这项工作由镍氢 R01 MH112815 部分提供资金。这项工作还得到了 Temerty 家庭基金会、赠款家庭基金会和坎贝尔家庭心理健康研究所在成瘾和精神健康中心的支持。

在《赫尔辛基宣言》的指导方针下, 我们当地道德委员会批准了这里提出的所有实验程序。
1. Neuronavigated 脑电图的头部注册
<ol><li>为每个参与者获得高分辨率的全头 T1-weighted 结构 MRI。根据神经导航制造商指南进行扫描。</li>
	<li>在导航系统上上传图像。检查是否正确扫描了核磁共振。选择基点 (耳前点, nasion 和鼻尖)。插入刺激目标 (基于解剖学或基于头部坐标、MNI 或 Talairach 坐标)。</li>
	<li>放置头部跟踪器在这样的方式, 使它不会移动在刺激会话和允许自由移动的 TMS 线圈。让参与者在注册开始前插入耳塞。</li>
	<li>将参与者的头部与3维 MRI 模型对齐。使用数字笔在 MRI 栈图像上选取的基点上触摸参与者的头部。选择和标记额外的点在顶叶, 颞和枕区的头部, 以减少注册错误, 在这些地区。</li>
	<li>验证注册。将数字化笔放在参与者的头上。检查计算机上的表示形式。如果它不在 MR 的相应点上, 请重复步骤1.4。</li>
	<li>
校准使用的 TMS 线圈 (在某些系统中不需要此步骤)。
	<ol>
<li>将跟踪器连接到线圈。</li>
		<li>将线圈放在校准块上, 这样所有跟踪器都可以从照相机中看到。</li>
		<li>按下计算机屏幕上的校准按钮, 将线圈保持在 5 s 的校准位置。</li>
	</ol>
</li>
</ol>2. TMS 脑电图实验
<ol><li>
将脑电图帽放在头上, 准备电极
	<ol>
<li>选择一个适合头部的帽子。确保所有电极紧密接触头皮和功能。如果超过2个电极不工作, 则使用相同或较小尺寸的另一顶盖。</li>
		<li>将直拉电极置于顶点, 在连接 nasion 和 inion 的线与 inion 上的兹电极之间进行一半的距离。 注: 将垂直 (在眼睛的上方和下方对刺激的眼睛) 和/或水平电极 (左眼和右从右, 略高于每个颧骨骨) 为 electrooculography (EOG)。</li>
		<li>调整注射器钝尖, 用导电凝胶填充。将尖端放在电极孔内, 然后轻轻按下柱塞法兰, 直到皮肤上有糊状。用钝尖的十字状动作轻轻擦洗头皮。确保粘贴不溢出在上面, 以避免桥接 (在电极之间的短路)。</li>
	</ol>
</li>
	<li>放置肌电图电极。放置两个一次性圆盘电极 (直径约30毫米) 在右外展拇短肌 (通缉令) 的腹部肌腱蒙太奇。根据制造商的指导原则放置地面。</li>
	<li>启动头部注册。按照步骤1.3–1.6。使用 DLPFC 的 MNI 或 Talairach 坐标。</li>
	<li>
热点和电机阈值。
	<ol>
<li>添加海绵 (人造纤维的 polyutherane) 在线圈下, 以减少线圈振动的电极在 TMS 脉冲。请注意, 泡沫应该是大约10毫米厚。</li>
		<li>指导参加者休息-舒适和轻松的手, 腿和脊柱。</li>
		<li>找到热点。将马达旋钮24作为 M1 的初始标志, 并移动线圈直到有相应的通告运动。使用 TMS 强度唤起欧洲议会议员约500µV 的通告。通过改变角度和倾角来优化线圈方向, 从而在热点上唤起最大的响应。</li>
		<li>节省神经导航软件中的线圈定位, 降低2–3% 步骤中的输出强度。给出10脉冲, 如果超过5的10的µV 响应超过50个, 然后继续降低强度。</li>
		<li>当诱发的10反应中少于5时, 通过1–2% 的步骤增加强度。MT 代表的强度, 产生的欧洲议会议员大于50µV 5 10 倍25。MT 之间的刺激间隔 (ISI) 应长于1秒, 通常设置为3、4或5秒。</li>
	</ol>
</li>
	<li>
使用以下步骤调整强度:
	<ol>
<li>从120% 的 MT 强度开始, 使欧洲议会议员超过 M1 从500到1500µV. 用这个刺激器的输出记录10个脉冲, 所以平均响应为 1 mV。增加或减少1–2% 步骤的强度, 直到达到平均 1 mV。</li>
		<li>对于刺激强度, 选择强度作为刺激器输出的百分比, e., 110%, 120% 等. </li>
		<li>在 V/米中找到相应的诱导场 (如果系统允许)。把线圈放在 DLPFC 上;调整刺激器的输出, 直到诱导场的计算与同一皮质深度的 M1 相同。</li>
	</ol>
</li>
	<li>数字化脑电图电极, 使他们的位置注册到大脑解剖。 注意: 这是一个非常重要的步骤, 用于定位神经元活化的分布和准确地重新定位电极在后续的会议。</li>
	<li>
记录 TMS-脑电图
	<ol>
<li>更换耳塞与耳塞与空气管连接到音频掩蔽 (e., 白色噪音), 如果可用, 并添加耳机超过他们。仅在 TMS 脉冲传递期间播放音频掩蔽。 注意: 此步骤可应用于步骤 2.4.2, 而无需播放音频掩蔽和小心, 这样头部跟踪器就不会移动。</li>
		<li>在线圈架上安装线圈, 确保线圈不移动或按下电极。确保海绵在电极和线圈之间。</li>
		<li>从参与者的视线中删除所有活动屏幕。指示参与者盯着一个固定点, 不要改变他/她的头部位置在 tms 交付, 而不是眨眼之间的 tms 脉冲。</li>
		<li>关掉任何荧光灯。为每个参与者随机运行单个脉冲 TMS、SICI、ICF 和 LICI。给出100个单配对脉冲。使用 3–4 s (±20%) 的各种 ISI 或 3–5 s 的常量 (见注)。在每个条件之间给出3–5分钟的休息, 这样参与者就可以放松和伸展。 注: SICI 和 ICF 涉及一个配对脉冲 TMS 范式与阈调节刺激 (CS) 和阈上测试刺激 (TS)。该协议中使用的 CS 是 80% MT 和 TS 的强度唤起 1 mV 峰到峰值26。用于最佳 SICI 的脉间间隔为2毫秒, ICF 在 12–1327。LICI 范式涉及一个超阈值 CS 的配对, 其强度唤起 1 mv 的峰值到峰值后再使用另一个阈上 TS 的强度, 诱发了 1 mV 机电峰值峰值, 并在一个跨脉冲间隔 100 ms. ISI 为单和配对脉冲范式是由刺激器的充电时间决定的 (我们的系统可以允许每4秒配对脉冲), 会话量 (更长的实验需要较小的 ISI, 以不覆盖参与者) 和分析是会发生。在这项研究中, 我们使用了恒定的 ISI 5 s 由于我们的刺激器的限制, 也因为我们需要几个周期的低频波段 (θ节奏) 的时间频率和功率谱分析。</li>
	</ol>
</li>
</ol>

Pantelis Lioumis 是 Nexstim 有限公司 (芬兰赫尔辛基) 的有偿顾问, 在提交的工作 (如 2017年之前的马达和语音制图 rTMS 应用) 之外。礼 Zomorrodi 是 Vielight 公司咨询委员会 (加拿大多伦多) 的成员。Zafiris j. Daskalakis 接受加拿大卫生研究所 (卫生研究院)、美国国立卫生研究院 (NIH)、韦斯顿脑研究所、加拿大脑部和 Temerty 家族通过 CAMH 基金会和坎贝尔研究提供的研究支持。研究所。他获得了研究支持和实物设备支持, 为调查员发起的研究从 Brainsway 有限公司, 他是网站主要研究员为三赞助发起的研究 Brainsway 有限公司。他收到来自 Magventure 的实物设备支持, 为这个调查员发起的研究。丹尼尔 m. Blumberger 接受加拿大卫生研究所 (卫生研究院)、美国国立卫生研究院 (NIH)、韦斯顿脑研究所、加拿大脑科和 Temerty 家族的研究支持, 通过 CAMH 基金会和坎贝尔研究研究所。他获得了研究支持和实物设备支持, 为调查员发起的研究从 Brainsway 有限公司, 他是网站主要研究员为三赞助发起的研究 Brainsway 有限公司。他收到来自 Magventure 的实物设备支持, 为这个调查员发起的研究。他收到了 Indivior 的调查员发起的试验的药物供应。他参加了 Janssen 咨询委员会。

TMS-脑电图使大多数皮质区域的直接和无创刺激和获得的结果神经元活动具有很好的时空分辨率30, 特别是当神经导航被利用。这一方法的进步的好处是基于事实, TMS 诱发脑电图信号来源于电神经活动, 它是一个指标的皮质皮质兴奋性。这在神经精神病人的人群中具有巨大的潜力, 在那里, TMS 脑电图可以作为当前和未来治疗干预的标志物。
该协议最关键的步骤?...

经颅磁刺激 (TMS) 是一种神经工具, 它允许非侵入性评估皮质神经元活动通过使用快速, 时变磁场脉冲1。这些磁场脉冲在线圈下方的表面皮层产生弱电流, 导致膜退极化。随后的皮质激活或调制直接关系到线圈的特点, 其角度和方向的头骨2。从线圈中排出的脉冲波形和神经元的底层状态也影响皮层激活3。
TMS 通过唤起行为或运动反应或通过中断与任务相关的处理来评估皮质功能。皮质-脊柱过程的兴奋性可以通过记录肌 (肌电图) 的反应, 从单一的 TMS 脉冲的运动皮层, 而 intracortical 兴奋 (intracortical 促进;ICF) 和抑制机制 (短和长的 intracortical 抑制;SICI 和 LICI) 可以用配对脉冲 TMS 进行探测。重复的 TMS 可以扰乱各种认知过程, 但主要是作为治疗工具的各种精神疾病。此外, tms 与同时脑电图 (tms 脑电图) 的结合可用于评估皮质皮质兴奋性和连接度4。最后, 如果对 TMS 的管理是用神经导航 (nTMS) 提供的, 它将允许精确的测试复测范式, 因为可以记录刺激的确切地点。大多数皮质地幔可以被靶向和刺激 (包括那些不产生可测量的物理或行为反应的区域), 从而可以在功能上映射皮层。
从单或配对脉冲 TMS 诱发的脑电图信号可以促进评估皮质皮质连接5和目前的大脑状态。TMS 引起的电流导致动作电位, 可以激活突触。突触后电流的分布可以通过脑电图6记录。eeg 信号可以用来量化和定位突触电流分布通过偶极模型7或最小范数估计8, 当多通道脑电图被使用, 并与电导率结构的头部占。结合 TMS-脑电图可用于研究皮质抑制过程9, 振荡10, 皮质皮质11和大脑纵裂相互作用12, 皮质可塑性13。最重要的是, TMS-脑电图可以探测在认知或运动任务中的兴奋性变化, 具有良好的测试复验可靠性14,15。重要的是, TMS-EEG 有可能确定神经信号, 可能作为反应的预测因素的治疗干预 (rTMS 或药理作用) 在测试复验设计16,17。
基于无框立体定向的原理, 对 TMS 的神经导航原理进行了研究。系统使用一个光学跟踪系统18 , 它采用了一个发光摄像头, 与连接到头部的光反射光学元件 (通过参考跟踪器) 和 TMS 线圈进行通信。在数字化参考工具或钢笔的帮助下, 神经导航允许在3维 MRI 模型上进行线圈定位。使用神经导航方便捕获的线圈方向, 位置和对准对象的头部, 以及数字化的脑电图电极位置。这些功能是测试重新检测设计实验和准确刺激侧前额叶皮质内特定位置的关键。
为了在测试复验实验中使用 TMS-EEG 协议, 需要对皮层区域进行准确的靶向和一致的刺激, 以获得可靠的信号。脑电记录可能容易受到不同的工件的影响。在脑电图电极上的 TMS 诱发的伪影可以用放大器过滤, 在延迟19、20或与不能饱和21的放大器后恢复。然而, 其他类型的伪影产生的眼球运动或眨眼, 颅内肌肉激活接近脑电图电极, 随机电极运动和他们的极化, 并通过线圈点击或躯体感觉必须考虑。仔细的主题准备, 确保电极阻抗低于 5 kΩ, 固定线圈在电极和泡沫之间的线圈和电极, 以减少振动 (或间隔消除低频工件22), 耳塞, 甚至听觉掩蔽应用于最小化这些文物23。这里提出的协议介绍了一个标准的过程, 以评估神经功能时, 刺激是应用在侧前额 (DLPFC)。重点是在 M19,15,16的研究中证实的共同配对脉冲范式。

<table border="0" cellpadding="0" cellspacing="0" style="width:869px;" width="868">
	<colgroup>
		<col />
		<col />
		<col />
		<col />
	</colgroup>
	<tbody>
		<tr height="40">
			<td height="40" style="height:40px;width:233px;">CED Micro1401-3</td>
			<td style="width:184px;">Cambridge Electronic Design Limited</td>
			<td style="width:221px;">CED Micro1401-3</td>
			<td style="width:231px;">Digital Data Recocrder</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;">BISTIM&#39;2 Package Option 1</td>
			<td>Magstim</td>
			<td>3234-00</td>
			<td>TMS paired pulse stimulator</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;">Magstim 200&#39;2 Unit (2 items)</td>
			<td>Magstim</td>
			<td>3010-00</td>
			<td>TMS stimulators</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;">UI controller</td>
			<td>Magstim</td>
			<td>3020-00</td>
			<td>TMS controller</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;">BISTIM&#39;2 UI controller</td>
			<td>Magstim</td>
			<td>3021-00</td>
			<td>TMS controller</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;">BISTIM connecting module</td>
			<td>Magstim</td>
			<td>3330-00</td>
			<td>TMS connecting module</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;">D70 Alpha Coil - P/N 4150-00 (Alpha 70mm double coil)</td>
			<td>Magstim</td>
			<td>4150-00</td>
			<td>TMS coil</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;">Brainsight</td>
			<td>Rogue-Resolutions</td>
			<td>Brainsight 2</td>
			<td>Neuronavigator</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;">Model 2024F</td>
			<td>Intronix</td>
			<td>2024F</td>
			<td>Electromyograph</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;">Neuroscan SynAmps RT 64 channel System</td>
			<td>Compumedics Neuroscan</td>
			<td>9032-0010-01</td>
			<td>Electroencephalograph</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;">Quick-Cap electrode system 64</td>
			<td>Compumedics Neuroscan</td>
			<td>96050255</td>
			<td>EEG Cap</td>
		</tr>
	</tbody>
</table>

combined transcranial magnetic stimulation and electroencephalography of the dorsolateral prefrontal cortex

经颅磁刺激 (TMS) 是一种非侵入性的方法, 通过短暂的、时变的磁场脉冲, 在皮层产生神经激发。皮质激活或其调制的启动取决于皮质区神经元的背景活化、线圈的特征、其位置和朝向。TMS 结合同时 electrocephalography (eeg) 和神经导航 (nTMS 脑电图), 可以对皮质皮质兴奋性和连通性的几乎所有皮层区域的可重现的方式进行评估。这一进步使 nTMS 脑电图成为一种强有力的工具, 能够准确地评估临床试验所需的测试复测范式中的大脑动力学和神经生理学。这种方法的局限性包括包含初始脑反应刺激的工件。因此, 删除工件的过程也可以提取有价值的信息。此外, 侧前额 (DLPFC) 刺激的最佳参数还不完全知道, 目前的协议利用运动皮层 (M1) 刺激范式的变化。然而, 进化的 nTMS-EEG 设计希望能够解决这些问题。这里提出的议定书介绍了一些标准的做法, 以评估神经功能从刺激到 DLPFC, 可适用于治疗精神障碍患者接受治疗, 如经颅直接电流刺激 (tDCS), 反复经颅磁刺激 (rTMS), 磁性癫痫治疗 (MST) 或抽搐治疗 (ECT)。

图 1一个健康志愿者在平均100个世纪以后 DLPFC 刺激在 F3 电极以后的 TMSevoked 潜力说明。在本例中, 我们在单独应用 ts 时, 突出显示 CS 对 ts 的影响。即使在一个主题中, CS 也会以清晰的方式调节 N100 偏转。在 SICI 和 LICI 会话中, 与 SP 条件16相比, N100 通常会增加, 并且在 ICF 中的绝对值会降低。在图 1<s...

Watch this Scientific Journal Video about Combined Transcranial Magnetic Stimulation and Electroencephalography of the Dorsolateral Prefrontal Cortex at JoVE.com

Combined Transcranial Magnetic Stimulation and Electroencephalography of the Dorsolateral Prefrontal Cortex

这里提出的协议是利用 intracortical 兴奋性测试-重新测试设计范式的 TMS-脑电图研究。该议定书的目的是制定可靠和可重复的皮质兴奋性措施, 以评估与治疗干预措施有关的神经功能, 如严重抑郁症等精神疾病。

侧前额叶皮质联合经颅磁刺激与脑电图的研究

Transcranial magnetic stimulation (TMS) is a non-invasive method that produces neural excitation in the cortex by means of brief, time-varying magnetic ...

combined-transcranial-magnetic-stimulation-electroencephalography

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Electromagnetic Induction

SCIENTISTS IN ACTION

11.6K 次观看.  Temerty Centre for Therapeutic Brain Intervention at the Centre for Addiction and Mental Health. 这里提出的协议是利用 intracortical 兴奋性测试-重新测试设计范式的 TMS-脑电图研究。该议定书的目的是制定可靠和可重复的皮质兴奋性措施, 以评估与治疗干预措施有关的神经功能, 如严重抑郁症等精神疾病。

视频: Combined Transcranial Magnetic Stimulation and Electroencephalography of the Dorsolateral Prefrontal Cortex

A Novel Approach for Documenting Phosphenes Induced by Transcranial Magnetic Stimulation

Stimulation of the human visual cortex produces a transient perception of light, known as a phosphene. Phosphenes are induced by invasive electrical stimulation of the occipital cortex, but also by non-invasive Transcranial Magnetic Stimulation (TMS)1 of the same cortical regions. The intensity at which a phosphene is induced (phosphene threshold) is a well established measure of visual cortical excitability and is used to study cortico-cortical interactions, functional organization 2, susceptibility to pathology 3,4 and visual processing 5-7. Phosphenes are typically defined by three characteristics: they are observed in the visual hemifield contralateral to stimulation; they are induced when the subject s eyes are open or closed, and their spatial location changes with the direction of gaze 2. Various methods have been used to document phosphenes, but a standardized methodology is lacking. We demonstrate a reliable procedure to obtain phosphene threshold values and introduce a novel system for the documentation and analysis of phosphenes. We developed the Laser Tracking and Painting system (LTaP), a low cost, easily built and operated system that records the location and size of perceived phosphenes in real-time. The LTaP system provides a stable and customizable environment for quantification and analysis of phosphenes.

Phosphenes are transient percepts of light that can be induced by applying Transcranial Magnetic Stimulation (TMS) to visually sensitive regions of cortex. We demonstrate a standard protocol for determining the phosphene threshold value and introduce a novel method for quantifying and analyzing perceived phosphenes.

一个新颖的方法记录经颅磁刺激诱发幻视

Stimulation of the human visual cortex produces a transient perception of light, known as a phosphene. Phosphenes are induced by invasive electrical ...

科研

神经科学

Combining Transcranial Magnetic Stimulation and fMRI to Examine the Default Mode Network

The default mode network is a group of brain regions that are active when an individual is not focused on the outside world and the brain is at "wakeful rest."1,2,3 It is thought the default mode network corresponds to self-referential or "internal mentation".2,3
It has been hypothesized that, in humans, activity within the default mode network is correlated with certain pathologies (for instance, hyper-activation has been linked to schizophrenia 4,5,6 and autism spectrum disorders 7 whilst hypo-activation of the network has been linked to Alzheimer's and other neurodegenerative diseases 8). As such, noninvasive modulation of this network may represent a potential therapeutic intervention for a number of neurological and psychiatric pathologies linked to abnormal network activation. One possible tool to effect this modulation is Transcranial Magnetic Stimulation: a non-invasive neurostimulatory and neuromodulatory technique that can transiently or lastingly modulate cortical excitability (either increasing or decreasing it) via the application of localized magnetic field pulses.9
In order to explore the default mode network's propensity towards and tolerance of modulation, we will be combining TMS (to the left inferior parietal lobe) with functional magnetic resonance imaging (fMRI). Through this article, we will examine the protocol and considerations necessary to successfully combine these two neuroscientific tools.

In this article, we examine the methodology and considerations relevant to the combination of TMS and fMRI to examine the effects of brain stimulation on the default network.

结合经颅磁刺激和功能磁共振成像检查默认模式网络

The default mode network is a group of brain regions that are active when an individual is not focused on the outside world and the brain is at "wakeful ...

Electrode Positioning and Montage in Transcranial Direct Current Stimulation

Transcranial direct current stimulation (tDCS) is a technique that has been intensively investigated in the past decade as this method offers a non-invasive and safe alternative to change cortical excitability2. The effects of one session of tDCS can last for several minutes, and its effects depend on polarity of stimulation, such as that cathodal stimulation induces a decrease in cortical excitability, and anodal stimulation induces an increase in cortical excitability that may last beyond the duration of stimulation6. These effects have been explored in cognitive neuroscience and also clinically in a variety of neuropsychiatric disorders &#x2013; especially when applied over several consecutive sessions4. One area that has been attracting attention of neuroscientists and clinicians is the use of tDCS for modulation of pain-related neural networks3,5. Modulation of two main cortical areas in pain research has been explored: primary motor cortex and dorsolateral prefrontal cortex7. Due to the critical role of electrode montage, in this article, we show different alternatives for electrode placement for tDCS clinical trials on pain; discussing advantages and disadvantages of each method of stimulation.

Transcranial direct current stimulation (tDCS) is an established technique to modulate cortical excitability1,2. It has been used as an investigative tool in neuroscience due to its effects on cortical plasticity, easy operation, and safe profile. One area that tDCS has been showing encouraging results is pain alleviation 3-5.

经颅直接电流刺激电极定位和蒙太奇

Transcranial direct current stimulation (tDCS) is a technique that has been intensively investigated in the past decade as this method offers a ...

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 ...

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 ...

Online Transcranial Magnetic Stimulation Protocol for Measuring Cortical Physiology Associated with Response Inhibition

We describe the development of a reproducible, child-friendly motor response inhibition task suitable for online Transcranial Magnetic Stimulation (TMS) characterization of primary motor cortex (M1) excitability and inhibition. Motor response inhibition prevents unwanted actions and is abnormal in several neuropsychiatric conditions. TMS is a non-invasive technology that can quantify M1 excitability and inhibition using single- and paired-pulse protocols and can be precisely timed to study cortical physiology with high temporal resolution. We modified the original Slater-Hammel (S-H) stop signal task to create a &#34;racecar&#34; version with TMS pulses time-locked to intra-trial events. This task is self-paced, with each trial initiating after a button push to move the racecar towards the 800 ms target. GO trials require a finger-lift to stop the racecar just before this target. Interspersed randomly are STOP trials (25%) during which the dynamically adjusted stop signal prompts subjects to prevent finger-lift. For GO trials, TMS pulses were delivered at 650 ms after trial onset; whereas, for STOP trials, the TMS pulses occurred 150 ms after the stop signal. The timings of the TMS pulses were decided based on electroencephalography (EEG) studies showing event-related changes in these time ranges during stop signal tasks. This task was studied in 3 blocks at two study sites (n=38) and we recorded behavioral performance and event-related motor-evoked potentials (MEP). Regression modelling was used to analyze MEP amplitudes using age as a covariate with multiple independent variables (sex, study site, block, TMS pulse condition [single- vs. paired-pulse], trial condition [GO, successful STOP, failed STOP]). The analysis showed that TMS pulse condition (p&#60;0.0001) and its interaction with trial condition (p=0.009) were significant. Future applications for this online S-H/TMS paradigm include the addition of simultaneous EEG acquisition to measure TMS-evoked EEG potentials. A potential limitation is that in children, the TMS pulse sound could&#160;affect behavioral task performance.

We describe an experimental procedure to quantify excitability and inhibition of primary motor cortex during a motor response inhibition task by using Transcranial Magnetic Stimulation throughout the course of a Stop Signal Task.

在线经颅磁刺激测量与反应抑制相关的皮质生理

We describe the development of a reproducible, child-friendly motor response inhibition task suitable for online Transcranial Magnetic Stimulation (TMS) ...

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 ...

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

Distal leg muscles receive neural input from motor cortical areas via the corticospinal tract, which is one of the main motor descending pathway in humans and can be assessed using transcranial magnetic stimulation (TMS). Given the role of distal leg muscles in upright postural and dynamic tasks, such as walking, a growing research interest in the assessment and modulation of the corticospinal tracts relative to the function of these muscles has emerged in the last decade. However, methodological parameters used in previous work have varied across studies making the interpretation of results from cross-sectional and longitudinal studies less robust. Therefore, use of a standardized TMS protocol specific to the assessment of leg muscles&#39; corticomotor response (CMR) will allow for direct comparison of results across studies and cohorts. The objective of this paper is to present a protocol that provides the flexibility to simultaneously assess the bilateral CMR of two main ankle antagonistic muscles, the tibialis anterior and soleus, using single pulse TMS with a neuronavigation system. The present protocol is applicable while the examined muscle is either fully relaxed or isometrically contracted at a defined percentage of maximum isometric voluntary contraction. Using each subject&#39;s structural MRI with the neuronavigation system ensures accurate and precise positioning of the coil over the leg cortical representations during assessment. Given the inconsistency in CMR derived measures, this protocol also describes a standardized calculation of these measures using automated algorithms. Though this protocol is not conducted during upright postural or dynamic tasks, it&#160;can be used to assess bilaterally any pair of leg muscles, either antagonistic or synergistic, in both neurologically intact and impaired subjects.

The present protocol describes the simultaneous, bilateral assessment of the corticomotor response of the tibialis anterior and soleus during rest and tonic voluntary activation using a single pulse transcranial magnetic stimulation and neuronavigation system.

导航经颅磁刺激踝关节脊椎通路的双边评价

Distal leg muscles receive neural input from motor cortical areas via the corticospinal tract, which is one of the main motor descending pathway in humans ...

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 ...

Employing Transcranial Magnetic Stimulation in a Resource Limited Environment to Establish Brain-Behavior Relationships

Neuroimaging is typically perceived as a resource demanding discipline. While this is the case in certain circumstances, institutions with limited resources have historically contributed significantly to the field of neuroscience, including neuroimaging. In the study of self-deception, we have successfully employed single-pulse TMS to determine the brain correlates of abilities including overclaiming and self-enhancement. Even without the use of neuro-navigation, methods provided here lead to successful outcomes. For example, it was discovered that decreases in self-deceptive responding lead to a decrease in affect. These methods provide data that are reliable and valid, and such methods provide research opportunities otherwise unavailable.&#160;Through the use of these methods, the overall knowledge base in the field of neuroscience is expanded, providing research opportunities to students such as those at our institution&#160;(Montclair State University is a Hispanic-Serving Institute) who are often denied such research experiences.

Transcranial Magnetic Stimulation (TMS) and low-frequency TMS (lfTMS) have&#160;been demonstrated to be major contributors to brain literature. Here we highlight the methods for investigating the cortical correlates of self-deception using TMS.