Effects of Multi-Session Repetitive Transcranial Magnetic Stimulation on Motor Control and Spontaneous Brain Activity in Multiple System Atrophy: A Pilot Study
机构:[1]Department of Neurodegenerative Disease, Centre of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China,重点科室诊疗科室神经病学中心神经病学中心首都医科大学附属天坛医院[2]Harvard Medical School, Harvard University, Roslindale, MA, United States
Background: Impaired motor control is one of the most common symptoms of multiple system atrophy (MSA). It arises from dysfunction of the cerebellum and its connected neural networks, including the primary motor cortex (M1), and is associated with altered spontaneous (i.e., resting-state) brain network activity. Non-invasive repetitive transcranial magnetic stimulation (rTMS) selectively facilitates the excitability of supraspinal networks. Repeated rTMS sessions have been shown to induce long-term changes to both resting-state brain dynamics and behavior in several neurodegenerative diseases. Here, we hypothesized that a multi-session rTMS intervention would improve motor control in patients with MSA, and that such improvements would correlate with changes in resting-state brain activity. Methods: Nine participants with MSA received daily sessions of 5 Hz rTMS for 5 days. rTMS targeted both the cerebellum and the bilateral M1. Before and within 3 days after the intervention, motor control was assessed by the motor item of the Unified Multiple System Atrophy Rating Scale (UMSARS). Resting-state brain activity was recorded by blood-oxygen-level dependency (BOLD) functional magnetic resonance imaging. The "complexity" of resting-state brain activity fluctuations was quantified within seven well-known functional cortical networks using multiscale entropy, a technique that estimates the degree of irregularity of the BOLD time-series across multiple scales of time. Results: The rTMS intervention was well-attended and was not associated with any adverse events. Average motor scores were lower (i.e., better performance) following the rTMS intervention as compared to baseline (t(8) = 2.3, p = 0.003). Seven of nine participants exhibited such pre-to-post intervention improvements. A trend toward an increase in resting-state complexity was observed within the motor network (t(8) = 1.86, p = 0.07). Participants who exhibited greater increases in motor network resting-state complexity demonstrated greater improvement in motor control (r2 = 0.72, p = 0.004). Conclusion: This pilot study demonstrated that a five-session rTMS intervention targeting the cerebellum and bilateral M1 is feasible and safe for those with MSA. More definitive, well-controlled trials are warranted to confirm our preliminary results that rTMS may alleviate the severity of motor dysfunction and modulate the multiscale dynamics of motor network brain activity.
基金:
Golden Bridge Project Seed Funding (Beijing Association for Science and Technology); Milstein Medical Asian American Partnership (MMAAP) Foundation; National Institute on AgingUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Aging (NIA) [2 P30 AG031679]
第一作者机构:[1]Department of Neurodegenerative Disease, Centre of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China,
通讯作者:
通讯机构:[1]Department of Neurodegenerative Disease, Centre of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China,[2]Harvard Medical School, Harvard University, Roslindale, MA, United States
推荐引用方式(GB/T 7714):
Liu Zhu,Ma Huizi,Poole Victoria,et al.Effects of Multi-Session Repetitive Transcranial Magnetic Stimulation on Motor Control and Spontaneous Brain Activity in Multiple System Atrophy: A Pilot Study[J].FRONTIERS IN BEHAVIORAL NEUROSCIENCE.2018,12:-.doi:10.3389/fnbeh.2018.00090.
APA:
Liu, Zhu,Ma, Huizi,Poole, Victoria,Wang, Xuemei,Wang, Zhan...&Feng, Tao.(2018).Effects of Multi-Session Repetitive Transcranial Magnetic Stimulation on Motor Control and Spontaneous Brain Activity in Multiple System Atrophy: A Pilot Study.FRONTIERS IN BEHAVIORAL NEUROSCIENCE,12,
MLA:
Liu, Zhu,et al."Effects of Multi-Session Repetitive Transcranial Magnetic Stimulation on Motor Control and Spontaneous Brain Activity in Multiple System Atrophy: A Pilot Study".FRONTIERS IN BEHAVIORAL NEUROSCIENCE 12.(2018):-