Intermittent theta burst stimulation over ipsilesional primary motor cortex of subacute ischemic stroke patients: A pilot study

AbstractDecisions about actions typically involve a period of deliberation that ends with the commitment to a choice and the motor processes overtly expressing that choice. Previous studies have shown that neural activity in sensorimotor areas, including the primary motor cortex (M1), correlates with deliberation features during action selection. Yet, the causal contribution of these areas to the decision process remains unclear. Here, we investigated whether M1 determines choice commitment, or whether it simply reflects decision signals coming from upstream structures and instead mainly contributes to the motor processes that follow commitment. To do so, we tested the impact of a disruption of M1 activity, induced by continuous theta burst stimulation (cTBS), on the behavior of human subjects in (1) a simple reaction time (SRT) task allowing us to estimate the duration of the motor processes and (2) a modified version of the tokens task (Cisek et al., 2009), which allowed us to estimate subjects’ time of commitment as well as accuracy criterion. The efficiency of cTBS was attested by a reduction in motor evoked potential amplitudes following M1 disruption, as compared to those following a sham stimulation. Furthermore, M1 cTBS lengthened SRTs, indicating that motor processes were perturbed by the intervention. Importantly, all of the behavioral results in the tokens task were similar following M1 disruption and sham stimulation, suggesting that the contribution of M1 to the deliberation process is potentially negligible. Taken together, these findings favor the view that M1 contribution is downstream of the decision process.New and noteworthyDecisions between actions are ubiquitous in the animal realm. Deliberation during action choices entails changes in the activity of the sensorimotor areas controlling those actions, but the causal role of these areas is still often debated. Using continuous theta burst stimulation, we show that disrupting the primary motor cortex (M1) delays the motor processes that follow instructed commitment but does not alter volitional deliberation, suggesting that M1 contribution may be downstream of the decision process.

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Facilitation of Auditory Comprehension After Theta Burst Stimulation of Wernicke's Area in Stroke Patients: A Pilot Study

Frontiers in Neurology ◽

10.3389/fneur.2019.01319 ◽

2020 ◽

Vol 10 ◽

Author(s):

Viviana Versace ◽

Kerstin Schwenker ◽

Patrick B. Langthaler ◽

Stefan Golaszewski ◽

Luca Sebastianelli ◽

...

Keyword(s):

Pilot Study ◽

Auditory Comprehension ◽

Theta Burst Stimulation ◽

Burst Stimulation ◽

Stroke Patients ◽

Wernicke’S Area ◽

Theta Burst ◽

Stimulation Of

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Theta Burst Stimulation over the human primary motor cortex modulates neural processes involved in movement preparation

Clinical Neurophysiology ◽

10.1016/j.clinph.2009.04.001 ◽

2009 ◽

Vol 120 (6) ◽

pp. 1195-1203 ◽

Cited By ~ 19

Author(s):

Enzo Ortu ◽

Diane Ruge ◽

Franca Deriu ◽

John C. Rothwell

Keyword(s):

Motor Cortex ◽

Primary Motor Cortex ◽

Movement Preparation ◽

Theta Burst Stimulation ◽

Burst Stimulation ◽

Neural Processes ◽

Theta Burst

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Improvement of spasticity following intermittent theta burst stimulation in multiple sclerosis is associated with modulation of resting-state functional connectivity of the primary motor cortices

Multiple Sclerosis Journal ◽

10.1177/1352458516661640 ◽

2016 ◽

Vol 23 (6) ◽

pp. 855-863 ◽

Cited By ~ 17

Author(s):

Clémence Boutière ◽

Caroline Rey ◽

Wafaa Zaaraoui ◽

Arnaud Le Troter ◽

Audrey Rico ◽

...

Keyword(s):

Multiple Sclerosis ◽

Motor Cortex ◽

Resting State ◽

Primary Motor Cortex ◽

Rehabilitation Programme ◽

Lower Limbs ◽

Theta Burst Stimulation ◽

Burst Stimulation ◽

Functional Reorganization ◽

Theta Burst

Background: Intermittent theta burst stimulation (iTBS) of the primary motor cortex improves transiently lower limbs spasticity in multiple sclerosis (MS). However, the cerebral mechanisms underlying this effect have never been investigated. Objective: To assess whether modulation of spasticity induced by iTBS is underlined by functional reorganization of the primary motor cortices. Methods: A total of 17 patients with MS suffering from lower limbs spasticity were randomized to receive real iTBS or sham iTBS during the first half of a 5-week indoor rehabilitation programme. Spasticity was assessed using the Modified Ashworth Scale and the Visual Analogue Scale at baseline, after the stimulation session and at the end of the rehabilitation programme. Resting-state functional magnetic resonance imaging (fMRI) was performed at the three time points, and brain functional networks topology was analysed using graph-theoretical approach. Results: At the end of stimulation, improvement of spasticity was greater in real iTBS group than in sham iTBS group ( p = 0.026). iTBS had a significant effect on the balance of the connectivity degree between the stimulated and the homologous primary motor cortex ( p = 0.005). Changes in inter-hemispheric balance were correlated with improvement of spasticity (rho = 0.56, p = 0.015). Conclusion: This longitudinal resting-state fMRI study evidences that functional reorganization of the primary motor cortices may underlie the effect of iTBS on spasticity in MS.

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Motor cortex disruption delays motor processes but not deliberation about action choices

Journal of Neurophysiology ◽

10.1152/jn.00163.2019 ◽

2019 ◽

Vol 122 (4) ◽

pp. 1566-1577 ◽

Cited By ~ 7

Author(s):

Gerard Derosiere ◽

David Thura ◽

Paul Cisek ◽

Julie Duque

Keyword(s):

Motor Cortex ◽

Decision Process ◽

Primary Motor Cortex ◽

Theta Burst Stimulation ◽

Burst Stimulation ◽

Sham Stimulation ◽

Motor Processes ◽

The Impact ◽

Theta Burst ◽

Continuous Theta Burst Stimulation

Decisions about actions typically involve a period of deliberation that ends with the commitment to a choice and the motor processes overtly expressing that choice. Previous studies have shown that neural activity in sensorimotor areas, including the primary motor cortex (M1), correlates with deliberation features during action selection. However, the causal contribution of these areas to the decision process remains unclear. Here, we investigated whether M1 determines choice commitment or whether it simply reflects decision signals coming from upstream structures and instead mainly contributes to the motor processes that follow commitment. To do so, we tested the impact of a disruption of M1 activity, induced by continuous theta burst stimulation (cTBS), on the behavior of human subjects in 1) a simple reaction time (SRT) task allowing us to estimate the duration of the motor processes and 2) a modified version of the tokens task (Cisek P, Puskas GA, El-Murr S. J Neurosci 29: 11560–11571, 2009), which allowed us to estimate subjects’ time of commitment as well as accuracy criterion. The efficiency of cTBS was attested by a reduction in motor evoked potential amplitudes following M1 disruption compared with those following a sham stimulation. Furthermore, M1 cTBS lengthened SRTs, indicating that motor processes were perturbed by the intervention. Importantly, all of the behavioral results in the tokens task were similar following M1 disruption and sham stimulation, suggesting that the contribution of M1 to the deliberation process is potentially negligible. Taken together, these findings favor the view that M1 contribution is downstream of the decision process. NEW & NOTEWORTHY Decisions between actions are ubiquitous in the animal realm. Deliberation during action choices entails changes in the activity of the sensorimotor areas controlling those actions, but the causal role of these areas is still often debated. With the use of continuous theta burst stimulation, we show that disrupting the primary motor cortex (M1) delays the motor processes that follow instructed commitment but does not alter volitional deliberation, suggesting that M1 contribution may be downstream of the decision process.

Download Full-text