University of Adelaide; Adelaide 5005 Australia
| | - Julia B. Pitcher
- The Robinson Research Institute; School of Medicine; University of Adelaide; Adelaide 5005 Australia
| | - Michael C. Ridding
- The Robinson Research Institute; School of Medicine; University of Adelaide; Adelaide 5005 Australia
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23
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Goldsworthy MR, Vallence AM, Hodyl NA, Semmler JG, Pitcher JB, Ridding MC. Probing changes in corticospinal excitability following theta burst stimulation of the human primary motor cortex. Clin Neurophysiol 2016; 127:740-747. [DOI: 10.1016/j.clinph.2015.06.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 04/19/2015] [Accepted: 06/12/2015] [Indexed: 10/23/2022]
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24
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López-Alonso V, Cheeran B, Fernández-del-Olmo M. Relationship Between Non-invasive Brain Stimulation-induced Plasticity and Capacity for Motor Learning. Brain Stimul 2015; 8:1209-19. [PMID: 26319358 DOI: 10.1016/j.brs.2015.07.042] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 07/02/2015] [Accepted: 07/24/2015] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Cortical plasticity plays a key role in motor learning (ML). Non-invasive brain stimulation (NIBS) paradigms have been used to modulate plasticity in the human motor cortex in order to facilitate ML. However, little is known about the relationship between NIBS-induced plasticity over M1 and ML capacity. HYPOTHESIS NIBS-induced MEP changes are related to ML capacity. METHODS 56 subjects participated in three NIBS (paired associative stimulation, anodal transcranial direct current stimulation and intermittent theta-burst stimulation), and in three lab-based ML task (serial reaction time, visuomotor adaptation and sequential visual isometric pinch task) sessions. ANALYSIS After clustering the patterns of response to the different NIBS protocols, we compared the ML variables between the different patterns found. We used regression analysis to explore further the relationship between ML capacity and summary measures of the MEPs change. We ran correlations with the "responders" group only. RESULTS We found no differences in ML variables between clusters. Greater response to NIBS protocols may be predictive of poor performance within certain blocks of the VAT. "Responders" to AtDCS and to iTBS showed significantly faster reaction times than "non-responders." However, the physiological significance of these results is uncertain. CONCLUSION MEP changes induced in M1 by PAS, AtDCS and iTBS appear to have little, if any, association with the ML capacity tested with the SRTT, the VAT and the SVIPT. However, cortical excitability changes induced in M1 by AtDCS and iTBS may be related to reaction time and retention of newly acquired skills in certain motor learning tasks.
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Affiliation(s)
- Virginia López-Alonso
- Faculty of Sciences of Sport and Physical Education, Department of Physical Education, University of A Coruña, A Coruña, Spain
| | - Binith Cheeran
- Department of Neurology, John Radcliffe Hospital, Headington, Oxford, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Miguel Fernández-del-Olmo
- Faculty of Sciences of Sport and Physical Education, Department of Physical Education, University of A Coruña, A Coruña, Spain.
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25
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Vallence AM, Goldsworthy MR, Hodyl NA, Semmler JG, Pitcher JB, Ridding MC. Inter- and intra-subject variability of motor cortex plasticity following continuous theta-burst stimulation. Neuroscience 2015. [PMID: 26208843 DOI: 10.1016/j.neuroscience.2015.07.043] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The potential of non-invasive brain stimulation (NIBS) for studying, and inducing, functionally relevant neuroplasticity is dependent on protocols that can induce lasting, robust and reliable effects. A current limiting factor is the large inter- and intra-subject variability in NIBS-induced neuroplastic responses. There has been some study of inter-subject response variability and factors that contribute to it; however, intra-subject response variability has, so far, received little investigation. OBJECTIVES By testing participants on multiple occasions we aimed to (1) compare inter- and intra-subject variability of neuroplastic responses induced by continuous theta-burst stimulation (cTBS); (2) determine whether the transcranial magnetic stimulation (TMS) intensity used to measure cTBS-induced neuroplastic responses contributes to response variability; (3) determine whether assessment of factors known to influence response variability can be used to explain some of the variability in cTBS-induced neuroplastic responses across experimental sessions. METHODS In three separate experimental sessions, motor-evoked potential (MEP) input-output (IO) curves were obtained before and after cTBS, and questionnaire-based assessments of physical activity and perceived stress were obtained. RESULTS cTBS-induced MEP suppression was greatest at the upper end of the IO curve (150-180% resting motor threshold; RMT) and most consistent across subjects and across experimental sessions when assessed with a TMS intensity of 150% RMT. The magnitude of cTBS-induced MEP suppression evoked at 150% RMT correlated with self-reported perceived stress, but not with self-reported physical activity. CONCLUSIONS The most reliable TMS intensity to probe cTBS-induced long-term depression (LTD)-like neuroplastic responses is 150% RMT. This is unlikely to simply be a ceiling effect and, we suggest, may be due to changes in the descending volley evoked at higher stimulus intensities. The perceived stress scale appears to be sufficiently sensitive to measure the influence of subject stress on LTD-like neuroplastic responses.
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Affiliation(s)
- A-M Vallence
- The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Australia; School of Psychology and Exercise Science, Murdoch University, Australia.
| | - M R Goldsworthy
- The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Australia
| | - N A Hodyl
- The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Australia
| | - J G Semmler
- Discipline of Physiology, School of Medical Sciences, University of Adelaide, Australia
| | - J B Pitcher
- The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Australia
| | - M C Ridding
- The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Australia
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26
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Plasticity Induced by Intermittent Theta Burst Stimulation in Bilateral Motor Cortices Is Not Altered in Older Adults. Neural Plast 2015; 2015:323409. [PMID: 26064691 PMCID: PMC4438185 DOI: 10.1155/2015/323409] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 04/22/2015] [Indexed: 01/28/2023] Open
Abstract
Numerous studies have reported that plasticity induced in the motor cortex by transcranial magnetic stimulation (TMS) is attenuated in older adults. Those investigations, however, have focused solely on the stimulated hemisphere. Compared to young adults, older adults exhibit more widespread activity across bilateral motor cortices during the performance of unilateral motor tasks, suggesting that the manifestation of plasticity might also be altered. To address this question, twenty young (<35 years old) and older adults (>65 years) underwent intermittent theta burst stimulation (iTBS) whilst attending to the hand targeted by the plasticity-inducing procedure. The amplitude of motor evoked potentials (MEPs) elicited by single pulse TMS was used to quantify cortical excitability before and after iTBS. Individual responses to iTBS were highly variable, with half the participants showing an unexpected decrease in cortical excitability. Contrary to predictions, however, there were no age-related differences in the magnitude or manifestation of plasticity across bilateral motor cortices. The findings suggest that advancing age does not influence the capacity for, or manifestation of, plasticity induced by iTBS.
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27
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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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28
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Efficacy and interindividual variability in motor-cortex plasticity following anodal tDCS and paired-associative stimulation. Neural Plast 2015; 2015:530423. [PMID: 25866683 PMCID: PMC4381571 DOI: 10.1155/2015/530423] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Revised: 02/27/2015] [Accepted: 02/27/2015] [Indexed: 02/06/2023] Open
Abstract
Interindividual response variability to various motor-cortex stimulation protocols has been recently reported. Comparative data of stimulation protocols with different modes of action is lacking. We aimed to compare the efficacy and response variability of two LTP-inducing stimulation protocols in the human motor cortex: anodal transcranial direct current stimulation (a-tDCS) and paired-associative stimulation (PAS25). In two experiments 30 subjects received 1mA a-tDCS and PAS25. Data analysis focused on motor-cortex excitability change and response defined as increase in MEP applying different cut-offs. Furthermore, the predictive pattern of baseline characteristics was explored. Both protocols induced a significant increase in motor-cortical excitability. In the PAS25 experiments the likelihood to develop a MEP response was higher compared to a-tDCS, whereas for intracortical facilitation (ICF) the likelihood for a response was higher in the a-tDCS experiments. Baseline ICF (12 ms) correlated positively with an increase in MEPs only following a-tDCS and responders had significantly higher ICF baseline values. Contrary to recent studies, we showed significant group-level efficacy following both stimulation protocols confirming older studies. However, we also observed a remarkable amount of nonresponders. Our findings highlight the need to define sufficient physiological read-outs for a given plasticity protocol and to develop predictive markers for targeted stimulation.
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29
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von Rein E, Hoff M, Kaminski E, Sehm B, Steele CJ, Villringer A, Ragert P. Improving motor performance without training: the effect of combining mirror visual feedback with transcranial direct current stimulation. J Neurophysiol 2015; 113:2383-9. [PMID: 25632079 DOI: 10.1152/jn.00832.2014] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 01/20/2015] [Indexed: 11/22/2022] Open
Abstract
Mirror visual feedback (MVF) during motor training has been shown to improve motor performance of the untrained hand. Here we thought to determine if MVF-induced performance improvements of the left hand can be augmented by upregulating plasticity in right primary motor cortex (M1) by means of anodal transcranial direct current stimulation (a-tDCS) while subjects trained with the right hand. Participants performed a ball-rotation task with either their left (untrained) or right (trained) hand on two consecutive days (days 1 and 2). During training with the right hand, MVF was provided concurrent with two tDCS conditions: group 1 received a-tDCS over right M1 (n = 10), whereas group 2 received sham tDCS (s-tDCS, n = 10). On day 2, performance was reevaluated under the same experimental conditions compared with day 1 but without tDCS. While baseline performance of the left hand (day 1) was not different between groups, a-tDCS exhibited stronger MVF-induced performance improvements compared with s-tDCS. Similar results were observed for day 2 (without tDCS application). A control experiment (n = 8) with a-tDCS over right M1 as outlined above but without MVF revealed that left hand improvement was significantly less pronounced than that induced by combined a-tDCS and MVF. Based on these results, we provide novel evidence that upregulating activity in the untrained M1 by means of a-tDCS is capable of augmenting MVF-induced performance improvements in young normal volunteers. Our findings suggest that concurrent MVF and tDCS might have synergistic and additive effects on motor performance of the untrained hand, a result of relevance for clinical approaches in neurorehabilitation and/or exercise science.
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Affiliation(s)
- Erik von Rein
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; and
| | - Maike Hoff
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; and
| | - Elisabeth Kaminski
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; and
| | - Bernhard Sehm
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; and
| | - Christopher J Steele
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; and
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; and Mind and Brain Institute, Charité and Humboldt University, Berlin, Germany
| | - Patrick Ragert
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; and
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30
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Goldsworthy MR, Müller-Dahlhaus F, Ridding MC, Ziemann U. Inter-subject variability of LTD-like plasticity in human motor cortex: a matter of preceding motor activation. Brain Stimul 2014; 7:864-70. [PMID: 25216649 DOI: 10.1016/j.brs.2014.08.004] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 08/07/2014] [Accepted: 08/07/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Continuous theta burst stimulation (cTBS) of the human primary motor cortex (M1) induces long-term depression (LTD)-like plastic changes in corticospinal excitability, but several studies have reported high inter-subject variability of this effect. Most studies use a tonic voluntary contraction of the target muscle before cTBS to set stimulation intensity; however, it is unclear how this might affect response variability. OBJECTIVE To examine the influence of pre-activation of the target hand muscle on inter-subject response variability to cTBS of the human M1. METHODS The response to cTBS was assessed by changes in motor evoked potential (MEP) amplitude in the right first dorsal interosseous (FDI) muscle. For Study 1, ten healthy subjects attended two sessions. They were instructed in one session to keep their FDI relaxed for the entire testing period (pre-relax), and in the other to perform a 2-min 10% of maximal voluntary tonic contraction 15 min before cTBS (pre-active). For Study 2, data from our previous study were re-analyzed to extend the pre-relax condition to an additional 26 subjects (total n = 36). RESULTS cTBS-induced highly consistent LTD-like MEP depression in the pre-relax condition, but not in the pre-active condition. Inter-subject response variability increased in the pre-active condition. CONCLUSIONS cTBS induces consistent LTD-like plasticity with low inter-subject variability if pre-activation of the stimulated motor cortex is avoided. This affirms a translational potential of cTBS in clinical applications that aim at reducing cortical excitability.
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Affiliation(s)
- Mitchell R Goldsworthy
- Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide 5005, Australia.
| | - Florian Müller-Dahlhaus
- Department of Neurology and Stroke, and Hertie Institute for Clinical Brain Research, Eberhard-Karls-University Tübingen, Tübingen D-72076, Germany; Department of Neurology, Goethe-University Frankfurt, Frankfurt/Main D-60590, Germany
| | - Michael C Ridding
- Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide 5005, Australia
| | - Ulf Ziemann
- Department of Neurology and Stroke, and Hertie Institute for Clinical Brain Research, Eberhard-Karls-University Tübingen, Tübingen D-72076, Germany; Department of Neurology, Goethe-University Frankfurt, Frankfurt/Main D-60590, Germany
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31
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Young-Bernier M, Tanguay AN, Davidson PSR, Tremblay F. Short-latency afferent inhibition is a poor predictor of individual susceptibility to rTMS-induced plasticity in the motor cortex of young and older adults. Front Aging Neurosci 2014; 6:182. [PMID: 25147523 PMCID: PMC4124866 DOI: 10.3389/fnagi.2014.00182] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 07/07/2014] [Indexed: 11/13/2022] Open
Abstract
Cortical plasticity, including long-term potentiation (LTP)-like plasticity, can be assessed non-invasively with repetitive transcranial magnetic stimulation (rTMS) protocols. In this study, we examined age differences in responses to intermittent theta burst stimulation (iTBS) in a group of 20 young and 18 healthy older adults. Because the cholinergic system plays a role in the neural processes underlying learning and memory, including LTP, we also investigated whether short latency afferent inhibition (SAI), a neurophysiological marker of central cholinergic activity, would be associated with age-related differences in LTP-like plasticity induced by iTBS. Methods: SAI was first assessed by examining the modulation of motor evoked potentials (MEPs) in response to median nerve conditioning 20 ms prior to TMS. Participants then underwent iTBS (3 pulses at 50 Hz every 200 ms for 2 s with 8 s between trains, repeated 20 times). MEP responses (120% resting motor threshold (RMT)) were assessed immediately after iTBS and 5, 10, and 20 min post-application. Results: Responses to iTBS were quite variable in both age groups, with only approximately 60% of the participants (n = 13 young and 10 older adults) showing the expected facilitation of MEP responses. There were no significant age group differences in MEP facilitation following iTBS. Although older adults exhibited reduced SAI, individual variations were not associated with susceptibility to express LTP-like induced plasticity after iTBS. Conclusion: Overall, these results are consistent with reports of high inter-individual variability in responses to iTBS. Although SAI was reduced in older adults, consistent with a deterioration of the cholinergic system with age, SAI levels were not associated with LTP-like plasticity as assessed with iTBS.
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Affiliation(s)
- Marielle Young-Bernier
- School of Psychology, University of Ottawa Ottawa, ON, Canada ; Bruyère Research Institute, University of Ottawa Ottawa, ON, Canada
| | - Annick N Tanguay
- School of Psychology, University of Ottawa Ottawa, ON, Canada ; Bruyère Research Institute, University of Ottawa Ottawa, ON, Canada
| | - Patrick S R Davidson
- School of Psychology, University of Ottawa Ottawa, ON, Canada ; Bruyère Research Institute, University of Ottawa Ottawa, ON, Canada ; Canadian Partnership for Stroke Recovery, University of Ottawa Ottawa, ON, Canada
| | - François Tremblay
- School of Psychology, University of Ottawa Ottawa, ON, Canada ; Bruyère Research Institute, University of Ottawa Ottawa, ON, Canada ; School of Rehabilitation Sciences, University of Ottawa Ottawa, ON, Canada
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López-Alonso V, Cheeran B, Río-Rodríguez D, Fernández-del-Olmo M. Inter-individual Variability in Response to Non-invasive Brain Stimulation Paradigms. Brain Stimul 2014; 7:372-80. [DOI: 10.1016/j.brs.2014.02.004] [Citation(s) in RCA: 530] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 02/03/2014] [Accepted: 02/12/2014] [Indexed: 01/30/2023] Open
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Comparing the efficacy of excitatory transcranial stimulation methods measuring motor evoked potentials. Neural Plast 2014; 2014:837141. [PMID: 24804104 PMCID: PMC3997131 DOI: 10.1155/2014/837141] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 03/07/2014] [Accepted: 03/07/2014] [Indexed: 11/25/2022] Open
Abstract
The common aim of transcranial stimulation methods is the induction or alterations of cortical excitability in a controlled way. Significant effects of each individual stimulation method have been published; however, conclusive direct comparisons of many of these methods are rare. The aim of the present study was to compare the efficacy of three widely applied stimulation methods inducing excitability enhancement in the motor cortex: 1 mA anodal transcranial direct current stimulation (atDCS), intermittent theta burst stimulation (iTBS), and 1 mA transcranial random noise stimulation (tRNS) within one subject group. The effect of each stimulation condition was quantified by evaluating motor-evoked-potential amplitudes (MEPs) in a fixed time sequence after stimulation. The analyses confirmed a significant enhancement of the M1 excitability caused by all three types of active stimulations compared to sham stimulation. There was no significant difference between the types of active stimulations, although the time course of the excitatory effects slightly differed. Among the stimulation methods, tRNS resulted in the strongest and atDCS significantly longest MEP increase compared to sham. Different time courses of the applied stimulation methods suggest different underlying mechanisms of action. Better understanding may be useful for better targeting of different transcranial stimulation techniques.
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Hinder MR, Reissig P, Fujiyama H. Noninvasive brain stimulation can elucidate and interact with the mechanisms underlying motor learning and retention: implications for rehabilitation. J Neurophysiol 2013; 111:897-9. [PMID: 24285870 DOI: 10.1152/jn.00766.2013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Seminal work in animals indicates that learning a motor task results in long-term potentiation (LTP) in primary motor cortex (M1) and a subsequent occlusion of LTP induction (Rioult-Pedotti et al. J Neurophysiol 98: 3688-3695, 2007). Using various forms of noninvasive brain stimulation in conjunction with a motor learning paradigm, Cantarero et al. (J Neurosci 33: 12862-12869, 2013) recently provided novel evidence to support the hypothesis that retention of motor skill is contingent upon this postlearning occlusion.
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Affiliation(s)
- Mark R Hinder
- Human Motor Control Laboratory, School of Medicine, University of Tasmania, Australia
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