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Tanguy D, Rametti-Lacroux A, Bouzigues A, Saracino D, Le Ber I, Godefroy V, Morandi X, Jannin P, Levy R, Batrancourt B, Migliaccio R, Azuar C, Dubois B, Lecouturier K, Araujo CM, Janvier E, Jourdain A, Rametti-Lacroux A, Coriou S, Brochard VB, Gaudebout C, Ferrand-Verdejo J, Bonnefous L, Pochan-Leva F, Jeanne L, Joulié M, Provost M, Renaud R, Hachemi S, Guillemot V, Bendetowicz D, Carle G, Socha J, Pineau F, Marin F, Liu Y, Mullot P, Mousli A, Blossier A, Visentin G, Tanguy D, Godefroy V, Sezer I, Boucly M, Cabrol-Douat B, Odobez R, Marque C, Tessereau-Barbot D, Raud A, Funkiewiez A, Chamayou C, Cognat E, Le Bozec M, Bouzigues A, Le Du V, Bombois S, Simard C, Fulcheri P, Guitton H, Peltier C, Lejeune FX, Jorgensen L, Mariani LL, Corvol JC, Valero-Cabre A, Garcin B, Volle E, Le Ber I, Migliaccio R, Levy R. Behavioural disinhibition in frontotemporal dementia investigated within an ecological framework. Cortex 2023; 160:152-166. [PMID: 36658040 DOI: 10.1016/j.cortex.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 09/29/2022] [Accepted: 11/09/2022] [Indexed: 12/29/2022]
Abstract
Disinhibition is a core symptom in behavioural variant frontotemporal dementia (bvFTD) particularly affecting the daily lives of both patients and caregivers. Yet, characterisation of inhibition disorders is still unclear and management options of these disorders are limited. Questionnaires currently used to investigate behavioural disinhibition do not differentiate between several subtypes of disinhibition, encompass observation biases and lack of ecological validity. In the present work, we explored disinhibition in an original semi-ecological situation, by distinguishing three categories of disinhibition: compulsivity, impulsivity and social disinhibition. First, we measured prevalence and frequency of these disorders in 23 bvFTD patients and 24 healthy controls (HC) in order to identify the phenotypical heterogeneity of disinhibition. Then, we examined the relationships between these metrics, the neuropsychological scores and the behavioural states to propose a more comprehensive view of these neuropsychiatric manifestations. Finally, we studied the context of occurrence of these disorders by investigating environmental factors potentially promoting or reducing them. As expected, we found that patients were more compulsive, impulsive and socially disinhibited than HC. We found that 48% of patients presented compulsivity (e.g., repetitive actions), 48% impulsivity (e.g., oral production) and 100% of the patients group showed social disinhibition (e.g., disregards for rules or investigator). Compulsivity was negatively related with emotions recognition. BvFTD patients were less active if not encouraged in an activity, and their social disinhibition decreased as activity increased. Finally, impulsivity and social disinhibition decreased when patients were asked to focus on a task. Summarising, this study underlines the importance to differentiate subtypes of disinhibition as well as the setting in which they are exhibited, and points to stimulating area for non-pharmacological management.
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Affiliation(s)
- Delphine Tanguy
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France; Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France
| | - Armelle Rametti-Lacroux
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Arabella Bouzigues
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Dario Saracino
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtriѐre, Department of Neurology, IM2A, Paris, France
| | - Isabelle Le Ber
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtriѐre, Department of Neurology, IM2A, Paris, France
| | - Valérie Godefroy
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Xavier Morandi
- Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France
| | - Pierre Jannin
- Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France
| | - Richard Levy
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France; Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France; AP-HP, Groupe Hospitalier Pitié-Salpêtriѐre, Department of Neurology, IM2A, Paris, France
| | - Bénédicte Batrancourt
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France.
| | - Raffaella Migliaccio
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtriѐre, Department of Neurology, IM2A, Paris, France.
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Boyer M, Beaudin P, Stengel C, Valero-Cabre A, Lohof A, Charpier S, Sherrard R, Mahon S. In vivo low-intensity magnetic stimulation durably alters neocortical neuron excitability and spontaneous activity. Brain Stimul 2023. [DOI: 10.1016/j.brs.2023.01.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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Toba M, Kaglik A, Dimby SF, Rastelli F, Pradat-Diehl P, Valero-Cabre A. La stimulation magnétique trans-crânienne répétitive à basse fréquence (rTMS) au niveau de l’hémisphère gauche est-elle efficace pour la rééducation de la négligence spatiale unilatérale persistante après un AVC ? Rev Neurol (Paris) 2022. [DOI: 10.1016/j.neurol.2022.02.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Maatoug R, Ekmen A, Valero-Cabre A, Millet B. Stimulation therapeutic approaches to better understand Obsessive Compulsive Disorder: The issue of 'where' to treat. Encephale 2020; 46:399-403. [PMID: 32014241 DOI: 10.1016/j.encep.2019.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 10/28/2019] [Accepted: 11/15/2019] [Indexed: 01/04/2023]
Abstract
The use of invasive and non-invasive brain stimulation and neuromodulation technologies combined with neuroimaging approaches can help refine with causal evidence our physiopathological understanding of the Obsessive-Compulsive Disorder (OCD). Two key structures, the Orbitofrontal Cortex (OFC) and the Anterior Cingulate Cortex (ACC) have been found dysfunctional in OCD compared to healthy volunteers and on such basis have been tested as therapeutic targets for invasive and non-invasive neuromodulation therapy. Hereinafter, evidence addressing the cognitive processes subtended by to those two brain regions and their role in wider associated cortico-subcortical networks is reviewed. Very specifically, their relevance for OCD clinical features is discussed in extenso and its modulation with invasive and non-invasive focal brain stimulation such as deep brain stimulation (DBS) or transcranial magnetic Stimulation (TMS). Most importantly, this article brings new insights bridging causal evidence on the structural and functional neuroanatomy subtending OCD and novel therapeutic perspectives based on focal brain stimulation.
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Affiliation(s)
- R Maatoug
- Hôpital La Pitié Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
| | - A Ekmen
- Hôpital La Pitié Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - A Valero-Cabre
- Hôpital La Pitié Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - B Millet
- Hôpital La Pitié Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
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Valero-Cabre A, Sanches C, Truong DQ, Bikson M, Teichmann M. Abstract #2: Improvement of language function following prefrontal transcranial direct current brain stimulation in Progressive Supranuclear Palsy. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Stengel C, Vernet M, Amengual J, Valero-Cabre A. P214 Noninvasive manipulation of fronto-parietal synchrony improves conscious visual perception in humans. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2016.10.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Redolar-Ripoll D, Viejo-Sobera R, Palaus M, Valero-Cabre A, Marrón E. Local pain during transcranial magnetic stimulation induced by ferromagnetic pigments in commonly used cosmetics. Clin Neurophysiol 2015; 126:2243-5. [DOI: 10.1016/j.clinph.2015.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/05/2015] [Accepted: 03/07/2015] [Indexed: 11/17/2022]
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Vernet M, Quentin R, Chanes L, Mitsumasu A, Valero-Cabre A. Corrigendum: Frontal eye field, where art thou? Anatomy, function, and non-invasive manipulation of frontal regions involved in eye movements and associated cognitive operations. Front Integr Neurosci 2014. [PMCID: PMC4227490 DOI: 10.3389/fnint.2014.00088] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Peschke C, Jin Y, Olk B, Valero-Cabre A, Hilgetag C. P 64. Cartography of causal contributions of human frontal cortex to visual attention. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.04.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Chica AB, Valero-Cabre A, Paz-Alonso PM, Bartolomeo P. Causal Contributions of the Left Frontal Eye Field to Conscious Perception. Cereb Cortex 2012; 24:745-53. [DOI: 10.1093/cercor/bhs357] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Brunoni AR, Nitsche MA, Bolognini N, Bikson M, Wagner T, Merabet L, Edwards DJ, Valero-Cabre A, Rotenberg A, Pascual-Leone A, Ferrucci R, Priori A, Boggio PS, Fregni F. Clinical research with transcranial direct current stimulation (tDCS): challenges and future directions. Brain Stimul 2012; 5:175-195. [PMID: 22037126 PMCID: PMC3270156 DOI: 10.1016/j.brs.2011.03.002] [Citation(s) in RCA: 885] [Impact Index Per Article: 73.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2010] [Revised: 01/25/2011] [Accepted: 03/03/2011] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers low-intensity, direct current to cortical areas facilitating or inhibiting spontaneous neuronal activity. In the past 10 years, tDCS physiologic mechanisms of action have been intensively investigated giving support for the investigation of its applications in clinical neuropsychiatry and rehabilitation. However, new methodologic, ethical, and regulatory issues emerge when translating the findings of preclinical and phase I studies into phase II and III clinical studies. The aim of this comprehensive review is to discuss the key challenges of this process and possible methods to address them. METHODS We convened a workgroup of researchers in the field to review, discuss, and provide updates and key challenges of tDCS use in clinical research. MAIN FINDINGS/DISCUSSION We reviewed several basic and clinical studies in the field and identified potential limitations, taking into account the particularities of the technique. We review and discuss the findings into four topics: (1) mechanisms of action of tDCS, parameters of use and computer-based human brain modeling investigating electric current fields and magnitude induced by tDCS; (2) methodologic aspects related to the clinical research of tDCS as divided according to study phase (ie, preclinical, phase I, phase II, and phase III studies); (3) ethical and regulatory concerns; and (4) future directions regarding novel approaches, novel devices, and future studies involving tDCS. Finally, we propose some alternative methods to facilitate clinical research on tDCS.
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Affiliation(s)
- Andre Russowsky Brunoni
- Department of Neurosciences and Behavior, Institute of Psychology, University of São Paulo, São Paulo, Brazil
| | - Michael A Nitsche
- Department of Clinical Neurophysiology, Georg-August University, Goettingen, Germany
| | - Nadia Bolognini
- Department of Psychology, University of Milano-Bicocca, Milan, Italy; Neuropsychological Laboratory, IRCCS Instituto Auxologico Italiano, Milan, Italy
| | - Marom Bikson
- The City College of City University of New York, New York, New York
| | - Tim Wagner
- Massachusetts Institute of Technology, Boston, Massachusetts
| | - Lotfi Merabet
- Massachusets Eye and Ear Infirmary, Harvard University, Boston, Massachusetts
| | | | | | - Alexander Rotenberg
- Department of Neurology, Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Non-invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Roberta Ferrucci
- Centro Clinico per la Neurostimolazione, le Neurotecnologie ed i Disordini del Movimento, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano Dipartimento di Scienze Neurologiche, Milan, Italy
| | - Alberto Priori
- Centro Clinico per la Neurostimolazione, le Neurotecnologie ed i Disordini del Movimento, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano Dipartimento di Scienze Neurologiche, Milan, Italy
| | - Paulo Sergio Boggio
- Social and Cognitive Neuroscience Laboratory and Developmental Disorders Program, Center for Health and Biological Sciences, Mackenzie Prebyterian University, Sao Paulo, Brazil
| | - Felipe Fregni
- Laboratory of Neuromodulation, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
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Valero-Cabre A, Wattiez N, Monfort M, François C, Rivaud-Péchoux S, Gaymard B, Pouget P. Frontal non-invasive neurostimulation modulates antisaccade preparation in non-human primates. PLoS One 2012; 7:e38674. [PMID: 22701691 PMCID: PMC3368878 DOI: 10.1371/journal.pone.0038674] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 05/10/2012] [Indexed: 11/29/2022] Open
Abstract
A combination of oculometric measurements, invasive electrophysiological recordings and microstimulation have proven instrumental to study the role of the Frontal Eye Field (FEF) in saccadic activity. We hereby gauged the ability of a non-invasive neurostimulation technology, Transcranial Magnetic Stimulation (TMS), to causally interfere with frontal activity in two macaque rhesus monkeys trained to perform a saccadic antisaccade task. We show that online single pulse TMS significantly modulated antisaccade latencies. Such effects proved dependent on TMS site (effects on FEF but not on an actively stimulated control site), TMS modality (present under active but not sham TMS on the FEF area), TMS intensity (intensities of at least 40% of the TMS machine maximal output required), TMS timing (more robust for pulses delivered at 150 ms than at 100 post target onset) and visual hemifield (relative latency decreases mainly for ipsilateral AS). Our results demonstrate the feasibility of using TMS to causally modulate antisaccade-associated computations in the non-human primate brain and support the use of this approach in monkeys to study brain function and its non-invasive neuromodulation for exploratory and therapeutic purposes.
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Affiliation(s)
- Antoni Valero-Cabre
- Université Pierre et Marie Curie, CNRS UMR 7225, INSERM UMRS 975, Institut du Cerveau et la Möelle (ICM), Paris, France
- Laboratory for Cerebral Dynamics Plasticity and Rehabilitation, Boston University School of Medicine, Boston, Massachusetts, United States of America
- Cognitive Neuroscience and Information Technology Research Program, Open University of Catalonia (UOC), Barcelona, Spain
- * E-mail: (PP); (AVC)
| | - Nicolas Wattiez
- Université Pierre et Marie Curie, CNRS UMR 7225, INSERM UMRS 975, Institut du Cerveau et la Möelle (ICM), Paris, France
| | - Morgane Monfort
- Université Pierre et Marie Curie, CNRS UMR 7225, INSERM UMRS 975, Institut du Cerveau et la Möelle (ICM), Paris, France
| | - Chantal François
- Université Pierre et Marie Curie, CNRS UMR 7225, INSERM UMRS 975, Institut du Cerveau et la Möelle (ICM), Paris, France
| | - Sophie Rivaud-Péchoux
- Université Pierre et Marie Curie, CNRS UMR 7225, INSERM UMRS 975, Institut du Cerveau et la Möelle (ICM), Paris, France
| | - Bertrand Gaymard
- Université Pierre et Marie Curie, CNRS UMR 7225, INSERM UMRS 975, Institut du Cerveau et la Möelle (ICM), Paris, France
| | - Pierre Pouget
- Université Pierre et Marie Curie, CNRS UMR 7225, INSERM UMRS 975, Institut du Cerveau et la Möelle (ICM), Paris, France
- * E-mail: (PP); (AVC)
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Chica AB, Paz-Alonso PM, Valero-Cabre A, Bartolomeo P. Neural Bases of the Interactions between Spatial Attention and Conscious Perception. Cereb Cortex 2012; 23:1269-79. [DOI: 10.1093/cercor/bhs087] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Chanes L, Chica AB, Valero-Cabre A. The combination of visuospatial cues and Transcranial Magnetic Stimulation (TMS) on the human Frontal Eye Fields (FEF) facilitates conscious visual detection. J Vis 2011. [DOI: 10.1167/11.11.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Pouget P, Wattiez N, Valero-Cabre A. Comment on: Exp Brain Res. 2011 May 5th. Transcranial magnetic stimulation of macaque frontal eye fields decreases saccadic reaction time. Gerits A, Ruff CC, Guipponi O, Wenderoth N, Driver J, Vanduffel W. Exp Brain Res 2011; 214:481-2. [PMID: 21901452 DOI: 10.1007/s00221-011-2840-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2011] [Accepted: 08/05/2011] [Indexed: 11/27/2022]
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Valero-Cabre A, Desimone C, Afifi L, Rushmore J. P20.19 An intensive daily regime of transcranial direct current stimulation (tDCS) improves enduring visuospatial neglect: lessons from an experimental study in felines. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60541-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rushmore RJ, Payne B, Valero-Cabre A. Recovery of function following unilateral damage to visuoparietal cortex. Exp Brain Res 2010; 203:693-700. [PMID: 20461362 DOI: 10.1007/s00221-010-2278-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2009] [Accepted: 04/22/2010] [Indexed: 12/19/2022]
Abstract
Damage to the visuoparietal cortex located in the banks of the middle suprasylvian gyrus of the cat has been shown to produce a deficit in the detection and localization of moving visual cues presented in the contralesional visual hemifield. There is evidence from reversible cooling deactivation studies that the integrity of this orienting function is not completely dependent on the VP cortex and that under the right circumstances, other brain regions may come online and completely take over the processing that subserves this behavior. We examined the recovery of orienting behavior after unilateral damage to the VP cortex. We found that consistent with previous data, VP damage produced an impairment in the capacity to detect and orient to moving visual stimuli in the contralesional visual field. Over a span of days, spontaneous recovery fully occurred. The ability to detect and localize static visual stimuli was tested as a fiducial measure of parietal cortex function, and this function did not recover. We conclude that the detection and localization of moving visual stimuli is not a function that requires VP cortex and argue for the existence of a parallel and redundant subcortical-cortical brain network that serves as the substrate for recovery of function.
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Affiliation(s)
- R J Rushmore
- Laboratory for Cerebral Dynamics, Plasticity and Rehabilitation, Department of Anatomy and Neurobiology, Boston University School of Medicine, 700 Albany Street, W702, Boston, MA 02118, USA.
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Valero-Cabre A, Pascual-Leone A, Payne BR. Non-invasive induction and cancellation of visuo-spatial neglect by repetitive transcranial magnetic stimulation (rTMS). J Vis 2010. [DOI: 10.1167/6.6.511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Kumru H, Murillo N, Samso JV, Valls-Sole J, Edwards D, Pelayo R, Valero-Cabre A, Tormos JM, Pascual-Leone A. Reduction of spasticity with repetitive transcranial magnetic stimulation in patients with spinal cord injury. Neurorehabil Neural Repair 2010; 24:435-41. [PMID: 20053952 DOI: 10.1177/1545968309356095] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Spasticity with increased tone and spasms is frequent in patients after spinal cord injury (SCI). Damage to descending corticospinal pathways that normally exert spinal segmental control is thought to play an important causal role in spasticity. The authors examined whether the modulation of excitability of the primary motor cortex with high-frequency repetitive transcranial magnetic stimulation (rTMS) could modify lower limb spasticity in patients with incomplete SCI. METHODS Patients were assessed by the Modified Ashworth Scale, Visual Analogue Scale, and the Spinal Cord Injury Spasticity Evaluation Tool (SCI-SET) and neurophysiologically with measures of corticospinal and segmental excitability by the H(max)/M(max), T reflex, and withdrawal reflex. Fifteen patients received 5 days of daily sessions of active (n = 14) or sham (n = 7) rTMS to the leg motor area (20 trains of 40 pulses at 20 Hz and an intensity of 90% of resting motor threshold for the biceps brachii muscle). RESULT A significant clinical improvement in lower limb spasticity was observed in patients following active rTMS but not after sham stimulation.This improvement lasted for at least 1 week following the intervention. Neurophysiological studies did not change. CONCLUSIONS High-frequency rTMS over the leg motor area can improve aspects of spasticity in patients with incomplete SCI.
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Affiliation(s)
- Hatice Kumru
- Hospital de Neurorehabilitación Institut Guttmann, Barcelona, Spain.
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Wagner T, Rushmore J, Eden U, Valero-Cabre A. Biophysical foundations underlying TMS: setting the stage for an effective use of neurostimulation in the cognitive neurosciences. Cortex 2008; 45:1025-34. [PMID: 19027896 DOI: 10.1016/j.cortex.2008.10.002] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2008] [Revised: 09/07/2008] [Accepted: 10/10/2008] [Indexed: 01/09/2023]
Abstract
Transcranial Magnetic Stimulation (TMS) induces electrical currents in the brain to stimulate neural tissue. This article reviews our present understanding of TMS methodology, focusing on its biophysical foundations. We concentrate on how the laws of electromagnetic induction apply to TMS; addressing issues such as the location, area (i.e., focality), depth, and mechanism of TMS. We also present a review of the present limitations and future potential of the technique.
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Affiliation(s)
- Tim Wagner
- Highland Instruments, Cambridge, MA 02138, USA.
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Valero-Cabre A, Kurtev S, Voitcu R, Jin Y, Rushmore R, Hilgetag C. Key cortical subregions involved in basic visuo-spatial tasks: A systematic TMS mapping study of bilateral human parietal cortex. Brain Stimul 2008. [DOI: 10.1016/j.brs.2008.06.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Valero-Cabre A, Afifi L, Rushmore R, Japp B, Hilgetag C, Jedd A. When opposite frequencies lead to same behavioral effects: A case for a reversible disconnection syndrome induced by rTMS on visuo-spatial networks? Brain Stimul 2008. [DOI: 10.1016/j.brs.2008.06.133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Wagner T, Eden U, Fregni F, Valero-Cabre A, Ramos-Estebanez C, Pronio-Stelluto V, Grodzinsky A, Zahn M, Pascual-Leone A. Transcranial magnetic stimulation and brain atrophy: a computer-based human brain model study. Exp Brain Res 2008; 186:539-50. [PMID: 18193208 DOI: 10.1007/s00221-007-1258-8] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2006] [Accepted: 12/14/2007] [Indexed: 01/30/2023]
Abstract
This paper is aimed at exploring the effect of cortical brain atrophy on the currents induced by transcranial magnetic stimulation (TMS). We compared the currents induced by various TMS conditions on several different MRI derived finite element head models of brain atrophy, incorporating both decreasing cortical volume and widened sulci. The current densities induced in the cortex were dependent upon the degree and type of cortical atrophy and were altered in magnitude, location, and orientation when compared to healthy head models. Predictive models of the degree of current density attenuation as a function of the scalp-to-cortex distance were analyzed, concluding that those which ignore the electromagnetic field-tissue interactions lead to inaccurate conclusions. Ultimately, the precise site and population of neural elements stimulated by TMS in an atrophic brain cannot be predicted based on healthy head models which ignore the effects of the altered cortex on the stimulating currents. Clinical applications of TMS should be carefully considered in light of these findings.
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Affiliation(s)
- Tim Wagner
- Division of Health Sciences and Technology, Harvard Medical School/Massachusetts Institute of Technology, Boston, MA, USA.
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Abstract
Noninvasive brain stimulation with transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS) is valuable in research and has potential therapeutic applications in cognitive neuroscience, neurophysiology, psychiatry, and neurology. TMS allows neurostimulation and neuromodulation, while tDCS is a purely neuromodulatory application. TMS and tDCS allow diagnostic and interventional neurophysiology applications, and focal neuropharmacology delivery. However, the physics and basic mechanisms of action remain incompletely explored. Following an overview of the history and current applications of noninvasive brain stimulation, we review stimulation device design principles, the electromagnetic and physical foundations of the techniques, and the current knowledge about the electrophysiologic basis of the effects. Finally, we discuss potential biomedical and electrical engineering developments that could lead to more effective stimulation devices, better suited for the specific applications.
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Affiliation(s)
- Timothy Wagner
- Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Department of Neurology, Harvard Medical School, Boston, Massachusetts 02215, USA
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Abstract
Visuospatial neglect is a common neurological syndrome caused by unilateral brain damage to the posterior and inferior parietal cerebral cortex, and is characterized by an inability to respond or orient to stimuli presented in the contralesional hemifield. Neglect has been elicited in experimental models of the rat, cat and monkey, and is thought to result in part from a pathological state of inhibition exerted on the damaged hemisphere by the hyperexcited intact hemisphere. We sought to test this theory by assessing neural activity levels in multiple brain structures during neglect using 2-deoxyglucose (2DG) as a metabolic marker of neural activity. Neglect was induced in two ways: (i) by cooling deactivation of posterior parietal cortex or (ii) in conjunction with broader cortical blindness produced by unilateral lesion of all contiguous visual cortical areas spanning occipital, parietal and temporal regions. The direction and magnitude of changes in 2DG uptake were measured in cerebral cortex and midbrain structures. Finally, the 2DG uptake was assessed in a group of cats in which the lesion-induced neglect component of blindness was cancelled by cooling of either the contralateral posterior parietal cortex or the contralateral superior colliculus (SC). Overall, we found that (i) both lesion- and cooling-induced neglect are associated with decreases in 2DG uptake in specific ipsilateral cortical and midbrain regions; (ii) levels of 2DG uptake in the intermediate and deep layers of the SC contralateral to both cooling and lesion deactivations are increased; (iii) changes in 2DG uptake were not identified in the contralateral cortex; and (iv) reversal of the lesion-induced neglect component of blindness is associated with a reduction of contralesional 2DG uptake to normal or subnormal levels. These data are in accord with theories of neglect that include mutually suppressive mechanisms between the two hemispheres, and we show that these mechanisms operate at the level of the SC, but are not apparent at the level of cortex. These results suggest that the most effective therapies for visual neglect will be those that act to decrease neural activity in the intermediate layers of the SC contralateral to the brain damage.
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Affiliation(s)
- R Jarrett Rushmore
- Laboratory of Cerebral Dynamics, Plasticity and Rehabilitation Department of Anatomy and Neurobiology, Boston University School of Medicine Boston, MA 02118, USA.
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