Combining inhibitory and facilitatory repetitive transcranial magnetic stimulation (rTMS) treatment improves motor function by modulating GABA in acute ischemic stroke patients.

BACKGROUND: The combination of inhibitory and facilitatory repetitive transcranial magnetic stimulation (rTMS) can improve motor function of stroke patients with undefined mechanism. It has been demonstrated that rTMS exhibits a neuro-modulatory effect by regulating the major inhibitory neurotransmitter γ-aminobutyric acid (GABA) in other diseases. OBJECTIVES: To evaluate the effect of combined inhibitory and facilitatory rTMS on GABA in the primary motor cortex (M1) for treating motor dysfunction after acute ischemic stroke. METHODS: 44 ischemic stroke patients with motor dysfunction were randomly divided into two groups. The treatment group was stimulated with 10 Hz rTMS at the ipsilesional M1 and 1 Hz rTMS at the contralesional M1. The sham group received bilateral sham stimulation at the motor cortices. The GABA level in the bilateral M1 was measured by proton magnetic resonance spectroscopy (1H-MRS) at 24 hours before and after rTMS stimulation. Motor function was measured using the Fugl-Meyer Assessment (FMA). The clinical assessments were performed before and after rTMS and after 3 months. RESULTS: The treatment group exhibited a greater improvement in motor function 24 hours after rTMS compared to the sham group. The increased improvement in motor function lasted for at least 3 months after treatment. Following 4 weeks of rTMS, the GABA level in the ipsilesional M1 of the treatment group was significantly decreased compared to the sham group. Furthermore, the change of FMA score for motor function was negatively correlated to the change of the GABA:Cr ratio. Finally, the effect of rTMS on motor function outcome was partially mediated by GABA level change in response to the treatment (27.7%). CONCLUSIONS: Combining inhibitory and facilitatory rTMS can decrease the GABA level in M1, which is correlated to the improvement of motor function. Thus, the GABA level in M1 may be a potential biomarker for treatment strategy decisions regarding rTMS neuromodulatory interventions.

Proteomic analysis of Camellia sinensis (L.) reveals a synergistic network in the response to drought stress and recovery.

Drought is a crucial limiting factor for tea yield and quality. To systematically characterize the molecular response of tea plants to drought stress and its capacity to recover, we used iTRAQ-based comparative proteomic approach to investigate the effects of drought on protein expression profiles in tea seedlings subjected to different drought treatments. A total of 3274 proteins were identified, of which 2169 and 2300 showed differential expressions during drought and recovery, respectively. Functional annotation showed that multiple biological processes were regulated, suggesting that tea plants probably employed multiple and synergistic resistance mechanisms in dealing with drought stress. Hierarchical clustering showed that chlorophyll a/b-binding proteins were up-regulated in DB and RE, suggesting that tea plants might regulate expression of chlorophyll a/b-binding proteins to maintain the photosystem II function during drought stress. Abundant proteins involved in sulfur-containing metabolite pathways, such as glutathione, taurine, hypotaurine, methionine, and cysteine, changed significantly during drought stress. Among them, TL29 interacted with LHCb6 to connect S-containing metabolites with chlorophyll a/b-binding proteins. This suggests that sulfur-containing compounds play important roles in the response to drought stress in tea plants. In addition, the expression of PAL was up-regulated in DA and down-regulated in DB. Cinnamyl alcohol dehydrogenase, caffeic acid O-methyltransferase, and 4-coumarate-CoA ligase also showed significant changes in expression levels, which regulated the biosynthesis of polyphenols. The results indicate that slight drought stress might promote polyphenol biosynthesis, while serious drought stress leads to inhibition. The expression of lipoxygenase and short-chain dehydrogenase increased during slight drought stress and some volatile metabolite pathways were enriched, indicating that drought stress might affect the tea aroma. The study provides valuable information that will lay the foundation for studies investigating the functions of drought response genes in tea leaves.