这项研究得到了俄罗斯科学基金会的资助 (合同号: 17-11-01273)。特别感谢安德烈 Afanasov 和来自电视技术多功能创新中心的同事 (国立研究大学, 经济学院, 莫斯科, 俄罗斯联邦) 的视频录制和视频编辑。

所有程序均由莫斯科高等经济学院 (HSE) 地方研究伦理委员会批准, 并征得所有与会者的同意. 
 注意: 参与者必须报告未植入的金属设备、神经或精神疾病、药物滥用或酗酒史。TMS 根据最新安全指南使用 20 。必须充分了解研究的性质, 并在开始实验前签署知情同意书。我们展示了一整套的设备, 运行在线组合可-TMS 协议的主要 M1 的刺激 ( 图 1 ;材料表). 
 1. 将肌电图 (肌电信号) 电极置于双极型腹部肌腱蒙太奇中 <ol> <li> 使用所有电极下的清洁擦洗清洁皮肤, 以实现低皮肤阻抗 (低于 10 kOhm). </li>
	<li> 将活动肌电图电极放置在第一个背侧骨间 (FDI) 肌肉上, 上部为2厘米的骨骼上的参考电极, 而地面电极则更接近于手臂的下部. </li>
</ol> 2。确定刺激协议的目标 注意: 在这里, 我们使用无框 tms 导航系统来实现 tms 线圈的正确定位. 
<ol> <li> 将跟踪传感器放置在眉毛和参与者鼻子上方的眉之间. </li>
	<li> 打开导航系统软件。使用个人参与者和 #39; 结构 T1 磁共振成像 (mri) 数据, 并通过导航系统执行 co-registration 的参与者和 #39 的头部和 3D mri 头部. </li>
	<li> 准确地, 把线圈放在主电机的手区域, 所谓的和 #34; 电机旋钮和 #34; 区域 ( 图 2 ). </li>
	<li> 开始应用单脉冲 TMS 和测试欧洲议员;TMS 由刺激器交付 (参见 材料表 ) 连接到一个标准图--八75毫米卷。定位 #34; 热点与 #34; 左侧 M1, 将线圈切线与头皮保持在一起, 手柄向后和侧面, 角度在45和 #176; 从参与者和 #39 的中线矢状轴; 头部. </li>
	<li> 一旦出现热点 ( 即, 在从对侧检测到的手部肌肉的阈值中引出了欧洲议员的头皮点), 就用铅笔标记它以方便可靶电极的应用. </li>
</ol> 3. 可电极准备 <ol> <li> 连接2表面盐水浸泡过的海绵电极 (大小: 5 cm x 7 厘米) 到刺激装置, 它可以产生电交流电流 ( 例如, Brainstim). </li>
	<li> 为了最大限度地减少皮肤的感觉, 不断饱和的电极与盐水溶液, 以保持阻抗低于 10 kOhm 整个刺激环节. </li>
</ol> 4. 可协议设置 <ol> <li> 使用刺激器设备设置可协议, 首先检查电池状态. </li>
	<li> 使用该软件, 打开一个新的会话并管理新的刺激协议. 
	<ol> <li> 命名协议 ( 例如, 和 #34; 测试版和 #34;). </li>
		<li> 设置刺激的频率 ( 例如, 20 Hz). </li>
		<li> 选择波形 ( 例如, 正弦). </li>
		<li> 设置刺激协议的总持续时间 ( 例如, 600s). </li>
		<li> 最后, 设置刺激的强度 (例如, 1 mA), 设置偏移量, 淡入淡出, 淡出, 并在和 #34 的阶段; 0 和 #34;. 
		注: 为了避免任何不利或不舒服的感觉神经效果, 可以建议在刺激 (三十年代左右) 的时间内逐渐消退. </li>
		<li> 激活设备和 #39; #34; 蓝牙和 #34; 功能并将协议从软件上传到刺激器. </li>
	</ol> </li> </ol> 5. 可电极蒙太奇 <ol> 将 #34; 目标和 #34; 电极在头皮上对应的标记点。将 #34、参考和 #34; 在同侧肩部的电极上使用特定的粘胶带, 在和 #34; 单蒙太奇和 #34; 21 . </li>
	<li> 小心调整头上的第一个弹性带, 相对于神经导航头-传感器位置。然后, 用第二条皮带固定目标电极位置. </li>
	<li> 一旦可电极放置在头皮和同侧肩上, 将它们连接到刺激器. </li>
	<li> 在刺激期开始前, 通过目视检查确保目标电极的位置集中在已标记的热点上. </li>
</ol> 6。确定静止马达阈值 (RMT) <ol> <li> 将 TMS 线圈置于目标可电极上, 并通过使用神经导航系统仔细调整热点 ( 图 3 ) 上的线圈位置. </li>
	<li> 相应地测量 RMT 到组合的可-tms 设置 ( 即, tms 线圈在电极)。具体来说, 调整 TMS 强度与可电极的厚度有关, 以检查一个可靠的 RMT. 
	<ol> <li> 单独测量 RMT, 它被定义为在外国直接投资肌肉中诱导一个 50 mV (峰) 在 5 10 试验中的振幅的最小强度, 22 . </li>
	</ol> </li> <li> 在 RMT 的110% 处设置 TMS 刺激的强度以启动实验会话. </li> </ol>
 7. 实验过程 <ol> <li> 打开肌电信号软件并启动肌电信号记录. </li>
	<li> 启动可刺激. </li>
	<li> 在刺激过程中, 将由随机间隔所散布的 TMS 单脉冲从3秒到5秒钟. </li>
	<li> 确保每个刺激的会话 (例如, 20 赫兹可刺激, 后跟一个假/另一个控制频率) 持续不超过90秒, 以闭会间隔约3分钟, 以避免可能的结转效果前面的刺激频率/情况 11 , 13 . </li>
</ol>

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作者没有什么可透露的。

这种方法是一个独特的机会, 直接测试可的在线效果, 通过测量脊髓输出通过欧洲议会议员记录的初级运动皮层。然而, TMS 线圈在可电极上的位置是一个关键的步骤, 应该准确地执行。因此, 我们首先建议实验者通过单脉冲 TMS 找到一个目标点, 然后将它标记在头皮上, 并在那之后, 将可电极放在热点上。此外, 一个神经导航系统的可用性, 关键支持一个最佳的目标点的定位, 单脉冲 TMS。在启动过程之前, 请确保参与者没有任何禁忌症24和 TMS20。
此外, 在 TMS 线圈下的可电极的厚度和位置可导致不同的 RMT 在标准工序。因此, 当 TMS 线圈已经位于可电极上时, 测量 RMT 是很重要的。
TMS-可在线方法代表了技术进步为基础研究和临床应用。由于大多数可的证据表明, 效果是突出的期间, 而不是停止后的刺激, 这种方法可能是有用的测试在线受益频率特异性的影响患者的运动疾病, 如必要的震颤,肌张力障碍, 帕金森氏症, 和其他运动疾病。
到目前为止, 这种联合的方法被用来调查马达和视觉皮层过程11,15。然而, 可本身被证明是一个可靠的技术, 以提高认知功能, 如内存和决策14,16,25,26,27。将来, 通过操纵不同的频率和靶向不同的皮层区域, 将重复 TMS (刺激) 与可结合起来的可能性可能有助于研究 so-called "neuroenhancement" 的机制。同样, 它已经表明, 可与图案的 TMS 协议, 如连续的θ脉冲刺激 (cTBS) 的组合, 导致了增强的可塑性效果, 只有当 cTBS 应用在阶段与峰值的可强制激活28. 此外, 虽然刺激被用作临床工具, 但它与可的结合可能导致新的临床方法的发展康复。
虽然这篇文章的重点是刺激 M1, 其他皮层地区可能是针对使用这种组合的方法。然而, 只有对人的马达系统的刺激可能导致可测量的马达诱发电位 (欧洲议员) 记录从对侧侧的肌肉在代表一个复合信号从系列降皮质-脊椎截击与不同的生成器29。另一方面, 其他电极部署可能会提供不同的机会来调查在线半球效果, 使用伴随的双边可在左, 右 M1 与脉冲 TMS。此外, 通过测量反应时间 (RT) 和准确度, 在线可-TMS 方法可用于针对不同皮层区域的行为任务。一方面, 可-TMS 方法提供了一种无工件的方法来研究人体运动功能;另一方面, 可脑电的方法可以为研究不同认知过程的神经相关性提供更多的可能性, 目标是多种皮层区域, 但仍然有更多的工件在信号记录里面。

经颅电刺激 (工商业污水附加费) 是一种促进技术, 允许通过不同的电流波形改变神经元状态1。在不同类型的工商业污水附加费中, 经颅交流刺激 (可) 能够在特定频率范围内传递正弦外部振荡电位, 并对知觉的生理神经活动进行调制,马达和认知过程2。使用可, 可以研究内源性振荡活动与脑过程之间的潜在因果关系。
在体内, 已经表明, 在不同的驱动频率下, 脉冲神经活动是同步的, 这表明神经元放电可以通过电应用的领域3。在动物模型中, 微弱的正弦可拽了广泛皮质神经元池的放电频率4。在人类, 可结合在线脑电图 (EEG) 允许诱导的 so-called "夹带" 效应的内源性振荡活动的互动与脑振荡的频率特定的方式5。然而, 由于交流诱发的工件6, 将可与神经影像方法结合以更好地了解在线机制仍然是值得商榷的。此外, 不能直接在受激靶区上记录 EEG 信号而不使用环形电极, 这是一个可疑的解决方案7。因此, 对这个问题缺乏系统性的研究。
到目前为止, 还没有明确的证据表明可在刺激停止后的持久作用。仅有少数研究显示了可在马达系统上的微弱和不明确的后遗症8。此外, EEG 证据仍然不清楚可的后遗症9。另一方面, 大多数可研究显示突出的在线效果10,11,12,13,14,15,16,17,18, 由于技术上的限制, 很难在生理水平上进行测量。因此, 我们的方法的总目标是提供一种替代方法, 以测试在线和频率依赖性的影响可的运动皮层 (M1) 通过提供单脉冲经颅磁刺激 (TMS)。TMS 允许研究员 "探针" 人体运动皮层的生理状态19。此外, 通过记录运动诱发电位对对侧的手, 我们可以调查的影响, 正在进行的可11。这种方法让我们可以通过在不同频率的在线电刺激中以无工件的方式来测量脊髓兴奋度的变化, 从而精确地监测其改变。此外, 此方法还可以测试任何其他附加的波形的在线效果。
为了证明联合可-TMS 的效果, 我们将通过应用20赫兹 AC 刺激的主要运动皮层 (M1), 而在线 neuronavigated 单脉冲 tms 提供穿插随机间隔从3到 5 s, 以测试 M1皮质兴奋性。

<table border="0" cellpadding="0" cellspacing="0" width="628">
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			<td height="42" style="height:42px;width:213px;">BrainStim, high-resolution transcranial stimulator</td>
			<td style="width:136px;">E.M.S., Bologna, Italy</td>
			<td style="width:123px;">EMS-BRAINSTIM</td>
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			<td height="63" style="height:63px;width:213px;">Pair of 1,5m cables for connection of conductive silicone electrodes</td>
			<td style="width:136px;">E.M.S., Bologna, Italy</td>
			<td style="width:123px;">EMS-CVBS15</td>
			<td style="width:157px;"></td>
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		<tr height="42">
			<td height="42" style="height:42px;width:213px;">Reusable conductive silicone electrodes 50x50mm</td>
			<td style="width:136px;">E.M.S., Bologna, Italy</td>
			<td style="width:123px;">FIA-PG970/2</td>
			<td style="width:157px;"></td>
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		<tr height="42">
			<td height="42" style="height:42px;width:213px;">Reusable spontex sponge for electrode 50x100mm</td>
			<td style="width:136px;">E.M.S., Bologna, Italy</td>
			<td style="width:123px;">FIA-PG916S</td>
			<td style="width:157px;"></td>
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			<td style="width:136px;">E.M.S., Bologna, Italy</td>
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			<td style="width:157px;"></td>
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			<td height="42" style="height:42px;width:213px;">Plastic non traumatic button</td>
			<td style="width:136px;">E.M.S., Bologna, Italy</td>
			<td style="width:123px;">FIA-PG905/99</td>
			<td style="width:157px;"></td>
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		<tr height="42">
			<td height="42" style="height:42px;width:213px;">Brainstim</td>
			<td style="width:136px;">E.M.S., Bologna, Italy</td>
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			<td style="width:157px;"></td>
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			<td height="42" style="height:42px;width:213px;">MagPro X100 MagOption - transcranial magnetic stimulator</td>
			<td style="width:136px;">MagVenture, Farum, Denmark</td>
			<td style="width:123px;">9016E0731</td>
			<td style="width:157px;"></td>
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			<td height="42" style="height:42px;width:213px;">8-shaped coil MC-B65-HO-2</td>
			<td style="width:136px;">MagVenture, Farum, Denmark</td>
			<td style="width:123px;">9016E0462</td>
			<td style="width:157px;"></td>
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			<td height="42" style="height:42px;width:213px;">Chair with neckrest</td>
			<td style="width:136px;">MagVenture, Farum, Denmark</td>
			<td style="width:123px;">9016B0081</td>
			<td style="width:157px;"></td>
		</tr>
		<tr height="63">
			<td height="63" style="height:63px;width:213px;">Localite TMS Navigator - Navigation platform, Premium edition</td>
			<td style="width:136px;">Localite, GmbH, Germany</td>
			<td style="width:123px;">21223</td>
			<td style="width:157px;"></td>
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			<td height="84" style="height:84px;width:213px;">Localite TMS Navigator - MR-based software, import data for morphological MRI (DICOM, NifTi)</td>
			<td style="width:136px;">Localite, GmbH, Germany</td>
			<td style="width:123px;">10226</td>
			<td style="width:157px;"></td>
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		<tr height="57">
			<td height="57" style="height:57px;width:213px;">MagVenture 24.8 coil tracker, Geom 1</td>
			<td style="width:136px;">Localite, GmbH, Germany</td>
			<td style="width:123px;">5221</td>
			<td style="width:157px;"></td>
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		<tr height="21">
			<td height="21" style="height:21px;width:213px;">Electrode wires for surface EMG</td>
			<td style="width:136px;">&#160;EBNeuro, Italy&#160;</td>
			<td style="width:123px;">6515</td>
			<td style="width:157px;"></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:213px;">Surface Electrodes for EEG/EMG</td>
			<td style="width:136px;">&#160;EBNeuro, Italy&#160;</td>
			<td style="width:123px;">6515</td>
			<td style="width:157px;"></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:213px;">BrainAmp ExG amplifier - bipolar amplifier&#160;</td>
			<td style="width:136px;">Brain Products, GmbH, Germany</td>
			<td style="width:123px;"></td>
			<td style="width:157px;"></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:213px;">&#160;BrainVision Recorder 1.21.0004&#160;</td>
			<td style="width:136px;">Brain Products, GmbH, Germany</td>
			<td style="width:123px;"></td>
			<td style="width:157px;"></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:213px;">Nuprep Skin Prep Gel&#160;</td>
			<td style="width:136px;">Weaver and Company, USA</td>
			<td></td>
			<td style="width:157px;"></td>
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			<td height="21" style="height:21px;width:213px;">Syringes</td>
			<td style="width:136px;"></td>
			<td style="width:123px;"></td>
			<td style="width:157px;"></td>
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			<td height="21" style="height:21px;width:213px;">Sticky tape</td>
			<td style="width:136px;"></td>
			<td style="width:123px;"></td>
			<td style="width:157px;"></td>
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		<tr height="21">
			<td height="21" style="height:21px;width:213px;">NaCl solution</td>
			<td style="width:136px;"></td>
			<td style="width:123px;"></td>
			<td style="width:157px;"></td>
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effects of transcranial alternating current stimulation on the primary motor cortex by online combined approach with transcranial magnetic stimulation

经颅交变电流刺激 (可) 是一种促进技术, 能够在特定频率下通过正弦电波形, 进而调节正在进行的皮层振荡活动。这 neurotool 允许建立内在振荡活动和行为之间的因果联系。大多数的可研究显示了可的在线效果。然而, 由于在脑电图 (eeg) 信号上交流诱发的伪影, 这项技术的基本作用机制知之甚少。在这里, 我们展示了一个独特的方法来调查的在线生理频率特异性的影响, 可的原发性运动皮质 (M1) 使用单脉冲经颅磁刺激 (TMS), 以探测皮层兴奋性变化。在我们的设置, TMS 线圈是放置在可电极, 而电机诱发电位 (欧洲议员) 收集测试的影响, 正在进行的 M1-tACS。到目前为止, 这种方法主要用于研究视觉和马达系统。然而, 目前的可-TMS 设置可以为未来的认知功能研究铺平道路。因此, 我们提供了一个 step-by 步骤的程序手册和视频指南。

2010年, 金井et al.显示了可/TMS 组合方法的第一个证据。在这项研究中, 作者应用可在初级视觉皮层 (V1), 并显示了一个频率特异的调节视觉皮层兴奋性测量的在线 TMS 诱导的 phosphene 知觉15。在 2011年, 通过 Feurra et al.对运动皮层兴奋性进行生理调节, 采用了更完善的协议版本。为了这样做, 这些作者在单脉冲 TMS 期间记录了欧洲议会议员, 而正在进行的可交付 (图 4)。作者报告了第一个因果证据的可能夹带20赫兹刺激的内源性怠速β M1 通过提高脊髓输出相对于其他控制频率, 控制站点 (顶叶刺激) 和控制实验 (周围尺神经实验)11 (图 5)。
在随后的一项研究中, Feurra 和合作者表明, 可的影响不仅是频率, 而且是依赖于状态的13。通过使用相同的联合蒙太奇, 可被应用在 M1 在两种不同的条件下: 休息和运动图像 (主题被要求想象捏紧动作)。根据先前的结果11, 只有 Beta 刺激 (20 hz) 在静止时增强了初级运动皮层的兴奋性, 而在运动图像任务中, 在θ (5 hz) 和α (10 hz) 刺激期间, 增强效应是显著的。这代表了第一个生理证据的国家依赖的影响, 由可。
到目前为止, 这种联合接触已经被用来进一步研究运动皮层 (表 1) 的功能。Guerra 和合作者应用可-TMS, 使用类似的方法, 以显示如何特定的神经元电路反应的刺激提供电机频率 (20 赫兹) 和机动车共振频率 (7 赫兹)。他们表明, 20 Hz 刺激取消了胆碱能 short-latency 传入抑制 (西) 的影响, 无论刺激的阶段。有趣的是, 谷氨酸皮质促进 (ICF) 和 GABAAergic 近皮质抑制 (SICI) 的变化是特定于阶段的23。
<img alt="Figure 1" class="xfigimg" src="/files/ftp_upload/55839/55839fig1.jpg"> 
图 1:同时可刺激所需材料的列表.盐水溶液, 控制装置, 松紧带, 海绵 (可), 可电缆电线和电极, 注射器, 粘胶带。<a href="//ecsource-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/55839/55839fig1large.jpg" target="_blank">请单击此处查看此图的较大版本.</a>
<img alt="Figure 2" class="xfigimg" src="/files/ftp_upload/55839/55839fig2.jpg"> 
图 2: 可-TMS 协议中的神经导航.红十字会表示, 一个记忆中的 TMS 热点的主要运动皮层。重叠的白色十字表示在协议期间的 TMS 线圈的在线定位, 作为正确方向的标志。<a href="//ecsource-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/55839/55839fig2large.jpg" target="_blank">请单击此处查看此图的较大版本.</a>
<img alt="Figure 3" class="xfigimg" src="/files/ftp_upload/55839/55839fig3.jpg"> 
图 3: 可-TMS 在主题的头皮上.TMS 线圈必须放置在目标可电极上。研究者应根据热点的神经导航坐标保持线圈的位置。<a href="//ecsource-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/55839/55839fig3large.jpg" target="_blank">请单击此处查看此图的较大版本.</a>
<img alt="Figure 4" class="xfigimg" src="/files/ftp_upload/55839/55839fig4.jpg"> 
图 4:通过使用在线可-TMS 方法进行实验设计的示意图表示.(a) 红色 ("靶") 电极放置在头皮上, 覆盖左侧运动皮质和右顶叶皮质 (P4 10-20 国际脑电图系统的位置)。蓝色 ("参考") 电极放置在与 PZ (10-20 国际脑电图系统) 位置对应的中线 (双极/头蒙太奇)。注意, 当前建议的参考电极放置在同侧肩部 (单蒙太奇), 而 P4 则用作控制位置。(b) Neuronavigated TMS: 线圈是在海绵电极上放置在左 M1。彩色三角形表示从精确目标的线圈位移的在线反馈, 公差为 2 mm (此图已从 Feurra et al., 2011)11中修改。<a href="//ecsource-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/55839/55839fig4large.jpg" target="_blank">请单击此处查看此图的较大版本.</a>
<img alt="Figure 5" class="xfigimg" src="/files/ftp_upload/55839/55839fig5.jpg"> 
图 5: 具有代表性的结果.(a) 通过不同实验条件获得的平均对数变换的机电振幅 (误差线表示标准误差) 值 (原始数据)。只有可提供的 beta 范围 (20 赫兹) 在电机皮层增加脊髓输出与所有其他条件 (基线, 5 hz, 10 hz, 40 hz, 和 20 hz 的顶叶皮质)。星号 (*) 表示20赫兹刺激对所有其他条件的显著差异。(b) 百分比变化与原始机电振幅值的基线 (此图已从 Feurra et al.、 2011)11中修改。<a href="//ecsource-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/55839/55839fig5large.jpg" target="_blank">请单击此处查看此图的较大版本.</a>
<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>作者</td>
			<td>任务</td>
			<td>频率</td>
			<td>强度</td>
			</tr></tbody></table>td 电极位置
			<td>结果</td>
		
		<tr>
			<td>Feurra et al., 2011</td>
			<td>静止脊髓兴奋性的测量</td>
			<td>5赫兹, 10 赫兹, 20 hz, 40 hz</td>
			<td>1 mA</td>
			<td>左 M1, 顶叶皮质, 尺神经</td>
			<td>20赫兹增加了欧洲议会议员的大小在休息</td>
		</tr>
		<tr>
			<td>Feurra et al., 2013</td>
			<td>静止和运动图像中脊髓兴奋性的测量</td>
			<td>5赫兹, 10 赫兹, 20 hz, 40 hz</td>
			<td>1 mA</td>
			<td>左 M1</td>
			<td>20赫兹增加的欧洲议会议员的大小在休息, 而5和 10 hz 增加了欧洲议员的大小在马达图像</td>
		</tr>
		<tr>
			<td>Cancelli et al., 2015</td>
			<td>静止脊髓兴奋性的测量</td>
			<td>20Hz</td>
			<td>2.2 mA</td>
			<td>双边 M1</td>
			<td>个体化和个性化电极对皮质兴奋性增强的差异</td>
		</tr>
		<tr>
			<td>Guerra et al., 2016</td>
			<td>静止脊髓兴奋性的测量</td>
			<td>7赫兹, 20 赫兹</td>
			<td>1 mA</td>
			<td>左 M1</td>
			<td>20赫兹可调制 SICI, ICF 和西</td>
		</tr>
	

表 1: 可在不同条件下对初级运动皮层的影响.频率, 强度, 皮质部位的刺激和结果。

Watch this Scientific Journal Video about Effects of Transcranial Alternating Current Stimulation on the Primary Motor Cortex by Online Combined Approach with Transcranial Magnetic Stimulation at JoVE

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

经颅交变电流刺激 (可) 允许以频率特异的方式调节皮质兴奋性。在这里, 我们展示了一个独特的方法, 结合在线可与单脉冲经颅磁刺激 (TMS), 以 "探针" 皮层兴奋性的手段, 电机诱发电位。

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 ...

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9.0K 次观看.  National Research University Higher School of Economics. 经颅交变电流刺激 (可) 允许以频率特异的方式调节皮质兴奋性。在这里, 我们展示了一个独特的方法, 结合在线可与单脉冲经颅磁刺激 (TMS), 以 "探针" 皮层兴奋性的手段, 电机诱发电位。

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

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 ...

Remotely Supervised Transcranial Direct Current Stimulation: An Update on Safety and Tolerability

The remotely supervised tDCS (RS-tDCS) protocol enables participation from home through guided and monitored self-administration of tDCS treatment while maintaining clinical standards. The current consensus regarding the efficacy of tDCS is that multiple treatment sessions are needed to observe targeted behavioral reductions in symptom burden. However, the requirement for patients to travel to clinic daily for stimulation sessions presents a major obstacle for potential participants, due to work or family obligations or limited ability to travel. This study presents a protocol that directly overcomes these obstacles by eliminating the need to travel to clinic for daily sessions.
This is an updated protocol for remotely supervised self-administration of tDCS for daily treatment sessions paired with a program of computer-based cognitive training for use in clinical trials. Participants only need to attend clinic twice, for a baseline and study-end visit. At baseline, participants are trained and provided with a study stimulation device, and a small laptop computer. Participants then complete the remainder of their stimulation sessions at home while they are monitored via videoconferencing software.
Participants complete computerized cognitive remediation during stimulation sessions, which may serve a therapeutic role or as a &#34;placeholder&#34; for other computer-based activity. Computers are enabled for real-time monitoring and remote control by study staff.
Outcome measures that assess feasibility and tolerance are administered remotely with the aid of visual analogue scales that are presented onscreen. Following completion of all RS-tDCS sessions, participants return to clinic for a study end visit in which all study equipment is returned.
Results support the safety, feasibility, and scalability of the RS-tDCS protocol for use in clinical trials. Across 46 patients, 748 RS-tDCS sessions have been completed. This protocol serves as a model for use in future clinical trials involving tDCS.

This manuscript provides an updated remote supervision protocol that enables participation in transcranial direct current stimulation (tDCS) clinical trials while receiving treatment sessions from home. The protocol has been successfully piloted in both patients with multiple sclerosis and Parkinson&#39;s disease.

远程监督的经颅直流电刺激: 安全性和耐受的最新进展

The remotely supervised tDCS (RS-tDCS) protocol enables participation from home through guided and monitored self-administration of tDCS treatment while ...

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) ...

Combined Transcranial Magnetic Stimulation and Electroencephalography of the Dorsolateral Prefrontal Cortex

Transcranial magnetic stimulation (TMS) is a non-invasive method that produces neural excitation in the cortex by means of brief, time-varying magnetic field pulses. The initiation of cortical activation or its modulation depends on the background activation of the neurons of the cortical region activated, the characteristics of the coil, its position and its orientation with respect to the head. TMS combined with simultaneous electrocephalography (EEG) and neuronavigation (nTMS-EEG) allows for the assessment of cortico-cortical excitability and connectivity in almost all cortical areas in a reproducible manner. This advance makes nTMS-EEG a powerful tool that can accurately assess brain dynamics and neurophysiology in test-retest paradigms that are required for clinical trials. Limitations of this method include artifacts that cover the initial brain reactivity to stimulation. Thus, the process of removing artifacts may also extract valuable information. Moreover, the optimal parameters for dorsolateral prefrontal (DLPFC) stimulation are not fully known and current protocols utilize variations from the motor cortex (M1) stimulation paradigms. However, evolving nTMS-EEG designs hope to address these issues. The protocol presented here introduces some standard practices for assessing neurophysiological functioning from stimulation to the DLPFC that can be applied in patients with treatment resistant psychiatric disorders that receive treatment such as transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), magnetic seizure therapy (MST) or electroconvulsive therapy (ECT).

The protocol presented here is for TMS-EEG studies utilizing intracortical excitability test-retest design paradigms. The intent of the protocol is to produce reliable and reproducible cortical excitability measures for assessing neurophysiological functioning related to therapeutic interventions in the treatment of neuropsychiatric diseases such as major depression.

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 ...

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 ...

Transcranial Direct Current Stimulation (tDCS) in Mice

Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique proposed as an alternative or complementary treatment for several neuropsychiatric diseases. The biological effects of tDCS are not fully understood, which is in part explained due to the difficulty in obtaining human brain tissue. This protocol describes a tDCS mouse model that uses a chronically implanted electrode allowing the study of the long-lasting biological effects of tDCS. In this experimental model, tDCS changes the cortical gene expression and offers a prominent contribution to the understanding of the rationale for its therapeutic use.

Transcranial Direct Current Stimulation tDCS in Mice

Transcranial direct current stimulation (tDCS) is a therapeutic technique proposed to treat psychiatric diseases. An animal model is essential for understanding the specific biological alterations evoked by tDCS. This protocol describes a tDCS mouse model that uses a chronically implanted electrode.

经颅直流电刺激 (tDCS) 在小鼠中的作用

Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique proposed as an alternative or complementary treatment for ...

Stimulation Location Determination using a 3D Digitizer with High-Definition Transcranial Direct Current Stimulation

The abundance of neuroimaging data and rapid development of machine learning has made it possible to investigate brain activation patterns. However, causal evidence of brain area activation leading to a behavior is often left missing. Transcranial direct current stimulation (tDCS), which can temporarily alter brain cortical excitability and activity, is a noninvasive neurophysiological tool used to study causal relationships in the human brain. High-definition transcranial direct current stimulation (HD-tDCS) is a noninvasive brain stimulation (NIBS) technique that produces a more focal current compared to conventional tDCS. Traditionally, the stimulation location has been roughly determined through the 10-20 EEG system, because determining precise stimulation points can be difficult. This protocol uses a 3D digitizer with HD-tDCS to increase accuracy in determination of stimulation points. The method is demonstrated using a 3D digitizer for more accurate localization of stimulation points in the right temporo-parietal junction (rTPJ).

Presented here is a protocol to achieve higher accuracy in determination of stimulation location combining a 3D digitizer with high-definition transcranial direct current stimulation.

使用具有高清晰度颅内直接电流刺激的 3D 数字化仪确定刺激位置

The abundance of neuroimaging data and rapid development of machine learning has made it possible to investigate brain activation patterns. However, ...