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Feys O, Wens V, Schuind S, Rikir E, Legros B, De Tiège X, Gaspard N. Variability of cortico-cortical evoked potentials in the epileptogenic zone is related to seizure occurrence. Ann Clin Transl Neurol 2024. [PMID: 39370736 DOI: 10.1002/acn3.52179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 07/16/2024] [Accepted: 07/31/2024] [Indexed: 10/08/2024] Open
Abstract
INTRODUCTION Cortico-cortical evoked potentials (CCEPs) were described as reproducible during trains of single-pulse electrical stimulations (SPES). Still, few studies described a variability of CCEPs that was higher within the epileptogenic zone (EZ). This study aimed at characterizing the relationship of CCEP variability with the occurrence of interictal/ictal epileptiform discharges at the temporal vicinity of the stimulation, but not during the stimulation, by effective connectivity modifications. METHODS We retrospectively included 20 patients who underwent SPES during their stereo-electroencephalography (SEEG). We analyzed the variability of CCEPs by using the post-stimulation time course of intertrial standard deviation (amplitude) and the timing of peak amplitude signal of CCEP epochs (latency). Values were corrected for the Euclidian distance between stimulating/recording electrodes. Receiver operating characteristics curves were used to assess the relationship with the EZ. The link between CCEP variability and interictal discharges occurrence, seizure frequency prior to the SEEG recording, and number of seizures during SEEG recording was assessed with Spearman's correlations. RESULTS A relationship was demonstrated between the EZ and both the distance-corrected latency variation (area under the curve (AUC): 0.73-0.74) and the distance-corrected amplitude variation (AUC: 0.71-0.72) and both were related with the occurrence of seizures. CONCLUSION Seizures before/during SEEG impact the dynamics of effective connectivity within the epileptogenic network by reducing the variability of CCEP latency/amplitude when the seizure frequency increases. It suggests a strengthening of the epileptogenic network with the occurrence of many seizures. These findings stress the importance of early epilepsy surgery at a time when the network organization has not yet been complete.
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Affiliation(s)
- Odile Feys
- Department of Neurology, Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Hôpital Erasme, Bruxelles, Belgium
- Laboratoire de Neuroanatomie et Neuroimagerie translationnelles (LN2T), Université libre de Bruxelles (ULB), ULB Neuroscience Institute (UNI), Bruxelles, Belgium
| | - Vincent Wens
- Laboratoire de Neuroanatomie et Neuroimagerie translationnelles (LN2T), Université libre de Bruxelles (ULB), ULB Neuroscience Institute (UNI), Bruxelles, Belgium
- Department of Translational Neuroimaging, Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Hôpital Erasme, Bruxelles, Belgium
| | - Sophie Schuind
- Department of Neurosurgery, Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Hôpital Erasme, Bruxelles, Belgium
| | - Estelle Rikir
- Department of Neurology, Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Hôpital Erasme, Bruxelles, Belgium
| | - Benjamin Legros
- Department of Neurology, Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Hôpital Erasme, Bruxelles, Belgium
| | - Xavier De Tiège
- Laboratoire de Neuroanatomie et Neuroimagerie translationnelles (LN2T), Université libre de Bruxelles (ULB), ULB Neuroscience Institute (UNI), Bruxelles, Belgium
- Department of Translational Neuroimaging, Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Hôpital Erasme, Bruxelles, Belgium
| | - Nicolas Gaspard
- Department of Neurology, Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Hôpital Erasme, Bruxelles, Belgium
- Department of Neurology, Yale University, New Haven, Connecticut, USA
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Souza VH, Castro KVFD, de Melo-Carneiro P, de Oliveira Gomes I, Camatti JR, Oliveira IAVFD, Sá KN, Baptista AF, Lucena R, Zugaib J. tDCS and local scalp cooling do not change corticomotor and intracortical excitability in healthy humans. Clin Neurophysiol 2024; 168:1-9. [PMID: 39388788 DOI: 10.1016/j.clinph.2024.09.023] [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: 04/10/2024] [Revised: 09/04/2024] [Accepted: 09/24/2024] [Indexed: 10/12/2024]
Abstract
OBJECTIVE Scalp cooling might increase the long-term potentiation (LTP)-like effect of transcranial direct current stimulation (tDCS) by reducing the threshold for after-effects according to metaplasticity and increasing electrical current density reaching the cortical neurons. We aimed to investigate whether priming scalp cooling potentiates the tDCS after-effect on motor cortex excitability. METHODS This study had a randomized, parallel-arms, sham-controlled, double-blinded design with an adequately powered sample of 105 healthy subjects. Corticomotor and intracortical excitability were assessed with motor evoked potentials (MEP) from transcranial magnetic stimulation (TMS) in short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF) paradigms. Subjects were randomly allocated into six intervention groups, including anodal and cathodal tDCS (1-mA/20-min), scalp cooling, and sham. MEPs were recorded before, immediately, and 15 min after the interventions. RESULTS We did not observe changes in MEP amplitude from single-pulse TMS, SICI, and ICF with any intervention protocol. CONCLUSION Anodal and cathodal tDCS did not have an LTP-like neuromodulatory effect on corticospinal and did not provide detectable GABAergic and glutamatergic neurotransmission changes, which were not influenced by priming scalp cooling. SIGNIFICANCE We provide strong evidence that tDCS (1-mA/20-min) does not alter corticomotor and intracortical excitability with or without priming scalp cooling.
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Affiliation(s)
- Victor H Souza
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland.
| | | | | | | | - Janine Ribeiro Camatti
- Graduate Program in Neuroscience and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil
| | | | - Katia Nunes Sá
- Postgraduation and Research, Bahiana School of Medicine and Public Health, Salvador, Brazil
| | - Abrahão Fontes Baptista
- Center for Mathematics, Computation and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil
| | - Rita Lucena
- Graduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil; Faculty of Medicine, Federal University of Bahia, Salvador, Brazil; Department of Neuroscience and Mental Health, Federal University of Bahia, Salvador, Brazil
| | - João Zugaib
- Institute of Health Sciences, Federal University of Bahia, Salvador, Brazil
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Choobsaz H, Ghotbi N, Ansari NN. Effects of dry needling on spasticity, cortical excitability, and range of motion in a patient with multiple sclerosis: a case report. J Med Case Rep 2024; 18:125. [PMID: 38521912 PMCID: PMC10960986 DOI: 10.1186/s13256-024-04452-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 02/08/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Dry needling is an intervention used by physiotherapists to manage muscle spasticity. We report the effects of three sessions of dry needling on ankle plantar flexor muscle spasticity and cortical excitability in a patient with multiple sclerosis. CASE PRESENTATION The patient was a 40-year-old Iranian woman with an 11-year history of multiple sclerosis. The study outcomes were measured by the modified modified Ashworth scale, transcranial magnetic stimulation parameters, and active and passive ankle range of motion. They were assessed before (T0), after three sessions of dry needling (T1), and at 2-week follow-up (T2). Our result showed: the modified modified Ashworth scale was improved at T2 from, 2 to 1. The resting motor threshold decreased from 63 to 61 and 57 at T1 and T2, respectively. The single test motor evokes potential increased from 76.2 to 78.3. The short intracortical inhibition increased from 23.6 to 35.4 at T2. The intracortical facilitation increased from 52 to 76 at T2. The ankle active and passive dorsiflexion ROM increased ~ 10° and ~ 6° at T2, respectively. CONCLUSION This case study presented a patient with multiple sclerosis who underwent dry needling of ankle plantar flexors with severe spasticity, and highlighted the successful use of dry needling in the management of spasticity, ankle dorsiflexion, and cortical excitability. Further rigorous investigations are warranted, employing randomized controlled trials with a sufficient sample of patients with multiple sclerosis. Trial registration IRCT20230206057343N1, registered 9 February 2023, https://en.irct.ir/trial/68454.
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Affiliation(s)
- Haniyeh Choobsaz
- School of Rehabilitation, Department of Physiotherapy, Tehran University of Medical Sciences, Tehran, Iran
| | - Nastaran Ghotbi
- School of Rehabilitation, Department of Physiotherapy, Tehran University of Medical Sciences, Tehran, Iran.
| | - Noureddin Nakhostin Ansari
- School of Rehabilitation, Department of Physiotherapy, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for War-Affected People, Tehran University of Medical Sciences, Tehran, Iran
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Sinisalo H, Rissanen I, Kahilakoski OP, Souza VH, Tommila T, Laine M, Nyrhinen M, Ukharova E, Granö I, Soto AM, Matsuda RH, Rantala R, Guidotti R, Kičić D, Lioumis P, Mutanen T, Pizzella V, Marzetti L, Roine T, Stenroos M, Ziemann U, Romani GL, Ilmoniemi RJ. Modulating brain networks in space and time: Multi-locus transcranial magnetic stimulation. Clin Neurophysiol 2024; 158:218-224. [PMID: 38184469 DOI: 10.1016/j.clinph.2023.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 11/17/2023] [Accepted: 12/15/2023] [Indexed: 01/08/2024]
Affiliation(s)
- Heikki Sinisalo
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland.
| | - Ilkka Rissanen
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | | | - Victor H Souza
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki, Aalto University, and Helsinki University Hospital, Helsinki, Finland; Department of Physics, Faculty of Philosophy Sciences and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Timo Tommila
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Mikael Laine
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Mikko Nyrhinen
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland; AMI Centre, Aalto NeuroImaging, Aalto University School of Science, Espoo, Finland
| | - Elena Ukharova
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Ida Granö
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Ana M Soto
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Renan H Matsuda
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland; Department of Physics, Faculty of Philosophy Sciences and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Robin Rantala
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Roberto Guidotti
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Dubravko Kičić
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Pantelis Lioumis
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki, Aalto University, and Helsinki University Hospital, Helsinki, Finland
| | - Tuomas Mutanen
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Vittorio Pizzella
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies (ITAB), University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Laura Marzetti
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies (ITAB), University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Timo Roine
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Matti Stenroos
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Ulf Ziemann
- Department of Neurology & Stroke, University of Tübingen, Tübingen, Germany; Hertie-Institute for Clinical Brain Research, Tübingen, Germany
| | - Gian Luca Romani
- Institute for Advanced Biomedical Technologies (ITAB), University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Risto J Ilmoniemi
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
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Marzetti L, Makkinayeri S, Pieramico G, Guidotti R, D'Andrea A, Roine T, Mutanen TP, Souza VH, Kičić D, Baldassarre A, Ermolova M, Pankka H, Ilmoniemi RJ, Ziemann U, Luca Romani G, Pizzella V. Towards real-time identification of large-scale brain states for improved brain state-dependent stimulation. Clin Neurophysiol 2024; 158:196-203. [PMID: 37827877 DOI: 10.1016/j.clinph.2023.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/04/2023] [Accepted: 09/13/2023] [Indexed: 10/14/2023]
Affiliation(s)
- Laura Marzetti
- Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, Chieti, Abruzzo, Italy; Institute for Advanced Biomedical Technologies, University of Chieti-Pescara, Chieti, Abruzzo, Italy.
| | - Saeed Makkinayeri
- Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, Chieti, Abruzzo, Italy
| | - Giulia Pieramico
- Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, Chieti, Abruzzo, Italy
| | - Roberto Guidotti
- Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, Chieti, Abruzzo, Italy
| | - Antea D'Andrea
- Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, Chieti, Abruzzo, Italy
| | - Timo Roine
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland; Turku Brain and Mind Center, University of Turku, Turku, Finland; BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki, Aalto University and Helsinki University Hospital, Helsinki, Finland
| | - Tuomas P Mutanen
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Victor H Souza
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki, Aalto University and Helsinki University Hospital, Helsinki, Finland
| | - Dubravko Kičić
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki, Aalto University and Helsinki University Hospital, Helsinki, Finland
| | - Antonello Baldassarre
- Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, Chieti, Abruzzo, Italy
| | - Maria Ermolova
- Hertie-Institute for Clinical Brain Research, Tübingen, Baden-Württemberg, Germany; Department of Neurology & Stroke, University of Tübingen, Tübingen, Baden-Württemberg, Germany
| | - Hanna Pankka
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Risto J Ilmoniemi
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Ulf Ziemann
- Hertie-Institute for Clinical Brain Research, Tübingen, Baden-Württemberg, Germany; Department of Neurology & Stroke, University of Tübingen, Tübingen, Baden-Württemberg, Germany
| | - Gian Luca Romani
- Institute for Advanced Biomedical Technologies, University of Chieti-Pescara, Chieti, Abruzzo, Italy
| | - Vittorio Pizzella
- Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, Chieti, Abruzzo, Italy; Institute for Advanced Biomedical Technologies, University of Chieti-Pescara, Chieti, Abruzzo, Italy
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Zhou L, Jin Y, Wu D, Cun Y, Zhang C, Peng Y, Chen N, Yang X, Zhang S, Ning R, Kuang P, Wang Z, Zhang P. Current evidence, clinical applications, and future directions of transcranial magnetic stimulation as a treatment for ischemic stroke. Front Neurosci 2023; 17:1177283. [PMID: 37534033 PMCID: PMC10390744 DOI: 10.3389/fnins.2023.1177283] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/28/2023] [Indexed: 08/04/2023] Open
Abstract
Transcranial magnetic stimulation (TMS) is a non-invasive brain neurostimulation technique that can be used as one of the adjunctive treatment techniques for neurological recovery after stroke. Animal studies have shown that TMS treatment of rats with middle cerebral artery occlusion (MCAO) model reduced cerebral infarct volume and improved neurological dysfunction in model rats. In addition, clinical case reports have also shown that TMS treatment has positive neuroprotective effects in stroke patients, improving a variety of post-stroke neurological deficits such as motor function, swallowing, cognitive function, speech function, central post-stroke pain, spasticity, and other post-stroke sequelae. However, even though numerous studies have shown a neuroprotective effect of TMS in stroke patients, its possible neuroprotective mechanism is not clear. Therefore, in this review, we describe the potential mechanisms of TMS to improve neurological function in terms of neurogenesis, angiogenesis, anti-inflammation, antioxidant, and anti-apoptosis, and provide insight into the current clinical application of TMS in multiple neurological dysfunctions in stroke. Finally, some of the current challenges faced by TMS are summarized and some suggestions for its future research directions are made.
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Affiliation(s)
- Li Zhou
- Key Laboratory of Acupuncture and Massage for Treatment of Encephalopathy, College of Acupuncture, Tuina and Rehabilitation, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Yaju Jin
- Key Laboratory of Acupuncture and Massage for Treatment of Encephalopathy, College of Acupuncture, Tuina and Rehabilitation, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Danli Wu
- Key Laboratory of Acupuncture and Massage for Treatment of Encephalopathy, College of Acupuncture, Tuina and Rehabilitation, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Yongdan Cun
- Key Laboratory of Acupuncture and Massage for Treatment of Encephalopathy, College of Acupuncture, Tuina and Rehabilitation, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Chengcai Zhang
- Key Laboratory of Acupuncture and Massage for Treatment of Encephalopathy, College of Acupuncture, Tuina and Rehabilitation, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Yicheng Peng
- Key Laboratory of Acupuncture and Massage for Treatment of Encephalopathy, College of Acupuncture, Tuina and Rehabilitation, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Na Chen
- Key Laboratory of Acupuncture and Massage for Treatment of Encephalopathy, College of Acupuncture, Tuina and Rehabilitation, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Xichen Yang
- Key Laboratory of Acupuncture and Massage for Treatment of Encephalopathy, College of Acupuncture, Tuina and Rehabilitation, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Simei Zhang
- Key Laboratory of Acupuncture and Massage for Treatment of Encephalopathy, College of Acupuncture, Tuina and Rehabilitation, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Rong Ning
- Key Laboratory of Acupuncture and Massage for Treatment of Encephalopathy, College of Acupuncture, Tuina and Rehabilitation, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Peng Kuang
- Key Laboratory of Acupuncture and Massage for Treatment of Encephalopathy, College of Acupuncture, Tuina and Rehabilitation, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Zuhong Wang
- Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, Yunnan, China
| | - Pengyue Zhang
- Key Laboratory of Acupuncture and Massage for Treatment of Encephalopathy, College of Acupuncture, Tuina and Rehabilitation, Yunnan University of Traditional Chinese Medicine, Kunming, China
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Pavey N, Menon P, van den Bos MAJ, Kiernan MC, Vucic S. Cortical inhibition and facilitation are mediated by distinct physiological processes. Neurosci Lett 2023; 803:137191. [PMID: 36924929 DOI: 10.1016/j.neulet.2023.137191] [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: 11/30/2022] [Revised: 03/01/2023] [Accepted: 03/11/2023] [Indexed: 03/17/2023]
Abstract
A complex interaction of inhibitory and facilitatory interneuronal processes may underlie development of cortical excitability in the human motor cortex. To determine whether distinct interneuronal processes mediated cortical excitability, threshold tracking transcranial magnetic stimulation was utilised to assess cortical excitability, with figure-of-eight coil oriented in posterior-anterior (PA), anterior-posterior (AP) and latero-medial (LM) directions. Motor evoked potential (MEP) responses were recorded over the contralateral abductor pollicis brevis. Resting motor threshold (RMT), short interval intracortical inhibition (SICI), short interval intracortical facilitation (SICF) and intracortical facilitation were recorded. Significant effects of coil orientation were evident on SICI (F = 8.560, P = 0.002) and SICF (F = 7.132, P = 0.003). SICI was greater when recorded with PA (9.7 ± 10.9%, P = 0.029) and AP (13.1 ± 7.0%, P = 0.003) compared to LM (5.2 ± 7.3%) directed currents. SICF was significantly greater with PA (-14.7 ± 8.1%, P = 0.016) and LM (-14.7 ± 8.8%, P = 0.005) compared to AP (-9.1 ± 7.2%) coil orientations. SICI recorded with LM and PA coil orientations were correlated (R = 0.7, P = 0.002), as was SICF recorded with AP vs LM (R = 0.60, P = 0.019) and LM vs PA (R = 0.69, P = 0.002) coil orientations. RMT was significantly smaller with PA compared to AP (P < 0.001) and LM (P = 0.018) stimulation. Recruitment of distinct interneuronal processes with variable cortical orientation and thresholds underlies short interval intracortical inhibition and facilitation.
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Affiliation(s)
- Nathan Pavey
- Brain and Nerve Research Centre, Concord Clinical School, University of Sydney, Concord Hospital, Sydney, NSW, Australia
| | - Parvathi Menon
- Brain and Nerve Research Centre, Concord Clinical School, University of Sydney, Concord Hospital, Sydney, NSW, Australia
| | - Mehdi A J van den Bos
- Brain and Nerve Research Centre, Concord Clinical School, University of Sydney, Concord Hospital, Sydney, NSW, Australia
| | | | - Steve Vucic
- Brain and Nerve Research Centre, Concord Clinical School, University of Sydney, Concord Hospital, Sydney, NSW, Australia.
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Roumengous T, Thakkar B, Peterson CL. Paired pulse transcranial magnetic stimulation in the assessment of biceps voluntary activation in individuals with tetraplegia. Front Hum Neurosci 2022; 16:976014. [PMID: 36405076 PMCID: PMC9669314 DOI: 10.3389/fnhum.2022.976014] [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: 06/22/2022] [Accepted: 10/17/2022] [Indexed: 09/08/2024] Open
Abstract
After spinal cord injury (SCI), motoneuron death occurs at and around the level of injury which induces changes in function and organization throughout the nervous system, including cortical changes. Muscle affected by SCI may consist of both innervated (accessible to voluntary drive) and denervated (inaccessible to voluntary drive) muscle fibers. Voluntary activation measured with transcranial magnetic stimulation (VATMS) can quantify voluntary cortical/subcortical drive to muscle but is limited by technical challenges including suboptimal stimulation of target muscle relative to its antagonist. The motor evoked potential (MEP) in the biceps compared to the triceps (i.e., MEP ratio) may be a key parameter in the measurement of biceps VATMS after SCI. We used paired pulse TMS, which can inhibit or facilitate MEPs, to determine whether the MEP ratio affects VATMS in individuals with tetraplegia. Ten individuals with tetraplegia following cervical SCI and ten non-impaired individuals completed single pulse and paired pulse VATMS protocols. Paired pulse stimulation was delivered at 1.5, 10, and 30 ms inter-stimulus intervals (ISI). In both the SCI and non-impaired groups, the main effect of the stimulation pulse (paired pulse compared to single pulse) on VATMS was not significant in the linear mixed-effects models. In both groups for the stimulation parameters we tested, the MEP ratio was not modulated across all effort levels and did not affect VATMS. Linearity of the voluntary moment and superimposed twitch moment relation was lower in SCI participants compared to non-impaired. Poor linearity in the SCI group limits interpretation of VATMS. Future work is needed to address methodological issues that limit clinical application of VATMS.
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Affiliation(s)
- Thibault Roumengous
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, United States
| | - Bhushan Thakkar
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA, United States
| | - Carrie L. Peterson
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, United States
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Souza VH, Nieminen JO, Tugin S, Koponen LM, Baffa O, Ilmoniemi RJ. TMS with fast and accurate electronic control: Measuring the orientation sensitivity of corticomotor pathways. Brain Stimul 2022; 15:306-315. [PMID: 35038592 DOI: 10.1016/j.brs.2022.01.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/30/2021] [Accepted: 01/12/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Transcranial magnetic stimulation (TMS) coils allow only a slow, mechanical adjustment of the stimulating electric field (E-field) orientation in the cerebral tissue. Fast E-field control is needed to synchronize the stimulation with the ongoing brain activity. Also, empirical models that fully describe the relationship between evoked responses and the stimulus orientation and intensity are still missing. OBJECTIVE We aimed to (1) develop a TMS transducer for manipulating the E-field orientation electronically with high accuracy at the neuronally meaningful millisecond-level time scale and (2) devise and validate a physiologically based model describing the orientation selectivity of neuronal excitability. METHODS We designed and manufactured a two-coil TMS transducer. The coil windings were computed with a minimum-energy optimization procedure, and the transducer was controlled with our custom-made electronics. The electronic E-field control was verified with a TMS characterizer. The motor evoked potential amplitude and latency of a hand muscle were mapped in 3° steps of the stimulus orientation in 16 healthy subjects for three stimulation intensities. We fitted a logistic model to the motor response amplitude. RESULTS The two-coil TMS transducer allows one to manipulate the pulse orientation accurately without manual coil movement. The motor response amplitude followed a logistic function of the stimulus orientation; this dependency was strongly affected by the stimulus intensity. CONCLUSION The developed electronic control of the E-field orientation allows exploring new stimulation paradigms and probing neuronal mechanisms. The presented model helps to disentangle the neuronal mechanisms of brain function and guide future non-invasive stimulation protocols.
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Affiliation(s)
- Victor Hugo Souza
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Physics, School of Philosophy, Science and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil; School of Physiotherapy, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil.
| | - Jaakko O Nieminen
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Sergei Tugin
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Lari M Koponen
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, USA
| | - Oswaldo Baffa
- Department of Physics, School of Philosophy, Science and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Risto J Ilmoniemi
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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