Volitional muscle activity paired with transcranial magnetic stimulation increases corticospinal excitability
Volitional muscle activity paired with transcranial magnetic stimulation increases corticospinal excitability
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DOI：
10.3389/fnins.2014.00442
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发表时间：
2015-01-12
影响因子：
4.3
通讯作者：
Fetz, Eberhard E.
中科院分区：
文献类型：
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作者：
Edwardson, Matthew A.;Avery, David H.;Fetz, Eberhard E.
对非人类灵长类动物活动依赖性刺激的研究表明，将意志肌肉活动的每个实例与即时皮质内刺激配对会导致长时程增强样效应。这项技术有望用于临床康复，但很少有研究人员在人类受试者中测试活动依赖性刺激。此外，还没有人研究过人类受试者中两个单独的目标肌肉的皮层表征上的活动依赖性刺激。我们假设，40分钟的经颅磁刺激（TMS）触发弹道肌肉活动在1 Hz的平均重复率将导致更大的增加皮质脊髓兴奋性比TMS提示的肌肉活动，这些变化将是特定的肌肉的研究。10名健康人类受试者参加了本交叉研究的4个单独阶段：（1）拇短展肌（APB）的视觉暗示的意志激活触发TMS（2）响应于从先前的APB触发的TMS会话的记录传递的TMS的APB的自愿激活（3）视觉提示的趾伸肌（艾德）的意志激活触发TMS（ED触发TMS），以及（4）响应于从先前ED触发的TMS会话（TMS提示艾德）的记录传递的TMS，艾德的自愿激活。与我们的假设相反，我们发现了所有条件下皮质脊髓兴奋性增加的证据，通过运动诱发电位面积的变化来测量。我们的结论是，单TMS脉冲配对之前或之后的肌肉活动可能会增加皮质脊髓的兴奋性，并需要进一步的研究，以澄清最佳的时间窗口诱导神经可塑性与活动依赖性刺激。这些发现将为未来临床康复活动依赖性刺激方案的设计提供信息。
Studies of activity-dependent stimulation in non-human primates suggest that pairing each instance of volitional muscle activity with immediate intracortical stimulation causes long-term-potentiation-like effects. This technique holds promise for clinical rehabilitation, yet few investigators have tested activity-dependent stimulation in human subjects. In addition, no one has studied activity-dependent stimulation on the cortical representation for two separate target muscles in human subjects. We hypothesized that 40 min of transcranial magnetic stimulation (TMS) triggered from ballistic muscle activity at a mean repetition rate of 1 Hz would cause greater increases in corticospinal excitability than TMS-cued muscle activity, and that these changes would be specific to the muscle of study. Ten healthy human subjects participated in 4 separate sessions in this crossover study: (1) visually cued volitional activation of the abductor pollicis brevis (APB) muscle triggering TMS (APB-Triggered TMS), (2) volitional activation of APB in response to TMS delivered from a recording of the prior APB-Triggered TMS session (TMS-Cued APB), (3) visually cued volitional activation of the extensor digitorum (ED) triggering TMS (ED-Triggered TMS), and (4) volitional activation of ED in response to TMS delivered from a recording of the prior ED-Triggered TMS session (TMS-Cued ED). Contrary to our hypothesis, we discovered evidence of increased corticospinal excitability for all conditions as measured by change in area of the motor evoked potential. We conclude that single TMS pulses paired either before or after muscle activity may increase corticospinal excitability and that further studies are needed to clarify the optimal time window for inducing neural plasticity with activity-dependent stimulation. These findings will inform the design of future activity-dependent stimulation protocols for clinical rehabilitation.