Interhemispheric inhibition (IHI) findings using ipsilateral silent period (iSP) in two stroke patients during acute and subacute phases after stroke

Invasive treatments and its associated risks are important factors of concern when the conditions are affecting the nervous system. Transcranial direct current stimulation (tDCS) is a non-invasive technique that stimulates brain areas through the scalp and has excitatory or inhibitory neuromodulatory effects. In the context of stroke patients, recovery is often impaired from the increased inhibition of the damaged area from the unaffected hemisphere. Fujimoto et al. uses dual-hemisphere transcranial direct current stimulation to address this interhemispheric inhibition and demonstrates that stroke patients were able to periodically restore sensory deficits.

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Effects of a single mental chronometry training session in subacute stroke patients – a randomized controlled trial

BMC Sports Science Medicine and Rehabilitation ◽

10.1186/s13102-020-00212-w ◽

2020 ◽

Vol 12 (1) ◽

Author(s):

Joachim Liepert ◽

Jana Stürner ◽

Imke Büsching ◽

Aida Sehle ◽

Mircea A. Schoenfeld

Keyword(s):

Motor Imagery ◽

Training Session ◽

Silent Period ◽

Motor Execution ◽

Stroke Patients ◽

Identification Task ◽

Sensory Deficits ◽

Subacute Stroke ◽

Mental Chronometry ◽

Motor Excitability

Abstract Background Motor imagery training might be helpful in stroke rehabilitation. This study explored if a single session of motor imagery (MI) training induces performance changes in mental chronometry (MC), motor execution, or changes of motor excitability. Methods Subacute stroke patients (n = 33) participated in two training sessions. The order was randomized. One training consisted of a mental chronometry task, the other training was a hand identification task, each lasting 30 min. Before and after the training session, the Box and Block Test (BBT) was fully executed and also performed as a mental version which served as a measure of MC. A subgroup analysis based on the presence of sensory deficits was performed. Patients were allocated to three groups (no sensory deficits, moderate sensory deficits, severe sensory deficits). Motor excitability was measured by transcranial magnetic stimulation (TMS) pre and post training. Amplitudes of motor evoked potentials at rest and during pre-innervation as well as the duration of cortical silent period were measured in the affected and the non-affected hand. Results Pre-post differences of MC showed an improved MC after the MI training, whereas MC was worse after the hand identification training. Motor execution of the BBT was significantly improved after mental chronometry training but not after hand identification task training. Patients with severe sensory deficits performed significantly inferior in BBT execution and MC abilities prior to the training session compared to patients without sensory deficits or with moderate sensory deficits. However, pre-post differences of MC were similar in the 3 groups. TMS results were not different between pre and post training but showed significant differences between affected and unaffected side. Conclusion Even a single training session can modulate MC abilities and BBT motor execution in a task-specific way. Severe sensory deficits are associated with poorer motor performance and poorer MC ability, but do not have a negative impact on training-associated changes of mental chronometry. Studies with longer treatment periods should explore if the observed changes can further be expanded. Trial registration DRKS, DRKS00020355, registered March 9th, 2020, retrospectively registered

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Relationship Between Interhemispheric Inhibition and Motor Cortex Excitability in Subacute Stroke Patients

Neurorehabilitation and Neural Repair ◽

10.1177/1545968307301769 ◽

2007 ◽

Vol 22 (1) ◽

pp. 4-21 ◽

Cited By ~ 148

Author(s):

Cathrin M. Bütefisch ◽

Marion Weβling ◽

Johannes Netz ◽

Rüdiger J. Seitz ◽

Volker Hömberg

Keyword(s):

Motor Cortex ◽

Stroke Patients ◽

Interhemispheric Inhibition ◽

Subacute Stroke ◽

Motor Cortex Excitability

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29. Cutaneous silent period in stroke patients with spasticity

Clinical Neurophysiology ◽

10.1016/j.clinph.2007.11.079 ◽

2008 ◽

Vol 119 (3) ◽

pp. e36 ◽

Cited By ~ 1

Author(s):

K. Jung ◽

J. Lee ◽

H. Choi ◽

D. Kim ◽

W. Yoo ◽

...

Keyword(s):

Silent Period ◽

Stroke Patients ◽

Cutaneous Silent Period

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FC40.2 Interhemispheric inhibition by voluntary motor cortex activation measured by enhancement of the ipsilateral silent period

Clinical Neurophysiology ◽

10.1016/j.clinph.2006.06.133 ◽

2006 ◽

Vol 117 ◽

pp. 1 ◽

Cited By ~ 1

Author(s):

M. Cincotta ◽

F. Giovannelli ◽

A. Borgheresi ◽

F. Balestrieri ◽

G. Zaccara ◽

...

Keyword(s):

Motor Cortex ◽

Silent Period ◽

Interhemispheric Inhibition ◽

Voluntary Motor

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Transcallosal inhibition in patients with callosal infarction

Journal of Neurophysiology ◽

10.1152/jn.01044.2011 ◽

2013 ◽

Vol 109 (3) ◽

pp. 659-665 ◽

Cited By ~ 20

Author(s):

Jie-Yuan Li ◽

Ping-Hong Lai ◽

Robert Chen

Keyword(s):

Transcranial Magnetic Stimulation ◽

Corpus Callosum ◽

Healthy Subjects ◽

Magnetic Stimulation ◽

Silent Period ◽

Normal Subjects ◽

Interhemispheric Inhibition ◽

Transcallosal Inhibition ◽

Long Latency ◽

Pass Through

Recent studies in normal subjects suggested that callosal motor fibers pass through the posterior body of the corpus callosum (CC), but this has not been tested in patients with callosal infarction. The objective of this study is to define the pathways involved in transcallosal inhibition by examining patients with infarctions in different subregions of the CC. We hypothesized that patients with lesions in the posterior one-half of the CC would have greater reduction in transcallosal inhibition between the motor cortices. Twenty-six patients with callosal infarction and 14 healthy subjects were studied. The callosal lesions were localized on sagittal MRI and were attributed to one of five segments of the CC. Transcranial magnetic stimulation was used to assess ipsilateral silent period (iSP) and short- and long-latency interhemispheric inhibition (SIHI and LIHI, respectively) originating from both motor cortices. The results showed that the iSP areas and durations were markedly reduced bilaterally in patients with callosal infarction compared with normal subjects. Patients with callosal infarctions also had less IHI bidirectionally compared with normal subjects. iSP areas and durations were lower in patients with lesions than in patients without lesions in segment 3 (posterior midbody) of the CC. Lesion burden in the posterior one-half of the CC negatively correlated transcallosal inhibition measured with iSP and SIHI. Our study suggests that callosal infarction led to reduced transcallosal inhibition, as measured by iSP, SIHI, and LIHI. Fibers mediating transcallosal inhibition cross the CC mainly in the posterior one-half.

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Modulation of interhemispheric inhibition by volitional motor activity: an ipsilateral silent period study

The Journal of Physiology ◽

10.1113/jphysiol.2009.175885 ◽

2009 ◽

Vol 587 (22) ◽

pp. 5393-5410 ◽

Cited By ~ 91

Author(s):

Fabio Giovannelli ◽

Alessandra Borgheresi ◽

Fabrizio Balestrieri ◽

Gaetano Zaccara ◽

Maria Pia Viggiano ◽

...

Keyword(s):

Motor Activity ◽

Silent Period ◽

Interhemispheric Inhibition

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Interhemispheric inhibition to the biceps brachii during arm cycling

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2020-0456 ◽

2020 ◽

Author(s):

Ryan Benson ◽

Evan James Lockyer ◽

Chris Compton ◽

Kevin E. Power

Keyword(s):

Transcranial Magnetic Stimulation ◽

Motor Cortex ◽

Magnetic Stimulation ◽

Biceps Brachii ◽

Silent Period ◽

Interhemispheric Inhibition ◽

Emg Amplitude ◽

Arm Cycling ◽

Cortical Circuit

This is the first demonstration of interhemispheric inhibition (IHI) during a locomotor output, arm cycling. IHI was quantified by assessing the depth of the ipsilateral silent period (iSP) evoked via transcranial magnetic stimulation (TMS) of the motor cortex. There was a significant reduction in EMG amplitude of the iSP during cycling compared to the control EMG (16.8 ± 17.1%; p<0.001). Depth and area for measuring the iSP during arm cycling are discussed. NOVELTY • First study to demonstrate activation of the cortical circuit, interhemispheric inhibition, during a locomotor output.

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