| 제목 |
Comparison of Hemodynamic Changes After rTMS over the Anatomical Hand Knob and Hand Motor Hotspot |
| 소속 |
Sungkyunkwan University, Department of Health Sciences and Technology1, Samsung Medical Center, Department of Rehabilitation Medicine2, Sungkyunkwan University, Department of Medical Device Management & Research, Department of Digital Health3 |
| 저자 |
Jinuk Kim1,2*, Heegoo Kim1,2, Jungsoo Lee2, Hwang-Jae Lee1,2, Yoonju Na2, Won Hyuk Chang2, Yun-Hee Kim1,2† |
1. Introduction
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive method of brain stimulation that induces cortical excitability in specific areas of the brain using a magnetic field. Low-frequency rTMS can induce upregulation of excitability in the contralateral hemisphere by interhemispheric interaction. This study aimed to compare the effects of interhemispheric modulation on hemodynamic changes after applying low-frequency rTMS over the anatomical hand knob (HK) and the transcranial magnetic stimulation (TMS) induced hand motor hotspot (hMHS) in the dominant motor cortex.
2. Methods
Ten healthy right-handed participants without a history of neurological or psychiatric symptoms (five males; mean age: 29.8 ± 2.8 years) participated in this randomized, single-blind, cross-over study. 1 Hz rTMS was applied to the participants under the three conditions as follows with a 24-hour washout period between each session; 1) 1 Hz rTMS stimulation for 20 minutes on the HK of the dominant hemisphere (HK-rTMS), 2) 1 Hz rTMS stimulation for 20 minutes on the hMHS of the dominant hemisphere (hMHS-rTMS), and 3) sham stimulation (Sham-rTMS). In each participant, functional near-infrared spectroscopy (fNIRS) was applied for measurement of regional cerebral oxyhemoglobin (oxyHb) concentration during a serial reaction time task (SRTT) with the non-dominant hand before and after each condition. The fNIRS data were analyzed using the statistical parametric mapping (SPM) software and time-series analysis to compare the mean and integral value of the oxyHb concentration after rTMS.
3. Results
The individual hMHS was located anterior and lateral to the HK. The SPM analysis showed increased oxyHb concentration over the motor cortical region of the non-dominant hemisphere after both HK-rTMS and hMHS-rTMS sessions. In contrast, no change was seen after Sham-rTMS. In addition, the changes in integral values of oxyHb concentration over the non-dominant motor cortical area were significantly increased after hMHS-rTMS only compared with Sham-rTMS.
4. Conclusions
These results demonstrated the interhemispheric modulation of hemodynamic changes by 1 Hz rTMS over the motor cortex. The hMHS-rTMS produced more robust neuromodulation effects of 1 Hz rTMS to the contralateral hemisphere than the HK-rTMS.
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