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Mazzi C, Mele S, Bagattini C, Sanchez-Lopez J, Savazzi S. Coherent activity within and between hemispheres: cortico-cortical connectivity revealed by rTMS of the right posterior parietal cortex. Front Hum Neurosci 2024; 18:1362742. [PMID: 38516308 PMCID: PMC10954802 DOI: 10.3389/fnhum.2024.1362742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 02/23/2024] [Indexed: 03/23/2024] Open
Abstract
Introduction Low frequency (1 Hz) repetitive transcranial stimulation (rTMS) applied over right posterior parietal cortex (rPPC) has been shown to reduce cortical excitability both of the stimulated area and of the interconnected contralateral homologous areas. In the present study, we investigated the whole pattern of intra- and inter-hemispheric cortico-cortical connectivity changes induced by rTMS over rPPC. Methods To do so, 14 healthy participants underwent resting state EEG recording before and after 30 min of rTMS at 1 Hz or sham stimulation over the rPPC (electrode position P6). Real stimulation was applied at 90% of motor threshold. Coherence values were computed on the electrodes nearby the stimulated site (i.e., P4, P8, and CP6) considering all possible inter- and intra-hemispheric combinations for the following frequency bands: delta (0.5-4 Hz), theta (4-8 Hz), alpha (8-12Hz), low beta (12-20 Hz), high beta (20-30 Hz), and gamma (30-50 Hz). Results and discussion Results revealed a significant increase in coherence in delta, theta, alpha and beta frequency bands between rPPC and the contralateral homologous sites. Moreover, an increase in coherence in theta, alpha, beta and gamma frequency bands was found between rPPC and right frontal sites, reflecting the activation of the fronto-parietal network within the right hemisphere. Summarizing, subthreshold rTMS over rPPC revealed cortico-cortical inter- and intra-hemispheric connectivity as measured by the increase in coherence among these areas. Moreover, the present results further confirm previous evidence indicating that the increase of coherence values is related to intra- and inter-hemispheric inhibitory effects of rTMS. These results can have implications for devising evidence-based rehabilitation protocols after stroke.
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Affiliation(s)
- Chiara Mazzi
- Perception and Awareness (PandA) Laboratory, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sonia Mele
- Perception and Awareness (PandA) Laboratory, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Chiara Bagattini
- Perception and Awareness (PandA) Laboratory, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Section of Neurosurgery, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Javier Sanchez-Lopez
- Escuela Nacional de Estudios Superiores Unidad Juriquilla, Universidad Nacional Autonoma de Mexico, Santiago de Querétaro, Mexico
| | - Silvia Savazzi
- Perception and Awareness (PandA) Laboratory, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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2
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Salatino A, Sarasso P, Piedimonte A, Garbarini F, Ricci R, Berti A. Modulation of Motor Awareness: A Transcranial Magnetic Stimulation Study in the Healthy Brain. Brain Sci 2023; 13:1422. [PMID: 37891791 PMCID: PMC10605796 DOI: 10.3390/brainsci13101422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 09/26/2023] [Accepted: 10/05/2023] [Indexed: 10/29/2023] Open
Abstract
Previous studies on the mechanisms underlying willed actions reported that the premotor cortex may be involved in the construction of motor awareness. However, its exact role is still under investigation. Here, we investigated the role of the dorsal premotor cortex (PMd) in motor awareness by modulating its activity applying inhibitory rTMS to PMd, before a specific motor awareness task (under three conditions: without stimulation, after rTMS and after Sham stimulation). During the task, subjects had to trace straight lines to a given target, receiving visual feedback of the line trajectories on a computer screen. Crucially, in most trials, the trajectories on the screen were deviated, and to produce straight lines, subjects had to correct their movements towards the opposite direction. After each trial, participants were asked to judge whether the line seen on the computer screen corresponded to the line actually drawn. Results show that participants in the No Stimulation condition did not recognize the perturbation until 14 degrees of deviation. Importantly, active, but not Sham, rTMS significantly modulated motor awareness, decreasing the amplitude of the angle at which participants became aware of the trajectory correction. These results suggest that PMd plays a crucial role in action self-monitoring.
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Affiliation(s)
- Adriana Salatino
- Department of Psychology, University of Turin, Via Po 14, 10123 Turin, Italy
| | - Pietro Sarasso
- Department of Psychology, University of Turin, Via Po 14, 10123 Turin, Italy
| | | | - Francesca Garbarini
- Department of Psychology, University of Turin, Via Po 14, 10123 Turin, Italy
| | - Raffaella Ricci
- Department of Psychology, University of Turin, Via Po 14, 10123 Turin, Italy
- NIT—Neuroscience Institute of Turin, Via Verdi, 8, 10124 Turin, Italy
| | - Anna Berti
- Department of Psychology, University of Turin, Via Po 14, 10123 Turin, Italy
- NIT—Neuroscience Institute of Turin, Via Verdi, 8, 10124 Turin, Italy
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3
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Improvement of Impulsivity and Decision Making by Transcranial Direct Current Stimulation of the Dorsolateral Prefrontal Cortex in a Patient with Gambling Disorder. J Gambl Stud 2022; 38:627-634. [PMID: 34213750 PMCID: PMC9120079 DOI: 10.1007/s10899-021-10050-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2021] [Indexed: 01/10/2023]
Abstract
Gambling disorder (GD) is a form of behavioral addiction. In recent years, it has been suggested that the application of transcranial Direct Current Stimulation (tDCS) to the dorsolateral prefrontal cortex (DLPFC), which plays a key role in top-down inhibitory control and impulsivity, may represent a new therapeutic approach for treating addictions. Here we investigated the effectiveness of a novel low dose tDCS protocol (i.e. six sessions of right anodal/left cathodal tDCS for 20 min, with a current intensity of 1 mA) applied to DLPFC in a patient with GD. To evaluate the effect of the proposed intervention, cognitive, psychological and behavioural evaluations were performed at different time points, pre and post intervention. The results showed improvement of impulsivity, decision making, and cognitive functioning after tDCS intervention. Findings of the present study suggest that low doses of right anodal/left cathodal tDCS to DLPFC may effectively improve gambling behaviour. They also suggest to carefully evaluate the effects of this tDCS polarity on the patient's emotional state. The current protocol warrants further investigation in large groups of patients, as it may provide relevant insights into the design of effective, low dose treatments of gambling disorder.
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Kim J, Kim H, Lee J, Lee HJ, Na Y, Chang WH, Kim YH. Comparison of hemodynamic changes after repetitive transcranial magnetic stimulation over the anatomical hand knob and hand motor hotspot: A functional near-infrared spectroscopy study. Restor Neurol Neurosci 2020; 38:407-417. [PMID: 33285650 PMCID: PMC7902962 DOI: 10.3233/rnn-201032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Low-frequency rTMS can induce upregulation of excitability in the contralateral hemisphere by interhemispheric interaction. OBJECTIVE The aim of this study was to compare the effects of interhemispheric modulation on hemodynamic changes after applying low-frequency rTMS over the anatomical hand knob (HK) and the hand motor hotspot (hMHS) in the dominant motor cortex. METHODS Ten healthy right-handed participants without a history of neurological or psychiatric symptoms (five males; 29.8±2.8 years) participated in this single-blind, randomized, cross-over study. rTMS was applied under three conditions over the dominant (left) hemisphere for 20 minutes: 1) 1 Hz rTMS stimulation on the HK (HK-rTMS), 2) 1 Hz rTMS stimulation on the hMHS (hMHS-rTMS), and 3) sham stimulation (Sham-rTMS). For all participants, functional near-infrared spectroscopy (fNIRS) was applied for measurement of cerebral oxyhemoglobin (oxyHb) and deoxyhemoglobin (deoxyHb) concentration over the non-dominant (right) hemisphere during a serial reaction time task (SRTT) with the non-dominant (left) hand before and after each condition. RESULTS The average coordinates of the hMHS (x = - 39.60 mm, y = - 17.11 mm, z = 66.40 mm) were anterior and lateral to the HK (x = - 36.72 mm, y = - 28.87 mm, z = 56.41 mm). In fNIRS time-series analysis, the integral value of oxyHb wassignificantly increased over the motor cortical region of the non-dominant hemisphere after the hMHS-rTMS compared with Sham-rTMS. The HK-rTMS also showed slight increment of oxyHb concentration but without statistical significance. The SPM group analysis showed greater magnitude of the activity in hMHS-rTMS than that of HK-rTMS after stimulation (p < 0.05). CONCLUSIONS These results demonstrated an interhemispheric modulation effect of hemodynamic changes by 1 Hz rTMS. The hMHS produced a more robust modulation effect of 1 Hz rTMS on the contralateral hemisphere than did the HK. Therefore, the rTMS can be considered a better stimulation target than the HK.
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Affiliation(s)
- Jinuk Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Heegoo Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Jungsoo Lee
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hwang-Jae Lee
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Yoonju Na
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Won Hyuk Chang
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yun-Hee Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea.,Department of Medical Device Management & Research, Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
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5
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Gammeri R, Iacono C, Ricci R, Salatino A. Unilateral Spatial Neglect After Stroke: Current Insights. Neuropsychiatr Dis Treat 2020; 16:131-152. [PMID: 32021206 PMCID: PMC6959493 DOI: 10.2147/ndt.s171461] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 12/24/2019] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Unilateral spatial neglect (USN) is a disorder of contralesional space awareness which often follows unilateral brain lesion. Since USN impairs awareness of contralesional space/body and often of concomitant motor disorders, its presence represents a negative prognostic factor of functional recovery. Thus, the disorder needs to be carefully diagnosed and treated. Here, we attempted to present a clear and concise picture of current insights in the comprehension and rehabilitation of USN. METHODS We first provided an updated overview of USN clinical and neuroanatomical features and then highlighted recent progresses in the diagnosis and rehabilitation of the disease. In relation to USN rehabilitation, we conducted a MEDLINE literature research on three of the most promising interventions for USN rehabilitation: prismatic adaptation (PA), non-invasive brain stimulation (NIBS), and virtual reality (VR). The identified studies were classified according to the strength of their methods. RESULTS The last years have witnessed a relative decrement of interest in the study of neuropsychological disorders of spatial awareness in USN, but a relative increase in the study of potential interventions for its rehabilitation. Although optimal protocols still need to be defined, high-quality studies have demonstrated the efficacy of PA, TMS and tDCS interventions for the treatment of USN. In addition, preliminary investigations are suggesting the potentials of GVS and VR approaches for USN rehabilitation. CONCLUSION Advancing neuropsychological and neuroscience tools to investigate USN pathophysiology is a necessary step to identify effective rehabilitation treatments and to foster our understanding of neurofunctional bases of spatial cognition in the healthy brain.
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Affiliation(s)
- Roberto Gammeri
- Department of Psychology, SAMBA (SpAtial, Motor and Bodily Awareness) Research Group, University of Turin, Turin, Italy
| | - Claudio Iacono
- Department of Psychology, SAMBA (SpAtial, Motor and Bodily Awareness) Research Group, University of Turin, Turin, Italy
| | - Raffaella Ricci
- Department of Psychology, SAMBA (SpAtial, Motor and Bodily Awareness) Research Group, University of Turin, Turin, Italy
- Neuroscience Institute of Turin (NIT), University of Turin, Turin, Italy
| | - Adriana Salatino
- Department of Psychology, SAMBA (SpAtial, Motor and Bodily Awareness) Research Group, University of Turin, Turin, Italy
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Ricci R, Salatino A, Caldano M, Perozzo P, Cerrato P, Pyasik M, Pia L, Berti A. Phantom touch: How to unmask sensory unawareness after stroke. Cortex 2019; 121:253-263. [DOI: 10.1016/j.cortex.2019.08.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 06/16/2019] [Accepted: 08/27/2019] [Indexed: 11/15/2022]
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Daini R. The Lack of Self-Consciousness in Right Brain-Damaged Patients Can Be due to a Disconnection From the Left Interpreter: The DiLeI Theory. Front Psychol 2019; 10:349. [PMID: 30873077 PMCID: PMC6403150 DOI: 10.3389/fpsyg.2019.00349] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 02/04/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Roberta Daini
- Psychology, Università degli Studi di Milano Bicocca, Milan, Italy
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8
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Lanina AA, Feurra M, Gorbunova ES. No Effect of the Right Posterior Parietal Cortex tDCS in Dual-Target Visual Search. Front Psychol 2018; 9:2112. [PMID: 30483172 PMCID: PMC6240658 DOI: 10.3389/fpsyg.2018.02112] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 10/12/2018] [Indexed: 11/22/2022] Open
Abstract
“Subsequent search misses” represent a decrease in accuracy at detecting a second target in a visual search task. In this study, we tested the possibility to modulate this effect via inhibition of the right posterior parietal cortex trough transcranial direct current stimulation (tDCS). The target stimuli were T-shapes presented among L-shaped distractors. The participant’s task was to detect targets or to report their absence. For each trial, targets could be represented by one high-salient target, one low-salient target, two different targets (one high salient and one low salient), two high salient targets, two low salient targets, or no targets at all (catch-trials). Offline tDCS was applied over the right (target site) or left (control site) posterior parietal cortex. Sham stimulation over the right posterior parietal cortex was included as a control (placebo). Stimulation lasted for 10 min. Afterward, participants were asked to perform the experiment. Our findings suggest that stimulation did not modulate any of the task conditions, suggesting potential limitation of the study: either tDCS was not enough powerful to modulate the task performance or the task was too easy to be modulated by stimulation.
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Affiliation(s)
- Alyona A Lanina
- Laboratory of Digital Interface User's Cognitive Psychology, National Research University Higher School of Economics, Moscow, Russia
| | - Matteo Feurra
- Centre for Cognition & Decision Making, Institute of Cognitive Neuroscience, National Research University Higher School of Economics, Moscow, Russia
| | - Elena S Gorbunova
- Laboratory of Digital Interface User's Cognitive Psychology, School of Psychology, National Research University Higher School of Economics, Moscow, Russia
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O'Brien AT, Bertolucci F, Torrealba-Acosta G, Huerta R, Fregni F, Thibaut A. Non-invasive brain stimulation for fine motor improvement after stroke: a meta-analysis. Eur J Neurol 2018; 25:1017-1026. [PMID: 29744999 DOI: 10.1111/ene.13643] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 03/22/2018] [Indexed: 11/28/2022]
Abstract
The aim of this study was to determine whether non-invasive brain stimulation (NIBS) techniques improve fine motor performance in stroke. We searched PubMed, EMBASE, Web of Science, SciELO and OpenGrey for randomized clinical trials on NIBS for fine motor performance in stroke patients and healthy participants. We computed Hedges' g for active and sham groups, pooled data as random-effects models and performed sensitivity analysis on chronicity, montage, frequency of stimulation and risk of bias. Twenty-nine studies (351 patients and 152 healthy subjects) were reviewed. Effect sizes in stroke populations for transcranial direct current stimulation and repeated transcranial magnetic stimulation were 0.31 [95% confidence interval (CI), 0.08-0.55; P = 0.010; Tau2 , 0.09; I2 , 34%; Q, 18.23; P = 0.110] and 0.46 (95% CI, 0.00-0.92; P = 0.05; Tau2 , 0.38; I2 , 67%; Q, 30.45; P = 0.007). The effect size of non-dominant healthy hemisphere transcranial direct current stimulation on non-dominant hand function was 1.25 (95% CI, 0.09-2.41; P = 0.04; Tau2 , 1.26; I2 , 93%; Q, 40.27; P < 0.001). Our results show that NIBS is associated with gains in fine motor performance in chronic stroke patients and healthy subjects. This supports the effects of NIBS on motor learning and encourages investigation to optimize their effects in clinical and research settings.
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Affiliation(s)
- A T O'Brien
- Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - F Bertolucci
- Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neuroscience and Neurorehabilitation, University Hospital of Pisa, Pisa, Italy
| | - G Torrealba-Acosta
- Department of Neurology, Neuroscience Research Center, University of Costa Rica, San José, Costa Rica
| | - R Huerta
- Department of Medicine, The National Autonomous University of Mexico, Mexico City, Mexico
| | - F Fregni
- Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - A Thibaut
- Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA.,Coma Science Group, GIGA-Consciousness, University and University Hospital of Liège, Liège, Belgium
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10
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Ianì F, Burin D, Salatino A, Pia L, Ricci R, Bucciarelli M. The beneficial effect of a speaker's gestures on the listener's memory for action phrases: The pivotal role of the listener's premotor cortex. BRAIN AND LANGUAGE 2018; 180-182:8-13. [PMID: 29653280 DOI: 10.1016/j.bandl.2018.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 01/24/2018] [Accepted: 03/31/2018] [Indexed: 06/08/2023]
Abstract
Memory for action phrases improves in the listeners when the speaker accompanies them with gestures compared to when the speaker stays still. Since behavioral studies revealed a pivotal role of the listeners' motor system, we aimed to disentangle the role of primary motor and premotor cortices. Participants had to recall phrases uttered by a speaker in two conditions: in the gesture condition, the speaker performed gestures congruent with the action; in the no-gesture condition, the speaker stayed still. In Experiment 1, half of the participants underwent inhibitory rTMS over the hand/arm region of the left premotor cortex (PMC) and the other half over the hand/arm region of the left primary motor cortex (M1). The enactment effect disappeared only following rTMS over PMC. In Experiment 2, we detected the usual enactment effect after rTMS over vertex, thereby excluding possible nonspecific rTMS effects. These findings suggest that the information encoded in the premotor cortex is a crucial part of the memory trace.
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Affiliation(s)
- Francesco Ianì
- Dipartimento di Psicologia, Università di Torino, Torino, Italy.
| | - Dalila Burin
- Smart-Aging Research Center & IDAC-Institute of Development, Aging and Cancer Tohoku University, Sendai, Japan
| | - Adriana Salatino
- Dipartimento di Psicologia, Università di Torino, Torino, Italy; SAMBA (SpAtial, Motor and Bodily Awareness) Research Group, Università di Torino, Torino, Italy
| | - Lorenzo Pia
- Dipartimento di Psicologia, Università di Torino, Torino, Italy; SAMBA (SpAtial, Motor and Bodily Awareness) Research Group, Università di Torino, Torino, Italy
| | - Raffaella Ricci
- Dipartimento di Psicologia, Università di Torino, Torino, Italy; SAMBA (SpAtial, Motor and Bodily Awareness) Research Group, Università di Torino, Torino, Italy
| | - Monica Bucciarelli
- Dipartimento di Psicologia, Università di Torino, Torino, Italy; Center for Logic, Language and Cognition, Università di Torino, Torino, Italy
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Effects of Excitatory Repetitive Transcranial Magnetic Stimulation of the P3 Point in Chronic Stroke Patients—Case Reports. Brain Sci 2018; 8:brainsci8050078. [PMID: 29710767 PMCID: PMC5977069 DOI: 10.3390/brainsci8050078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 04/15/2018] [Accepted: 04/24/2018] [Indexed: 11/17/2022] Open
Abstract
Objective: To evaluate the effects of excitatory repetitive transcranial magnetic stimulation (rTMS) of the international 10–20 system P3 point (intraparietal sulcus region) in chronic patients with a frontal lesion and parietal sparing due to stroke on the impaired upper (UL) and lower limb (LL) as measured by the Fugl-Meyer Assessment (FMA). Methods: Three patients (C1: 49.83/2.75, C2: 53.17/3.83, C3: 63.33/3.08-years-old at stroke/years post-stroke, respectively) received two weeks (five days/week) of rTMS at 10 Hz of P3. A patient was treated in similar conditions with a sham coil (S1: 56.58/4.33). Patients were evaluated before, after, and two months post-treatment (A1, A2, and A3, respectively). Results: For LL, the scores of the motor function subsection of C1 and C3 as well as the sensory function of C2 increased by A2 and remained by A3. For UL, the score of the motor function of C2 and C3 also increased, but the score of C3 decreased by A3. The score of the range of motion subsection of C3 increased by the two follow-up evaluations. Conclusion: This study suggests excitatory rTMS over P3 may be of use for some chronic stroke patients, but these findings need to be verified in a future clinical trial.
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Martín-Arévalo E, Schintu S, Farnè A, Pisella L, Reilly KT. Adaptation to Leftward Shifting Prisms Alters Motor Interhemispheric Inhibition. Cereb Cortex 2018; 28:528-537. [PMID: 27993820 PMCID: PMC6248503 DOI: 10.1093/cercor/bhw386] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 11/15/2016] [Accepted: 11/17/2016] [Indexed: 11/14/2022] Open
Abstract
Adaptation to rightward shifting prisms (rightward prism adaptation, RPA) ameliorates neglect symptoms in patients while adaptation to leftward shifting prisms (leftward prism adaptation, LPA) induces neglect-like behaviors in healthy subjects. It has been hypothesized that prism adaptation (PA) modulates interhemispheric balance between the parietal cortices by inhibiting the posterior parietal cortex (PPC) contralateral to the prismatic deviation, but PA's effects on interhemispheric inhibition (IHI) have not been directly investigated. Since there are hyper-excitable connections between the PPC and primary motor cortex (M1) in the left hemisphere of neglect patients, we reasoned that LPA might mimic right hemisphere lesions by reducing parietal IHI, hyper-exciting the left PPC and PPC-M1 connections, and in turn altering IHI at the motor level. Namely, we hypothesized that LPA would increase IHI from the left to the right M1. We examined changes in left-to-right and right-to-left IHI between the 2 M1s using the ipsilateral silent period (iSP) (Meyer et al. 1995) before and after either LPA or RPA. The iSP was significantly longer after LPA but only from left-to-right and it did not change at all after RPA. This is the first physiological demonstration that LPA alters IHI in the healthy brain.
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Affiliation(s)
- Elisa Martín-Arévalo
- ImpAct team, Lyon Neuroscience Research Center, INSERM
U1028, CRNS-UMR5292, 16 Ave. Doyen Lépine, 69676 Bron
Cedex, France
- Lyon 1 University, F-69373 Lyon, France
| | - Selene Schintu
- ImpAct team, Lyon Neuroscience Research Center, INSERM
U1028, CRNS-UMR5292, 16 Ave. Doyen Lépine, 69676 Bron
Cedex, France
- Lyon 1 University, F-69373 Lyon, France
- Behavioral Neurology Unit, National Institute of
Neurological Disorders and Stroke, National Institutes of Health,
10 Center Bethesda, MD, USA
| | - Alessandro Farnè
- ImpAct team, Lyon Neuroscience Research Center, INSERM
U1028, CRNS-UMR5292, 16 Ave. Doyen Lépine, 69676 Bron
Cedex, France
- Lyon 1 University, F-69373 Lyon, France
- Hospices Civils de Lyon, Neuro-immersion & Mouvement
et Handicap, F-69676 Lyon, France
| | - Laure Pisella
- ImpAct team, Lyon Neuroscience Research Center, INSERM
U1028, CRNS-UMR5292, 16 Ave. Doyen Lépine, 69676 Bron
Cedex, France
- Lyon 1 University, F-69373 Lyon, France
| | - Karen T Reilly
- ImpAct team, Lyon Neuroscience Research Center, INSERM
U1028, CRNS-UMR5292, 16 Ave. Doyen Lépine, 69676 Bron
Cedex, France
- Lyon 1 University, F-69373 Lyon, France
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Paired-Pulse Parietal-Motor Stimulation Differentially Modulates Corticospinal Excitability across Hemispheres When Combined with Prism Adaptation. Neural Plast 2016; 2016:5716179. [PMID: 27418979 PMCID: PMC4933861 DOI: 10.1155/2016/5716179] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Accepted: 05/24/2016] [Indexed: 11/18/2022] Open
Abstract
Rightward prism adaptation ameliorates neglect symptoms while leftward prism adaptation (LPA) induces neglect-like biases in healthy individuals. Similarly, inhibitory repetitive transcranial magnetic stimulation (rTMS) on the right posterior parietal cortex (PPC) induces neglect-like behavior, whereas on the left PPC it ameliorates neglect symptoms and normalizes hyperexcitability of left hemisphere parietal-motor (PPC-M1) connectivity. Based on this analogy we hypothesized that LPA increases PPC-M1 excitability in the left hemisphere and decreases it in the right one. In an attempt to shed some light on the mechanisms underlying LPA's effects on cognition, we investigated this hypothesis in healthy individuals measuring PPC-M1 excitability with dual-site paired-pulse TMS (ppTMS). We found a left hemisphere increase and a right hemisphere decrease in the amplitude of motor evoked potentials elicited by paired as well as single pulses on M1. While this could indicate that LPA biases interhemispheric connectivity, it contradicts previous evidence that M1-only MEPs are unchanged after LPA. A control experiment showed that input-output curves were not affected by LPA per se. We conclude that LPA combined with ppTMS on PPC-M1 differentially alters the excitability of the left and right M1.
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Repetitive transcranial magnetic stimulation for rehabilitation of poststroke dysphagia: A randomized, double-blind clinical trial. Clin Neurophysiol 2016; 127:1907-13. [DOI: 10.1016/j.clinph.2015.11.045] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 11/27/2015] [Accepted: 11/30/2015] [Indexed: 11/19/2022]
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Salatino A, Poncini M, George MS, Ricci R. Hunting for right and left parietal hot spots using single-pulse TMS: modulation of visuospatial perception during line bisection judgment in the healthy brain. Front Psychol 2014; 5:1238. [PMID: 25400612 PMCID: PMC4215615 DOI: 10.3389/fpsyg.2014.01238] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 10/11/2014] [Indexed: 11/25/2022] Open
Abstract
A series of studies have consistently reproduced left neglect-like bias on line length estimation tasks in healthy participants by applying transcranial magnetic stimulation (TMS) over the right posterior parietal cortex (PPC), while no significant changes have been reported when stimulating the left PPC. However, a notable inter-individual variability in the right parietal site where TMS modulates visuospatial perception can be observed, and no general agreement exists on how to identify the optimal parietal site of stimulation. In the present study, we propose a new site-finding TMS protocol to easily identify the optimum parietal location, or “hot spot,” where TMS may modulate visuospatial perception on a line length estimation task (the Landmark task). Single-pulse TMS at 115% of motor threshold was applied 150 ms after the visual stimulus onset over nine different sites of a 3 cm × 3 cm grid, centred over right or left PPC (P4 and P3 according to the 10–20 EEG system, respectively) in eight healthy participants. Stimulation of right PPC induced a significant left neglect-like bias, when the coil was applied over the most posterior and dorso-posterior sites. Unexpectedly, TMS over left PPC also produced left neglect-like bias. However, in this case significant effects were found when targeting the most anterior and dorso-anterior portions of the grid. These results are discussed in relation to recent findings on neural networks underlying spatial cognition. The hunting protocol we propose might offer an economical and easy-to-use tool to functionally identify the optimal parietal site where TMS can modulate visuospatial perception, in healthy subjects and possibly in post-stroke patients undergoing repetitive transcranial magnetic stimulation treatment.
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Affiliation(s)
- Adriana Salatino
- Dipartimento di Psicologia, Università di Torino Torino, Italy ; Brain Stimulation Lab and Center for Advanced Imaging Research, Medical University of South Carolina Charleston, SC, USA
| | - Marisa Poncini
- Dipartimento di Psicologia, Università di Torino Torino, Italy
| | - Mark S George
- Brain Stimulation Lab and Center for Advanced Imaging Research, Medical University of South Carolina Charleston, SC, USA
| | - Raffaella Ricci
- Dipartimento di Psicologia, Università di Torino Torino, Italy ; Brain Stimulation Lab and Center for Advanced Imaging Research, Medical University of South Carolina Charleston, SC, USA
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Abstract
Purpose of review Noninvasive brain stimulation (NIBS) is increasingly used to enhance the recovery of function after stroke. The purpose of this review is to highlight and discuss some unresolved questions that need to be addressed to better understand and exploit the potential of NIBS as a therapeutic tool. Recent findings Recent meta-analyses showed that the treatment effects of NIBS in patients with stroke are rather inconsistent across studies and the evidence for therapeutic efficacy is still uncertain. This raises the question of how NIBS can be developed further to improve its therapeutic efficacy. Summary This review addressed six questions: How does NIBS facilitate the recovery of function after stroke? Which brain regions should be targeted by NIBS? Is there a particularly effective NIBS modality that should be used? Does the location of the stroke influence the therapeutic response? How often should NIBS be repeated? Is the functional state of the brain during or before NIBS relevant to therapeutic efficacy of NIBS? We argue that these questions need to be tackled to obtain sufficient mechanistic understanding of how NIBS facilitates the recovery of function. This knowledge will be critical to fully unfold the therapeutic effects of NIBS and will pave the way towards adaptive NIBS protocols, in which NIBS is tailored to the individual patient.
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Normalizing biased spatial attention with parietal rTMS in a patient with focal hand dystonia. Brain Stimul 2014; 7:912-4. [PMID: 25178660 DOI: 10.1016/j.brs.2014.07.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 07/22/2014] [Accepted: 07/22/2014] [Indexed: 11/22/2022] Open
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