Abstract
The corticospinal system and local spinal circuits control human bipedal locomotion. The primary motor cortex is phase-dependently activated during gait; this cortical input is critical for foot flexor activity during the swing phase. We investigated whether gait-combined rhythmic brain stimulation can induce neuroplasticity in the foot area of the motor cortex and alter gait parameters. Twenty-one healthy subjects participated in the single-blinded, cross-over study. Each subject received anodal transcranial patterned direct current stimulation over the foot area of the right motor cortex during gait, sham stimulation during gait, and anodal transcranial patterned direct current stimulation during rest in a random order. Six subjects were excluded due to a failure in the experimental recording procedure. Complete-case analysis was performed using the data from the remaining 15 subjects. Self-paced gait speed and left leg stride length were significantly increased after the stimulation during gait, but not after the sham stimulation during gait or the stimulation during rest. In addition, a significant increase was found in the excitability of the corticospinal pathway of the left tibialis anterior muscle 30 min after stimulation during gait. Anodal transcranial patterned direct current stimulation during gait entrained the gait cycle to enhance motor cortical activity in some subjects. These findings suggest that the stimulation during gait induced neuroplasticity in corticospinal pathways driving flexor muscles during gait.
Highlights
During human bipedal locomotion, cortical and supraspinal projections control posture and leg movements in coordination with the spinal locomotor system [1]
There were no adverse effects of Transcranial magnetic stimulation (TMS) and transcranial alternating current stimulation (tACS) with a constant direct current (DC) offset
No participants exhibited significant phase synchronization index (PSI) [average PSI (± standard deviation (SD)): 0.38 ± 0.28, 95% confidence interval (CI): 0.292–0.997], suggesting that they did not sense the rhythmicity of stimulation during tACS
Summary
Cortical and supraspinal projections control posture and leg movements in coordination with the spinal locomotor system [1]. Patterned rhythmic transcranial direct current stimulation (tDCS) such as transcranial alternating current stimulation (tACS) [8,9,10,11,12] and tACS with a constant direct current (DC) offset [13,14,15], are noninvasive methods of modulating brain activity. These approaches can modulate intrinsic brain rhythmicity, thereby altering sensorimotor and cognitive functions [16,17,18,19,20,21,22]. The main outcome measure was gait parameters, and the secondary measure was M1 excitability controlling a tibialis anterior (TA) muscle as one of foot flexor muscles
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