Interhemispheric Competition After Stroke: Brain Stimulation to Enhance Recovery of Function of the Affected Hand

2009 ◽  
Vol 23 (7) ◽  
pp. 641-656 ◽  
Author(s):  
Dennis A. Nowak ◽  
Christian Grefkes ◽  
Mitra Ameli ◽  
Gereon R. Fink
Keyword(s):  
Brain Stimulation ◽  
Motor Behavior ◽  
Cortical Excitability ◽  
Recovery Of Function ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Hand Function ◽  
Clinical Effects ◽  
Sensorimotor Network ◽  
Interhemispheric Competition ◽  
Plastic Changes

Background and purpose. Within the concept of interhemispheric competition, technical modulation of the excitability of motor areas in the contralesional and ipsilesional hemisphere has been applied in an attempt to enhance recovery of hand function following stroke. This review critically summarizes the data supporting the use of novel electrophysiological concepts in the rehabilitation of hand function after stroke. Summary of review. Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are powerful tools to inhibit or facilitate cortical excitability. Modulation of cortical excitability may instantaneously induce plastic changes within the cortical network of sensorimotor areas, thereby improving motor function of the affected hand after stroke. No significant adverse effects have been noted when applying brain stimulation in stroke patients. To date, however, the clinical effects are small to moderate and short lived. Future work should elucidate whether repetitive administration of rTMS or tDCS over several days and the combination of these techniques with behavioral training (ie, physiotherapy) could result in an enhanced effectiveness. Conclusion. Brain stimulation is a safe and promising tool to induce plastic changes in the cortical sensorimotor network to improve motor behavior after stroke. However, several methodological issues remain to be answered to further improve the effectiveness of these new approaches.

scholarly journals Noninvasive Brain Stimulation for Motor Recovery after Stroke: Mechanisms and Future Views

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Naoyuki Takeuchi ◽  
Shin-Ichi Izumi
Keyword(s):  
Brain Stimulation ◽  
Neural Plasticity ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Motor Recovery ◽  
Cortical Reorganization ◽  
Motor Deficits ◽  
Stroke Patients ◽  
Noninvasive Brain Stimulation ◽  
Interhemispheric Competition ◽  
Underlying Mechanisms

Repetitive transcranial magnetic stimulation and transcranial direct current stimulation are noninvasive brain stimulation (NIBS) techniques that can alter excitability of the human cortex. Considering the interhemispheric competition occurring after stroke, improvement in motor deficits can be achieved by increasing the excitability of the affected hemisphere or decreasing the excitability of the unaffected hemisphere. Many reports have shown that NIBS application improves motor function in stroke patients by using their physiological peculiarity. For continuous motor improvement, it is important to impart additional motor training while NIBS modulates the neural network between both hemispheres and remodels the disturbed network in the affected hemisphere. NIBS can be an adjuvant therapy for developed neurorehabilitation strategies for stroke patients. Moreover, recent studies have reported that bilateral NIBS can more effectively facilitate neural plasticity and induce motor recovery after stroke. However, the best NIBS pattern has not been established, and clinicians should select the type of NIBS by considering the NIBS mechanism. Here, we review the underlying mechanisms and future views of NIBS therapy and propose rehabilitation approaches for appropriate cortical reorganization.

tDCS dans le traitement de la dépression : un exemple de recherche clinique translationnelle

2014 ◽  
Vol 29 (S3) ◽  
pp. 668-668
Author(s):  
E. Haffen
Keyword(s):  
Animal Models ◽  
Direct Current ◽  
Brain Stimulation ◽  
Depressive Disorders ◽  
Cortical Excitability ◽  
Biological Psychiatry ◽  
Clinical Effects ◽  
Cognitive Effects ◽  
Non Invasive ◽  
Technological Advances

Since the discovery of psychopharmacological treatments in the early 1950s, followed by the development of second-generation antidepressants, biological psychiatry has not achieved much progress. Recent technological advances in the field of non-invasive brain stimulation open new perspectives in the treatment of depressive disorders (MDD). Amongst them, transcranial direct current stimulation (tDCS) modulates cortical excitability and induces long-lasting effects. Here, we aimed at evaluating whether tDCS has potential to be developed as an innovative treatment in psychiatry. We conducted several studies in humans and animal models, exploring clinical and cognitive effects, especially in MDD. Our findings indicated beneficial clinical effects of tDCS. The data published to date are promising and supports the use of tDCS as a treatment for MDD. However, its place regarding other treatments still has to be determined before becoming a routine clinical treatment.

scholarly journals Repetitive Transcranial Magnetic Stimulation Improves Handwriting in Parkinson’s Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Bubblepreet K. Randhawa ◽  
Becky G. Farley ◽  
Lara A. Boyd
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Brain Stimulation ◽  
Magnetic Stimulation ◽  
Primary Motor Cortex ◽  
Cortical Excitability ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Motor Task ◽  
Brain Regions ◽  
Fine Motor ◽  
The Impact

Background. Parkinson disease (PD) is characterized by hypometric movements resulting from loss of dopaminergic neurons in the substantia nigra. PD leads to decreased activation of the supplementary motor area (SMA); the net result of these changes is a poverty of movement. The present study determined the impact of 5 Hz repetitive transcranial magnetic stimulation (rTMS) over the SMA on a fine motor movement, handwriting (writing cursive “l”s), and on cortical excitability, in individuals with PD.Methods. In a cross-over design, ten individuals with PD were randomized to receive either 5 Hz or control stimulation over the SMA. Immediately following brain stimulation right handed writing was assessed.Results. 5 Hz stimulation increased vertical size of handwriting and diminished axial pressure. In addition, 5 Hz rTMS significantly decreased the threshold for excitability in the primary motor cortex.Conclusions. These data suggest that in the short term 5 Hz rTMS benefits functional fine motor task performance, perhaps by altering cortical excitability across a network of brain regions. Further, these data may provide the foundation for a larger investigation of the effects of noninvasive brain stimulation over the SMA in individuals with PD.

Deep brain stimulation modulates hypothalamic-brainstem fibers in cluster headache: case report

2020 ◽  
Vol 132 (3) ◽  
pp. 717-720 ◽  
Author(s):  
Sérgio A. F. Dantas ◽  
Eduardo J. L. Alho ◽  
Juliano J. da Silva ◽  
Nilson N. Mendes Neto ◽  
Erich Talamoni Fonoff ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Cluster Headache ◽  
Brain Stimulation ◽  
Clinical Effects ◽  
Chronic Stimulation ◽  
Mammillary Bodies ◽  
Fiber Tracts ◽  
White Matter Region ◽  
Deep Brain ◽  
Stimulation Of

Hypothalamic deep brain stimulation (DBS) has been used for more than a decade to treat cluster headache (CH) but its mechanisms remain poorly understood. The authors have successfully treated a patient with CH using hypothalamic DBS and found that the contact used for chronic stimulation was located in a white matter region posterior to the mammillary bodies. Fiber tracts crossing that region were the medial forebrain bundle and those interconnecting the hypothalamus and brainstem, including the dorsal longitudinal fasciculus. Because the stimulation of axons is an important mechanism of DBS, some of its clinical effects in CH may be related to the stimulation of fibers interconnecting the hypothalamus and brainstem.

scholarly journals Effects of non-invasive brain stimulation in children and young people with psychiatric disorders: a protocol for a systematic review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Yael D. Lewis ◽  
Lucy Gallop ◽  
Iain C. Campbell ◽  
Ulrike Schmidt
Keyword(s):  
Systematic Review ◽  
Young People ◽  
Psychiatric Disorders ◽  
Brain Stimulation ◽  
Grey Literature ◽  
Significant Proportion ◽  
Clinical Effects ◽  
Children And Young People ◽  
Non Invasive ◽  
Specific Symptoms

Abstract Background Most psychiatric disorders have their onset in childhood or adolescence, and if not fully treated have the potential for causing life-long psycho-social and physical sequelae. Effective psychotherapeutic and medication treatments exist, but a significant proportion of children and young people do not make a full recovery. Thus, novel, safe, brain-based alternatives or adjuncts to conventional treatments are needed. Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are non-invasive brain stimulation (NIBS) techniques which have shown clinical benefits in adult psychiatric conditions. However, in children and young people their efficacy is not well established. The objective of this study will be to systematically evaluate the evidence on clinical effects of NIBS in children and young people with psychiatric disorders, assessing disorder-specific symptoms, mood and neurocognitive functions. Methods We designed and registered a study protocol for a systematic review. We will include randomised and non-randomised controlled trials and observational studies (e.g. cohort, case-control, case series) assessing the effects of NIBS in children and young people (aged ≤ 24 years old) for psychiatric disorders. The primary outcome will be reduction of disorder-specific symptoms. Secondary outcomes will include effects on mood and cognition. A comprehensive search from database inception onwards will be conducted in MEDLINE, EMBASE and PsycINFO. Grey literature will be identified through searching multiple clinical trial registries. Two reviewers will independently screen all citations, full-text articles and abstract data. The methodological quality of the studies will be appraised using appropriate tools. We will provide a narrative synthesis of the evidence and according to heterogeneity will conduct an appropriate meta-analysis. Additional analyses will be conducted to explore the potential sources of heterogeneity. Discussion This systematic review will provide a broad and comprehensive evaluation of the evidence on clinical effects of NIBS in children and young people with psychiatric disorders. Our findings will be reported according to the PRISMA guidelines and will be of interest to multiple audiences (including patients, researchers, healthcare professionals and policy-makers). Results will be published in a peer-reviewed journal. Systematic review registration PROSPERO CRD42019158957

scholarly journals Cerebellar rTMS and PAS effectively induce cerebellar plasticity

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Martje G. Pauly ◽  
Annika Steinmeier ◽  
Christina Bolte ◽  
Feline Hamami ◽  
Elinor Tzvi ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Healthy Subjects ◽  
Primary Motor Cortex ◽  
Cortical Excitability ◽  
Motor Evoked Potentials ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Premotor Cortex ◽  
Motor Pathways ◽  
Non Invasive ◽  
Cerebellar Plasticity

AbstractNon-invasive brain stimulation techniques including repetitive transcranial magnetic stimulation (rTMS), continuous theta-burst stimulation (cTBS), paired associative stimulation (PAS), and transcranial direct current stimulation (tDCS) have been applied over the cerebellum to induce plasticity and gain insights into the interaction of the cerebellum with neo-cortical structures including the motor cortex. We compared the effects of 1 Hz rTMS, cTBS, PAS and tDCS given over the cerebellum on motor cortical excitability and interactions between the cerebellum and dorsal premotor cortex / primary motor cortex in two within subject designs in healthy controls. In experiment 1, rTMS, cTBS, PAS, and tDCS were applied over the cerebellum in 20 healthy subjects. In experiment 2, rTMS and PAS were compared to sham conditions in another group of 20 healthy subjects. In experiment 1, PAS reduced cortical excitability determined by motor evoked potentials (MEP) amplitudes, whereas rTMS increased motor thresholds and facilitated dorsal premotor-motor and cerebellum-motor cortex interactions. TDCS and cTBS had no significant effects. In experiment 2, MEP amplitudes increased after rTMS and motor thresholds following PAS. Analysis of all participants who received rTMS and PAS showed that MEP amplitudes were reduced after PAS and increased following rTMS. rTMS also caused facilitation of dorsal premotor-motor cortex and cerebellum-motor cortex interactions. In summary, cerebellar 1 Hz rTMS and PAS can effectively induce plasticity in cerebello-(premotor)-motor pathways provided larger samples are studied.

scholarly journals The Role of the Parietal Lobe in Visual Extinction Studied with Transcranial Magnetic Stimulation

2009 ◽  
Vol 21 (10) ◽  
pp. 1946-1955 ◽  
Author(s):  
Lorella Battelli ◽  
George A. Alvarez ◽  
Thomas Carlson ◽  
Alvaro Pascual-Leone
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Visual Tracking ◽  
Magnetic Stimulation ◽  
Posterior Parietal Cortex ◽  
Parietal Lobe ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Visual Fields ◽  
Brain Regions ◽  
Visual Extinction ◽  
Interhemispheric Competition

Interhemispheric competition between homologous areas in the human brain is believed to be involved in a wide variety of human behaviors from motor activity to visual perception and particularly attention. For example, patients with lesions in the posterior parietal cortex are unable to selectively track objects in the contralesional side of visual space when targets are simultaneously present in the ipsilesional visual field, a form of visual extinction. Visual extinction may arise due to an imbalance in the normal interhemispheric competition. To directly assess the issue of reciprocal inhibition, we used fMRI to localize those brain regions active during attention-based visual tracking and then applied low-frequency repetitive transcranial magnetic stimulation over identified areas in the left and right intraparietal sulcus to asses the behavioral effects on visual tracking. We induced a severe impairment in visual tracking that was selective for conditions of simultaneous tracking in both visual fields. Our data show that the parietal lobe is essential for visual tracking and that the two hemispheres compete for attentional resources during tracking. Our results provide a neuronal basis for visual extinction in patients with parietal lobe damage.

scholarly journals Effect of Transcranial Brain Stimulation for the Treatment of Alzheimer Disease: A Review

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Raffaele Nardone ◽  
Jürgen Bergmann ◽  
Monica Christova ◽  
Francesca Caleri ◽  
Frediano Tezzon ◽  
...  
Keyword(s):  
Alzheimer Disease ◽  
Brain Stimulation ◽  
Cognitive Rehabilitation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Pharmacological Treatments ◽  
Noninvasive Methods ◽  
Functional Changes ◽  
Beneficial Effects ◽  
Limited Effectiveness ◽  
Transcranial Brain Stimulation

Available pharmacological treatments for Alzheimer disease (AD) have limited effectiveness, are expensive, and sometimes induce side effects. Therefore, alternative or complementary adjuvant therapeutic strategies have gained increasing attention. The development of novel noninvasive methods of brain stimulation has increased the interest in neuromodulatory techniques as potential therapeutic tool for cognitive rehabilitation in AD. In particular, repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are noninvasive approaches that induce prolonged functional changes in the cerebral cortex. Several studies have begun to therapeutically use rTMS or tDCS to improve cognitive performances in patients with AD. However, most of them induced short-duration beneficial effects and were not adequately powered to establish evidence for therapeutic efficacy. Therefore, TMS and tDCS approaches, seeking to enhance cognitive function, have to be considered still very preliminary. In future studies, multiple rTMS or tDCS sessions might also interact, and metaplasticity effects could affect the outcome.

Combining transcranial brain stimulation and PET/SPECT molecular imaging

2021 ◽  
Author(s):  
Sang Soo Cho ◽  
Antonio P. Strafella
Keyword(s):  
Brain Stimulation ◽  
Single Photon ◽  
Photon Emission ◽  
Functional Magnetic Resonance ◽  
Single Photon Emission ◽  
Neurochemical Mechanisms ◽  
Brain Functions ◽  
Positron Emission ◽  
Transcranial Brain Stimulation ◽  
Plastic Changes

Transcranial brain stimulation (TMS) was introduced in 1985 by Barker and his colleagues. Since then, further improvements in technology have allowed additional applications and new stimulation protocols. In the last decade, while the use of TMS has expanded enormously in basic science as well as in the clinical scenario, the underlying neurophysiological or neurochemical mechanisms are still not fully understood. Positron emission tomography (PET) and single-photon emission computerized tomography (SPECT) are neuroimaging modalities utilized to investigate brain functions. In spite of their lower spatial and time resolution compared with functional magnetic resonance imaging (fMRI) and electroencephalography (EEG), PET/SPECT have helped to elucidate some of the neurochemical mechanisms and neural plastic changes associated with TMS. In this chapter, we will provide an overview of these techniques, describing methodological details and application of TMS-PET/SPECT imaging in basic and clinical studies.

scholarly journals Implicit Motor Imagery and the Lateral Occipitotemporal Cortex: Hints for Tailoring Non-Invasive Brain Stimulation

2020 ◽  
Vol 17 (16) ◽  
pp. 5851 ◽  
Author(s):  
Massimiliano Conson ◽  
Roberta Cecere ◽  
Chiara Baiano ◽  
Francesco De Bellis ◽  
Gabriela Forgione ◽  
...  
Keyword(s):  
Motor Imagery ◽  
Brain Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Dominant Hand ◽  
Non Invasive ◽  
Implicit Motor ◽  
Left And Right ◽  
Occipitotemporal Cortex ◽  
Biomechanical Effect ◽  
Motor Representations

Background: Recent evidence has converged in showing that the lateral occipitotemporal cortex is over-recruited during implicit motor imagery in elderly and in patients with neurodegenerative disorders, such as Parkinson’s disease. These data suggest that when automatically imaging movements, individuals exploit neural resources in the visual areas to compensate for the decline in activating motor representations. Thus, the occipitotemporal cortex could represent a cortical target of non-invasive brain stimulation combined with cognitive training to enhance motor imagery performance. Here, we aimed at shedding light on the role of the left and right lateral occipitotemporal cortex in implicit motor imagery. Methods: We applied online, high-frequency, repetitive transcranial magnetic stimulation (rTMS) over the left and right lateral occipitotemporal cortex while healthy right-handers judged the laterality of hand images. Results: With respect to the sham condition, left hemisphere stimulation specifically reduced accuracy in judging the laterality of right-hand images. Instead, the hallmark of motor simulation, i.e., the biomechanical effect, was never influenced by rTMS. Conclusions: The lateral occipitotemporal cortex seems to be involved in mental representation of the dominant hand, at least in right-handers, but not in reactivating sensorimotor information during simulation. These findings provide useful hints for developing combined brain stimulation and behavioural trainings to improve motor imagery.

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