Kumru Hatice, Albu Sergiu, Rothwell John, Leon Daniel, Flores Cecilia, Opisso Eloy, Tormos Josep Maria, Valls-Sole Josep
Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, 08916 Badalona, Barcelona, Spain; Universidad Autonoma de Barcelona, 08193 Bellaterra (Cerdanyola del Vallès), Spain; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain.
Department of Psychology, Texas A&M University, College Station, TX 77843, USA.
Clin Neurophysiol. 2017 Oct;128(10):2043-2047. doi: 10.1016/j.clinph.2017.06.041. Epub 2017 Jul 17.
Repetitive application of peripheral electrical stimuli paired with transcranial magnetic stimulation (rTMS) of M1 cortex at low frequency, known as paired associative stimulation (PAS), is an effective method to induce motor cortex plasticity in humans. Here we investigated the effects of repetitive peripheral magnetic stimulation (rPMS) combined with low frequency rTMS ('magnetic-PAS') on intracortical and corticospinal excitability and whether those changes were widespread or circumscribed to the cortical area controlling the stimulated muscle.
Eleven healthy subjects underwent three 10min stimulation sessions: 10HzrPMS alone, applied in trains of 5 stimuli every 10s (60 trains) on the extensor carpi radialis (ECR) muscle; rTMS alone at an intensity 120% of ECR threshold, applied over motor cortex of ECR and at a frequency of 0.1Hz (60 stimuli) and magnetic PAS, i.e., paired rPMS and rTMS. We recorded motor evoked potentials (MEPs) from ECR and first dorsal interosseous (FDI) muscles. We measured resting motor threshold, motor evoked potentials (MEP) amplitude at 120% of RMT, short intracortical inhibition (SICI) at interstimulus interval (ISI) of 2ms and intracortical facilitation (ICF) at an ISI of 15ms before and immediately after each intervention.
Magnetic-PAS but not rTMS or rPMS applied separately, increased MEP amplitude and reduced short intracortical inhibition in ECR but not in FDI muscle.
Magnetic-PAS can increase corticospinal excitability and reduce intracortical inhibition. The effects may be specific for the area of cortical representation of the stimulated muscle.
Application of magnetic-PAS might be relevant for motor rehabilitation.
将外周电刺激与M1皮质的低频重复经颅磁刺激（rTMS）配对重复应用，即配对联想刺激（PAS），是诱导人类运动皮质可塑性的一种有效方法。在此，我们研究了重复外周磁刺激（rPMS）联合低频rTMS（“磁PAS”）对皮质内和皮质脊髓兴奋性的影响，以及这些变化是广泛存在还是局限于控制受刺激肌肉的皮质区域。
11名健康受试者接受了3次10分钟的刺激疗程：单独的10Hz rPMS，以每10秒5次刺激的序列（60个序列）施加于桡侧腕伸肌（ECR）；单独的rTMS，强度为ECR阈值的120%，施加于ECR的运动皮质，频率为0.1Hz（60次刺激），以及磁PAS，即配对的rPMS和rTMS。我们记录了ECR和第一背侧骨间肌（FDI）的运动诱发电位（MEP）。在每次干预前和干预后立即测量静息运动阈值、RMT的120%时的运动诱发电位（MEP）幅度、2ms刺激间隔（ISI）时的短皮质内抑制（SICI）以及15ms ISI时的皮质内易化（ICF）。
磁PAS而非单独应用的rTMS或rPMS，增加了ECR的MEP幅度并降低了其短皮质内抑制，但对FDI肌肉没有影响。
磁PAS可增加皮质脊髓兴奋性并降低皮质内抑制。这些效应可能对受刺激肌肉的皮质代表区域具有特异性。
磁PAS的应用可能与运动康复相关。
