1
|
Qi F, Nitsche MA, Ren X, Wang D, Wang L. Top-down and bottom-up stimulation techniques combined with action observation treatment in stroke rehabilitation: a perspective. Front Neurol 2023; 14:1156987. [PMID: 37497013 PMCID: PMC10367110 DOI: 10.3389/fneur.2023.1156987] [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: 02/03/2023] [Accepted: 06/26/2023] [Indexed: 07/28/2023] Open
Abstract
Stroke is a central nervous system disease that causes structural lesions and functional impairments of the brain, resulting in varying types, and degrees of dysfunction. The bimodal balance-recovery model (interhemispheric competition model and vicariation model) has been proposed as the mechanism of functional recovery after a stroke. We analyzed how combinations of motor observation treatment approaches, transcranial electrical (TES) or magnetic (TMS) stimulation and peripheral electrical (PES) or magnetic (PMS) stimulation techniques can be taken as accessorial physical therapy methods on symptom reduction of stroke patients. We suggest that top-down and bottom-up stimulation techniques combined with action observation treatment synergistically might develop into valuable physical therapy strategies in neurorehabilitation after stroke. We explored how TES or TMS intervention over the contralesional hemisphere or the lesioned hemisphere combined with PES or PMS of the paretic limbs during motor observation followed by action execution have super-additive effects to potentiate the effect of conventional treatment in stroke patients. The proposed paradigm could be an innovative and adjunctive approach to potentiate the effect of conventional rehabilitation treatment, especially for those patients with severe motor deficits.
Collapse
Affiliation(s)
- Fengxue Qi
- Sports, Exercise and Brain Sciences Laboratory, Beijing Sport University, Beijing, China
| | - Michael A. Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Xiping Ren
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
| | - Duanwei Wang
- Shandong Mental Health Center, Shandong University, Jinan, Shandong, China
| | - Lijuan Wang
- Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing Sport University, Beijing, China
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| |
Collapse
|
2
|
Brancucci A, Rivolta D, Nitsche MA, Manippa V. The effects of transcranial random noise stimulation on motor function: A comprehensive review of the literature. Physiol Behav 2023; 261:114073. [PMID: 36608913 DOI: 10.1016/j.physbeh.2023.114073] [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: 11/21/2022] [Revised: 12/23/2022] [Accepted: 01/01/2023] [Indexed: 01/05/2023]
Abstract
The present review considers all papers published on the topic up to the end of the year 2022. Transcranial random noise stimulation (tRNS) is a non-invasive neuromodulation technique introduced about 15 years ago whose use is becoming increasingly widespread in neuroscience. It consists of the application over the scalp of a weak, white noise-like current, through electrodes having a surface of several square centimetres, for a duration ranging from seconds to minutes. Despite its relatively low spatial and temporal resolution, tRNS has well defined effects on central motor excitability, which critically depend on stimulation parameters. These effects seem to be chiefly based on an effect on neuronal membrane sodium channels and can last much longer than the stimulation itself. While the effects at the cellular level in the motor cortex are becoming progressively clear, much more studies are needed to understand the effects of tRNS on motor behaviour and performance, where initial research results are nevertheless promising, in both basic and applied research.
Collapse
Affiliation(s)
- Alfredo Brancucci
- Dipartimento di Scienze Motorie, Umane e della Salute, Università di Roma "Foro Italico", Italy.
| | - Davide Rivolta
- Dipartimento di Scienze della Formazione, Psicologia, Comunicazione, Università degli studi di Bari "Aldo Moro", Italy
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; Bielefeld University, University Hospital OWL, Protestant Hospital of Bethel Foundation, University Clinic of Psychiatry and Psychotherapy and University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Germany
| | - Valerio Manippa
- Dipartimento di Scienze della Formazione, Psicologia, Comunicazione, Università degli studi di Bari "Aldo Moro", Italy; Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| |
Collapse
|
3
|
Zhou Z, Chen S, Li Y, Zhao J, Li G, Chen L, Wu Y, Zhang S, Shi X, Chen X, Xu S, Ren M, Chang S, Shan C. Comparison of Sensory Observation and Somatosensory Stimulation in Mirror Neurons and the Sensorimotor Network: A Task-Based fMRI Study. Front Neurol 2022; 13:916990. [PMID: 35847217 PMCID: PMC9279701 DOI: 10.3389/fneur.2022.916990] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/25/2022] [Indexed: 12/03/2022] Open
Abstract
Objective This study aimed to investigate brain plasticity by somatosensory stimulation (SS) and sensory observation (SO) based on mirror neuron and embodied cognition theory. Action observation therapy has been widely adopted for motor function improvement in post-stroke patients. However, it is uncertain whether the SO approach can also contribute to the recovery of sensorimotor function after stroke. In this study, we explored the therapeutic potential of SO for sensorimotor dysfunction and provided new evidence for neurorehabilitation. Methods Twenty-six healthy right-handed adults (12 men and 14 women), aged 18–27 (mean, 22.12; SD, 2.12) years were included. All subjects were evaluated with task-based functional magnetic resonance imaging (fMRI) to discover the characteristics and differences in brain activation between SO and SS. We adopted a block design with two conditions during fMRI scanning: observing a sensory video of brushing (task condition A, defined as SO) and brushing subjects' right forearms while they watched a nonsense string (task condition B, defined as SS). One-sample t-tests were performed to identify brain regions and voxels activated for each task condition. A paired-sample t-test and conjunction analysis were performed to explore the differences and similarities between SO and SS. Results The task-based fMRI showed that the bilateral postcentral gyrus, left precentral gyrus, bilateral middle temporal gyrus, right supramarginal gyrus, and left supplementary motor area were significantly activated during SO or SS. In addition to these brain regions, SO could also activate areas containing mirror neurons, like the left inferior parietal gyrus. Conclusion SO could activate mirror neurons and sensorimotor network-related brain regions in healthy subjects like SS. Therefore, SO may be a promising novel therapeutic approach for sensorimotor dysfunction recovery in post-stroke patients.
Collapse
Affiliation(s)
- Zhiqing Zhou
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Songmei Chen
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai No. 3 Rehabilitation Hospital, Shanghai, China
| | - Yuanli Li
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China
| | - Jingjun Zhao
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guanwu Li
- Department of Radiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lei Chen
- Department of Radiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuwei Wu
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Sicong Zhang
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaolong Shi
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xixi Chen
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shutian Xu
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China
| | - Meng Ren
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shixin Chang
- Department of Radiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Shixin Chang
| | - Chunlei Shan
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China
- Chunlei Shan
| |
Collapse
|
5
|
20 Hz Transcranial Alternating Current Stimulation Inhibits Observation-Execution-Related Motor Cortex Excitability. J Pers Med 2021; 11:jpm11100979. [PMID: 34683120 PMCID: PMC8541383 DOI: 10.3390/jpm11100979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 12/31/2022] Open
Abstract
The present study aimed to investigate the effect of transcranial alternating current stimulation (tACS) on the primary motor cortex (M1) during action observation, and subsequent action execution, on motor cortex excitability. The participants received tACS at 10 Hz or 20 Hz, or a sham stimulation over the left M1 for 10 min while they observed a video displaying a repeated button-tapping task using the right hand, and then performed an identical task with their right hand. Motor-evoked potential (MEP) amplitudes were measured before (T0) and after the action observation paired with tACS or a sham stimulation (T1), and after the performance of the action (T2). The results showed that MEPs were significantly reduced at time point T1 (p = 0.042, Cohen’s d = 0.611) and T2 (p = 0.0003, Cohen’s d = 0.852) in the 20 Hz tACS condition, in contrast with the sham stimulation. There was a significantly smaller MEP amplitude at time point T2 in the 20 Hz tACS condition, as compared to the 10 Hz tACS condition (p = 0.01, Cohen’s d = 0.622), but the MEP amplitude did not significantly change at time point T1 between the 20 Hz and 10 Hz tACS conditions (p = 0.136, Cohen’s d = 0.536). There were no significant differences at time point T1 and T2 between the 10 Hz tACS condition and the sham stimulation. We conclude that 20 Hz tACS during action observation inhibited motor cortex excitability and subsequently inhibited execution-related motor cortex excitability. The effects of tACS on task-related motor cortex excitability are frequency-dependent.
Collapse
|
6
|
Zschorlich VR, Behrendt F, de Lussanet MHE. Multimodal Sensorimotor Integration of Visual and Kinaesthetic Afferents Modulates Motor Circuits in Humans. Brain Sci 2021; 11:brainsci11020187. [PMID: 33546384 PMCID: PMC7913510 DOI: 10.3390/brainsci11020187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 01/20/2021] [Accepted: 02/01/2021] [Indexed: 11/16/2022] Open
Abstract
Optimal motor control requires the effective integration of multi-modal information. Visual information of movement performed by others even enhances potentials in the upper motor neurons through the mirror-neuron system. On the other hand, it is known that motor control is intimately associated with afferent proprioceptive information. Kinaesthetic information is also generated by passive, external-driven movements. In the context of sensory integration, it is an important question how such passive kinaesthetic information and visually perceived movements are integrated. We studied the effects of visual and kinaesthetic information in combination, as well as isolated, on sensorimotor integration, compared to a control condition. For this, we measured the change in the excitability of the motor cortex (M1) using low-intensity Transcranial magnetic stimulation (TMS). We hypothesised that both visual motoneurons and kinaesthetic motoneurons enhance the excitability of motor responses. We found that passive wrist movements increase the motor excitability, suggesting that kinaesthetic motoneurons do exist. The kinaesthetic influence on the motor threshold was even stronger than the visual information. Moreover, the simultaneous visual and passive kinaesthetic information increased the cortical excitability more than each of them independently. Thus, for the first time, we found evidence for the integration of passive kinaesthetic- and visual-sensory stimuli.
Collapse
Affiliation(s)
- Volker R. Zschorlich
- Department of Movement Science, University of Rostock, Ulmenstraße 69, 18057 Rostock, Germany
- Correspondence:
| | - Frank Behrendt
- Reha Rheinfelden, Research Department, Salinenstrasse 98, CH-4310 Rheinfelden, Switzerland;
| | - Marc H. E. de Lussanet
- Department of Movement Science, and OCC Center for Cognitive and Behavioral Neuroscience, University of Münster, Horstmarer Landweg 62b, 48149 Münster, Germany;
| |
Collapse
|
7
|
Qi F, Nitsche MA, Zschorlich VR. Modulating Observation-Execution-Related Motor Cortex Activity by Cathodal Transcranial Direct Current Stimulation. Brain Sci 2019; 9:E121. [PMID: 31130692 PMCID: PMC6563080 DOI: 10.3390/brainsci9050121] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/18/2019] [Accepted: 05/23/2019] [Indexed: 12/27/2022] Open
Abstract
The aim of this randomized sham-controlled study was to examine the impact of cathodal transcranial direct current stimulation (ctDCS) of the primary motor cortex (M1) during movement observation on subsequent execution-related motor cortex activity. Thirty healthy participants received sham or real ctDCS (1 mA) over the left M1 for 10 minutes, respectively. The participants observed a video showing repeated button pressing tasks of the right hand during the sham or real ctDCS, followed by performance of these tasks by the right hand. Motor-evoked potentials (MEP) were recorded from the resting right first dorsal interosseous muscle before movement observation during the sham or real ctDCS, immediately after observation of actions, and after subsequent movement execution. The results of the ANOVA showed a significant main effect on the group (F1,28 = 4.60, p = 0.041) and a significant interaction between time and the group (F2,56 = 5.34, p = 0.008). As revealed by respective post hoc tests, ctDCS induced a significant reduction of MEP amplitudes in connection with movement observation (p = 0.026, Cohen's d = 0.861) and after subsequent movement execution (p = 0.018, Cohen's d = 0.914) in comparison with the sham stimulation. It is concluded that ctDCS during movement observation was effective in terms of modulating motor cortex excitability. Moreover, it subsequently influenced execution-related motor cortex activity. This indicates a possible application for rehabilitative treatment in syndromes with pathologically enhanced cortical activity.
Collapse
Affiliation(s)
- Fengxue Qi
- Department of Movement Science, Faculty of Philosophy, University of Rostock, 18057 Rostock, Germany.
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, 44139 Dortmund, Germany.
- Department of Sport Training, Sport Coaching College, Beijing Sport University, Beijing 100084, China.
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, 44139 Dortmund, Germany.
- Department of Neurology, University Medical Hospital Bergmannsheil, 44789 Bochum, Germany.
| | - Volker R Zschorlich
- Department of Movement Science, Faculty of Philosophy, University of Rostock, 18057 Rostock, Germany.
- Faculty of Medicine, University of Rostock, 18055 Rostock, Germany.
- Department Ageing of Individuals and Society, Faculty of Interdisciplinary Research, University of Rostock, 18051 Rostock, Germany.
| |
Collapse
|