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Kulasingham JP, Brodbeck C, Khan S, Marsh EB, Simon JZ. Bilaterally Reduced Rolandic Beta Band Activity in Minor Stroke Patients. Front Neurol 2022; 13:819603. [PMID: 35418932 PMCID: PMC8996122 DOI: 10.3389/fneur.2022.819603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 02/14/2022] [Indexed: 11/24/2022] Open
Abstract
Stroke patients with hemiparesis display decreased beta band (13–25 Hz) rolandic activity, correlating to impaired motor function. However, clinically, patients without significant weakness, with small lesions far from sensorimotor cortex, exhibit bilateral decreased motor dexterity and slowed reaction times. We investigate whether these minor stroke patients also display abnormal beta band activity. Magnetoencephalographic (MEG) data were collected from nine minor stroke patients (NIHSS < 4) without significant hemiparesis, at ~1 and ~6 months postinfarct, and eight age-similar controls. Rolandic relative beta power during matching tasks and resting state, and Beta Event Related (De)Synchronization (ERD/ERS) during button press responses were analyzed. Regardless of lesion location, patients had significantly reduced relative beta power and ERS compared to controls. Abnormalities persisted over visits, and were present in both ipsi- and contra-lesional hemispheres, consistent with bilateral impairments in motor dexterity and speed. Minor stroke patients without severe weakness display reduced rolandic beta band activity in both hemispheres, which may be linked to bilaterally impaired dexterity and processing speed, implicating global connectivity dysfunction affecting sensorimotor cortex independent of lesion location. Findings not only illustrate global network disruption after minor stroke, but suggest rolandic beta band activity may be a potential biomarker and treatment target, even for minor stroke patients with small lesions far from sensorimotor areas.
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Affiliation(s)
- Joshua P Kulasingham
- Department of Electrical and Computer Engineering, University of Maryland, College Park, MD, United States
| | - Christian Brodbeck
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, United States
| | - Sheena Khan
- Department of Neurology, The Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Elisabeth B Marsh
- Department of Neurology, The Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Jonathan Z Simon
- Department of Electrical and Computer Engineering, University of Maryland, College Park, MD, United States.,Department of Biology, University of Maryland, College Park, MD, United States.,Institute for Systems Research, University of Maryland, College Park, MD, United States
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Pfeifer KJ, Kromer JA, Cook AJ, Hornbeck T, Lim EA, Mortimer BJP, Fogarty AS, Han SS, Dhall R, Halpern CH, Tass PA. Coordinated Reset Vibrotactile Stimulation Induces Sustained Cumulative Benefits in Parkinson's Disease. Front Physiol 2021; 12:624317. [PMID: 33889086 PMCID: PMC8055937 DOI: 10.3389/fphys.2021.624317] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 02/05/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Abnormal synchronization of neuronal activity in dopaminergic circuits is related to motor impairment in Parkinson's disease (PD). Vibrotactile coordinated reset (vCR) fingertip stimulation aims to counteract excessive synchronization and induce sustained unlearning of pathologic synaptic connectivity and neuronal synchrony. Here, we report two clinical feasibility studies that examine the effect of regular and noisy vCR stimulation on PD motor symptoms. Additionally, in one clinical study (study 1), we examine cortical beta band power changes in the sensorimotor cortex. Lastly, we compare these clinical results in relation to our computational findings. METHODS Study 1 examines six PD patients receiving noisy vCR stimulation and their cortical beta power changes after 3 months of daily therapy. Motor evaluations and at-rest electroencephalographic (EEG) recordings were assessed off medication pre- and post-noisy vCR. Study 2 follows three patients for 6+ months, two of whom received daily regular vCR and one patient from study 1 who received daily noisy vCR. Motor evaluations were taken at baseline, and follow-up visits were done approximately every 3 months. Computationally, in a network of leaky integrate-and-fire (LIF) neurons with spike timing-dependent plasticity, we study the differences between regular and noisy vCR by using a stimulus model that reproduces experimentally observed central neuronal phase locking. RESULTS Clinically, in both studies, we observed significantly improved motor ability. EEG recordings observed from study 1 indicated a significant decrease in off-medication cortical sensorimotor high beta power (21-30 Hz) at rest after 3 months of daily noisy vCR therapy. Computationally, vCR and noisy vCR cause comparable parameter-robust long-lasting synaptic decoupling and neuronal desynchronization. CONCLUSION In these feasibility studies of eight PD patients, regular vCR and noisy vCR were well tolerated, produced no side effects, and delivered sustained cumulative improvement of motor performance, which is congruent with our computational findings. In study 1, reduction of high beta band power over the sensorimotor cortex may suggest noisy vCR is effectively modulating the beta band at the cortical level, which may play a role in improved motor ability. These encouraging therapeutic results enable us to properly plan a proof-of-concept study.
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Affiliation(s)
- Kristina J. Pfeifer
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Justus A. Kromer
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Alexander J. Cook
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Traci Hornbeck
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Erika A. Lim
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, United States
| | | | - Adam S. Fogarty
- Department of Neurology, Stanford University School of Medicine, Stanford, CA, United States
| | - Summer S. Han
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, United States
- Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, CA, United States
| | - Rohit Dhall
- Center for Neurodegenerative Disorders, Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Casey H. Halpern
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Peter A. Tass
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, United States
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