Changes in Serial Optical Topography and TMS during Task Performance after Constraint-Induced Movement Therapy in Stroke: A Case Study

Park, Si-Woon; Butler, Andrew; Cavalheiro, Vanessa; Alberts, Jay L.; Wolf, Steven L.

doi:10.1177/0888439004265113

Cited by 47 publications

(30 citation statements)

References 45 publications

(91 reference statements)

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“…An increase in M1 excitability at posttraining measures has been shown also and consistently in TMS studies using much shorter training periods (one training session lasting several minutes up to 1 h) (Garry et al 2004;Hayashi et al 2002;Muellbacher et al 2001). Recent studies have been carried out to evaluate diverse motor trainings (mainly constraint-induced-therapy approaches) in stroke patients by means of TMS, and Wrst results also suggest increased TMS motor map areas in the contralateral motor cortex following treatment, indicating increased excitability Park et al 2004). We assume that the increased corticospinal excitability which accompanied motor training in the present study is a necessary prerequisite for inducing plastic changes within the motor cortex-a condition that is present beyond the actual motor performance.…”

Section: Training-related Increase Of Corticospinal Excitabilitymentioning

confidence: 70%

Extensive training of elementary finger tapping movements changes the pattern of motor cortex excitability

et al. 2006

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There is evidence of a strong capacity for functional and structural reorganization in the human motor system. However, past research has focused mainly on complex movement sequences over rather short training durations. In this study we investigated changes in corticospinal excitability associated with longer training of elementary, maximum-speed tapping movements. All participating subjects were consistent right-handers and were trained using either the right (experiment 1) or the left thumb (experiment 2). Transcranial magnetic stimulation was applied to obtain motor evoked potentials (MEPs) from the abductor pollicis brevis (APB) muscle of the right and the left hand before and after training. As a result of training, a signiWcant increase was observed in tapping speed accompanied by increased MEPs, recorded from the trained APB muscle, following contralateral M1 stimulation. In the case of subdominant-hand training we additionally demonstrate increased MEP amplitudes evoked at the right APB (untrained hand) in the Wrst training week. Enhanced corticospinal excitability associated with practice of elementary movements may constitute a necessary precursor for inducing plastic changes within the motor system. The involvement of the ipsilateral left M1 likely reXects the predominant role of the left M1 in the general control (modiWcation) of simple motor parameters in right-handed subjects.

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Section: Training-related Increase Of Corticospinal Excitabilitymentioning

confidence: 70%

Extensive training of elementary finger tapping movements changes the pattern of motor cortex excitability

et al. 2006

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“…Our literature search identified 28 relevant training studies that quantified neural plasticity changes for further analysis to determine if inclusion in this meta-analysis was appropriate (Brouwer & Ambury, 1994;Carey et al, 2002;Cramer, 2004;Cramer et al, 1999;Cramer et al, 1997;Foltys et al, 2003;Jang et al, 2003;Jang et al, 2005;Könönen et al, 2005;Koski et al, 2004;Levy et al, 2001;Liepert, Bauder et al, 2000;Liepert, Graef et al, 2000;Liepert et al, 2001;Lindberg et al, 2004;Luft et al, 2004;Muellbacher et al, 2002;Nelles, 2004;Nelles et al, 2001;Newton et al, 2002;Park et al, 2004;Platz et al, 2005;Schaechter et al, 2002;Seitz et al, 2004;Sonde et al, 2001;Stinear & Byblow, 2004;Wittenberg et al, 2003). For meta-analysis inclusion, each article was originally examined for changes in neural representation measured in four areas of interest: (1) primary motor cortex (M1), (2) supplementary motor area, (3) dorsal premotor area, and (4) cingulate area.…”

Section: Subjects: Study Selection and Inclusion/exclusion Criteriamentioning

confidence: 99%

“…According to the above stated criteria and consistent with meta-analysis techniques, 15 studies (Brouwer & Ambury, 1994;Cramer, 2004;Cramer et al, 1999;Cramer et al, 1997;Foltys et al, 2003;Levy et al, 2001;Liepert, Graef et al, 2000;Lindberg et al, 2004;Nelles, 2004;Newton et al, 2002;Park et al, 2004;Seitz et al, 2004;Sonde et al, 2001;Wittenberg et al, 2003) were excluded from the initial list of articles because 10 were not designed as rehabilitation studies (Brouwer & Ambury, 1994;Cramer, 2004;Cramer et al, 1999;Cramer et al, 1997;Foltys et al, 2003;Liepert, Graef et al, 2000;Nelles, 2004;Newton et al, 2002;Seitz et al, 2004;Sonde et al, 2001), four articles used unique analyses and data displays that made it impossible to calculate standardized effect sizes Levy et al, 2001;Lindberg et al, 2004;Wittenberg et al, 2003), and one was a case study (Park et al, 2004). The 13 remaining studies (Carey et al, 2002;Jang et al, 2003;Jang et al, 2005;Könönen et al, 2005;Koski et al, 2004;Liepert, Bauder et al, 2000;Liepert et al, 2001;Luft et al, 2004;Muellbacher et al, 2002;Nelles et al, 2001;…”

Section: Subjects: Study Selection and Inclusion/exclusion Criteriamentioning

confidence: 99%

Movement-dependent stroke recovery: A systematic review and meta-analysis of TMS and fMRI evidence

et al. 2008

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Evidence indicates that experience-dependent cortical plasticity underlies post-stroke motor recovery of the impaired upper extremity. Motor skill learning in neurologically intact individuals is thought to involve the primary motor cortex, and the majority of studies in the animal literature have studied changes in the primary sensorimotor cortex with motor rehabilitation. Whether changes in engagement in the sensorimotor cortex occur in humans after stroke currently is an area of much interest. The present study conducted a meta-analysis on stroke studies examining changes in neural representations following therapy specifically targeting the upper extremity to determine if rehabilitation-related motor recovery is associated with neural plasticity in the sensorimotor cortex of the lesioned hemisphere. Twenty-eight studies investigating upper extremity neural representations (e.g., TMS, fMRI, PET, or SPECT) were identified, and 13 met inclusion criteria as upper extremity intervention training studies. Common outcome variables representing changes in the primary motor and sensorimotor cortices were used in calculating standardized effect sizes for each study. The primary fixed effects model meta-analysis revealed a large overall effect size (E.S. = 0.84, S.D. = 0.15, 95% C.I. = 0.76 -0.93). Moreover, a fail-safe analysis indicated that 42 null effect studies would be necessary to lower the overall effect size to an insignificant level. These results indicate that neural changes in the sensorimotor cortex of the lesioned hemisphere accompany functional paretic upper extremity motor gains achieved with targeted rehabilitation interventions.

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“…Transcranial magnetic stimulation (TMS) has gained considerable acceptance as a method to non-invasively study adaptive changes in motor cortex as a consequence of repeated practice or learning in able-bodied individuals (e.g., Tinazzi and Zanette 1998) and as a consequence of injury in individuals who have suffered strokes, limb amputation and spinal cord injury (e.g., Turton et al 1996;Liepert et al 1998;Capaday et al 2000;Park et al 2004). For example, effects of some rehabilitation techniques following brain injury have been evaluated by estimating the motor cortical area that is responsive to suprathreshold stimulation of a muscle of interest (e.g., Liepert et al 1998).…”

Section: Introductionmentioning

confidence: 99%

Variability of motor potentials evoked by transcranial magnetic stimulation depends on muscle activation

2006

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The purpose of this research was to determine whether motor cortex excitability assessed using transcranial magnetic stimulation (TMS) is less variable when subjects maintain a visually controlled low-level contraction of the muscle of interest. We also examined the dependence of single motor evoked potential (MEP) amplitude on stimulation intensity and pre-stimulus muscle activation level using linear and non-linear multiple regression analysis. Eight healthy adult subjects received single pulse TMS over the left motor cortex at a point where minimal stimulation intensity was required to produce MEPs in extensor digitorum communis (EDC). Voluntary activation of the muscle was controlled by visual display of a target force (indicated by a stable line on an oscilloscope) and the isometric force produced as the subject attempted to extend the fingers (indicated by a line on the oscilloscope representing the finger extension force) while subjects were instructed to: exert zero extension force (0%) and produce forces equal to 5 and 10% of maximum voluntary finger extension under separate conditions. Relative variability (coefficient of variation) of single MEPs at a constant stimulus intensity and of pre-stimulus muscle EMG was lower during maintained 5 and 10% contractions than at 0% contraction levels. Therefore, maintaining a stable low intensity contraction helps stabilize cortical and spinal excitability. Multiple regression analyses showed that a linear dependence of single MEPs on stimulation intensity and pre-stimulus muscle activation level produced similar fits to those for a non-linear dependence on stimulus intensity and a linear dependence on pre-stimulus EMG. Thus, a simple linear method can be used to assess dependence of single MEP amplitudes on both stimulus intensity (to characterize slope of the recruitment curve) and low intensity background muscle activation level.

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Changes in Serial Optical Topography and TMS during Task Performance after Constraint-Induced Movement Therapy in Stroke: A Case Study

Abstract: The authors examined serial changes in optical topography in a stroke patient performing a functional task, as well as clinical and physiologic measures while undergoing constraint-induced

Cited by 47 publications

References 45 publications

Extensive training of elementary finger tapping movements changes the pattern of motor cortex excitability

Extensive training of elementary finger tapping movements changes the pattern of motor cortex excitability

Movement-dependent stroke recovery: A systematic review and meta-analysis of TMS and fMRI evidence

Variability of motor potentials evoked by transcranial magnetic stimulation depends on muscle activation

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