Kaneko Fuminari, Shibata Eriko, Hayami Tatsuya, Nagahata Keita, Aoyama Toshiyuki
Laboratory of Sensory Motor Science and Sports Neuroscience, First Division of Physical Therapy, Sapporo Medical University, West 17- South 1, Chuo-ku, Sapporo City, Japan.
Development Research Group for Advanced Neuroscience-based Rehabilitation, Sapporo Medical University, West 17- South 1, Chuo-ku, Sapporo City, Japan.
J Neuroeng Rehabil. 2016 Apr 15;13:36. doi: 10.1186/s12984-016-0143-8.
A kinesthetic illusion induced by a visual stimulus (KI) can produce vivid kinesthetic perception. During KI, corticospinal tract excitability increases and results in the activation of cerebral networks. Transcranial direct current stimulation (tDCS) is emerging as an alternative potential therapeutic modality for a variety of neurological and psychiatric conditions, such that identifying factors that enhance the magnitude and duration of tDCS effects is currently a topic of great scientific interest. This study aimed to establish whether the combination of tDCS with KI and sensory-motor imagery (MI) induces larger and longer-lasting effects on the excitability of corticomotor pathways in healthy Japanese subjects.
A total of 21 healthy male volunteers participated in this study. Four interventions were investigated in the first experiment: (1) anodal tDCS alone (tDCSa), (2) anodal tDCS with visually evoked kinesthetic illusion (tDCSa + KI), (3) anodal tDCS with motor imagery (tDCSa + MI), and (4) anodal tDCS with kinesthetic illusion and motor imagery (tDCSa + KIMI). In the second experiment, we added a sham tDCS intervention with kinesthetic illusion and motor imagery (sham + KIMI) as a control for the tDCSa + KIMI condition. Direct currents were applied to the right primary motor cortex. Corticospinal excitability was examined using transcranial magnetic stimulation of the area associated with the left first dorsal interosseous.
In the first experiment, corticomotor excitability was sustained for at least 30 min following tDCSa + KIMI (p < 0.01). The effect of tDCSa + KIMI on corticomotor excitability was greater and longer-lasting than that achieved in all other conditions. In the second experiment, significant effects were not achieved following sham + KIMI.
Our results suggest that tDCSa + KIMI has a greater therapeutic potential than tDCS alone for inducing higher excitability of the corticospinal tract. The observed effects may be related to sustained potentiation of resultant cerebral activity during combined KI, MI, and tDCSa.
视觉刺激诱发的动觉错觉（KI）可产生生动的动觉感知。在KI期间，皮质脊髓束兴奋性增加并导致脑网络激活。经颅直流电刺激（tDCS）正在成为治疗各种神经和精神疾病的一种潜在替代治疗方式，因此，确定增强tDCS效应的幅度和持续时间的因素目前是一个具有重大科学意义的课题。本研究旨在确定tDCS与KI和感觉运动想象（MI）相结合是否会对健康日本受试者的皮质运动通路兴奋性产生更大且更持久的影响。
共有21名健康男性志愿者参与本研究。在第一个实验中研究了四种干预措施：（1）单独阳极tDCS（tDCSa），（2）阳极tDCS结合视觉诱发动觉错觉（tDCSa + KI），（3）阳极tDCS结合运动想象（tDCSa + MI），以及（4）阳极tDCS结合动觉错觉和运动想象（tDCSa + KIMI）。在第二个实验中，我们添加了假tDCS结合动觉错觉和运动想象（假刺激 + KIMI）作为tDCSa + KIMI条件的对照。将直流电施加于右侧初级运动皮层。使用经颅磁刺激左侧第一背侧骨间肌相关区域来检查皮质脊髓兴奋性。
在第一个实验中，tDCSa + KIMI后皮质运动兴奋性持续至少30分钟（p < 0.01）。tDCSa + KIMI对皮质运动兴奋性的影响比所有其他条件下的影响更大且更持久。在第二个实验中，假刺激 + KIMI后未产生显著影响。
我们的结果表明，对于诱导皮质脊髓束更高的兴奋性，tDCSa + KIMI比单独的tDCS具有更大的治疗潜力。观察到的效果可能与在KI、MI和tDCSa联合期间所产生的大脑活动的持续增强有关。
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