Finger Tapping Task Activation vs. TMS Hotspot: Different Locations and Networks.

Both functional magnetic resonance imaging (fMRI) and transcranial magnetic stimulation (TMS) have been used to non-invasively localize the human motor functional area. These locations can be clinically used as stimulation target of TMS treatment. However, it has been reported that the finger tapping fMRI activation and TMS hotspot were not well-overlapped. The aim of the current study was to measure the distance between the finger tapping fMRI activation and the TMS hotspot, and more importantly, to compare the network difference by using resting-state fMRI. Thirty healthy participants underwent resting-state fMRI, task fMRI, and then TMS hotspot localization. We found significant difference of locations between finger tapping fMRI activation and TMS hotspot. Specifically, the finger tapping fMRI activation was more lateral than the TMS hotspot in the premotor area. The fMRI activation peak and TMS hotspot were taken as seeds for resting-state functional connectivity analyses. Compared with TMS hotspot, finger tapping fMRI activation peak showed more intensive functional connectivity with, e.g., the bilateral premotor, insula, putamen, and right globus pallidus. The findings more intensive networks of finger tapping activation than TMS hotspot suggest that TMS treatment targeting on the fMRI activation area might result in more remote effects and would be more helpful for TMS treatment on movement disorders.

Intermittent theta burst stimulation facilitates functional connectivity from the dorsal premotor cortex to primary motor cortex.

BACKGROUND: Motor information in the brain is transmitted from the dorsal premotor cortex (PMd) to the primary motor cortex (M1), where it is further processed and relayed to the spinal cord to eventually generate muscle movement. However, how information from the PMd affects M1 processing and the final output is unclear. Here, we applied intermittent theta burst stimulation (iTBS) to the PMd to alter cortical excitability not only at the application site but also at the PMd projection site of M1. We aimed to determine how PMd iTBS-altered information changed M1 processing and the corticospinal output. METHODS: In total, 16 young, healthy participants underwent PMd iTBS with 600 pulses (iTBS600) or sham-iTBS600. Corticospinal excitability, short-interval intracortical inhibition (SICI), and intracortical facilitation (ICF) were measured using transcranial magnetic stimulation before and up to 60 min after stimulation. RESULTS: Corticospinal excitability in M1 was significantly greater 15 min after PMd iTBS600 than that after sham-iTBS600 (p = 0.012). Compared with that after sham-iTBS600, at 0 (p = 0.014) and 15 (p = 0.037) min after iTBS600, SICI in M1 was significantly decreased, whereas 15 min after iTBS600, ICF in M1 was significantly increased (p = 0.033). CONCLUSION: Our results suggested that projections from the PMd to M1 facilitated M1 corticospinal output and that this facilitation may be attributable in part to decreased intracortical inhibition and increased intracortical facilitation in M1. Such a facilitatory network may inform future understanding of the allocation of resources to achieve optimal motion output.

Modulation of hand motor skill performance induced by motor practice combined with matched or mismatched hand posture motor imagery.

Motor imagery (MI), the mental rehearsal of a movement without muscle activation, combined with motor practice (MP) improves the performance of athletes and promotes rehabilitation of motor function among patients with brain injury. The actual hand posture influences the mental simulation of hand movements such that the ability of MI to affect corticospinal excitability is enhanced when the actual hand posture is consistent with the imagined movement of the hand. However, how MP combined with matched or mismatched hand posture MI modulates hand motor skill performance and the underlying neural mechanisms remain unclear. Thus, we first investigated whether MI hand posture that was compatible or incompatible with the actual MP influenced motor performance and corticospinal excitability induced by MI combined with MP. Twenty-eight healthy young adults repeatedly imagined either (1) closing their right hand into a fist with the thumb on top of the fingers and then opening the hand before actually performing that exact motor action or (2) performing the same motor skill but first imagining the right thumb touching the little finger before opening the hand . Changes in the peak acceleration of the hand grasp were measured to assess motor performance. The amplitudes of motor-evoked potentials (MEPs) in a target muscle were obtained using transcranial magnetic stimulation to assess corticospinal activation, a measure of primary cortex stimulation, before, immediately after, and 20 min after the performance. When the results of two-way repeated-measures analyses of variance assessing the effects of the protocols and time on the various measurements were found to be significant, post hoc paired t tests with Bonferroni corrections for multiple comparisons were applied. The results showed that both peak grasp acceleration and corticospinal excitability significantly increased immediately and 20 min after task completion (p < 0.05 for all) only when the MI hand posture matched with that of the actual MP. We then determined whether this increased corticospinal activity was associated with decreased short-interval intracortical inhibition, as measured using paired-pulse transcranial magnetic stimulation. Similar to our previous results, we found that short-interval intracortical inhibition was significantly decreased immediately and 20 min after task completion (p < 0.05 for both) only when MI matched MP. We concluded that the increased motor performance and corticospinal excitability induced by MI and MP depended on the match between the hand posture in the MI and MP, and that this increased corticospinal excitability was associated with disinhibition of the primary motor cortex activity.

The interplay between cognitive tasks and vision for upright posture balance in adolescents.

BACKGROUND: The control of an upright stance in humans is important in medicine, psychology, and physiology. The maintenance of upright stance balance depends not only on sensory information from proprioceptive, vestibular, cutaneous, and visual sources but also on cognitive resources. The present study investigated the effects of cognitive tasks while standing with eyes open on upright stance balance in adolescents. We hypothesized that performing a cognitive task while standing with eyes open would increase body sway among these adolescents and that the upright posture would thus become less stable. METHODS: A static balance assessment system comprising a force platform connected to a computer was used to evaluate the stability of the upright stance among 21 healthy adolescents under six conditions: no cognitive task, a relatively easy cognitive task, or the same cognitive task made more difficult, with each task being performed while the eyes were open and again while the eyes were closed. The participants performed mental calculations as fast as possible by subtracting either 3 or 18 from a random three-digit number continuously, for the simple cognitive task or the difficult cognitive task, respectively. Each calculation was completed within 10 s. The evaluation indexes used to measure upright posture stability were the root mean square (RMS) of the total body sway in the mediolateral and anteroposterior directions, the mean velocity (MV) value of the total body sway, and the Romberg quotient (RQ) of these values. RESULTS: The RMS (p < 0.01) and MV (p < 0.01) values of the upright posture sway were lower when participants performed no cognitive task and their eyes were open than when their eyes were closed. When their eyes were open, compared with no cognitive task, the values of the measures evaluating upright posture sway were higher, meaning the stance was less stable, while performing either the simple or the more difficult cognitive task (RMS: simple task, p < 0.01; difficult task, p < 0.05; MV: simple task, p < 0.01; difficult task, p < 0.01) although no significant differences were detected for the RMS or MV values between the simple and more difficult cognitive tasks. The RQs for both the RMS and the total MV values of the upright posture sway during performance of the difficult cognitive task were significantly lower than when the participants performed no task. CONCLUSION: Performance of a cognitive task significantly reduced the upright posture balance in adolescents during eyes open although increased task difficulty did not show a greater effect. The interference between the performance of a cognitive task and the visual control of an upright stance may be attributable in part to cognitive and visual processing streams competing for common central resources, consistent with the Multiple Resource Theory of information processing.

Motor learning enhanced by combined motor imagery and noninvasive brain stimulation is associated with reduced short-interval intracortical inhibition.

BACKGROUND: Motor imagery (MI) improves motor skill learning, which is further enhanced when MI is paired with primary motor cortex transcranial brain stimulation or with electrical stimulation of the peripheral median nerve. Applying both stimulation types (here with 25 ms intervals) is called paired associative stimulation (PAS25). The final primary motor cortex output is determined by combined excitatory and intracortical inhibitory circuits, and reducing the latter is associated with enhanced synaptic transmission and efficacy. Indeed, short-interval intracortical inhibition (SICI) inhibits motor evoked potentials (MEPs), and motor learning has been associated with decreased SICI and increased cortical excitability. Here, we investigated whether cortical excitability and SICI are altered by PAS25 applied after MI-induced modulation of motor learning. METHODS: Peak acceleration of a hand-grasping movement and MEPs and SICI were measured before and after MI alone, PAS25 alone, and MI followed by PAS25 in 16 healthy participants to evaluate changes in motor learning, corticospinal excitability, and intracortical inhibition. RESULTS: After PAS25 alone, MEP amplitude increased while peak acceleration was unchanged. However, PAS25 applied following MI not only significantly enhanced both peak acceleration (p = 0.011) and MEP amplitude (p = 0.004) but also decreased SICI (p = 0.011). Moreover, we found that this decrease in SICI was significantly correlated with both the peak acceleration (r = 0.49, p = 0.029) and the MEP amplitude (r = 0.56, p = 0.013). CONCLUSIONS: These results indicate that brain function altered by PAS25 of the motor cortex enhances MI-induced motor learning and corticospinal excitability and decreases SICI, suggesting that SICI underlies, at least in part, PAS25 modulation of motor learning.

Differences between motor execution and motor imagery of grasping movements in the motor cortical excitatory circuit.

BACKGROUND: Both motor imagery (MI) and motor execution (ME) can facilitate motor cortical excitability. Although cortical excitability is modulated by intracortical inhibitory and excitatory circuits in the human primary motor cortex, it is not clear which intracortical circuits determine the differences in corticospinal excitability between ME and MI. METHODS: We recruited 10 young healthy subjects aged 18-28 years (mean age: 22.1 ± 3.14 years; five women and five men) for this study. The experiment consisted of two sets of tasks involving grasp actions of the right hand: imagining and executing them. Corticospinal excitability and short-interval intracortical inhibition (SICI) were measured before the interventional protocol using transcranial magnetic stimulation (baseline), as well as at 0, 20, and 40 min (T0, T20, and T40) thereafter. RESULTS: Facilitation of corticospinal excitability was significantly greater after ME than after MI in the right abductor pollicis brevis (APB) at T0 and T20 (p < 0.01 for T0, and p < 0.05 for T20), but not in the first dorsal interosseous (FDI) muscle. On the other hand, no significant differences in SICI between ME and MI were found in the APB and FDI muscles. The facilitation of corticospinal excitability at T20 after MI correlated with the Movement Imagery Questionnaire (MIQ) scores for kinesthetic items (Rho = -0.646, p = 0.044) but did not correlate with the MIQ scores for visual items (Rho = -0.265, p = 0.458). DISCUSSION: The present results revealed significant differences between ME and MI on intracortical excitatory circuits of the human motor cortex, suggesting that cortical excitability differences between ME and MI may be attributed to the activation differences of the excitatory circuits in the primary motor cortex.