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Critzer SS, Bosch TJ, Fercho KA, Scholl JL, Baugh LA. Water and brain function: effects of hydration status on neurostimulation with transcranial magnetic stimulation. J Neurophysiol 2024; 132:791-807. [PMID: 39081213 PMCID: PMC11427052 DOI: 10.1152/jn.00143.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/15/2024] [Accepted: 07/25/2024] [Indexed: 08/30/2024] Open
Abstract
Neurostimulation/neurorecording are tools to study, diagnose, and treat neurological/psychiatric conditions. Both techniques depend on volume conduction between scalp and excitable brain tissue. Here, we examine how neurostimulation with transcranial magnetic stimulation (TMS) is affected by hydration status, a physiological variable that can influence the volume of fluid spaces/cells, excitability, and cellular/global brain functioning. Normal healthy adult participants (32, 9 males) had common motor TMS measures taken in a repeated-measures design from dehydrated (12-h overnight fast/thirst) and rehydrated (identical dehydration protocol followed by rehydration with 1 L water in 1 h) testing days. The target region was left primary motor cortex hand area. Response at the target muscle was recorded with electromyography. Urinalysis confirmed hydration status. Motor hotspot shifted in half of participants. Motor threshold decreased in rehydration, indicating increased excitability. Even after redosing/relocalizing TMS to the new threshold/hotspot, rehydration still showed evidence of increased excitability: recruitment curve measures generally shifted upward and the glutamate-dependent paired-pulse protocol, short intracortical facilitation (SICF), was increased. Short intracortical inhibition (SICI), long intracortical inhibition (LICI), long intracortical facilitation (LICF), and cortical silent period (CSP) were relatively unaffected. The hydration perturbations were mild/subclinical based on the magnitude/speed and urinalysis. Motor TMS measures showed evidence of expected physiological changes of osmotic challenges. Rehydration showed signs of macroscopic and microscopic volume changes including decreased scalp-cortex distance (brain closer to stimulator) and astrocyte swelling-induced glutamate release. Hydration may be a source of variability affecting any techniques dependent on brain volumes/volume conduction. These concepts are important for researchers/clinicians using such techniques or dealing with the wide variety of disease processes involving water balance.NEW & NOTEWORTHY Hydration status can affect brain volumes and excitability, which should affect techniques dependent on electrical volume conduction, including neurostimulation/recording. We test the previously unknown effects of hydration on neurostimulation with TMS and briefly review relevant physiology of hydration. Rehydration showed lower motor threshold, shifted motor hotspot, and generally larger responses even after compensating for threshold/hotspot changes. This is important for clinical and research applications of neurostimulation/neurorecording and the many clinical disorders related to water balance.
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Affiliation(s)
- Sam S Critzer
- Basic Biomedical Sciences & Center for Brain and Behavior Research, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota, United States
- Department of Psychiatry, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, United States
| | - Taylor J Bosch
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, United States
| | - Kelene A Fercho
- FAA Civil Aerospace Medical Institute, Oklahoma City, Oklahoma, United States
| | - Jamie L Scholl
- Basic Biomedical Sciences & Center for Brain and Behavior Research, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota, United States
| | - Lee A Baugh
- Basic Biomedical Sciences & Center for Brain and Behavior Research, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota, United States
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Aloi D, Jalali R, Calzolari S, Lafanechere M, Miall RC, Fernández-Espejo D. Multi-session tDCS paired with passive mobilisation of the thumb modulates thalamo-cortical coupling during command following in the healthy brain. Neuroimage 2023; 274:120145. [PMID: 37121374 DOI: 10.1016/j.neuroimage.2023.120145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/05/2023] [Accepted: 04/27/2023] [Indexed: 05/02/2023] Open
Abstract
Therapeutic options to restore responsiveness in patients with prolonged disorder of consciousness (PDOC) are limited. We have recently shown that a single session of tDCS over M1 delivered at rest can reduce thalamic self-inhibition during motor command following. Here, we build upon this by exploring whether pairing tDCS with a concurrent passive mobilisation protocol can further influence thalamo-M1 dynamics and whether these changes are enhanced after multiple stimulation sessions. Specifically, we used Dynamic Causal Modelling (DCM) of functional magnetic resonance imaging (fMRI) data from 22 healthy participants to assess changes on effective connectivity within the motor network during active thumb movements after 1 or 5 sessions of tDCS paired with passive mobilisations of the thumb. We found that a single anodal tDCS session (paired with passive mobilisation of the thumb) decreased self-inhibition in M1, with five sessions further enhancing this effect. In addition, anodal tDCS increased thalamo-M1 excitation as compared to cathodal stimulation, with the effects maintained after 5 sessions. Together, our results suggest that pairing anodal tDCS with passive mobilisation across multiple sessions may facilitate thalamo-cortical dynamics that are relevant for behavioural responsiveness in PDOC. More broadly, they offer a mechanistic window into the neural underpinnings of the cumulative effects of multi-session tDCS.
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Affiliation(s)
- Davide Aloi
- School of Psychology, University of Birmingham; Centre for Human Brain Health, University of Birmingham
| | - Roya Jalali
- School of Psychology, University of Birmingham; Centre for Human Brain Health, University of Birmingham
| | - Sara Calzolari
- School of Psychology, University of Birmingham; Centre for Human Brain Health, University of Birmingham
| | - Melanie Lafanechere
- School of Psychology, University of Birmingham; Centre for Human Brain Health, University of Birmingham
| | | | - Davinia Fernández-Espejo
- School of Psychology, University of Birmingham; Centre for Human Brain Health, University of Birmingham.
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Fujita T, Sone T, Yamamoto Y, Yamane K, Tsuchiya K, Ohira Y, Otsuki K, Iokawa K. Impact of Sensory Impairment on Improvement of Upper-limb Function in Patients under 75 Years of Age with Subacute Stroke: A Preliminary Study. Prog Rehabil Med 2021; 6:20210045. [PMID: 34888427 PMCID: PMC8613479 DOI: 10.2490/prm.20210045] [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: 05/13/2021] [Accepted: 10/20/2021] [Indexed: 11/09/2022] Open
Abstract
Objectives: The aim of this study was to investigate whether an interaction exists between sensory impairment and age with respect to the recovery of upper-limb function in patients with subacute stroke. Methods: This retrospective observational study included 83 patients recovering from subacute stroke in a rehabilitation hospital ward. The recovery of upper-limb function in four groups classified by age and sensory impairment were compared using analysis of covariance. Furthermore, multiple regression analysis was performed with recovery of upper-limb function as the dependent variable and with binarized sensory impairment and binarized age and their interaction term as the independent variables. Results: The estimated marginal means of upper-limb recovery were significantly higher in the non-late elderly (≤74 years) without sensory impairment group than in the other three groups. No significant differences were observed among the following three groups: the non-late elderly with sensory impairment, the late elderly (≥75 years) without sensory impairment, and the late elderly with sensory impairment. In multiple regression analysis, the interaction term between sensory impairment and age was significantly associated with improvement in upper-limb function (β=0.16, P <0.05). Age alone was significant, but sensory impairment alone was not significant. Conclusions: Sensory impairment in patients with subacute stroke affects the recovery of upper-limb function as a result of age interactions.
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Affiliation(s)
- Takaaki Fujita
- Department of Occupational Therapy, School of Health Sciences, Fukushima Medical University, Fukushima, Japan
| | - Toshimasa Sone
- Department of Occupational Therapy, School of Health Sciences, Fukushima Medical University, Fukushima, Japan
| | - Yuichi Yamamoto
- Department of Rehabilitation, Kita-Fukushima Medical Center, Date, Japan
| | - Kazuhiro Yamane
- Department of Rehabilitation, Kita-Fukushima Medical Center, Date, Japan
| | - Kenji Tsuchiya
- Department of Rehabilitation Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Japan
| | - Yoko Ohira
- Department of Rehabilitation, Kita-Fukushima Medical Center, Date, Japan
| | - Koji Otsuki
- Department of Rehabilitation, Kita-Fukushima Medical Center, Date, Japan
| | - Kazuaki Iokawa
- Department of Occupational Therapy, School of Health Sciences, Fukushima Medical University, Fukushima, Japan
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Kim HC, Lee W, Kunes J, Yoon K, Lee JE, Foley L, Kowsari K, Yoo SS. Transcranial focused ultrasound modulates cortical and thalamic motor activity in awake sheep. Sci Rep 2021; 11:19274. [PMID: 34588588 PMCID: PMC8481295 DOI: 10.1038/s41598-021-98920-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 09/08/2021] [Indexed: 11/09/2022] Open
Abstract
Transcranial application of pulsed low-intensity focused ultrasound (FUS) modulates the excitability of region-specific brain areas, and anesthetic confounders on brain activity warrant the evaluation of the technique in awake animals. We examined the neuromodulatory effects of FUS in unanesthetized sheep by developing a custom-fit headgear capable of reproducibly placing an acoustic focus on the unilateral motor cortex (M1) and corresponding thalamic area. The efferent responses to sonication, based on the acoustic parameters previously identified in anesthetized sheep, were measured using electromyography (EMG) from both hind limbs across three experimental conditions: on-target sonication, off-target sonication, and without sonication. Excitatory sonication yielded greater amplitude of EMG signals obtained from the hind limb contralateral to sonication than that from the ipsilateral limb. Spurious appearance of motion-related EMG signals limited the amount of analyzed data (~ 10% selection of acquired data) during excitatory sonication, and the averaged EMG response rates elicited by the M1 and thalamic stimulations were 7.5 ± 1.4% and 6.7 ± 1.5%, respectively. Suppressive sonication, while sheep walked on the treadmill, temporarily reduced the EMG amplitude from the limb contralateral to sonication. No significant change was found in the EMG amplitudes during the off-target sonication. Behavioral observation throughout the study and histological analysis showed no sign of brain tissue damage caused by the acoustic stimulation. Marginal response rates observed during excitatory sonication call for technical refinement to reduce motion artifacts during EMG acquisitions as well as acoustic aberration correction schemes to improve spatial accuracy of sonication. Yet, our results indicate that low-intensity FUS modulated the excitability of regional brain tissues reversibly and safely in awake sheep, supporting its potential in theragnostic applications.
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Affiliation(s)
- Hyun-Chul Kim
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Wonhye Lee
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Jennifer Kunes
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Kyungho Yoon
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Ji Eun Lee
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Lori Foley
- Translational Discovery Laboratory, Brigham and Women's Hospital, Boston, MA, USA
| | - Kavin Kowsari
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Seung-Schik Yoo
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
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Yoon K, Lee W, Lee JE, Xu L, Croce P, Foley L, Yoo SS. Effects of sonication parameters on transcranial focused ultrasound brain stimulation in an ovine model. PLoS One 2019; 14:e0224311. [PMID: 31648261 PMCID: PMC6812789 DOI: 10.1371/journal.pone.0224311] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 10/10/2019] [Indexed: 01/01/2023] Open
Abstract
Low-intensity focused ultrasound (FUS) has significant potential as a non-invasive brain stimulation modality and novel technique for functional brain mapping, particularly with its advantage of greater spatial selectivity and depth penetration compared to existing non-invasive brain stimulation techniques. As previous studies, primarily carried out in small animals, have demonstrated that sonication parameters affect the stimulation efficiency, further investigation in large animals is necessary to translate this technique into clinical practice. In the present study, we examined the effects of sonication parameters on the transient modification of excitability of cortical and thalamic areas in an ovine model. Guided by anatomical and functional neuroimaging data specific to each animal, 250 kHz FUS was transcranially applied to the primary sensorimotor area associated with the right hind limb and its thalamic projection in sheep (n = 10) across multiple sessions using various combinations of sonication parameters. The degree of effect from FUS was assessed through electrophysiological responses, through analysis of electromyogram and electroencephalographic somatosensory evoked potentials for evaluation of excitatory and suppressive effects, respectively. We found that the modulatory effects were transient and reversible, with specific sonication parameters outperforming others in modulating regional brain activity. Magnetic resonance imaging and histological analysis conducted at different time points after the final sonication session, as well as behavioral observations, showed that repeated exposure to FUS did not damage the underlying brain tissue. Our results suggest that FUS-mediated, non-invasive, region-specific bimodal neuromodulation can be safely achieved in an ovine model, indicating its potential for translation into human studies.
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Affiliation(s)
- Kyungho Yoon
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Wonhye Lee
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Ji Eun Lee
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Linda Xu
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Phillip Croce
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Lori Foley
- Translational Discovery Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Seung-Schik Yoo
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
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Dissociation between cortical and spinal excitability of the antagonist muscle during combined motor imagery and action observation. Sci Rep 2019; 9:13120. [PMID: 31511567 PMCID: PMC6739353 DOI: 10.1038/s41598-019-49456-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 08/21/2019] [Indexed: 11/23/2022] Open
Abstract
Inhibitory neural control of antagonist muscle is one of the fundamental neural mechanism of coordinated human limb movement. Previous studies have revealed that motor execution (ME) and motor imagery (MI) share many common neural substrates; however, whether inhibitory neural activity occurs during MI remains unknown. In addition, recent studies have demonstrated that a combined MI and action observation (MI + AO) produces strong neurophysiological changes compared with MI or AO alone. Therefore, we investigated inhibitory changes in cortical and spinal excitability of the antagonist muscle during MI + AO and ME. Single-pulse transcranial magnetic stimulation (TMS) experiments revealed that corticospinal excitability of the antagonist muscle was decreased during MI + AO. Conversely, F-wave experiments showed that F-wave persistence of the antagonist muscle increased. Paired-pulse TMS experiment also demonstrated that short-interval intracortical inhibition (SICI) did not contribute to this inhibition. Therefore, cortical mediated inhibition, except for SICI, may be related to this inhibition. Conversely, such clear inhibition of the antagonist muscle was not observed during ME, presumably owing to the effects of muscle contraction to decelerate the movements and/or sensory input accompanying the joint movements. These findings provide important insights into the neurophysiological differences between MI + AO and ME.
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Onishi H. Cortical excitability following passive movement. Phys Ther Res 2018; 21:23-32. [PMID: 30697506 DOI: 10.1298/ptr.r0001] [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] [Received: 08/06/2018] [Accepted: 09/12/2018] [Indexed: 12/15/2022]
Abstract
In brain injury rehabilitation, passive movement exercises are frequently used to maintain or improve mobility and range of motion. They can also induce beneficial and sustained neuroplastic changes. Neuroimaging studies have revealed that passive movements without motor commands activate not only the primary somatosensory cortex but also the primary motor cortex, supplementary motor area, and posterior parietal cortex as well as the secondary somatosensory cortex (S2) in healthy subjects. Repetitive passive movement has also been reported to induce increases or decreases in cortical excitability. In this review, we focused on the following: cortical activity following passive movement; cortical excitability during passive movement; and changes in cortical excitability after repetitive passive movement.
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Affiliation(s)
- Hideaki Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare.,Department of Physical Therapy, Niigata University of Health and Welfare
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