tDCS modulates effective connectivity during motor command following; a potential therapeutic target for disorders of consciousness.
tDCS modulates effective connectivity during motor command following; a potential therapeutic target for disorders of consciousness.
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DOI：
10.1016/j.neuroimage.2021.118781
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发表时间：
2022-02-15
期刊：
影响因子：
5.7
通讯作者：
Fernández-Espejo D
中科院分区：
文献类型：
--
作者：
Aloi D;Jalali R;Tilsley P;Miall RC;Fernández-Espejo D
经颅直流电刺激（tDCS）作为长期意识障碍（PDOC）无反应患者的潜在治疗途径正引起越来越多的关注。然而，迄今为止的研究结果喜忧参半。在这里，我们提出了一个新的方向，直接解决PDOC缺乏反应的机制，并使用这些来定义我们的目标和我们首先在健康大脑中干预的成功。我们报告2个实验，评估是否tDCS的初级运动皮层（M1-tDCS;实验1）和小脑（CB-tDCS;实验2）在休息时管理调制丘脑-皮质耦合在随后的命令以下的任务通常用于临床评估意识。这两个实验都使用了假手术和极性对照、随机、双盲、交叉设计。在实验1中，22名参与者在MRI扫描仪中接受阳极、阴极和假M1-tDCS治疗。另外22名参与者在实验2中接受了与cb-tDCS相同的方案。我们使用fMRI的动态因果模型来验证tDCS在响应命令的简单拇指运动期间对大脑活动和动力学的影响。我们发现，M1-tDCS增加丘脑兴奋和阴极cb-tDCS增加兴奋性耦合从丘脑到M1。所有这些变化都是极性特异性的。结合，我们的实验表明，tDCS可以成功地调节长距离的丘脑-皮层动力学在命令通过靶向皮层区域。这表明，M1-和cb-tDCS可能使PDOC患者能够克服其反应性降低的根源运动缺陷，从而改善其康复选择和生活质量。
Transcranial direct current stimulation (tDCS) is attracting increasing interest as a potential therapeutic route for unresponsive patients with prolonged disorders of consciousness (PDOC). However, research to date has had mixed results. Here, we propose a new direction by directly addressing the mechanisms underlying lack of responsiveness in PDOC, and using these to define our targets and the success of our intervention in the healthy brain first. We report 2 experiments that assess whether tDCS to the primary motor cortex (M1-tDCS; Experiment 1) and the cerebellum (cb-tDCS; Experiment 2) administered at rest modulate thalamo-cortical coupling in a subsequent command following task typically used to clinically assess awareness. Both experiments use sham- and polarity-controlled, randomised, double-blind, crossover designs. In Experiment 1, 22 participants received anodal, cathodal, and sham M1-tDCS sessions while in the MRI scanner. A further 22 participants received the same protocol with cb-tDCS in Experiment 2. We used Dynamic Causal Modelling of fMRI to characterise the effects of tDCS on brain activity and dynamics during simple thumb movements in response to command. We found that M1-tDCS increased thalamic excitation and that Cathodal cb-tDCS increased excitatory coupling from thalamus to M1. All these changes were polarity specific. Combined, our experiments demonstrate that tDCS can successfully modulate long range thalamo-cortical dynamics during command following via targeting of cortical regions. This suggests that M1- and cb-tDCS may allow PDOC patients to overcome the motor deficits at the root of their reduced responsiveness, improving their rehabilitation options and quality of life as a result.
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DOI：
10.1523/jneurosci.2184-09.2009
发表时间：
2009-07-15
期刊：
The Journal of neuroscience : the official journal of the Society for Neuroscience
影响因子：
--
作者：
Galea JM;Jayaram G;Ajagbe L;Celnik P
通讯作者：
Celnik P
影响因子：
2.7
作者：
Elliott, L;Walker, L
通讯作者：
Walker, L
影响因子：
4.9
作者：
Cummiford, Chelsea M.;Nascimento, Thiago D.;DaSilva, Alexandre F.
通讯作者：
DaSilva, Alexandre F.
影响因子：
2.5
作者：
Jang, Sung Ho;Ahn, Sang Ho;Kwon, Yong Hyun
通讯作者：
Kwon, Yong Hyun
基于ICA的人工制品去除和加速fMRI获取，以改善静止状态网络成像。
影响因子：
5.7
作者：
Griffanti L;Salimi-Khorshidi G;Beckmann CF;Auerbach EJ;Douaud G;Sexton CE;Zsoldos E;Ebmeier KP;Filippini N;Mackay CE;Moeller S;Xu J;Yacoub E;Baselli G;Ugurbil K;Miller KL;Smith SM
通讯作者：
Smith SM