Lasting cortical activation after repetitive TMS of the motor cortex - A glucose metabolic study
Lasting cortical activation after repetitive TMS of the motor cortex - A glucose metabolic study
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DOI：
10.1212/wnl.54.4.956
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发表时间：
2000-02-22
期刊：
影响因子：
9.9
通讯作者：
Bartenstein, P
中科院分区：
文献类型：
--
作者：
Siebner, HR;Peller, M;Bartenstein, P
目的：大脑[F-18]氟脱氧-D-葡萄糖PET（[F-18]FDG-PET）用于观察在初级运动皮层（M1（HAND））的左手区域重复经颅磁刺激（rTMS）后的持久神经元激活。背景：应用于M1（HAND），rTMS已被证明产生超出刺激本身时间的皮质运动兴奋性调制。研究方法：8名右利手受试者在两种实验条件下接受了非定量[F-18]FDG-PET测量：静息时和左侧M1（HAND）局灶性亚阈值5-Hz rTMS后。在rTMS后条件下，在左侧M1（HAND）上给予1，800个磁脉冲后立即注射[F-18]FDG。使用逐体素Student t检验和感兴趣体积（VOI）分析确定条件之间的标准化局部脑葡萄糖代谢率（标准化rCMRglc）的相对差异。分析先验地限于M1（HAND）、辅助运动区（SMA）和两个半球的初级听觉皮层。结果：左侧M1（HAND）的5 Hz rTMS导致双侧M1（HAND）和SMA内标准化rCMRglc的持续相对增加。这些运动皮层区域内持续的相对rCMRglc增加的幅度和地形图表现出相当大的个体间差异。结论：在初级运动皮层的手部区域上的阈下5-Hz重复经颅磁刺激（rTMS）与超过刺激时间的一组不同的运动皮层区域中的持续神经元激活相关。目前的研究结果表明，[F-18]FDG-PET可以定位和量化rTMS后突触皮质活动的区域净变化，从而可能阐明rTMS相关治疗作用的机制。
Objective: Cerebral [F-18]fluorodeoxy-D-glucose PET ([F-18]FDG-PET) was used to visualize the lasting neuronal activation after repetitive transcranial magnetic stimulation (rTMS) over the left hand area of the primary motor cortex (M1(HAND)). Background: Applied over M1(HAND), rTMS has been shown to produce a modulation of corticomotor excitability beyond the time of stimulation itself. Methods: Eight right-handed subjects underwent nonquantitative [F-18]FDG-PET measurements during two experimental conditions: at rest and after focal subthreshold 5-Hz rTMS over the left M1(HAND). In the post-rTMS condition, [F-18]FDG was injected immediately after the administration of 1,800 magnetic pulses over the left M1(HAND). Relative differences in normalized regional cerebral metabolic rate of glucose (normalized rCMRglc) between conditions were determined using a voxel-by-voxel Student's t-test and volume-of-interest (VOI) analysis. Analysis was a priori restricted to the M1(HAND), the supplementary motor area (SMA), and the primary auditory cortex of both hemispheres. Results: A 5-Hz rTMS of the left M1(HAND), caused a lasting relative increase in normalized rCMRglc within the M1(HAND) bilaterally and the SMA. The magnitude and the topographic pattern of persisting relative rCMRglc increases within these motor cortical areas demonstrated considerable interindividual variations. Conclusions: Subthreshold 5-Hz repetitive transcranial magnetic stimulation (rTMS) over the hand area of the primary motor cortex is associated with a persisting neuronal activation in a distinct set of motor cortical areas beyond the time of stimulation. The current findings demonstrate that [F-18]FDG-PET can localize and quantify regional net changes in synaptic cortical activity after rTMS and thus might elucidate the mechanisms underlying rTMS-associated therapeutic effects.