Abstract
BackgroundNon-invasive neuromodulation is an emerging therapy for children with early brain injury but is difficult to apply to preschoolers when windows of developmental plasticity are optimal. Transcranial static magnetic field stimulation (tSMS) decreases primary motor cortex (M1) excitability in adults but effects on the developing brain are unstudied.Objective/HypothesisWe aimed to determine the effects of tSMS on cortical excitability and motor learning in healthy children. We hypothesized that tSMS over right M1 would reduce cortical excitability and inhibit contralateral motor learning.MethodsThis randomized, sham-controlled, double-blinded, three-arm, cross-over trial enrolled 24 healthy children aged 10–18 years. Transcranial Magnetic Stimulation (TMS) assessed cortical excitability via motor-evoked potential (MEP) amplitude and paired pulse measures. Motor learning was assessed via the Purdue Pegboard Test (PPT). A tSMS magnet (677 Newtons) or sham was held over left or right M1 for 30 min while participants trained the non-dominant hand. A linear mixed effect model was used to examine intervention effects.ResultsAll 72 tSMS sessions were well tolerated without serious adverse effects. Neither cortical excitability as measured by MEPs nor paired-pulse intracortical neurophysiology was altered by tSMS. Possible behavioral effects included contralateral tSMS inhibiting early motor learning (p < 0.01) and ipsilateral tSMS facilitating later stages of motor learning (p < 0.01) in the trained non-dominant hand.ConclusiontSMS is feasible in pediatric populations. Unlike adults, tSMS did not produce measurable changes in MEP amplitude. Possible effects of M1 tSMS on motor learning require further study. Our findings support further exploration of tSMS neuromodulation in young children with cerebral palsy.
Highlights
Brain injury can result in cerebral palsy (CP) and lifelong disability for millions (A Kirton, 2013a; Oskoui et al, 2016)
Given its potential ease of application in young children and therapeutically relevant effects on M1 excitability, we aimed to evaluate whether Transcranial static magnetic field stimulation (tSMS) could alter M1 excitability and motor learning in typically developing children
The final sample of participants who consented and completed the study consisted of 24 participants (13 males)
Summary
Brain injury can result in cerebral palsy (CP) and lifelong disability for millions (A Kirton, 2013a; Oskoui et al, 2016). Randomized trials suggest that repetitive transcranial magnetic stimulation (rTMS) (Gillick et al, 2015; Kirton et al, 2016) and transcranial direct current stimulation (tDCS) (Kirton et al, 2017; Gillick et al, 2018) may enhance motor learning in hemiparetic children. Proof-of-principle studies have demonstrated that the enhancement of motor learning seen in adults with tDCS of the primary motor cortex (M1) (Reis et al, 2009) occurs in children (Ciechanski and Kirton, 2017; Cole et al, 2018). Transcranial static magnetic field stimulation (tSMS) decreases primary motor cortex (M1) excitability in adults but effects on the developing brain are unstudied
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