The Role of Primary Motor Cortex: More Than Movement Execution

Brain and muscles magnetic stimulation in a drug-free case of Parkinson's disease: Motor improvements concomitant to neuroplasticty

Noninvasive stimulation of the nervous system is of growing interest in Parkinson's disease (PD) to slow-down motor decline and decrease medication and its side-effects. Repetitive transcranial magnetic stimulation (rTMS) used in PD to modulate the excitability of the primary motor cortex (M1) provided controversial results, in part because of interactions with medication. This warrants to administer rTMS in drug-free patients. Repetitive peripheral magnetic stimulation (rPMS of muscles) has not yet been tested in PD. Its influence on M1 plasticity (as tested by TMS, transcranial magnetic stimulation) and sensorimotor disorders in other health conditions makes it worth be explored in PD. Thus, rTMS and rPMS were tested in a drug-free woman (52 years old, PD-diagnosed 10 years ago) in four different rTMS + rPMS combinations (one week apart): sham-sham, real-real, real-sham, sham-real. rTMS was applied over M1 contralateral to the most impaired bodyside, and rPMS on muscles of the legs, trunk, and arms, bilaterally. M1 plasticity (TMS measures) and motor symptoms and function (clinical outcomes) were measured at different timepoints. The real-real session induced the largest motor improvements, with possible summation of effects between sessions, and maintenance at follow-up (80 days later). This was paralleled by changes of M1 facilitation and inhibition. This sheds a new light on the link between TMS measures of M1 plasticity and motor changes in PD and informs on the remaining potential for neuroplasticity and functional improvement after 10 years of PD with no antiparkinsonian drug. De novo patients with PD (drug-free) should be motivated to participate in future randomized clinical trials to further test the slow-down or delay of motor decline under noninvasive neurostimulation regimens, whatever the stage of the disease.

Fusing multi-scale functional connectivity patterns via Multi-Branch Vision Transformer (MB-ViT) for macaque brain age prediction

Brain age (BA) is defined as a measure of brain maturity and could help characterize both the typical brain development and neuropsychiatric disorders in mammals. Various biological phenotypes have been successfully applied to predict BA of human using chronological age (CA) as label. However, whether the BA of macaque, one of the most important animal models, can also be reliably predicted is largely unknown. To address this question, we propose a novel deep learning model called Multi-Branch Vision Transformer (MB-ViT) to fuse multi-scale (i.e., from coarse-grained to fine-grained) brain functional connectivity (FC) patterns derived from resting state functional magnetic resonance imaging (rs-fMRI) data to predict BA of macaques. The discriminative functional connections and the related brain regions contributing to the prediction are further identified based on Gradient-weighted Class Activation Mapping (Grad-CAM) method. Our proposed model successfully predicts BA of 450 normal rhesus macaques from the publicly available PRIMatE Data Exchange (PRIME-DE) dataset with lower mean absolute error (MAE) and mean square error (MSE) as well as higher Pearson's correlation coefficient (PCC) and coefficient of determination (R2) compared to other baseline models. The correlation between the predicted BA and CA reaches as high as 0.82 of our proposed method. Furthermore, our analysis reveals that the functional connections predominantly contributing to the prediction results are situated in the primary motor cortex (M1), visual cortex, area v23 in the posterior cingulate cortex, and dysgranular temporal pole. In summary, our proposed deep learning model provides an effective tool to accurately predict BA of primates (macaque in this study), and lays a solid foundation for future studies of age-related brain diseases in those animal models.

Volitional modulation of neuronal activity in the external globus pallidus by engagement of the cortical-basal ganglia circuit

Volitional modulation of neural activity is not confined to the cortex but extends to various brain regions. Yet, it remains unclear whether neurons in the basal ganglia structure, the external globus pallidus (GPe), can be volitionally controlled. Here, we employed a volitional conditioning task to compare the volitional modulation of GPe and primary motor cortex (M1) neurons as well as the underlying circuits and control mechanisms. The results revealed that the volitional modulation of GPe neuronal activity engaged both M1 and substantia nigra pars reticulata (SNr) neurons, indicating the involvement of the cortex-GPe-SNr loop. In contrast, the volitional modulation of M1 neurons primarily occurred through the engagement of M1 local circuitry. Furthermore, lesioning M1 neurons did not affect the volitional learning or volitional control signal in GPe, whereas lesioning of GPe neurons impaired the learning process for the volitional modulation of M1 neuronal activity at the intermediate stage. Additionally, lesion of GPe neurons enhanced M1 neuronal activity when performing the volitional control task without reward delivery and a random reward test. Taken together, our findings demonstrated that GPe neurons could be volitionally controlled by engagement of the cortical-basal ganglia circuit and inhibit learning process for the volitional modulation of M1 neuronal activity by regulating M1 neuronal activity. Thus, GPe neurons can be effectively harnessed for independent volitional modulation for neurorehabilitation in patients with cortical damage. KEY POINTS: The cortical-basal ganglia circuit contributes to the volitional modulation of GPe neurons. Volitional modulation of M1 neuronal activity mainly engages M1 local circuitry. Bilateral GPe lesioning impedes volitional learning at the intermediate stages. Lesioning of GPe neurons inhibits volitional learning process by regulating M1 neuronal activity.

Effects of divided attention on movement-related cortical potential in community-dwelling elderly adults: A preliminary study

Dual-tasking is defined as performing two or more tasks concurrently. This study aimed to investigate the effect of divided attention on movement-related cortical potential (MRCP) during dual-task performance in 11 community-dwelling elderly individuals while the load of the secondary task was altered. MRCP was recorded during a single task (ST), simple dual task (S-DT), and complex dual task (C-DT) as no-, low-, and high-load divided attention tasks, respectively. The ST involved self-paced tapping with an extended right index finger. In the S-DT and C-DT, the subjects simultaneously performed the ST and a visual number counting task with different levels of load. The coefficient of variation of movement frequency was significantly more variable in the C-DT than in the ST. The MRCP amplitude from electroencephalography electrode C3, contralateral to the moving hand, was significantly higher in the C-DT than in the ST. Higher attention diversion led to a significant reduction in MRCP amplitude in the participants. These results suggest that attention division in dual-task situations plays an important role in movement preparation and execution. We propose that MRCP can serve as a marker for screening the ability of older individuals to perform dual-tasks.

Machine learning models for diagnosis of essential tremor and dystonic tremor using grey matter morphological networks

BACKGROUND

Essential tremor (ET) and dystonic tremor (DT) are the two most common tremor disorders, and misdiagnoses are very common due to similar tremor symptoms. In this study, we explore the structural network mechanisms of ET and DT using brain grey matter (GM) morphological networks and combine those with machine learning models.

METHODS

3D-T1 structural images of 75 ET patients, 71 DT patients, and 79 healthy controls (HCs) were acquired. We used voxel-based morphometry to obtain GM images and constructed GM morphological networks based on the Kullback-Leibler divergence-based similarity (KLS) method. We used the GM volumes, morphological relations, and global topological properties of GM-KLS morphological networks as input features. We employed three classifiers to perform the classification tasks. Moreover, we conducted correlation analysis between discriminative features and clinical characteristics.

RESULTS

16 morphological relations features and 1 global topological metric were identified as the discriminative features, and mainly involved the cerebello-thalamo-cortical circuits and the basal ganglia area. The Random Forest (RF) classifier achieved the best classification performance in the three-classification task, achieving a mean accuracy (mACC) of 78.7%, and was subsequently used for binary classification tasks. Specifically, the RF classifier demonstrated strong classification performance in distinguishing ET vs. HCs, ET vs. DT, and DT vs. HCs, with mACCs of 83.0 %, 95.2 %, and 89.3 %, respectively. Correlation analysis demonstrated that four discriminative features were significantly associated with the clinical characteristics.

CONCLUSION

This study offers new insights into the structural network mechanisms of ET and DT. It demonstrates the effectiveness of combining GM-KLS morphological networks with machine learning models in distinguishing between ET, DT, and HCs.

Interhemispheric functional in age-related macular degeneration patient: a resting-state functional MRI study

Age-related macular degeneration (AMD) is a prevalent disease leading to severe visual impairment in the elderly population. Despite this, the pathogenesis of AMD remains largely unexplored. The application of resting-state functional MRI (rs-fMRI) allows for the detection of coherent intrinsic brain activities along with the interactions taking place between the two hemispheres. In the frame of our study, we utilize voxel-mirrored homotopic connectivity (VMHC) as an rs-fMRI method to carry out a comparative analysis of functional homotopy between the two hemispheres with the aim of further understanding the pathogenesis of AMD patients. In our study, we utilized the VMHC method to explore levels of brain activity in individuals diagnosed with AMD, planning to investigate potential links with their clinical characteristics. We extended our invitation to 20 AMD patients and 20 healthy controls from Jiangxi Provincial People's Hospital to participate in this research. rs-fMRIs were captured for each participant, and associated neural activity levels were examined using the VMHC method. Remarkably, our comparative examination with the healthy control group revealed significantly reduced VMHC in the cuneus, superior occipital lobe, precentral gyrus, and superior parietal lobule in the patient cohort. Utilizing the VMHC method allows us to identify discrepancies in the visual pathways of AMD patients compared with standard controls, potentially explaining the common challenges among AMD patients with object recognition, face recognition, and reading.

Manipulation of Glutamatergic Neuronal Activity in the Primary Motor Cortex Regulates Cardiac Function in Normal and Myocardial Infarction Mice

Cardiac function is under neural regulation; however, brain regions in the cerebral cortex responsible for regulating cardiac function remain elusive. In this study, retrograde trans-synaptic viral tracing is used from the heart to identify a specific population of the excitatory neurons in the primary motor cortex (M1) that influences cardiac function in mice. Optogenetic activation of M1 glutamatergic neurons increases heart rate, ejection fraction, and blood pressure. By contrast, inhibition of M1 glutamatergic neurons decreased cardiac function and blood pressure as well as tyrosine hydroxylase (TH) expression in the heart. Using viral tracing and optogenetics, the median raphe nucleus (MnR) is identified as one of the key relay brain regions in the circuit from M1 that affect cardiac function. Then, a mouse model of cardiac injury is established caused by myocardial infarction (MI), in which optogenetic activation of M1 glutamatergic neurons impaired cardiac function in MI mice. Moreover, ablation of M1 neurons decreased the levels of norepinephrine and cardiac TH expression, and enhanced cardiac function in MI mice. These findings establish that the M1 neurons involved in the regulation of cardiac function and blood pressure. They also help the understanding of the neural mechanisms underlying cardiovascular regulation.

Modulation of intracortical circuits in primary motor cortex during automatic action tendencies

Humans display automatic action tendencies toward emotional stimuli, showing faster automatic behavior (i.e., approaching a positive stimulus and avoiding a negative stimulus) than regulated behavior (i.e., avoiding a positive stimulus and approaching a negative stimulus). Previous studies have shown that the primary motor cortex is involved in the processing of automatic actions, with higher motor evoked potential amplitudes during automatic behavior elicited by single-pulse transcranial magnetic stimulation. However, it is unknown how intracortical circuits are involved with automatic action tendencies. Here, we measured short-interval intracortical inhibition and intracortical facilitation within the primary motor cortex by using paired-pulse transcranial magnetic stimulation protocols during a manikin task, which has been widely used to explore approaching and avoiding behavior. Results showed that intracortical facilitation was stronger during automatic behavior than during regulated behavior. Moreover, there was a significant negative correlation between reaction times and intracortical facilitation effect during automatic behavior: individuals with short reaction times had stronger faciliatory activity, as shown by higher intracortical facilitation. By contrast, no significant difference was found for short-interval intracortical inhibition between automatic behavior and regulated behavior. The results indicated that the intracortical facilitation circuit, mediated by excitatory glutamatergic neurons, in the primary motor cortex, plays an important role in mediating automatic action tendencies. This finding further supports the link between emotional perception and the action system.

Anodal transcranial direct current stimulation enhances response inhibition and attention allocation in fencers

Background

The aim of this study is to investigate the acute effects of anodal transcranial direct current stimulation (tDCS) on reaction time, response inhibition and attention in fencers.

Methods

Sixteen professional female fencers were recruited, and subjected to anodal tDCS and sham stimulation in the primary motor area (M1) one week apart in a randomized, crossover, single-blind design. A two-factor analysis of variance with repeated measures was used to analyze the effects of stimulation conditions (anodal stimulation, sham stimulation) and time (pre-stimulation, post-stimulation) on reaction time, response inhibition, and attention in fencers.

Results

The study found a significant improvement in response inhibition and attention allocation from pre-stimulation to post-stimulation following anodal tDCS but not after sham stimulation. There was no statistically significant improvement in reaction time and selective attention.

Conclusions

A single session of anodal tDCS could improve response inhibition, attention allocation in female fencers. This shows that tDCS has potential to improve aspects of an athlete's cognitive performance, although we do not know if such improvements would transfer to improved performance in competition. However, more studies involving all genders, large samples, and different sports groups are needed in the future to further validate the effect of tDCS in improving the cognitive performance of athletes.

Out-of-phase transcranial alternating current stimulation modulates the neurodynamics of inhibitory control

Transcranial alternating current stimulation (tACS) is an efficient neuromodulation technique that enhances cognitive function in a non-invasive manner. Using functional magnetic resonance imaging, we investigated whether tACS with different phase lags (0° and 180°) between the dorsal anterior cingulate and left dorsolateral prefrontal cortices modulated inhibitory control performance during the Stroop task. We found out-of-phase tACS mediated improvements in task performance, which was neurodynamically reflected as putamen, dorsolateral prefrontal, and primary motor cortical activation as well as prefrontal-based top-down functional connectivity. Our observations uncover the neurophysiological bases of tACS-phase-dependent neuromodulation and provide a feasible non-invasive approach to effectively modulate inhibitory control.

Integrative function of proprioceptive system in the acute effects of whole body vibration on the movement performance in young adults

Background

The proprioceptive system coordinates locomotion, but its role in short-term integration and recovery of motor activity in imbalance of motor patterns and body remains debated. The aim of this study is investigating the functional role of proprioceptive system in motor patterns and body balance in healthy young adults.

Methods

70 participants (aged 20.1 ± 0.3) were divided into experimental groups EG1 (n = 30), EG2 (n = 30), control group (CG, n = 10). EG1 performed single WBV session on Power Plate (7 exercises adapted to Functional Movement Screen (FMS). EG2 performed single session of FMS Exercises (FMSE). CG didn't perform any physical activity. All participants performed pre- and post-session of FMS and stabilometric measurements.

Results

FMS total score in EG1 increased by 2.0 ± 0.2 (p0 < 0.001), this was significantly differed (p0 < 0.001) from EG2 and CG. Acute effects of WBV and FMSE on rate of change and standard deviation (SD) of pressure center (COP) were shown in all groups during Static Test (p0 < 0.01). SD increased (p0 < 0.01) in Given Setting Test in EG1 and EG2, and in Romberg Test (p0 < 0.001) in EG1. Length, width and area (p0 < 0.01) of confidence ellipse, containing 95% of the statokinesiogram points, decreased in Static Test in EG1; width and area (p0 < 0.01) decreased in EG2 group. Significant (p0 < 0.01) decrease in Given Setting Test was in EG1, and significant (p0 < 0.01) increase was in Romberg Test (open eyes) in CG. Maximum amplitude of COP oscillations: significantly (p0 < 0.01) decreasing along X and Y axes in EG1 and EG2, and along Y axis in CG during Static Test; along Y axis (p0 < 0.01) in all groups during Given Setting Test. Significant differences were identified (p0 < 0.01) in calculated energy consumption for COP moving during all stabilometric tests. However, inter-group differences in COP after acute WBV and FMSE sessions have not been identified.

Conclusions

Acute WBV session eliminates the deficits in motor patterns which is not the case after acute FMSE session, which, according to our integrative movement tuning hypothesis, is due to high activation of integrative function of proprioceptive system. Efficacy of WBV and FMSE on COP performance indicates a high sensitivity of postural control to different levels of proprioceptive system activity.

Neurogenetic underpinnings of nicotine use severity: Integrating the brain transcriptomes and GWAS variants via network approaches

Our study focused on human brain transcriptomes and the genetic risks of cigarettes per day (CPD) to investigate the neurogenetic mechanisms of individual variation in nicotine use severity. We constructed whole-brain and intramodular region-specific coexpression networks using BrainSpan's transcriptomes, and the genomewide association studies identified risk variants of CPD, confirmed the associations between CPD and each gene set in the region-specific subnetworks using an independent dataset, and conducted bioinformatic analyses. Eight brain-region-specific coexpression subnetworks were identified in association with CPD: amygdala, hippocampus, medial prefrontal cortex (MPFC), orbitofrontal cortex (OPFC), dorsolateral prefrontal cortex, striatum, mediodorsal nucleus of the thalamus (MDTHAL), and primary motor cortex (M1C). Each gene set in the eight subnetworks was associated with CPD. We also identified three hub proteins encoded by GRIN2A in the amygdala, PMCA2 in the hippocampus, MPFC, OPFC, striatum, and MDTHAL, and SV2B in M1C. Intriguingly, the pancreatic secretion pathway appeared in all the significant protein interaction subnetworks, suggesting pleiotropic effects between cigarette smoking and pancreatic diseases. The three hub proteins and genes are implicated in stress response, drug memory, calcium homeostasis, and inhibitory control. These findings provide novel evidence of the neurogenetic underpinnings of smoking severity.

Alterations in functional connectivity in patients with non-specific chronic low back pain after motor control exercise: a randomized trial

BACKGROUND

Motor control exercise (MCE) is effective in alleviating non-specific chronic low back pain (NCLBP). Neuro-imaging research is warranted to explore the underlying neural mechanisms of MCE.

AIM

We used resting-state functional magnetic resonance imaging (rs-fMRI) to explore the central mechanism underpinning the effects of MCE in patients with NCLBP.

DESIGN

A randomized, single-blinded, controlled trial.

SETTING

The setting was out-patient and community.

POPULATION

Fifty-eight patients with NCLBP.

METHODS

Patients were randomized into the MCE or manual therapy (MT) group. All the participants completed pain-related clinical assessments and rs-fMRI scans before and after intervention. We performed exploratory whole-brain analyses in regional homogeneity (ReHo) and resting-state functional connectivity (rsFC) with significant post-pre differences in ReHo before and after intervention, and investigated associations between imaging and pain-related clinical assessments.

RESULTS

Compared with the MT group, a greater alleviation in pain intensity and disability was observed in the MCE group after intervention, and was sustained at the 6-month follow-up (P<0.001). Only the MCE group showed increased ReHo values in the right pre-central gyrus and decreased ReHo values in the bilateral posterior cerebellum (voxel level P<0.001, cluster-level FWE corrected P<0.05). Decreased rsFC of the right posterior cerebellum-left superior parietal gyrus and left insula were significantly positively associated with pain-related disability (voxel level P<0.001, cluster-level FWE corrected P<0.05).

CONCLUSIONS

These findings demonstrated that MCE had superior effects in relieving pain and pain-related disability, which might be associated with its modulation of rsFC between the cerebellum and areas involved in sensory-discriminative processing of noxious and somato-sensory stimuli, affection, and cognition.

CLINICAL REHABILITATION IMPACT

This study provided preliminary evidence that MCE might alleviate NCLBP through its modulation of the function of brain areas related to chronic pain and postural control. Those results support MCE's clinical application and help physiotherapists to provide better multidisciplinary interventions with the combination of MCE and other first-line treatments.

The trial-by-trial fluctuations in primary motor cortex excitability during attentional bias among smokers: A transcranial magnetic stimulation study

Background

A relatively new computational approach called trial-level bias score (TL-BS) has shown that attentional bias to smoking-related stimuli in smokers fluctuates temporally, trial by trial, during attention tasks. Here, we investigated the reliability of using TL-BS values to assess attentional bias and the electrophysiology mechanisms undergirding fluctuations in attentional bias among smokers.

Method

In total, 26 male smokers and 26 male non-smokers performed a dot-probe task in Experiment 1. In Experiment 2, an additional 23 male smokers and 23 male non-smokers performed the same task while undergoing single-pulse transcranial magnetic stimulation, which was used to investigate corticospinal excitability.

Results

It showed that assessing TL-BS parameters for reaction time (RT) was more reliable than calculating the traditional mean attentional bias score; however, this superior reliability was no longer apparent after controlling for general RT variability. There was a significant difference between smokers and non-smokers in TL-BS parameters calculated for both RT and motor-evoked potential (MEP) amplitude. However, TL-BS parameters for RT and MEP amplitude were strongly correlated with general RT variability and general MEP variability, respectively.

Conclusions

Our findings indicated that TL-BS parameters may not be ideal for measuring attentional bias at either the behavioral or electrophysiology level; however, larger general RT and MEP amplitude variabilities in non-smokers may indicate dysregulation of cognitive processing in smokers.

Altered resting-state brain function in endurance athletes

Previous research has confirmed significant differences in regional brain activity and functional connectivity between endurance athletes and non-athletes. However, no studies have investigated the differences in topological efficiency of the brain functional network between endurance athletes and non-athletes. Here, we compared differences in regional activities, functional connectivity, and topological properties to explore the functional basis associated with endurance training. The results showed significant correlations between Regional Homogeneity in the motor cortex, visual cortex, cerebellum, and the training intensity parameters. Alterations in functional connectivity among the motor cortex, visual cortex, cerebellum, and the inferior frontal gyrus and cingulate gyrus were significantly correlated with training intensity parameters. In addition, the graph theoretical analysis results revealed a significant reduction in global efficiency among athletes. This decline is mainly caused by decreased nodal efficiency and nodal local efficiency of the cerebellar regions. Notably, the sensorimotor regions, such as the precentral gyrus and supplementary motor areas, still exhibit increased nodal efficiency and nodal local efficiency. This study not only confirms the improvement of regional activity in brain regions related to endurance training, but also offers novel insights into the mechanisms through which endurance athletes undergo changes in the topological efficiency of the brain functional network.

A Scoping Review on the Use of Non-Invasive Brain Stimulation Techniques for Persistent Post-Concussive Symptoms

BACKGROUND

In the context of managing persistent post-concussive symptoms (PPCS), existing treatments like pharmacotherapy, cognitive behavioral therapy, and physical rehabilitation show only moderate effectiveness. The emergence of neuromodulation techniques in PPCS management has led to debates regarding optimal stimulation parameters and their overall efficacy.

METHODS

this scoping review involved a comprehensive search of PubMed and ScienceDirect databases, focusing on controlled studies examining the therapeutic potential of non-invasive brain stimulation (NIBS) techniques in adults with PPCS.

RESULTS

Among the 940 abstracts screened, only five studies, encompassing 103 patients (12 to 29 per study), met the inclusion criteria. These studies assessed the efficacy of transcranial direct current stimulation (tDCS), or repetitive transcranial magnetic stimulation (rTMS), applied to specific brain regions (i.e., the left dorsolateral pre-frontal cortex (DLPFC) or left motor cortex (M1)) for addressing cognitive and psychological symptoms, headaches, and general PPCSs. The results indicated improvements in cognitive functions with tDCS. In contrast, reductions in headache intensity and depression scores were observed with rTMS, while no significant findings were noted for general symptoms with rTMS.

CONCLUSION

although these pilot studies suggest promise for rTMS and tDCS in PPCS management, further research with larger-scale investigations and standardized protocols is imperative to enhance treatment outcomes for PPCS patients.

Aging alters functional connectivity of motor theta networks during sensorimotor reactions

OBJECTIVE

Both cognitive and primary motor networks alter with advancing age in humans. The networks activated in response to external environmental stimuli supported by theta oscillations remain less well explored. The present study aimed to characterize the effects of aging on the functional connectivity of response-related theta networks during sensorimotor tasks.

METHODS

Electroencephalographic signals were recorded in young and middle-to-older age adults during three tasks performed in two modalities, auditory and visual: a simple reaction task, a Go-NoGo task, and a choice-reaction task. Response-related theta oscillations were computed. The phase-locking value (PLV) was used to analyze the spatial synchronization of primary motor and motor control theta networks.

RESULTS

Performance was overall preserved in older adults. Independently of the task, aging was associated with reorganized connectivity of the contra-lateral primary motor cortex. In younger adults, it was synchronized with motor control regions (intra-hemispheric premotor/frontal and medial frontal). In older adults, it was only synchronized with intra-hemispheric sensorimotor regions.

CONCLUSIONS

Motor theta networks of older adults manifest a functional decoupling between the response-generating motor cortex and motor control regions, which was not modulated by task variables. The overall preserved performance in older adults suggests that the increased connectivity within the sensorimotor network is associated with an excessive reliance on sensorimotor feedback during movement execution compensating for a deficient cognitive regulation of motor regions during sensorimotor reactions.

SIGNIFICANCE

New evidence is provided for the reorganization of motor networks during sensorimotor reactions already at the transition from middle to old age.

Memory consolidation of sequence learning and dynamic adaptation during wakefulness

Motor learning involves acquiring new movement sequences and adapting motor commands to novel conditions. Labile motor memories, acquired through sequence learning and dynamic adaptation, undergo a consolidation process during wakefulness after initial training. This process stabilizes the new memories, leading to long-term memory formation. However, it remains unclear if the consolidation processes underlying sequence learning and dynamic adaptation are independent and if distinct neural regions underpin memory consolidation associated with sequence learning and dynamic adaptation. Here, we first demonstrated that the initially labile memories formed during sequence learning and dynamic adaptation were stabilized against interference through time-dependent consolidation processes occurring during wakefulness. Furthermore, we found that sequence learning memory was not disrupted when immediately followed by dynamic adaptation and vice versa, indicating distinct mechanisms for sequence learning and dynamic adaptation consolidation. Finally, by applying patterned transcranial magnetic stimulation to selectively disrupt the activity in the primary motor (M1) or sensory (S1) cortices immediately after sequence learning or dynamic adaptation, we found that sequence learning consolidation depended on M1 but not S1, while dynamic adaptation consolidation relied on S1 but not M1. For the first time in a single experimental framework, this study revealed distinct neural underpinnings for sequence learning and dynamic adaptation consolidation during wakefulness, with significant implications for motor skill enhancement and rehabilitation.

Brain positron emission tomography in idiopathic normal-pressure hydrocephalus: new 18 F-fluorodeoxyglucose pattern in a long-known syndrome

AIM

Patients with idiopathic normal-pressure hydrocephalus (iNPH) can show a global reduction in cerebral glucose metabolism at [ 18 F]Fluorodeoxyglucose (FDG) PET. The presence of caudate hypometabolism has been identified as a potential biomarker in iNPH, yet there is limited evidence of hypermetabolic findings in patients with iNPH so far.

METHODS

We retrieved retrospectively patients with iNPH and normal cognitive assessment, evaluated before surgery undergoing brain [ 18 F]FDG-PET. The 18 F-FDG-PET brain scans were compared to those of a control group of healthy subjects, matched for age and sex, by statistical parametric mapping (SPM) to identify areas of relative hypo- and hypermetabolism. Furthermore, the existence of a correlation between areas of hypo- and hypermetabolism in the patient group was tested.

RESULTS

Seven iNPH patients (mean age 74 ± 6 years) were found in the hospital database. SPM group analysis revealed clusters of significant hypometabolism ( P  = 0.001) in the iNPH group in the dorsal striatum, involving caudate and putamen bilaterally. Clusters of significant hypermetabolism ( P  = 0.001) were revealed in the bilateral superior and precentral frontal gyrus (BA 4, 6). A significant inverse correlation between striatal hypometabolism and bilateral superior and precentral frontal gyrus hypermetabolism was revealed ( P  < 0.001 corrected for multiple comparisons).

CONCLUSION

In this cohort, patients with iNPH showed subcortical hypometabolism, including bilateral dorsal striatum. To the best of our knowledge, this is the first report demonstrating a hypermetabolic pattern in the primary motor and premotor areas, and showing an inverse correlation between the striatum and motor cortex in patients with iNPH.

Effects of transcranial direct current stimulation over human motor cortex on cognitive-motor and sensory-motor functions

The primary motor cortex (M1) is broadly acknowledged for its crucial role in executing voluntary movements. Yet, its contributions to cognitive and sensory functions remain largely unexplored. Transcranial direct current stimulation (tDCS) is a noninvasive neurostimulation method that can modify brain activity, thereby enabling the establishment of a causal link between M1 activity and behavior. This study aimed to investigate the online effects of tDCS over M1 on cognitive-motor and sensory-motor functions. Sixty-four healthy participants underwent either anodal or sham tDCS while concurrently performing a set of standardized robotic tasks. These tasks provided sensitive and objective assessments of brain functions, including action selection, inhibitory control, cognitive control of visuomotor skills, proprioceptive sense, and bimanual coordination. Our results revealed that anodal tDCS applied to M1 enhances decision-making capacity in selecting appropriate motor actions and avoiding distractors compared to sham stimulation, suggesting improved action selection and inhibitory control capabilities. Furthermore, anodal tDCS reduces the movement time required to accomplish bimanual movements, suggesting enhanced bimanual performance. However, we found no impact of anodal tDCS on cognitive control of visuomotor skills and proprioceptive sense. This study suggests that augmenting M1 activity via anodal tDCS influences cognitive-motor and sensory-motor functions in a task-dependent manner.

Analysis of functional connectivity using machine learning and deep learning in different data modalities from individuals with schizophrenia

Objective. Schizophrenia(SCZ) is a severe mental disorder associated with persistent or recurrent psychosis, hallucinations, delusions, and thought disorders that affect approximately 26 million people worldwide, according to the World Health Organization. Several studies encompass machine learning (ML) and deep learning algorithms to automate the diagnosis of this mental disorder. Others study SCZ brain networks to get new insights into the dynamics of information processing in individuals suffering from the condition. In this paper, we offer a rigorous approach with ML and deep learning techniques for evaluating connectivity matrices and measures of complex networks to establish an automated diagnosis and comprehend the topology and dynamics of brain networks in SCZ individuals.Approach.For this purpose, we employed an functional magnetic resonance imaging (fMRI) and electroencephalogram (EEG) dataset. In addition, we combined EEG measures, i.e. Hjorth mobility and complexity, with complex network measurements to be analyzed in our model for the first time in the literature.Main results.When comparing the SCZ group to the control group, we found a high positive correlation between the left superior parietal lobe and the left motor cortex and a positive correlation between the left dorsal posterior cingulate cortex and the left primary motor. Regarding complex network measures, the diameter, which corresponds to the longest shortest path length in a network, may be regarded as a biomarker because it is the most crucial measure in different data modalities. Furthermore, the SCZ brain networks exhibit less segregation and a lower distribution of information. As a result, EEG measures outperformed complex networks in capturing the brain alterations associated with SCZ.Significance. Our model achieved an area under receiver operating characteristic curve (AUC) of 100% and an accuracy of 98.5% for the fMRI, an AUC of 95%, and an accuracy of 95.4% for the EEG data set. These are excellent classification results. Furthermore, we investigated the impact of specific brain connections and network measures on these results, which helped us better describe changes in the diseased brain.

Neural representations for multi-context visuomotor adaptation and the impact of common representation on multi-task performance: a multivariate decoding approach

The human brain's remarkable motor adaptability stems from the formation of context representations and the use of a common context representation (e.g., an invariant task structure across task contexts) derived from structural learning. However, direct evaluation of context representations and structural learning in sensorimotor tasks remains limited. This study aimed to rigorously distinguish neural representations of visual, movement, and context levels crucial for multi-context visuomotor adaptation and investigate the association between representation commonality across task contexts and adaptation performance using multivariate decoding analysis with fMRI data. Here, we focused on three distinct task contexts, two of which share a rotation structure (i.e., visuomotor rotation contexts with -90° and +90° rotations, in which the mouse cursor's movement was rotated 90 degrees counterclockwise and clockwise relative to the hand-movement direction, respectively) and the remaining one does not (i.e., mirror-reversal context where the horizontal movement of the computer mouse was inverted). This study found that visual representations (i.e., visual direction) were decoded in the occipital area, while movement representations (i.e., hand-movement direction) were decoded across various visuomotor-related regions. These findings are consistent with prior research and the widely recognized roles of those areas. Task-context representations (i.e., either -90° rotation, +90° rotation, or mirror-reversal) were also distinguishable in various brain regions. Notably, these regions largely overlapped with those encoding visual and movement representations. This overlap suggests a potential intricate dependency of encoding visual and movement directions on the context information. Moreover, we discovered that higher task performance is associated with task-context representation commonality, as evidenced by negative correlations between task performance and task-context-decoding accuracy in various brain regions, potentially supporting structural learning. Importantly, despite limited similarities between tasks (e.g., rotation and mirror-reversal contexts), such association was still observed, suggesting an efficient mechanism in the brain that extracts commonalities from different task contexts (such as visuomotor rotations or mirror-reversal) at multiple structural levels, from high-level abstractions to lower-level details. In summary, while illuminating the intricate interplay between visuomotor processing and context information, our study highlights the efficiency of learning mechanisms, thereby paving the way for future exploration of the brain's versatile motor ability.

Behavioral Effects of Repetitive Transcranial Magnetic Stimulation in Disorders of Consciousness: A Systematic Review and Meta-Analysis

Traumatic brain injury, cardiac arrest, intracerebral hemorrhage, and ischemic stroke may cause disorders of consciousness (DoC). Repetitive transcranial magnetic stimulation (rTMS) has been used to promote the recovery of disorders of consciousness (DoC) patients. In this meta-analysis, we examined whether rTMS can relieve DoC patient symptoms. We searched through journal articles indexed in PubMed, the Web of Science, Embase, Scopus, and the Cochrane Library until 20 April 2023. We assessed whether studies used rTMS as an intervention and reported the pre- and post-rTMS coma recovery scale-revised (CRS-R) scores. A total of 207 patients from seven trials were included. rTMS significantly improved the recovery degree of patients; the weighted mean difference (WMD) of the change in the CRS-R score was 1.89 (95% confidence interval (CI): 1.39-2.39; p < 0.00001) in comparison with controls. The subgroup analysis showed a significant improvement in CRS-R scores in rTMS over the dorsolateral prefrontal cortex (WMD = 2.24; 95% CI: 1.55-2.92; p < 0.00001; I2 = 31%) and the primary motor cortex (WMD = 1.63; 95% CI: 0.69-2.57; p = 0.0007; I2 = 14%). Twenty-hertz rTMS significantly improved CRS-R scores in patients with DoC (WMD = 1.61; 95% CI: 0.39-2.83; p = 0.010; I2 = 31%). Furthermore, CRS-R scores in rTMS over 20 sessions significantly improved (WMD = 1.75; 95% CI: 0.95-2.55; p < 0.0001; I2 = 12%). rTMS improved the symptoms of DoC patients; however, the available evidence remains limited and inadequate.

Psychopathic traits and altered resting-state functional connectivity in incarcerated adolescent girls

Previous work in incarcerated boys and adult men and women suggest that individuals scoring high on psychopathic traits show altered resting-state limbic/paralimbic, and default mode functional network properties. However, it is unclear whether similar results extend to high-risk adolescent girls with elevated psychopathic traits. This study examined whether psychopathic traits [assessed via the Hare Psychopathy Checklist: Youth Version (PCL:YV)] were associated with altered inter-network connectivity, intra-network connectivity (i.e., functional coherence within a network), and amplitude of low-frequency fluctuations (ALFFs) across resting-state networks among high-risk incarcerated adolescent girls (n = 40). Resting-state networks were identified by applying group independent component analysis (ICA) to resting-state fMRI scans, and a priori regions of interest included limbic, paralimbic, and default mode network components. We tested the association of psychopathic traits (PCL:YV Factor 1 measuring affective/interpersonal traits and PCL:YV Factor 2 assessing antisocial/lifestyle traits) to these three resting-state measures. PCL:YV Factor 1 scores were associated with increased low-frequency and decreased high-frequency fluctuations in components corresponding to the default mode network, as well as increased intra-network FNC in components corresponding to cognitive control networks. PCL:YV Factor 2 scores were associated with increased low-frequency fluctuations in sensorimotor networks and decreased high-frequency fluctuations in default mode, sensorimotor, and visual networks. Consistent with previous analyses in incarcerated adult women, our results suggest that psychopathic traits among incarcerated adolescent girls are associated with altered intra-network ALFFs-primarily that of increased low-frequency and decreased high-frequency fluctuations-and connectivity across multiple networks including paralimbic regions. These results suggest stable neurobiological correlates of psychopathic traits among women across development.

Effects of neurofeedback on standing postural control task with combined imagined and executed movements

Introduction

Motor imagery (MI) is a method of imagining movement without actual movement, and its use in combination with motor execution (ME) enhances the effects of motor learning. Neurofeedback (NFB) is another method that promotes the effects of MI. This study aimed to investigate the effects of NFB on combined MI and ME (MIME) training in a standing postural control task.

Methods

Sixteen participants were randomly divided into MIME and MIME + NFB groups and performed 10 trials of a postural control task on an unstable board, with nine trials of MI in between. Electroencephalogram was assessed during MI, and the MIME + NFB group received neurofeedback on the degree of MI via auditory stimulation. A postural control task using an unstable board was performed before and after the MIME task, during which postural instability was evaluated.

Results

Postural instability was reduced after the MIME task in both groups. In addition, the root mean square, which indicates the sway of the unstable board, was significantly reduced in the MIME + NFB group compared to that in the MIME group.

Conclusion

Our results indicate that MIME training is effective for motor learning of standing postural control. Furthermore, when MI and ME are combined, the feedback on the degree of MI enhances the learning effect.

Neuropsychological Activations and Networks While Performing Visual and Kinesthetic Motor Imagery

This study aimed to answer the questions 'What are the neural networks and mechanisms involved in visual and kinesthetic motor imagery?', and 'Is part of cognitive processing included during visual and kinesthetic motor imagery?' by investigating the neurophysiological networks and activations during visual and kinesthetic motor imagery using motor imagery tasks (golf putting). The experiment was conducted with 19 healthy adults. Functional magnetic resonance imaging (fMRI) was used to examine neural activations and networks during visual and kinesthetic motor imagery using golf putting tasks. The findings of the analysis on cerebral activation patterns based on the two distinct types of motor imagery indicate that the posterior lobe, occipital lobe, and limbic lobe exhibited activation, and the right hemisphere was activated during the process of visual motor imagery. The activation of the temporal lobe and the parietal lobe were observed during the process of kinesthetic motor imagery. This study revealed that visual motor imagery elicited stronger activation in the right frontal lobe, whereas kinesthetic motor imagery resulted in greater activation in the left frontal lobe. It seems that kinesthetic motor imagery activates the primary somatosensory cortex (BA 2), the secondary somatosensory cortex (BA 5 and 7), and the temporal lobe areas and induces human sensibility. The present investigation evinced that the neural network and the regions of the brain that are activated exhibit variability contingent on the category of motor imagery.

Chronic Δ9-tetrahydrocannabinol treatment has dose-dependent effects on open field exploratory behavior and [3H] SR141716A receptor binding in the rat brain

AIMS

Acute and chronic Δ⁹-THC exposure paradigms affect the body differently. More must be known about the impact of chronic Δ⁹-THC on cannabinoid-1 (CB1R) and mu-opioid (MOR) receptor levels in the brain. The present study examined chronic Δ⁹-THC's effects on CB1R and MOR levels and locomotor activity.

MAIN METHODS

Adolescent Sprague-Dawley rats were given daily intraperitoneal injections of Δ⁹-THC [0.75mg/kg (low dose or LD) or 2.0 mg/kg (high dose or HD)] or vehicle for 24 days, and locomotion in the open field was tested after the first and fourth weeks of chronic Δ⁹-THC exposure. Brains were harvested at the end of treatment. [³H] SR141716A and [³H] DAMGO autoradiography assessed CB1R and MOR levels, respectively.

KEY FINDINGS

Relative to each other, chronic HD rats showed reduced vertical plane (VP) entries and time, while LD rats had increased VP entries and time for locomotion, as assessed by open-field testing; no effects were found relative to the control. Autoradiography analyses showed that HD Δ⁹-THC significantly decreased CB1R binding relative to LD Δ⁹-THC in the cingulate (33%), primary motor (42%), secondary motor (33%) somatosensory (38%), rhinal (38%), and auditory (50%) cortices; LD Δ⁹-THC rats displayed elevated binding in the primary motor (33% increase) and hypothalamic (33 % increase) regions compared with controls. No significant differences were observed in MOR binding for the LD or HD compared to the control.

SIGNIFICANCE

These results demonstrate that chronic Δ⁹-THC dose-dependently altered CB1R levels throughout the brain and locomotor activity in the open field.

Structural and functional activities of brain in patients with vascular cognitive impairment: A case-controlled magnetic resonance imaging study

This study aimed to identify abnormal brain regions and imaging indices of vascular cognitive impairment (VCI) and explore specific imaging diagnostic markers of VCI. In this study, 24 patients with VCI were allocated to the VCI group and 25 healthy subjects were assigned to the healthy control (HC) group. Demographic data and neuropsychological test scores were compared using SPSS 25.0. The structural and functional imaging data were post-processed and statistically analyzed using CAT12, DPARSF and SPM12 software, based on the MATLAB platform. The structural and functional indices of gray matter volume (GMV) and regional homogeneity (ReHo) were obtained, and inter-group data were analyzed using an independent-sample t test. Sex, age, years of education, and total brain volume were used as covariates. Compared to the HC group, the GMV of VCI in the VCI group decreased significantly in the rectus muscles of the bilateral gyrus, left superior temporal gyrus, left supplementary motor area (SMA), right insula, right superior temporal gyrus, right anterior cuneiform lobe, and right anterior central gyrus (PRECG) (P < .05, FWE correction), without GMV enlargement in the brain area. ReHo decreased in the right inferior temporal gyrus (ITG), right parahippocampal gyrus, and left temporal pole (middle temporal gyrus, right lingual gyrus, left posterior central gyrus, and right middle temporal gyrus), the areas of increased ReHo were the left caudate nucleus, left rectus gyrus, right anterior cingulate gyrus and lateral cingulate gyrus (P < .05, FWE correction). Correlation analysis showed that the GMV of the left superior temporal gyrus was positively correlated with the Montreal Cognitive Assessment (MoCA) score (P < .05), and the GMV of the right insula was positively correlated with the MESE and long delayed memory scores (P < .05). There was a significant positive correlation between the ReHo and short-term delayed memory scores in the middle temporal gyrus of the left temporal pole (P < .05). The volume of GMV and ReHo decreased in VCI patients, suggesting that impairment of brain structure and function in specific regions is the central mechanism of cognitive impairment in these patients. Meanwhile, the functional indices of some brain regions were increased, which may be a compensatory mechanism for the cognitive impairment associated with VCI.

Down and up! Does the mu rhythm index a gating mechanism in the developing motor system?

Developmental research on action processing in the motor cortex relies on a key neural marker - a decrease in 6-12 Hz activity (coined mu suppression). However, recent evidence points towards an increase in mu power, specific for the observation of others' actions. Complementing the findings on mu suppression, this raises the critical question for the functional role of the mu rhythm in the developing motor system. We here discuss a potential solution to this seeming controversy by suggesting a gating function of the mu rhythm: A decrease in mu power may index the facilitation, while an increase may index the inhibition of motor processes, which are critical during action observation. This account may advance our conception of action understanding in early brain development and points towards critical directions for future research.

Simultaneous multimodal fNIRS-EEG recordings reveal new insights in neural activity during motor execution, observation, and imagery

Motor execution, observation, and imagery are important skills used in motor learning and rehabilitation. The neural mechanisms underlying these cognitive-motor processes are still poorly understood. We used a simultaneous recording of functional near-infrared spectroscopy (fNIRS) and electroencephalogram (EEG) to elucidate the differences in neural activity across three conditions requiring these processes. Additionally, we used a new method called structured sparse multiset Canonical Correlation Analysis (ssmCCA) to fuse the fNIRS and EEG data and determine the brain regions of neural activity consistently detected by both modalities. Unimodal analyses revealed differentiated activation between conditions; however, the activated regions did not fully overlap across the two modalities (fNIRS: left angular gyrus, right supramarginal gyrus, as well as right superior and inferior parietal lobes; EEG: bilateral central, right frontal, and parietal). These discrepancies might be because fNIRS and EEG detect different signals. Using fused fNIRS-EEG data, we consistently found activation over the left inferior parietal lobe, superior marginal gyrus, and post-central gyrus during all three conditions, suggesting that our multimodal approach identifies a shared neural region associated with the Action Observation Network (AON). This study highlights the strengths of using the multimodal fNIRS-EEG fusion technique for studying AON. Neural researchers should consider using the multimodal approach to validate their findings.

Benchmarking framework for machine learning classification from fNIRS data

Background

While efforts to establish best practices with functional near infrared spectroscopy (fNIRS) signal processing have been published, there are still no community standards for applying machine learning to fNIRS data. Moreover, the lack of open source benchmarks and standard expectations for reporting means that published works often claim high generalisation capabilities, but with poor practices or missing details in the paper. These issues make it hard to evaluate the performance of models when it comes to choosing them for brain-computer interfaces.

Methods

We present an open-source benchmarking framework, BenchNIRS, to establish a best practice machine learning methodology to evaluate models applied to fNIRS data, using five open access datasets for brain-computer interface (BCI) applications. The BenchNIRS framework, using a robust methodology with nested cross-validation, enables researchers to optimise models and evaluate them without bias. The framework also enables us to produce useful metrics and figures to detail the performance of new models for comparison. To demonstrate the utility of the framework, we present a benchmarking of six baseline models [linear discriminant analysis (LDA), support-vector machine (SVM), k-nearest neighbours (kNN), artificial neural network (ANN), convolutional neural network (CNN), and long short-term memory (LSTM)] on the five datasets and investigate the influence of different factors on the classification performance, including: number of training examples and size of the time window of each fNIRS sample used for classification. We also present results with a sliding window as opposed to simple classification of epochs, and with a personalised approach (within subject data classification) as opposed to a generalised approach (unseen subject data classification).

Results and discussion

Results show that the performance is typically lower than the scores often reported in literature, and without great differences between models, highlighting that predicting unseen data remains a difficult task. Our benchmarking framework provides future authors, who are achieving significant high classification scores, with a tool to demonstrate the advances in a comparable way. To complement our framework, we contribute a set of recommendations for methodology decisions and writing papers, when applying machine learning to fNIRS data.

Dual-site TMS as a tool to probe effective interactions within the motor network: a review

Dual-site transcranial magnetic stimulation (ds-TMS) is well suited to investigate the causal effect of distant brain regions on the primary motor cortex, both at rest and during motor performance and learning. However, given the broad set of stimulation parameters, clarity about which parameters are most effective for identifying particular interactions is lacking. Here, evidence describing inter- and intra-hemispheric interactions during rest and in the context of motor tasks is reviewed. Our aims are threefold: (1) provide a detailed overview of ds-TMS literature regarding inter- and intra-hemispheric connectivity; (2) describe the applicability and contributions of these interactions to motor control, and; (3) discuss the practical implications and future directions. Of the 3659 studies screened, 109 were included and discussed. Overall, there is remarkable variability in the experimental context for assessing ds-TMS interactions, as well as in the use and reporting of stimulation parameters, hindering a quantitative comparison of results across studies. Further studies examining ds-TMS interactions in a systematic manner, and in which all critical parameters are carefully reported, are needed.

Cognitive and motor cortex activation during robot-assisted multi-sensory interactive motor rehabilitation training: An fNIRS based pilot study

Objective

This study aimed to evaluate the effects of multiple virtual reality (VR) interaction modalities based on force-haptic feedback combined with visual or auditory feedback in different ways on cerebral cortical activation by functional near-infrared spectroscopy (fNIRS). Methods: A modular multi-sensory VR interaction system based on a planar upper-limb rehabilitation robot was developed. Twenty healthy participants completed active elbow flexion and extension training in four VR interaction patterns, including haptic (H), haptic + auditory (HA), haptic + visual (HV), and haptic + visual + auditory (HVA). Cortical activation changes in the sensorimotor cortex (SMC), premotor cortex (PMC), and prefrontal cortex (PFC) were measured.

Results

Four interaction patterns all had significant activation effects on the motor and cognitive regions of the cerebral cortex (p < 0.05). Among them, in the HVA interaction mode, the cortical activation of each ROI was the strongest, followed by HV, HA, and H. The connectivity between channels of SMC and bilateral PFC, as well as the connectivity between channels in PMC, was the strongest under HVA and HV conditions. Besides, the two-way ANOVA of visual and auditory feedback showed that it was difficult for auditory feedback to have a strong impact on activation without visual feedback. In addition, under the condition of visual feedback, the effect of fusion auditory feedback on the activation degree was significantly higher than that of no auditory feedback.

Conclusions

The interaction mode of visual, auditory, and haptic multi-sensory integration is conducive to stronger cortical activation and cognitive control. Besides, there is an interaction effect between visual and auditory feedback, thus improving the cortical activation level. This research enriches the research on activation and connectivity of cognitive and motor cortex in the process of modular multi-sensory interaction training of rehabilitation robots. These conclusions provide a theoretical basis for the optimal design of the interaction mode of the rehabilitation robot and the possible scheme of clinical VR rehabilitation.

Combination of noninvasive brain stimulation and constraint-induced movement therapy in patients with stroke: a systematic review and meta-analysis

INTRODUCTION

Constraint-induced movement therapy (CIMT) and noninvasive brain stimulation (NIBS) are used to counteract learned nonuse phenomenon and imbalance in interhemispheric inhibition following stroke. The aim of this study is to summarize the available evidence on the effects of combining NIBS with CIMT in patients with stroke.

METHOD

PubMed, Embase, Web of Science (WoS), PEDro, OTSeeker, and CENTRAL were searched for randomized controlled trials comparing the use of NIBS+CIMT with sham NIBS+CIMT. Data on variables such as time since stroke and mean scores and standard deviations on outcomes assessed such as motor function were extracted. Cochrane risks of bias assessment tool and PEDro scale were used to assess the risk of bias and methodological quality of the included studies.

RESULTS

The results showed that both NIBS+CIMT and sham NIBS+CIMT improved all outcomes post-intervention and at follow-up. However, NIBS+CIMT is superior to sham NIBS+CIMT at improving level of motor impairment (SMD = 1.75, 95% CI = 0.49 to 3.01, P = 0.007) post-intervention and hand function (SMD = 1.21, 95% CI = 0.07 to 2.35, P = 0.04) at follow-up.

CONCLUSIONS

The addition of NIBS to CIMT seems to provide additional benefits to the recovery of function following stroke.

Alterations in brain structure and function associated with pediatric growth hormone deficiency: A multi-modal magnetic resonance imaging study

Introduction

Pediatric growth hormone deficiency (GHD) is a disease resulting from impaired growth hormone/insulin-like growth factor-1 (IGF-1) axis but the effects of GHD on children's cognitive function, brain structure and brain function were not yet fully illustrated.

Methods

Full Wechsler Intelligence Scales for Children, structural imaging, diffusion tensor imaging, and resting-state functional magnetic resonance imaging were assessed in 11 children with GHD and 10 matched healthy controls.

Results

(1) The GHD group showed moderate cognitive impairment, and a positive correlation existed between IGF-1 levels and cognitive indices. (2) Mean diffusivity was significantly increased in both corticospinal tracts in GHD group. (3) There were significant positive correlations between IGF-1 levels and volume metrics of left thalamus, left pallidum and right putamen but a negative correlation between IGF-1 levels and cortical thickness of the occipital lobe. And IGF-1 levels negatively correlated with fractional anisotropy in the superior longitudinal fasciculus and right corticospinal tract. (4) Regional homogeneity (ReHo) in the left hippocampus/parahippocampal gyrus was negatively correlated with IGF-1 levels; the amplitude of low-frequency fluctuation (ALFF) and ReHo in the paracentral lobe, postcentral gyrus and precentral gyrus were also negatively correlated with IGF-1 levels, in which region ALFF fully mediates the effect of IGF-1 on working memory index.

Conclusion

Multiple subcortical, cortical structures, and regional neural activities might be influenced by serum IGF-1 levels. Thereinto, ALFF in the paracentral lobe, postcentral gyrus and precentral gyrus fully mediates the effect of IGF-1 on the working memory index.

Recent advances in understanding neuronal diversity and neural circuit complexity across different brain regions using single-cell sequencing

Neural circuits are characterized as interconnecting neuron networks connected by synapses. Some kinds of gene expression and/or functional changes of neurons and synaptic connections may result in aberrant neural circuits, which has been recognized as one crucial pathological mechanism for the onset of many neurological diseases. Gradual advances in single-cell sequencing approaches with strong technological advantages, as exemplified by high throughput and increased resolution for live cells, have enabled it to assist us in understanding neuronal diversity across diverse brain regions and further transformed our knowledge of cellular building blocks of neural circuits through revealing numerous molecular signatures. Currently published transcriptomic studies have elucidated various neuronal subpopulations as well as their distribution across prefrontal cortex, hippocampus, hypothalamus, and dorsal root ganglion, etc. Better characterization of brain region-specific circuits may shed light on new pathological mechanisms involved and assist in selecting potential targets for the prevention and treatment of specific neurological disorders based on their established roles. Given diverse neuronal populations across different brain regions, we aim to give a brief sketch of current progress in understanding neuronal diversity and neural circuit complexity according to their locations. With the special focus on the application of single-cell sequencing, we thereby summarize relevant region-specific findings. Considering the importance of spatial context and connectivity in neural circuits, we also discuss a few published results obtained by spatial transcriptomics. Taken together, these single-cell sequencing data may lay a mechanistic basis for functional identification of brain circuit components, which links their molecular signatures to anatomical regions, connectivity, morphology, and physiology. Furthermore, the comprehensive characterization of neuron subtypes, their distributions, and connectivity patterns via single-cell sequencing is critical for understanding neural circuit properties and how they generate region-dependent interactions in different context.

Topological patterns of motor networks in Parkinson’s disease with different sides of onset: A resting-state-informed structural connectome study

Parkinson’s disease (PD) has a characteristically unilateral pattern of symptoms at onset and in the early stages; this lateralization is considered a diagnostically important diagnosis feature. We aimed to compare the graph-theoretical properties of whole-brain networks generated by using resting-state functional MRI (rs-fMRI), diffusion tensor imaging (DTI), and the resting-state-informed structural connectome (rsSC) in patients with left-onset PD (LPD), right-onset PD (RPD), and healthy controls (HCs). We recruited 26 patients with PD (13 with LPD and 13 with RPD) as well as 13 age- and sex-matched HCs. Rs-fMRI and DTI were performed in all subjects. Graph-theoretical analysis was used to calculate the local and global efficiency of a whole-brain network generated by rs-fMRI, DTI, and rsSC. Two-sample t-tests and Pearson correlation analysis were conducted. Significantly decreased global and local efficiency were revealed specifically in LPD patients compared with HCs when the rsSC network was used; no significant intergroup difference was found by using rs-fMRI or DTI alone. For rsSC network analysis, multiple network metrics were found to be abnormal in LPD. The degree centrality of the left precuneus was significantly correlated with the Unified Parkinson’s Disease Rating Scale (UPDRS) score and disease duration (p = 0.030, r = 0.599; p = 0.037, r = 0.582). The topological properties of motor-related brain networks can differentiate LPD and RPD. Nodal metrics may serve as important structural features for PD diagnosis and monitoring of disease progression. Collectively, these findings may provide neurobiological insights into the lateralization of PD onset.

Effects of short-term arm immobilization on motor skill acquisition

Learning to sequence movements is necessary for skillful interaction with the environment. Neuroplasticity, particularly long-term potentiation (LTP), within sensorimotor networks underlies the acquisition of motor skill. Short-term immobilization of the arm, even less than 12 hours, can reduce corticospinal excitability and increase the capacity for LTP-like plasticity within the contralateral primary motor cortex. However, it is still unclear whether short-term immobilization influences motor skill acquisition. The current study aimed to evaluate the effect of short-term arm immobilization on implicit, sequence-specific motor skill acquisition using a modified Serial Reaction Time Task (SRTT). Twenty young, neurotypical adults underwent a single SRTT training session after six hours of immobilization of the non-dominant arm or an equivalent period of no immobilization. Our results demonstrated that participants improved SRTT performance overall after training, but there was no evidence of an effect of immobilization prior to task training on performance improvement. Further, improvements on the SRTT were not sequence-specific. Taken together, motor skill acquisition for sequential, individuated finger movements improved following training but the effect of six hours of immobilization was difficult to discern.

Long-interval intracortical inhibition in primary motor cortex related to working memory in middle-aged adults

Introduction

Excitability of the primary motor cortex measured with TMS has been associated with cognitive dysfunctions in patient populations. However, only a few studies have explored this relationship in healthy adults, and even fewer have considered the role of biological sex.

Methods

Ninety-seven healthy middle-aged adults (53 male) completed a TMS protocol and a neuropsychological assessment. Resting Motor Threshold (RMT) and Long-Interval Intracortical Inhibition (LICI) were assessed in the left motor cortex and related to attention, episodic memory, working memory, reasoning, and global cognition composite scores to evaluate the relationship between cortical excitability and cognitive functioning.

Results

In the whole sample, there was a significant association between LICI and cognition; specifically, higher motor inhibition was related to better working memory performance. When the sample was broken down by biological sex, LICI was only associated with working memory, reasoning, and global cognition in men. No associations were found between RMT and cognitive functions.

Conclusion

Greater intracortical inhibition, measured by LICI, could be a possible marker of working memory in healthy middle-aged adults, and biological sex plays a critical role in this association.

Repetitive transcranial magnetic stimulation of the primary motor cortex in stroke survivors-more than motor rehabilitation: A mini-review

Stroke is a leading cause of morbidity and mortality among elderly populations worldwide. During the early phase of stroke, restoring blood circulation is of utmost importance to protect neurons from further injury. Once the initial condition is stabilized, various rehabilitation techniques can be applied to help stroke survivors gradually regain their affected functions. Among these techniques, transcranial magnetic stimulation (TMS) has emerged as a novel method to assess and modulate cortical excitability non-invasively and aid stroke survivors in the rehabilitation process. Different cortical regions have been targeted using TMS based on the underlying pathology and distorted function. Despite the lack of a standard operational procedure, repetitive TMS (rTMS) of the primary motor cortex (M1) is considered a promising intervention for post-stroke motor rehabilitation. However, apart from the motor response, mounting evidence suggests that M1 stimulation can be employed to treat other symptoms such as dysphagia, speech impairments, central post-stroke pain, depression, and cognitive dysfunction. In this mini-review, we summarize the therapeutic uses of rTMS stimulation over M1 in stroke survivors and discuss the potential mechanistic rationale behind it.

Gray Matter Abnormalities in Myotonic Dystrophy Type 1: A Voxel-Wise Meta-Analysis

Background

A growing number of voxel-based morphometry (VBM) studies have demonstrated widespread gray matter (GM) abnormalities in myotonic dystrophy type 1 (DM1), but the findings are heterogeneous. This study integrated previous VBM studies to identify consistent GM changes in the brains of patients with DM1.

Methods

Systematic retrieval was conducted in Web of Science, Pubmed, and Embase databases to identify VBM studies that met the inclusion requirements. Data were extracted. The Seed-based d Mapping with Permutation of Subject Images (SDM-PSI) software was used for meta-analysis of voxel aspects.

Results

A total of eight VBM studies were included, including 176 patients with DM1 and 198 healthy controls (HCs). GM volume in patients with DM1 was extensively reduced compared with HCs, including bilateral rolandic operculum, bilateral posterior central gyrus, bilateral precentral gyrus, right insula, right heschl gyrus, right superior temporal gyrus, bilateral supplementary motor area, bilateral middle cingulate gyrus/paracingulate gyrus, left paracentral lobule, and bilateral caudate nucleus. Meta-regression analysis found that regional GM abnormalities were associated with disease duration and Rey-Osterrieth Complex Figure (ROCF)-recall scores.

Conclusion

DM1 is not only a disease of muscle injury but also a multisystem disease involving brain motor and neuropsychiatric regions, providing a basis for the pathophysiological mechanism of DM1.

Abnormal functional connectivities patterns of multidomain cognitive impairments in pontine stroke patients

Cognitive dysfunction in patients with infratentorial stroke has been paid little attention. Brainstem stroke may disrupt network connectivity across the whole brain and affect multidomain cognition, but the details of this process remain unclear. The study aimed to investigate the effects of stroke‐induced pontine injury on whole‐brain network connectivity and cognitive function. We included 47 patients with pontine stroke and 56 healthy comparisons (HC), who underwent cognitive tests and functional magnetic resonance imaging (fMRI). Seven meaningful brain networks were identified using independent component analysis (ICA). Patients with pontine stroke had decreased intra‐network functional connectivities (FCs) in the primary perceptual and higher cognitive control networks, including sensorimotor network (SMN), visual network (VIS), default mode network (DMN), and salience network (SAN), as well as decreased inter‐network FCs in the primary perceptual (VIS‐SMN) and higher cognitive control networks (bilateral frontoparietal networks, rFPN‐lFPN). While the FCs between the primary perceptual and higher cognitive control networks (VIS‐DMN, VIS‐rFPN, VIS‐lFPN) were increased. Furthermore, the alterations in these FCs correlated with patients' cognitive measurements. These findings suggested that the infratentorial stroke can induce dysfunctional connectivity in both primary perceptual and higher cognitive control networks at the whole‐brain level, which may be attributable to the neural substrates of multidomain cognitive deficits in these patients.

Repetitive Transcranial Magnetic Stimulation of the Primary Motor Cortex beyond Motor Rehabilitation: A Review of the Current Evidence

Transcranial magnetic stimulation (TMS) has emerged as a novel technique to stimulate the human brain through the scalp. Over the years, identifying the optimal brain region and stimulation parameters has been a subject of debate in the literature on therapeutic uses of repetitive TMS (rTMS). Nevertheless, the primary motor cortex (M1) has been a conventional target for rTMS to treat motor symptoms, such as hemiplegia and spasticity, as it controls the voluntary movement of the body. However, with an expanding knowledge base of the M1 cortical and subcortical connections, M1-rTMS has shown a therapeutic efficacy that goes beyond the conventional motor rehabilitation to involve pain, headache, fatigue, dysphagia, speech and voice impairments, sleep disorders, cognitive dysfunction, disorders of consciousness, anxiety, depression, and bladder dysfunction. In this review, we summarize the latest evidence on using M1-rTMS to treat non-motor symptoms of diverse etiologies and discuss the potential mechanistic rationale behind the management of each of these symptoms.

The role of the primary motor cortex in motor imagery: A theta burst stimulation study

While mentally simulated actions activate similar neural structures to overt movement, the role of the primary motor cortex (PMC) in motor imagery remains disputed. The aim of the study was to use continuous theta burst stimulation (cTBS) to modulate corticospinal activity to investigate the putative role of the PMC in implicit motor imagery in young adults with typical and atypical motor ability. A randomized, double blind, sham‐controlled, crossover, offline cTBS protocol was applied to 35 young adults. During three separate sessions, adults with typical and low motor ability (developmental coordination disorder [DCD]), received active cTBS to the PMC and supplementary motor area (SMA), and sham stimulation to either the PMC or SMA. Following stimulation, participants completed measures of motor imagery (i.e., hand rotation task) and visual imagery (i.e., letter number rotation task). Although active cTBS significantly reduced corticospinal excitability in adults with typical motor ability, neither task performance was altered following active cTBS to the PMC or SMA, compared to performance after sham cTBS. These results did not differ across motor status (i.e., typical motor ability and DCD). These findings are not consistent with our hypothesis that the PMC (and SMA) is directly involved in motor imagery. Instead, previous motor cortical activation observed during motor imagery may be an epiphenomenon of other neurophysiological processes and/or activity within brain regions involved in motor imagery. This study highlights the need to consider multi‐session theta burst stimulation application and its neural effects when probing the putative role of motor cortices in motor imagery.

A controlled continuous theta burst stimulation protocol was adopted to examine the role of the primary motor cortex in motor imagery. While corticospinal excitability was suppressed in individuals with typical motor ability, no changes in imagery performance were detected after applying active stimulation to the motor regions. This suggests that motor regions may not be causally implicated in motor imagery and/or that multiple stimulation sessions may be required when inducing cognitive‐behavioral changes.

A comparative evaluation of neurophysiological activity, active tactile sensibility and stereognostic ability of complete denture prosthesis, and implant-supported prosthesis wearer-A pilot study

AIM

The study aimed to evaluate the effect of implant-supported prosthesis in completely edentulous participants in terms of osseoperception ability, neural activity, and stereognostic ability in comparison to removable prosthetic options.

MATERIALS AND METHODS

A total sample of 18 patients, irrespective of gender and age were allocated into three groups according to the three-treatment protocol (upper and lower complete denture, upper complete denture opposing lower implant-retained overdenture, implant-supported fixed prosthesis in both arches). Four weeks after completion of the treatment procedure active tactile sensibility (ATS) was checked by using varying thicknesses (12, 40, 80, 100, 200 μ) of articulating foils and papers. Functional magnetic resonance imaging (fMRI) was performed to record neurophysiological activity in cerebral cortex in all the participants. Various forms of test pieces (heat cure acrylic resin) were used to evaluate stereognostic ability. Data regarding the neurophysiological activity were analyzed by using Krushkal-Wallis test and p ≤ 0.05 was considered to be statistically significant. Data from stereognostic ability test procedure and ATS were compared by using chi-squared test and p ≤ 0.05 was considered to be statistically significant.

RESULTS

Statistically significant difference was found in between the articulating foils in terms of true negative responses as the foil thickness increased in participants wearing complete denture in both the arches (p = 0.004) and implant-supported fixed prosthesis in both the arches (p = 0.010). Participants in implant-supported fixed prosthesis group showed significantly more activation in primary motor cortex (right side), somatosensory cortex (left side), angular gyrus (both sides), temporal lobe (left) compared to other groups. No significant difference found in thalamus and premotor cortex region in between the participants of different groups. No statistically significant difference found in between the groups in terms of true responses identifying correct shapes. Mean number of correct responses in stereognostic ability test were 4.16 (83.33%), 3.5 (70%), 3.83 (76.66%) for participants of complete denture group, upper complete denture opposing lower implant retained overdenture group, and implant-supported fixed prosthesis group, respectively.

CONCLUSION

Primary motor cortex, somatosensory cortex, and other regions of brain were diffusely activated in participants wearing implant-supported fixed prosthesis in both the arches. Less number of false responses were recorded in participants of implant-supported fixed prosthesis group and upper complete denture opposing lower implant-retained overdenture group in ATS test compared to participants wearing complete denture in both the arches.

The primary motor cortex: the hub of motor learning in rodents

The primary motor cortex, a dynamic center for overall motion control and decision making, undergoes significant alterations upon neural stimulation. Over the last few decades, data from numerous studies using rodent models have improved our understanding of the morphological and functional plasticity of the primary motor cortex. In particular, spatially specific formation of dendritic spines and their maintenance during distinct behaviors is considered crucial for motor learning. However, whether the modifications of specific synapses are associated with motor learning should be studied further. In this review, we summarized the findings of prior studies on the features and dynamics of the primary motor cortex in rodents.

Brain structural alterations in autism and criminal psychopathy

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Autism and psychopathy are both disorders of social cognition and share numerous of their features but still differ distinctively in their clinical phenotype.

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The lower grey matter volumes in the right temporal pole and the left inferior frontal gyrus are the most prominent findings distinguishing violent offenders with high psychopatic from ASD individuals.

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Violent offenders with high psychopatic traits and individuals with ASD both present similar lower grey matter volumes in the right precentral cortex compared to controls.

The goal of this study was to elucidate the anatomical brain basis of social cognition through two disorders with distinctively different phenotypes of social interaction. We compared structural MR images of 20 individuals with autism spectrum disorder (ASD), 19 violent offenders with high psychopathic traits, and 19 control participants using voxel-based morphometry (VBM). Our earlier study showed lower grey matter volume (GMV) values in the insula, frontal cortex, and sensorimotor cortex of the offender group compared to controls. In the present study, the images of the ASD group revealed lower GMV in the left precuneus, right cerebellum, and right precentral gyrus in comparison with controls. The comparison between the offender and ASD groups showed lower GMV values for the right temporal pole and left inferior frontal gyrus in the offender group. There was also an overlap of both disorders in the right pre-central cortex, showing lower GMV compared to controls. Our findings suggest structural differences between violent offenders with high psychopathy traits and ASD individuals in the frontotemporal social brain network areas, previously associated with empathy. We also provide evidence of similar abnormal structures in the motor cortex for both of these disorders, possibly related to uniting issues of social cognition.

The Relationship between Motor Coordination and Imitation: An fNIRS Study

Although motor coordination and imitation are important factors affecting motor skill learning, few studies have examined the relationship between them in healthy adults. In order to address this in the present study, we used fNIRS to analyze the relationship between motor coordination and imitation in college students. Our results showed that: (1) motor coordination in female students was positively correlated with the average time taken to perform an imitation; (2) the mean imitation time was negatively correlated with the activation level of the supplementary motor cortex, primary somatosensory cortex, and angular gyrus of the mirror neuron system; (3) motor coordination in female students moderated mirror neuron system (MNS) activation and imitation. For women with low rather than high motor coordination, higher MNS activation was associated with a stronger imitation ability. These results demonstrate that motor coordination in female students is closely related to action imitation, and that it moderates the activation of the MNS, as measured via fNIRS.

Repetitive Transcranial Magnetic Stimulation in the Treatment of Alzheimer's Disease and Other Dementias

Dementia is a debilitating impairment of cognitive functions that affects millions of people worldwide. There are several diseases belonging to the dementia spectrum, most prominently Alzheimer’s disease (AD), vascular dementia (VD), Lewy body dementia (LBD) and frontotemporal dementia (FTD). Repetitive transcranial magnetic stimulation (rTMS) is a safe, non-invasive form of brain stimulation that utilizes a magnetic coil to generate an electrical field and induce numerous changes in the brain. It is considered efficacious for the treatment of various neuropsychiatric disorders. In this paper, we review the available studies involving rTMS in the treatment of these dementia types. The majority of studies have involved AD and shown beneficial effects, either as a standalone, or as an add-on to standard-of-care pharmacological treatment and cognitive training. The dorsolateral prefrontal cortex seems to hold a central position in the applied protocols, but several parameters still need to be defined. In addition, rTMS has shown potential in mild cognitive impairment as well. Regarding the remaining dementias, research is still at preliminary phases, and large, randomized studies are currently lacking.