Department of Neurology, Faculty of Medicine, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan; Department of Neurology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Salemba Raya No. 6, Jakarta 10430, Indonesia.
Department of Neurology, Faculty of Medicine, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan; Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Nishimachi 36-1, Yonago 683-8504, Japan.
Clin Neurophysiol. 2022 Jun;138:9-17. doi: 10.1016/j.clinph.2022.03.009. Epub 2022 Mar 21.
Quadripulse magnetic stimulation (QPS) is useful for changing corticospinal excitability, but the long-term depression (LTD)-like effect considerably has low responder rate. To solve this problem, we modified inhibitory QPS (QPS) by pairing it with the application of an electrical stimulus (ES) to peripheral nerves (paired-associative QPS [PA-QPS]), and investigated the effects of PA-QPS on motor-evoked potentials (MEPs).
The peripheral-nerve ES was applied at two timings with a synchrony to transcranial magnetic stimulation (TMS) over the primary motor cortex (M1). The intrapair interval between ES and TMS was the N20-peak latency plus 2 ms for PA-QPS, and N20-peak latency minus 5 ms for PA-QPS. MEPs elicited by TMS over the left M1 were recorded from the right abductor pollicis brevis muscle before and after the interventions. The responder rates of PA-QPS and QPS was also studied.
The PA-QPS induced larger LTD-like effect than QPS, and the PA-QPS induced smaller aftereffect than QPS. The responder rates were significantly higher for PA-QPS than for QPS.
The new protocol, PA-QPS, induces powerful and consistent LTD-like aftereffects in the corticospinal tract neurons.
PA-QPS is suitable for use in physiological evaluations and therapeutic approaches in various neurological disorders.
四脉冲磁场刺激（QPS）可用于改变皮质脊髓兴奋性，但长时程抑制（ LTD ）样效应的低应答率相当高。为了解决这个问题，我们通过将其与外周神经电刺激（ES）配对来修改抑制性 QPS（QPS）（联合关联 QPS [PA-QPS]），并研究了 PA-QPS 对运动诱发电位（MEP）的影响。
外周神经 ES 在与经颅磁刺激（TMS）同步的两个时间施加到初级运动皮层（M1）上。PA-QPS 的内对间隔是 ES 和 TMS 之间的 N20 峰潜伏期加 2ms，PA-QPS 的 N20 峰潜伏期减 5ms。在干预前后，从右拇指外展短肌记录 TMS 诱发的左侧 M1 运动诱发电位。还研究了 PA-QPS 和 QPS 的应答率。
PA-QPS 诱导的 LTD 样效应大于 QPS，PA-QPS 诱导的后效小于 QPS。PA-QPS 的应答率明显高于 QPS。
新方案 PA-QPS 可在皮质脊髓束神经元中诱导强大而一致的 LTD 样后效。
PA-QPS 适用于各种神经障碍的生理评估和治疗方法。
