Low-Frequency rTMS over Contralesional M1 Increases Ipsilesional Cortical Excitability and Motor Function with Decreased Interhemispheric Asymmetry in Subacute Stroke: A Randomized Controlled Study

Objective. To determine the long-term effects of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) over the contralesional M1 preceding motor task practice on the interhemispheric asymmetry of the cortical excitability and the functional recovery in subacute stroke patients with mild to moderate arm paresis. Methods. Twenty-four subacute stroke patients were randomly allocated to either the experimental or control group. The experimental group underwent rTMS over the contralesional M1 (1 Hz), immediately followed by 30 minutes of motor task practice (10 sessions within 2 weeks). The controls received sham rTMS and the same task practice. Following the 2-week intervention period, the task practice was continued twice weekly for another 10 weeks in both groups. Outcomes were evaluated at baseline (T0), at the end of the 2-week stimulation period (T1), and at 12-week follow-up (T2). Results. The MEP (paretic hand) and interhemispheric asymmetry, Fugl-Meyer motor assessment, Action Research Arm Test, and box and block test scores improved more in the experimental group than controls at T1 ( p < 0.05 ). The beneficial effects were largely maintained at T2. Conclusion. LF-rTMS over the contralesional M1 preceding motor task practice was effective in enhancing the ipsilesional cortical excitability and upper limb function with reducing interhemispheric asymmetry in subacute stroke patients with mild to moderate arm paresis. Significance. Adding LF-rTMS prior to motor task practice may reduce interhemispheric asymmetry of cortical excitabilities and promote upper limb function recovery in subacute stroke with mild to moderate arm paresis.

Dynamics of interhemispheric relations as a result of functional treatment in children with non-paralytic operated strabismus

Purpose. To study the dynamics of interhemispheric interactions in children with friendly strabismus as a result of functional treatment. Material and methods. The study included 135 children aged 6 to 8 (average 6.8±0.1) years with convergent non-paralytic operated strabismus in combination with hypermetropic refraction and 96 children of the same age in the control group (average 7.1±0.1 years) without ophthalmic pathology. In children with strabismus, the leading hand and dominant eye were determined before and after functional treatment. Characteristics of spatial perception were evaluated by copying of complex geometric shapes which were Taylor's (right-handed) and Ray-Osterritz's (lefthanded). Results. After functional treatment in the group of children with non-paralytic strabismus, along with improved binocular functions and improved performance of the Taylor and Ray-Osterritz tests, there was an increase in the number of ambidextrous children and a significant decrease in the number of left-handers (p<0.001). Conclusion. The increase in the number of symmetrical lateral phenotypes against the background of improved binocular functions and spatial perception characteristics as a result of functional treatment of children with non-paralytic strabismus indicates an improvement of their interhemispheric interactions and can be an additional criterion for the ef fectiveness of treatment. Key words: lateral phenotypes, interhemispheric asymmetry, functional treatment of strabismus

Interhemispheric Asymmetry of the Brain in Patients with Type 1 Diabetes Mellitus and Cognitive Impairment

With an ageing of population and a splurging epidemic of diabetes mellitus (DM), the prevalence of complications associated with pathology of the central nervous system are expected to increase, which in the future may have serious consequences for public health. It is known that one of the main manifestations of brain damage in type 1 diabetes is cognitive impairment, which is possibly associated with the peculiarities of vascularization and interhemispheric asymmetry, which requires in-depth analysis using modern neuroimaging methods. The aim of the study is to assess the symmetry of structural, metabolic and neurovascularization changes in the brain in patients with type 1 diabetes and cognitive impairment. The study included 120 patients with type 1 diabetes aged 18 to 45 years suffering from cognitive impairment, and 30 people without cognitive decline which constituted the control group. Neuropsychological testing included the Montreal Cognitive Dysfunction Assessment Scale (MoCA test). For neuroimaging methods, standard magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), contrast and non-contrast-enhanced perfusion were used. Statistical processing was carried out using the SPSS Statistic 2020 software. In patients with type 1 diabetes with cognitive impairment, as manifested by impaired memory and/or attention, perfusion imaging revealed the presence of brain asymmetry zones. Standard MRI allowed to demonstrate changes in the white, gray matter and hippocampus in the right hemisphere. The results obtained were refined taking into account the topical localization, so during the perfusion study, regions with asymmetric blood flow were identified - namely, the white matter of the frontal lobe and the gray matter in the occipital lobe. Spectroscopy of the brain revealed that it was in these areas of the brain that the most significant metabolic disorders were noted – in the form of significantly altered ratio of N-acetylaspartate (NAA) / choline (Cho) on the left, along with the asymmetry in phosphocreatine level (Cr 2) on the right. In conclusion, early preclinical predictive diagnostics with the use of modern neuroimaging methods allows for timely detection of impaired vascularization and brain metabolism in this group of patients.

Inter-species cortical registration between macaques and humans using a functional network property under a spherical demons framework

Systematic evaluation of cortical differences between humans and macaques calls for inter-species registration of the cortex that matches homologous regions across species. For establishing homology across brains, structural landmarks and biological features have been used without paying sufficient attention to functional homology. The present study aimed to determine functional homology between the human and macaque cortices, defined in terms of functional network properties, by proposing an iterative functional network-based registration scheme using surface-based spherical demons. The functional connectivity matrix of resting-state functional magnetic resonance imaging (rs-fMRI) among cortical parcellations was iteratively calculated for humans and macaques. From the functional connectivity matrix, the functional network properties such as principal network components were derived to estimate a deformation field between the human and macaque cortices. The iterative registration procedure updates the parcellation map of macaques, corresponding to the human connectome project’s multimodal parcellation atlas, which was used to derive the macaque’s functional connectivity matrix. To test the plausibility of the functional network-based registration, we compared cortical registration using structural versus functional features in terms of cortical regional areal change. We also evaluated the interhemispheric asymmetry of regional area and its inter-subject variability in humans and macaques as an indirect validation of the proposed method. Higher inter-subject variability and interhemispheric asymmetry were found in functional homology than in structural homology, and the assessed asymmetry and variations were higher in humans than in macaques. The results emphasize the significance of functional network-based cortical registration across individuals within a species and across species.

Sex-Related Differences in the Interhemispheric Asymmetry of Cerebral Energy Metabolism in Young People Living in the Arctic Zone of the Russian Federation

In the Arctic region, adaptive reactions of the body put pressure on its functional systems and are accompanied by changes in cerebral energy metabolism in the central nervous system. Despite the fact that patterns of interhemispheric asymmetry and interaction are part of the brain’s essential, fundamental mechanism, no data is currently available on the neurometabolic features of interhemispheric asymmetry in men and women living in the Arctic zone of the Russian Federation. The aim of this paper was to identify the differences in cerebral energy metabolism in men and women born and living in the Arctic zone of the Russian Federation with different types of interhemispheric asymmetry according to the distribution of DC-potential level. Materials and methods. The study involved 63 subjects (30 men and 33 women) aged 30–34 years born and living in Arkhangelsk. Cerebral energy metabolism was assessed using the 5-channel Neuro-KM hardware and software complex. Distribution of DC-potential level was analysed by mapping the monopolar values and calculating their gradients. To calculate interhemispheric asymmetry of cerebral energy metabolism, an interhemispheric gradient was used, i.e. the potential difference between the right and left temporal leads (Td-Ts). The obtained DC-potential level results were compared with average standard values. The results of the study indicate differences in the distribution of the processes of cerebral energy metabolism in men and women with different types of hemispheric dominance. The most balanced cerebral metabolism was identified in men with right hemisphere dominance and in women with left hemisphere dominance. The presence of sex-related differences in the hemispheric asymmetry of cerebral energy metabolism may reflect different strategies of adaptation to the climatic conditions of northern latitudes in men and women.

Interhemispheric asymmetry during NREM sleep in the dog

Functional hemispheric asymmetry was evidenced in many species during sleep. Dogs seem to show hemispheric asymmetry during wakefulness; however, their asymmetric neural activity during sleep was not yet explored. The present study investigated interhemispheric asymmetry in family dogs using non-invasive polysomnography. EEG recordings during 3-h-long afternoon naps were carried out (N = 19) on two occasions at the same location. Hemispheric asymmetry was assessed during NREM sleep, using bilateral EEG channels. To include periods with high homeostatic sleep pressure and to reduce the variance of the time spent in NREM sleep between dogs, the first two sleep cycles were analysed. Left hemispheric predominance of slow frequency range was detected in the first sleep cycle of sleep recording 1, compared to the baseline level of zero asymmetry as well as to the first sleep cycle of sleep recording 2. Regarding the strength of hemispheric asymmetry, we found greater absolute hemispheric asymmetry in the second sleep cycle of sleep recording 1 and 2 in the frequency ranges of alpha, sigma and beta, compared to the first sleep cycle. Differences between sleep recordings and consecutive sleep cycles might be indicative of adaptation-like processes, but do not closely resemble the results described in humans.

Intrahemispheric EEG: A New Perspective for Quantitative EEG Assessment in Poststroke Individuals

The ratio between slower and faster frequencies of brain activity may change after stroke. However, few studies have used quantitative electroencephalography (qEEG) index of ratios between slower and faster frequencies such as the delta/alpha ratio (DAR) and the power ratio index (PRI; delta + theta / alpha + beta ) for investigating the difference between the affected and unaffected hemisphere poststroke. Here, we proposed a new perspective for analyzing DAR and PRI within each hemisphere and investigated the motor impairment-related interhemispheric frequency oscillations. Forty-seven poststroke subjects and twelve healthy controls were included in the study. Severity of upper limb motor impairment was classified according to the Fugl–Meyer assessment in mild/moderate ( n = 25 ) and severe ( n = 22 ). The qEEG indexes (PRI and DAR) were computed for each hemisphere (intrahemispheric index) and for both hemispheres (cerebral index). Considering the cerebral index (DAR and PRI), our results showed a slowing in brain activity in poststroke patients when compared to healthy controls. Only the intrahemispheric PRI index was able to find significant interhemispheric differences of frequency oscillations. Despite being unable to detect interhemispheric differences, the DAR index seems to be more sensitive to detect motor impairment-related frequency oscillations. The intrahemispheric PRI index may provide insights into therapeutic approaches for interhemispheric asymmetry after stroke.

Simultaneously stimulating both brain hemispheres by rTMS in patients with unilateral brain lesions decreases interhemispheric asymmetry

Background: Interhemispheric asymmetry caused by brain lesions is an adverse factor in the recovery of patients with neurological deficits. Repetitive transcranial magnetic stimulation (rTMS) has been shown to modulate cortical oscillation and proposed as an approach to rebalance the symmetry, which has not been documented well. Objective: In this study, we investigated the influence of repetitive transcranial magnetic stimulation (rTMS) on EEG power in patients with unilateral brain lesions by simultaneously stimulating both brain hemispheres and to elucidate asymmetrical changes in rTMS-induced neurophysiological activity. Methods: Fourteen patients with unilateral brain lesions were treated with one active and one sham session of 10 Hz rTMS over the vertex (Cz position). Resting-state EEGs were recorded before and immediately after rTMS. The brain symmetry index (BSI), calculated from a fast Fourier transform, was employed to quantify the power asymmetry in both hemispheres and paired channels over the entire range and five frequency bands (delta, theta, alpha, beta and gamma bands). Results: Comparison between active and sham sessions demonstrated rTMS-induced EEG after-effects. rTMS in the active session significantly reduced the BSI in patients with unilateral brain lesions over the entire frequency range (t = 2.767, P = 0.016). Among the five frequency bands, rTMS only induced a noticeable decrease in the BSI in the delta band (t = 2.254, P = 0.042). Furthermore, analysis of different brain regions showed that significant changes in the BSI of the alpha band were only demonstrated in the posterior parietal lobe. In addition, EEG topographic mapping showed a decreased power of delta oscillations in the ipsilesional hemisphere, whereas distinct cortical oscillations were observed in the alpha band around the parietal-occipital lobe in the contralesional hemisphere. Conclusions: When both brain hemispheres were simultaneously activated, rTMS decreased interhemispheric asymmetry primarily via reducing the delta band in the lesioned hemisphere.

Interhemispheric asymmetry of climate change projections of boreal winter surface winds in CanESM5 large ensemble simulations

A recent study of future changes in global wind power using an ensemble of ten CMIP5 climate simulations indicated an interhemispheric asymmetry of wind power changes over the 21st century, featured by power decreases across the Northern Hemisphere mid-latitudes and increases across the tropics and subtropics of the Southern Hemisphere. Here we analyze future global projections of surface mean and extreme winds by means of a single-model initial-condition 50-member ensemble of climate simulations generated with CanESM5, the Canadian model participated in CMIP6. We analyze the ensemble mean and spread of boreal winter mean and extreme wind trends over the next half-century (2021-2070) and explore the contribution of internal climate variability to these trends. Surface wind speed is projected to mostly decrease in northern mid-low latitudes and southern mid-latitudes and increase in northern high latitudes and southern tropical and subtropical regions, with considerable regional variations. Large ensemble spreads are apparent, especially with remarkable differences over northern parts of South America and northern Russia. The interhemispheric asymmetry of wind projections is found in most ensemble members, and can be related to large-scale changes in surface temperature and atmospheric circulation. The extreme wind has similar structure of future projections, whereas its reductions tend to be more consistent over northern mid-latitudes. The projected mean and extreme wind changes are attributed to changes in both externally anthropogenic forced and internal climate variability generated components. The spread in wind projections is partially due to large-scale atmospheric circulation variability.