Several techniques that involve transcranial magnetic stimulation (TMS) can be used to measure brain plasticity noninvasively in humans. These include paired-associative stimulation (PAS), repetitive transcranial magnetic stimulation (rTMS) and theta burst stimulation (TBS). Some of these techniques are based the principle of use dependent plasticity or are designed to mimic protocols used to induce long-term potentiation or depression in animal studies. These studies have been applied to certain neurological and psychiatric disorders to investigate their pathophysiology. For example, PAS induced plasticity is enhanced in dystonia and stroke but is reduced in Huntington’s disease and schizophrenia. Furthermore, TMS may be used to modulate brain plasticity and has therapeutic potential in neurological and psychiatric disorders such as stroke, Parkinson’s disease, dystonia and depression.
Robert Chen and Kaviraja Udupa
Abbey C. Thomas, Brian G. Pietrosimone and Carter J. Bayer
Context: Transcranial magnetic stimulation (TMS) may provide important information regarding the corticospinal mechanisms that may contribute to the neuromuscular activation impairments. Paired-pulse TMS testing is a reliable method for measuring intracortical facilitation and inhibition; however, little evidence exists regarding agreement of these measures in the quadriceps. Objective: To determine the between-sessions and interrater agreement of intracortical excitability (short- and long-interval intracortical inhibition [SICI, LICI] and intracortical facilitation [ICF]) in the dominant-limb quadriceps. Design: Reliability study. Setting: Research laboratory. Participants: 13 healthy volunteers (n = 6 women; age 24.7 ± 2.1 y; height 1.7 ± 0.1 m; mass 77.1 ± 17.4 kg). Intervention: Participants completed 2 TMS sessions separated by 1 wk. Main Outcome Measures: Two investigators measured quadriceps SICI, LICI, and ICF at rest and actively (5% of maximal voluntary isometric contraction). All participants were seated in a dynamometer with the knee flexed to 90°. Intracortical-excitability paradigm and investigator order were randomized. Bland-Altman analyses were used to establish agreement. Results: Agreement was stronger between sessions within a single investigator than between investigators and for active than resting measures. Agreement was strongest for resting SICI and active ICF and LICI between sessions for each investigator. Conclusions: Quadriceps intracortical excitability may be measured longitudinally by a single investigator, though active muscle contraction should be elicited during testing.
Y.L. Lo, H.H. Zhang, C.C. Wang, Z.Y. Chin, S. Fook-Chong, C. Gabriel and C.T. Guan
In overt reading and singing tasks, actual vocalization of words in a rhythmic fashion is performed. During execution of these tasks, the role of underlying vascular processes in relation to cortical excitability changes in a spatial manner is uncertain. Our objective was to investigate cortical excitability changes during reading and singing with transcranial magnetic stimulation (TMS), as well as vascular changes with nearinfrared spectroscopy (NIRS). Findings with TMS and NIRS were correlated. TMS and NIRS recordings were performed in 5 normal subjects while they performed reading and singing tasks separately. TMS was applied over the left motor cortex at 9 positions 2.5 cm apart. NIRS recordings were made over these identical positions. Although both TMS and NIRS showed significant mean cortical excitability and hemodynamic changes from baseline during vocalization tasks, there was no significant spatial correlation of these changes evaluated with the 2 techniques over the left motor cortex. Our findings suggest that increased left-sided cortical excitability from overt vocalization tasks in the corresponding “hand area” were the result of “functional connectivity,” rather than an underlying “vascular overflow mechanism” from the adjacent speech processing or face/mouth areas. Our findings also imply that functional neurophysiological and vascular methods may evaluate separate underlying processes, although subjects performed identical vocalization tasks. Future research combining similar methodologies should embrace this aspect and harness their separate capabilities.
Christopher A. Knight
Column-editor : Thomas W. Kaminski
János Négyesi, Menno P. Veldman, Kelly M.M. Berghuis, Marie Javet, József Tihanyi and Tibor Hortobágyi
transfer-receiving hand. We supplemented the behavioral data with transcranial magnetic stimulation (TMS) measures to examine the potential underlying mechanisms involved in skill acquisition and its intermanual transfer. Materials and Methods Participants In total, 34 right-handed healthy adults (age 22
Stephen P. Bailey, Julie Hibbard, Darrin La Forge, Madison Mitchell, Bart Roelands, G. Keith Harris and Stephen Folger
improvement in performance is unclear; however, it is believed that the CHO MR enhances the excitability of the motor cortex via oral CHO receptors. Gant et al 3 provided supportive evidence for this premise when they found that the motor-evoked potential (MEP) response to transcranial magnetic stimulation
Alex V. Nowicky, Alison H. McGregor and Nick J. Davey
We used transcranial magnetic stimulation (TMS) to study corticospinal excitability to erector Spinae (ES) muscles during graded voluntary contractions in bilateral trunk extension (BTE) and forced expiratory breath holding (FEBH) in normal individuals. Motor evoked potentials (MEPs) could be produced in all subjects in the absence of voluntary activation. At maximum voluntary contraction, levels of surface electromyographic (EMG) activity were 4 times greater during BTE than FEBH. When EMG was normalized to maximum. MEP amplitudes increased in proportion to contraction in both tasks. MEPs in FEBH were compared with extrapolated values at similar EMG levels in BTE and were found to be larger. EMG and MEPs in left and right ES were symmetrical throughout the range of contractions in both tasks. ES muscles have a facilitation pattern similar to that previously shown in leg muscles, but subtle differences at low levels of EMG suggest that the facilitation is dependent on the task.
Katherine G. Holste, Alia L. Yasen, Matthew J. Hill and Anita D. Christie
The purpose of this study was to assess the effect of a cognitive task on motor cortex excitability and inhibition. Transcranial magnetic stimulation of the motor cortex was performed on 20 healthy individuals (18–24 years; 9 females) to measure motor evoked potentials (MEPs) and cortical silent periods at baseline, during, and following a secondary cognitive task. The MEP amplitude increased from 0.50 ± 0.09–0.87 ± 0.50 mV during a secondary cognitive task (p = .04), and returned to baseline (0.48 ± 0.31 mV; p = .90) posttask. The CSP duration also increased from 93.48 ± 28.76–113.6 ± 33.68 ms (p = .001) during the cognitive task, and returned to baseline posttask (89.0 ± 6.9 ms; p = .88). In the presence of a cognitive task, motor cortex excitability and inhibition were both increased relative to baseline. The increase in inhibition may help to explain the motor deficits experienced while performing a secondary cognitive task.
Francesca Wightman, Suzanne Delves, Caroline M. Alexander and Paul H. Strutton
Descending bilateral control of external oblique (EO) and latissimus dorsi (LD) was investigated using transcranial magnetic stimulation. Contralateral (CL) motor evoked potential (MEP) thresholds were lower and latencies were shorter than for ipsilateral (IL) MEPs. Hotspots for EO were symmetrical; this was not the case for LD. The volumes of drive to the left and right muscles were not different. The laterality index was not different between the left and right muscles. The average index for the EO muscles was closer to zero than that for LD, suggesting a stronger IL drive to EO. The symmetry of drive to each muscle did not differ; however, the symmetry of drive varies within a subject for different muscles and between subjects for the same muscle. The findings may be useful in understanding a number of clinical conditions relating to the trunk and also for predicting the outcome of rehabilitative strategies.
Matthew Harkey, Michelle M. McLeod, Masafumi Terada, Phillip A. Gribble and Brian G. Pietrosimone
Spinal-reflexive and corticomotor excitability may have a critical role in altering muscle function needed to stabilize the ankle in people with chronic ankle instability (CAI).
To determine the association between self-reported disability and both spinal-reflexive and corticomotor excitability in people with CAI.
Descriptive laboratory study.
30 participants with CAI.
Main Outcome Measures:
Soleus spinal-reflexive excitability was measured with normalized Hoffmann reflexes (H:M ratio), and corticomotor excitability was measured with transcranial magnetic stimulation and quantified by normalized motor-evoked-potential (MEP) amplitudes at 120% of active motor threshold (120%MEP). Self-reported disability was quantified with the activities-of-daily-living and sport subscales of the Foot and Ankle Ability Measure (FAAM-ADL and FAAM-S). Separate linear Pearson product–moment correlations and nonlinear quadratic correlations were used to determine associations between the neural-excitability and disability variables.
Thirty participants were included in the spinal-reflexive-excitability analysis, while only 19 were included in the corticomotor analysis. There was a significant, weak linear association between H:M ratio and FAAM-ADL (R = .39, P = .03) and a nonsignificant, weak linear association between H:M ratio and FAAM-S (R = .36, P = .06). There were significant, moderate quadratic associations between H:M ratio and both FAAM-ADL (R = .48, P = .03) and FAAM-S (R = .50, P = .02). There was a significant, moderate linear association between 120%MEP and FAAM-ADL (R = –.48, P = .04) and a nonsignificant, moderate negative linear association between FAAM-S (R = –.42, P = .07). There was a significant, moderate quadratic association between 120%MEP and FAAM-ADL (R = .57, P = .046) and a significant, strong quadratic correlation between 120%MEP and FAAM-S (R = .71, P = .004).
There are significant quadratic associations between self-reported disability and both spinal-reflexive and corticomotor excitability of the soleus. CAI participants with low or high neural excitability present with lower function.