Modulation Of Motor Cortex Excitability Research Articles

P 84 Altered sensorimotor integration of afferent inhibition in patients with complex regional pain syndrome

Introduction: The complex regional pain syndrome (CRPS) is a chronic pain condition which frequently results in sensorimotor dysfunction of the affected limb. With respect to pathophysiology an impaired interaction in sensorimotor cortex has been hypothesized 1 . Sensorimotor interactions can be assessed through transcranial magnetic stimulation (TMS) that is preceded by an electrical stimulation of peripheral motor or sensory nerves (short/ long afferent inhibition; SAI/LAI). Previous studies revealed only minor alterations of LAI using peripheral motor stimulation in CRPS 2 . This study uses a more comprehensive assessment of SAI and LAI, induced by motor and sensory peripheral stimulation, to assess interaction of the sensorimotor system in CRPS. Methods : 13 unilateral upper limb affected patients with CRPS (9 females, 54 ± 17.8 years) and 11 controls (HCs; 8 females, 52± 18.3 years) received TMS on either hemisphere. SAI and LAI were induced by a motor (m_) or sensory (s_) median nerve stimulation preceded by TMS with 20ms (m_SAI) and 200ms (m_LAI) or 23ms (s_SAI) and 203ms (s_LAI), respectively 3 . Twenty paired and single TMS stimuli were randomly applied for each condition. Results: Pain levels were 5.1±1.5/10 at rest and 7.4±2.1/10 during movements. ANOVA revealed a significant group effect for patients vs. HCs on the affected side (F=2.2, p=0.048). Post hoc tests were corrected for multiple comparisons and showed reduced inhibition in patients after sensory stimulation (s_SAI: t=-2.51, p=0.04; s_LAI: t=-2.53 p=0.038) and motor stimulation with ISI 200ms (m_LAI: t=-2.62, p=0.032). Afferent sensorimotor inhibition was lower in patients with longer disease duration (r=-0.66, p=0.014). Discussion: We demonstrate altered sensorimotor integration of afferent inhibition in CRPS. Since afferent inhibition after sensory stimulation is thought to be mediated via interconnections especially between Brodmann area 3b of somatosensory and the motor cortex, our results complement existing literature about maladaptive cortical plasticity of these regions in CRPS 4,5 . Impairment in LAI, that is thought to involve higher-order somatosensory cortical areas and the posterior parietal cortex is in line with existing literature on chronic pain 2,4 . Future longitudinal investigation should evaluate intra- and intercortical sensorimotor integration systematically in CRPS to better understand their impact in development of sensorimotor symptoms. Literature: 1 Harris AJ. Cortical origins of pathological pain. Lancet 1999. 2 Morgante et al. Normal sensorimotor plasticity in complex regional pain syndrome with fixed posture of the hand. Mov Disord. 2017. 3 Sailer A, et al. Brain. 2003. 4 Chen et al. Modulation of motor cortex excitability by median nerve and digit stimulation. Exp Brain Res. 1999. 5 Pfannmöller et al. Investigations on maladaptive plasticity in the sensorimotor cortex of unilateral upper limb CRPS I patients. RNN. 2019.

Modulation of motor cortex excitability and plasticity using transcranial focused ultrasound

Modulation of motor cortex excitability and plasticity using transcranial focused ultrasound

The Effects of 1 mA tACS and tRNS on Children/Adolescents and Adults: Investigating Age and Sensitivity to Sham Stimulation.

The aim of this study was to investigate the effect of transcranial random noise (tRNS) and transcranial alternating current (tACS) stimulation on motor cortex excitability in healthy children and adolescents. Additionally, based on our recent results on the individual response to sham in adults, we explored this effect in the pediatric population. We included 15 children and adolescents (10–16 years) and 28 adults (20–30 years). Participants were stimulated four times with 20 Hz and 140 Hz tACS, tRNS, and sham stimulation (1 mA) for 10 minutes over the left M1HAND. Single-pulse MEPs (motor evoked potential), short-interval intracortical inhibition, and facilitation were measured by TMS before and after stimulation (baseline, 0, 30, 60 minutes). We also investigated aspects of tolerability. According to the individual MEPs response immediately after sham stimulation compared to baseline (Wilcoxon signed-rank test), subjects were regarded as responders or nonresponders to sham. We did not find a significant age effect. Regardless of age, 140 Hz tACS led to increased excitability. Incidence and intensity of side effects did not differ between age groups or type of stimulation. Analyses on responders and nonresponders to sham stimulation showed effects of 140 Hz, 20 Hz tACS, and tRNS on single-pulse MEPs only for nonresponders. In this study, children and adolescents responded to 1 mA tRNS and tACS comparably to adults regarding the modulation of motor cortex excitability. This study contributes to the findings that noninvasive brain stimulation is well tolerated in children and adolescents including tACS, which has not been studied before. Finally, our study supports a modulating role of sensitivity to sham stimulation on responsiveness to a broader stimulation and age range.

P144 TDCS intensity-dependent online modulation of motor cortex excitability: A combined TDCS-TMS study

P144 TDCS intensity-dependent online modulation of motor cortex excitability: A combined TDCS-TMS study

FV 1 Cholinergic brain structure and sensory-afferent modulation of motor cortex excitability

Introduction The basal forebrain provides important output within the cholinergic system. The cholinergic system may also influence the effects of paired associative stimulation (PAS), a plasticity inducing protocol involving paired median nerve and motor cortex stimulation, and short latency afferent inhibition (SAI) in which a median nerve sensory afferent stimulus induces short lasting conditioning effects on motor cortex excitability. The responses to either PAS or SAI can be variable. Here we hypothesized that the basal forebrain structural characteristics, or those of the thalamus as important sensory-afferent relay station with cholinergic input, relate to the functional influence of the cholinergic system measured using PAS or SAI. We therefore asked whether structural variability in these cholinergic brain areas could explain some of that functional variability observed with PAS or SAI. Material and methods Forty healthy volunteers (12 male; mean age 60, range 26–81) underwent a facilitatory PAS protocol with an inter-stimulus interval (ISI) of around 25 ms. An LTP-like facilitatory response was defined as an increase post-PAS of MEP amplitude of at least 10% relative to pre-PAS MEP size. SAI employed median nerve condition of motor cortex stimulation with inhibitory as well as facilitatory ISIs. We obtained T1 MPRAGE sequences on a 3T MRI scanner. MRI data were processed using Statistical Parametric Mapping and the CAT12 Toolbox (http://www.neuro.uni-jena.de/cat/) implemented in Matlab 2015a. Volumes of the basal forebrain were determined using a stereotactic atlas based on combined postmortem MRI and histological examination of cholinergic nuclei. As it is based on the histological examination of a single brain specimen and may not generalize across individuals, we also used volumes of right and left BFCS as obtained from the CAT12 toolbox. We used ANOVA models for group comparisons of responders and non-responders to PAS or SAI. Results Nineteen participants (48%) had an LTP-like response to PAS. Age, sex, or motor thresholds did not predict the PAS response. SAI had inhibitory effects in 80% of participants (n = 32). There was no association between the amount of PAS effects and the SAI response. Basal forebrain and right thalamus volumes were larger in SAI responders while volumes were similar in PAS responders and non-responders. Discussion The results suggest that a larger basal forebrain cholinergic output system, and a larger thalamus as sensory-afferent relay station that receives cholinergic input facilitate the short lasting modulation of motor cortex excitability in the SAI paradigm. This could be because of higher cholinergic tone. The cholinergic system may be less important in longer lasting modulation of motor cortex excitability in the PAS paradigm where an LTP-like response may involve more GABA-ergic neurotransmission.

P18 TDCS intensity-dependent online modulation of motor cortex excitability: a combined TDCS-TMS study

P18 TDCS intensity-dependent online modulation of motor cortex excitability: a combined TDCS-TMS study

Corticospinal excitability is modulated by distinct movement patterns during action observation.

It is well established that excitability of the primary motor cortex increases during action observation. However, the modulation of motor cortex excitability during observation of different actions, with distinct movement patterns, is not fully understood. The aim of the current study was to examine time-dependent changes in corticospinal excitability during observation of two actions with different levels of complexity. We developed videos of two distinct actions (a point and a reach-and-grasp), that were matched in video length, action onset, and onset of kinematics. Single-pulse transcranial magnetic stimulation was used to investigate time-dependent changes in primary motor cortex excitability during observation of the two actions. Motor evoked potentials (MEP) were recorded from two intrinsic hand muscles, namely first dorsal interosseous (FDI) and abductor digiti minimi. Results showed no difference in MEP amplitude during observation of a static hand compared to observation of the actions. When comparing the point to the grasp action, there were two key findings showing time-dependent changes in motor cortex excitability: first, greater MEP amplitude in FDI during observation of the point than the grasp action at an early time-point (index finger extension) and second, greater MEP amplitude in FDI during observation of the grasp than the point action at a later time-point (hand opening to form a grasp). These results show that excitability of the primary motor cortex is differentially modulated during observation of a point and grasp action, suggesting that the action observation network is engaged in a time-dependent manner during action observation.

Modulation of motor cortex excitability by paired peripheral and transcranial magnetic stimulation.

Repetitive application of peripheral electrical stimuli paired with transcranial magnetic stimulation (rTMS) of M1 cortex at low frequency, known as paired associative stimulation (PAS), is an effective method to induce motor cortex plasticity in humans. Here we investigated the effects of repetitive peripheral magnetic stimulation (rPMS) combined with low frequency rTMS ('magnetic-PAS') on intracortical and corticospinal excitability and whether those changes were widespread or circumscribed to the cortical area controlling the stimulated muscle. Eleven healthy subjects underwent three 10min stimulation sessions: 10HzrPMS alone, applied in trains of 5 stimuli every 10s (60 trains) on the extensor carpi radialis (ECR) muscle; rTMS alone at an intensity 120% of ECR threshold, applied over motor cortex of ECR and at a frequency of 0.1Hz (60 stimuli) and magnetic PAS, i.e., paired rPMS and rTMS. We recorded motor evoked potentials (MEPs) from ECR and first dorsal interosseous (FDI) muscles. We measured resting motor threshold, motor evoked potentials (MEP) amplitude at 120% of RMT, short intracortical inhibition (SICI) at interstimulus interval (ISI) of 2ms and intracortical facilitation (ICF) at an ISI of 15ms before and immediately after each intervention. Magnetic-PAS, but not rTMS or rPMS applied separately, increased MEP amplitude and reduced short intracortical inhibition in ECR but not in FDI muscle. Magnetic-PAS can increase corticospinal excitability and reduce intracortical inhibition. The effects may be specific for the area of cortical representation of the stimulated muscle. Application of magnetic-PAS might be relevant for motor rehabilitation.

Modulation of motor cortex excitability predicts antidepressant response to prefrontal cortex repetitive transcranial magnetic stimulation

BackgroundRepetitive transcranial magnetic stimulation (rTMS) targeting the left dorsolateral prefrontal cortex (DLPFC) is a treatment option for patients with medication-resistant major depressive disorder (MDD). However, antidepressant response is variable and there are currently no response predictors with sufficient accuracy for clinical use. ObjectiveWe report on results of an observational open-label study to determine whether the modulatory effect of 10 Hz motor cortex (MC) rTMS is predictive of the antidepressant effect of 10 Hz DLPFC rTMS. MethodsFifty-one medication-resistant MDD patients were enrolled for a 10-day treatment course of DLPFC rTMS and antidepressant response was assessed according to post-treatment reduction of the 17-item Hamilton Rating Scale for Depression score. Prior to treatment, we assessed the modulation of motor evoked potential (MEP) amplitude by MC rTMS. MEP's were induced with single TMS pulses and measured using surface electromyography. MEP modulation was calculated as the change of mean MEP amplitude after MC rTMS. ResultsMEP modulation proved to be a robust predictor of reduction of clinician-rated depression severity following the course of DLPFC rTMS: larger MC rTMS-induced increase of corticospinal excitability anticipated a better antidepressant response. This was found both in univariate analyses (Spearman regression: rho = 0.43, p < 0.005) and a multivariable linear regression model (β = 0.25, p < 0.0001) controlling for baseline depression severity, age and resting motor threshold. ConclusionsThese findings suggest that MC rTMS-induced modulation of corticospinal excitability warrants further evaluation as a potential predictive biomarker of antidepressant response to left DLPFC 10 Hz rTMS.

P037 Transcranial static magnetic field stimulation-induced modulation of motor cortex excitability in Parkinson’s disease

Question tSMS is a new non-pharmacological, low-cost, non-invasive brain stimulation (NIBS) technique that decreases cortical excitability in healthy subjects. The effects of tSMS in Parkinson’s disease remain unknown. We designed this study to test the ability of transcranial static magnetic field stimulation (tSMS) to modulate motor cortex excitability in patients with Parkinson’s disease. Methods We performed a randomized double-blind sham-controlled cross-over study to assess cortical excitability before and immediately after tSMS (or sham) applied for 10 min to the motor cortex of patients with Parkinson’s disease. Motor cortex excitability was quantified by the amplitude of motor evoked potentials (MEPs) elicited by single-pulse transcranial magnetic stimulation (TMS). In a separated single-blind experimental session we evaluated the effects of tSMS on SICI and SICF. Patients were studied both after overnight withdrawal of dopaminergic therapy (OFF) medication and after an acute dose of levodopa (ON). Results tSMS significantly decreased MEP amplitudes compared to sham in patients OFF medication, but not ON medication. Furthermore, tSMS induced an increase in SICI and a reduction in SICF only in OFF condition. Conclusions These results suggest a dopamine dependency of tSMS-induced cortical changes and encourage the application of tSMS for future clinical trials in patients with Parkinson’s disease.

Long-latency modulation of motor cortex excitability by ipsilateral posterior inferior frontal gyrus and pre-supplementary motor area.

The primary motor cortex (M1) is strongly influenced by several frontal regions. Dual-site transcranial magnetic stimulation (dsTMS) has highlighted the timing of early (<40 ms) prefrontal/premotor influences over M1. Here we used dsTMS to investigate, for the first time, longer-latency causal interactions of the posterior inferior frontal gyrus (pIFG) and pre-supplementary motor area (pre-SMA) with M1 at rest. A suprathreshold test stimulus (TS) was applied over M1 producing a motor-evoked potential (MEP) in the relaxed hand. Either a subthreshold or a suprathreshold conditioning stimulus (CS) was administered over ipsilateral pIFG/pre-SMA sites before the TS at different CS-TS inter-stimulus intervals (ISIs: 40–150 ms). Independently of intensity, CS over pIFG and pre-SMA (but not over a control site) inhibited MEPs at an ISI of 40 ms. The CS over pIFG produced a second peak of inhibition at an ISI of 150 ms. Additionally, facilitatory modulations were found at an ISI of 60 ms, with supra- but not subthreshold CS intensities. These findings suggest differential modulatory roles of pIFG and pre-SMA in M1 excitability. In particular, the pIFG –but not the pre-SMA– exerts intensity-dependent modulatory influences over M1 within the explored time window of 40-150 ms, evidencing fine-tuned control of M1 output.

Modulation of motor cortex excitability by peripheral magnetic stimulation of different stimulus sites and frequencies.

Peripheral stimulation is known to influence the state of cortical excitability. The purpose of this study is to investigate whether peripheral magnetic stimulation has similar effects on cortical excitability to transcranial magnetic stimulation (TMS). A magnetic stimulator with a flat figure-of-eight coil was used for both TMS, and peripheral magnetic stimulation applied to the bilateral forearms. TMS was performed on the left primary motor cortex to evaluate influence of the peripheral magnetic stimulation, and motor evoked potential (MEP) was measured from the right first dorsal interosseous. Peripheral magnetic stimulation was performed at a stimulus frequency of 1 Hz or 10 Hz, to the stimulus sites on the right and left supination of the forearm. The effects of peripheral magnetic stimulation were evaluated by comparing the mean MEP amplitude elicited by TMS before and after peripheral magnetic stimulation. We found that cortical excitability varied according to the stimulation site and frequency of the peripheral magnetic stimulation. The inhibition of cortical excitability was observed following 1 Hz peripheral magnetic stimulation over the right forearm (p<;0.001). In contrast, increased cortical excitability was observed using 1 Hz peripheral magnetic stimulation over the left forearm and 10 Hz stimulation over either the right or left forearms. We suggest that peripheral magnetic stimulation has a similar effect to TMS, and can induce both facilitation and inhibition of cortical excitability.

Reduced afferent-induced facilitation of primary motor cortex excitability in restless legs syndrome

Restless legs syndrome (RLS) is characterized by the association of an urge to move, and vesperal or nocturnal sensory symptoms; it is frequently associated with periodic limb movements. Evidence from imaging and electrophysiological studies suggests that RLS is linked to changes in sensorimotor integration. Nevertheless, the underlying mechanisms have not been characterized, and the cortical origin has yet to be confirmed.The objective of the present study was to establish whether or not sensorimotor integration in RLS patients is impaired in the evening. The time-dependent modulation of motor cortex excitability following peripheral electric nerve stimulation was studied in 14 idiopathic RLS patients, and 14 paired healthy controls. Different inter-stimulus intervals were used to measure short-latency and long-latency afferent inhibition (SAI and LAI) and afferent-induced facilitation (AIF). Motor evoked potentials were recorded from the first dorsal interosseous muscle in two experimental sessions (one in the morning and one in the evening).With the exception of LAI (which was present in the morning but absent in the evening in both healthy controls and RLS patients), no circadian variations were observed in sensorimotor integration. Although SAI was present in patients with RLS, AIF was disrupted (relative to controls) – suggesting the presence of an indirect sensorimotor integration disorder affecting the long corticocortical pathways in patients with RLS. The lack of circadian modulation in sensorimotor integration suggests that clinical circadian variations have other causes.

Sex-Specific Automatic Responses to Infant Cries: TMS Reveals Greater Excitability in Females than Males in Motor Evoked Potentials.

Neuroimaging reveals that infant cries activate parts of the premotor cortical system. To validate this effect in a more direct way, we used event-related transcranial magnetic stimulation (TMS). Here, we investigated the presence and the time course of modulation of motor cortex excitability in young adults who listened to infant cries. Specifically, we recorded motor evoked potentials (MEPs) from the biceps brachii (BB) and interosseus dorsalis primus (ID1) muscles as produced by TMS delivered from 0 to 250 ms after sound onset in six steps of 50 ms in 10 females and 10 males. We observed an excitatory modulation of MEPs at 100 ms from the onset of infant cry specific to females and to the ID1 muscle. We regard this modulation as a response to natural cry sounds because it was attenuated to stimuli increasingly different from natural cry and absent in a separate group of females who listened to non-cry stimuli physically matched to natural infant cries. Furthermore, the 100-ms latency of this response is not compatible with a voluntary reaction to the stimulus but suggests an automatic, bottom-up audiomotor association. The brains of adult females appear to be tuned to respond to infant cries with automatic motor excitation.

Cortical Excitability During Passive Action Observation in Hospitalized Adults With Subacute Moderate to Severe Traumatic Brain Injury

Studies indicate that motor functions in patients with traumatic brain injury (TBI) can be improved with action observation. It has been hypothesized that this clinical practice relies on modulation of motor cortical excitability elicited by passive action observation in patients with TBI, a phenomenon shown thus far only in normal controls. The purpose of this work was to test this hypothesis and characterize the modulation of motor cortex excitability during passive action observation in patients with subacute moderate to severe TBI. We measured motor evoked potentials induced by single-pulse transcranial magnetic stimulation to the left primary motor cortex and recorded from the contralateral first dorsal interosseus while 20 participants observed videos of static and moving right index finger. Results were compared with those of 20 age-and gender-matched healthy controls. As expected, greater excitability was elicited during moving than static stimuli in healthy subjects. However, this was not observed in patients with TBI. Modulation of motor excitability during action observation is impaired in patients with TBI depending on motor dysfunction, lesion site, and number of days postinjury. These preliminary results suggest a strategy to identify patients in whom action observation might be a valuable neurorehabilitative strategy.

27. Modulation of motor cortex excitability and brain activation in professional pianists during music listening: A combined EEG and TMS study

Neuroimaging studies have reported mirroring motor activation to music listening in musicians. Actual corticospinal modulation remains to be clarified. We tested the motor cortex modulation in pianists while listening to well-known, predictable melodic sequences, using Transcranial Magnetic Stimulation (TMS) and electroencephalography (EEG). Two groups of subjects were studied: pianists (n = 10) and controls (n = 10). Participants listened to a melodic sequence containing the alternating repetition of a scale in two different octaves. Using a circular coil on the vertex, Motor Evoked Potentials (MEP) were recorded bilaterally on both hands at different time points, with 32 channels EEG monitoring. EEG event-related desynchronization (ERD) of the mu rhythm was assessed by comparing its spectral power during listening vs rest. Pianists, not controls, showed modulation of MEPs amplitude of right hand muscles according to the timing of their activation during actual performance. Left sensori-motor frontal mu ERD to the melodic sequence played with the right hand was present in 9 pianists vs 4 control. The dynamic auditory induced motor resonance to music listening observed in pianists suggests the presence of an audio-motor mirror system that can be related to the ability of musician to confer a gestural meaning to well-known melodies.

Modulation of motor cortex excitability in obsessive-compulsive disorder: An exploratory study on the relations of neurophysiology measures with clinical outcome

Low-frequency repetitive transcranial magnetic stimulation (rTMS) to supplementary motor area (SMA) showed clinical benefit in obsessive-compulsive disorder (OCD). Here we tested whether clinical improvement was associated with enhanced cortical inhibition as measured by single and paired-pulse TMS variables. In 18 OCD patients receiving 4 weeks of either active or sham rTMS in a double-blind randomized trial, we assessed bilateral resting and active motor thresholds (RMT and AMT), cortical silent period (CSP), short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF). We tested correlations between changes in Yale-Brown Obsessive Compulsive Scale-Self-report (Y-BOCS-SR), Clinical Global Impression-Severity subscale (CGI-S) and cortical excitability measures. Active rTMS increased right hemisphere RMT whose change correlated with Y-BOCS-SR improvement. Baseline RMT hemispheric asymmetry, defined as the difference between left and right hemispheres RMT, and its normalization after active rTMS correlated with Y-BOCS-SR and CGI-S improvements. Active rTMS also increased right hemisphere SICI whose change correlated with Y-BOCS-SR and CGI-S at week 4, and with normalization of baseline RMT hemispheric asymmetry. Treatment-induced changes in cortical excitability measures are consistent with an inhibitory action of SMA rTMS on dysfunctional motor circuits in OCD. Correlations of neurophysiology measures with therapeutic outcome are supportive of the role of SMA in the modulation of OCD symptoms.

P 175. Modulation of motor cortex excitability and skilled task learning

Question Primary motor cortex (M1) is the principal cortical motor output and thus should be involved in motor learning. Theta burst stimulation (TBS) provides a mean for a non-invasive transient modulation of cortical activity and excitability of the targeted cortical area. In this study we aimed to check whether changes in M1 excitability induced by facilitatory and inhibitory TBS protocols can affect learning of a skilled movement with non-dominant hand. Methods 30 right-handed healthy subjects (mean age 25 ± 7 y, 12 women) participated in the study. They were divided into three experimental groups (10 subject each) according to the intervention they had: (1) facilitatory, intermittent TBS (iTBS) protocol-the iTBS group; (2) inhibitory, continuous TBS (cTBS) protocol-the cTBS group; and (3) placebo, sham iTBS protocol-Placebo group. During iTBS protocol, short bursts of 50 Hz stimulation (3 pulses of 80% aMT) were applied at 5 Hz in 2 s trains every 10 s, for a total of 600 pulses. The cTBS protocol was the same except that bursts were applied continuously (600 pulses in total). The sham iTBS protocol was the same as the iTBS protocol, but a placebo coil was used. Motor cortex hand area for the non-dominant side was targeted. Motor cortex excitability was assessed by measuring motor evoked potentials (MEP) from the first dorsal interosseus muscle (single pulse TMS at 120% rMT). Motor performance was evaluated using Purdue peg-board (PPB) test and simple reaction time (RT) at 3 time-points: before (B), immediately after (T0), and at 30 (T30) min following TBS intervention. Results For MEP results (Fig. 1), ANOVA showed significant effects of factor Group-post hoc pair-wise analyses showed as significant differences between all groups. However, significant was Group × Time interaction as well: following placebo, MEPs remained unchanged in comparison to time B; following iTBS, MEPs increased significantly at T0, but then returned towards the baseline at T30; in contrast, following cTBS, MEPs were significantly reduced at both T0 and T30. For PPB results (Fig. 2), ANOVA showed significant effects of both factors, Group and Time. Post-hoc pair-wise analyses showed that cTBS differed significantly from both iTBS and Placebo groups, while the latter two did not differ. However, Group × Time interaction was significant as well: following placebo, number of pegs positioned on PBB test increased significantly at T0 in comparison to B, and continued with significant increase towards T30; following iTBS results on PBB test also increased significantly at T0, but subsequently remained at the same level up to T30 (although difference between Placebo and iTBS at T30 was not significant); following cTBS, the number of pegs did not change or decreased slightly at T0, only to show significant increase afterwards towards T30 (but still significantly below Placebo). RT did not change following either of the stimulation procedures. Conclusion Results suggest that changes in M1 excitability are of only partial functional significance for early phases of motor learning in healthy people. Decrease of excitability can considerably reduce efficiency of learning for up to 30 min. In contrast, increase of excitability seems not able to bring any additional improvement over one that is seen spontaneously and may even have mild disruptive effect. Alternatively, achieved increase of M1 excitability may have been below the threshold for inducing learning changes.

IS 17. Effects of focal static magnetic fields on the human cortex

The non-invasive modulation of motor cortex excitability by the application of static magnetic fields through the scalp was investigated in healthy humans. Static magnetic fields were obtained by using cylindrical NdFeB magnets. (tSMS) in conscious subjects. We observed an average reduction of motor cortex excitability of up to 25%, as revealed by TMS, which lasted for several minutes after the end of 10min of static magnetic field stimulation (tSMS). The effect of tSMS was dose-dependent (intensity of the magnetic field) and duration dependent, but not polarity-dependent. We used transcranial electric stimulation (TES) to establish that the tSMS-induced reduction of motor cortex excitability was not due to corticospinal axon and/or spinal excitability, but specifically involved intracortical networks. We further explored the tSMS effects on EEG oscillations in the visual cortex and during visual attentional performance in healthy humans. We specifically examined the hypothesis that these effects could be related to an increase of alpha band activity, and therefore, associated to an inhibitory effect. During real but not sham tSMS over the visual cortex, there was a significant increase of the alpha band power. Moreover, we observed a similar reaction time (RTs) pattern during real and sham tSMS for most of trials. However, a significant slowing of RTs emerged across those trials with a higher difficulty levels during real in comparison to sham tSMS . Further studies using tSMS are required to extend the knowledge of the functional significance of cortical excitability changes and brain oscillations changes induced by the application of small magnets over the scalp. These results suggest that tSMS using small static magnets may be a promising tool to modulate cerebral excitability in a non-invasive, painless, and reversible way.

Differential modulation of motor cortex excitability in BDNF Met allele carriers following experimentally induced and use‐dependent plasticity

The purpose of this study was to investigate how healthy young subjects with one of three variants of the brain-derived neurotrophic factor (BDNF) gene modulate motor cortex excitability following experimentally induced and use-dependent plasticity interventions. Electromyographic recordings were obtained from the right first dorsal interosseous (FDI) muscle of 12 Val/Val, ten Val/Met and seven Met/Met genotypes (aged 18-39 years). Transcranial magnetic stimulation of the left hemisphere was used to assess changes in FDI motor-evoked potentials (MEPs) following three separate interventions involving paired associative stimulation, a simple ballistic task and complex visuomotor tracking task using the index finger. Val/Val subjects increased FDI MEPs following all interventions (≥ 25%, P < 0.01), whereas the Met allele carriers only showed increased MEPs after the simple motor task (≥ 26%, P < 0.01). In contrast to the simple motor task, there was no significant change in MEPs for the Val/Met subjects (7%, P = 0.50) and a reduction in MEPs for the Met/Met group (-38%, P < 0.01) following the complex motor task. Despite these differences in use-dependent plasticity, the performance of both motor tasks was not different between BDNF genotypes. We conclude that modulation of motor cortex excitability is strongly influenced by the BDNF polymorphism, with the greatest differences observed for the complex motor task. We also found unique motor cortex plasticity in the rarest form of the BDNF polymorphism (Met/Met subjects), which may have implications for functional recovery after disease or injury to the nervous system in these individuals.