Inter-individual Variability in Response to Non-invasive Brain Stimulation Paradigms
Inter-individual Variability in Response to Non-invasive Brain Stimulation Paradigms
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DOI：
10.1016/j.brs.2014.02.004
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发表时间：
2014-05-01
影响因子：
7.7
通讯作者：
Fernandez-del-Olmo, Miguel
中科院分区：
文献类型：
--
作者：
Lopez-Alonso, Virginia;Cheeran, Binith;Fernandez-del-Olmo, Miguel
背景资料：非侵入性脑刺激（NIBS）范例在其安全调节皮质可塑性的能力方面是独特的，以用于实验或治疗应用。然而，越来越多的人关注这些范式的有效性和可靠性的个体间变异性。假设：如果假设多峰分布，NIBS范式的个体间变异性将得到更好的解释。在每个受试者（n = 56）的三个不同的会话中，我们研究了配对联想刺激（PAS（25）），阳极经颅DC刺激（AtDCS）和间歇性θ波群刺激（iTBS）方案。我们应用聚类分析来检测个体之间不同的反应模式。此外，我们测试了基线TMS测量是否（如短皮质内抑制（SICI）、静息运动阈值（RMT））或时间等因素可以预测个体的反应模式。在刺激后的第一个小时内，所有三种模式均显示出相似的功效--对整个样本的兴奋性或抑制性回路没有显著影响，AtDCS的表现并不比iTBS或PAS 25好。聚类分析显示了双峰应答模式，但分别只有39%、45%和43%的受试者对PAS（25）、AtDCS和iTBS的应答符合预期。刺激前SICI占PAS反应变异性的10%（25），但没有其他基线指标可预测反应。最后，我们报告的影响样本量的计算和显着的效果，样品enrichment.Conclusion：NIBS的实验和治疗应用的高速率的“剂量失败”的影响导致我们得出结论，解决个体间的变异性是一个关键领域的关注领域。(C)2014爱思唯尔公司All rights reserved.
Background: Non-invasive Brain Stimulation (NIBS) paradigms are unique in their ability to safely modulate cortical plasticity for experimental or therapeutic applications. However, increasingly, there is concern regarding inter-individual variability in the efficacy and reliability of these paradigms.Hypothesis: Inter-individual variability in response to NIBS paradigms would be better explained if a multimodal distribution was assumed.Methods: In three different sessions for each subject (n = 56), we studied the Paired Associative Stimulation (PAS(25)), Anodal transcranial DC stimulation (AtDCS) and intermittent theta burst stimulation (iTBS) protocols. We applied cluster analysis to detect distinct patterns of response between individuals. Furthermore, we tested whether baseline TMS measures (such as short intracortical inhibition (SICI), resting motor threshold (RMT)) or factors such as time of day could predict each individual's response pattern.Results: All three paradigms show similar efficacy over the first hour post stimulation - there is no significant effect on excitatory or inhibitory circuits for the whole sample, and AtDCS fares no better than iTBS or PAS25. Cluster analysis reveals a bimodal response pattern - but only 39%, 45% and 43% of subjects responded as expected to PAS(25), AtDCS, and iTBS respectively. Pre-stimulation SICI accounted for 10% of the variability in response to PAS(25), but no other baseline measures were predictive of response. Finally, we report implications for sample size calculation and the remarkable effect of sample enrichment.Conclusion: The implications of the high rate of 'dose-failure' for experimental and therapeutic applications of NIBS lead us to conclude that addressing inter-individual variability is a key area of concern for the field. (C) 2014 Elsevier Inc. All rights reserved.