Name: non-invasive modulation and robotic mapping of motor cortex in the developing brain
Uploaded: 2019-07-01T12:30:00
Description: Watch this Scientific Journal Video about Non-Invasive Modulation and Robotic Mapping of Motor Cortex in the Developing Brain at JoVE.com

这项研究得到了加拿大卫生研究院的支持。

本协议中描述的所有方法均已获得卡尔加里大学联合健康研究伦理委员会(REB16-2474)的批准。该协议如图1所示。
1. 非侵入性脑刺激禁忌症
<ol><li>在招聘前,筛查所有参与者的 TMS15和 tDCS1的禁忌症。</li>
</ol>2. 颅内磁刺激运动映射
<ol><li>为导航 TMS 准备 MRI
	<ol>
<li>获取每个参与者的结构 MRI (T1)。如果 MRI 无法?...

<ol>
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A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Localization+of+the+motor+hand+area+to+a+knob+on+the+precentral+gyrus.+A+new+landmark.">Localization of the motor hand area to a knob on the precentral gyrus. A new landmark.</a> Brain. 120 (Pt 1), 141-157 (1997).</li><li>Garvey, M. A., Mall, V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transcranial+magnetic+stimulation+in+children.">Transcranial magnetic stimulation in children.</a> Clinical Neurophysiology. 119 (5), 973-984 (2008).</li><li>Borckardt, J. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+pilot+study+investigating+the+effects+of+fast+left+prefrontal+rTMS+on+chronic+neuropathic+pain.">A pilot study investigating the effects of fast left prefrontal rTMS on chronic neuropathic pain.</a> Pain Medicine (Malden, Mass.). 10 (5), 840-849 (2009).</li><li>Villamar, M. F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Focal+modulation+of+the+primary+motor+cortex+in+fibromyalgia+using+4&#215;1-ring+high-definition+transcranial+direct+current+stimulation+(HD-tDCS):+immediate+and+delayed+analgesic+effects+of+cathodal+and+anodal+stimulation.">Focal modulation of the primary motor cortex in fibromyalgia using 4&#215;1-ring high-definition transcranial direct current stimulation (HD-tDCS): immediate and delayed analgesic effects of cathodal and anodal stimulation.</a> The Journal of Pain. 14 (4), 371-383 (2013).</li><li>Ciechanski, P., Kirton, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transcranial+Direct-Current+Stimulation+Can+Enhance+Motor+Learning+in+Children.">Transcranial Direct-Current Stimulation Can Enhance Motor Learning in Children.</a> Cerebral Cortex. 27 (5), 2758-2767 (2017).</li><li>Kirton, A., Andersen, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Brain+stimulation+and+constraint+for+hemiparesis+after+perinatal+stroke:+The+PLASTIC+CHAMPS+trial.">Brain stimulation and constraint for hemiparesis after perinatal stroke: The PLASTIC CHAMPS trial.</a> European Journal of Paediatric Neurology. 19 (S1), S10 (2015).</li><li>Ginhoux, R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+custom+robot+for+Transcranial+Magnetic+Stimulation:+First+assessment+on+healthy+subjects.">A custom robot for Transcranial Magnetic Stimulation: First assessment on healthy subjects.</a> 2013 35th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC). , 5352-5355 (2013).</li><li>Grau, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Conscious+brain-to-brain+communication+in+humans+using+non-invasive+technologies.">Conscious brain-to-brain communication in humans using non-invasive technologies.</a> PloS One. 9 (8), e105225 (2014).</li><li>Julkunen, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Methods+for+estimating+cortical+motor+representation+size+and+location+in+navigated+transcranial+magnetic+stimulation.">Methods for estimating cortical motor representation size and location in navigated transcranial magnetic stimulation.</a> Journal of Neuroscience Methods. 232, 125-133 (2014).</li><li>van de Ruit, M., Perenboom, M. 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TMS还在临床小儿科人群中进行了探索,包括围产期中风22和脑瘫,其中TMS运动图成功地在脑瘫儿童中创建,以探索介入可塑性机制。使用既定的协议8,TMS运动图成功地收集了在典型的发育的儿童,目前正在收集围产期中风和半脑瘫儿童的多中心临床试验(NCT03216837)。描述TMS运动映射方法将允许在健康儿童和运动障碍儿童中复制和进一步应用协议。
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非侵入性脑刺激可以测量和调节人脑功能1,2。最常见的目标是运动皮层,部分原因是直接和可测量的生物输出(运动诱发电位),但也由于神经系统疾病的高流行导致运动系统功能障碍和残疾。这种庞大的全球疾病负担包括影响儿童(如脑瘫)的高比例,脑瘫是影响全世界约1 700万人的终身残疾的主要原因。尽管这种临床相关性和神经刺激技术的多样化和不断增长的能力,在发展中的大脑中的应用才刚刚开始被定义4。需要改进儿童现有和新出现的非侵入性脑刺激方法的特征,以推动在发育中大脑的应用。
颅内磁刺激(TMS)是一种成熟的神经生理学工具,越来越多地用于成人的非侵入性、无痛、耐受性和安全性。TMS在儿童的经验相对有限,但稳步增加。TMS 提供磁场,以诱导大脑中皮质神经元群的区域激活,净输出反映在目标肌肉运动引发电位 (MEP) 中。系统应用单脉冲TMS可以定义体内运动皮层的图谱。开创性动物研究5和新兴的人类TMS研究6已经表明,运动图如何帮助为皮质神经可塑性机制提供信息。导航运动映射是一种TMS技术,用于绘制人体运动皮层以询问功能皮质区域。电机图的变化与人类马达系统的塑料变化有关7。机器人TMS技术的最新进展为提高电机映射效率和精度带来了新的机遇。我们小组最近证明,机器人TMS电机映射是可行的,高效,并且耐受性良好的儿童8。
颅内直接电流刺激(tDCS)是一种非侵入性脑刺激,可以改变皮质兴奋性和调节人类行为。已经有很多研究研究tDCS在成人的影响(>10,000受试者),但不到2%的研究集中在发育的大脑9。将成人证据翻译到儿科应用非常复杂,由于儿童差异复杂,需要修改协议。例如,我们和其他人已经表明,与10、11岁的成年人相比,儿童经历的电场更大、更强。在儿童中实现tDCS方法的标准化对于确保安全、一致的应用、改进复制和推进该领域具有重要意义。儿童运动学习调制tDCS的经验有限,但增加12。tDCS对特定脑瘫人群的转化应用正向晚期临床试验迈进13。通过高清晰度tDCS(HD-tDCS)进行更多焦刺激的努力,只是在14岁儿童中首次得到研究。我们证明HD-tDCS在运动学习方面与健康儿童14岁的传统tDCS相似。描述 HD-tDCS 方法将允许在子中复制和进一步应用此类协议。

<table>
	<tbody>
		<tr>
			<td>1x1 SMARTscan Stimulator</td>
			<td>Soterix Medical Inc.</td>
			<td>https://soterixmedical.com/research/1x1/tdcs/device</td>
			<td></td>
		</tr>
		<tr>
			<td>4x1 HD-tDCS Adaptor</td>
			<td>Soterix Medical Inc.</td>
			<td>https://soterixmedical.com/research/hd-tdcs/4x1</td>
			<td></td>
		</tr>
		<tr>
			<td>Brainsight Neuronavigation</td>
			<td>Roge Resolution</td>
			<td>https://www.rogue-resolutions.com/catalogue/neuro-navigation/brainsight-tms-navigation/</td>
			<td></td>
		</tr>
		<tr>
			<td>Carbon Rubber Electrode</td>
			<td>Soterix Medical Inc.</td>
			<td>https://soterixmedical.com/research/1x1/accessories/carbon-ruber-electrode</td>
			<td></td>
		</tr>
		<tr>
			<td>EASYpad Electrode</td>
			<td>Soterix Medical Inc.</td>
			<td>https://soterixmedical.com/research/1x1/accessories/1x1-easypad</td>
			<td></td>
		</tr>
		<tr>
			<td>EASYstraps</td>
			<td>Soterix Medical Inc.</td>
			<td>https://soterixmedical.com/research/1x1/accessories/1x1-easystrap</td>
			<td></td>
		</tr>
		<tr>
			<td>EMG Amplifier</td>
			<td>Bortec Biomedical</td>
			<td>http://www.bortec.ca/pages/amt_16.htm</td>
			<td></td>
		</tr>
		<tr>
			<td>HD1 Electrode Holder</td>
			<td>Soterix Medical Inc.</td>
			<td>https://soterixmedical.com/research/hd-tdcs/accessories/hd1-holder</td>
			<td>Standard Base HD-Electrode Holder for High Definition tES (HD-tES)</td>
		</tr>
		<tr>
			<td>HD-Electrode</td>
			<td>Soterix Medical Inc.</td>
			<td>https://soterixmedical.com/research/hd-tdcs/accessories/hd-electrode</td>
			<td>Sintered ring HD-Electrode.</td>
		</tr>
		<tr>
			<td>HD-Gel</td>
			<td>Soterix Medical Inc.</td>
			<td>https://soterixmedical.com/research/hd-tdcs/accessories/hd-gel</td>
			<td>HD-GEL for High Definition tES (HD-tES)</td>
		</tr>
		<tr>
			<td>Micro 1401 Data Acquisition System</td>
			<td>Cambridge Electronics http://ced.co.uk/products/mic3in</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Purdue Pegboard</td>
			<td>Lafayette Instrument Company</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Saline solution</td>
			<td>Baxter</td>
			<td>http://www.baxter.ca/en/products-expertise/iv-solutions-premixed-drugs/products/iv-solutions.page</td>
			<td></td>
		</tr>
		<tr>
			<td>Soterix Medical HD-Cap</td>
			<td>Soterix Medical Inc.</td>
			<td>https://soterixmedical.com/research/hd-tdcs/accessories/hd-cap</td>
			<td></td>
		</tr>
		<tr>
			<td>TMS Robot</td>
			<td>Axilium Robotics</td>
			<td>http://www.axilumrobotics.com/en/</td>
			<td></td>
		</tr>
		<tr>
			<td>TMS Stimulator and Coil</td>
			<td>Magstim Inc</td>
			<td>https://www.magstim.com/neuromodulation/</td>
			<td></td>
		</tr>
	</tbody>
</table>

non-invasive modulation and robotic mapping of motor cortex in the developing brain

使用颅内磁刺激(TMS)绘制运动皮层具有质疑运动皮层生理和可塑性的潜力,但对儿童具有独特的挑战。同样,颅内直流刺激(tDCS)可以改善成人的运动学习,但最近才应用于儿童。使用tDCS和新兴技术,如高清晰度tDCS(HD-tDCS),需要特殊的方法学考虑在发展中的大脑。机器人TMS运动映射可能赋予映射独特的优势,特别是在正在发育的大脑。在这里,我们的目标是为两种能够同时探索儿童运动皮层调制和运动图的集成方法提供实用、标准化的方法。首先,我们描述了机器人TMS电机映射的协议。以运动皮层为中心的个性化 MRI 导航 12x12 网格引导机器人管理单脉冲 TMS。每个网格点的平均电机唤起电位 (MEP) 振幅用于生成单个手部肌肉的 3D 运动图,其结果包括地图区域、体积和重心。还包括测量这两种方法的安全性和耐受性的工具。其次,我们描述了tDCS和HD-tDCS在调节运动皮层和运动学习中的应用。介绍了实验训练模式和样本结果。这些方法将推动非侵入性脑刺激在儿童中的应用。

使用这里介绍的方法,我们完成了一个随机的,假控制的介入试验8。右手儿童(n = 24,12-18岁),这两种非侵入性脑刺激均无禁忌症。在这项研究中,如果参与者使用神经性精神药物或对tDCS不天真,则被明确排除在外。没有辍学。
机器人TMS运动图获得基线运动图,并作为一种潜在的机制,监测神经塑性及皮质兴奋性变化后...

Watch this Scientific Journal Video about Non-Invasive Modulation and Robotic Mapping of Motor Cortex in the Developing Brain at JoVE.com

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

发育中大脑运动皮质的非侵入性调制和机器人映射

我们演示了儿童运动皮层的调制(tDCS、HD-tDCS)和映射(机器人TMS)的协议。

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

我们的协议涉及使用世界上第一个儿科 TMS 机器人来绘制健康儿童和早期脑损伤（如围产期中风）的儿童的运动皮层图。协议将 MRI 成像与神经导航集成在一起，使我们能够以更高的精度和精度获取地图，从而缩短映射会话时间。它有助于消除人为错误，提高年轻患者的安全性和耐人性。运动映射尚未用于诊断或预后目的，然而，它是一种新技术，用于测量大脑在大脑受损发生或干预后如何变化和重新布线。具有不同目标的类似技术可用于语言区域映射。语言和电机映射对于手术前规划非常重要。首先使用神经导航软件中的标签来重建皮肤和全脑曲线。选择新外观、外观和计算外观。确保包括鼻子和头顶。然后，选择新的和完整的大脑曲线。将绿色选择框封闭在大脑外，但位于头骨内部。选择计算曲线。将剥离深度调整为 4.0 至 6.0 毫米。选择配置地标。将四个地标放在鼻子尖、鼻塞和重建皮肤两只耳朵的凹口处。命名与它们的解剖结构对应的地标。选择目标的选项卡以查看曲线脑。选择新的矩形网格。将均匀的 12 到 12 坐标网格，在重建的大脑表面放置 7 毫米间距，在运动皮层的手把手上。接下来，使用右侧的目标定位工具优化旋转、倾斜和曲率的网格定位。将网格点转换为轨迹，引导机器人定位 TMS 线圈。调整轨迹的角度，使它们与纵向裂缝或大脑的45度。使用捕捉工具外推和优化曲线脑的轨迹。最后，使用四个传感器测试初始化和定位 TMS 机械臂和座椅以欢迎位置并校准力板传感器。首先护送学员进入测试室，并让他们填写安全问卷。然后，将学员放在机器人椅上，并调整靠背和颈部休息。确保他们的脚是支撑的。在制图过程中用枕头支撑手臂和手。清洁皮肤上感兴趣的肌肉。将氯化银银表面电极放在参与者的双手和前臂上，瞄准四个大骨前肢肌肉。第一个侧间， 绑架者的腹， 绑架者， 绑架者数字小米， 和手腕挤出机。使用兼容的 EMG 软件将放大器连接到数据收集计算机。接下来，将表面电极连接到肌电图（EMG、放大器和数据采集系统），确保接地电极也连接在一起。使用地标指针共同注册学员头部的四个地标，并使用验证选项卡确保参与者头部正确注册。然后，选择最接近参与者的手刀的网格点。选择与目标按钮的对齐，将机器人持有的 TMS 线圈与此目标位置对齐。选择"联系人"。使用接触力指示器监控触点质量，并确保指示灯为绿色或黄色。指示学员不要移超出机械臂的范围。确保参与者的手部肌肉放松，在接触前保持静止。选择对齐并跟随，这样如果参与者移动，线圈将居中在目标上。使用 TMS 机器上的 TMS 触发按钮，以 40 到 60% 的最大刺激器输出强度提供 5 到 10 个 TMS 脉冲。最后，确定网格点，为左或右 FDI 肌肉提供最大和最一致的电机激发潜力。确定静止电机阈值为最低强度，在 10 次刺激中，FDI 肌肉中产生的 MEP 至少为 50 微伏。首先，在接近热点的网格点以一秒的间向和120%RMT的强度提供四个单脉冲 TMS 脉冲。然后，在相邻的网格点重复。沿响应点按线性方式继续，直到到达无响应点，该点指定地图的第一个寄宿区域。然后，继续映射以在矩形网格的所有四个方向上建立板点。使用 EMG 软件记录所有肌肉的所有 MEP，用于离线分析。在三到四个网格点后，选择"关闭"并让学员休息，直到他们准备好继续。接下来，使用相同网格的硬拷贝版本跟踪刺激顺序，以便进一步分析。使用机器人 TMS 完成映射。最后，使用自定义编码脚本通过联系作者生成可用的 3D 电机映射。使用响应式轨迹站点计算电机地图面积和体积。将重心计算为每个坐标位置的电机表示的加权平均值。这些结果表明，tDCS和HD-tDCS在五天的培训中提高了学习率。与假人相比，主动干预组在第四天和第五天的左手平均PPT得分有更大的改善。这种方法从以前的研究中复制，并合并了数据集。复制数据表明，与假组相比，tDCS和HD-tDCS组的学习率显著上升。规划过程与执行过程同样重要。网格和轨迹应小心地覆盖在 MRI 上。如果使用大脑模板，应从参与者头部采集多个样本。此过程可以完成干预前和干预后，以回答由此产生的电机映射更改。按照此过程执行评估可以指示电机映射度量与功能结果之间的关系。利用这个协议，研究人员可以学习如何使用机器人TMS准确、及时地生成运动图，以及在儿童中安全地生成运动图。主要的挑战包括引导机器人并使其优化其目标区域。轨迹必须精确确定。使用倾斜参数和旋转参数的多种组合练习线圈对齐有助于优化线圈轨迹设计。这些仪器都不是危险的。当机器人触摸参与者的头部时，不断观察机器人非常重要，因为机器人会对任何头部运动做出反应。

Research

JoVE Journal

Neuroscience

Functional Imaging of Auditory Cortex in Adult Cats using High-field fMRI

听觉皮层在成年猫用高场磁共振成像功能成像

Current knowledge of sensory processing in the mammalian auditory system is mainly derived from electrophysiological studies in a variety of animal ...

科研

神经科学

Live Imaging of Mitosis in the Developing Mouse Embryonic Cortex

有丝分裂中的不同发育阶段小鼠胚胎皮层实时成像

Although of short duration, mitosis is a complex and dynamic multi-step process fundamental for development of organs including the brain. In the ...

Non-invasive Parenchymal, Vascular and Metabolic High-frequency Ultrasound and Photoacoustic Rat Deep Brain Imaging

非侵入性的脑实质，血管和代谢高频超声和光声大鼠深脑成像

Photoacoustics and high frequency ultrasound stands out as powerful tools for neurobiological applications enabling high-resolution imaging on the central ...

Non-invasive Assessment of Changes in Corticomotoneuronal Transmission in Humans

非侵入性评估人类皮质神经元传播的变化

The corticospinal pathway is the major pathway connecting the brain with the muscles and is therefore highly relevant for movement control and motor ...

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

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 ...

Imaging Neural Activity in the Primary Somatosensory Cortex Using Thy1-GCaMP6s Transgenic Mice

Imaging Neural Activity in the Primary Somatosensory Cortex Using Thy1-GCaMP6s Transgenic Mice

胸腺1-gmcmp6 转基因小鼠在原代体血源皮质中的成像神经活性

The mammalian brain exhibits marked symmetry across the sagittal plane. However, detailed description of neural dynamics in symmetric brain regions in ...

In Vivo Single-Molecule Tracking at the Drosophila Presynaptic Motor Nerve Terminal

In Vivo Single-Molecule Tracking at the Drosophila Presynaptic Motor Nerve Terminal

在体内果蝇前运动神经末端的单分子跟踪

An increasing number of super-resolution microscopy techniques are helping to uncover the mechanisms that govern the nanoscale cellular world. ...

Combined Transcranial Magnetic Stimulation and Electroencephalography of the Dorsolateral Prefrontal Cortex

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 ...

Evaluation of Hemisphere Lateralization with Bilateral Local Field Potential Recording in Secondary Motor Cortex of Mice

小鼠二次运动皮质中双边局部场电位记录半球横向化评价

This article demonstrates complete, detailed procedures for both in vivo bilateral recording and analysis of local field potential (LFP) in the cortical ...

Translational Brain Mapping at the University of Rochester Medical Center: Preserving the Mind Through Personalized Brain Mapping

罗切斯特大学医学中心的转化脑图:通过个性化大脑映射保护大脑

The Translational Brain Mapping Program at the University of Rochester is an interdisciplinary effort that integrates cognitive science, neurophysiology, ...