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29. Effects of visual deprivation on primary motor cortex excitability of healthy subjects: A study with repetitive transcranial magnetic stimulation
Society Proceedings / Clinical Neurophysiology 124 (2013) e189–e223
significantly increased both at the baseline and at the end of the rTMS treatment. However considering the acute effect of rTMS, only at the day 15 rTMS determined a significant increase of P300 latency as in healthy subjects. Our data confirm antidepressant effectiveness of rTMS for TDR. Neurocognitive effects were limited to Verbal Learning. P300 seems no to be a response predictor but eventually a Neurophysiological marker of efficacy. doi:10.1016/j.clinph.2013.06.052
26. Excitatory deep repetitive transcranial magnetic stimulation with H-coil improves motor control in Parkinson’s disease: A pilot study—E. Houdayer, F. Spagnolo, M. Fichera, R. Chieffo, D. Dalla Libera, L. Straffi, E. Coppi, A. Nuara, L. Ferrari, G. Di Maggio, M. Bianco, S. Velikova, A. Zangen, G. Comi, M.A. Volonté, L. Leocani (Milan, Negev, Israel) Our aim was to investigate, in a pilot study, the clinical and neurophysiological effects of non-invasive, deep repetitive transcranial magnetic stimulation (DrTMS) in Parkinson’s disease (PD), using the H coil. Twenty patients (3F; 63 ± 9 y.o.; PD duration: 6 ± 3 y) underwent 12 DrTMS sessions in 4 weeks. Excitatory 10 Hz DrTMS was applied over the primary motor cortex contralateral to the patient’s worse side (WS) and the bilateral prefrontal cortices. Motor control was assessed before and after DrTMS, OFF medication, using clinical (UPDRSIII, lateralized scores, timed arm tapping, and NineHole Peg Test) and neurophysiological measurements (Event-Related Desynchronization (ERD) of the mu and beta sensorimotor rhythms during self-paced WS wrist extensions). No drop-outs or adverse events were recorded. UPDRSIII (global and subscores) and timed tests significantly improved after treatment (p < 0.001). Mu and beta ERD latency onsets were significantly increased after treatment (Mu: 1237 ± 177 ms before, and 2024 ± 215 ms after; beta: 1247 ± 151 ms before, and 2229 ± 179 ms after; p < 0.01). DrTMS is a safe treatment for PD. It improved motor symptoms and significantly modulated the cerebral activity related to motor planning. Further placebo controlled, randomized studies are needed to assess the therapeutic efficacy DrTMS and its consequences on cortical motor control. doi:10.1016/j.clinph.2013.06.053
27. Modulation of motor cortex excitability and brain activation in professional pianists during music listening: A combined EEG and TMS study—A. Nuara, E. Houdayer, J. Gonzalez-Rosa, R. Chieffo, F. Spagnolo, G. Comi, L. Leocani (Milan) Neuroimaging studies have reported mirroring motor activation to music listening in musicians. Actual corticospinal modulation remains to be clarified. We tested the motor cortex modulation in pianists while listening to well-known, predictable melodic sequences, using Transcranial Magnetic Stimulation (TMS) and electroencephalography (EEG). Two groups of subjects were studied: pianists (n = 10) and controls (n = 10). Participants listened to a melodic sequence containing the alternating repetition of a scale in two different octaves. Using a circular coil on the vertex, Motor Evoked Potentials (MEP) were recorded bilaterally on both hands at different time points, with 32 channels EEG monitoring. EEG event-related desynchronization (ERD) of the mu rhythm was assessed by comparing its spectral power during listening vs rest. Pianists, not controls, showed modulation of MEPs amplitude of right hand muscles according to the timing of their activation during actual performance. Left sensori-motor frontal mu ERD to the melodic sequence played with the right hand was present in 9 pianists vs
e195
4 control. The dynamic auditory induced motor resonance to music listening observed in pianists suggests the presence of an audiomotor mirror system that can be related to the ability of musician to confer a gestural meaning to well-known melodies. doi:10.1016/j.clinph.2013.06.054
28. Visuomotor functional connectivity: A TMS study—G. Strigaro, D. Ruge, A. Chen, JC. Rothwell, R. Cantello (Novara, London, UK) The interaction between visual inputs and motor system is of crucial importance in movement control. We studied the functional connectivity between visual and motor cortex by means of transcranial magnetic stimulation. Sixteen volunteers (21– 51 yrs) participated in this study. We measured resting motor threshold (RMT) of the hand motor area and phosphene threshold (PT). A conditioning stimulus (CS) delivered over visual cortex at different intensities (80 and 90% PT) was followed at random interstimulus intervals (ISIs) (12, 15, 18, 21, 24, 27, 30, 35 and 40 ms) by a test stimulus (TS) over left motor cortex to evoke a motor evoked potential (MEP) of 1 mV from right FDI. The conditioned-MEP was expressed as a percentage of the unconditioned-MEP amplitude. One-way ANOVAs analyzed the effects of the CS with “ISIs” as main factor. ANOVA showed a main effect of ISI when the CS intensity was 80% PT (F(9, 90) = 3.410, p = 0.001) and 90% PT (F(9, 99) = 3.081, p = 0.003). Post hoc analysis confirmed that the size of the conditioned-MEP was significantly reduced at 18, 21, 24, 40 ms (p < 0.05) with 80% PT, and significantly reduced at 18, 21, 27, 30, 35, 40 ms (p < 0.02) with 90% PT. In subjects at rest, conditioning stimuli over the visual cortex produce inhibitory changes on corticospinal excitability with a time course between 18 and 40 ms. doi:10.1016/j.clinph.2013.06.055
29. Effects of visual deprivation on primary motor cortex excitability of healthy subjects: A study with repetitive transcranial magnetic stimulation—G. Capua, C. Cambieri, D. Lopergolo, G. Tartaglia, M. Ceccanti, M. Gabriele, V. Frasca, M. Inghilleri (Rome) Our aim was to investigate whether rapid changes in visual input or prolonged visual deafferentation modify primary motor cortex (M1) excitability in healthy subjects. rTMS, consisting of 10 stimuli delivered at 5 Hz, at 120% of resting motor threshold was delivered over M1 in 13 healthy volunteers. They were instructed to relax under eyes-opened (EO) and eyes-closed (EC) resting conditions. Two experimental sessions were performed. In the first session, subjects were tested in both EO and EC conditions in order to see whether short visual deprivation affected the M1 excitability, through the possible changes in the motor evoked potential (MEP) amplitude during the rTMS. In the second session, rTMS was delivered both under EO with room lights on and after 30 min of blindfolding in order to evaluate the effects of prolonged visual deprivation on the M1 excitability. A short-term visual deprivation left the MEP facilitation unchanged during 5 Hz-rTMS trains, whilst 30 min of blindfolding significantly decreased the MEP facilitation. The short-term visual deprivation condition did not significantly influence the M1 excitability, whereas prolonged visual deafferentation decreased rTMS-induced MEP facilitation. Prolonged visual deafferentation can significantly modulate motor cortical synaptic plasticity. doi:10.1016/j.clinph.2013.06.056
significantly increased both at the baseline and at the end of the rTMS treatment. However considering the acute effect of rTMS, only at the day 15 rTMS determined a significant increase of P300 latency as in healthy subjects. Our data confirm antidepressant effectiveness of rTMS for TDR. Neurocognitive effects were limited to Verbal Learning. P300 seems no to be a response predictor but eventually a Neurophysiological marker of efficacy. doi:10.1016/j.clinph.2013.06.052
26. Excitatory deep repetitive transcranial magnetic stimulation with H-coil improves motor control in Parkinson’s disease: A pilot study—E. Houdayer, F. Spagnolo, M. Fichera, R. Chieffo, D. Dalla Libera, L. Straffi, E. Coppi, A. Nuara, L. Ferrari, G. Di Maggio, M. Bianco, S. Velikova, A. Zangen, G. Comi, M.A. Volonté, L. Leocani (Milan, Negev, Israel) Our aim was to investigate, in a pilot study, the clinical and neurophysiological effects of non-invasive, deep repetitive transcranial magnetic stimulation (DrTMS) in Parkinson’s disease (PD), using the H coil. Twenty patients (3F; 63 ± 9 y.o.; PD duration: 6 ± 3 y) underwent 12 DrTMS sessions in 4 weeks. Excitatory 10 Hz DrTMS was applied over the primary motor cortex contralateral to the patient’s worse side (WS) and the bilateral prefrontal cortices. Motor control was assessed before and after DrTMS, OFF medication, using clinical (UPDRSIII, lateralized scores, timed arm tapping, and NineHole Peg Test) and neurophysiological measurements (Event-Related Desynchronization (ERD) of the mu and beta sensorimotor rhythms during self-paced WS wrist extensions). No drop-outs or adverse events were recorded. UPDRSIII (global and subscores) and timed tests significantly improved after treatment (p < 0.001). Mu and beta ERD latency onsets were significantly increased after treatment (Mu: 1237 ± 177 ms before, and 2024 ± 215 ms after; beta: 1247 ± 151 ms before, and 2229 ± 179 ms after; p < 0.01). DrTMS is a safe treatment for PD. It improved motor symptoms and significantly modulated the cerebral activity related to motor planning. Further placebo controlled, randomized studies are needed to assess the therapeutic efficacy DrTMS and its consequences on cortical motor control. doi:10.1016/j.clinph.2013.06.053
27. Modulation of motor cortex excitability and brain activation in professional pianists during music listening: A combined EEG and TMS study—A. Nuara, E. Houdayer, J. Gonzalez-Rosa, R. Chieffo, F. Spagnolo, G. Comi, L. Leocani (Milan) Neuroimaging studies have reported mirroring motor activation to music listening in musicians. Actual corticospinal modulation remains to be clarified. We tested the motor cortex modulation in pianists while listening to well-known, predictable melodic sequences, using Transcranial Magnetic Stimulation (TMS) and electroencephalography (EEG). Two groups of subjects were studied: pianists (n = 10) and controls (n = 10). Participants listened to a melodic sequence containing the alternating repetition of a scale in two different octaves. Using a circular coil on the vertex, Motor Evoked Potentials (MEP) were recorded bilaterally on both hands at different time points, with 32 channels EEG monitoring. EEG event-related desynchronization (ERD) of the mu rhythm was assessed by comparing its spectral power during listening vs rest. Pianists, not controls, showed modulation of MEPs amplitude of right hand muscles according to the timing of their activation during actual performance. Left sensori-motor frontal mu ERD to the melodic sequence played with the right hand was present in 9 pianists vs
e195
4 control. The dynamic auditory induced motor resonance to music listening observed in pianists suggests the presence of an audiomotor mirror system that can be related to the ability of musician to confer a gestural meaning to well-known melodies. doi:10.1016/j.clinph.2013.06.054
28. Visuomotor functional connectivity: A TMS study—G. Strigaro, D. Ruge, A. Chen, JC. Rothwell, R. Cantello (Novara, London, UK) The interaction between visual inputs and motor system is of crucial importance in movement control. We studied the functional connectivity between visual and motor cortex by means of transcranial magnetic stimulation. Sixteen volunteers (21– 51 yrs) participated in this study. We measured resting motor threshold (RMT) of the hand motor area and phosphene threshold (PT). A conditioning stimulus (CS) delivered over visual cortex at different intensities (80 and 90% PT) was followed at random interstimulus intervals (ISIs) (12, 15, 18, 21, 24, 27, 30, 35 and 40 ms) by a test stimulus (TS) over left motor cortex to evoke a motor evoked potential (MEP) of 1 mV from right FDI. The conditioned-MEP was expressed as a percentage of the unconditioned-MEP amplitude. One-way ANOVAs analyzed the effects of the CS with “ISIs” as main factor. ANOVA showed a main effect of ISI when the CS intensity was 80% PT (F(9, 90) = 3.410, p = 0.001) and 90% PT (F(9, 99) = 3.081, p = 0.003). Post hoc analysis confirmed that the size of the conditioned-MEP was significantly reduced at 18, 21, 24, 40 ms (p < 0.05) with 80% PT, and significantly reduced at 18, 21, 27, 30, 35, 40 ms (p < 0.02) with 90% PT. In subjects at rest, conditioning stimuli over the visual cortex produce inhibitory changes on corticospinal excitability with a time course between 18 and 40 ms. doi:10.1016/j.clinph.2013.06.055
29. Effects of visual deprivation on primary motor cortex excitability of healthy subjects: A study with repetitive transcranial magnetic stimulation—G. Capua, C. Cambieri, D. Lopergolo, G. Tartaglia, M. Ceccanti, M. Gabriele, V. Frasca, M. Inghilleri (Rome) Our aim was to investigate whether rapid changes in visual input or prolonged visual deafferentation modify primary motor cortex (M1) excitability in healthy subjects. rTMS, consisting of 10 stimuli delivered at 5 Hz, at 120% of resting motor threshold was delivered over M1 in 13 healthy volunteers. They were instructed to relax under eyes-opened (EO) and eyes-closed (EC) resting conditions. Two experimental sessions were performed. In the first session, subjects were tested in both EO and EC conditions in order to see whether short visual deprivation affected the M1 excitability, through the possible changes in the motor evoked potential (MEP) amplitude during the rTMS. In the second session, rTMS was delivered both under EO with room lights on and after 30 min of blindfolding in order to evaluate the effects of prolonged visual deprivation on the M1 excitability. A short-term visual deprivation left the MEP facilitation unchanged during 5 Hz-rTMS trains, whilst 30 min of blindfolding significantly decreased the MEP facilitation. The short-term visual deprivation condition did not significantly influence the M1 excitability, whereas prolonged visual deafferentation decreased rTMS-induced MEP facilitation. Prolonged visual deafferentation can significantly modulate motor cortical synaptic plasticity. doi:10.1016/j.clinph.2013.06.056