Corticospinal excitability modulation by pairing peripheral nerve stimulation with cortical states of movement initiation.

KEY POINTS: We compare the effects on corticospinal excitability of repeatedly delivering peripheral nerve stimulation at three time points (-30 ms, 0 ms, +50 ms) relative to muscle onset in a cue-guided task. Plastic changes in excitability are only observed when stimuli are delivered immediately before the time when muscles activate, while stimuli delivered at muscle onset or shortly later (0, +50 ms) have no effect. Plastic effects are abolished if there is ongoing volitional electromyogram activity in the muscles prior to the onset of the phasic contraction. The plastic effects induced by timing peripheral stimulation relative to electromyographic markers of muscle activation are as effective as those that occur if stimulation is timed relative to electroencephalographic markers of motor cortical activation. We provide a simple alternative protocol to induce plasticity in people in whom electroencephalogram recording is difficult. ABSTRACT: Plastic changes in corticospinal excitability (CSE) and motor function can be induced in a targeted and long-term manner if afferent volleys evoked by peripheral nerve stimulation are repeatedly associated with the peak of premovement brain activity assessed with an electroencephalogram (EEG). The present study investigated whether other factors might also characterize this optimal brain state for plasticity induction. In healthy human volunteers (n = 24), we found that the same reliable changes in CSE can be induced by timing peripheral afferent stimulation relative to the onset of electromyogram (EMG) activity rather than using the EEG peak. Specifically, we observed an increase in CSE when peripheral stimulation activated the cortex just before movement initiation. By contrast, there was no effect on CSE if the afferent input reached the cortex at the same time or after EMG onset, consistent with the idea that the temporal order of synaptic activation from afferent input and voluntary movement is important for production of plasticity. Finally, in 14 volunteers, we found that background voluntary muscle activity prior to movement also abolished the effect on CSE. One possible explanation is that the intervention strengthens synapses that are inactive at rest but change their activity in anticipation of movement, and that the intervention fails when the synapses are tonically active during background EMG activity. Overall, we demonstrate that, in individuals with voluntary control of muscles targeted by our intervention, EMG signals are a suitable alternative to an EEG for inducing plasticity by coupling movement-related brain states with peripheral afferent input.

The effects of repetitive transcranial magnetic stimulation on the cognition and neuronal excitability of mice.

This study aimed to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on the cognition and neuronal excitability of Kunming mice during the natural aging of the brain. Twenty young (2-3-month-old) female mice, 20 adult (9-10-month-old) female mice and 12 aged (14-15-month-old) female mice were divided into two groups (control and rTMS treatment). rTMS-treated groups were subjected to high-frequency (20 Hz) rTMS treatment for 15 days. Novel object recognition (NOR) and step-down tests were performed to examine cognition of learning and memory. The whole-cell patch clamp technique was used to record the resting membrane potential (RMP) and action potential (AP), and the intrinsic properties of the AP were analyzed (the frequence of AP, the after hyperpolarizing potential (AHP), the AP peak amplitude, the time to AP amplitude, the average rise/down slope). Results showed that the cognition and neuronal excitability of hippocampal dentate gyrus (DG) granule cells were significantly declined only in aged animals while no statistic differences were found between young and adult animals. Chronic high-frequency rTMS could significantly improve the age-related cognitive impairment in parallel with enhancing the DG granule cells' neuronal excitability.

Magnetic stimulation at Neiguan (PC6) acupoint increases connections between cerebral cortex regions.

Stimulation at specific acupoints can activate cortical regions in human subjects. Previous studies have mainly focused on a single brain region. However, the brain is a network and many brain regions participate in the same task. The study of a single brain region alone cannot clearly explain any brain-related issues. Therefore, for the present study, magnetic stimulation was used to stimulate the Neiguan (PC6) acupoint, and 32-channel electroencephalography data were recorded before and after stimulation. Brain functional networks were constructed based on electroencephalography data to determine the relationship between magnetic stimulation at the PC6 acupoint and cortical excitability. Results indicated that magnetic stimulation at the PC6 acupoint increased connections between cerebral cortex regions.

Analysis of the effect of repeated-pulse transcranial magnetic stimulation at the Guangming point on electroencephalograms.

Here, we administered repeated-pulse transcranial magnetic stimulation to healthy people at the left Guangming (GB37) and a mock point, and calculated the sample entropy of electroencephalo-gram signals using nonlinear dynamics. Additionally, we compared electroencephalogram sample entropy of signals in response to visual stimulation before, during, and after repeated-pulse tran-scranial magnetic stimulation at the Guangming. Results showed that electroencephalogram sample entropy at left (F3) and right (FP2) frontal electrodes were significantly different depending on where the magnetic stimulation was administered. Additionally, compared with the mock point, electroencephalogram sample entropy was higher after stimulating the Guangming point. When visual stimulation at Guangming was given before repeated-pulse transcranial magnetic stimula-tion, significant differences in sample entropy were found at five electrodes (C3, Cz, C4, P3, T8) in parietal cortex, the central gyrus, and the right temporal region compared with when it was given after repeated-pulse transcranial magnetic stimulation, indicating that repeated-pulse transcranial magnetic stimulation at Guangming can affect visual function. Analysis of electroencephalogram revealed that when visual stimulation preceded repeated pulse transcranial magnetic stimulation, sample entropy values were higher at the C3, C4, and P3 electrodes and lower at the Cz and T8 electrodes than visual stimulation followed preceded repeated pulse transcranial magnetic stimula-tion. The findings indicate that repeated-pulse transcranial magnetic stimulation at the Guangming evokes different patterns of electroencephalogram signals than repeated-pulse transcranial mag-netic stimulation at other nearby points on the body surface, and that repeated-pulse transcranial magnetic stimulation at the Guangming is associated with changes in the complexity of visually evoked electroencephalogram signals in parietal regions, central gyrus, and temporal regions.