Combining aerobic exercise and repetitive transcranial magnetic stimulation to improve brain function in health and disease

Hendrikse, Joshua; Kandola, Aaron; Coxon, James P.; Rogasch, Nigel C.; Yücel, Murat

doi:10.1016/j.neubiorev.2017.09.023

Cited by 42 publications

(28 citation statements)

References 138 publications

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“…Exercise upregulates a number of mechanisms which influence neuroplasticity (Hendrikse et al, 2017). Through increased circulation of neurotrophins and growth factors (such as BDNF; Neeper, Gómez-Pinilla, Choi, & Cotman, 1995), increased cerebral blood flow (Maass et al, 2015), and altered neurotransmission (e.g.…”

Section: Associations Between Exercise and Changes To Working Memory mentioning

confidence: 99%

“…Applying rTMS following exercise may capitalise on the priming effects of exercise on neuroplasticity (i.e. via increased cerebral blood flow and upregulated BDNF), whereas engaging in exercise following rTMS may have a consolidating effect, maintaining an environment conducive to neuroplasticity (Hendrikse et al, 2017). Indeed, there is some evidence that performing exercise prior to (McDonnell et al, 2013), or following (Singh, Duncan, & Staines, 2016) a single dose of cTBS, has different effects on cortical excitability.…”

Section: Limitations and Future Directionsmentioning

confidence: 99%

“…Cardiorespiratory exercise is another factor known to influence neuroplasticity, and may provide an effective method for augmenting the effects of rTMS (Hendrikse, Kandola, Coxon, Rogasch, & Yücel, 2017). Exercise is a sub-domain of physical activity and refers to deliberate, repetitive movement intended to maintain or improve physical fitness (Caspersen, Powell, & Christenson, 1985).…”

Section: Introductionmentioning

confidence: 99%

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The effects of multi-day rTMS and cardiorespiratory fitness on working memory and local GABA concentration

Hendrikse

Thompson

Suo

et al. 2020

Preprint

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Working memory (WM) refers to the capacity to temporarily retain and manipulate finite amounts of information; a critical process in complex behaviours such as reasoning, comprehension, and learning. This cognitive function is supported by a parietal-prefrontal network and linked to the activity of key brain neurotransmitters, such as gamma-aminobutyric acid (GABA). Impairments in WM are seen in a range of psychiatric and neurological disorders, and there are currently no effective methods of remediating WM deficits. In this study, we analysed secondary outcome measures from a trial investigating the effects of multi-day rTMS on cognition. Participants received four days of 20 Hz rTMS to an individualised region of left parietal cortex in one week, and an individualised region of pre-supplementary motor area (pre-SMA) in a separate week. We assessed changes to WM function before and after each week of stimulation (N = 39), and changes to GABA concentration before and after stimulation in week one using MR spectroscopy (N = 18 per stimulation condition). We hypothesised that multi-day parietal rTMS would enhance WM and reduce GABA concentration, but this was not observed. Instead, we report some evidence of improved WM function and increased GABA concentration following pre-SMA rTMS, although this effect was variable across individuals. Additionally, we found that higher cardiorespiratory fitness was associated with greater WM improvement following pre-SMA stimulation. While there are a number of factors known to influence the response to rTMS, increasing cardiorespiratory fitness may provide a novel approach to enhance cognitive outcomes. Given the clinical utility of both exercise and rTMS, future studies are required to determine whether additive effects may be achieved when applied in tandem.

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Section: Associations Between Exercise and Changes To Working Memory mentioning

confidence: 99%

Section: Limitations and Future Directionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The effects of multi-day rTMS and cardiorespiratory fitness on working memory and local GABA concentration

Hendrikse

Thompson

Suo

et al. 2020

Preprint

Self Cite

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“…Future studies may investigate whether certain physiological or lifestyle factors (e.g. parietal-hippocampal FC at baseline or concurrent level of physical activity (Hendrikse et al 2017;Ridding & Ziemann, 2010) are predictive of associative memory changes following rTMS.…”

Section: Multi-day Parietal Rtms Associative Memory and Hippocampalmentioning

confidence: 99%

Multi-day rTMS exerts site-specific effects on functional connectivity but does not influence associative memory performance

Hendrikse

Coxon

Thompson

et al. 2020

Preprint

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Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation technique with the capacity to modulate brain network connectivity and cognitive function. Recent studies have demonstrated long-lasting improvements in associative memory and resting-state connectivity following multi-day repetitive TMS (rTMS) to individualised parietal-hippocampal networks. We aimed to assess the reproducibility and network-and cognitive-specificity of these effects following multi-day rTMS. Participants received four days of 20 Hz rTMS to a subject-specific region of left lateral parietal cortex exhibiting peak functional connectivity to the left hippocampus. In a separate week, the same stimulation protocol was applied to a subject-specific region of pre-supplementary motor area (pre-SMA) exhibiting peak functional connectivity to the left putamen. We assessed changes to associative memory before and after each week of stimulation (N = 39), and changes to resting-state functional connectivity before and after stimulation in week one (N = 36). We found no evidence of long-lasting enhancement of associative memory or increased parieto-hippocampal connectivity following multi-day rTMS to the parietal cortex, nor increased pre-SMA-putamen connectivity following multi-day rTMS to pre-SMA. Instead, we observed some evidence of site-specific modulations of functional connectivity lasting ~24 hours, with reduced connectivity within targeted networks and increased connectivity across distinct non-targeted networks. Our findings suggest a complex interplay between multi-day rTMS and network connectivity. Further work is required to develop reliable rTMS paradigms for driving changes in functional connectivity between cortical and subcortical regions.

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“…Essas características tornam a TMS uma ferramenta indiscutivelmente útil para a avaliação da atividade do cérebro, da plasticidade, da representação de músculos e de funções facilitatórias ou inibitórias do cérebro 13 . Além disso, é um excelente recurso para ser associado a outras modalidades ativas de exercícios terapêuticos que podem ser aplicados nos intervalos dos trens de pulsos 14 .…”

Section: Non-invasive Neuromodulation As a Physiotherapeutic Resourceunclassified

Neuromodulação não invasiva como recurso fisioterapêutico no tratamento das disfunções neurológicas e musculoesqueléticas

Baptista

Sá²

2020

Rev Pesq Fisio

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Neuromodulação não invasiva como recurso fisioterapêutico no tratamento das disfunções neurológicas e musculoesqueléticasNon-invasive neuromodulation as a physiotherapeutic resource in the treatment of neurological and musculoskeletal dysfunctions As técnicas de neuromodulação incluem uma variedade de procedimentos desenvolvidos para modular a atividade do sistema nervoso humano e melhorar diversas condições de saúde. O uso da neuromodulação clínica não invasiva (NNI) se desenvolveu inicialmente através de sua aplicação em casos de doenças psiquiátricas, depois sendo aplicada com outros fins, como no controle da dor crônica, distúrbios do movimento, epilepsia, zumbido e na reabilitação após Acidente Vascular Cerebral (AVC) 1,2 . Recentemente, estudos vêm demonstrando que o uso da NNI associada a terapias ativas apresenta efeitos potencializados. Evidências são identificadas quando a NNI está associada à terapia ocupacional 3 , ao treino robótico assistido para o membro superior 4 , à terapia cognitvo-comportamental para depressão 5 , à terapia de linguagem para afasia 6 , entre outros. Iosa e colaboradores 7 apontam a neuromodulação entre as sete tecnologias mais promissoras para o futuro da reabilitação. A Fisioterapia é uma profissão que se propõe a tratar as disfunções de movimento com auxílio de recursos físicos. Correntes elétricas e eletromagnéticas compõem, portanto, o arsenal de recursos usados por estes profissionais. Dentre as técnicas mais utilizadas com fins neuromodulatórios estão a Estimulação Magnética Transcraniana repetitiva (rTMS -do inglês repetitive Transcranial Magnetic Stimulation), a Eletroestimulação Transcraniana com Corrente Constante (tDCS -do inglês transcranial Direct Current Stimulation) e as diversas técnicas de Estimulação Elétrica Periférica (PES -do inglês Peripheral Electrical Stimulation). Estas técnicas agem em geral aumentando ou diminuindo a excitabilidade dos córtices cerebral ou cerebelar, fazendo com que neurônios e redes neuronais mudem seus estados de funcionamento. Seu uso tem sentido principalmente quando o funcionamento no sistema nervoso central está alterado em termos de excitabilidade e/ou conectividade, caracterizando estados patológicos de funcionamento. A tDCS consiste em uma técnica de modulação cortical não invasiva indolor que, através da aplicação de corrente contínua de baixa intensidade sobre o escalpo craniano, é capaz de alterar a excitabilidade cortical e assim interferir no desempenho de diferentes funções. Desta forma, pode influenciar funções motoras e sensoriais 8 . Seus efeitos dependem principalmente da polaridade de corrente aplicada, da sua intensidade, do tempo de aplicação, da área estimulada e da densidade da corrente 8,9 . Sob o eletrodo anódico se observa, na maior parte das vezes, aumento da excitabilidade; enquanto sob o catódico, se observa uma inibição cortical.

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Combining aerobic exercise and repetitive transcranial magnetic stimulation to improve brain function in health and disease

Cited by 42 publications

References 138 publications

The effects of multi-day rTMS and cardiorespiratory fitness on working memory and local GABA concentration

The effects of multi-day rTMS and cardiorespiratory fitness on working memory and local GABA concentration

Multi-day rTMS exerts site-specific effects on functional connectivity but does not influence associative memory performance

Neuromodulação não invasiva como recurso fisioterapêutico no tratamento das disfunções neurológicas e musculoesqueléticas

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