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Wunderle V, Kuzu TD, Tscherpel C, Fink GR, Grefkes C, Weiss PH. Age- and sex-related changes in motor functions: a comprehensive assessment and component analysis. Front Aging Neurosci 2024; 16:1368052. [PMID: 38813530 PMCID: PMC11133706 DOI: 10.3389/fnagi.2024.1368052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 04/23/2024] [Indexed: 05/31/2024] Open
Abstract
Age-related motor impairments often cause caregiver dependency or even hospitalization. However, comprehensive investigations of the different motor abilities and the changes thereof across the adult lifespan remain sparse. We, therefore, extensively assessed essential basic and complex motor functions in 444 healthy adults covering a wide age range (range 21 to 88 years). Basic motor functions, here defined as simple isolated single or repetitive movements in one direction, were assessed by means of maximum grip strength (GS) and maximum finger-tapping frequency (FTF). Complex motor functions, comprising composite sequential movements involving both proximal and distal joints/muscle groups, were evaluated with the Action Research Arm Test (ARAT), the Jebsen-Taylor Hand Function Test (JTT), and the Purdue Pegboard Test. Men achieved higher scores than women concerning GS and FTF, whereas women stacked more pins per time than men during the Purdue Pegboard Test. There was no significant sex effect regarding JTT. We observed a significant but task-specific reduction of basic and complex motor performance scores across the adult lifespan. Linear regression analyses significantly predicted the participants' ages based on motor performance scores (R2 = 0.502). Of note, the ratio between the left- and right-hand performance remained stable across ages for all tests. Principal Component Analysis (PCA) revealed three motor components across all tests that represented dexterity, force, and speed. These components were consistently present in young (21-40 years), middle-aged (41-60 years), and older (61-88 years) adults, as well as in women and men. Based on the three motor components, K-means clustering analysis differentiated high- and low-performing participants across the adult life span. The rich motor data set of 444 healthy participants revealed age- and sex-dependent changes in essential basic and complex motor functions. Notably, the comprehensive assessment allowed for generating robust motor components across the adult lifespan. Our data may serve as a reference for future studies of healthy subjects and patients with motor deficits. Moreover, these findings emphasize the importance of comprehensively assessing different motor functions, including dexterity, force, and speed, to characterize human motor abilities and their age-related decline.
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Affiliation(s)
- Veronika Wunderle
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany
| | - Taylan D. Kuzu
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany
| | - Caroline Tscherpel
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany
- Department of Neurology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Gereon R. Fink
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Christian Grefkes
- Department of Neurology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Peter H. Weiss
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
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Kuo HI, Qi FX, Paulus W, Kuo MF, Nitsche MA. Noradrenergic Enhancement of Motor Learning, Attention, and Working Memory in Humans. Int J Neuropsychopharmacol 2021; 24:490-498. [PMID: 33617635 PMCID: PMC8278798 DOI: 10.1093/ijnp/pyab006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 12/15/2020] [Accepted: 02/18/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Noradrenaline has an important role as a neuromodulator of the central nervous system. Noradrenergic enhancement was recently shown to enhance glutamate-dependent cortical facilitation and long term potentiation-like plasticity. As cortical excitability and plasticity are closely linked to various cognitive processes, here we aimed to explore whether these alterations are associated with respective cognitive performance changes. Specifically, we assessed the impact of noradrenergic enhancement on motor learning (serial reaction time task), attentional processes (Stroop interference task), and working memory performance (n-back letter task). METHODS The study was conducted in a cross-over design. Twenty-five healthy humans performed the respective cognitive tasks after a single dose of the noradrenaline reuptake inhibitor reboxetine or placebo administration. RESULTS The results show that motor learning, attentional processes, and working memory performance in healthy participants were improved by reboxetine application compared with placebo. CONCLUSIONS The results of the present study thus suggest that noradrenergic enhancement can improve memory formation and executive functions in healthy humans. The respective changes are in line with related effects of noradrenaline on cortical excitability and plasticity.
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Affiliation(s)
- Hsiao-I Kuo
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan,Dept. Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Feng-Xue Qi
- Key Laboratory of Sport Training of General Admission of Sport of China, Beijing Sport University, Xinxin Road, Haidian District, Beijing, China,Department of Sport Training, Sport Coaching College, Beijing Sport University, Beijing, China
| | - Walter Paulus
- Department of Clinical Neurophysiology, University Medical Center, Georg-August-University, Göttingen, Germany
| | - Min-Fang Kuo
- Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Michael A Nitsche
- Department of Clinical Neurophysiology, University Medical Center, Georg-August-University, Göttingen, Germany,Dept. Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany,Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany,Correspondence: M. A. Nitsche, MD, Department Psychology and Neurosciences, Leibniz Research Center for Working Environment and Human Factors, Ardeystrasse 67, 44139 Dortmund, Germany ()
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Tscherpel C, Hensel L, Lemberg K, Vollmer M, Volz LJ, Fink GR, Grefkes C. The differential roles of contralesional frontoparietal areas in cortical reorganization after stroke. Brain Stimul 2020; 13:614-624. [PMID: 32289686 DOI: 10.1016/j.brs.2020.01.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 01/10/2020] [Accepted: 01/28/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Studies examining the contribution of contralesional brain regions to motor recovery after stroke have revealed conflicting results comprising both supporting and disturbing influences. Especially the relevance of contralesional brain regions beyond primary motor cortex (M1) has rarely been studied, particularly concerning the temporal dynamics post-stroke. METHODS We, therefore, used online transcranial magnetic stimulation (TMS) interference to longitudinally assess the role of contralesional (right) frontoparietal areas for recovery of hand motor function after left hemispheric stroke: contralesional M1, contralesional dorsal premotor cortex (dPMC), and contralesional anterior intraparietal sulcus (IPS). Fourteen stroke patients and sixteen age-matched healthy subjects performed motor tasks of varying complexity with their (paretic) right hand. Motor performance was quantified using three-dimensional kinematic data. All patients were assessed twice, (i) in the first week, and (ii) after more than three months post-stroke. RESULTS While we did not observe a significant effect of TMS interference on movement kinematics following the stimulation of contralesional M1 and dPMC in the first week post-stroke, we found improvements of motor performance upon interference with contralesional IPS across motor tasks early after stroke, an effect that persisted into the later phase. By contrast, for dPMC, TMS-induced deterioration of motor performance was only evident three months post-stroke, suggesting that a supportive role of contralesional premotor cortex might evolve with reorganization. CONCLUSION We here highlight time-sensitive and region-specific effects of contralesional frontoparietal areas after left hemisphere stroke, which may influence on neuromodulation regimes aiming at supporting recovery of motor function post-stroke.
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Affiliation(s)
- Caroline Tscherpel
- Department of Neurology, University Hospital Cologne, Cologne, Germany; Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Lukas Hensel
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Katharina Lemberg
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Mattias Vollmer
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Lukas J Volz
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Gereon R Fink
- Department of Neurology, University Hospital Cologne, Cologne, Germany; Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Christian Grefkes
- Department of Neurology, University Hospital Cologne, Cologne, Germany; Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany.
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Tscherpel C, Hensel L, Lemberg K, Freytag J, Michely J, Volz LJ, Fink GR, Grefkes C. Age affects the contribution of ipsilateral brain regions to movement kinematics. Hum Brain Mapp 2019; 41:640-655. [PMID: 31617272 PMCID: PMC7268044 DOI: 10.1002/hbm.24829] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 10/02/2019] [Accepted: 10/04/2019] [Indexed: 12/21/2022] Open
Abstract
Healthy aging is accompanied by changes in brain activation patterns in the motor system. In older subjects, unilateral hand movements typically rely on increased recruitment of ipsilateral frontoparietal areas. While the two central concepts of aging‐related brain activity changes, “Hemispheric Asymmetry Reduction in Older Adults” (HAROLD), and “Posterior to Anterior Shift in Aging” (PASA), have initially been suggested in the context of cognitive tasks and were attributed to compensation, current knowledge regarding the functional significance of increased motor system activity remains scarce. We, therefore, used online interference transcranial magnetic stimulation in young and older subjects to investigate the role of key regions of the ipsilateral frontoparietal cortex, that is, (a) primary motor cortex (M1), (b) dorsal premotor cortex (dPMC), and (c) anterior intraparietal sulcus (IPS) in the control of hand movements of different motor demands. Our data suggest a change of the functional roles of ipsilateral brain areas in healthy age with a reduced relevance of ipsilateral M1 and a shift of importance toward dPMC for repetitive high‐frequency movements. These results support the notion that mechanisms conceptualized in the models of “PASA” and “HAROLD” also apply to the motor system.
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Affiliation(s)
- Caroline Tscherpel
- Medical Faculty, University of Cologne and Department of Neurology, University Hospital Cologne, Cologne, Germany.,Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Lukas Hensel
- Medical Faculty, University of Cologne and Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Katharina Lemberg
- Medical Faculty, University of Cologne and Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Jana Freytag
- Medical Faculty, University of Cologne and Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Jochen Michely
- Medical Faculty, University of Cologne and Department of Neurology, University Hospital Cologne, Cologne, Germany.,Wellcome Trust Centre for Neuroimaging, University College London, London, UK
| | - Lukas J Volz
- Medical Faculty, University of Cologne and Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Gereon R Fink
- Medical Faculty, University of Cologne and Department of Neurology, University Hospital Cologne, Cologne, Germany.,Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Christian Grefkes
- Medical Faculty, University of Cologne and Department of Neurology, University Hospital Cologne, Cologne, Germany.,Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
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KLASS MALGORZATA, ROELANDS BART, MEEUSEN ROMAIN, DUCHATEAU JACQUES. Acute Effect of Noradrenergic Modulation on Motor Output Adjustment in Men. Med Sci Sports Exerc 2018; 50:1579-1587. [DOI: 10.1249/mss.0000000000001622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Abstract
INTRODUCTION Brain injuries are one of the leading causes of disability worldwide. It is estimated that nearly half of patients who develop severe sequelae will continue with a chronic severe disability despite having received an appropriate rehabilitation program. For more than 3 decades, there has been a worldwide effort to investigate the possibility of pharmacologically stimulating the neuroplasticity process for enhancing the recovery of these patients. OBJECTIVE The objective of this article is to make a critical and updated review of the available evidence that supports the positive effect of different drugs on the recovery from brain injury. METHOD To date, there have been several clinical trials that tested different drugs that act on different neurotransmitter systems: catecholaminergic, cholinergic, serotonergic, and glutamatergic. There is both basic and clinical evidence that may support some positive effect of these drugs on motor, cognitive, and language skills; however, only few of the available studies are of sufficient methodological quality (placebo controlled, randomized, blinded, multicenter, etc) to make solid conclusions about their beneficial effects. CONCLUSIONS Currently, the pharmacological stimulation of neuroplasticity still does not have enough scientific evidence to make a systematic therapeutic recommendation for all patients, but it certainly is a feasible and very promising field for future research.
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Kuo HI, Paulus W, Batsikadze G, Jamil A, Kuo MF, Nitsche MA. Acute and Chronic Noradrenergic Effects on Cortical Excitability in Healthy Humans. Int J Neuropsychopharmacol 2017; 20:634-643. [PMID: 28430976 PMCID: PMC5574667 DOI: 10.1093/ijnp/pyx026] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 03/05/2017] [Accepted: 04/18/2017] [Indexed: 11/16/2022] Open
Abstract
Background Noradrenaline is a major neuromodulator in the central nervous system, and it is involved in the pathophysiology of diverse neuropsychiatric diseases. Previous transcranial magnetic stimulation studies suggested that acute application of selective noradrenaline reuptake inhibitors enhances cortical excitability in the human brain. However, other, such like clinical effects, usually require prolonged noradrenaline reuptake inhibitor treatment, which might go along with different physiological effects. Methods The purpose of this study was to investigate the acute and chronic effects of the selective noradrenaline reuptake inhibitor reboxetine on cortical excitability in healthy humans in a double-blind, placebo-controlled, randomized crossover study. Sixteen subjects were assessed with different transcranial magnetic stimulation measurements: motor thresholds, input-output curve, short-latency intracortical inhibition and intracortical facilitation, I-wave facilitation, and short-interval afferent inhibition before and after placebo or reboxetine (8 mg) single-dose administration. Afterwards, the same subjects took reboxetine (8 mg/d) consecutively for 21 days. During this period (subjects underwent 2 experimental sessions with identical transcranial magnetic stimulation measures under placebo or reboxetine), transcranial magnetic stimulation measurements were assessed before and after drug intake. Results Both single-dose and chronic administration of reboxetine increased cortical excitability; increased the slope of the input-output curve, intracortical facilitation, and I-wave facilitation; but decreased short-latency intracortical inhibition and short-interval afferent inhibition. Moreover, chronic reboxetine showed a larger enhancement of intracortical facilitation and I-wave facilitation compared with single-dose application. Conclusions The results show physiological mechanisms of noradrenergic enhancement possibly underlying the functional effects of reboxetine regarding acute and chronic application.
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Affiliation(s)
- Hsiao-I Kuo
- Department of Clinical Neurophysiology, University Medical Center, Georg-August-University, Göttingen, Germany (Ms H.-I. Kuo, Paulus, Mr Jamil, and Nitsche); Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany (Ms H.-I. Kuo, Mr Jamil, M.-F. Kuo, and Nitsche); Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany (Dr Nitsche); Department of Neurology, Essen University Hospital, University of Duisburg-Essen, Germany (Dr Batsikadze)
| | - Walter Paulus
- Department of Clinical Neurophysiology, University Medical Center, Georg-August-University, Göttingen, Germany (Ms H.-I. Kuo, Paulus, Mr Jamil, and Nitsche); Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany (Ms H.-I. Kuo, Mr Jamil, M.-F. Kuo, and Nitsche); Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany (Dr Nitsche); Department of Neurology, Essen University Hospital, University of Duisburg-Essen, Germany (Dr Batsikadze)
| | - Giorgi Batsikadze
- Department of Clinical Neurophysiology, University Medical Center, Georg-August-University, Göttingen, Germany (Ms H.-I. Kuo, Paulus, Mr Jamil, and Nitsche); Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany (Ms H.-I. Kuo, Mr Jamil, M.-F. Kuo, and Nitsche); Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany (Dr Nitsche); Department of Neurology, Essen University Hospital, University of Duisburg-Essen, Germany (Dr Batsikadze)
| | - Asif Jamil
- Department of Clinical Neurophysiology, University Medical Center, Georg-August-University, Göttingen, Germany (Ms H.-I. Kuo, Paulus, Mr Jamil, and Nitsche); Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany (Ms H.-I. Kuo, Mr Jamil, M.-F. Kuo, and Nitsche); Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany (Dr Nitsche); Department of Neurology, Essen University Hospital, University of Duisburg-Essen, Germany (Dr Batsikadze)
| | - Min-Fang Kuo
- Department of Clinical Neurophysiology, University Medical Center, Georg-August-University, Göttingen, Germany (Ms H.-I. Kuo, Paulus, Mr Jamil, and Nitsche); Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany (Ms H.-I. Kuo, Mr Jamil, M.-F. Kuo, and Nitsche); Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany (Dr Nitsche); Department of Neurology, Essen University Hospital, University of Duisburg-Essen, Germany (Dr Batsikadze)
| | - Michael A Nitsche
- Department of Clinical Neurophysiology, University Medical Center, Georg-August-University, Göttingen, Germany (Ms H.-I. Kuo, Paulus, Mr Jamil, and Nitsche); Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany (Ms H.-I. Kuo, Mr Jamil, M.-F. Kuo, and Nitsche); Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany (Dr Nitsche); Department of Neurology, Essen University Hospital, University of Duisburg-Essen, Germany (Dr Batsikadze)
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Kuo H, Paulus W, Batsikadze G, Jamil A, Kuo M, Nitsche MA. Acute and chronic effects of noradrenergic enhancement on transcranial direct current stimulation-induced neuroplasticity in humans. J Physiol 2017; 595:1305-1314. [PMID: 27925214 PMCID: PMC5309376 DOI: 10.1113/jp273137] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 10/17/2016] [Indexed: 12/30/2022] Open
Abstract
KEY POINTS Chronic administration of the selective noradrenaline reuptake inhibitor (NRI) reboxetine (RBX) increased and prolonged the long-term potentiation-like plasticity induced by anodal transcranial direct current stimulation (tDCS) for over 24 h. Chronic administration of RBX converted cathodal tDCS-induced long-term depression-like plasticity into facilitation for 120 min. Chronic noradrenergic activity enhancement on plasticity of the human brain might partially explain the delayed therapeutic impact of selective NRIs in depression and other neuropsychiatric diseases. ABSTRACT Noradrenaline affects cognition and motor learning processes via its impact on long-term potentiation (LTP) and depression (LTD). We aimed to explore the impact of single dose and chronic administration of the selective noradrenaline reuptake inhibitor (NRI) reboxetine (RBX) on plasticity induced by transcranial direct current stimulation (tDCS) in healthy humans via a double-blinded, placebo-controlled, randomized crossover study. Sixteen healthy volunteers received placebo or single dose RBX (8 mg) before anodal or cathodal tDCS of the primary motor cortex. Afterwards, the same subjects took RBX (8 mg day-1 ) consecutively for 21 days. During this period, two additional interventions were performed (RBX with anodal or cathodal tDCS), to explore the impact of chronic RBX treatment on plasticity. Plasticity was monitored by motor-evoked potential amplitudes elicited by transcranial magnetic stimulation. Chronic administration of RBX increased and prolonged the LTP-like plasticity induced by anodal tDCS for over 24 h. Chronic RBX significantly converted cathodal tDCS-induced LTD-like plasticity into facilitation, as compared to the single dose condition, for 120 min after stimulation. The results show a prominent impact of chronic noradrenergic enhancement on plasticity of the human brain that might partially explain the delayed therapeutic impact of selective NRIs in depression and other neuropsychiatric diseases.
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Affiliation(s)
- Hsiao‐I. Kuo
- Department of Clinical Neurophysiology, University Medical CenterGeorg‐August‐UniversityRobert‐Koch‐Straße 4037075GöttingenGermany
- Department of Psychology and NeurosciencesLeibniz Research Centre for Working Environment and Human FactorsArdeystrasse 67DortmundGermany
| | - Walter Paulus
- Department of Clinical Neurophysiology, University Medical CenterGeorg‐August‐UniversityRobert‐Koch‐Straße 4037075GöttingenGermany
| | - Giorgi Batsikadze
- Department of Clinical Neurophysiology, University Medical CenterGeorg‐August‐UniversityRobert‐Koch‐Straße 4037075GöttingenGermany
- Department of Neurology, Essen University HospitalUniversity of Duisburg‐EssenGermany
| | - Asif Jamil
- Department of Clinical Neurophysiology, University Medical CenterGeorg‐August‐UniversityRobert‐Koch‐Straße 4037075GöttingenGermany
- Department of Psychology and NeurosciencesLeibniz Research Centre for Working Environment and Human FactorsArdeystrasse 67DortmundGermany
| | - Min‐Fang Kuo
- Department of Psychology and NeurosciencesLeibniz Research Centre for Working Environment and Human FactorsArdeystrasse 67DortmundGermany
| | - Michael A. Nitsche
- Department of Clinical Neurophysiology, University Medical CenterGeorg‐August‐UniversityRobert‐Koch‐Straße 4037075GöttingenGermany
- Department of Psychology and NeurosciencesLeibniz Research Centre for Working Environment and Human FactorsArdeystrasse 67DortmundGermany
- Department of NeurologyUniversity Medical Hospital BergmannsheilBochumGermany
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Grefkes C, Fink GR. Connectivity-based approaches in stroke and recovery of function. Lancet Neurol 2014; 13:206-16. [PMID: 24457190 DOI: 10.1016/s1474-4422(13)70264-3] [Citation(s) in RCA: 349] [Impact Index Per Article: 34.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
After focal damage, cerebral networks reorganise their structural and functional anatomy to compensate for both the lesion itself and remote effects. Novel developments in the analysis of functional neuroimaging data enable us to assess in vivo the specific contributions of individual brain areas to recovery of function and the effect of treatment on cortical reorganisation. Connectivity analyses can be used to investigate the effect of stroke on cerebral networks, and help us to understand why some patients make a better recovery than others. This systems-level view also provides insights into how neuromodulatory interventions might target pathological network configurations associated with incomplete recovery. In the future, such analyses of connectivity could help to optimise treatment regimens based on the individual network pathology underlying a particular neurological deficit, thereby opening the way for stratification of patients based on the possible response to an intervention.
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Affiliation(s)
- Christian Grefkes
- Department of Neurology, University Hospital Cologne, Köln, Germany; Neuromodulation and Neurorehabilitation, Max Planck Institute for Neurological Research, Köln, Germany; Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany.
| | - Gereon R Fink
- Department of Neurology, University Hospital Cologne, Köln, Germany; Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
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10
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Binder E, Hagelweide K, Wang LE, Kornysheva K, Grefkes C, Fink GR, Schubotz RI. Sensory-guided motor tasks benefit from mental training based on serial prediction. Neuropsychologia 2013; 54:18-27. [PMID: 24321273 DOI: 10.1016/j.neuropsychologia.2013.11.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 11/19/2013] [Accepted: 11/22/2013] [Indexed: 11/16/2022]
Abstract
Mental strategies have been suggested to constitute a promising approach to improve motor abilities in both healthy subjects and patients. This behavioural effect has been shown to be associated with changes of neural activity in premotor areas, not only during movement execution, but also while performing motor imagery or action observation. However, how well such mental tasks are performed is often difficult to assess, especially in patients. We here used a novel mental training paradigm based on the serial prediction task (SPT) in order to activate premotor circuits in the absence of a motor task. We then tested whether this intervention improves motor-related performance such as sensorimotor transformation. Two groups of healthy young participants underwent a single-blinded five-day cognitive training schedule and were tested in four different motor tests on the day before and after training. One group (N=22) received the SPT-training and the other one (N=21) received a control training based on a serial match-to-sample task. The results revealed significant improvements of the SPT-group in a sensorimotor timing task, i.e. synchronization of finger tapping to a visually presented rhythm, as well as improved visuomotor coordination in a sensory-guided pointing task compared to the group that received the control training. However, mental training did not show transfer effects on motor abilities in healthy subjects beyond the trained modalities as evident by non-significant changes in the Jebsen-Taylor handfunctiontest. In summary, the data suggest that mental training based on the serial prediction task effectively engages sensorimotor circuits and thereby improves motor behaviour.
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Affiliation(s)
- Ellen Binder
- Department of Neurology, University Hospital Cologne, Cologne, Germany; Max Planck Institute for Neurological Research, Cologne, Germany; Cognitive Neurology Section, Institute of Neuroscience and Medicine (INM3), Research Centre Jülich, Jülich, Germany.
| | - Klara Hagelweide
- Max Planck Institute for Neurological Research, Cologne, Germany; Institute for Psychology, University of Münster, Münster, Germany
| | - Ling E Wang
- Division of Speech and Hearing Sciences, Faculty of Education, The University of Hong Kong, Hong Kong, China
| | - Katja Kornysheva
- Max Planck Institute for Neurological Research, Cologne, Germany
| | - Christian Grefkes
- Department of Neurology, University Hospital Cologne, Cologne, Germany; Max Planck Institute for Neurological Research, Cologne, Germany; Cognitive Neurology Section, Institute of Neuroscience and Medicine (INM3), Research Centre Jülich, Jülich, Germany
| | - Gereon R Fink
- Department of Neurology, University Hospital Cologne, Cologne, Germany; Cognitive Neurology Section, Institute of Neuroscience and Medicine (INM3), Research Centre Jülich, Jülich, Germany
| | - Ricarda I Schubotz
- Max Planck Institute for Neurological Research, Cologne, Germany; Institute for Psychology, University of Münster, Münster, Germany
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11
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Wang LE, Fink GR, Diekhoff S, Rehme AK, Eickhoff SB, Grefkes C. Noradrenergic enhancement improves motor network connectivity in stroke patients. Ann Neurol 2010; 69:375-88. [PMID: 21387380 DOI: 10.1002/ana.22237] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Revised: 08/12/2010] [Accepted: 08/20/2010] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Both animal and human data suggest that noradrenergic stimulation may enhance motor performance after brain damage. We conducted a placebo-controlled, double-blind and crossover design study to investigate the effects of noradrenergic stimulation on the cortical motor system in hemiparetic stroke patients. METHODS Stroke patients (n = 11) in the subacute or chronic stage with mild-to-moderate hand paresis received a single oral dose of 6 mg reboxetine (RBX), a selective noradrenaline reuptake inhibitor. We used functional magnetic resonance imaging and dynamic causal modeling to assess changes in neural activity and interregional effective connectivity while patients moved their paretic hand. RESULTS RBX stimulation significantly increased maximum grip power and index finger-tapping frequency of the paretic hand. Enhanced motor performance was associated with a reduction of cortical "hyperactivity" toward physiological levels as observed in healthy control subjects, especially in the ipsilesional ventral premotor cortex (vPMC) and supplementary motor area (SMA), but also in the temporoparietal junction and prefrontal cortex. Connectivity analyses revealed that in stroke patients neural coupling with SMA or vPMC was significantly reduced compared with healthy controls. This "hypoconnectivity" was partially normalized when patients received RBX, especially for the coupling of ipsilesional SMA with primary motor cortex. INTERPRETATION The data suggest that noradrenergic stimulation by RBX may help to modulate the pathologically altered motor network architecture in stroke patients, resulting in increased coupling of ipsilesional motor areas and thereby improved motor function.
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Affiliation(s)
- Ling E Wang
- Cognitive Neurology Section, Institute of Neuroscience and Medicine, Research Centre Juelich, Germany
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Jepma M, Te Beek ET, Wagenmakers EJ, van Gerven JMA, Nieuwenhuis S. The role of the noradrenergic system in the exploration-exploitation trade-off: a psychopharmacological study. Front Hum Neurosci 2010; 4:170. [PMID: 21206527 PMCID: PMC3009473 DOI: 10.3389/fnhum.2010.00170] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2010] [Accepted: 08/08/2010] [Indexed: 01/01/2023] Open
Abstract
Animal research and computational modeling have indicated an important role for the neuromodulatory locus coeruleus–norepinephrine (LC–NE) system in the control of behavior. According to the adaptive gain theory, the LC–NE system is critical for optimizing behavioral performance by regulating the balance between exploitative and exploratory control states. However, crucial direct empirical tests of this theory in human subjects have been lacking. We used a pharmacological manipulation of the LC–NE system to test predictions of this theory in humans. In a double-blind parallel-groups design (N = 52), participants received 4 mg reboxetine (a selective norepinephrine reuptake inhibitor), 30 mg citalopram (a selective serotonin reuptake inhibitor), or placebo. The adaptive gain theory predicted that the increased tonic NE levels induced by reboxetine would promote task disengagement and exploratory behavior. We assessed the effects of reboxetine on performance in two cognitive tasks designed to examine task (dis)engagement and exploitative versus exploratory behavior: a diminishing-utility task and a gambling task with a non-stationary pay-off structure. In contrast to predictions of the adaptive gain theory, we did not find differences in task (dis)engagement or exploratory behavior between the three experimental groups, despite demonstrable effects of the two drugs on non-specific central and autonomic nervous system parameters. Our findings suggest that the LC–NE system may not be involved in the regulation of the exploration–exploitation trade-off in humans, at least not within the context of a single task. It remains to be examined whether the LC–NE system is involved in random exploration exceeding the current task context.
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Affiliation(s)
- Marieke Jepma
- Leiden University Institute for Psychological Research Leiden, Netherlands
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Grefkes C, Wang LE, Eickhoff SB, Fink GR. Noradrenergic modulation of cortical networks engaged in visuomotor processing. ACTA ACUST UNITED AC 2009; 20:783-97. [PMID: 19687293 DOI: 10.1093/cercor/bhp144] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Both animal and human data suggest that stimulation of the noradrenergic system may influence neuronal excitability in regions engaged in sensory processing and visuospatial attention. We tested the hypothesis that the neural mechanisms subserving motor performance in tasks relying on the visuomotor control of goal-directed hand movements might be modulated by noradrenergic influences. Healthy subjects were stimulated using the selective noradrenaline reuptake inhibitor reboxetine (RBX) in a placebo-controlled crossover design. Functional magnetic resonance imaging and dynamic causal modeling (DCM) were used to assess drug-related changes in blood oxygen level-dependent activity and interregional connectivity while subjects performed a joystick task requiring goal-directed movements. Improved task performance under RBX was associated with increased activity in right visual, intraparietal and superior frontal cortex (premotor/frontal eye field). DCM revealed that the neuronal coupling among these regions was significantly enhanced when subjects were stimulated with RBX. Concurrently, right intraparietal cortex and right superior frontal cortex exerted a stronger driving influence on visuomotor areas of the left hemisphere, including SMA and M1. These effects were independent from task difficulty. The data suggest that stimulating noradrenergic mechanisms may rearrange the functional network architecture within and across the hemispheres, for example, by synaptic gating, thereby optimizing motor behavior.
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Affiliation(s)
- Christian Grefkes
- Neuromodulation & Neurorehabilitation, Max Planck Institute for Neurological Research, 50931 Cologne, Germany.
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