Bilateral Assessment of the Corticospinal Pathways of the Ankle Muscles Using Navigated Transcranial Magnetic Stimulation

Charalambos C. Charalambous; Jing Nong Liang; Steve A. Kautz; Mark S. George; Mark G. Bowden

doi:10.3791/58944

사용 하 여 발목 근육의 Corticospinal 통로의 양측 평가 Transcranial 자석 자극 탐색

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Neuroscience

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JoVE Journal Neuroscience

Bilateral Assessment of the Corticospinal Pathways of the Ankle Muscles Using Navigated Transcranial Magnetic Stimulation

사용 하 여 발목 근육의 Corticospinal 통로의 양측 평가 Transcranial 자석 자극 탐색

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11:06 min

February 19, 2019

DOI: 10.3791/58944-v

Charalambos C. Charalambous^1,2, Jing Nong Liang^3,4, Steve A. Kautz^2,5, Mark S. George^5,6, Mark G. Bowden^2,5,7

¹Department of Neurology,New York University School of Medicine, ²Department of Health Sciences and Research,Medical University of South Carolina, ³Department of Physical Therapy,University of Nevada Las Vegas, ⁴Department of Health Professions,Medical University of South Carolina, ⁵Ralph H. Johnson VA Medical Center, ⁶Department of Psychiatry,Medical University of South Carolina, ⁷Division of Physical Therapy,Medical University of South Carolina

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Overview

This protocol details a standardized method for assessing the corticomotor responses of the tibialis anterior and soleus muscles using transcranial magnetic stimulation (TMS) and neuronavigation. It addresses the challenges of detecting motor-evoked potentials in distal lower extremity muscles during both rest and voluntary activation.

Key Study Components

Area of Science

Neuroscience
Motor control
Electrophysiology

Background

Standardizing assessments of lower extremity muscles is crucial for motor control studies.
This technique is beneficial for both neurologically healthy individuals and stroke patients.
Prior literature has focused primarily on the tibialis anterior with varying methodologies.

Purpose of Study

To standardize lower extremity assessments using TMS.
To identify knowledge gaps regarding motor control during gait.
To consolidate various approaches within existing literature.

Methods Used

This study employs a neuronavigation system alongside TMS.
Key muscles examined include the tibialis anterior and soleus, with detailed electrode placement procedures.
Specific steps involve verifying signal quality and locating motor hotspots bilaterally.
Baseline signal quality is verified through specific testing protocols to minimize noise interference.

Main Results

The method enhances the clarity and reliability of EMG readings for motor assessments.
Corticomotor responses can be accurately measured during tonic voluntary activations.
Identifying the hot spot for each muscle aids in more effective stimulation protocols.
This standardization allows for improved comparison across studies and subjects.

Conclusions

This study provides a robust protocol for bilateral corticomotor response assessments.
The methodology enables the exploration of neural mechanisms underlying motor control and gait.
Identifying and addressing interfering factors can lead to more insightful research outcomes.

Frequently Asked Questions

What are the advantages of using this protocol?

This protocol standardizes the assessment of lower extremity muscle activity, improving comparability of results across different studies.

How is the electrical activity of muscles assessed?

Electromyographic signals are recorded from the tibialis anterior and soleus while subjecting them to TMS during voluntary activations.

What steps are involved in setting up the neuronavigation system?

Subjects' MRI files are uploaded and then co-registered to identify key anatomical landmarks for accurate TMS targeting.

How does the method ensure signal quality?

Signal quality is verified through preliminary tests, ensuring minimal noise before gathering data during the actual assessments.

What types of outcomes are measured during the study?

The primary outcomes include the amplitude and latency of motor-evoked potentials evoked by TMS in the assessed muscles.

현재 프로토콜 설명 단일 펄스 transcranial 자석 자극 및 neuronavigation를 사용 하 여 나머지와 토 닉 자발적인 활성화 중 앞쪽에 tibialis soleus의 corticomotor 응답 동시, 양자 평가 시스템입니다.

이 프로토콜은 말단 하부 말단 근육에서 모터에서 발장된 잠재력을 감지하는 매우 어려운 작업으로 접근 방식을 표준화하기 때문에 매우 중요합니다. 이 기술의 주요 장점은 종종 티비알리스 전방에만 초점을 맞추고 다양한 기술을 사용하는 낮은 사지 자극과 관련된 문헌을 통합한다는 것입니다. 우리는 신경학적으로 건강한 개별뿐만 아니라 뇌졸중을 가진 사람들에 있는 이 기술을 공부했습니다.

그러나 이 기술의 중요성은 낮은 사지 평가를 표준화하는 것입니다. 이 기술은 걸음걸이 중에 모터 제어에 대한 이해의 격차를 식별하고 간섭 요인의 제어를 허용하지 않은 연구를 다시 방문 할 수있는 기회를 허용합니다. 절차를 보여주는 것은 존 킨드레드, 박사, 박사 후 학자, 브라이언 Cence, 연구 코디네이터, 모두 우리의 연구 실험실에서 될 것입니다.

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