Koch Giacomo, Mori Francesco, Marconi Barbara, Codecà Claudia, Pecchioli Cristiano, Salerno Silvia, Torriero Sara, Lo Gerfo Emanuele, Mir Pablo, Oliveri Massimiliano, Caltagirone Carlo
Laboratorio di Neurologia Clinica e Comportamentale, Fondazione Santa Lucia IRCCS, Via Ardeatina, 306, 00179 Rome, Italy.
Clin Neurophysiol. 2008 Nov;119(11):2559-69. doi: 10.1016/j.clinph.2008.08.008. Epub 2008 Sep 27.
The cerebellum takes part in several motor functions through its influence on the motor cortex (M1). Here, we applied the theta burst stimulation (TBS) protocol, a novel form of repetitive Transcranial Magnetic Stimulation (rTMS) over the lateral cerebellum. The aim of this study was to test whether TBS of the lateral cerebellum could be able to modulate the excitability of the contralateral M1 in healthy subjects.
Motor-evoked potentials (MEPs) amplitude, short intracortical inhibition (SICI), long intracortical inhibition (LICI) and short intracortical facilitation (SICF) were tested in the M1 before and after cerebellar continuous TBS (cTBS) or intermittent TBS (iTBS).
We found that cTBS induced a reduction of SICI and an increase of LICI. On the other hand, cerebellar iTBS reduced LICI. MEPs amplitude also differently vary following cerebellar stimulation with cTBS or iTBS, resulting in a decrease by the former and an increase by the latter.
Although the interpretation of these data remains highly speculative, these findings reveal that the cerebellar cortex undergoes bidirectional plastic changes that modulate different intracortical circuits within the contralateral primary motor cortex.
Long-lasting modifications of these pathways could be useful to treat various pathological conditions characterized by an altered cortical excitability.
小脑通过对运动皮层(M1)的影响参与多种运动功能。在此,我们应用了theta爆发刺激(TBS)方案,这是一种对小脑外侧进行重复经颅磁刺激(rTMS)的新形式。本研究的目的是测试小脑外侧的TBS是否能够调节健康受试者对侧M1的兴奋性。
在小脑连续TBS(cTBS)或间歇性TBS(iTBS)前后,测试M1中的运动诱发电位(MEP)幅度、短皮质内抑制(SICI)、长皮质内抑制(LICI)和短皮质内易化(SICF)。
我们发现cTBS诱导SICI降低和LICI增加。另一方面,小脑iTBS降低了LICI。MEP幅度在小脑cTBS或iTBS刺激后也有不同变化,前者使其降低,后者使其增加。
尽管对这些数据的解释仍极具推测性,但这些发现揭示了小脑皮质经历双向可塑性变化,可调节对侧初级运动皮层内不同的皮质内回路。
这些通路的长期改变可能有助于治疗各种以皮质兴奋性改变为特征的病理状况。