Brain State-Dependent Closed-Loop Modulation of Paired Associative Stimulation Controlled by Sensorimotor Desynchronization.
Brain State-Dependent Closed-Loop Modulation of Paired Associative Stimulation Controlled by Sensorimotor Desynchronization.
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DOI：
10.3389/fncel.2016.00115
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发表时间：
2016
影响因子：
5.3
通讯作者：
Gharabaghi A
中科院分区：
文献类型：
--
作者：
Royter V;Gharabaghi A
背景资料：配对外周电刺激（ES）和经颅磁刺激（TMS）增加皮质脊髓兴奋性时，应用特定的时间模式。当这两种刺激技术分别应用时，运动想象（MI）相关的振荡调制放大了ES相关的皮层效应-感觉运动事件相关去极化（ERD）和TMS诱导的外周反应-运动诱发电位（MEP）。然而，大脑自我调节对这些刺激技术的关联配对的影响仍然不清楚。目的：本初步研究的目的是探讨在相关ES和TMS期间MI相关ERD对随后皮质脊髓兴奋性的影响。方法：在6名健康受试者的手指伸展MI期间，通过β波段（16-22 Hz）ERD控制对趾总伸肌（EDC）的功能性电刺激（FES）和随后对侧初级运动皮层（M1）的单脉冲TMS（110%静息运动阈值（RMT））的配对应用，并在脑机接口环境中应用。通过获取干预前后MEP峰-峰幅度和曲线下面积的刺激-反应曲线（SRC）来探讨神经相关性。测试结果：应用约150对联合FES和TMS导致MEP振幅和AUC显著增加，表明诱导的皮质脊髓兴奋性增加是由额外神经元池的募集介导的。MEP的增加是大脑状态依赖性的，与β带ERD相关，但与背景EDC肌肉活动无关;这一发现与所施加的FES强度无关。结论：这些结果可能与开发闭环治疗方法有关，例如在神经康复的背景下应用大脑状态依赖性配对联想刺激（PAS）。
Background: Pairing peripheral electrical stimulation (ES) and transcranial magnetic stimulation (TMS) increases corticospinal excitability when applied with a specific temporal pattern. When the two stimulation techniques are applied separately, motor imagery (MI)-related oscillatory modulation amplifies both ES-related cortical effects—sensorimotor event-related desynchronization (ERD), and TMS-induced peripheral responses—motor-evoked potentials (MEP). However, the influence of brain self-regulation on the associative pairing of these stimulation techniques is still unclear. Objective: The aim of this pilot study was to investigate the effects of MI-related ERD during associative ES and TMS on subsequent corticospinal excitability. Method: The paired application of functional electrical stimulation (FES) of the extensor digitorum communis (EDC) muscle and subsequent single-pulse TMS (110% resting motor threshold (RMT)) of the contralateral primary motor cortex (M1) was controlled by beta-band (16–22 Hz) ERD during MI of finger extension and applied within a brain-machine interface environment in six healthy subjects. Neural correlates were probed by acquiring the stimulus-response curve (SRC) of both MEP peak-to-peak amplitude and area under the curve (AUC) before and after the intervention. Result: The application of approximately 150 pairs of associative FES and TMS resulted in a significant increase of MEP amplitudes and AUC, indicating that the induced increase of corticospinal excitability was mediated by the recruitment of additional neuronal pools. MEP increases were brain state-dependent and correlated with beta-band ERD, but not with the background EDC muscle activity; this finding was independent of the FES intensity applied. Conclusion: These results could be relevant for developing closed-loop therapeutic approaches such as the application of brain state-dependent, paired associative stimulation (PAS) in the context of neurorehabilitation.