TY - JOUR
T1 - Immediate effects of intermittent theta burst stimulation on primary motor cortex in stroke patients: A concurrent TMS-EEG study
AU - Bai, Zhongfei
AU - Zhang, Jiaqi
AU - Fong, Kenneth N. K.
N1 - Publisher Copyright:
Author
Funding Information:
The work of Zhongfei Bai was supported in part by the Shanghai Sailing Program, Shanghai, China, under Grant 20YF1445100; and in part by the Shanghai Municipal Health Commission Clinical Research Program under Grant 20224Y0220. The work of Kenneth N. K. Fong was supported in part by the General Research Fund (GRF), Research Grants Council, University Grants Committee, Hong Kong SAR, under Grant 15105919M.
Publisher Copyright:
Author
Funding Information:
The work of Zhongfei Bai was supported in part by the Shanghai Sailing Program, Shanghai, China, under Grant 20YF1445100; and in part by the Shanghai Municipal Health Commission Clinical Research Program under Grant 20224Y0220. The work of Kenneth N. K. Fong was supported in part by the General Research Fund (GRF), Research Grants Council, University Grants Committee, Hong Kong SAR, under Grant 15105919M.
Publisher Copyright:
© 2001-2011 IEEE.
PY - 2023/6/5
Y1 - 2023/6/5
N2 - The neurophysiological effect of intermittent theta burst stimulation (iTBS) has been examined with TMS-electromyography (EMG)-based outcomes in healthy people; however, its effects in intracortical excitability and inhibition are largely unknown in patients with stroke. Concurrent transcranial magnetic stimulation and electroencephalogram (TMS-EEG) recording can be used to investigate both intracortical excitatory and inhibitory circuits of the primary motor cortex (M1) instantly and the property of brain networks at once. This study was to investigate the immediate effects of iTBS on intracortical excitatory and inhibitory circuits, neural connectivity, and network properties in patients with chronic stroke, using TMS-EEG and TMS-EMG approaches. In this randomized, sham-controlled, crossover study, 20 patients with chronic stroke received two separate stimulation conditions: a single-session iTBS or sham stimulation applied to the ipsilesional M1, in two separate visits, with a washout period of five to seven days between the two visits. A battery of TMS-EMG and TMS-EEG measurements were taken before and immediately after stimulation during the visit. Compared with sham stimulation, iTBS was effective in enhancing the amplitude of ipsilesional MEPs (p = 0.015) and P30 of TMS-evoked potentials located at the ipsilesional M1 (p = 0.037). However, iTBS did not show superior effects on ipsilesional intracortical facilitation, cortical silent period, or short-interval intracortical inhibition. Regarding the effects on TMS-related oscillations, and neural connectivity, comparisons of iTBS and sham did not yield any significant differences. iTBS facilitates intracortical excitability in patients with chronic stroke, but it does not show modulatory effects in intracortical inhibition.
AB - The neurophysiological effect of intermittent theta burst stimulation (iTBS) has been examined with TMS-electromyography (EMG)-based outcomes in healthy people; however, its effects in intracortical excitability and inhibition are largely unknown in patients with stroke. Concurrent transcranial magnetic stimulation and electroencephalogram (TMS-EEG) recording can be used to investigate both intracortical excitatory and inhibitory circuits of the primary motor cortex (M1) instantly and the property of brain networks at once. This study was to investigate the immediate effects of iTBS on intracortical excitatory and inhibitory circuits, neural connectivity, and network properties in patients with chronic stroke, using TMS-EEG and TMS-EMG approaches. In this randomized, sham-controlled, crossover study, 20 patients with chronic stroke received two separate stimulation conditions: a single-session iTBS or sham stimulation applied to the ipsilesional M1, in two separate visits, with a washout period of five to seven days between the two visits. A battery of TMS-EMG and TMS-EEG measurements were taken before and immediately after stimulation during the visit. Compared with sham stimulation, iTBS was effective in enhancing the amplitude of ipsilesional MEPs (p = 0.015) and P30 of TMS-evoked potentials located at the ipsilesional M1 (p = 0.037). However, iTBS did not show superior effects on ipsilesional intracortical facilitation, cortical silent period, or short-interval intracortical inhibition. Regarding the effects on TMS-related oscillations, and neural connectivity, comparisons of iTBS and sham did not yield any significant differences. iTBS facilitates intracortical excitability in patients with chronic stroke, but it does not show modulatory effects in intracortical inhibition.
KW - Electrodes
KW - Hemorrhaging
KW - Muscles
KW - Primary motor cortex
KW - Recording
KW - Scalp
KW - Stroke (medical condition)
KW - cortical excitability
KW - intracortical inhibition
KW - theta burst stimulation
KW - transcranial magnetic stimulation-evoked potentials
KW - Cortical excitability
UR - http://www.scopus.com/inward/record.url?scp=85161566626&partnerID=8YFLogxK
U2 - 10.1109/TNSRE.2023.3282659
DO - 10.1109/TNSRE.2023.3282659
M3 - Journal article
SN - 1534-4320
VL - 31
SP - 2758
EP - 2766
JO - IEEE Transactions on Neural Systems and Rehabilitation Engineering
JF - IEEE Transactions on Neural Systems and Rehabilitation Engineering
ER -