Effects of Transcranial Direct Current Stimulation and High-Definition Transcranial Direct Current Stimulation Enhanced Motor Learning on Robotic Transcranial Magnetic Stimulation Motor Maps in Children

Frontiers in Human Neuroscience, Vol. 15 (2021)

Mots clés
Auteurs
  • Adrianna Giuffre
  • Calgary Pediatric Stroke Program, Alberta Children’s Hospital, Calgary, AB, Canada
  • Adrianna Giuffre
  • Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
  • Adrianna Giuffre
  • Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
  • Ephrem Zewdie
  • Calgary Pediatric Stroke Program, Alberta Children’s Hospital, Calgary, AB, Canada
  • Ephrem Zewdie
  • Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
  • Ephrem Zewdie
  • Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
  • James G. Wrightson
  • Calgary Pediatric Stroke Program, Alberta Children’s Hospital, Calgary, AB, Canada
  • James G. Wrightson
  • Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
  • Lauran Cole
  • Calgary Pediatric Stroke Program, Alberta Children’s Hospital, Calgary, AB, Canada
  • Helen L. Carlson
  • Calgary Pediatric Stroke Program, Alberta Children’s Hospital, Calgary, AB, Canada
  • Helen L. Carlson
  • Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
  • Hsing-Ching Kuo
  • Department of Physical Medicine & Rehabilitation, University of California, Davis, Sacramento, CA, United States
  • Ali Babwani
  • Calgary Pediatric Stroke Program, Alberta Children’s Hospital, Calgary, AB, Canada
  • Adam Kirton
  • Calgary Pediatric Stroke Program, Alberta Children’s Hospital, Calgary, AB, Canada
  • Adam Kirton
  • Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
  • Adam Kirton
  • Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

Résumé

Introduction: Conventional transcranial direct current stimulation (tDCS) and high-definition tDCS (HD-tDCS) may improve motor learning in children. Mechanisms are not understood. Neuronavigated robotic transcranial magnetic stimulation (TMS) can produce individualised maps of primary motor cortex (M1) topography. We aimed to determine the effects of tDCS- and HD-tDCS-enhanced motor learning on motor maps.Methods: Typically developing children aged 12–18 years were randomised to right M1 anodal tDCS, HD-tDCS, or Sham during training of their left-hand on the Purdue Pegboard Task (PPT) over 5 days. Bilateral motor mapping was performed at baseline (pre), day 5 (post), and 6-weeks retention time (RT). Primary muscle was the first dorsal interosseous (FDI) with secondary muscles of abductor pollicis brevis (APB) and adductor digiti minimi (ADM). Primary mapping outcomes were volume (mm2/mV) and area (mm2). Secondary outcomes were centre of gravity (COG, mm) and hotspot magnitude (mV). Linear mixed-effects modelling was employed to investigate effects of time and stimulation type (tDCS, HD-tDCS, Sham) on motor map characteristics.Results: Twenty-four right-handed participants (median age 15.5 years, 52% female) completed the study with no serious adverse events or dropouts. Quality maps could not be obtained in two participants. No effect of time or group were observed on map area or volume. LFDI COG (mm) differed in the medial-lateral plane (x-axis) between tDCS and Sham (p = 0.038) from pre-to-post mapping sessions. Shifts in map COG were also observed for secondary left-hand muscles. Map metrics did not correlate with behavioural changes.Conclusion: Robotic TMS mapping can safely assess motor cortex neurophysiology in children undergoing motor learning and neuromodulation interventions. Large effects on map area and volume were not observed while changes in COG may occur. Larger controlled studies are required to understand the role of motor maps in interventional neuroplasticity in children.

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