MECHANISMS OF ACTION OF TMS-INDUCED PERFORMANCE ENCHANCEMENT

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 背景和目的：本文提出的研究计划的长期目的是研究TMS提高人类表现的作用机制。众所周知，如果应用得当，TMS可以改变人类的表现。无论是急性的还是慢性的，TMS诱导的表现增强的作用机制还不是很清楚。我们假设单次TMS引起的短暂性操作增强是通过刺激部位神经元兴奋性的增加(目标1)，而不是通过增加连接性或募集来实现的。对于多节段TMS，我们假设TMS辅助治疗与单独的运动练习相比将提高学习速度和最大表现，但TMS本身并不能改善运动表现的这两个参数(具体目标2)。我们还假设，TMS对SMA手的佐剂将比TMS对M1手的佐剂对运动学习有更大的影响(目标2)。我们假设，对于单独的运动练习和TMS辅助治疗：1.学习速度将与增加的连接性相关：3.增加的兴奋性将与这两个性能变量中的任何一个变量无关(特定目标3)。 研究计划和方法：该提案将使用几种非侵入性成像和电生理技术。功能磁共振成像将评估在运动过程中招募的皮质体积的变化。TMS和PET将共同用于检测区域间连通性的增强。TMS/PET和包括运动诱发电位(MEP)在内的电生理测量将用于检测神经元兴奋性的变化。这些拟议的实验将确定单会话M1-Hand TMS增强电机性能的作用机制。他们还将确定多节M1-Hand和SMA-Hand TMS作为练习诱导的运动能力增强的佐剂的有效性。此外，这项研究将比较练习诱导的运动学习、单独使用TMS和TMS作为辅助提高运动能力的作用机制。这里提出的研究计划将创建一个知识库，为TMS的合理发展提供信息，将其作为辅助治疗与初级治疗一起用于治疗神经、精神和发育障碍。我们预测，拟议研究的结果将对中风的管理产生直接影响，中风是美国第三大死亡原因。中风残留症状的治疗主要以物理治疗和作业治疗为主。将TMS作为理疗的辅助手段，将降低卒中患者的发病率，提高患者的生活质量。这项研究的发现也将阐明TMS的作用机制，TMS正被用作抑郁症的辅助治疗。 这项研究对受试者没有治疗或诊断价值。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. BACKGROUND AND OBJECTIVE: The long-range purpose of the research program presented here is to study the mechanisms of action by which TMS enhances human performance. It is well-established that, when properly applied, TMS can alter human performance. The mechanisms of action underlying TMS-induced performance enhancements, both acute and chronic, are not well understood. We hypothesize that the transient performance enhancement induced by single-session TMS is mediated by increased neuronal excitability at the stimulated site (Aim 1), but not by increased connectivity or recruitment. For multi-session TMS, we hypothesize that TMS adjuvant treatment will increase rate of learning and maximum performance achieved in comparison to motor practice alone, but that TMS alone will not improve either parameter of motor performance (Specific Aim 2). We also hypothesize that adjuvant TMS to SMA hand will have a greater effect on motor learning than adjuvant TMS to M1 hand (Aim 2). We hypothesize that for both motor practice alone and TMS adjuvant therapy: 1. rate of learning will be correlated with increased connectivity: and 3. increased excitability will not be correlated with either performance variable (Specific Aim 3). RESEARCH PLAN AND METHODS: The proposal will use several non invasive imaging and electrophysiological techniques. Functional MRI will assess alterations in the volume of cortex recruited during performance. TMS and PET will be used cojointly to detect enhancements in inter-regional connectivity. TMS/PET and electrophysiological measures including motor-evoked potentials (MEP) will be used to detect alterations in neuronal excitability. These proposed experiments will determine the mechanisms of action used by single-session M1-hand TMS enhanced motor performance. They will also determine the efficacy of multi-session M1-hand and SMA-hand TMS as adjuvants to practive-induced enhancement of motor performance. Further, this study will compare the mechanisms of action of practice-induced motor learning, TMS-alone and TMS as a adjuvant for enhancement of motor performance. The research program presented here will create a knowledge base which will inform the rational development of TMS as adjuvant treatment to be used in conjunction with primary therapies in the tratment of neurological, psychiatric and developmental disorders. We predict that the results from the proposed studies will have direct impact on the managemtn of stroke which is the third leading cause of death in the US. Treatment of residual sympomos of stroke is mainly physical and occupational therapy. Applying TMS as an adjunct to physical therapy will reduce morbidity and improve quality of life of stroke patients. The findings from this study will also shed light on the mechanism of action of TMS that is being used as an adjunct therapy in depression. This study does not have therapeutic or diagnostic value to subjects.