Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea.
Restor Neurol Neurosci. 2020;38(6):407-417. doi: 10.3233/RNN-201032.
Low-frequency rTMS can induce upregulation of excitability in the contralateral hemisphere by interhemispheric interaction.
The aim of this study was to compare the effects of interhemispheric modulation on hemodynamic changes after applying low-frequency rTMS over the anatomical hand knob (HK) and the hand motor hotspot (hMHS) in the dominant motor cortex.
Ten healthy right-handed participants without a history of neurological or psychiatric symptoms (five males; 29.8±2.8 years) participated in this single-blind, randomized, cross-over study. rTMS was applied under three conditions over the dominant (left) hemisphere for 20 minutes: 1) 1 Hz rTMS stimulation on the HK (HK-rTMS), 2) 1 Hz rTMS stimulation on the hMHS (hMHS-rTMS), and 3) sham stimulation (Sham-rTMS). For all participants, functional near-infrared spectroscopy (fNIRS) was applied for measurement of cerebral oxyhemoglobin (oxyHb) and deoxyhemoglobin (deoxyHb) concentration over the non-dominant (right) hemisphere during a serial reaction time task (SRTT) with the non-dominant (left) hand before and after each condition.
The average coordinates of the hMHS (x = - 39.60 mm, y = - 17.11 mm, z = 66.40 mm) were anterior and lateral to the HK (x = - 36.72 mm, y = - 28.87 mm, z = 56.41 mm). In fNIRS time-series analysis, the integral value of oxyHb wassignificantly increased over the motor cortical region of the non-dominant hemisphere after the hMHS-rTMS compared with Sham-rTMS. The HK-rTMS also showed slight increment of oxyHb concentration but without statistical significance. The SPM group analysis showed greater magnitude of the activity in hMHS-rTMS than that of HK-rTMS after stimulation (p < 0.05).
These results demonstrated an interhemispheric modulation effect of hemodynamic changes by 1 Hz rTMS. The hMHS produced a more robust modulation effect of 1 Hz rTMS on the contralateral hemisphere than did the HK. Therefore, the rTMS can be considered a better stimulation target than the HK.
低频 rTMS 通过半球间相互作用诱导对侧半球兴奋性上调。
本研究旨在比较应用低频 rTMS 于解剖学手部旋钮 (HK) 和优势运动热点 (hMHS) 对优势运动皮层后,对侧半球血流动力学变化的半球间调制效应。
10 名无神经或精神病史的健康右利手参与者(5 名男性;29.8±2.8 岁)参加了这项单盲、随机、交叉研究。rTMS 在 20 分钟内以三种条件应用于左半球(优势半球):1)HK 上的 1 Hz rTMS 刺激(HK-rTMS),2)hMHS 上的 1 Hz rTMS 刺激(hMHS-rTMS),和 3)假刺激(Sham-rTMS)。对于所有参与者,在每个条件之前和之后,应用功能近红外光谱 (fNIRS) 测量非优势(右)半球在左手进行连续反应时间任务 (SRTT) 时的脑氧合血红蛋白 (oxyHb) 和脱氧血红蛋白 (deoxyHb) 浓度。
hMHS 的平均坐标(x= - 39.60 mm,y= - 17.11 mm,z= 66.40 mm)在前部和侧部比 HK(x= - 36.72 mm,y= - 28.87 mm,z= 56.41 mm)。在 fNIRS 时间序列分析中,与 Sham-rTMS 相比,hMHS-rTMS 后非优势半球运动皮质区域的 oxyHb 积分值明显增加。HK-rTMS 也显示出 oxyHb 浓度的轻微增加,但无统计学意义。SPM 组分析显示,刺激后 hMHS-rTMS 的活动幅度大于 HK-rTMS(p<0.05)。
这些结果表明,1 Hz rTMS 通过半球间相互作用产生血流动力学变化的调制效应。与 HK 相比,1 Hz rTMS 对 hMHS 的对侧半球产生更强的调制效应。因此,rTMS 可以被认为是比 HK 更好的刺激靶点。