Changes in transcranial magnetic stimulation outcome measures in response to upper-limb physical training in stroke: A systematic review of randomized controlled trials / Louis-David Beaulieu in Annals of physical and rehabilitation medicine, Vol. 61, n°4 (Juillet 2018)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 61, n°4 (Juillet 2018) . - p. 224-234 Titre : Changes in transcranial magnetic stimulation outcome measures in response to upper-limb physical training in stroke: A systematic review of randomized controlled trials Type de document : texte imprimé Auteurs : Louis-David Beaulieu ; Marie-Hélène Milot Année de publication : 2018 Article en page(s) : p. 224-234 Note générale : Doi : 10.1016/j.rehab.2017.04.003 Langues : Anglais (eng) Mots-clés : Transcranial magnetic stimulation  Stroke  Upper-limb physical training  Systematic review  Brain plasticity  Clinical outcome Résumé : Background Physical training is known to be an effective intervention to improve sensorimotor impairments after stroke. However, the link between brain plastic changes, assessed by transcranial magnetic stimulation (TMS), and sensorimotor recovery in response to physical training is still misunderstood. We systematically reviewed reports of randomized controlled trials (RCTs) involving the use of TMS over the primary motor cortex (M1) to probe brain plasticity after upper-limb physical training interventions in people with stroke. Methods We searched 5 databases for articles published up to October 2016, with additional studies identified by hand-searching. RCTs had to investigate pre/post-intervention changes in at least one TMS outcome measure. Two independent raters assessed the eligibility of potential studies and reviewed the selected articles’ quality by using 2 critical appraisal scales. Results In total, 14 reports of RCTs (pooled participants=358; mean 26±12 per study) met the selection criteria. Overall, 11 studies detected plastic changes with TMS in the presence of clinical improvements after training, and these changes were more often detected in the affected hemisphere by using map area and motor evoked potential (MEP) latency outcome measures. Plastic changes mostly pointed to increased M1/corticospinal excitability and potential interhemispheric rebalancing of M1 excitability, despite sometimes controversial results among studies. Also, the strength of the review observations was affected by heterogeneous TMS methods and upper-limb interventions across studies as well as several sources of bias within the selected studies. Conclusions The current evidence encourages the use of TMS outcome measures, especially MEP latency and map area to investigate plastic changes in the brain after upper-limb physical training post-stroke. However, more studies involving rigorous and standardized TMS procedures are needed to validate these observations. Permalink : ./index.php?lvl=notice_display&id=80594 [article] Changes in transcranial magnetic stimulation outcome measures in response to upper-limb physical training in stroke: A systematic review of randomized controlled trials [texte imprimé] / Louis-David Beaulieu ; Marie-Hélène Milot . - 2018 . - p. 224-234. Doi : 10.1016/j.rehab.2017.04.003 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 61, n°4 (Juillet 2018) . - p. 224-234 Mots-clés : Transcranial magnetic stimulation  Stroke  Upper-limb physical training  Systematic review  Brain plasticity  Clinical outcome Résumé : Background Physical training is known to be an effective intervention to improve sensorimotor impairments after stroke. However, the link between brain plastic changes, assessed by transcranial magnetic stimulation (TMS), and sensorimotor recovery in response to physical training is still misunderstood. We systematically reviewed reports of randomized controlled trials (RCTs) involving the use of TMS over the primary motor cortex (M1) to probe brain plasticity after upper-limb physical training interventions in people with stroke. Methods We searched 5 databases for articles published up to October 2016, with additional studies identified by hand-searching. RCTs had to investigate pre/post-intervention changes in at least one TMS outcome measure. Two independent raters assessed the eligibility of potential studies and reviewed the selected articles’ quality by using 2 critical appraisal scales. Results In total, 14 reports of RCTs (pooled participants=358; mean 26±12 per study) met the selection criteria. Overall, 11 studies detected plastic changes with TMS in the presence of clinical improvements after training, and these changes were more often detected in the affected hemisphere by using map area and motor evoked potential (MEP) latency outcome measures. Plastic changes mostly pointed to increased M1/corticospinal excitability and potential interhemispheric rebalancing of M1 excitability, despite sometimes controversial results among studies. Also, the strength of the review observations was affected by heterogeneous TMS methods and upper-limb interventions across studies as well as several sources of bias within the selected studies. Conclusions The current evidence encourages the use of TMS outcome measures, especially MEP latency and map area to investigate plastic changes in the brain after upper-limb physical training post-stroke. However, more studies involving rigorous and standardized TMS procedures are needed to validate these observations. Permalink : ./index.php?lvl=notice_display&id=80594

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Transcranial direct current stimulation over multiple days enhances motor performance of a grip task / Julie Fan in Annals of physical and rehabilitation medicine, Vol. 60, n° 5 (September 2017)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 60, n° 5 (September 2017) . - p. 329-333 Titre : Transcranial direct current stimulation over multiple days enhances motor performance of a grip task Type de document : texte imprimé Auteurs : Julie Fan, Auteur ; Marie-Hélène Milot, Auteur ; Julien Voisin, Auteur Année de publication : 2017 Article en page(s) : p. 329-333 Langues : Anglais (eng) Français (fre) Mots-clés : Performance  Stimulation  Cerveau  Motor performance,Neurostimulation,Primary motor cortex,Grip control,Neurorehabilitation Résumé : Background: Recovery of handgrip is critical after stroke since it is positively related to upper limb function. To boost motor recovery, transcranial direct current stimulation (tDCS) is a promising, non-invasive brain stimulation technique for the rehabilitation of persons with stroke. When applied over the primary motor cortex (M1), tDCS has been shown to modulate neural processes involved in motor learning. However, no studies have looked at the impact of tDCS on the learning of a grip task in both stroke and healthy individuals. Objective: To assess the use of tDCS over multiple days to promote motor learning of a grip task using a learning paradigm involving a speed-accuracy tradeoff in healthy individuals. Methods: In a double-blinded experiment, 30 right-handed subjects (mean age: 22.1+3.3 years) participated in the study and were randomly assigned to an anodal (n =15) or sham (n =15) stimulation group. First, subjects performed the grip task with their dominant hand while following the pace of a metronome. Afterwards, subjects trained on the task, at their own pace, over 5 consecutive days while receiving sham or anodal tDCS over M1. After training, subjects performed de novo the metronome-assisted task. The change in performance between the pre and post metronome-assisted task was used to assess the impact of the grip task and tDCS on learning. Results: Anodal tDCS over M1 had a significant effect on the speed-accuracy tradeoff function. The anodal tDCS group showed significantly greater improvement in performance (39.28+15.92%) than the sham tDCS group (24.06+16.35%) on the metronome-assisted task, t (28)=2.583, P =0.015 (effect size d =0.94). Conclusions: Anodal tDCS is effective in promoting grip motor learning in healthy individuals. Further studies are warranted to test its potential use for the rehabilitation of fine motor skills in stroke patients. Permalink : ./index.php?lvl=notice_display&id=51697 [article] Transcranial direct current stimulation over multiple days enhances motor performance of a grip task [texte imprimé] / Julie Fan, Auteur ; Marie-Hélène Milot, Auteur ; Julien Voisin, Auteur . - 2017 . - p. 329-333. Langues : Anglais (eng) Français (fre) in Annals of physical and rehabilitation medicine > Vol. 60, n° 5 (September 2017) . - p. 329-333 Mots-clés : Performance  Stimulation  Cerveau  Motor performance,Neurostimulation,Primary motor cortex,Grip control,Neurorehabilitation Résumé : Background: Recovery of handgrip is critical after stroke since it is positively related to upper limb function. To boost motor recovery, transcranial direct current stimulation (tDCS) is a promising, non-invasive brain stimulation technique for the rehabilitation of persons with stroke. When applied over the primary motor cortex (M1), tDCS has been shown to modulate neural processes involved in motor learning. However, no studies have looked at the impact of tDCS on the learning of a grip task in both stroke and healthy individuals. Objective: To assess the use of tDCS over multiple days to promote motor learning of a grip task using a learning paradigm involving a speed-accuracy tradeoff in healthy individuals. Methods: In a double-blinded experiment, 30 right-handed subjects (mean age: 22.1+3.3 years) participated in the study and were randomly assigned to an anodal (n =15) or sham (n =15) stimulation group. First, subjects performed the grip task with their dominant hand while following the pace of a metronome. Afterwards, subjects trained on the task, at their own pace, over 5 consecutive days while receiving sham or anodal tDCS over M1. After training, subjects performed de novo the metronome-assisted task. The change in performance between the pre and post metronome-assisted task was used to assess the impact of the grip task and tDCS on learning. Results: Anodal tDCS over M1 had a significant effect on the speed-accuracy tradeoff function. The anodal tDCS group showed significantly greater improvement in performance (39.28+15.92%) than the sham tDCS group (24.06+16.35%) on the metronome-assisted task, t (28)=2.583, P =0.015 (effect size d =0.94). Conclusions: Anodal tDCS is effective in promoting grip motor learning in healthy individuals. Further studies are warranted to test its potential use for the rehabilitation of fine motor skills in stroke patients. Permalink : ./index.php?lvl=notice_display&id=51697

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