Priming sensorimotor cortex to enhance task-specific training after subcortical stroke
Priming sensorimotor cortex to enhance task-specific training after subcortical stroke
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DOI：
10.1016/j.clinph.2013.11.020
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发表时间：
2014-07-01
影响因子：
4.7
通讯作者：
Byblow, Winston D.
中科院分区：
文献类型：
--
作者：
Ackerley, Suzanne J.;Stinear, Cathy M.;Byblow, Winston D.
目的：这项双盲假对照交叉研究调查了中风后初级感觉和运动皮层之间的相互作用及其对 Theta 突发刺激 (TBS) 的反应。方法：13 名患有上肢损伤的慢性皮质下中风患者进行了标准化灵活性训练，以同侧 M1 间歇性 TBS (iTBS(iM1))、对侧 M1 连续 TBS (cTBS(cM1)) 或假 TBS 为启动。检查了对感觉运动整合、皮质运动兴奋性、感觉和握力提升动力学的影响。结果：iTBS（iM1）后，麻痹性握力提升性能的改善伴随着训练期间同侧 M1 兴奋性的立即促进以及随后同侧短潜伏期传入抑制（SAI）的增加。经过 cTBS(cM1) 和训练后，精确握力提升性能得到改善，同时病灶 M1 兴奋性增加，但对病灶 SAI 没有影响。对感觉表现没有影响。结论：初级运动皮层 iTBS 不仅调节 M1 皮质脊髓兴奋性，还增加 M1 对感觉输入的接受性。意义：用 iTBS(iM1) 启动可以增强同侧感觉运动整合，并促进皮质下中风后更好质量的感觉运动训练。 (C) 2013 年国际临床神经生理学联合会。由爱思唯尔爱尔兰有限公司出版。保留所有权利。
Objective: This double-blind sham-controlled crossover study investigated the interactions between primary sensory and motor cortex after stroke and their response to Theta Burst Stimulation (TBS).Methods: Thirteen chronic subcortical stroke patients with upper limb impairment performed standardised dexterity training primed with ipsilesional M1 intermittent TBS (iTBS(iM1)), contralesional M1 continuous TBS (cTBS(cM1)) or sham TBS. The effects on sensorimotor integration, corticomotor excitability, sensation and grip-lift kinetics were examined.Results: After iTBS(iM1), improvements in paretic grip-lift performance were accompanied by an immediate facilitation of ipsilesional M1 excitability and a subsequent increase in ipsilesional short latency afferent inhibition (SAI) during training. Precision grip-lift performance improved after cTBS(cM1) and training, alongside increased ipsilesional M1 excitability with no effect on ipsilesional SAI. There were no effects on sensory performance.Conclusion: Primary motor cortex iTBS not only modulates M1 corticospinal excitability but also increases M1 receptiveness to sensory input.Significance: Priming with iTBS(iM1) may enhance ipsilesional sensorimotor integration and facilitate better quality sensorimotor training after subcortical stroke. (C) 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.