Ann Rehabil Med.  2014 Jun;38(3):297-303. 10.5535/arm.2014.38.3.297.

Interhemispheric Modulation of Dual-Mode, Noninvasive Brain Stimulation on Motor Function

• Park E
• Kim YH
• Chang WH
• Kwon TG
• Shin YI

• KMID: 2165745
• DOI: http://doi.org/10.5535/arm.2014.38.3.297

Abstract

OBJECTIVE
To investigate the effects of simultaneous, bihemispheric, dual-mode stimulation using repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) on motor functions and cortical excitability in healthy individuals.
METHODS
Twenty-five healthy, right-handed volunteers (10 men, 15 women; mean age, 25.5 years) were enrolled. All participants received four randomly arranged, dual-mode, simultaneous stimulations under the following conditions: condition 1, high-frequency rTMS over the right primary motor cortex (M1) and sham tDCS over the left M1; condition 2, high-frequency rTMS over the right M1 and anodal tDCS over the left M1; condition 3, high-frequency rTMS over the right M1 and cathodal tDCS over the left M1; and condition 4, sham rTMS and sham tDCS. The cortical excitability of the right M1 and motor functions of the left hand were assessed before and after each simulation.
RESULTS
Motor evoked potential (MEP) amplitudes after stimulation were significantly higher than before stimulation, under the conditions 1 and 2. The MEP amplitude in condition 2 was higher than both conditions 3 and 4, while the MEP amplitude in condition 1 was higher than condition 4. The results of the Purdue Pegboard test and the box and block test showed significant improvement in conditions 1 and 2 after stimulation.
CONCLUSION
Simultaneous stimulation by anodal tDCS over the left M1 with high-frequency rTMS over the right M1 could produce interhemispheric modulation and homeostatic plasticity, which resulted in modulation of cortical excitability and motor functions.

Keyword

Bihemispheric stimulation; Transcranial direct current stimulation (tDCS); Transcranial magnetic stimulation (TMS); Interhemispheric modulation; Motor function

MeSH Terms

Brain*
Evoked Potentials, Motor
Female
Hand
Humans
Male
Motor Cortex
Plastics
Transcranial Magnetic Stimulation
Volunteers
Plastics

Figure

• 

  Fig. 1 Experimental design. Condition 1, high-frequency rTMS over the right M1 and sham tDCS over the left M1; condition 2, high-frequency rTMS over the right M1 and simultaneous anodal tDCS over the left M1; condition 3, high-frequency rTMS over the right M1 and simultaneous cathodal tDCS over the left M1; and condition 4, sham tDCS over the left M1 and sham rTMS over the right M1. Hand motor function tests, MEP amplitudes, and MEP latency were assessed immediately before and after the stimulation in each condition. rTMS, transcranial magnetic stimulation; tDCS, transcranial direct current stimulation; M1, primary motor cortex; MEP, motor evoked potential.

• 

  Fig. 2 (A) MEP amplitude and (B) MEP latency in the right M1 pre- and post-stimulations. Error bars represent the standard deviation for each condition. *p<0.05 between pre- and post-stimulation, **p<0.05 among conditions. rTMS, transcranial magnetic stimulation; tDCS, transcranial direct current stimulation; M1, primary motor cortex; MEP, motor evoked potential.

• 

  Fig. 3 (A) The Purdue Pegboard test and (B) the box and block test in the left hand, pre- and post-stimulations. Error bars represent the standard deviation for each condition. *p<0.05 between pre- and post-stimulations. rTMS, transcranial magnetic stimulation; tDCS, transcranial direct current stimulation.

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