The effect of coil type and limb dominance in the assessment of lower-limb motor cortex excitability using TMS
The effect of coil type and limb dominance in the assessment of lower-limb motor cortex excitability using TMS
复制标题
DOI：
10.1016/j.neulet.2019.01.050
复制
发表时间：
2019-04-23
影响因子：
2.5
通讯作者：
Kiernan, Matthew C.
中科院分区：
文献类型：
--
作者：
Dharmadasa, Thanuja;Matamala, Jose M.;Kiernan, Matthew C.
目的：经颅磁刺激（TMS）的临床应用迅速增加，但大多数研究都针对上肢肌肉，很少探索下肢。线圈选择的差异增加了下肢研究的方法学困难，并对这些参数的一致性解释提出了挑战。本研究的目的是确定最佳线圈的选择，用于评估下肢皮层兴奋性和评估正常皮层functions.Methods：69记录进行了从胫骨前肌48名健康参与者的偏侧。使用单脉冲TMS和成对脉冲阈值跟踪TMS（TT-TMS）范例探索了目前用于下肢研究的三种线圈类型（90 mm圆形; 70 mm 8字形;和110 mm双锥），同时还评估了外周功能。双侧记录（优势肌肉与非优势肌肉）确定皮质对称性。结果：双锥形线圈显示出最大的功效，与交替线圈选择相比，具有显著较低的静息运动阈值（49.0 +/-2.3%，p < 0.0005）和更大的皮质内促进作用。使用双锥线圈，配对脉冲TT-TMS产生的平均短间期皮质内抑制为11.3 +/-1.2%，平均皮质内易化为-6.1 +/-1.9%。优势和非优势hemisles.Conclusions之间没有差异：本研究确定了目前使用的线圈下肢TMS之间的皮质参数的关键差异。具体而言，这表明了标准化下肢TMS协议的重要性，特别是对于疾病病理学的准确解释。
Purpose: Clinical application of transcranial magnetic stimulation (TMS) has rapidly increased but the majority of studies have targeted upper limb muscles, with few exploring the lower-limb. Differences of coil choice have added to methodological difficulties of lower-limb studies and have challenged consistent interpretation of these parameters. The aims of this study were to determine the optimal coil choice for assessing lower-limb cortical excitability and assess laterality of normal cortical function.Methods: 69 recordings were undertaken from the tibialis anterior muscle from 48 healthy participants. Three coil types currently used in lower-limb studies (90 mm circular; 70 mm figure-of-8; and 110 mm double cone) were explored using single pulse TMS and paired-pulse threshold tracking TMS (TT-TMS) paradigms, with peripheral function also assessed. Cortical symmetry was ascertained with bilateral recordings (dominant versus non-dominant muscles).Results: The double-cone coil showed greatest efficacy, with significantly lower resting motor thresholds (49.0 +/- 2.3%, p < 0.0005) and greater intracortical facilitation compared to the alternate coil choices. Using the double-cone coil, paired-pulse TT-TMS generated an averaged short interval intracortical inhibition of 11.3 +/- 1.2%, with an averaged intracortical facilitation of -6.1 +/- 1.9%. There were no differences between dominant and non-dominant hemispheres.Conclusions: The present study identified key differences in cortical parameters between the currently utilised coils for lower-limb TMS. Specifically, this indicates the importance of standardizing the lower-limb TMS protocol, particularly for accurate interpretation in disease pathology.