Hollis Asha, Zewdie Ephrem, Nettel-Aguirre Alberto, Hilderley Alicia, Kuo Hsing-Ching, Carlson Helen L, Kirton Adam
Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Front Neurosci. 2020 May 19;14:464. doi: 10.3389/fnins.2020.00464. eCollection 2020.
Non-invasive neuromodulation is an emerging therapy for children with early brain injury but is difficult to apply to preschoolers when windows of developmental plasticity are optimal. Transcranial static magnetic field stimulation (tSMS) decreases primary motor cortex (M1) excitability in adults but effects on the developing brain are unstudied.
OBJECTIVE/HYPOTHESIS: We aimed to determine the effects of tSMS on cortical excitability and motor learning in healthy children. We hypothesized that tSMS over right M1 would reduce cortical excitability and inhibit contralateral motor learning.
This randomized, sham-controlled, double-blinded, three-arm, cross-over trial enrolled 24 healthy children aged 10-18 years. Transcranial Magnetic Stimulation (TMS) assessed cortical excitability via motor-evoked potential (MEP) amplitude and paired pulse measures. Motor learning was assessed via the Purdue Pegboard Test (PPT). A tSMS magnet (677 Newtons) or sham was held over left or right M1 for 30 min while participants trained the non-dominant hand. A linear mixed effect model was used to examine intervention effects.
All 72 tSMS sessions were well tolerated without serious adverse effects. Neither cortical excitability as measured by MEPs nor paired-pulse intracortical neurophysiology was altered by tSMS. Possible behavioral effects included contralateral tSMS inhibiting early motor learning ( < 0.01) and ipsilateral tSMS facilitating later stages of motor learning ( < 0.01) in the trained non-dominant hand.
tSMS is feasible in pediatric populations. Unlike adults, tSMS did not produce measurable changes in MEP amplitude. Possible effects of M1 tSMS on motor learning require further study. Our findings support further exploration of tSMS neuromodulation in young children with cerebral palsy.
非侵入性神经调节是治疗早期脑损伤儿童的一种新兴疗法,但在发育可塑性窗口最佳时,很难应用于学龄前儿童。经颅静磁场刺激(tSMS)可降低成人初级运动皮层(M1)的兴奋性,但对发育中大脑的影响尚未得到研究。
目的/假设:我们旨在确定tSMS对健康儿童皮层兴奋性和运动学习的影响。我们假设,右侧M1区域的tSMS会降低皮层兴奋性并抑制对侧运动学习。
本随机、假对照、双盲、三臂、交叉试验纳入了24名10 - 18岁的健康儿童。经颅磁刺激(TMS)通过运动诱发电位(MEP)幅度和配对脉冲测量来评估皮层兴奋性。通过普渡钉板测试(PPT)评估运动学习。在参与者训练非优势手时,将一个tSMS磁体(677牛顿)或假磁体置于左侧或右侧M1区域30分钟。使用线性混合效应模型来检验干预效果。
所有72次tSMS治疗均耐受性良好,无严重不良反应。tSMS既未改变通过MEP测量的皮层兴奋性,也未改变配对脉冲皮质内神经生理学。可能的行为学效应包括,对侧tSMS抑制了训练的非优势手的早期运动学习(<0.01),同侧tSMS促进了运动学习的后期阶段(<0.01)。
tSMS在儿科人群中是可行的。与成人不同,tSMS并未使MEP幅度产生可测量的变化。M1区域tSMS对运动学习的可能影响需要进一步研究。我们的研究结果支持在患有脑瘫的幼儿中进一步探索tSMS神经调节。