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Neuroscience
M1 Kortikospinal İnhibisyonunu Araştırmak için Tek Darbeli Transkraniyal Manyetik Stimülasyonun İ...
M1 Kortikospinal İnhibisyonunu Araştırmak için Tek Darbeli Transkraniyal Manyetik Stimülasyonun İ...
JoVE Journal
Neuroscience
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JoVE Journal Neuroscience
Measuring Contralateral Silent Period Induced by Single-Pulse Transcranial Magnetic Stimulation to Investigate M1 Corticospinal Inhibition

M1 Kortikospinal İnhibisyonunu Araştırmak için Tek Darbeli Transkraniyal Manyetik Stimülasyonun İndüklediği Kontralateral Sessiz Dönemin Ölçülmesi

Full Text
3,328 Views
07:33 min
August 23, 2022

DOI: 10.3791/64231-v

Ingrid Rebello-Sanchez1, Joao Parente1, Kevin Pacheco-Barrios1,2, Anna Marduy1, Danielle Carolina Pimenta1, Daniel Lima1, Eric Slawka1, Alejandra Cardenas-Rojas1, Gleysson Rodrigues Rosa1, Kamran Nazim3, Abhishek Datta3,4, Felipe Fregni1

1Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital,Harvard Medical School, 2Universidad de Investigación para la Generación y Síntesis de Evidencia en Salud, Universidad San Ignacio de Loyola, 3Research and Development,Soterix Medical, 4City College of New York

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Overview

The article presents a protocol for assessing the contralateral silent period (cSP) as a biomarker for cortical excitability and treatment response, particularly in the context of studying M1 corticospinal inhibition in upper and lower limbs. This method is intended to provide insights into the complexities of corticospinal inhibitory circuitry, aiming to aid in the diagnosis of various neurological diseases.

Key Study Components

Area of Science

  • Neuroscience
  • Clinical neurophysiology
  • Electromyography

Background

  • The contralateral silent period is a measure of corticospinal inhibition.
  • Understanding cSP can help index cortical excitability.
  • Identifying treatment responses in neurological conditions is vital.
  • Current methodologies are aimed at improving the reliability and reproducibility of assessments.

Purpose of Study

  • To provide a robust method for assessing cSP's role in corticospinal inhibition.
  • To contribute to identifying biomarkers for various neurological diseases.
  • To enhance the procedural rigor in clinical neurophysiology research.

Methods Used

  • The protocol employs transcranial magnetic stimulation (TMS) to assess corticospinal excitability.
  • Participants’ first dorsal interosseous (FDI) muscle is monitored via electromyography (EMG).
  • Parameters such as the resting motor threshold and suprathreshold stimuli are systematically determined.
  • The method includes careful electrode positioning and standardized force measurements for contraction.
  • Various cortical landmarks are identified for effective target localization.

Main Results

  • The study underscores the feasibility of measuring cSP and its application as a biomarker.
  • Results indicate cSP reflects changes in corticospinal excitability during voluntary contraction.
  • Procedure validates the effectiveness of eliciting MEPs and capturing important EMG data.
  • It highlights critical metrics for suprathreshold TMS stimuli in varying study populations.

Conclusions

  • This study establishes a framework for assessing cSP, enabling advances in understanding cortical inhibition.
  • The methodological rigor is expected to aid researchers in exploring neurological disease mechanisms.
  • The findings suggest potential applications in clinical diagnostics and treatment monitoring.

Frequently Asked Questions

What are the advantages of using TMS for assessing cSP?
TMS allows for non-invasive measurement of brain activity and provides direct insights into corticospinal excitability. It is critical for understanding neural mechanisms in both health and disease.
How is the first dorsal interosseous (FDI) muscle selected for assessment?
The FDI muscle is chosen based on its role in finger movement assessment, with precise electrode placements to ensure accurate EMG readings during TMS stimulation.
What types of outcomes are typically measured using this protocol?
Outcomes include motor evoked potentials (MEPs), measures of corticospinal inhibition, and the duration of the contralateral silent period.
How can the protocol be adapted for different populations?
Researchers can adjust stimulus intensities and measurement parameters based on the specific neurological conditions or demographics of the study populations.
What are the key limitations of this assessment method?
Variability in individual responses to TMS, along with potential limitations in electrode placement, may affect data consistency. Standardization across studies is essential for comparability.

Kontralateral sessiz dönem (cSP) değerlendirmesi, kortikal uyarılabilirliği ve tedavi yanıtını indekslemek için umut verici bir biyobelirteçtir. Üst ve alt ekstremitelerin M1 kortikospinal inhibisyonunu incelemek için amaçlanan cSP'yi değerlendirmek için bir protokol gösteriyoruz.

Bu protokolde, kortikospinal inhibisyonun üst ve alt ekstremite değerlendirmesi için uygulanabilir, kolayca tekrarlanabilir ve güvenilir bir yöntem göstereceğiz. Kontralateral sessiz dönem, kompleks kortikospinal inhibitör devrelerden bilgi sağlayan bir metriktir. Bu nedenle, bu yöntem, farklı nörolojik hastalıklar için tanısal, vekil ve prediktif bir biyobelirtecin umut verici bir adayıdır.

Prosedürü gösterenler, laboratuvarımdan araştırma görevlileri olan Danielle Pimenta, Anne Pessoto ve Daniel Lima olacak. Elektrotları konumlandırmak üzere kası seçmek için, denekten ellerini masanın üzerine eğilimli bir pozisyonda koymasını isteyin. Daha sonra ilk dorsal interosseöz veya FDI kasını tanımlamak için, denekten işaret parmağını dirence karşı kaçırmalarını, elin geri kalanını sabit tutmasını ve bölgeyi çarpıntı yaparken masaya uzanmasını isteyin.

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