Kobayashi Masahito, Théoret Hugo, Pascual-Leone Alvaro
Behavioral Neurology Unit, Department of Neurology, Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
Eur J Neurosci. 2009 Feb;29(4):833-6. doi: 10.1111/j.1460-9568.2009.06628.x. Epub 2009 Feb 5.
The primary motor cortex (M1) plays a critical role in early aspects of motor skill learning. Given the notion of inter-hemispheric competition, unilateral disruption of M1 may increase excitability of the unaffected motor cortex and thus improve motor learning with the ipsilateral hand. We applied slow-frequency repetitive transcranial magnetic stimulation (rTMS) before the initiation of practice of a simple motor skill. Participants were randomly divided into three stimulation groups: (i) ipsilateral M1; (ii) contralateral M1; and (iii) Cz (control site). The mean execution time and error rate were recorded in four sessions distributed over 2 days. Disruption of M1 with rTMS slowed down skill acquisition with the contralateral hand, albeit non significantly, but paradoxically enhanced learning with the ipsilateral hand. This was evidenced by a significant decrease of execution time at the end of day 1 in the group that received rTMS over the ipsilateral M1 compared with both control groups (Cz and contralateral M1 stimulation). This supports the notion of inter-hemispheric competition and provides novel insights that may be applicable to neurorehabilitation.
初级运动皮层(M1)在运动技能学习的早期阶段起着关键作用。鉴于半球间竞争的概念,单侧M1的破坏可能会增加未受影响的运动皮层的兴奋性,从而改善同侧手的运动学习。我们在开始练习一项简单运动技能之前应用了低频重复经颅磁刺激(rTMS)。参与者被随机分为三个刺激组:(i)同侧M1;(ii)对侧M1;以及(iii)Cz(对照部位)。在分布于2天的四个时段中记录平均执行时间和错误率。rTMS对M1的破坏减缓了对侧手的技能习得,尽管不显著,但矛盾的是增强了同侧手的学习。这一点通过与两个对照组(Cz和对侧M1刺激)相比,在同侧M1接受rTMS的组中,第1天结束时执行时间显著缩短得到证明。这支持了半球间竞争的概念,并提供了可能适用于神经康复的新见解。