scholarly journals Evidence for a Window of Enhanced Plasticity in the Human Motor Cortex Following Ischemic Stroke

2021 ◽  
pp. 154596832199233
Author(s):  
Brenton Hordacre ◽  
Duncan Austin ◽  
Katlyn E. Brown ◽  
Lynton Graetz ◽  
Isabel Pareés ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Synaptic Plasticity ◽  
Motor Cortex ◽  
Human Brain ◽  
Evoked Potential ◽  
Cortical Excitability ◽  
Motor Evoked Potential ◽  
Stroke Survivors ◽  
Behavioral Training ◽  
Human Motor Cortex

Background In preclinical models, behavioral training early after stroke produces larger gains compared with delayed training. The effects are thought to be mediated by increased and widespread reorganization of synaptic connections in the brain. It is viewed as a period of spontaneous biological recovery during which synaptic plasticity is increased. Objective To look for evidence of a similar change in synaptic plasticity in the human brain in the weeks and months after ischemic stroke. Methods We used continuous theta burst stimulation (cTBS) to activate synapses repeatedly in the motor cortex. This initiates early stages of synaptic plasticity that temporarily reduces cortical excitability and motor-evoked potential amplitude. Thus, the greater the effect of cTBS on the motor-evoked potential, the greater the inferred level of synaptic plasticity. Data were collected from separate cohorts (Australia and UK). In each cohort, serial measurements were made in the weeks to months following stroke. Data were obtained for the ipsilesional motor cortex in 31 stroke survivors (Australia, 66.6 ± 17.8 years) over 12 months and the contralesional motor cortex in 29 stroke survivors (UK, 68.2 ± 9.8 years) over 6 months. Results Depression of cortical excitability by cTBS was most prominent shortly after stroke in the contralesional hemisphere and diminished over subsequent sessions ( P = .030). cTBS response did not differ across the 12-month follow-up period in the ipsilesional hemisphere ( P = .903). Conclusions Our results provide the first neurophysiological evidence consistent with a period of enhanced synaptic plasticity in the human brain after stroke. Behavioral training given during this period may be especially effective in supporting poststroke recovery.

scholarly journals Obesity is Associated with Reduced Plasticity of the Human Motor Cortex

2020 ◽  
Vol 10 (9) ◽  
pp. 579
Author(s):  
Sophia X. Sui ◽  
Michael C. Ridding ◽  
Brenton Hordacre
Keyword(s):  
Motor Cortex ◽  
Evoked Potential ◽  
Cortical Excitability ◽  
Motor Evoked Potential ◽  
Healthy Weight ◽  
Theta Burst Stimulation ◽  
Burst Stimulation ◽  
Weight Group ◽  
Theta Burst ◽  
Continuous Theta Burst Stimulation

Obesity is characterised by excessive body fat and is associated with several detrimental health conditions, including cardiovascular disease and diabetes. There is some evidence that people who are obese have structural and functional brain alterations and cognitive deficits. It may be that these neurophysiological and behavioural consequences are underpinned by altered plasticity. This study investigated the relationship between obesity and plasticity of the motor cortex in people who were considered obese (n = 14, nine males, aged 35.4 ± 14.3 years) or healthy weight (n = 16, seven males, aged 26.3 ± 8.5 years). A brain stimulation protocol known as continuous theta burst transcranial magnetic stimulation was applied to the motor cortex to induce a brief suppression of cortical excitability. The suppression of cortical excitability was quantified using single-pulse transcranial magnetic stimulation to record and measure the amplitude of the motor evoked potential in a peripheral hand muscle. Therefore, the magnitude of suppression of the motor evoked potential by continuous theta burst stimulation was used as a measure of the capacity for plasticity of the motor cortex. Our results demonstrate that the healthy-weight group had a significant suppression of cortical excitability following continuous theta burst stimulation (cTBS), but there was no change in excitability for the obese group. Comparing the response to cTBS between groups demonstrated that there was an impaired plasticity response for the obese group when compared to the healthy-weight group. This might suggest that the capacity for plasticity is reduced in people who are obese. Given the importance of plasticity for human behaviour, our results add further emphasis to the potentially detrimental health effects of obesity.

Intraoperative Motor Evoked Potential Alteration in Intracranial Tumor Surgery and Its Relation to Signal Alteration in Postoperative Magnetic Resonance Imaging

Neurosurgery ◽  
2010 ◽  
Vol 67 (2) ◽  
pp. 302-313 ◽  
Author(s):  
Andrea Szelényi ◽  
Elke Hattingen ◽  
Stefan Weidauer ◽  
Volker Seifert ◽  
Ulf Ziemann
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Motor Cortex ◽  
Evoked Potential ◽  
Corticospinal Tract ◽  
Motor Evoked Potential ◽  
Motor Deficit ◽  
Warning Sign ◽  
Precentral Gyrus ◽  
Resonance Imaging

Abstract OBJECTIVE To determine the degree to which the pattern of intraoperative isolated, unilateral alteration of motor evoked potential (MEP) in intracranial surgery was related to motor outcome and location of new postoperative signal alterations on magnetic resonance imaging (MRI). METHODS In 29 patients (age, 42.8 ± 18.2 years; 15 female patients; 25 supratentorial, 4 infratentorial procedures), intraoperative MEP alterations in isolation (without significant alteration in other evoked potential modalities) were classified as deterioration (> 50% amplitude decrease and/or motor threshold increase) or loss, respectively, or reversible and irreversible. Postoperative MRI was described for the location and type of new signal alteration. RESULTS New motor deficit was present in all 5 patients with irreversible MEP loss, in 7 of 10 patients with irreversible MEP deterioration, in 1 of 6 patients with reversible MEP loss, and in 0 of 8 patients with reversible MEP deterioration. Irreversible compared with reversible MEP alteration was significantly more often correlated with postoperative motor deficit (P < .0001). In 20 patients, 22 new signal alterations affected 29 various locations (precentral gyrus, n = 5; corticospinal tract, n = 19). Irreversible MEP alteration was more often associated with postoperative new signal alteration in MRI compared with reversible MEP alteration (P = .02). MEP loss was significantly more often associated with subcortically located new signal alteration (P = .006). MEP deterioration was significantly more often followed by new signal alterations located in the precentral gyrus (P = .04). CONCLUSION MEP loss bears a higher risk than MEP deterioration for postoperative motor deficit resulting from subcortical postoperative MR changes in the corticospinal tract. In contrast, MEP deterioration points to motor cortex lesion. Thus, even MEP deterioration should be considered a warning sign if surgery close to the motor cortex is performed.

scholarly journals Systematic examination of low-intensity ultrasound parameters on human motor cortex excitability and behavior

eLife ◽  
2020 ◽  
Vol 9 ◽  
Author(s):  
Anton Fomenko ◽  
Kai-Hsiang Stanley Chen ◽  
Jean-François Nankoo ◽  
James Saravanamuttu ◽  
Yanqiu Wang ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Short Interval ◽  
Motor Evoked Potential ◽  
Cortical Inhibition ◽  
Transcranial Ultrasound ◽  
Human Motor Cortex ◽  
Low Intensity ◽  
Visuomotor Task ◽  
Motor Cortex Excitability ◽  
And Behavior

Low-intensity transcranial ultrasound (TUS) can non-invasively modulate human neural activity. We investigated how different fundamental sonication parameters influence the effects of TUS on the motor cortex (M1) of 16 healthy subjects by probing cortico-cortical excitability and behavior. A low-intensity 500 kHz TUS transducer was coupled to a transcranial magnetic stimulation (TMS) coil. TMS was delivered 10 ms before the end of TUS to the left M1 hotspot of the first dorsal interosseous muscle. Varying acoustic parameters (pulse repetition frequency, duty cycle, and sonication duration) on motor-evoked potential amplitude were examined. Paired-pulse measures of cortical inhibition and facilitation, and performance on a visuomotor task was also assessed. TUS safely suppressed TMS-elicited motor cortical activity, with longer sonication durations and shorter duty cycles when delivered in a blocked paradigm. TUS increased GABAA-mediated short-interval intracortical inhibition and decreased reaction time on visuomotor task but not when controlled with TUS at near-somatosensory threshold intensity.

Dopaminergic modulation of long-lasting direct current-induced cortical excitability changes in the human motor cortex

2006 ◽  
Vol 23 (6) ◽  
pp. 1651-1657 ◽  
Author(s):  
Michael A. Nitsche ◽  
Christian Lampe ◽  
Andrea Antal ◽  
David Liebetanz ◽  
Nicolas Lang ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Direct Current ◽  
Cortical Excitability ◽  
Human Motor Cortex ◽  
Dopaminergic Modulation ◽  
Human Motor

scholarly journals Neuroplasticity Changes on Human Motor Cortex Induced by Acupuncture Therapy: A Preliminary Study

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Yi Yang ◽  
Ines Eisner ◽  
Siqi Chen ◽  
Shaosong Wang ◽  
Fan Zhang ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Acupuncture Therapy ◽  
Motor Cortex ◽  
Magnetic Stimulation ◽  
Primary Motor Cortex ◽  
Motor Evoked Potential ◽  
Interhemispheric Inhibition ◽  
Human Motor Cortex ◽  
Interhemispheric Competition ◽  
Resting Motor Threshold

While neuroplasticity changes measured by transcranial magnetic stimulation have been proved to be highly correlated to motor recovery and have been tested in various forms of interventions, it has not been applied to investigate the neurophysiologic mechanism of acupuncture therapy. The aim of this study is to investigate neuroplasticity changes induced by a single session of acupuncture therapy in healthy adults, regarding the excitability change on bilateral primary motor cortex and interhemispheric inhibition. Ten subjects took a 30-minute acupuncture therapy and the same length relaxing phase in separate days. Transcranial magnetic stimulation measures, including resting motor threshold, amplitudes of motor-evoked potential, and interhemispheric inhibition, were assessed before and 10 minutes after intervention. Acupuncture treatment showed significant changes on potential amplitude from both ipsilateral and contralateral hemispheres to acupuncture compared to baseline. Also, interhemispheric inhibition from the contralateral motor cortex to the opposite showed a significant decline. The results indicated that corticomotoneuronal excitability and interhemispheric competition could be modulated by acupuncture therapy on healthy subjects. The following question about whether these changes will be observed in the same way on stroke patients and whether they correlate with the therapeutic effect on movement need to be answered by following studies. This trial is registered with ISRCTN13074245.

scholarly journals The effects of forearm position and contraction intensity on cortical and spinal excitability during a submaximal force steadiness task of the elbow flexors

2020 ◽  
Vol 123 (2) ◽  
pp. 522-528
Author(s):  
Alexandra F. Yacyshyn ◽  
Samantha Kuzyk ◽  
Jennifer M. Jakobi ◽  
Chris J. McNeil
Keyword(s):  
Evoked Potential ◽  
Biceps Brachii ◽  
Cortical Excitability ◽  
Motor Evoked Potential ◽  
Elbow Flexor ◽  
Elbow Flexors ◽  
Neural Excitability ◽  
Force Steadiness ◽  
Maximal Force ◽  
Spinal Excitability

Elbow flexor force steadiness is less with the forearm pronated (PRO) compared with neutral (NEU) or supinated (SUP) and may relate to neural excitability. Although not tested in a force steadiness paradigm, lower spinal and cortical excitability was observed separately for biceps brachii in PRO, possibly dependent on contractile status at the time of assessment. This study aimed to investigate position-dependent changes in force steadiness as well as spinal and cortical excitability at a variety of contraction intensities. Thirteen males (26 ± 7 yr; means ± SD) performed three blocks (PRO, NEU, and SUP) of 24 brief (~6 s) isometric elbow flexor contractions (5, 10, 25 or 50% of maximal force). During each contraction, transcranial magnetic stimulation or transmastoid stimulation was delivered to elicit a motor-evoked potential (MEP) or cervicomedullary motor-evoked potential (CMEP), respectively. Force steadiness was lower in PRO compared with NEU and SUP ( P ≤ 0.001), with no difference between NEU and SUP. Similarly, spinal excitability (CMEP/maximal M wave) was lower in PRO than NEU (25 and 50% maximal force; P ≤ 0.010) and SUP (all force levels; P ≤ 0.004), with no difference between NEU and SUP. Cortical excitability (MEP/CMEP) did not change with forearm position ( P = 0.055); however, a priori post hoc testing for position showed excitability was 39.8 ± 38.3% lower for PRO than NEU at 25% maximal force ( P = 0.006). The data suggest that contraction intensity influences the effect of forearm position on neural excitability and that reduced spinal and, to a lesser extent, cortical excitability could contribute to lower force steadiness in PRO compared with NEU and SUP. NEW & NOTEWORTHY To address conflicting reports about the effect of forearm position on spinal and cortical excitability of the elbow flexors, we examine the influence of contraction intensity. For the first time, excitability data are considered in a force steadiness context. Motoneuronal excitability is lowest in pronation and this disparity increases with contraction intensity. Cortical excitability exhibits a similar pattern from 5 to 25% of maximal force. Lower corticospinal excitability likely contributes to relatively poor force steadiness in pronation.

Does Navigated Transcranial Stimulation Increase the Accuracy of Tractography? A Prospective Clinical Trial Based on Intraoperative Motor Evoked Potential Monitoring During Deep Brain Stimulation

Neurosurgery ◽  
2015 ◽  
Vol 76 (6) ◽  
pp. 766-776 ◽  
Author(s):  
Marie-Therese Forster ◽  
Alexander Claudius Hoecker ◽  
Jun-Suk Kang ◽  
Johanna Quick ◽  
Volker Seifert ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Motor Cortex ◽  
Brain Stimulation ◽  
Evoked Potential ◽  
Motor Evoked Potential ◽  
Fiber Tracking ◽  
Active Electrode ◽  
Electrode Contact ◽  
Evoked Potential Monitoring ◽  
Deep Brain

AbstractBACKGROUND:Tractography based on diffusion tensor imaging has become a popular tool for delineating white matter tracts for neurosurgical procedures.OBJECTIVE:To explore whether navigated transcranial magnetic stimulation (nTMS) might increase the accuracy of fiber tracking.METHODS:Tractography was performed according to both anatomic delineation of the motor cortex (n = 14) and nTMS results (n = 9). After implantation of the definitive electrode, stimulation via the electrode was performed, defining a stimulation threshold for eliciting motor evoked potentials recorded during deep brain stimulation surgery. Others have shown that of arm and leg muscles. This threshold was correlated with the shortest distance between the active electrode contact and both fiber tracks. Results were evaluated by correlation to motor evoked potential monitoring during deep brain stimulation, a surgical procedure causing hardly any brain shift.RESULTS:Distances to fiber tracks clearly correlated with motor evoked potential thresholds. Tracks based on nTMS had a higher predictive value than tracks based on anatomic motor cortex definition (P < .001 and P = .005, respectively). However, target site, hemisphere, and active electrode contact did not influence this correlation.CONCLUSION:The implementation of tractography based on nTMS increases the accuracy of fiber tracking. Moreover, this combination of methods has the potential to become a supplemental tool for guiding electrode implantation.

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