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Swanson CW, Fling BW. Links between Neuroanatomy and Neurophysiology with Turning Performance in People with Multiple Sclerosis. SENSORS (BASEL, SWITZERLAND) 2023; 23:7629. [PMID: 37688084 PMCID: PMC10490793 DOI: 10.3390/s23177629] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/14/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023]
Abstract
Multiple sclerosis is accompanied by decreased mobility and various adaptations affecting neural structure and function. Therefore, the purpose of this project was to understand how motor cortex thickness and corticospinal excitation and inhibition contribute to turning performance in healthy controls and people with multiple sclerosis. In total, 49 participants (23 controls, 26 multiple sclerosis) were included in the final analysis of this study. All participants were instructed to complete a series of turns while wearing wireless inertial sensors. Motor cortex gray matter thickness was measured via magnetic resonance imaging. Corticospinal excitation and inhibition were assessed via transcranial magnetic stimulation and electromyography place on the tibialis anterior muscles bilaterally. People with multiple sclerosis demonstrated reduced turning performance for a variety of turning variables. Further, we observed significant cortical thinning of the motor cortex in the multiple sclerosis group. People with multiple sclerosis demonstrated no significant reductions in excitatory neurotransmission, whereas a reduction in inhibitory activity was observed. Significant correlations were primarily observed in the multiple sclerosis group, demonstrating lateralization to the left hemisphere. The results showed that both cortical thickness and inhibitory activity were associated with turning performance in people with multiple sclerosis and may indicate that people with multiple sclerosis rely on different neural resources to perform dynamic movements typically associated with fall risk.
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Affiliation(s)
- Clayton W. Swanson
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL 32608, USA;
- Department of Neurology, University of Florida, Gainesville, FL 32608, USA
| | - Brett W. Fling
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO 80521, USA
- Molecular, Cellular, and Integrative Neuroscience Program, Colorado State University, Fort Collins, CO 80521, USA
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Hanson MR, Swanson CW, Whittier TT, Fling BW. Inhibitory signaling as a predictor of leg force control in young and older adults. Exp Brain Res 2022; 240:1005-1016. [PMID: 35171308 DOI: 10.1007/s00221-022-06321-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/29/2022] [Indexed: 11/04/2022]
Abstract
As the populations of the United States and developed nations age, motor control performance is adversely impacted, resulting in functional impairments that can diminish quality of life. Generally, force control in the lower limb worsens with age, with older adults (OA) displaying more variable and less accurate submaximal forces. Corticospinal inhibitory signaling may influence force control, with those OA who maintain corticospinal inhibitory signaling capacity achieving steadier forces. This study aimed to assess the relationships between lower limb force control and transcranial magnetic stimulation (TMS) measures of corticospinal inhibition (i.e., cortical silent period (cSP) duration and depth). 15 OA and 14 young adults (YA) were recruited for this study. All subjects underwent a TMS protocol to elicit the cSP while maintaining 15% of their maximal force in their knee extensor muscles. OA and YA did not display differences in force control metrics or corticospinal inhibitory measures. However, in OA, maximal cSP depth (%dSP max) was associated with lower force variability. No other significant relationships existed in the YA or OA groups. Future studies will benefit from evaluating a range of target forces and target muscles to assess potential relationships between sensorimotor inhibitory capacity and control of muscle force output.
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Affiliation(s)
- Moriah R Hanson
- Department of Occupational Therapy, Colorado State University, Fort Collins, CO, USA
| | - Clayton W Swanson
- Department of Health & Exercise Science, Colorado State University, 1582 Campus Delivery, Moby B-201A, Fort Collins, CO, 80523, USA
| | - Tyler T Whittier
- Department of Health & Exercise Science, Colorado State University, 1582 Campus Delivery, Moby B-201A, Fort Collins, CO, 80523, USA
| | - Brett W Fling
- Department of Health & Exercise Science, Colorado State University, 1582 Campus Delivery, Moby B-201A, Fort Collins, CO, 80523, USA. .,Molecular, Cellular, and Integrative Neuroscience Program, Colorado State University, Fort Collins, CO, USA.
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Discriminative Mobility Characteristics between Neurotypical Young, Middle-Aged, and Older Adults Using Wireless Inertial Sensors. SENSORS 2021; 21:s21196644. [PMID: 34640963 PMCID: PMC8512820 DOI: 10.3390/s21196644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/27/2021] [Accepted: 10/03/2021] [Indexed: 11/23/2022]
Abstract
Age-related mobility research often highlights significant mobility differences comparing neurotypical young and older adults, while neglecting to report mobility outcomes for middle-aged adults. Moreover, these analyses regularly do not determine which measures of mobility can discriminate groups into their age brackets. Thus, the current study aimed to provide a comprehensive analysis for commonly performed aspects of mobility (walking, turning, sit-to-stand, and balance) to determine which variables were significantly different and furthermore, able to discriminate between neurotypical young adults (YAs), middle-aged adults (MAAs), and older adults (OAs). This study recruited 20 YAs, 20 MAAs, and 20 OAs. Participants came into the laboratory and completed mobility testing while wearing wireless inertial sensors. Mobility tests assessed included three distinct two-minute walks, 360° turns, five times sit-to-stands, and a clinical balance test, capturing 99 distinct mobility metrics. Of the various mobility tests assessed, only 360° turning measures demonstrated significance between YAs and MAAs, although the capacity to discriminate between groups was achieved for gait and turning measures. A variety of mobility measures demonstrated significance between MAAs and OAs, and furthermore discrimination was achieved for each mobility test. These results indicate greater mobility differences between MAAs and OAs, although discrimination is achievable for both group comparisons.
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Pesonen H, Laakkonen EK, Hautasaari P, Aukee P, Kovanen V, Sipilä S, Finni T, Tarkka IM. Perimenopausal women show modulation of excitatory and inhibitory neuromuscular mechanisms. BMC WOMENS HEALTH 2021; 21:133. [PMID: 33789654 PMCID: PMC8011394 DOI: 10.1186/s12905-021-01275-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 03/21/2021] [Indexed: 11/25/2022]
Abstract
Background Menopausal transition exposes women to an early decline in muscle force and motor function. Changes in muscle quality and function, especially in lower limbs, are crucial, as they expose individuals to increased risk of falls. To elucidate some of the related neuromuscular mechanisms, we investigated cortical inhibition and peripheral muscle twitch force potentiation in women during the early and late stages of perimenopause. Methods Participants were 63 women aged 48–55 years categorized as early (EP, n = 25) or late (LP, n = 38) perimenopausal according to serum follicle-stimulating hormone (FSH) levels and menstrual diaries. EP women had an irregular menstrual cycle and FSH < 25 IU/L, while LP women had an irregular cycle and > 25 IU/L. We examined motor evoked potential (MEP) and silent period (SP) elicited by transcranial magnetic stimulation (TMS), in the tibialis anterior muscle at 20%, 40%, and 60% of maximal voluntary contraction (MVC) levels, and twitch force potentiation in plantar flexors. Results EP group showed a longer SP duration in 40% MVC condition and larger motor evoked potential amplitude in 20% MVC condition compared to the LP group. No group difference was detected in twitch force potentiation; however, it correlated negatively with FSH levels. Other factors, such as age, height, body mass index, or physical activity did not explain group differences. Conclusions Our preliminary results indicate subtle modulation in both TMS-induced inhibitory and excitatory mechanisms and twitch force potentiation in women already in the late perimenopausal stage. This suggests that the reduction of estrogens may have an accelerating role in the aging process of neuromuscular control.
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Affiliation(s)
- Heidi Pesonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Jyväskylä, Finland.
| | - Eija K Laakkonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Jyväskylä, Finland.,Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Pekka Hautasaari
- Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Jyväskylä, Finland
| | - Pauliina Aukee
- Department of Obstetrics and Gynecology, Pelvic Floor Research and Therapy Unit, Central Finland Central Hospital, Jyväskylä, Finland
| | - Vuokko Kovanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Jyväskylä, Finland.,Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Sarianna Sipilä
- Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Jyväskylä, Finland.,Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Taija Finni
- Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Jyväskylä, Finland
| | - Ina M Tarkka
- Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014, Jyväskylä, Finland
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Proessl F, Canino MC, Beckner ME, Sinnott AM, Eagle SR, LaGoy AD, Conkright WR, Sterczala AJ, Connaboy C, Ferrarelli F, Germain A, Nindl BC, Flanagan SD. Characterizing off-target corticospinal responses to double-cone transcranial magnetic stimulation. Exp Brain Res 2021; 239:1099-1110. [PMID: 33547521 DOI: 10.1007/s00221-021-06044-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/18/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The double-cone coil (D-CONE) is frequently used in transcranial magnetic stimulation (TMS) experiments that target the motor cortex (M1) lower-limb representation. Anecdotal evidence and modeling studies have shed light on the off-target effects of D-CONE TMS but the physiological extent remains undetermined. PURPOSE To characterize the off-target effects of D-CONE TMS based on bilateral corticospinal responses in the legs and hands. METHODS Thirty (N = 30) participants (9 women, age: 26 ± 5yrs) completed a stimulus-response curve procedure with D-CONE TMS applied to the dominant vastus lateralis (cVL) and motor-evoked potentials (MEPs) recorded in each active VL and resting first dorsal interosseous (FDI). As a positive control (CON), the dominant FDI was directly targeted with a figure-of-eight coil and MEPs were similarly recorded in each active FDI and resting VL. MEPMAX, V50 and MEP latencies were compared with repeated-measures ANOVAs or mixed-effects analysis and Bonferroni-corrected pairwise comparisons. RESULTS Off-target responses were evident in all muscles, with similar MEPMAX in the target (cVL) and off-target (iVL) leg (p = 0.99) and cFDI compared with CON (p = 0.99). cFDI and CON MEPMAX were greater than iFDI (p < 0.01). A main effect of target (p < 0.001) indicated that latencies were shorter with CON but similar in all muscles with D-CONE. DISCUSSION Concurrent MEP recordings in bilateral upper- and lower-extremity muscles confirm that lower-limb D-CONE TMS produces substantial distance-dependent off-target effects. In addition to monitoring corticospinal responses in off-target muscles to improve targeting accuracy in real-time, future studies may incorporate off-target information into statistical models post-hoc.
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Affiliation(s)
- F Proessl
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, School of Health and Rehabilitation Sciences, University of Pittsburgh, 3860 South Water St, Pittsburgh, PA, 15203, USA
| | - M C Canino
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, School of Health and Rehabilitation Sciences, University of Pittsburgh, 3860 South Water St, Pittsburgh, PA, 15203, USA
| | - M E Beckner
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, School of Health and Rehabilitation Sciences, University of Pittsburgh, 3860 South Water St, Pittsburgh, PA, 15203, USA
| | - A M Sinnott
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, School of Health and Rehabilitation Sciences, University of Pittsburgh, 3860 South Water St, Pittsburgh, PA, 15203, USA
| | - S R Eagle
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, School of Health and Rehabilitation Sciences, University of Pittsburgh, 3860 South Water St, Pittsburgh, PA, 15203, USA
| | - A D LaGoy
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, School of Health and Rehabilitation Sciences, University of Pittsburgh, 3860 South Water St, Pittsburgh, PA, 15203, USA.,Department of Psychiatry, University of Pittsburgh Medical School, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - W R Conkright
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, School of Health and Rehabilitation Sciences, University of Pittsburgh, 3860 South Water St, Pittsburgh, PA, 15203, USA
| | - A J Sterczala
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, School of Health and Rehabilitation Sciences, University of Pittsburgh, 3860 South Water St, Pittsburgh, PA, 15203, USA
| | - C Connaboy
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, School of Health and Rehabilitation Sciences, University of Pittsburgh, 3860 South Water St, Pittsburgh, PA, 15203, USA
| | - F Ferrarelli
- Department of Psychiatry, University of Pittsburgh Medical School, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - A Germain
- Department of Psychiatry, University of Pittsburgh Medical School, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - B C Nindl
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, School of Health and Rehabilitation Sciences, University of Pittsburgh, 3860 South Water St, Pittsburgh, PA, 15203, USA
| | - S D Flanagan
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, School of Health and Rehabilitation Sciences, University of Pittsburgh, 3860 South Water St, Pittsburgh, PA, 15203, USA.
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