Abstract
Bilateral motor training is a useful method for modifying corticospinal excitability. The effects of bilateral movement that are caused by artificial stimulation on corticospinal excitability have not been reported. We compared motor-evoked potentials (MEPs) of the primary motor cortex (M1) after conventional bilateral motor training and artificial bilateral movements generated by electromyogram activity of abductor pollicis brevis (APB) muscle-triggered peripheral nerve stimulation (c-MNS) and transcranial magnetic stimulation of the ipsilateral M1 (i-TMS). A total of three protocols with different interventions—bilateral finger training, APB-triggered c-MNS, and APB-triggered i-TMS—were administered to 12 healthy participants. Each protocol consisted of 360 trials of 30 min for each trial. MEPs that were induced by single-pulse TMS, short-interval intracortical inhibition (SICI), and intracortical facilitation (ICF) that were induced by paired-pulse TMS were assessed as outcome measures at baseline and at 0, 20, 40, and 60 min after intervention. MEP amplitude significantly increased up to 40 min post-intervention in all protocols compared to that at the baseline, although there were some differences in the changing pattern of ICF and SICI in each protocol. These findings suggest that artificial bilateral movement has the potential to increase the ipsilateral cortical excitability of the moving finger.
Highlights
Accepted: 28 December 2021The most common motor impairment that is seen among stroke survivors is paresis.Approximately 80% patients have upper arm paresis at the acute stage and 40% continue to have chronic upper arm paresis [1]
For the resting motor threshold (RMT) at baseline, a separate one-way ANOVA revealed a significant effect of intervention (F (2, 22) = 3.448, p = 0.05, ηp 2 = 0.239, 1 − β = 0.585)
The baseline RMT in the abductor pollicis brevis (APB)-triggered c-median nerve stimulation (MNS) was significantly higher than that in the bilateral finger movement training (BFT)
Summary
Accepted: 28 December 2021The most common motor impairment that is seen among stroke survivors is paresis.Approximately 80% patients have upper arm paresis at the acute stage and 40% continue to have chronic upper arm paresis [1]. Upper arm paresis limits the activities of daily living (ADL) [2]. Older adults frequently use bilateral hand movements to perform everyday activities [3]; patients with stroke minimally use their paretic hand in daily life despite significant improvements in their hand function [4]. A contributing factor is an abnormal increase in inter-hemispheric inhibition (IHI) in the unaffected hemisphere [5]. Bilateral motor training (BMT) is an effective method for improving post-stroke upper extremity function and the ability to perform ADL [6]. Reviews on BMT have emphasized its importance in improving upper arm function in patients with chronic stroke [7,8]. A hypothetical mechanism of recovery with BMT is the normalization of abnormal IHI [11].
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