Nigel C. Rogasch

Corticomotor plasticity and learning of a ballistic thumb training task are diminished in older adults

This study examined changes in corticomotor excitability and plasticity after a thumb abduction training task in young and old adults. Electromyographic (EMG) recordings were obtained from right abductor pollicis brevis (APB, target muscle) and abductor digiti minimi (ADM, control muscle) in 14 young (18-24 yr) and 14 old (61-82 yr) adults. The training task consisted of 300 ballistic abductions of the right thumb to maximize peak thumb abduction acceleration (TAAcc). Transcranial magnetic stimulation (TMS) of the left primary motor cortex was used to assess changes in APB and ADM motor evoked potentials (MEPs) and short-interval intracortical inhibition (SICI) before, immediately after, and 30 min after training. No differences in corticomotor excitability (resting and active TMS thresholds, MEP input-output curves) or SICI were observed in young and old adults before training. Motor training resulted in improvements in peak TAAcc in young (177% improvement, P < 0.001) and old (124%, P = 0.005) subjects, with greater improvements in young subjects (P = 0.002). Different thumb kinematics were observed during task performance, with increases in APB EMG related to improvements in peak TAAcc in young (r(2) = 0.46, P = 0.008) but not old (r(2) = 0.09, P = 0.3) adults. After training, APB MEPs were 50% larger (P < 0.001 compared with before) in young subjects, with no change after training in old subjects (P = 0.49), suggesting reduced use-dependent corticomotor plasticity with advancing age. These changes were specific to APB, because no training-related change in MEP amplitude was observed in ADM. No significant association was observed between change in APB MEP and improvement in TAAcc with training in individual young and old subjects. SICI remained unchanged after training in both groups, suggesting that it was not responsible for the diminished use-dependent corticomotor plasticity for this task in older adults.

Assessing cortical network properties using TMS–EEG

The past decade has seen significant developments in the concurrent use of transcranial magnetic stimulation (TMS) and electroencephalography (EEG) to directly assess cortical network properties such as excitability and connectivity in humans. New hardware solutions, improved EEG amplifier technology, and advanced data processing techniques have allowed substantial reduction of the TMS‐induced artifact, which had previously rendered concurrent TMS–EEG impossible. Various physiological artifacts resulting from TMS have also been identified, and methods are being developed to either minimize or remove these sources of artifact. With these developments, TMS–EEG has unlocked regions of the cortex to researchers that were previously inaccessible to TMS. By recording the TMS‐evoked response directly from the cortex, TMS–EEG provides information on the excitability, effective connectivity, and oscillatory tuning of a given cortical area, removing the need to infer such measurements from indirect measures. In the following review, we investigate the different online and offline methods for reducing artifacts in TMS–EEG recordings and the physiological information contained within the TMS‐evoked cortical response. We then address the use of TMS–EEG to assess different cortical mechanisms such as cortical inhibition and neural plasticity, before briefly reviewing studies that have utilized TMS–EEG to explore cortical network properties at rest and during different functional brain states. Hum Brain Mapp, 2013.

Removing artefacts from TMS-EEG recordings using independent component analysis: Importance for assessing prefrontal and motor cortex network properties

INTRODUCTIONnThe combination of transcranial magnetic stimulation and electroencephalography (TMS-EEG) is emerging as a powerful tool for causally investigating cortical mechanisms and networks. However, various artefacts contaminate TMS-EEG recordings, particularly over regions such as the dorsolateral prefrontal cortex (DLPFC). The aim of this study was to substantiate removal of artefacts from TMS-EEG recordings following stimulation of the DLPFC and motor cortex using independent component analysis (ICA).nnnMETHODSn36 healthy volunteers (30.8 ± 9 years, 9 female) received 75 single TMS pulses to the left DLPFC or left motor cortex while EEG was recorded from 57 electrodes. A subset of 9 volunteers also received 50 sham pulses. The large TMS artefact and early muscle activity (-2 to ~15 ms) were removed using interpolation and the remaining EEG signal was processed in two separate ICA runs using the FastICA algorithm. Five sub-types of TMS-related artefacts were manually identified: remaining muscle artefacts, decay artefacts, blink artefacts, auditory-evoked potentials and other noise-related artefacts. The cause of proposed blink and auditory-evoked potentials was assessed by concatenating known artefacts (i.e. voluntary blinks or auditory-evoked potentials resulting from sham TMS) to the TMS trials before ICA and evaluating grouping of resultant independent components (ICs). Finally, we assessed the effect of removing specific artefact types on TMS-evoked potentials (TEPs) and TMS-evoked oscillations.nnnRESULTSnOver DLPFC, ICs from proposed muscle and decay artefacts correlated with TMS-evoked muscle activity size, whereas proposed TMS-evoked blink ICs combined with voluntary blinks and auditory ICs with auditory-evoked potentials from sham TMS. Individual artefact sub-types characteristically distorted each measure of DLPFC function across the scalp. When free of artefact, TEPs and TMS-evoked oscillations could be measured following DLPFC stimulation. Importantly, characteristic TEPs following motor cortex stimulation (N15, P30, N45, P60, N100) could be recovered from artefactual data, corroborating the reliability of ICA-based artefact correction.nnnCONCLUSIONSnVarious different artefacts contaminate TMS-EEG recordings over the DLPFC and motor cortex. However, these artefacts can be removed with apparent minimal impact on neural activity using ICA, allowing the study of TMS-evoked cortical network properties.

Hemispheric differences in use-dependent corticomotor plasticity in young and old adults.

The aim of this study was to examine corticomotor excitability and plasticity following repetitive thumb abduction training in left and right hands of young and old adults. Electromyographic recordings were obtained from the abductor pollicis brevis (APB) muscle of 12 young (aged 18–27xa0years) and 14 old (aged 63–75xa0years) adults. Motor training consisted of 300 ballistic abductions of the thumb to maximize peak abduction acceleration, with each hand tested in a separate session. Transcranial magnetic stimulation (TMS) over the primary motor cortex (M1) was used to assess changes in contralateral APB motor-evoked potentials (MEPs) and short-interval intracortical inhibition (SICI) before and after training. For young and old adults, APB MEP amplitude increased for both hands after training, which is indicative of use-dependent plasticity. However, the increase in MEP amplitude was 21% (Pxa0=xa00.04) greater in the left (non-dominant) hand compared with the right (dominant) hand. This occurred despite a 40% greater improvement in peak thumb abduction acceleration (motor learning) for the right hand in young subjects compared with the left hand in young subjects (Pxa0<xa00.04) and the right hand in old subjects (Pxa0<xa00.01). Furthermore, no difference in use-dependent plasticity was observed between young and old adults, and SICI remained unchanged following ballistic training for both hands in all subjects. These findings suggest that there is greater strengthening of corticomotor circuits for control of the left compared with the right hand during simple ballistic thumb training and that an age-related decline in motor learning was observed only in the dominant hand. In contrast to previous studies, these data also indicate that young and old adults can demonstrate similar use-dependent corticomotor plasticity during this simple thumb-training task.

Mechanisms underlying long-interval cortical inhibition in the human motor cortex: a TMS-EEG study

Long-interval cortical inhibition (LICI) refers to suppression of neuronal activity following paired-pulse transcranial magnetic stimulation (TMS) with interstimulus intervals (ISIs) between 50 and 200 ms. LICI can be measured either from motor-evoked potentials (MEPs) in small hand muscles or directly from the cortex using concurrent electroencephalography (EEG). However, it remains unclear whether EEG inhibition reflects similar mechanisms to MEP inhibition. Eight healthy participants received single- and paired-pulse TMS (ISI = 100 ms) over the motor cortex. MEPs were measured from a small hand muscle (first dorsal interosseus), whereas early (P30, P60) and late (N100) TMS-evoked cortical potentials (TEPs) were measured over the motor cortex using EEG. Conditioning and test TMS intensities were altered, and modulation of LICI strength was measured using both methods. LICI of MEPs and both P30 and P60 TEPs increased in strength with increasing conditioning intensities and decreased with increasing test intensities. LICI of N100 TEPs remained unchanged across all conditions. In addition, MEP and P30 LICI strength correlated with the slope of the N100 evoked by the conditioning pulse. LICI of early and late TEP components was differentially modulated with altered TMS intensities, suggesting independent underlying mechanisms. LICI of P30 is consistent with inhibition of cortical excitation similar to MEPs, whereas LICI of N100 may reflect presynaptic autoinhibition of inhibitory interneurons. The N100 evoked by the conditioning pulse is consistent with the mechanism responsible for LICI, most likely GABA(B)-mediated inhibition of cortical activity.

Cortical inhibition of distinct mechanisms in the dorsolateral prefrontal cortex is related to working memory performance: A TMS–EEG study

Paired-pulse transcranial magnetic stimulation combined with electroencephalography (TMS-EEG) is a method for studying cortical inhibition from the dorsolateral prefrontal cortex (DLPFC). However, little is known about the mechanisms underlying TMS-evoked cortical potentials (TEPs) from this region, let alone inhibition of these components. The aim of this study was to assess cortical inhibition of distinct TEPs and oscillations in the DLPFC using TMS-EEG and to investigate the relationship of these mechanisms to working memory. 30 healthy volunteers received single and paired (interstimulus interval = 100 msec) TMS to the left DLPFC. Variations in long-interval cortical inhibition (LICI) of different TEP peaks (N40, P60, N100) and different TMS-evoked oscillations (alpha, lower beta, upper beta, gamma) were compared between individuals. Variation in N100 slope following single pulse TMS, another putative marker of inhibition, was also compared with LICI of each measure. Finally, these measures were correlated with performance of a working memory task. LICI resulted in significant suppression of all TEP peaks and TMS-evoked oscillations (all p < .05). There were no significant correlations between LICI of different TEP peaks or TMS-evoked oscillations with the exception of P60 and N100. Variation in N100 slope correlated with LICI of N40 and beta oscillations. In addition, LICI of P60 and N100 were differentially correlated with working memory performance. The results suggest that both the LICI paradigm and N100 following single pulse TMS reflect complementary methods for assessing GABAB-mediated cortical inhibition in the DLPFC. Furthermore, these measures demonstrate the importance of prefrontal GABAB-mediated inhibitory control for working memory performance.

Eccentric Muscle Damage Has Variable Effects on Motor Unit Recruitment Thresholds and Discharge Patterns in Elbow Flexor Muscles

The purpose of this study was to determine the effect of eccentric muscle damage on recruitment threshold force and repetitive discharge properties of low-threshold motor units. Ten subjects performed four tasks involving isometric contraction of elbow flexors while electromyographic (EMG) data were recorded from human biceps brachii and brachialis muscles. Tasks were 1) maximum voluntary contraction (MVC); 2) constant-force contraction at various submaximal targets; 3) motor unit recruitment threshold task; and 4) minimum motor unit discharge rate task. These tasks were performed on three separate days before, immediately after, and 24 h after eccentric exercise of elbow flexor muscles. MVC force declined (42%) immediately after exercise and remained depressed (29%) 24 h later, indicative of muscle damage. Mean motor unit recruitment threshold for biceps brachii was 8.4+/-4.2% MVC, (n=34) before eccentric exercise, and was reduced by 41% (5.0+/-3.0% MVC, n=34) immediately after and by 39% (5.2+/-2.5% MVC, n=34) 24 h after exercise. No significant changes in motor unit recruitment threshold were observed in the brachialis muscle. However, for the minimum tonic discharge rate task, motor units in both muscles discharged 11% faster (10.8+/-2.0 vs. 9.7+/-1.7 Hz) immediately after (n=29) exercise compared with that before (n=32). The minimum discharge rate variability was greater in brachialis muscle immediately after exercise (13.8+/-3.1%) compared with that before (11.9+/-3.1%) and 24 h after exercise (11.7+/-2.4%). No significant changes in minimum discharge rate variability were observed in the biceps brachii motor units after exercise. These results indicate that muscle damage from eccentric exercise alters motor unit recruitment thresholds for >or=24 h, but the effect is not the same in the different elbow flexor muscles.

Use of theta-burst stimulation in changing excitability of motor cortex: A systematic review and meta-analysis

Noninvasive brain stimulation has been demonstrated to modulate cortical activity in humans. In particular, theta burst stimulation (TBS) has gained notable attention due to its ability to induce lasting physiological changes after short stimulation durations. The present study aimed to provide a comprehensive meta-analytic review of the efficacy of two TBS paradigms; intermittent (iTBS) and continuous (cTBS), on corticospinal excitability in healthy individuals. Literature searches yielded a total of 87 studies adhering to the inclusion criteria. iTBS yielded moderately large MEP increases lasting up to 30 min with a pooled SMD of 0.71 (p<0.00001). cTBS produced a reduction in MEP amplitudes lasting up to 60 min, with the largest effect size seen at 5 min post stimulation (SMD=-0.9, P<0.00001). The collected studies were of heterogeneous nature, and a series of tests conducted indicated a degree of publication bias. No significant change in SICI and ICF was observed, with exception to decrease in SICI with cTBS at the early time point (SMD=0.42, P=0.00036). The results also highlight several factors contributing to TBS efficacy, including the number of pulses, frequency of stimulation and BDNF polymorphisms. Further research investigating optimal TBS stimulation parameters, particularly for iTBS, is needed in order for these paradigms to be successfully translated into clinical settings.

Cortical Inhibition, Excitation, and Connectivity in Schizophrenia: A Review of Insights From Transcranial Magnetic Stimulation

Schizophrenia (SCZ) is a debilitating mental illness with an elusive pathophysiology. Over the last decade, theories emphasizing cortical dysfunction have received increasing attention to explain the heterogeneous symptoms experienced in SCZ. Transcranial magnetic stimulation (TMS) is a noninvasive form of brain stimulation that is particularly suited to probing the fidelity of specific excitatory and inhibitory neuronal populations in conscious humans. In this study, we review the contribution of TMS in assessing inhibitory and excitatory neuronal populations and their long-range connections in SCZ. In addition, we discuss insights from combined TMS and electroencephalography into the functional consequences of impaired excitation/inhibition on cortical oscillations in SCZ.

Short-Latency Artifacts Associated with Concurrent TMS–EEG

BACKGROUNDnConcurrent transcranial magnetic stimulation and electroencephalography (TMS-EEG) is an emerging method for studying cortical network properties. However, various artifacts affect measurement of TMS-evoked cortical potentials (TEPs), especially within 30xa0ms of stimulation.nnnOBJECTIVE/HYPOTHESISnThe aim of this study was to assess the origin and recovery of short-latency TMS-EEG artifacts (<30xa0ms) using different stimulators and under different experimental conditions.nnnMETHODSnEEG was recorded during TMS delivered to a phantom head (melon) and 12 healthy volunteers with different TMS machines, at different scalp positions, at different TMS intensities, and following paired-pulse TMS. Recovery from the TMS artifact and other short-latency artifacts were compared between conditions.nnnRESULTSnFollowing phantom stimulation, the artifact resulting from different TMS machines (Magstim 200, Magventure MagPro R30 and X100) and pulse shapes (monophasic and biphasic) resulted in different artifact profiles. After accounting for differences between machines, TMS artifacts recovered within ∼12xa0ms. This was replicated in human participants, however a large secondary artifact (peaks at 5 and 10xa0ms) became prominent following stimulation over lateral scalp positions, which only recovered after ∼25-40xa0ms. Increasing TMS intensity increased secondary artifact amplitude over both motor and prefrontal cortex. There was no consistent modulation of the secondary artifact following inhibitory paired-pulse TMS (interstimulus intervalxa0=xa0100xa0ms) over motor cortex.nnnCONCLUSIONSnThe secondary artifact observed in humans is consistent with activation of scalp muscles following TMS. TEPs can be recorded within a short period of time (10-12xa0ms) following TMS, however measures must be taken to avoid muscle stimulation.