Atsuhiro Tsubaki

Corticomotor excitability induced by anodal transcranial direct current stimulation with and without non-exhaustive movement

We investigated whether anodal transcranial direct current stimulation (tDCS) applied to the motor cortex during non-exhaustive active or passive movements enhances corticomotor excitability after tDCS or whether it reduces post-exercise depression (PED) after non-exhaustive active or passive movements if PED was observed without tDCS. Nine healthy subjects participated in this study. Anodal tDCS with a current of 2 mA was applied to the left scalp over the primary motor area. All subjects underwent the following five interventions: tDCS delivered for 10 min during relaxation (tDCS condition) and repetitive voluntary and passive finger abduction-adduction movements, each performed without and with tDCS for 10 min (active condition, tDCS+active condition, passive condition, tDCS+passive condition). The active movements were performed at 10% maximum voluntary contraction. Motor evoked potentials (MEPs) were recorded from the right first dorsal interosseus muscle before the intervention (pre-intervention) and 2 and 10 min after the intervention (post-2 min and post-10 min, respectively). Under the tDCS condition, the MEP amplitudes at post-2 and -10 min were significantly increased compared with those before the intervention. Under the active, passive, and tDCS+active conditions, the MEP amplitudes at post-2 min were significantly decreased compared with those before the interventions. Under the tDCS+passive condition, the MEP amplitude remained unchanged. These results demonstrated that anodal tDCS did not reduce PED after active movements but after passive movements and that the anodal tDCS effects were highly dependent on the state of the subject during stimulation.

The effect of anodal transcranial direct current stimulation over the primary motor or somatosensory cortices on somatosensory evoked magnetic fields.

OBJECTIVES The purpose of this study was to investigate the effect of anodal transcranial direct-current stimulation (tDCS) applied over the primary motor (M1) or the primary somatosensory (S1) cortices on somatosensory evoked magnetic fields (SEFs) following median nerve stimulation. METHODS Anodal tDCS was applied for 15min on the left motor or somatosensory cortices at 1mA. SEFs were recorded following right median nerve stimulation using a magnetoencephalography (MEG) system before and after the application of tDCS. SEFs was measured and compared before and after tDCS was applied over M1 or S1. RESULTS The source strengths for the P35m and P60m increased after tDCS was applied over M1 and that for the P60m increased after tDCS was applied over S1. The mean equivalent current dipole (ECD) location for the P35m was located significantly anterior to that of the N20m, but only during post 1 (10-20min after tDCS was applied over M1). CONCLUSION Our results indicated that the anodal tDCS applied over M1 affected the P35m and P60m sources on SEF components, while that applied over S1 influenced the P60m source. SIGNIFICANCE We demonstrated anodal tDCS applied over M1 or S1 can modulate somatosensory processing and components of SEFs, confirming the hypothesis for locally distinct generators of the P35m and P60m sources.

Physical function was related to mortality in patients with chronic kidney disease and dialysis

Previous studies have shown that exercise improves aerobic capacity, muscular functioning, cardiovascular function, walking capacity, and health‐related quality of life (QOL) in patients with chronic kidney disease (CKD) and dialysis. Recently, additional studies have shown that higher physical activity contributes to survival and decreased mortality as well as physical function and QOL in patients with CKD and dialysis. Herein, we review the evidence that physical function and physical activity play an important role in mortality for patients with CKD and dialysis. During November 2016, Medline and Web of Science databases were searched for published English medical reports (without a time limit) using the terms “CKD” or “dialysis” and “mortality” in conjunction with “exercise capacity,” “muscle strength,” “activities of daily living (ADL),” “physical activity,” and “exercise.” Numerous studies suggest that higher exercise capacity, muscle strength, ADL, and physical activity contribute to lower mortality in patients with CKD and dialysis. Physical function is associated with mortality in patients with CKD and dialysis. Increasing physical function may decrease the mortality rate of patients with CKD and dialysis. Physicians and medical staff should recognize the importance of physical function in CKD and dialysis. In addition, exercise is associated with reduced mortality among patients with CKD and dialysis.

Effect of Transcranial Direct Current Stimulation over the Primary Motor Cortex on Cerebral Blood Flow: A Time Course Study Using Near-infrared Spectroscopy

Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that is applied during stroke rehabilitation. The purpose of this study was to examine diachronic intracranial hemodynamic changes using near-infrared spectroscopy (NIRS) during tDCS applied to the primary motor cortex (M1). Seven healthy volunteers were tested during real stimulation (anodal and cathodal) and during sham stimulation. Stimulation lasted 20 min and NIRS data were collected for about 23 min including the baseline. NIRS probe holders were positioned over the entire contralateral sensory motor area. Compared to the sham condition, both anodal and cathodal stimulation resulted in significantly lower oxyhemoglobin (O2Hb) concentrations in the contralateral premotor cortex (PMC), supplementary motor area (SMA), and M1 (p<0.01). Particularly in the SMA, the O2Hb concentration during anodal stimulation was significantly lower than that during the sham condition (p<0.01), while the O2Hb concentration during cathodal stimulation was lower than that during anodal stimulation (p<0.01). In addition, in the primary sensory cortex, the O2Hb concentration during anodal stimulation was significantly higher than the concentrations during both cathodal stimulation and the sham condition (p<0.05). The factor of time did not demonstrate significant differences. These results suggest that both anodal and cathodal tDCS cause widespread changes in cerebral blood flow, not only in the area immediately under the electrode, but also in other areas of the cortex.

Effect of Valsalva Maneuver-Induced Hemodynamic Changes on Brain Near-Infrared Spectroscopy Measurements

Near-infrared spectroscopy (NIRS) is widely used to measure human brain activation on the basis of cerebral hemodynamic response. However, a limitation of NIRS is that systemic changes influence the measured signals. The purpose of this study was to clarify the relationship between NIRS signals and blood pressure during the Valsalva maneuver. Nine healthy volunteers performed a 20-s Valsalva maneuver to change their blood pressure. Changes in oxyhemoglobin (O2Hb) concentration were measured with 34 channels with an inter-optode distance of 30 mm for deep-penetration measurements (deepO2Hb) and 9 channels with an inter-optode distance of 15 mm for shallow-penetration measurements (shallowO2Hb). The difference value (diffO2Hb) between deepO2Hb and shallowO2Hb was calculated. Mean arterial pressure (MAP) was recorded by volume clamping the finger pulse, and skin blood flow changes were measured at the forehead. Pearsons correlation coefficients between deepO2Hb and MAP, shallowO2Hb and MAP, and diffO2Hb and MAP were 0.893 (P < 0.01), 0.963 (P < 0.01), and 0.831 (P < 0.01), respectively. The results suggest that regional and systemic changes in the cardiovascular state strongly influence NIRS signals.

Effect of Range and Angular Velocity of Passive Movement on Somatosensory Evoked Magnetic Fields

To clarify characteristics of each human somatosensory evoked field (SEF) component following passive movement (PM), PM1, PM2, and PM3, using high spatiotemporal resolution 306-channel magnetoencephalography and varying PM range and angular velocity. We recorded SEFs following PM under three conditions [normal range–normal velocity (NN), small range–normal velocity (SN), and small range–slow velocity (SS)] with changing movement range and angular velocity in 12 participants and calculated the amplitude, equivalent current dipole (ECD) location, and the ECD strength for each component. All components were observed in six participants, whereas only PM1 and PM3 in the other six. Clear response deflections at the ipsilateral hemisphere to PM side were observed in seven participants. PM1 amplitude was larger under NN and SN conditions, and mean ECD location for PM1 was at primary motor area. PM3 amplitude was larger under SN condition and mean ECD location for PM3 under SS condition was at primary somatosensory area. PM1 amplitude was dependent on the angular velocity of PM, suggesting that PM1 reflects afferent input from muscle spindle, whereas PM3 amplitude was dependent on the duration. The ECD for PM3 was located in the primary somatosensory cortex, suggesting that PM3 reflects cutaneous input. We confirmed the hypothesis for locally distinct generators and characteristics of each SEF component.

Correlation Between the Cerebral Oxyhaemoglobin Signal and Physiological Signals During Cycling Exercise: A Near-Infrared Spectroscopy Study

Near-infrared spectroscopy (NIRS) is a widely used noninvasive method for measuring human brain activation based on the cerebral haemodynamic response. However, systemic changes can influence the signals parameters. Our study aimed to investigate the relationships between NIRS signals and skin blood flow (SBF) or blood pressure during dynamic movement. Nine healthy volunteers (mean age, 21.3 ± 0.7 years; 6 women) participated in this study. The oxyhaemoglobin (O2Hb) signal, SBF, and mean arterial pressure (MAP) were measured while the volunteers performed multi-step incremental exercise on a bicycle ergometer, at workloads corresponding to 30, 50, and 70 % of peak oxygen consumption (VO2peak) for 5 min. The Pearsons correlation coefficients for the O2Hb signal and SBF at 50 and 70 % VO2peak were 0.877 (P < 0.01) and -0.707 (P < 0.01), respectively. The correlation coefficients for O2Hb and MAP during warm-up, 30 % VO2peak, and 50 % VO2peak were 0.725 (P < 0.01), 0.472 (P < 0.01), and 0.939 (P < 0.01), respectively. Changes in the state of the cardiovascular system influenced O2Hb signals positively during low and moderate-intensity exercise, whereas a negative relationship was observed during high-intensity exercise. These results suggest that the relationship between the O2Hb signal and systemic changes is affected by exercise intensity.

Changes in Cortical Oxyhaemoglobin Signal During Low-Intensity Cycle Ergometer Activity: A Near-Infrared Spectroscopy Study

Near-infrared spectroscopy (NIRS) is a widely used non-invasive method for measuring human brain activation based on the cerebral hemodynamic response during gross motor tasks. However, systemic changes can influence measured NIRS signals. We aimed to determine and compare time-dependent changes in NIRS signal, skin blood flow (SBF), and mean arterial pressure (MAP) during low-intensity, constant, dynamic exercise. Nine healthy volunteers (22.1±1.7 years, 3 women) participated in this study. After a 4-min pre-exercise rest and a 4-min warm-up, they exercised on a bicycle ergometer at workloads corresponding to 30% VO2 peak for 20 min. An 8-min rest period followed the exercise. Cortical oxyhaemoglobin signals (O2Hb) were recorded while subjects performed the exercise, using an NIRS system. Changes in SBF and MAP were also measured during exercise. O2Hb increased to 0.019 mM cm over 6 min of exercise, decreased slightly from 13 min towards the end of the exercise. SBF continued to increase over 16 min of the exercise period and thereafter decreased till the end of measurement. MAP fluctuated from -1.0 to 7.1 mmHg during the exercise. Pearsons correlation coefficients between SBF and O2Hb, and MAP and O2Hb differed in each time phase, from -0.365 to 0.713. During low-intensity, constant, dynamic exercise, the profile of changes in measurements of O2Hb, SBF, and MAP differed. These results suggested that it is necessary to confirm the relationship between O2Hb and systemic factors during motor tasks in order to detect cortical activation during gross motor tasks.

Changes in Oxyhemoglobin Concentration in the Prefrontal Cortex and Primary Motor Cortex During Low- and Moderate-Intensity Exercise on a Cycle Ergometer

The present study investigated whether changes in oxyhemoglobin (O2Hb) concentration over time differed across brain regions according to differences in gross movement intensity. Thirteen healthy adults (21.2 ± 1.0 years, 8 women) participated in this study. After 180 s of rest, the participants performed 600 s of exercise on a cycle ergometer. Exercise intensity was set at 30%VO2peak and 50%VO2peak. The prefrontal cortex (PFC) and primary motor cortex (M1) were chosen as regions of interest. In addition, mean arterial pressure (MAP) and scalp blood flow (SBF) were measured simultaneously. O2Hb concentration in PFC and M1 was significantly decreased in initial phase of the exercise, while it was significantly increased from the mid to final phase for both intensities compared with resting state values (p < 0.01). The O2Hb concentrations in the PFC and M1 were significantly decreased in the initial exercise phase. However, the MAP and SBF values did not exhibit a similar pattern. The main findings of our study were the follows: (1) During cycle ergometer exercise at the 30% and 50% O2Hb peak, the after O2Hb concentrations were transiently decreased in the initial exercise phase, and the concentrations then steadily increased in both the PFC and M1; and (2) the duration of the transient decreases in the O2Hb concentrations varied according to the brain region and exercise intensity.

Site Specificity of Changes in Cortical Oxyhaemoglobin Concentration Induced by Water Immersion

Our previous studies have shown that water immersion (WI) changes sensorimotor processing and cortical excitability in the sensorimotor regions of the brain. The present study examined the site specificity of the brain activation during WI using functional near infrared spectroscopy (fNIRS). Cortical oxyhaemoglobin (O2Hb) levels in the anterior and posterior parts of the supplementary motor area (pre-SMA and SMA), primary motor cortex (M1), primary somatosensory cortex (S1), and posterior parietal cortex (PPC) were recorded using fNIRS (OMM-3000; Shimadzu Co.) before, during, and after WI in nine healthy participants. The cortical O2Hb levels in SMA, M1, S1, and PPC significantly increased during the WI and increased gradually along with the filling of the WI tank. These changes were not seen in the pre-SMA. The results show that WI-induced increases in cortical O2Hb levels are at least somewhat site specific: there was little brain activation in response to somatosensory input in the pre-SMA, but robust activation in other areas.