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TMS 和 PNS 频率对伴有高频外周成分的 PAS 中 MEP 增强的影响。

The impact of TMS and PNS frequencies on MEP potentiation in PAS with high-frequency peripheral component.

机构信息

Department of Neurology, Christian Doppler Medical Centre, Paracelsus Medical University and Centre for Cognitive Neuroscience, Salzburg, Austria.

BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

出版信息

PLoS One. 2020 May 29;15(5):e0233999. doi: 10.1371/journal.pone.0233999. eCollection 2020.

DOI:10.1371/journal.pone.0233999
PMID:32470028
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7259644/
Abstract

Paired associative stimulation (PAS) combines transcranial magnetic stimulation (TMS) and peripheral nerve stimulation (PNS) to induce plastic changes in the corticospinal tract. PAS employing single 0.2-Hz TMS pulses synchronized with the first pulse of 50-100 Hz PNS trains potentiates motor-evoked potentials (MEPs) in a stable manner in healthy participants and enhances voluntary motor output in spinal cord injury (SCI) patients. We further investigated the impact of settings of this PAS variant on MEP potentiation in healthy subjects. In experiment 1, we compared 0.2-Hz vs 0.4-Hz PAS. In experiment 2, PNS frequencies of 100 Hz, 200 Hz, and 400 Hz were compared. In experiment 3, we added a second TMS pulse. When compared with 0.4-Hz PAS, 0.2-Hz PAS was significantly more effective after 30 minutes (p = 0.05) and 60 minutes (p = 0.014). MEP potentiation by PAS with 100-Hz and 200-Hz PNS did not differ. PAS with 400-Hz PNS was less effective than 100-Hz (p = 0.023) and 200-Hz (p = 0.013) PNS. Adding an extra TMS pulse rendered PAS strongly inhibitory. These negative findings demonstrate that the 0.2-Hz PAS with 100-Hz PNS previously used in clinical studies is optimal and the modifications employed here do not enhance its efficacy.

摘要

经颅磁刺激 (TMS) 和周围神经刺激 (PNS) 相结合的成对关联刺激 (PAS) 可诱导皮质脊髓束产生塑性变化。在健康参与者中，采用与 50-100 Hz PNS 脉冲的第一个脉冲同步的单个 0.2 Hz TMS 脉冲的 PAS 以稳定的方式增强运动诱发电位 (MEPs)，并增强脊髓损伤 (SCI) 患者的自主运动输出。我们进一步研究了这种 PAS 变体的设置对健康受试者 MEP 增强的影响。在实验 1 中，我们比较了 0.2 Hz 与 0.4 Hz PAS。在实验 2 中，比较了 100 Hz、200 Hz 和 400 Hz 的 PNS 频率。在实验 3 中，我们添加了第二个 TMS 脉冲。与 0.4 Hz PAS 相比，0.2 Hz PAS 在 30 分钟后（p = 0.05）和 60 分钟后（p = 0.014）明显更有效。100 Hz 和 200 Hz PNS 的 PAS 引起的 MEP 增强没有差异。400 Hz PNS 的 PAS 不如 100 Hz（p = 0.023）和 200 Hz（p = 0.013）PNS 有效。添加额外的 TMS 脉冲使 PAS 具有强烈的抑制作用。这些负面发现表明，先前在临床研究中使用的 100 Hz PNS 的 0.2 Hz PAS 是最佳的，并且这里采用的修改并未增强其功效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe0d/7259644/4936017dc3eb/pone.0233999.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe0d/7259644/857e97cafbb3/pone.0233999.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe0d/7259644/d2b3f350681d/pone.0233999.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe0d/7259644/93b49d17852f/pone.0233999.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe0d/7259644/4936017dc3eb/pone.0233999.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe0d/7259644/857e97cafbb3/pone.0233999.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe0d/7259644/d2b3f350681d/pone.0233999.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe0d/7259644/93b49d17852f/pone.0233999.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe0d/7259644/4936017dc3eb/pone.0233999.g004.jpg

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