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Jeong H, Song M, Jang SH, Kim J. Investigating the cortical effect of false positive feedback on motor learning in motor imagery based rehabilitative BCI training. J Neuroeng Rehabil 2025; 22:61. [PMID: 40102969 PMCID: PMC11916930 DOI: 10.1186/s12984-025-01597-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 02/28/2025] [Indexed: 03/20/2025] Open
Abstract
BACKGROUND Motor imagery-based brain-computer interface (MI-BCI) is a promising solution for neurorehabilitation. Many studies proposed that reducing false positive (FP) feedback is crucial for inducing neural plasticity by BCI technology. However, the effect of FP feedback on cortical plasticity induction during MI-BCI training is yet to be investigated. OBJECTIVE This study aims to validate the hypothesis that FP feedback affects the cortical plasticity of the user's MI during MI-BCI training by first comparing two different asynchronous MI-BCI paradigms (with and without FP feedback), and then comparing its effectiveness with that of conventional motor learning methods (passive and active training). METHODS Twelve healthy volunteers and four patients with stroke participated in the study. We implemented two electroencephalogram-driven asynchronous MI-BCI systems with different feedback conditions. The feedback was provided by a hand exoskeleton robot performing hand open/close task. We assessed the hemodynamic responses in two different feedback conditions and compared them with two conventional motor learning methods using functional near-infrared spectroscopy with an event-related design. The cortical effects of FP feedback were analyzed in different paradigms, as well as in the same paradigm via statistical analysis. RESULTS The MI-BCI without FP feedback paradigm induced higher cortical activation in MI, focusing on the contralateral motor area, compared to the paradigm with FP feedback. Additionally, within the same paradigm providing FP feedback, the task period immediately following FP feedback elicited a lower hemodynamic response in the channel located over the contralateral motor area compared to the MI-BCI paradigm without FP feedback (p = 0.021 for healthy people; p = 0.079 for people with stroke). In contrast, task trials where there was no FP feedback just before showed a higher hemodynamic response, similar to the MI-BCI paradigm without FP feedback (p = 0.099 for healthy people, p = 0.084 for people with stroke). CONCLUSIONS FP feedback reduced cortical activation for the users during MI-BCI training, suggesting a potential negative effect on cortical plasticity. Therefore, minimizing FP feedback may enhance the effectiveness of rehabilitative MI-BCI training by promoting stronger cortical activation and plasticity, particularly in the contralateral motor area.
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Affiliation(s)
- Hojun Jeong
- School of Mechanical Engineering, Sungkyunkwan University, Suwon, Gyeonggi-do, 16419, Republic of Korea
| | - Minsu Song
- Department of Psychology, University of British Columbia, Vancouver, V6T 1Z4, Canada
| | - Sung-Ho Jang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, 42415, Republic of Korea
| | - Jonghyun Kim
- School of Mechanical Engineering, Sungkyunkwan University, Suwon, Gyeonggi-do, 16419, Republic of Korea.
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Gao Y, Li R, Ma Q, Bartholomay KL, Lightbody AA, Reiss AL. Longitudinal Changes in Functional Neural Activation and Sensitization During Face Processing in Fragile X Syndrome. Biol Psychiatry 2025; 97:499-506. [PMID: 38945386 PMCID: PMC11680719 DOI: 10.1016/j.biopsych.2024.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 06/17/2024] [Accepted: 06/21/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Fragile X syndrome (FXS) is a genetic condition associated with increased risk for social anxiety and avoidance. Using functional near-infrared spectroscopy (fNIRS), we previously demonstrated aberrant neural activity responding to faces in young girls with FXS cross-sectionally. Here, we tested the hypothesis that abnormalities in neural activation and sensitization would increase with age in 65 girls with FXS (ages 6-16 years) relative to an age-matched control group of 52 girls who had comparable cognitive function and clinical symptoms. METHODS fNIRS data were collected at 2 time points (mean [SD] = 2.8 [0.6] years apart) during a face processing task. Linear mixed-effect models examined longitudinal neural profiles in girls with FXS and control participants. Correlational analysis was performed to examine associations between neural sensitization (increasing neural response to repeated stimuli) and clinical ratings. RESULTS In the FXS group, 24 participants had 1 fNIRS scan, and 32 had 2 scans. In the control group, 28 participants had 1 fNIRS scan, and 22 had 2 scans. Brain activations in the superior frontal gyrus were higher in girls with FXS than control participants at both time points. Neural sensitization also increased in girls with FXS at a higher rate than control participants in the superior frontal gyrus when responding to upright faces. For the FXS group, sensitization in the superior frontal gyrus positively correlated with longitudinal increases in anxiety and social avoidance scores. CONCLUSIONS Girls with FXS show increasingly abnormal neural activation and sensitization responding to faces over time. Aberrant neural sensitization in girls with FXS is associated with longitudinal changes in anxiety and social skills.
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Affiliation(s)
- Yuanyuan Gao
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
| | - Rihui Li
- Center for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Taipa, Macau SAR; Department of Electrical and Computer Engineering, Faculty of Science and Technology, University of Macau, Taipa, Macau SAR
| | - Qianheng Ma
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Kristi L Bartholomay
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California; Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado
| | - Amy A Lightbody
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Allan L Reiss
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California; Department of Radiology, Stanford University, Stanford, California; Department of Pediatrics, Stanford University, Stanford, California
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Chen SY, Tsou MH, Chen KY, Liu YC, Lin MT. Impact of repetitive transcranial magnetic stimulation on cortical activity: a systematic review and meta-analysis utilizing functional near-infrared spectroscopy evaluation. J Neuroeng Rehabil 2024; 21:108. [PMID: 38915003 PMCID: PMC11194950 DOI: 10.1186/s12984-024-01407-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 06/19/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Repeated transcranial magnetic stimulation (rTMS) could induce alterations in cortical excitability and promote neuroplasticity. To precisely quantify these effects, functional near-infrared spectroscopy (fNIRS), an optical neuroimaging modality adept at detecting changes in cortical hemodynamic responses, has been employed concurrently alongside rTMS to measure and tailor the impact of diverse rTMS protocols on the brain cortex. OBJECTIVE This systematic review and meta-analysis aimed to elucidate the effects of rTMS on cortical hemodynamic responses over the primary motor cortex (M1) as detected by fNIRS. METHODS Original articles that utilized rTMS to stimulate the M1 cortex in combination with fNIRS for the assessment of cortical activity were systematically searched across the PubMed, Embase, and Scopus databases. The search encompassed records from the inception of these databases up until April, 2024. The assessment for risk of bias was also conducted. A meta-analysis was also conducted in studies with extractable raw data. RESULTS Among 312 studies, 14 articles were eligible for qualitative review. 7 studies were eligible for meta-analysis. A variety of rTMS protocols was employed on M1 cortex. In inhibitory rTMS, multiple studies observed a reduction in the concentration of oxygenated hemoglobin [HbO] at the ipsilateral M1, contrasted by an elevation at the contralateral M1. Meta-analysis also corroborated this consistent trend. Nevertheless, certain investigations unveiled diminished [HbO] in bilateral M1. Several studies also depicted intricate inhibitory or excitatory interplay among distinct cortical regions. CONCLUSION Diverse rTMS protocols led to varied patterns of cortical activity detected by fNIRS. Meta-analysis revealed a trend of increasing [HbO] in the contralateral cortices and decreasing [HbO] in the ipsilateral cortices following low frequency inhibitory rTMS. However, due to the heterogeneity between studies, further research is necessary to comprehensively understand rTMS-induced alterations in brain activity.
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Affiliation(s)
- Shao-Yu Chen
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7 Chung-Shan South Road, Taipei City, 10002, Taiwan
| | - Meng-Hsuan Tsou
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, 3F., No.17, Xuzhou Rd., Zhongzheng Dist, Taipei City, 10002, Taiwan
| | - Kuan-Yu Chen
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7 Chung-Shan South Road, Taipei City, 10002, Taiwan
| | - Yan-Ci Liu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, 3F., No.17, Xuzhou Rd., Zhongzheng Dist, Taipei City, 10002, Taiwan.
- Physical Therapy Center, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 1, Changde St., Zhongzheng Dist, Taipei City, 10022, Taiwan.
| | - Meng-Ting Lin
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7 Chung-Shan South Road, Taipei City, 10002, Taiwan.
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Tian D, Izumi SI. Different effects of I-wave periodicity repetitive TMS on motor cortex interhemispheric interaction. Front Neurosci 2023; 17:1079432. [PMID: 37457007 PMCID: PMC10349661 DOI: 10.3389/fnins.2023.1079432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
Background Activity of the neural circuits in the human motor cortex can be probed using transcranial magnetic stimulation (TMS). Changing TMS-induced current direction recruits different cortical neural circuits. I-wave periodicity repetitive TMS (iTMS) substantially modulates motor cortex excitability through neural plasticity, yet its effect on interhemispheric interaction remains unclear. Objective To explore the modulation of interhemispheric interaction by iTMS applied in different current directions. Materials and Methods Twenty right-handed healthy young volunteers (aged 27.5 ± 5.0 years) participated in this study with three visits. On each visit, iTMS in posterior-anterior/anterior-posterior direction (PA-/AP-iTMS) or sham-iTMS was applied to the right hemisphere, with corticospinal excitability and intracortical facilitation of the non-stimulated left hemisphere evaluated at four timepoints. Ipsilateral silent period was also measured at each timepoint probing interhemispheric inhibition (IHI). Results PA- and AP-iTMS potentiated cortical excitability concurrently in the stimulated right hemisphere. Corticospinal excitability of the non-stimulated left hemisphere increased 10 min after both PA- and AP-iTMS intervention, with a decrease in short-interval intracortical facilitation (SICF) observed in AP-iTMS only. Immediately after the intervention, PA-iTMS tilted the IHI balance toward inhibiting the non-stimulated hemisphere, while AP-iTMS shifted the balance toward the opposite direction. Conclusions Our findings provide systematic evidence on the plastic modulation of interhemispheric interaction by PA- and AP-iTMS. We show that iTMS induces an interhemispheric facilitatory effect, and that PA- and AP-iTMS differs in modulating interhemispheric inhibition.
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Affiliation(s)
- Dongting Tian
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shin-Ichi Izumi
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Japan
- Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan
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Li R, Bruno JL, Jordan T, Miller JG, Lee CH, Bartholomay KL, Marzelli MJ, Piccirilli A, Lightbody AA, Reiss AL. Aberrant Neural Response During Face Processing in Girls With Fragile X Syndrome: Defining Potential Brain Biomarkers for Treatment Studies. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:311-319. [PMID: 34555563 PMCID: PMC8964834 DOI: 10.1016/j.bpsc.2021.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/02/2021] [Accepted: 09/07/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Children and adolescents with fragile X syndrome (FXS) manifest significant symptoms of anxiety, particularly in response to face-to-face social interaction. In this study, we used functional near-infrared spectroscopy to reveal a specific pattern of brain activation and habituation in response to face stimuli in young girls with FXS, an important but understudied clinical population. METHODS Participants were 32 girls with FXS (age: 11.8 ± 2.9 years) and a control group of 28 girls without FXS (age: 10.5 ± 2.3 years) matched for age, general cognitive function, and autism symptoms. Functional near-infrared spectroscopy was used to assess brain activation during a face habituation task including repeated upright/inverted faces and greeble (nonface) objects. RESULTS Compared with the control group, girls with FXS showed significant hyperactivation in the frontopolar and dorsal lateral prefrontal cortices in response to all face stimuli (upright + inverted). Lack of neural habituation (and significant sensitization) was also observed in the FXS group in the frontopolar cortex in response to upright face stimuli. Finally, aberrant frontopolar sensitization in response to upright faces in girls with FXS was significantly correlated with notable cognitive-behavioral and social-emotional outcomes relevant to this condition, including executive function, autism symptoms, depression, and anxiety. CONCLUSIONS These findings strongly support a hypothesis of neural hyperactivation and accentuated sensitization during face processing in FXS, a phenomenon that could be developed as a biomarker end point for improving treatment trial evaluation in girls with this condition.
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Affiliation(s)
- Rihui Li
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
| | - Jennifer L Bruno
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Tracy Jordan
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Jonas G Miller
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Cindy H Lee
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Kristi L Bartholomay
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Matthew J Marzelli
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Aaron Piccirilli
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Amy A Lightbody
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Allan L Reiss
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California; Departments of Radiology and Pediatrics, Stanford University, Stanford, California
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Li R, Hosseini H, Saggar M, Balters SC, Reiss AL. Current opinions on the present and future use of functional near-infrared spectroscopy in psychiatry. NEUROPHOTONICS 2023; 10:013505. [PMID: 36777700 PMCID: PMC9904322 DOI: 10.1117/1.nph.10.1.013505] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 01/13/2023] [Indexed: 05/19/2023]
Abstract
Functional near-infrared spectroscopy (fNIRS) is an optical imaging technique for assessing human brain activity by noninvasively measuring the fluctuation of cerebral oxygenated- and deoxygenated-hemoglobin concentrations associated with neuronal activity. Owing to its superior mobility, low cost, and good tolerance for motion, the past few decades have witnessed a rapid increase in the research and clinical use of fNIRS in a variety of psychiatric disorders. In this perspective article, we first briefly summarize the state-of-the-art concerning fNIRS research in psychiatry. In particular, we highlight the diverse applications of fNIRS in psychiatric research, the advanced development of fNIRS instruments, and novel fNIRS study designs for exploring brain activity associated with psychiatric disorders. We then discuss some of the open challenges and share our perspectives on the future of fNIRS in psychiatric research and clinical practice. We conclude that fNIRS holds promise for becoming a useful tool in clinical psychiatric settings with respect to developing closed-loop systems and improving individualized treatments and diagnostics.
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Affiliation(s)
- Rihui Li
- Stanford University, Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford, California, United States
| | - Hadi Hosseini
- Stanford University, Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford, California, United States
| | - Manish Saggar
- Stanford University, Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford, California, United States
| | - Stephanie Christina Balters
- Stanford University, Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford, California, United States
| | - Allan L. Reiss
- Stanford University, Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford, California, United States
- Stanford University, Department of Radiology and Pediatrics, Stanford, California, United States
- Stanford University, Department of Pediatrics, Stanford, California, United States
- Address all correspondence to Allan L. Reiss,
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Xia Y, Tang X, Hu R, Liu J, Zhang Q, Tian S, Wang W, Li C, Zhu Y. Cerebellum-Cerebrum paired target magnetic stimulation on balance function and brain network of patients with stroke: A functional near-infrared spectroscopy pilot study. Front Neurol 2022; 13:1071328. [PMID: 36619935 PMCID: PMC9813387 DOI: 10.3389/fneur.2022.1071328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 11/24/2022] [Indexed: 12/24/2022] Open
Abstract
Transcranial magnetic stimulation (TMS) modulation over the cerebellum, primary motor cortex, and supplementary motor cortex individually can improve the balance function of patients with stroke. However, whether their combination could have a better balance modulation effect is uncertain. Therefore, we hypothesized that performing TMS over a combination of these targets can regulate the balance function of patients with stroke. We compared the effects of one-session TMS on eye-open and eye-closed balance conditions in patients with stroke, using different target pairs of unilateral cerebellar (CB-single), cerebellar-primary motor cortex (CB-M1), and cerebellar-supplementary motor area (CB-SMA) targets. A total of 31 patients with stroke were enrolled and randomly divided into three groups to receive single sessions of intermittent theta burst stimulation each. Functional near-infrared spectrum data on resting and standing task states (eye-open and eye-closed) and center of pressure parameters (eye-open and eye-closed) were collected before and after the intervention. Compared with the results in the CB-single group, five intergroup differences in the changes in the center of pressure parameters in the CB-M1 group and two significant differences in the CB-SMA group were observed after one session of intermittent theta burst stimulation. In the CB-SMA group, 12 out of the 14 parameters improved significantly in the EC condition after the intervention. Meanwhile, the functional near-infrared spectrum results showed that the CB-SMA group exhibited a significant inhibitory pattern in the resting-state functional connectivity, which was not observed in the other two groups. In conclusion, we believe that paired targeting of the CB-SMA can reshape the brain network and improve the balance function of patients with stroke.
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Ma H, Zhai Y, Xu Z, Fan S, Wu X, Xu J, Wu S, Ma C. Increased cerebral cortex activation in stroke patients during electrical stimulation of cerebellar fastigial nucleus with functional near-infrared spectroscopy. Front Neurosci 2022; 16:895237. [PMID: 36061594 PMCID: PMC9433974 DOI: 10.3389/fnins.2022.895237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022] Open
Abstract
Background Electrical stimulation of the cerebellar fastigial nucleus (FNS) has been shown to protect animals against cerebral ischemic injury. However, the changes in cortical activation as a response to FNS have not been illustrated in humans. Objective This study aims to detect functional connectivity changes in the brain of stroke patients, and investigate the cortical activation caused by FNS through measuring the oxygenated hemoglobin concentration (HBO) in the cerebral cortex of stroke patients and healthy controls (HCs). Methods This study recruited 20 patients with stroke and 20 HCs with all the following factors matched: age, gender and BMI. The experiment session was made up of the pre-task baseline, FNS task period, and post-task baseline. FNS task period contains 5 blocks, each block encompassing the resting state (30 s) and the FNS state (30 s). HBO signals were acquired by functional near-infrared spectroscopy (fNIRS) from the Prefrontal Cortex (PFC), the Motor Cortex (MC) and the Occipital Cortex (OC) throughout the experiment. The Pearson correlation coefficient was used to calculate the resting-state functional connectivity strength between the two groups, and the general linear model (GLM) was used to calculate the activation of 39 fNIRS channels during FNS in stroke patients and HCs, respectively. Results The coupling strength of stroke patients were significantly decreased in the following regions: right MC and left MC (t = 4.65, p = 0.0007), right MC and left OC (t = 2.93, p = 0.04), left MC and left OC (t = 2.81, p = 0.04). In stroke patients, the changes in cerebral oxygenated hemoglobin (ΔHBO) among 12 channels (CH) in the bilateral PFC and bilateral MC regions were significantly increased during the FNS state (FDR corrected p < 0.05) compared with the resting state. In HCs, only 1 channel was increased (FDR corrected p < 0.05) in the left PFC during FNS. Conclusion By using the FNS and fNIRS techniques, the characteristics of functional connectivity were found to decrease in stroke patients. It was also noticed that FNS activates the PFC and MC regions. These findings may help to guide functional rehabilitation in stroke patients.
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Mittal N, Lewis C, Cho Y, Peterson CL, Hadimani RL. Effect of Fiber Tracts and Depolarized Brain Volume on Resting Motor Thresholds During Transcranial Magnetic Stimulation. IEEE TRANSACTIONS ON MAGNETICS 2022; 58:1-6. [DOI: 10.1109/tmag.2022.3148214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
Affiliation(s)
- Neil Mittal
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Connor Lewis
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Yeajin Cho
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Carrie L. Peterson
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Ravi L. Hadimani
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
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Interhemispheric Facilitatory Effect of High-Frequency rTMS: Perspective from Intracortical Facilitation and Inhibition. Brain Sci 2022; 12:brainsci12080970. [PMID: 35892411 PMCID: PMC9332419 DOI: 10.3390/brainsci12080970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 02/04/2023] Open
Abstract
The activity of excitatory and inhibitory neural circuits in the motor cortex can be probed and modified by transcranial magnetic stimulation (TMS) and repetitive TMS (rTMS), noninvasively. At present, not only has a consensus regarding the interhemispheric effect of high frequency rTMS not been reached, but the attributes of these TMS-related circuits are also poorly understood. To address this question comprehensively, we integrated a single- and paired-pulse TMS evaluation with excitatory 20-Hz rTMS intervention in order to probe the interhemispheric effect on the intracortical circuits by high-frequency rTMS. In the rest state, after 20-Hz rTMS, a significant increase of single-pulse MEP and paired-pulse intracortical facilitation (ICF) in the non-stimulated hemisphere was observed with good test–retest reliability. Intracortical inhibition (measured by the cortical silent period) in the unstimulated hemisphere also increased after rTMS. No significant time–course change was observed in the sham-rTMS group. The results provide the evidence that 20-Hz rTMS induced a reliable interhemispheric facilitatory effect. Findings from the present study suggest that the glutamatergic facilitatory system and the GABAergic inhibitory system may vary synchronously.
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Li C, Zhang N, Han Q, Zhang L, Xu S, Tu S, Xie Y, Wang Z. Prolonged Continuous Theta Burst Stimulation Can Regulate Sensitivity on Aβ Fibers: An Functional Near-Infrared Spectroscopy Study. Front Mol Neurosci 2022; 15:887426. [PMID: 35493324 PMCID: PMC9039327 DOI: 10.3389/fnmol.2022.887426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/16/2022] [Indexed: 11/13/2022] Open
Abstract
Objective High-frequency repetitive transcranial magnetic stimulation (rTMS) induces analgesic effects in both experimental pain and clinical pain conditions. However, whether rTMS can modulate sensory and pain thresholds on sensory fibers is still unclear. Here, we compared the effects of three rTMS paradigms on sensory and pain thresholds conducted by different sensory fibers (Aβ, Aδ, and C fibers) with sham stimulation and investigate the potential brain activation using functional near-infrared spectroscopy (fNIRS). Methods Forty right-handed healthy subjects were randomly allocated into one of four groups. Each subject received one session rTMS [prolonged continuous theta-burst stimulation (pcTBS), intermittent theta-burst stimulation (iTBS), 10 Hz rTMS or sham]. Current perception threshold (CPT), pain tolerance threshold (PTT), and fNIRS were measured at baseline, immediately after stimulation, and 1 h after stimulation, respectively. Results Significant differences between treatments were observed for changes for CPT 2,000 Hz between baseline and 1 h after rTMS (F = 6.551, P < 0.001): pcTBS versus sham (P = 0.004) and pcTBS versus 10 Hz rTMS (P = 0.007). There were significant difference in average HbO μm in the right frontopolar cortex (FPC) [channel 23: P = 0.030 (pcTBS versus sham: P = 0.036)], left dorsolateral prefrontal cortex (DLPFC) [channel 7: P = 0.006 (pcTBS versus sham: P = 0.004)], left FPC [channel 17: P = 0.014 (pcTBS versus sham: P = 0.046), channel 22: P = 0.004 (pcTBS versus sham: P = 0.004)] comparing four group in 1 h after stimulation in PTT 2000 Hz (Aβ-fiber). Conclusion Prolonged continuous theta-burst stimulation can regulate sensitivity on Aβ fibers. In addition, single-session pcTBS placed on left M1 can increase the excitability of DLPFC and FPC, indicating the interaction between M1 and prefrontal cortex may be a potential mechanism of analgesic effect of rTMS. Studies in patients with central post-stroke pain are required to confirm the potential clinical applications of pcTBS.
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Mechanisms of Repetitive Transcranial Magnetic Stimulation on Post-stroke Depression: A Resting-State Functional Magnetic Resonance Imaging Study. Brain Topogr 2022; 35:363-374. [PMID: 35286526 DOI: 10.1007/s10548-022-00894-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 02/21/2022] [Indexed: 12/25/2022]
Abstract
We aimed to identify neural mechanisms underlying clinical response to repetitive transcranial magnetic stimulation (rTMS) in post-stroke depression (PSD) by the Resting-state functional magnetic resonance imaging (rs-fMRI). Thirty-two depressed patients after ischemic stroke were randomized in a 1:1 ratio to receive 20 min of 5 Hz rTMS or sham over left dorsolateral prefrontal cortex (DLPFC) in addition to routine supportive treatments. The clinical outcome was measured by the 17-item Hamilton Depression Rating Scale (HDRS-17), while the imaging results were acquired from rs-fMRI, including regional homogeneity (ReHo), fractional amplitude of low-frequency fluctuation (fALFF) and seed-based dynamic functional connection (dFC). HRSD-17 scores were improved in the two groups after treatment (P < 0.01), while greater mood improvement was observed in the rTMS group (P < 0.05). Compared with the sham group, the rTMS group demonstrated regions with higher ReHo and fALFF values locating mainly in the left hemisphere and highly consistent with the default mode network (DMN) (p < 0.05). Using the medial prefrontal cortex (mPFC) and posterior cingulate cortex (PCC) as seeds, significant difference between the two groups in dFC within the DMN was found after treatment, including 10 connections with increased connectivity strength and 2 connections with reduced connectivity strength. The ReHo, fALFF and dFC values within DMN in the rTMS group were negatively correlated with the HDRS scores after treatment (P < 0.05). Our results indicated reductions in depressive symptoms following rTMS in PSD are associated with functional alterations of different depression-related areas within the DMN.
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Kan RLD, Mak ADP, Chan SKW, Zhang BBB, Fong KNK, Kranz GS. Protocol for a prospective open-label clinical trial to investigate the utility of concurrent TBS/fNIRS for antidepressant treatment optimisation. BMJ Open 2022; 12:e053896. [PMID: 35144953 PMCID: PMC8845219 DOI: 10.1136/bmjopen-2021-053896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Repetitive transcranial magnetic stimulation (rTMS) with theta burst stimulation (i.e. TBS) of the dorsolateral prefrontal cortex (DLPFC) is an innovative treatment for major depressive disorder (MDD). However, fewer than 50% of patients show sufficient response to this treatment; markers for response prediction are urgently needed. Research shows considerable individual variability in the brain responses to rTMS. However, whether differences in individual DLPFC modulation by rTMS can be used as a predictive marker for treatment response remains to be investigated. Here, we present a research programme that will exploit the combination of functional near-infrared spectroscopy (fNIRS) with brain stimulation. Concurrent TBS/fNIRS will allow us to systematically investigate TBS-induced modulation of blood oxygenation as a proxy for induced brain activity changes. The findings from this study will (1) elucidate the immediate effects of excitatory and inhibitory TBS on prefrontal activity in TBS treatment-naïve patients with MDD and (2) validate the potential utility of TBS-induced brain modulation at baseline for the prediction of antidepressant response to 4 weeks of daily TBS treatment. METHODS AND ANALYSIS Open-label, parallel-group experiment consisting of two parts. In part 1, 70 patients and 37 healthy controls will be subjected to concurrent TBS/fNIRS. Intermittent TBS (iTBS) and continuous TBS (cTBS) will be applied on the left and right DLPFC, respectively. fNIRS data will be acquired before, during and several minutes after stimulation. In part 2, patients who participated in part 1 will receive a 4 week iTBS treatment of the left DLPFC, performed daily for 5 days per week. Psychometric evaluation will be performed periodically and at 1 month treatment follow-up. Statistical analysis will include a conventional, as well as a machine learning approach. ETHICS AND DISSEMINATION Ethics approval was obtained from the Institutional Review Board. Findings will be disseminated through scientific journals, conferences and university courses. TRIAL REGISTRATION NUMBER NCT04526002.
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Affiliation(s)
- Rebecca L D Kan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Arthur D P Mak
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China
| | - Sherry K W Chan
- Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Bella B B Zhang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Kenneth N K Fong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Georg S Kranz
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Wien, Austria
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, People's Republic of China
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Ding Q, Lin T, Wu M, Yang W, Li W, Jing Y, Ren X, Gong Y, Xu G, Lan Y. Influence of iTBS on the Acute Neuroplastic Change After BCI Training. Front Cell Neurosci 2021; 15:653487. [PMID: 33776653 PMCID: PMC7994768 DOI: 10.3389/fncel.2021.653487] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 02/22/2021] [Indexed: 12/21/2022] Open
Abstract
Objective: Brain-computer interface (BCI) training is becoming increasingly popular in neurorehabilitation. However, around one third subjects have difficulties in controlling BCI devices effectively, which limits the application of BCI training. Furthermore, the effectiveness of BCI training is not satisfactory in stroke rehabilitation. Intermittent theta burst stimulation (iTBS) is a powerful neural modulatory approach with strong facilitatory effects. Here, we investigated whether iTBS would improve BCI accuracy and boost the neuroplastic changes induced by BCI training. Methods: Eight right-handed healthy subjects (four males, age: 20-24) participated in this two-session study (BCI-only session and iTBS+BCI session in random order). Neuroplastic changes were measured by functional near-infrared spectroscopy (fNIRS) and single-pulse transcranial magnetic stimulation (TMS). In BCI-only session, fNIRS was measured at baseline and immediately after BCI training. In iTBS+BCI session, BCI training was followed by iTBS delivered on the right primary motor cortex (M1). Single-pulse TMS was measured at baseline and immediately after iTBS. fNIRS was measured at baseline, immediately after iTBS, and immediately after BCI training. Paired-sample t-tests were used to compare amplitudes of motor-evoked potentials, cortical silent period duration, oxygenated hemoglobin (HbO2) concentration and functional connectivity across time points, and BCI accuracy between sessions. Results: No significant difference in BCI accuracy was detected between sessions (p > 0.05). In BCI-only session, functional connectivity matrices between motor cortex and prefrontal cortex were significantly increased after BCI training (p's < 0.05). In iTBS+BCI session, amplitudes of motor-evoked potentials were significantly increased after iTBS (p's < 0.05), but no change in HbO2 concentration or functional connectivity was observed throughout the whole session (p's > 0.05). Conclusions: To our knowledge, this is the first study that investigated how iTBS targeted on M1 influences BCI accuracy and the acute neuroplastic changes after BCI training. Our results revealed that iTBS targeted on M1 did not influence BCI accuracy or facilitate the neuroplastic changes after BCI training. Therefore, M1 might not be an effective stimulation target of iTBS for the purpose of improving BCI accuracy or facilitate its effectiveness; other brain regions (i.e., prefrontal cortex) are needed to be further investigated as potentially effective stimulation targets.
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Affiliation(s)
- Qian Ding
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Tuo Lin
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Manfeng Wu
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Wenqing Yang
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Wanqi Li
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Yinghua Jing
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Xiaoqing Ren
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Yulai Gong
- Sichuan Provincial Rehabilitation Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Guangqing Xu
- Department of Rehabilitation Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yue Lan
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
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Li R, Li S, Roh J, Wang C, Zhang Y. Multimodal Neuroimaging Using Concurrent EEG/fNIRS for Poststroke Recovery Assessment: An Exploratory Study. Neurorehabil Neural Repair 2020; 34:1099-1110. [DOI: 10.1177/1545968320969937] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background Persistent motor deficits are very common in poststroke survivors and often lead to disability. Current clinical measures for profiling motor impairment and assessing poststroke recovery are largely subjective and lack precision. Objective A multimodal neuroimaging approach was developed based on concurrent functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG) to identify biomarkers associated with motor function recovery and document the poststroke cortical reorganization. Methods EEG and fNIRS data were simultaneously recorded from 9 healthy controls and 18 stroke patients during a hand-clenching task. A novel fNIRS-informed EEG source imaging approach was developed to estimate cortical activity and functional connectivity. Subsequently, graph theory analysis was performed to identify network features for monitoring and predicting motor function recovery during a 4-week intervention. Results The task-evoked strength at ipsilesional primary somatosensory cortex was significantly lower in stroke patients compared with healthy controls ( P < .001). In addition, across the 4-week rehabilitation intervention, the strength at ipsilesional premotor cortex (PMC) ( R = 0.895, P = .006) and the connectivity between bilateral primary motor cortices (M1) ( R = 0.9, P = .007) increased in parallel with the improvement of motor function. Furthermore, a higher baseline strength at ipsilesional PMC was associated with a better motor function recovery ( R = 0.768, P = .007), while a higher baseline connectivity between ipsilesional supplementary motor cortex (SMA)–M1 implied a worse motor function recovery ( R = −0.745, P = .009). Conclusion The proposed multimodal EEG/fNIRS technique demonstrates a preliminary potential for monitoring and predicting poststroke motor recovery. We expect such findings can be further validated in future study.
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Affiliation(s)
- Rihui Li
- University of Houston, Houston, TX, USA
| | - Sheng Li
- University of Texas Health Science Center, Houston, TX, USA
| | | | - Chushan Wang
- Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, Guangdong, China
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Li R, Zhao C, Wang C, Wang J, Zhang Y. Enhancing fNIRS Analysis Using EEG Rhythmic Signatures: An EEG-Informed fNIRS Analysis Study. IEEE Trans Biomed Eng 2020; 67:2789-2797. [PMID: 32031925 DOI: 10.1109/tbme.2020.2971679] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Neurovascular coupling represents the relationship between changes in neuronal activity and cerebral hemodynamics. Concurrent Electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) recording and integration analysis has emerged as a promising multi-modal neuroimaging approach to study the neurovascular coupling as it provides complementary properties with regard to high temporal and moderate spatial resolution of brain activity. In this study we developed an EEG-informed-fNIRS analysis framework to investigate the neuro-correlate between neuronal activity and cerebral hemodynamics by identifying specific EEG rhythmic modulations which contribute to the improvement of the fNIRS-based general linear model (GLM) analysis. Specifically, frequency-specific regressors derived from EEG were used to construct design matrices to guide the GLM analysis of the fNIRS signals collected during a hand grasp task. Our results showed that the EEG-informed fNIRS GLM analysis, especially the alpha and beta band, revealed significantly higher sensitivity and specificity in localizing the task-evoked regions compared to the canonical boxcar model, demonstrating the strong correlations between hemodynamic response and EEG rhythmic modulations. Results also indicated that analysis based on the deoxygenated hemoglobin (HbR) signal slightly outperformed the oxygenated hemoglobin (HbO)-based analysis. The findings in our study not only validate the feasibility of enhancing fNIRS GLM analysis using simultaneously recorded EEG signals, but also provide a new perspective to study the neurovascular coupling of brain activity.
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