MC和JR是由德国研究基金会（DFG RE 2740 / 3-1）的支持。

伦理学声明 :人类研究需要进入研究前参与者的书面知情同意书。获得由参加者招募前相关伦理委员会批准。确保研究是符合赫尔辛基宣言。这里报告的调查结果代表（图4）的基础上，根据赫尔辛基的第 59届WMA大会，首尔，2008年10月修订和弗赖堡大学的地方伦理委员会批准的宣言进行的一项研究。所有受试者都给研究项目前6名的书面知情同意书。 1.安全筛选<ol><li>屏幕无创脑刺激3， 如潜在禁忌的参与者，通过问卷调查25。 </li></ol> 2.运动皮层本地化<ol><li>由两个迪之一找到参与者的手运动皮层stinct方法，通过定位的经颅磁刺激（TMS）诱导的MEP感兴趣的肌肉的脑表示，或基于用测量带 26脑电图10/20国际系统上通过定位标准M1位置（C3 / C4） 。 </li><li>对于TMS诱发的MEP记录询问参与者以去除可能由TMS的磁场的影响，包括信用卡，移动电话和在一般的金属物体的任何对象。 </li><li>请参与者坐得舒服。 </li><li>验证EMG放大器和使用软件的接口时，用于信号配置和采集计算机之间的连接。 </li><li>打开EMG放大器和连接EMG电极电缆。 </li><li>清洁参与者的皮肤通过在其中电极将被放置在手的区域的皮肤制备糊料轻轻擦。去除多余的用干净的纱布垫。 </li><li>附加EMG表面电极在腹部肌腱蒙太奇上的手部肌肉息（例如，右手的分枝拇短展肌）并连接接地电极（例如，上前臂）。该研究的目的确定使用哪个手部肌肉。 注意:对于可重复使用的电极，有必要将其连接到参加者的皮肤之前应用在电极表面上的导电膏的量小。 </li><li> （可选步骤）如果MEP的数据存储需要开始为环境保护部收购的录音软件。 </li><li>检查肌电图阻抗值。确保阻抗为&lt;20欧姆。 </li><li>打开磁刺激仪，按相应的"充电"按钮，充电电容。 </li><li>广场上的纵裂参与者头皮数字8字形TMS线圈和其移动到运动皮层区（约定位C3 /脑电图10/20国际体系的C4）。按住TMS线圈在参考纵裂fissu一个45°-50Ø角重27,28，与手柄向后导向，产生从后部皮质电流流动到前壁29。 注意:两个不同的TMS线圈用于电机皮质定位:图-的八个或圆形线圈。如果可能的话，使用数字8字形的线圈，因为它提供了更多的局灶性脑刺激30和皮质兴奋31测量更高的可靠性。 </li><li>当磁刺激器进行充电（显示在屏幕上），或者按触发按钮或踩踏脚踏开关，或通过软件程序自动放电，刺激。这将随后通过放置在参与者的头皮连接的TMS线圈提供一个单一TMS脉冲。默认的TMS脉冲设置（如，100微秒上升的感应电流和800微秒的衰减时间为单相激励的时间;对于双相刺激短衰减时间）是特定于设备（固件）。 </li><li>低刺激强度开始（例如，设置强度使用的刺激刺激强度控制旋钮，45％的输出），并观察对肌电图可见放大器欧洲议会议员。 <ol><li>如果没有MEP是可见的增长2-5％的步刺激强度，直到MEP是明显存在（例如，0.5-1 mV的幅度）。按触发按钮或激活脚踏开关，如果脉冲传递不是自动重复刺激。告知参与者的刺激会稍强，而且肢体运动，面部抽搐和眼睛闪烁的预期。 注 :建立脉冲之间5秒的最小间隔，以避免对大脑兴奋低频刺激作用。 </li></ol></li><li>径向移动的线圈在初始刺激部位周围1厘米步骤找到与单一的TMS脉冲的施加之后的最大的MEP响应光斑。从那里，再次开始移动线圈，以确保在"热点"（与最大的MEP波幅皮质区）。 注 :（ 例如 ，用于电网标识）不推荐，因为瓶盖需求NEBS电极放置和热点位置可能会丢失被删除的本地化过程中的使用头帽。 </li><li>降低刺激强度在约2％-steps使用上，刺激器的刺激强度控制器旋钮（MEP仍然必须存在）。这将避免误差因超大的刺激。在围绕热点1厘米步骤径向移动线圈和检查MEP规模再次确认的热点。热点还是应该对应最大，最稳定的MEP幅度。 注:请参与者自愿承包感兴趣的肌肉，如果热点难以找到（如，不存在MEP在高温的刺激强度）。通过这样做，刺激强度需要引出的MEP降低它可以更容易地识别相关皮层刺激位点。如果使用这种方法，要求参与者找到一个相关的刺激位置后放松肌肉和调整刺激强度以便可靠的MEP可以当肌肉静止时被发现。继续寻找热点。 </li><li>马克的热点位置和线圈的方向与非永久皮肤标记。 </li><li>对于双边M1刺激，重复步骤对侧肢体2.11至2.16。 </li></ol> 3. NEBS电极的准备<ol><li>将电缆连接到橡胶电极，然后将海绵内袋的电极。确保电极的大小和海绵包大小做匹配。材料是在标准尺寸（例如，5×5厘米2，5×7厘米2）市售的。 </li><li>浸泡在两侧用等渗氯化钠溶液的海绵袋，但避免过度浸泡，防止盐桥或滴到了志愿者。 <ol><li>这一步是optionaL:要使用绷带代替橡皮筋时防止NaCl溶液泄漏，将电极和海绵袋内部的非导电性橡胶海绵盖子。 注:另外 ，覆盖导电膏橡胶电极，并直接把他们放在参与者的头部， 即不使用海绵袋或橡胶海绵套。 </li></ol></li></ol> 4. NEBS电极放置（图1） <ol><li>发现表示电动机皮质热点的头部标记（S）和周围的区域分离的头发。 </li><li>为了提高电导轻轻揉头部周围的标记用40-50％的酒精或皮肤准备膏浸泡棉签皮肤洁净区前电极放置在皮肤上。不要抓破皮肤！去除多余的用等渗氯化钠溶液棉签，并再次清洁区。后来干的区域。 注意:确保头部标记（S）保持可见;如果需要的话。 </li&gt; <li>放置头部标记为感兴趣的M1（对侧感兴趣的手）以下的一个电极。使海绵尽可能与皮肤直接接触。放置电极电缆向参加者的背部，以避免刺激和/或任务执行期间的干扰，并缓和连接到NEBS设备。 注:电极下方的毛发返潮。在毛发过多润燥情况下，使用纸张或毛巾吸收多余的。 注意:对于阳极TDCS，放置在所关注的运动皮层热点的电极（兴奋性的增加是所希望的）对应于阳极，通常连接到红色电缆。阴极（通常连接到一个黑色或蓝色线）放置在相对眶上区域或M1（见下文）。通常，电极放置为TRNS一样，虽然在古典协议没有极性特异性由于交替柯伦Ť流动。如果刺激设置包括刺激抵消特定位置可能是重要的。 </li><li> 单侧M1刺激代替第二电极（阳极TDCS:阴极）在对侧眶上区域（对应于脑电图10/20国际系统到电极FP2）。确保电缆朝向参与者的背面导向。 </li><li>对于双边M1刺激跳过步骤4.4。将第二电极（阳极TDCS:阴极）上的相反M1中的头标同侧在研究中使用的肢以下。确保电缆朝向参与者的背面导向。 </li><li>用弹性绷带的内 - 外方向以稳定M1电极圆两次覆盖头部，然后用剩余的绷带在前后方向圆覆盖头，以稳定两电极。 </li><li>使用粘合带固定奔达的端即</li><li>对参与者的颈部或衬衫胶带固定电缆。 </li><li>电极电缆连接到设备NEBS。 </li></ol><img alt="图2" src="/files/ftp_upload/53367/53367fig2.jpg" /> 在非侵入性的电脑刺激协议使用用于NEBS的协议图2.材料。的传统材料包括NEBS设备，电极线，导电橡胶电极，穿孔海绵包装袋，橡胶海绵罩（选配），等渗氯化钠溶液和绷带。 <a href="https://www.jove.com/files/ftp_upload/53367/53367fig2large.jpg" target="_blank">请点击此处查看该图的放大版本。</a> 5.刺激<ol><li>切换NEBS设备。 </li><li>关于调整刺激类型（TDCS或TRNS），强度（例如，以1mA，1.5 mA或2毫安），期限（例 ​​如，10-40米NEBS设备设置在），斜坡上下相关的刺激类型的附加 ​​因素TRNS（例如，频谱）的刺激和最大强度，典型地8-15秒开始之间（时间），和。 注:按照惯例，假刺激包括斜坡向上紧接着斜坡下降。因此，参加者的刺激的感觉，但在刺激的持续时间不足以发挥对脑功能持久的影响。一些NEBS设备包括学习模式，让参与者和研究者的致盲通过输入研究的具体科目代码。该代码会自动确定刺激设置。另外，第二实验者可以设置每个会话的刺激设置，并覆盖从实验者进行刺激的显示。 </li><li>告知与NEBS相关的潜在副作用的参与者。常见的不良反应包括:皮肤瘙痒/刺痛或烧灼感未derneath电极，头痛，和不适32。灼烧感，可能与皮肤电极接触不良的征兆。 </li><li>启动刺激。 注:常见的刺激持续时间根据调查报告上皮层兴奋的变化（见代表结果部分）约10-20分钟。凭经验，最大刺激持续时间为40分钟3。 </li><li>斜坡和刺激时检查刺激的连续性。如果阻抗过高或电极与皮肤的接触不好，刺激可能自动终止。 注:如果阻抗过高或参与者报告的刺激过程中增加的不适尝试通过减小阻抗，例如，更好行了吧电极在刺激部位或添加导电介质。 NaCl溶液可通过它们放置Ø后直接用注射器在海绵中加入n中的头。 注:出于安全原因，一些设备在整个报告的刺激阻抗。如果阻抗达到特定阈值的NEBS设备可以关闭（例如，55千欧）。 </li><li>如果与电机任务的执行共同施加NEBS，刺激斜坡上升和参与者感觉舒适刺激后开始测试/训练。如果这项研究不包括刺激时电机的任务，确保参与者仍然在刺激期就位，并且醒了，等到刺激结束。 </li><li>请与参与者的刺激的副作用，例如，通过发放标准化问卷32或直接询问参与者。在研究中，包括刺激多天的情况下，注意天之间的任何可能的副作用。 注意:对于致盲疗效评估，每个刺激sessio后请参与者n至猜测哪些刺激类型（假/条件）参与者接受。如果实验者也被蒙蔽，实验者也可以注意他对参与者的刺激类型的猜测。比较实际的刺激类型的答案来验证正确的猜测33的速度。 </li><li>消毒用不含有害物质，如40-50％的乙醇电极和海绵。在水彻底冲洗后。让材料在储存前晾干。 </li></ol>

作者什么都没有透露。

本协议描述的典型材料，并使用NEBS，特别是单侧和双侧M1刺激阳极TDCS，和单边TRNS学习手运动功能的调节和技能的程序步骤。前选择一个特定的NEBS协议用 ​​于人体运动系统的研究中， 例如 ，在运动学习，方法方面的背景下（安全性，耐受，致盲）以及概念方面（在特定的脑区域蒙太奇或电流类型特异性效应）需要被考虑在内。优点和三种策略的限制将在表1中。 <table fo:k...

非侵入性的电脑刺激（NEBS），的电流到大脑的通过完整头骨的施用，可以修改大脑功能和行为1 - 3。为了优化的NEBS的战略理解，导致神经生理学和行为影响的内在机制仍需要治疗潜力。在不同的实验室应用和刺激程序完全透明的标准化提供了数据的可比性，它支持拟议的行动机制的结果和评价的可靠解释的基础。经颅直流电刺激（TDCS）或经颅交流电刺激（TACS）由所施加的电流的参数不同:TDCS由两个电极（阳极和阴极）2之间的一个单向恒定电流流动- 6，同时 TACS使用施加的交流电流在特定频率7。颅随机噪声刺激（TRNS）是TACS的一种特殊形式，它使用在随机的频率施加的交流电流（例如，100-640赫兹），导致迅速变化的刺激强度和除去极性相关的影响4,6,7。极性是仅相关性，如果刺激设置包括刺激补偿 ，例如，噪声频谱随机地改变周围1毫安基线强度（通常不使用）。对于本文的目的，我们将使用的电机系统TDCS和TRNS的影响，密切关注到我们的实验室6最近的一份出版物集中精力工作。 TRNS的作用的基本机制甚至更少理解比TDCS的但与后者可能不同。从理论上讲，在随机共振的概念框架TRNS推出刺激诱发的噪点为神经系统，它可以通过改变日提供一种信号处理的好处Ë信噪比4,8,9。 TRNS可主要放大较弱的信号，从而可以优化特定任务的大脑活动（内源性噪音9）。阳极TDCS增加由自发的神经元放电率10变更指示或增加运动诱发电位（MEP）皮质兴奋振幅2中战胜了几分钟到几小时的持续刺激作用。在被称为长时程增强突触效能持久的增加被认为有助于学习和记忆。事实上，阳极TDCS提高运动皮层突触由弱突触输入11多次激活突触效能。根据，改进的运动功能/技能获取常常显露仅当刺激是共同施加有马达训练11 - 13，也表明突触共激活，因为这活性依赖性过程的一个先决条件。然而，在C的增加之间的因果关系ortical兴奋性（增加的燃烧率或MEP振幅）一方面和改善突触效能另一方面（LTP或行为功能如马达学习）尚未得到证实。 NEBS施加到初级运动皮层（M1）已经吸引了越来越多的关注是安全，有效的方法调节人体运动功能1。神经生理效应和行为结果可以取决于刺激策略（例如，TDCS极性或TRNS），电极的大小和蒙太奇4 - 6,14,15。除了 ​​主题固有解剖和生理因素电极蒙太奇显著影响的电场分布，并且可能导致在皮层16内传播的电流不同的模式- 18。除了 ​​电极的施加的电流的大小的强度确定交付3的电流密度。公共电极蒙太奇在人体运动系统的研究包括（ 图1）:1）阳 ​​极TDCS 单方面M1刺激与位于感兴趣的M1与位于对侧额头上的阴极的阳极;这种方法的基本思想是在感兴趣的6,13,19 M1兴奋的上调- 22; 2）阳极TDCS 双边M1刺激（也被称为与位于感兴趣的M1与位于对侧M1 5,6,14,23,24阴极阳极"bihemispheric"或"双重"刺激）;这种方法的基本思想是通过兴奋性的上调在感兴趣的M1最大化刺激好处，同时在相反的M1下调兴奋性（即，两个M1S之间纵裂抑制的调制）; 3）TRNS，只有上面提到的单方面刺激M1蒙太奇一直investigated 4,6;与此蒙太奇兴奋性增强TRNS的影响已被发现为100-640赫兹4的频谱。脑刺激策略和电极蒙太奇的选择代表了在临床或研究设置的有效和可靠的使用NEBS的一个关键步骤。这里作为人类电机系统用于研究和方法和概念方面进行了讨论这三个NEBS过程进行详细说明。为单侧或双侧TDCS和单边TRNS材料是相同的（ 图2）。 <img alt="图1" src="/files/ftp_upload/53367/53367fig1.jpg" /> 图1.电极蒙太奇和不同的NEBS战略电流方向。（一）单边阳极经颅直流电刺激（TDCS），阳极集中在感兴趣的初级运动皮层和阴极定位在ŧ他对侧眶上区域。 （二）双边运动皮层刺激，阳极和阴极都位于每过一台电机皮质。阳极的位置决定的为阳极TDCS感兴趣的运动皮层。 （三）对于单边经颅随机噪声刺激（TRNS），一个电极位于上运动皮层和在对侧眶上区域的另一个电极。电极之间的电流流动是由黑色箭头表示。阳极（+，红色），负极（ - ，蓝色），交流电（+/-，绿色）。 <a href="https://www.jove.com/files/ftp_upload/53367/53367fig1large.jpg" target="_blank">请点击此处查看该图的放大版本。</a>

<table><tbody><tr><td>NEBS device (DC Stimulator plus)</td><td>Neuroconn</td><td></td><td></td></tr><tr><td>Electrode cables</td><td>Neuroconn</td><td></td><td></td></tr><tr><td>Conductive-rubber electrodes</td><td>Neuroconn</td><td></td><td>5x5 cm</td></tr><tr><td>Perforated sponge bags</td><td>Neuroconn</td><td></td><td>5x5 cm</td></tr><tr><td>Non-conductive rubber sponge cover</td><td>Amrex-Zetron</td><td>FG-02-A103</td><td>Rubber pad 3&quot;*3&quot;</td></tr><tr><td>NaCl isotonic solution&amp;nbsp;</td><td>B. Braun Melsungen AG&amp;nbsp;</td><td>A1151</td><td>Ecoflac, 0,9%</td></tr><tr><td>Cotton crepe bandage</td><td>Paul Hartmann AG</td><td>931004</td><td>8x5m, textile elasticity</td></tr><tr><td>Adhesive tape (Leukofix)</td><td>BSN medical</td><td>02122-00</td><td>2,5cm*5m</td></tr><tr><td>Skin preparation paste</td><td>Weaver</td><td>10-30</td><td></td></tr><tr><td>Magnetic stimulator</td><td>Magstim</td><td>3010-00</td><td>Magstim 200</td></tr><tr><td>EMG conductive paste</td><td>GE Medical Systems</td><td>217083</td><td></td></tr><tr><td>EMG bipolar electrodes</td><td>e.g., Natus Medical Inc. Viking 4&amp;nbsp;</td><td></td><td></td></tr><tr><td>EMG amplifier</td><td>e.g., Natus Medical Inc. Viking 4&amp;nbsp;</td><td></td><td></td></tr><tr><td>Cable for EMG signal transmission</td><td>e.g., Natus Medical Inc. Viking 4</td><td></td><td></td></tr><tr><td>Data acquisition unit&amp;nbsp;</td><td>Cambridge Electronic Design (CED)</td><td>MK1401-3</td><td>AD converter</td></tr><tr><td>Computer for signal recording and offline analysis</td><td></td><td></td><td></td></tr><tr><td>Signal 4.0.9</td><td>Cambridge Electronic Design (CED)</td><td></td><td>Software</td></tr><tr><td>non-permanent skin marker</td><td>Edding</td><td>8020</td><td>1 mm, blue</td></tr></tbody></table>

non-invasive electrical brain stimulation montages for modulation of human motor function

非侵入性的电脑刺激（NEBS）用于调制大脑功能和行为，既为研究和临床用途。特别是，NEBS可经颅或者作为直流电刺激（TDCS）或交流电刺激（TACS）施加。这些刺激类型的发挥时间，剂量和在运动功能和技巧在健康受试者学习TDCS特定极性效应的情况下。最近，TDCS已被用于增强肢体残疾的患者中风或运动障碍的治疗。本文提供了一个一步一步的协议目标与TDCS和经颅随机噪声刺激（TRNS）初级运动皮层，使用预先定义的频率范围内随机应用的电流TACS的具体形式。两种不同的刺激蒙太奇的设置进行解释。在这两个蒙太奇的发射电极（阳极为TDCS）放置在所感兴趣的主要运动皮层。对于单侧运动皮质的刺激接收电极放置在对侧前额上，而对于双边运动皮质的刺激接收电极放置在相对的主运动皮层。的优点和各蒙太奇皮质兴奋性和包括学习运动功能的调制的缺点进行了讨论，以及安全性，耐受性和致盲方面。

调查NEBS的人体运动系统的影响是要考虑适当成果的措施是非常重要的。电机系统的一个优点是由电生理工具皮质表示的可访问性。运动诱发电位经常用作马达皮质兴奋的一个指标。在29微安/ cm 2的电流密度应用的9分钟或更长阳极TDCS后，马达皮质兴奋进行至少30分钟，在大多数的健康志愿者19,21,22（ 也参见图3）的增加。阴极TDCS大?...

Watch this Scientific Journal Video about Non-Invasive Electrical Brain Stimulation Montages for Modulation of Human Motor Function at JoVE.com

Non-Invasive Electrical Brain Stimulation Montages for Modulation of Human Motor Function

非侵入性的电脑刺激能调节大脑皮质功能和行为，既为研究和临床用途。这个协议描述了人体运动系统的调制不同脑刺激的方法。

非侵入电脑刺激蒙太奇的人体运动功能的调节

Non-invasive electrical brain stimulation (NEBS) is used to modulate brain function and behavior, both for research and clinical purposes. In particular, ...

non-invasive-electrical-brain-stimulation-montages-for-modulation

Research

JoVE Journal

Behavior

13.0K 次观看.  Albert Ludwigs University Freiburg. 非侵入性的电脑刺激能调节大脑皮质功能和行为，既为研究和临床用途。这个协议描述了人体运动系统的调制不同脑刺激的方法。 

视频: Non-Invasive Electrical Brain Stimulation Montages for Modulation of Human Motor Function

Corticospinal Excitability Modulation During Action Observation

This study used the transcranial magnetic stimulation/motor evoked potential (TMS/MEP) technique to pinpoint when the automatic tendency to mirror someone else's action becomes anticipatory simulation of a complementary act. TMS was delivered to the left primary motor cortex corresponding to the hand to induce the highest level of MEP activity from the abductor digiti minimi (ADM; the muscle serving little finger abduction) as well as the first dorsal interosseus (FDI; the muscle serving index finger flexion/extension) muscles. A neuronavigation system was used to maintain the position of the TMS coil, and electromyographic (EMG) activity was recorded from the right ADM and FDI muscles. Producing original data with regard to motor resonance, the combined TMS/MEP technique has taken research on the perception-action coupling mechanism a step further. Specifically, it has answered the questions of how and when observing another person's actions produces motor facilitation in an onlooker's corresponding muscles and in what way corticospinal excitability is modulated in social contexts.

Single-pulse transcranial magnetic stimulation over the primary motor cortex, neuronavigation, and registration of electromyographic activity of hand muscles were used in this study to explore corticospinal excitability while participants were observing action sequences.

行动观察期间皮质脊体兴奋调节

This study used the transcranial magnetic stimulation/motor evoked potential (TMS/MEP) technique to pinpoint when the automatic tendency to mirror someone ...

科研

行为学

Multifunctional Setup for Studying Human Motor Control Using Transcranial Magnetic Stimulation, Electromyography, Motion Capture, and Virtual Reality

The study of neuromuscular control of movement in humans is accomplished with numerous technologies. Non-invasive methods for investigating neuromuscular function include transcranial magnetic stimulation, electromyography, and three-dimensional motion capture. The advent of readily available and cost-effective virtual reality solutions has expanded the capabilities of researchers in recreating &#8220;real-world&#8221; environments and movements in a laboratory setting. Naturalistic movement analysis will not only garner a greater understanding of motor control in healthy individuals, but also permit the design of experiments and rehabilitation strategies that target specific motor impairments (e.g. stroke). The combined use of these tools will lead to increasingly deeper understanding of neural mechanisms of motor control. A key requirement when combining these data acquisition systems is fine temporal correspondence between the various data streams. This protocol describes a multifunctional system&#8217;s overall connectivity, intersystem signaling, and the temporal synchronization of recorded data. Synchronization of the component systems is primarily accomplished through the use of a customizable circuit, readily made with off the shelf components and minimal electronics assembly skills.

Transcranial magnetic stimulation, electromyography, and 3D motion capture are commonly used non-invasive techniques for investigating neuromuscular function in humans. In this paper, we describe a protocol that synchronously samples data generated by all three of these tools along with the unique addition of virtual reality stimulus presentation and feedback.

多功能设置研究人类电机控制用经颅磁刺激，肌电图，运动捕捉和虚拟现实

The study of neuromuscular control of movement in humans is accomplished with numerous technologies. Non-invasive methods for investigating neuromuscular ...

Utilizing Transcranial Magnetic Stimulation to Study the Human Neuromuscular System

Transcranial magnetic stimulation (TMS) has been in use for more than 20 years 1, and has grown exponentially in popularity over the past decade. While the use of TMS has expanded to the study of many systems and processes during this time, the original application and perhaps one of the most common uses of TMS involves studying the physiology, plasticity and function of the human neuromuscular system. Single pulse TMS applied to the motor cortex excites pyramidal neurons transsynaptically 2 (Figure 1) and results in a measurable electromyographic response that can be used to study and evaluate the integrity and excitability of the corticospinal tract in humans 3. Additionally, recent advances in magnetic stimulation now allows for partitioning of cortical versus spinal excitability 4,5. For example, paired-pulse TMS can be used to assess intracortical facilitatory and inhibitory properties by combining a conditioning stimulus and a test stimulus at different interstimulus intervals 3,4,6-8. In this video article we will demonstrate the methodological and technical aspects of these techniques. Specifically, we will demonstrate single-pulse and paired-pulse TMS techniques as applied to the flexor carpi radialis (FCR) muscle as well as the erector spinae (ES) musculature. Our laboratory studies the FCR muscle as it is of interest to our research on the effects of wrist-hand cast immobilization on reduced muscle performance6,9, and we study the ES muscles due to these muscles clinical relevance as it relates to low back pain8. With this stated, we should note that TMS has been used to study many muscles of the hand, arm and legs, and should iterate that our demonstrations in the FCR and ES muscle groups are only selected examples of TMS being used to study the human neuromuscular system.

Transcranial magnetic stimulation (TMS) is a non-invasive tool to gain insight on the physiology and function of the human nervous system. Here, we present our TMS techniques to study cortical excitability of the upper limb and lumbar musculature.

利用经颅磁刺激，以研究人类的神经肌肉系统

Transcranial magnetic stimulation (TMS) has been in use for more than 20 years 1, and has grown exponentially in popularity over the past decade.  While ...

医学

Neuronavigation-guided Repetitive Transcranial Magnetic Stimulation for Aphasia

Repetitive transcranial magnetic stimulation (rTMS) is widely used for several neurological conditions, as it has gained acknowledgement for its potential therapeutic effects. Brain excitability is non-invasively modulated by rTMS, and rTMS to the language areas has proved its potential effects on treatment of aphasia. In our protocol, we aim to artificially induce virtual aphasia in healthy subjects by inhibiting Brodmann area 44 and 45 using neuronavigational TMS (nTMS), and F3 of the International 10-20 EEG system for conventional TMS (cTMS). To measure the degree of aphasia, changes in reaction time to a picture naming task pre- and post-stimulation are measured and compare the delay in reaction time between nTMS and cTMS. Accuracy of the two TMS stimulation methods is compared by averaging the Talairach coordinates of the target and the actual stimulation. Consistency of stimulation is demonstrated by the error range from the target. The purpose of this study is to demonstrate use of nTMS and to describe the benefits and limitations of the nTMS compared to those of cTMS.

This study is designed to test the hypothesis that neuronavigational system-guided transcranial magnetic stimulation has higher accuracy for targeting the intended target as demonstrated by eliciting a greater degree of virtual aphasia in healthy subjects, measured by delay in reaction time to picture naming.

神经导航引导下重复经颅磁刺激的失语

Repetitive transcranial magnetic stimulation (rTMS) is widely used for several neurological conditions, as it has gained acknowledgement for its potential ...

Brain State-dependent Brain Stimulation with Real-time Electroencephalography-Triggered Transcranial Magnetic Stimulation

The effect of a stimulus to the brain depends not only on the parameters of the stimulus but also on the dynamics of brain activity at the time of the stimulation. The combination of electroencephalography (EEG) and transcranial magnetic stimulation (TMS) in a real-time brain state-dependent stimulation system allows the study of relations of dynamics of brain activity, cortical excitability, and plasticity induction. Here, we demonstrate a newly developed method to synchronize the timing of brain stimulation with the phase of ongoing EEG oscillations using a real-time data analysis system. This real-time EEG-triggered TMS of the human motor cortex, when TMS is synchronized with the surface EEG negative peak of the sensorimotor &#181;-alpha (8-14 Hz) rhythm, has shown differential corticospinal excitability and plasticity effects. The utilization of this method suggests that real-time information about the instantaneous brain state can be used for efficacious plasticity induction. Additionally, this approach enables personalized EEG-synchronized brain stimulation which may lead to the development of more effective therapeutic brain stimulation protocols.

This paper describes real-time electroencephalography-triggered transcranial magnetic stimulation to study and modulate human brain networks.

脑状态依赖性脑刺激与实时脑脑图触发颅内磁刺激

The effect of a stimulus to the brain depends not only on the parameters of the stimulus but also on the dynamics of brain activity at the time of the ...

The Use of Magnetic Resonance Spectroscopy as a Tool for the Measurement of Bi-hemispheric Transcranial Electric Stimulation Effects on Primary Motor Cortex Metabolism

Transcranial direct current stimulation (tDCS) is a neuromodulation technique that has been increasingly used over the past decade in the treatment of neurological and psychiatric disorders such as stroke and depression. Yet, the mechanisms underlying its ability to modulate brain excitability to improve clinical symptoms remains poorly understood 33. To help improve this understanding, proton magnetic resonance spectroscopy (1H-MRS) can be used as it allows the in vivo quantification of brain metabolites such as &#947;-aminobutyric acid (GABA) and glutamate in a region-specific manner 41. In fact, a recent study demonstrated that 1H-MRS is indeed a powerful means to better understand the effects of tDCS on neurotransmitter concentration 34. This article aims to describe the complete protocol for combining tDCS (NeuroConn MR compatible stimulator) with 1H-MRS at 3 T using a MEGA-PRESS sequence. We will describe the impact of a protocol that has shown great promise for the treatment of motor dysfunctions after stroke, which consists of bilateral stimulation of primary motor cortices 27,30,31. Methodological factors to consider and possible modifications to the protocol are also discussed.

This article aims to describe a basic protocol for combining transcranial direct current stimulation (tDCS) with proton magnetic resonance spectroscopy (1H-MRS) measurements to investigate the effects of bilateral stimulation on primary motor cortex metabolism.

磁共振波谱的用途，用于对初级运动皮层新陈代谢双半球经颅电刺激效果的测量工具一

Transcranial direct current stimulation (tDCS) is a neuromodulation technique that has been increasingly used over the past decade in the treatment of ...

神经科学

Effects of Transcranial Alternating Current Stimulation on the Primary Motor Cortex by Online Combined Approach with Transcranial Magnetic Stimulation

Transcranial Alternating Current Stimulation (tACS) is a neuromodulatory technique able to act through sinusoidal electrical waveforms in a specific frequency and in turn modulate ongoing cortical oscillatory activity. This neurotool allows the establishment of a causal link between endogenous oscillatory activity and behavior. Most of the tACS studies have shown online effects of tACS. However, little is known about the underlying action mechanisms of this technique because of the AC-induced artifacts on Electroencephalography (EEG) signals. Here we show a unique approach to investigate online physiological frequency-specific effects of tACS of the primary motor cortex (M1) by using single pulse Transcranial Magnetic Stimulation (TMS) to probe cortical excitability changes. In our setup, the TMS coil is placed over the tACS electrode while Motor Evoked Potentials (MEPs) are collected to test the effects of the ongoing M1-tACS. So far, this approach has mainly been used to study the visual and motor systems. However, the current tACS-TMS setup can pave the way for future investigations of cognitive functions. Therefore, we provide a step-by-step manual and video guidelines for the procedure.

Transcranial Alternating Current Stimulation (tACS) allows the modulation of cortical excitability in a frequency-specific fashion. Here we show a unique approach which combines online tACS with single pulse Transcranial Magnetic Stimulation (TMS) in order to "probe" cortical excitability by means of Motor Evoked Potentials.

经颅磁刺激在线联合方法对经颅交流电刺激对原发性运动皮层的影响

Transcranial Alternating Current Stimulation (tACS) is a neuromodulatory technique able to act through sinusoidal electrical waveforms in a specific ...

The Combined Use of Transcranial Direct Current Stimulation and Robotic Therapy for the Upper Limb

Neurologic disorders such as stroke and cerebral palsy are leading causes of long-term disability and can lead to severe incapacity and restriction of daily activities due to lower and upper limb impairments. Intensive physical and occupational therapy are still considered main treatments, but new adjunct therapies to standard rehabilitation that may optimize functional outcomes are being studied.
Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that polarizes underlying brain regions through the application of weak direct currents through electrodes on the scalp, modulating cortical excitability. Increased interest in this technique can be attributed to its low cost, ease of use, and effects on human neural plasticity. Recent research has been performed to determine the clinical potential of tDCS in diverse conditions such as depression, Parkinson&#39;s disease, and motor rehabilitation after stroke. tDCS helps enhance brain plasticity and seems to be a promising technique in rehabilitation programs.
A number of robotic devices have been developed to assist in the rehabilitation of upper limb function after stroke. The rehabilitation of motor deficits is often a long process requiring multidisciplinary approaches for a patient to achieve maximum independence. These devices do not intend to replace manual rehabilitation therapy; instead, they were designed as an additional tool to rehabilitation programs, allowing immediate perception of results and tracking of improvements, thus helping patients to stay motivated.
Both tDSC and robot-assisted therapy are promising add-ons to stroke rehabilitation and target the modulation of brain plasticity, with several reports describing their use to be associated with conventional therapy and the improvement of therapeutic outcomes. However, more recently, some small clinical trials have been developed that describe the associated use of tDCS and robot-assisted therapy in stroke rehabilitation. In this article, we describe the combined methods used in our institute for improving motor performance after stroke.

The combined use of transcranial direct current stimulation and robotic therapy as an add-on for conventional rehabilitation therapy may result in improved therapeutic outcomes due to modulation of brain plasticity. In this article, we describe the combined methods used in our institute for improving motor performance after stroke.

经颅直流电刺激与上肢机器人治疗的联合应用

Neurologic disorders such as stroke and cerebral palsy are leading causes of long-term disability and can lead to severe incapacity and restriction of ...

Non-Invasive Modulation and Robotic Mapping of Motor Cortex in the Developing Brain

Mapping the motor cortex with transcranial magnetic stimulation (TMS) has potential to interrogate motor cortex physiology and plasticity but carries unique challenges in children. Similarly, transcranial direct current stimulation (tDCS) can improve motor learning in adults but has only recently been applied to children. The use of tDCS and emerging techniques like high&#8211;definition tDCS (HD-tDCS) require special methodological considerations in the developing brain. Robotic TMS motor mapping may confer unique advantages for mapping, particularly in the developing brain. Here, we aim to provide a practical, standardized approach for two integrated methods capable of simultaneously exploring motor cortex modulation and motor maps in children. First, we describe a protocol for robotic TMS motor mapping. Individualized, MRI-navigated 12x12 grids centered on the motor cortex guide a robot to administer single-pulse TMS. Mean motor evoked potential (MEP) amplitudes per grid point are used to generate 3D motor maps of individual hand muscles with outcomes including map area, volume, and center of gravity. Tools to measure safety and tolerability of both methods are also included. Second, we describe the application of both tDCS and HD-tDCS to modulate the motor cortex and motor learning. An experimental training paradigm and sample results are described. These methods will advance the application of non-invasive brain stimulation in children.

We demonstrate protocols for the modulation (tDCS, HD-tDCS) and mapping (robotic TMS) of the motor cortex in children.

发育中大脑运动皮质的非侵入性调制和机器人映射

Mapping the motor cortex with transcranial magnetic stimulation (TMS) has potential to interrogate motor cortex physiology and plasticity but carries ...

Measuring and Manipulating Functionally Specific Neural Pathways in the Human Motor System with Transcranial Magnetic Stimulation

Understanding interactions between brain areas is important for the study of goal-directed behavior. Functional neuroimaging of brain connectivity has provided important insights into fundamental processes of the brain like cognition, learning, and motor control. However, this approach cannot provide causal evidence for the involvement of brain areas of interest. Transcranial magnetic stimulation (TMS) is a powerful, noninvasive tool for studying the human brain that can overcome this limitation by transiently modifying brain activity. Here, we highlight recent advances using a paired-pulse, dual-site TMS method with two coils that causally probes cortico-cortical interactions in the human motor system during different task contexts. Additionally, we describe a dual-site TMS protocol based on cortical paired associative stimulation (cPAS) that transiently enhances synaptic efficiency in two interconnected brain areas by applying repeated pairs of cortical stimuli with two coils. These methods can provide a better understanding of the mechanisms underlying cognitive-motor function as well as a new perspective on manipulating specific neural pathways in a targeted fashion to modulate brain circuits and improve behavior. This approach may prove to be an effective tool to develop more sophisticated models of brain-behavior relations and improve diagnosis and treatment of many neurological and psychiatric disorders.

This article describes new approaches to measure and strengthen functionally specific neural pathways with transcranial magnetic stimulation. These advanced noninvasive brain stimulation methodologies can provide new opportunities for the understanding of brain-behavior relations and development of new therapies to treat brain disorders.

利用颅内磁刺激测量和操纵人体运动系统中功能特定的神经通路

Understanding interactions between brain areas is important for the study of goal-directed behavior. Functional neuroimaging of brain connectivity has ...