Hanna Faber1, Alexander Opitz2, Florian Müller-Dahlhaus1, Ulf Ziemann3. 1. Department of Neurology & Stroke, and Hertie Institute for Clinical Brain Research, University of Tübingen, Germany. 2. Center for Biomedical Imaging and Neuromodulation, Nathan Kline Institute for Psychiatric Research Orangeburg, NY, USA; Center for the Developing Brain, Child Mind Institute New York, NY, USA. 3. Department of Neurology & Stroke, and Hertie Institute for Clinical Brain Research, University of Tübingen, Germany. Electronic address: ulf.ziemann@uni-tuebingen.de.
Abstract
BACKGROUND:Transcranial direct current stimulation (tDCS) can polarize the cortex of the human brain. OBJECTIVE/HYPOTHESIS: We sought to verify the hypothesis that posterior-anterior (PA) but not anterior-posterior (AP) tDCS of primary motor cortex (M1) produces cooperative effects with corticospinal plasticity induced by paired associative stimulation of the supplementary motor area (SMA) to M1 projection (PASSMA→M1) in a highly controlled experimental design. METHODS: Three experimental conditions were tested in a double-blinded, randomized crossover design in 15 healthy adults: Navigated PASSMA→M1 during PA-tDCS (35 cm2 electrodes, anode 3 cm posterior to M1 hand area, cathode over contralateral frontopolar cortex, 1 mA, 2 × 5 min) or AP-tDCS (reversed polarity), or sham-tDCS. Effects were analyzed over 120 min post-intervention by changes of motor evoked potential (MEP) amplitude in a hand muscle. RESULTS: There was no significant effect of tDCS on PASSMA→M1 induced plasticity in the repeated-measures ANOVA. However, post-hoc within-subject contrasts revealed a significant tDCS with PASSMA→M1 interaction. This was explained by PA-tDCS and AP-tDCS modifying the PASSMA→M1 effect into the same direction in 13/15 subjects (87%, p = 0.004 for deviation from equality). Sizes of the PA-tDCS and AP-tDCS effects were correlated (rs = 0.53, p = 0.044). A control experiment demonstrated that PA-tDCS and AP-tDCS alone (without PASSMA→M1) had no effect on MEP amplitude. CONCLUSIONS: Data point to unidirectional tDCS effects on PASSMA→M1 induced plasticity irrespective of tDCS polarity, in contrast to our hypothesis. We propose that radial symmetry of cortical columns, gyral geometry of motor cortex, and cooperativity of plasticity induction can explain the findings.
RCT Entities:
BACKGROUND: Transcranial direct current stimulation (tDCS) can polarize the cortex of the human brain. OBJECTIVE/HYPOTHESIS: We sought to verify the hypothesis that posterior-anterior (PA) but not anterior-posterior (AP) tDCS of primary motor cortex (M1) produces cooperative effects with corticospinal plasticity induced by paired associative stimulation of the supplementary motor area (SMA) to M1 projection (PASSMA→M1) in a highly controlled experimental design. METHODS: Three experimental conditions were tested in a double-blinded, randomized crossover design in 15 healthy adults: Navigated PASSMA→M1 during PA-tDCS (35 cm2 electrodes, anode 3 cm posterior to M1 hand area, cathode over contralateral frontopolar cortex, 1 mA, 2 × 5 min) or AP-tDCS (reversed polarity), or sham-tDCS. Effects were analyzed over 120 min post-intervention by changes of motor evoked potential (MEP) amplitude in a hand muscle. RESULTS: There was no significant effect of tDCS on PASSMA→M1 induced plasticity in the repeated-measures ANOVA. However, post-hoc within-subject contrasts revealed a significant tDCS with PASSMA→M1 interaction. This was explained by PA-tDCS and AP-tDCS modifying the PASSMA→M1 effect into the same direction in 13/15 subjects (87%, p = 0.004 for deviation from equality). Sizes of the PA-tDCS and AP-tDCS effects were correlated (rs = 0.53, p = 0.044). A control experiment demonstrated that PA-tDCS and AP-tDCS alone (without PASSMA→M1) had no effect on MEP amplitude. CONCLUSIONS: Data point to unidirectional tDCS effects on PASSMA→M1 induced plasticity irrespective of tDCS polarity, in contrast to our hypothesis. We propose that radial symmetry of cortical columns, gyral geometry of motor cortex, and cooperativity of plasticity induction can explain the findings.
Keywords:
Human motor cortex; Paired associative stimulation; Plasticity; Polarization; Supplementary motor area; Transcranial direct current stimulation