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P26-11 Effect of complex hand movements on the excitability of ipsilateral motor cortex
29th International Congress of Clinical Neurophysiology P26-8 Time course of excitability in corticospinal tract after mirror therapy Y. Kohno1 , H. Sekiguchi2 , H. Kadota3 , S. Takeuchi2,4 , T. Ueno1 , H. Nagata1 , Y. Nakajima4 1 Department of Neurology, Ibaraki Prefectural University of Health Sciences Hospital, Ibaraki, Japan, 2 Sports Management Program, Faculty of Business and Information Sciences, Jobu University, Japan, 3 Graduate School of Education, The University of Tokyo, Japan, 4 Department of Rehabilitation for Sensory Functions, Research Institute, National Rehabilitation Center for Persons with Disabilities, Japan Objective: Mirror therapy (MT) is a unique procedure in the rehabilitation for patient with hemiparesis. It has been reported that this procedure facilitates excitability in corticospinal tract of the mirrored-side, but duration of this effect is unknown. We investigate a time course of the effect using transcranial magnetic stimulation (TMS). Methods: Nine-healthy volunteers (sex: five males and four female, age: from 20 to 35 years-old) were participated in this study. Motor evoked potentials (MEP) of the left first dorsal interosseus muscle were measured from just after MT to 30-second in every five seconds. MEP were normalized to the baseline MEP. Subjects were asked to sway their right index finger horizontally at about 2 Hz in the ‘mirror box’. In control session, we use the ‘mirror box without mirror’. MEP of these two conditions were analyzed using paired t test. Results: All subjects felt illusion as if the left hand were moving during MT. In the control session, MEP were stable after MT with ‘mirror box without mirror’. The first MEP of MT was a significant increase than control session, whereas second and the later MEP were not significant. Conclusions: The facilitation of excitability in corticospinal tract lasts only very short duration in MT using a simple motor task. In order to prolong or consolidate the effect of MT, repetition and conducting a more complex task are needed. P26-9 Effects of transcutaneous electrical stimulation combined with pedaling exercise on spinal interneurons in healthy persons
S259 P26-10 Enhancement of non-dominant precise hand motor function by anodal transcranial direct current stimulation A. Matsuo1 , H. Maeoka1 , M. Hiyamizu1 , K. Ikuno2,3 , K. Shomoto1,3 , S. Morioka1,3 1 Department of Physical Therapy, Faculty of Health Science, Kio University, Nara, Japan, 2 Department of Rehabilitation, Nishiyamato Rehabilitation Hospital, Japan, 3 Graduate School of Health Sciences, Kio University, Japan Objective: Transcranial direct current stimulation (tDCS) is non-invasive powerful method to modulate brain activity. It can enhance motor learning and working memory in healthy subjects. However, the effect of tDCS in the precise upper limbs movement is not clear. Our aim in this study is to investigate whether the effect of anodal tDCS of the nondominant primary motor cortex (M1) on precise hand motor performance in healthy right-handed volunteers. Methods: Fourteen healthy subjects (2 female, mean age: 21.7 years) participated for single-blinded, sham controlled, crossover trial. Ethical approval for this study was obtained from Ethics Research Committee at the Kio University and all procedures were carried out according to the Declaration of Helsinki. Anodal tDCS or sham tDCS was randomly delivered on the M1 in non-dominant hemisphere. The duration of tDCS was 20 minutes and sham was 30 second. A circle-drawing task, including a total path length, deviation average area and deviation average distance, using a UM-ART (Hutech Co.) and grip strength measurement were performed before, immediately after and 30 minutes after anodal or sham tDCS to assess time-dependent changes in motor performance. A blinded rater assessed motor function. Results: A significant difference wasn’t shown between the anodal tDCS and the sham tDCS in the total path length and the deviation average distance. In the anodal tDCS condition, deviation average area in the circle-drawing task was significantly improved, but not after the sham tDCS. In the grip strength, there was no change in either of anodal tDCS and sham tDCS. Conclusions: Anodal tDCS on the non-dominant M1 improved the precise motor function of the non-dominant hand. We speculate that the modulation of the brain activities by anodal tDCS leaded a behavioral change.
T. Yamaguchi1,2,3 , T. Fujiwara1 , K. Saito4 , S. Tanabe5 , Y. Muraoka3 , R. Osu6 , Y. Otaka4 , K. Kondo4 , A. Kimura7 , M. Liu1 1 Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan, 2 Research Fellow of Japan Society for the Promotion of Science, Japan, 3 National Hospital Organization Murayama Medical Center, Clinical Research Center, Tokyo, Japan, 4 Tokyo Bay Rehabilitation Hospital, Chiba, Japan, 5 Faculty of Rehabilitation School of Health Sciences, Fujita Health University, Aichi, Japan, 6 Advanced Telecommunications Research Institute International, Kyoto, Japan, 7 Keio University Tsukigase rehabilitation center, Shizuoka, Japan
T. Morishita1 , M. Ninomiya1 , K. Uehara1 , K. Funase1 1 Division of Human Sciences, Graduate School of Integrated Arts and Sciences, Hiroshima University, Japan
Background and Objective: Pedaling could facilitate phasic and coordinated muscle activities even in patients with stroke. There are possibilities that pedaling reduces lower extremity spasticity in persons with stroke or spinal cord injury. Some studies showed that transcutaneous electrical stimulation (TES) could affect reciprocal inhibition. The aim of this study was to examine the effects of TES combined with pedaling (p-TES) on spinal interneurons. Methods: Ten healthy persons, mean age was 27.3±3.0, were recruited. Using a servo-dynamically controlled ergometer with a trunk support, they pedaled at a resistance of 5 N-m at their comfortable speeds. TES was applied to common peroneal nerve during the extension phase of the pedaling cycle. The pulse duration and frequency were 0.3 ms and 30 Hz. The stimulus intensity was adjusted to be slightly above the motor threshold of tibialis anterior muscle. They also received TES alone and pedaling alone. The interval of p-TES, TES and pedaling was more than 1 weak and the order of the three interventions was randomized. We assessed reciprocal inhibition using a soleus H-reflex conditioning-test paradigm. The magnitude of the reciprocal inhibition was measured before, immediately after, 15 min and 30 min after each intervention. Results: We found that reciprocal inhibition increased immediately after each of the three conditions. The increased reciprocal inhibition induced with p-TES lasted for at least 15 min, whereas TES and pedaling had only immediate effects. Conclusion: It was demonstrated that p-TES could induce short term a plastic change of spinal interneurons. In future studies, we would like to examine whether p-TES might be effective to reduce spasticity in the patient population.
Objective: In the present study, we examined the effect of complex hand movement on the excitability of ipsilateral motor cortex, including changes of short interval intracortical inhibition (SICI) and intracortical facilitation (ICF). Methods: Ten right-handed subjects (8 males and 2 females, 19 22 years) participated in the present study after giving their written informed consent. Transcranial magnetic stimulation (TMS) was delivered to evoke the motor evoked potential (MEP) from the contralateral first dorsal interosseous (FDI), i.e., non-movement resting hand. Test-TMS intensity was adjusted to around 120% of resting motor threshold (rMT). For the paired-pulse TMS paradigm, conditioning-TMS intensity was set to 80% of rMT. And the interstimulus intervals were fixed at 3 ms for SICI and 12 ms for ICF, respectively. As a sensorimotor task, we adopted a complex hand movement (CM) task using the chopsticks to pick up and transport the glass balls, repeatedly. As a control task, a pseudo-CM (pCM) task was also performed. These tasks were carried out in both hands, respectively. Results: During CM task, MEPs were markedly increased in comparison to those during a pCM task. These effects were not dependent on the amount of background EMG (bEMG) of FDI in the period of 100 ms prior to TMS during these tasks. SICI was significantly decreased during CM task, showing disinhibition of the ipsilateral motor cortex. These effects were more obvious when using a non-dominant hand. Conclusion: Present findings suggest that differences between the effects of CM and pCM task on the excitability of ipsilateral motor cortex were the results of the different properties of these tasks, i.e., sensorimotor task or not. The CM task as a sensorimotor task strongly affected the excitability of ipsilateral motor cortex via the transcallosal pathway.
P26-11 Effect of complex hand movements on the excitability of ipsilateral motor cortex
S259 P26-10 Enhancement of non-dominant precise hand motor function by anodal transcranial direct current stimulation A. Matsuo1 , H. Maeoka1 , M. Hiyamizu1 , K. Ikuno2,3 , K. Shomoto1,3 , S. Morioka1,3 1 Department of Physical Therapy, Faculty of Health Science, Kio University, Nara, Japan, 2 Department of Rehabilitation, Nishiyamato Rehabilitation Hospital, Japan, 3 Graduate School of Health Sciences, Kio University, Japan Objective: Transcranial direct current stimulation (tDCS) is non-invasive powerful method to modulate brain activity. It can enhance motor learning and working memory in healthy subjects. However, the effect of tDCS in the precise upper limbs movement is not clear. Our aim in this study is to investigate whether the effect of anodal tDCS of the nondominant primary motor cortex (M1) on precise hand motor performance in healthy right-handed volunteers. Methods: Fourteen healthy subjects (2 female, mean age: 21.7 years) participated for single-blinded, sham controlled, crossover trial. Ethical approval for this study was obtained from Ethics Research Committee at the Kio University and all procedures were carried out according to the Declaration of Helsinki. Anodal tDCS or sham tDCS was randomly delivered on the M1 in non-dominant hemisphere. The duration of tDCS was 20 minutes and sham was 30 second. A circle-drawing task, including a total path length, deviation average area and deviation average distance, using a UM-ART (Hutech Co.) and grip strength measurement were performed before, immediately after and 30 minutes after anodal or sham tDCS to assess time-dependent changes in motor performance. A blinded rater assessed motor function. Results: A significant difference wasn’t shown between the anodal tDCS and the sham tDCS in the total path length and the deviation average distance. In the anodal tDCS condition, deviation average area in the circle-drawing task was significantly improved, but not after the sham tDCS. In the grip strength, there was no change in either of anodal tDCS and sham tDCS. Conclusions: Anodal tDCS on the non-dominant M1 improved the precise motor function of the non-dominant hand. We speculate that the modulation of the brain activities by anodal tDCS leaded a behavioral change.
T. Yamaguchi1,2,3 , T. Fujiwara1 , K. Saito4 , S. Tanabe5 , Y. Muraoka3 , R. Osu6 , Y. Otaka4 , K. Kondo4 , A. Kimura7 , M. Liu1 1 Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan, 2 Research Fellow of Japan Society for the Promotion of Science, Japan, 3 National Hospital Organization Murayama Medical Center, Clinical Research Center, Tokyo, Japan, 4 Tokyo Bay Rehabilitation Hospital, Chiba, Japan, 5 Faculty of Rehabilitation School of Health Sciences, Fujita Health University, Aichi, Japan, 6 Advanced Telecommunications Research Institute International, Kyoto, Japan, 7 Keio University Tsukigase rehabilitation center, Shizuoka, Japan
T. Morishita1 , M. Ninomiya1 , K. Uehara1 , K. Funase1 1 Division of Human Sciences, Graduate School of Integrated Arts and Sciences, Hiroshima University, Japan
Background and Objective: Pedaling could facilitate phasic and coordinated muscle activities even in patients with stroke. There are possibilities that pedaling reduces lower extremity spasticity in persons with stroke or spinal cord injury. Some studies showed that transcutaneous electrical stimulation (TES) could affect reciprocal inhibition. The aim of this study was to examine the effects of TES combined with pedaling (p-TES) on spinal interneurons. Methods: Ten healthy persons, mean age was 27.3±3.0, were recruited. Using a servo-dynamically controlled ergometer with a trunk support, they pedaled at a resistance of 5 N-m at their comfortable speeds. TES was applied to common peroneal nerve during the extension phase of the pedaling cycle. The pulse duration and frequency were 0.3 ms and 30 Hz. The stimulus intensity was adjusted to be slightly above the motor threshold of tibialis anterior muscle. They also received TES alone and pedaling alone. The interval of p-TES, TES and pedaling was more than 1 weak and the order of the three interventions was randomized. We assessed reciprocal inhibition using a soleus H-reflex conditioning-test paradigm. The magnitude of the reciprocal inhibition was measured before, immediately after, 15 min and 30 min after each intervention. Results: We found that reciprocal inhibition increased immediately after each of the three conditions. The increased reciprocal inhibition induced with p-TES lasted for at least 15 min, whereas TES and pedaling had only immediate effects. Conclusion: It was demonstrated that p-TES could induce short term a plastic change of spinal interneurons. In future studies, we would like to examine whether p-TES might be effective to reduce spasticity in the patient population.
Objective: In the present study, we examined the effect of complex hand movement on the excitability of ipsilateral motor cortex, including changes of short interval intracortical inhibition (SICI) and intracortical facilitation (ICF). Methods: Ten right-handed subjects (8 males and 2 females, 19 22 years) participated in the present study after giving their written informed consent. Transcranial magnetic stimulation (TMS) was delivered to evoke the motor evoked potential (MEP) from the contralateral first dorsal interosseous (FDI), i.e., non-movement resting hand. Test-TMS intensity was adjusted to around 120% of resting motor threshold (rMT). For the paired-pulse TMS paradigm, conditioning-TMS intensity was set to 80% of rMT. And the interstimulus intervals were fixed at 3 ms for SICI and 12 ms for ICF, respectively. As a sensorimotor task, we adopted a complex hand movement (CM) task using the chopsticks to pick up and transport the glass balls, repeatedly. As a control task, a pseudo-CM (pCM) task was also performed. These tasks were carried out in both hands, respectively. Results: During CM task, MEPs were markedly increased in comparison to those during a pCM task. These effects were not dependent on the amount of background EMG (bEMG) of FDI in the period of 100 ms prior to TMS during these tasks. SICI was significantly decreased during CM task, showing disinhibition of the ipsilateral motor cortex. These effects were more obvious when using a non-dominant hand. Conclusion: Present findings suggest that differences between the effects of CM and pCM task on the excitability of ipsilateral motor cortex were the results of the different properties of these tasks, i.e., sensorimotor task or not. The CM task as a sensorimotor task strongly affected the excitability of ipsilateral motor cortex via the transcallosal pathway.
P26-11 Effect of complex hand movements on the excitability of ipsilateral motor cortex