Rapid-rate paired associative stimulation of the median nerve and motor cortex can produce long-lasting changes in motor cortical excitability in humans
Rapid-rate paired associative stimulation of the median nerve and motor cortex can produce long-lasting changes in motor cortical excitability in humans
复制标题
DOI：
10.1113/jphysiol.2006.114025
复制
发表时间：
2006-09-01
影响因子：
5.5
通讯作者：
Siebner, Hartwig Roman
中科院分区：
文献类型：
--
作者：
Quartarone, Angelo;Rizzo, Vincenzo;Siebner, Hartwig Roman
重复经颅磁刺激（rTMS）或重复外周神经电刺激（rENS）可以诱导人类运动皮质（M1）兴奋性的变化，这种变化通常是短暂且可变的，并且仅在长时间刺激后发生。在10名健康志愿者中，我们使用了一种新的重复配对联想刺激（rPAS）协议，以促进和延长rENS和rTMS对皮层兴奋性的影响。右侧正中神经亚运动阈值5Hz rENS与左侧M1亚运动阈值5Hz rTMS以恒定间隔同步2min。外周刺激与经颅刺激之间的刺激间期（ISI）设定为10ms（5Hz rPAS（10ms））或25ms（5Hz rPAS（25ms））。在右侧拇短展肌（APB）的热点上给予TMS。在rPAS前和rPAS后，我们测量了条件M1的非条件运动诱发电位（MEP）、皮质内抑制（ICI）和易化（ICF）、短潜伏期和长潜伏期传入抑制（SAI和LAI）的幅度。5 Hz rPAS（25 ms）方案而不是5 Hz rPAS 10（ms）方案引起松弛的APB肌肉中平均MEP振幅的躯体特异性增加。5 Hz rPAS（25 ms）方案也导致SAI丧失，但SAI个体变化与皮质脊髓兴奋性之间无相关性。这些后效在5 Hz rPAS（25 ms）后6 h仍存在。对ICI、ICF和LAI的影响不一致。单独给药时，5 Hz rENS和5 Hz rTMS方案未能诱导皮质脊髓兴奋性的任何变化。这些结果表明，2分钟的5 Hz rPAS（25 ms）产生一个持久的和躯体特异性的皮质脊髓兴奋性增加，可能是通过感觉运动去抑制。
Repetitive transcranial magnetic stimulation (rTMS) or repetitive electrical peripheral nerve stimulation (rENS) can induce changes in the excitability of the human motor cortex (M1) that is often short-lasting and variable, and occurs only after prolonged periods of stimulation. In 10 healthy volunteers, we used a new repetitive paired associative stimulation (rPAS) protocol to facilitate and prolong the effects of rENS and rTMS on cortical excitability. Sub-motor threshold 5 Hz rENS of the right median nerve was synchronized with submotor threshold 5 Hz rTMS of the left M1 at a constant interval for 2 min. The interstimulus interval (ISI) between the peripheral stimulus and the transcranial stimulation was set at 10 ms (5 Hz rPAS(10ms)) or 25 ms (5 Hz rPAS(25ms)). TMS was given over the hot spot of the right abductor pollicis brevis (APB) muscle. Before and after rPAS, we measured the amplitude of the unconditioned motor evoked potential (MEP), intracortical inhibition (ICI) and facilitation (ICF), short- and long-latency afferent inhibition (SAI and LAI) in the conditioned M1. The 5 Hz rPAS(25ms) protocol but not the 5 Hz rPAS10(ms) protocol caused a somatotopically specific increase in mean MEP amplitudes in the relaxed APB muscle. The 5 Hz rPAS(25ms) protocol also led to a loss of SAI, but there was no correlation between individual changes in SAI and corticospinal excitability. These after-effects were still present 6 h after 5 Hz rPAS(25ms). There was no consistent effect on ICI, ICF and LAI. The 5 Hz rENS and 5 Hz rTMS protocols failed to induce any change in corticospinal excitability when given alone. These findings show that 2 min of 5 Hz rPAS(25ms) produce a long-lasting and somatotopically specific increase in corticospinal excitability, presumably by sensorimotor disinhibition.