Aftereffects of 2 Noninvasive Brain Stimulation Techniques on Corticospinal Excitability in Persons With Chronic Stroke

Goh, Hui-Ting; Chan, Hwang Ching; Abdul-Latif, Lydia

doi:10.1097/npt.0000000000000064

Cited by 17 publications

(6 citation statements)

References 48 publications

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“…Seven [ 10 , 26 , 29 , 30 , 33 , 35 , 41 ] and 13 [ 43 , 45 , 47 , 48 , 61 – 63 , 66 , 70 , 73 , 74 , 76 , 77 ] studies evaluated the effects of a single session and multiple sessions of HF-rTMS on the affected M1 in cortical excitability, respectively. Khedr et al showed that more patients presented MEP responses after receiving 10 sessions of real HF-rTMS than sham [ 43 ].…”

Section: Resultsmentioning

confidence: 99%

Effects of transcranial magnetic stimulation in modulating cortical excitability in patients with stroke: a systematic review and meta-analysis

Bai

Zhang

Fong

2022

J NeuroEngineering Rehabil

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Background Transcranial magnetic stimulation (TMS) has attracted plenty of attention as it has been proved to be effective in facilitating motor recovery in patients with stroke. The aim of this study was to systematically review the effects of repetitive TMS (rTMS) and theta burst stimulation (TBS) protocols in modulating cortical excitability after stroke. Methods A literature search was carried out using PubMed, Medline, EMBASE, CINAHL, and PEDro, to identify studies that investigated the effects of four rTMS protocols—low and high frequency rTMS, intermittent and continuous TBS, on TMS measures of cortical excitability in stroke. A random-effects model was used for all meta-analyses. Results Sixty-one studies were included in the current review. Low frequency rTMS was effective in decreasing individuals’ resting motor threshold and increasing the motor-evoked potential of the non-stimulated M1 (affected M1), while opposite effects occurred in the stimulated M1 (unaffected M1). High frequency rTMS enhanced the cortical excitability of the affected M1 alone. Intermittent TBS also showed superior effects in rebalancing bilateral excitability through increasing and decreasing excitability within the affected and unaffected M1, respectively. Due to the limited number of studies found, the effects of continuous TBS remained inconclusive. Motor impairment was significantly correlated with various forms of TMS measures. Conclusions Except for continuous TBS, it is evident that these protocols are effective in modulating cortical excitability in stroke. Current evidence does support the effects of inhibitory stimulation in enhancing the cortical excitability of the affected M1.

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Section: Resultsmentioning

confidence: 99%

Effects of transcranial magnetic stimulation in modulating cortical excitability in patients with stroke: a systematic review and meta-analysis

Bai

Zhang

Fong

2022

J NeuroEngineering Rehabil

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“…Directly after stimulation, participants executed three different movement tasks (as explained below) that all involve the TA as a prime mover. The tasks were designed to be completed within 30 min after tDCS due to the time-limited effects of the stimulation [28, 29]. One participant used an ankle-foot orthosis and two participants used an implanted ankle-dorsiflexion functional electrical stimulation system in daily life; these aids were not used during the experiment.…”

Section: Methodsmentioning

confidence: 99%

Offline effects of transcranial direct current stimulation on reaction times of lower extremity movements in people after stroke: a pilot cross-over study

Coppens

Staring

Nonnekes

et al. 2019

J NeuroEngineering Rehabil

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BackgroundTranscranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that has shown promise for rehabilitation after stroke. Ipsilesional anodal tDCS (a-tDCS) over the motor cortex increases corticospinal excitability, while contralesional cathodal tDCS (c-tDCS) restores interhemispheric balance, both resulting in offline improved reaction times of delayed voluntary upper-extremity movements. We aimed to investigate whether tDCS would also have a beneficial effect on delayed leg motor responses after stroke. In addition, we identified whether variability in tDCS effects was associated with the level of leg motor function.MethodsIn a cross-over design, 13 people with chronic stroke completed three 15-min sessions of anodal, cathodal and sham stimulation over the primary motor cortex on separate days in an order balanced across participants. Directly after stimulation, participants performed a comprehensive set of lower-extremity tasks involving the paretic tibialis anterior (TA): voluntary ankle-dorsiflexion, gait initiation, and backward balance perturbation. For all tasks, TA onset latencies were determined. In addition, leg motor function was determined by the Fugl-Meyer Assessment – leg score (FMA-L). Repeated measures ANOVA was used to reveal tDCS effects on reaction times. Pearson correlation coefficients were used to establish the relation between tDCS effects and leg motor function.ResultsFor all tasks, TA reaction times did not differ across tDCS sessions. For gait initiation and backward balance perturbation, differences between sham and active stimulation (a-tDCS or c-tDCS) did not correlate with leg motor function. Yet, for ankle dorsiflexion, individual reaction time differences between c-tDCS and sham were strongly associated with FMA-L, with more severely impaired patients exhibiting slower paretic reaction times following c-tDCS.ConclusionWe found no evidence for offline tDCS-induced benefits. Interestingly, we found that c-tDCS may have unfavorable effects on voluntary control of the paretic leg in severely impaired patients with chronic stroke. This finding points at potential vicarious control from the unaffected hemisphere to the paretic leg. The absence of tDCS-induced effects on gait and balance, two functionally relevant tasks, shows that such motor behavior is inadequately stimulated by currently used tDCS applications.Trial registrationThe study is registered in the Netherlands Trial Register (NL5684; April 13th, 2016).

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“…Given a constant current density, about 10 min tDCS can cause the duration of the excitability changes ( Nitsche et al, 2008 ). And there is research showing anodal tDCS induced effects that last at least 1 h ( Goh et al, 2015 ). Our trust game tasks were all completed within 30 min after tDCS.…”

Section: Methodsmentioning

confidence: 99%

Does rDLPFC activity alter trust? Evidence from a tDCS study

Sun,

Lu,

Zheng

et al. 2023

Front. Neurosci.

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Trust plays an important role in the human economy and people’s social lives. Trust is affected by various factors and is related to many brain regions, such as the dorsolateral prefrontal cortex (DLPFC). However, few studies have focused on the impact of the DLPFC on trust through transcranial direct current stimulation (tDCS), although abundant psychology and neuroscience studies have theoretically discussed the possible link between DLPFC activity and trust. In the present study, we aimed to provide evidence of a causal relationship between the rDLPFC and trust behavior by conducting multiple rounds of the classical trust game and applying tDCS over the rDLPFC. We found that overall, anodal stimulation increased trust compared with cathodal stimulation and sham stimulation, while the results in different stages were not completely the same. Our work indicates a causal relationship between rDLPFC excitability and trust behavior and provides a new direction for future research.

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Aftereffects of 2 Noninvasive Brain Stimulation Techniques on Corticospinal Excitability in Persons With Chronic Stroke

Abstract: See Video (Supplemental Digital Content 1, http://links.lww.com/JNPT/A83) for more insights from the authors.

Cited by 17 publications

References 48 publications

Effects of transcranial magnetic stimulation in modulating cortical excitability in patients with stroke: a systematic review and meta-analysis

Effects of transcranial magnetic stimulation in modulating cortical excitability in patients with stroke: a systematic review and meta-analysis

Offline effects of transcranial direct current stimulation on reaction times of lower extremity movements in people after stroke: a pilot cross-over study

Does rDLPFC activity alter trust? Evidence from a tDCS study

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