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Hejazi HS, Khanmohammadi R, Olyaei G, Qanbari S. The effects of combining sensorimotor training with transcranial direct current stimulation on the anticipatory and compensatory postural adjustments in patients with chronic low back pain. Disabil Rehabil 2024:1-13. [PMID: 38982892 DOI: 10.1080/09638288.2024.2375756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 06/24/2024] [Indexed: 07/11/2024]
Abstract
PURPOSE To investigate the effects of concurrent sensorimotor training (SMT) and transcranial direct current stimulation (tDCS) on the anticipatory and compensatory postural adjustments (APAs and CPAs) in patients with chronic low back pain (CLBP). METHOD The interventions included (1) SMT plus tDCS and (2) SMT plus sham tDCS. Outcome measures were the normalized integrals of electromyography activity (NIEMG) during the phases of anticipatory and compensatory, and muscle onset latency. The investigated muscles were ipsilateral and contralateral multifidus (MF), transversus abdominus/internal oblique (TrA/IO), and gluteus medius (GM). RESULTS Between-group comparisons demonstrated that ipsilateral TrA/IO NIEMG during CPA1 (p = 0.010) and ipsilateral GM NIEMG during CPA1 (p = 0.002) and CPA2 (p = 0.025) were significantly lower in the SMT combined with tDCS than in the control group. Furthermore, this group had greater NIEMG for contralateral GM during APA1 than the control group (p = 0.032). Moreover, the onset latency of contralateral TrA/IO was significantly earlier after SMT combined with tDCS (p = 0.011). CONCLUSIONS Both groups that received SMT showed positive effects, but anodal tDCS had an added value over sham stimulation for improving postural control strategies in patients with CLBP. Indeed, SMT combined with tDCS leads to stronger APA and less demand for CPA. RCT REGISTRATION NUMBER IRCT20220228054149N1. REGISTRATION DATE 2022-04-04.
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Affiliation(s)
- Hanie Sadat Hejazi
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Khanmohammadi
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Olyaei
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheila Qanbari
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
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Neige C, Vassiliadis P, Ali Zazou A, Dricot L, Lebon F, Brees T, Derosiere G. Connecting the dots: harnessing dual-site transcranial magnetic stimulation to quantify the causal influence of medial frontal areas on the motor cortex. Cereb Cortex 2023; 33:11339-11353. [PMID: 37804253 DOI: 10.1093/cercor/bhad370] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 10/09/2023] Open
Abstract
Dual-site transcranial magnetic stimulation has been widely employed to investigate the influence of cortical structures on the primary motor cortex. Here, we leveraged this technique to probe the causal influence of two key areas of the medial frontal cortex, namely the supplementary motor area and the medial orbitofrontal cortex, on primary motor cortex. We show that supplementary motor area stimulation facilitates primary motor cortex activity across short (6 and 8 ms) and long (12 ms) inter-stimulation intervals, putatively recruiting cortico-cortical and cortico-subcortico-cortical circuits, respectively. Crucially, magnetic resonance imaging revealed that this facilitatory effect depended on a key morphometric feature of supplementary motor area: individuals with larger supplementary motor area volumes exhibited more facilitation from supplementary motor area to primary motor cortex for both short and long inter-stimulation intervals. Notably, we also provide evidence that the facilitatory effect of supplementary motor area stimulation at short intervals is unlikely to arise from spinal interactions of volleys descending simultaneously from supplementary motor area and primary motor cortex. On the other hand, medial orbitofrontal cortex stimulation moderately suppressed primary motor cortex activity at both short and long intervals, irrespective of medial orbitofrontal cortex volume. These results suggest that dual-site transcranial magnetic stimulation is a fruitful approach to investigate the differential influence of supplementary motor area and medial orbitofrontal cortex on primary motor cortex activity, paving the way for the multimodal assessment of these fronto-motor circuits in health and disease.
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Affiliation(s)
- Cécilia Neige
- Université Bourgogne Franche-Comté, INSERM UMR1093-CAPS, UFR des Sciences du Sport, F-21078, Dijon, France
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PsyR2 Team, F-69500, Bron, France
- Centre Hospitalier le Vinatier, 95 Boulevard Pinel, 300 3969678 Bron Cedex, France
| | - Pierre Vassiliadis
- Institute of Neuroscience, Université Catholique de Louvain, Avenue E. Mounier 53 & 73, 1200, Brussels, Belgium
- Defitech Chair for Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), École Polytechnique Fédérale de Lausanne (EPFL), 1202, Geneva, Switzerland
| | - Abdelkrim Ali Zazou
- Institute of Neuroscience, Université Catholique de Louvain, Avenue E. Mounier 53 & 73, 1200, Brussels, Belgium
| | - Laurence Dricot
- Institute of Neuroscience, Université Catholique de Louvain, Avenue E. Mounier 53 & 73, 1200, Brussels, Belgium
| | - Florent Lebon
- Université Bourgogne Franche-Comté, INSERM UMR1093-CAPS, UFR des Sciences du Sport, F-21078, Dijon, France
| | - Thomas Brees
- Institute of Neuroscience, Université Catholique de Louvain, Avenue E. Mounier 53 & 73, 1200, Brussels, Belgium
| | - Gerard Derosiere
- Institute of Neuroscience, Université Catholique de Louvain, Avenue E. Mounier 53 & 73, 1200, Brussels, Belgium
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, Impact Team, F-69500, Bron, France
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Neige C, Rannaud Monany D, Lebon F. Exploring cortico-cortical interactions during action preparation by means of dual-coil transcranial magnetic stimulation: A systematic review. Neurosci Biobehav Rev 2021; 128:678-692. [PMID: 34274404 DOI: 10.1016/j.neubiorev.2021.07.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 05/31/2021] [Accepted: 07/13/2021] [Indexed: 10/20/2022]
Abstract
Action preparation is characterized by a set of complex and distributed processes that occur in multiple brain areas. Interestingly, dual-coil transcranial magnetic stimulation (TMS) is a relevant technique to probe effective connectivity between cortical areas, with a high temporal resolution. In the current systematic review, we aimed at providing a detailed picture of the cortico-cortical interactions underlying action preparation focusing on dual-coil TMS studies. We considered four theoretical processes (impulse control, action selection, movement initiation and action reprogramming) and one task modulator (movement complexity). The main findings highlight 1) the interplay between primary motor cortex (M1) and premotor, prefrontal and parietal cortices during action preparation, 2) the varying (facilitatory or inhibitory) cortico-cortical influence depending on the theoretical processes and the TMS timing, and 3) the key role of the supplementary motor area-M1 interactions that shape the preparation of simple and complex movements. These findings are of particular interest for clinical perspectives, with a need to better characterize functional connectivity deficiency in clinical population with altered action preparation.
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Affiliation(s)
- Cécilia Neige
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, F-21000, Dijon, France
| | - Dylan Rannaud Monany
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, F-21000, Dijon, France
| | - Florent Lebon
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, F-21000, Dijon, France.
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Intervention-induced changes in neural connectivity during motor preparation may affect cortical activity at motor execution. Sci Rep 2020; 10:7326. [PMID: 32355238 PMCID: PMC7193567 DOI: 10.1038/s41598-020-64179-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 04/07/2020] [Indexed: 12/22/2022] Open
Abstract
Effective interventions have demonstrated the ability to improve motor function by reengaging ipsilesional resources, which appears to be critical and feasible for hand function recovery even in individuals with severe chronic stroke. However, previous studies focus on changes in brain activity related to motor execution. How changes in motor preparation may facilitate these changes at motor execution is still unclear. To address this question, 8 individuals with severe chronic hemiparetic stroke participated in a device-assisted intervention for seven weeks. We then quantified changes in both coupling between regions during motor preparation and changes in topographical cortical activity at motor execution for both hand opening in isolation and together with the shoulder using high-density EEG. We hypothesized that intervention-induced changes in cortico-cortico interactions during motor preparation would lead to changes in activity at motor execution specifically towards an increased reliance on the ipsilesional hemisphere. In agreement with this hypothesis, we found that, following the intervention, individuals displayed a reduction in coupling from ipsilesional M1 to contralesional M1 within gamma frequencies during motor preparation for hand opening. This was followed by a reduction in activity in the contralesional primary sensorimotor cortex during motor execution. Similarly, during lifting and opening, a shift to negative coupling within ipsilesional M1 from gamma to beta frequencies was accompanied by an increase in ipsilesional primary sensorimotor cortex activity following the intervention. Together, these results show that intervention-induced changes in coupling within or between motor regions during motor preparation may affect cortical activity at execution.
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Lefebvre S, Jann K, Schmiesing A, Ito K, Jog M, Schweighofer N, Wang DJJ, Liew SL. Differences in high-definition transcranial direct current stimulation over the motor hotspot versus the premotor cortex on motor network excitability. Sci Rep 2019; 9:17605. [PMID: 31772347 PMCID: PMC6879500 DOI: 10.1038/s41598-019-53985-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 11/06/2019] [Indexed: 01/07/2023] Open
Abstract
The effectiveness of transcranial direct current stimulation (tDCS) placed over the motor hotspot (thought to represent the primary motor cortex (M1)) to modulate motor network excitability is highly variable. The premotor cortex-particularly the dorsal premotor cortex (PMd)-may be a promising alternative target to reliably modulate motor excitability, as it influences motor control across multiple pathways, one independent of M1 and one with direct connections to M1. This double-blind, placebo-controlled preliminary study aimed to differentially excite motor and premotor regions using high-definition tDCS (HD-tDCS) with concurrent functional magnetic resonance imaging (fMRI). HD-tDCS applied over either the motor hotspot or the premotor cortex demonstrated high inter-individual variability in changes on cortical motor excitability. However, HD-tDCS over the premotor cortex led to a higher number of responders and greater changes in local fMRI-based complexity than HD-tDCS over the motor hotspot. Furthermore, an analysis of individual motor hotspot anatomical locations revealed that, in more than half of the participants, the motor hotspot is not located over anatomical M1 boundaries, despite using a canonical definition of the motor hotspot. This heterogeneity in stimulation site may contribute to the variability of tDCS results. Altogether, these preliminary findings provide new considerations to enhance tDCS reliability.
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Affiliation(s)
- Stephanie Lefebvre
- Neural Plasticity and Neurorehabilitation Laboratory, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States
| | - Kay Jann
- Laboratory of FMRI Technology (LOFT), USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
- Laboratory of Neuro Imaging (LONI), USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Allie Schmiesing
- Neural Plasticity and Neurorehabilitation Laboratory, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States
| | - Kaori Ito
- Neural Plasticity and Neurorehabilitation Laboratory, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States
| | - Mayank Jog
- Laboratory of FMRI Technology (LOFT), USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
- Laboratory of Neuro Imaging (LONI), USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Nicolas Schweighofer
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| | - Danny J J Wang
- Laboratory of FMRI Technology (LOFT), USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
- Laboratory of Neuro Imaging (LONI), USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Sook-Lei Liew
- Neural Plasticity and Neurorehabilitation Laboratory, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States.
- Laboratory of Neuro Imaging (LONI), USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA.
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Corticomotor excitability reduction induced by experimental pain remains unaffected by performing a working memory task as compared to staying at rest. Exp Brain Res 2019; 237:2205-2215. [DOI: 10.1007/s00221-019-05587-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 06/17/2019] [Indexed: 12/18/2022]
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Neige C, Mavromatis N, Gagné M, Bouyer LJ, Mercier C. Effect of movement-related pain on behaviour and corticospinal excitability changes associated with arm movement preparation. J Physiol 2018; 596:2917-2929. [PMID: 29855037 DOI: 10.1113/jp276011] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 04/17/2018] [Indexed: 12/14/2022] Open
Abstract
KEY POINTS Experimental pain or its anticipation influence motor preparation processes as well as upcoming movement execution, but the underlying physiological mechanisms remain unknown. Our results showed that movement-related pain modulates corticospinal excitability during motor preparation. In accordance with the pain adaptation theory, corticospinal excitability was higher when the muscle has an antagonist (vs. an agonist) role for the upcoming movement associated with pain. Anticipation of movement-related pain also affects motor initiation and execution, with slower movement initiation (longer reaction times) and faster movement execution compared to movements that do not evoke pain. These results confirm the implementation of protective strategies during motor preparation known to be relevant for acute pain, but which may potentially have detrimental long-term consequences and lead to the development of chronic pain. ABSTRACT When a movement repeatedly generates pain, we anticipate movement-related pain and establish self-protective strategies during motor preparation, but the underlying mechanisms remains poorly understood. The current study investigated the effect of movement-related pain anticipation on the modulation of behaviour and corticospinal excitability during the preparation of arm movements. Participants completed an instructed-delay reaction-time (RT) task consisting of elbow flexions and extensions instructed by visual cues. Nociceptive laser stimulations (unconditioned stimuli) were applied to the lateral epicondyle during movement execution in a specific direction (CS+) but not in the other (CS-), depending on experimental group. During motor preparation, transcranial magnetic stimulation was used to measure corticospinal excitability in the biceps brachii (BB). RT and peak end-point velocity were also measured. Neurophysiological results revealed an opposite modulation of corticospinal excitability in BB depending on whether it plays an agonist (i.e. flexion) or antagonist (i.e. extension) role for the CS+ movements (P < 0.001). Moreover, behavioural results showed that for the CS+ movements RT did not change relative to baseline, whereas the CS- movements were initiated more quickly (P = 0.023) and the CS+ flexion movements were faster relative to the CS- flexion movements (P < 0.001). This is consistent with the pain adaptation theory which proposes that in order to protect the body from further pain, agonist muscle activity is reduced and antagonist muscle activity is increased. If these strategies are initially relevant and lead to short-term pain alleviation, they may potentially have detrimental long-term consequences and lead to the development of chronic pain.
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Affiliation(s)
- Cécilia Neige
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Québec, QC, Canada.,Department of Rehabilitation, Laval University, Québec, QC, Canada
| | - Nicolas Mavromatis
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Québec, QC, Canada.,Department of Rehabilitation, Laval University, Québec, QC, Canada
| | - Martin Gagné
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Québec, QC, Canada
| | - Laurent J Bouyer
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Québec, QC, Canada.,Department of Rehabilitation, Laval University, Québec, QC, Canada
| | - Catherine Mercier
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Québec, QC, Canada.,Department of Rehabilitation, Laval University, Québec, QC, Canada
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