Biomedical subjects

Christian Gerloff

Publications and source records attributed to Christian Gerloff.

9 recordsLinked to original sources

PubMed2003

Disinhibition of the contralateral motor cortex by low-frequency rTMS.

Low-frequency repetitive transcranial magnetic stimulation (rTMS) of the primary motor cortex (M1) results in a lasting decrease of motor evoked potentials (MEPs). Here we investigated the effects of supra-threshold rTMS (15 min, 1 Hz) to the left M1 on the excitability of the stimulated and homologous (unstimulated) M1 in healthy subjects by using single and double pulse TMS before and after rTMS. We found reduction of MEP amplitudes on the stimulated side and, most importantly, disinhibition of intracortical excitability of the homologous M1. This crossed effect of rTMS supports the concept of a physiological balance of reciprocal inhibitory projections and emphasizes that rTMS can induce remote effects that are relevant for the physiological interpretation of such interventions.

Adult↗

PubMed2003

Transient suppression of tinnitus by transcranial magnetic stimulation.

It has been proposed that tinnitus is associated with an irregular activation of the temporoparietal cortex. If this activity is a functionally relevant component of the tinnitus-related network, a virtual temporary lesion of this area should result in transient reduction of tinnitus. To test this hypothesis, we applied 10Hz repetitive transcranial magnetic stimulation to eight scalp and four control positions in 14 patients with chronic tinnitus. Stimulation of left temporoparietal cortex significantly reduced tinnitus (Friedman analysis of variance, p < 0.05; compared with control), indicating that secondary auditory areas can be critical for tinnitus perception, perhaps as a consequence of maladaptive cortical reorganization.

Adult↗

PubMed2003

Ipsilateral cortical activation during finger sequences of increasing complexity: representation of movement difficulty or memory load?

OBJECTIVE: To investigate, if increasing ipsilateral cortical activation during sequential finger movements of increasing complexity relates to the difficulty of transitions ('sequence complexity') or to increasing motor memory load ('sequence length'). METHODS: Pre-learned, memorized sequences (MEM) of different complexities (SIMPLE=e.g., 2-2-2-2-2-2-2-2-2-2-2-2-2-2-2-2; SCALE=e.g., 2-5-4-3-2-5-4-3-2-5-4-3-2-5-4-3; and COMPLEX=e.g., 5-3-2-4-3-4-2-5-4-4-2-3-5-2-4-3; 2=index, 5=pinky) were randomly alternated with visually instructed, novel sequences (NOV) of matched complexity. In this design, memory load co-varied with complexity during MEM because of increasing length of the memorized sequences. In NOV, memory load was eliminated because each sequence element was prompted by an instructive visual cue. Cortical activation was measured by spectral power analysis of 28-channel electroencephalogram (EEG) in 15 healthy, right-handed subjects. RESULTS: The increases of ipsilateral sensorimotor activation from SIMPLE over SCALE to COMPLEX in NOV were linearly correlated with the corresponding pattern in MEM (P<0.01). No significant differences were found between MEM and NOV (analysis of variance, n.s.). CONCLUSIONS: The similar dynamics of cortical activation patterns across movement sequences during MEM and NOV indicate that increasing ipsilateral activation primarily reflects processing of increasingly difficult transitions between movements, and not motor memory load. SIGNIFICANCE: Function of ipsilateral sensorimotor areas during complex motor behavior.

Adult↗

PubMed2003

Enhancing cognitive performance with repetitive transcranial magnetic stimulation at human individual alpha frequency.

We applied rapid-rate repetitive transcranial magnetic stimulation (rTMS) at individual alpha frequency (IAF) to improve cognitive performance by influencing the dynamics of alpha desynchronization. Previous research indicates that a large upper alpha power in a reference interval preceding a task is related to both large suppression of upper alpha power during the task and good performance. Here, we tested the hypothesis that rTMS at individual upper alpha frequency (IAF + 1 Hz) can enhance alpha power in the reference interval, and can thus improve task performance. Repetitive TMS was delivered to the mesial frontal (Fz) and right parietal (P6) cortex, and as sham condition with 90 degrees-tilted coil (P6 position). The behavioural effect was assessed in a mental rotation task. Further control conditions were rTMS at a lower IAF (IAF - 3 Hz) and at 20 Hz. The results indicate that rTMS at IAF + 1 Hz can enhance task performance and, concomitantly, the extent of task-related alpha desynchronization. This provides further evidence for the functional relevance of oscillatory neuronal activity in the alpha band for the implementation of cognitive performance.

Adolescent↗

PubMed2002

Enhancement of human cortico-motoneuronal excitability by the selective norepinephrine reuptake inhibitor reboxetine.

It has been proposed that norepinephrine plays a critical role in the modulation of cortical excitability, which in turn is thought to influence functional recovery from brain lesions. The purpose of the present experiments was to determine if it is possible to modulate cortical excitability with the selective norepinephrine reuptake inhibitor reboxetine in intact humans. Recruitment curve and intracortical facilitation, assessed by transcranial magnetic stimulation, were increased after oral intake of 8 and 4 mg reboxetine, in the absence of changes in motor threshold, intracortical inhibition, M-response, F-wave or H-reflex. These results demonstrate that reboxetine enhances cortical excitability and raise the possibility that it could act as a plasticity enhancing substance potentially useful in combination with neurorehabilitative strategies geared to enhance neurorehabilitation.

Adrenergic Uptake Inhibitors↗

PubMed2002

Bimanual coordination and interhemispheric interaction.

Bimanual coordination of skilled finger movements requires intense functional coupling of the motor areas of both cerebral hemispheres. This coupling can be measured non-invasively in humans with task-related coherence analysis of multi-channel surface electroencephalography. Since bimanual coordination is a high-level capability that virtually always requires training, this review is focused on changes of interhemispheric coupling associated with different stages of bimanual learning. Evidence is provided that the interaction between hemispheres is of particular importance in the early phase of command integration during acquisition of a novel bimanual task. It is proposed that the dynamic changes in interhemispheric interaction reflect the establishment of efficient bimanual 'motor routines'. The effects of callosal damage on bimanual coordination and learning are reviewed as well as functional imaging studies related to bimanual movement. There is evidence for an extended cortical network involved in bimanual motor activities which comprises the bilateral primary sensorimotor cortex (SM1), supplementary motor area, cingulate motor area, dorsal premotor cortex and posterior parietal cortex. Current concepts about the functions of these structures in bimanual motor behavior are reviewed.

Adult↗

PubMed2002

Inhibitory control of acquired motor programmes in the human brain.

An important basis of skilled human behaviour is the appropriate retrieval of acquired and memorized motor programmes ('motor memory traces'). Appropriate retrieval is warranted if motor programmes are only activated if necessary and are, probably more often, inhibited if required by the context of a given situation. It is unknown how this type of inhibition is accomplished in the brain. We studied context-dependent modulation of motor memory traces in 18 volunteers and six patients with focal dystonia. Cortical function was assessed with transcranial magnetic stimulation over the primary motor cortex (M1) and with task-related analysis of oscillatory EEG activity. An activation (ACT) and inhibition (INH) condition were compared. In both, visual cues were presented at 1/s. In ACT, subjects had to respond to these cues with individual finger movements as learned in a preceding training session. In INH, subjects had to observe the cues without retrieval of motor responses. During INH, inhibitory control of the motor memory trace was confirmed by significant amplitude reduction of motor evoked potentials (MEPs) compared with baseline. This was accompanied by a significant increase of 11-13 Hz oscillatory activity over the sensorimotor areas during INH. During active retrieval of the motor memory traces, the reverse was true (increased MEP amplitudes, decreased oscillatory 11-13 Hz activity). In a small sample of dystonic patients (n = 6), the increase of 11-13 Hz oscillatory activity during INH was consistently absent. The present data demonstrate for the first time cortical correlates of appropriate, context-dependent inhibition of motor memory traces. We propose that focal increases of oscillatory activity are instrumental for inhibitory control at the cortical level. This concept is supported by the preliminary observations in dystonic patients who are known to have deficits of inhibitory motor control and in whom these context-dependent focal increases of oscillatory activity were absent.

Adult↗

PubMed2002

Two types of ipsilateral reorganization in congenital hemiparesis: a TMS and fMRI study.

Reorganization after early brain injuries is not only determined by the maturational stage of the CNS at the time of the insult (timing), but also by the structural properties, location and extent of the lesion. This study addresses the impact of different lesion extents on the type of reorganization induced in a cohort of patients with lesions of uniform structure and location (unilateral periventricular defects) and similar timing (early third trimester of pregnancy). Twelve young adult patients with congenital hemiparesis and 10 age-matched controls were studied. The severity of structural damage to hand motor projections of the cortico-spinal tract was assessed on semi-coronal MRI reconstructions along anatomical landmarks of cortico-spinal tract somatotopy. The functional integrity of these crossed cortico-spinal projections in the affected hemisphere, as well as the presence of any abnormal ipsilateral projections to the paretic hand, was examined by transcranial magnetic stimulation (TMS). Cortical activation during simple voluntary hand movements was studied by functional MRI (fMRI). Patients with small lesions (SL; n = 4) and only mild hand motor impairment possessed intact crossed cortico-spinal projections to the paretic hand, whereas no motor response could be elicited by TMS of the affected hemisphere in those with large lesions (LL; n = 6) and more severe hand motor impairment. Evidence for compensatory recruitment of the unaffected hemisphere was found in both subgroups. In the SL group, fMRI demonstrated ipsilateral activation of premotor areas, without any abnormal projections to the paretic hand originating from these sites. In the LL group, such abnormal ipsilateral projections to the paretic hand were indeed found, and fMRI confirmed cortical activation of an abnormal ipsilateral hand motor representation in the primary sensorimotor region of the unaffected hemisphere. Two patients with intermediate-sized lesions presented combined features of both groups (SL, LL). In conclusion, this study provides evidence that the type of cortico-spinal reorganization depends on the extent of the brain lesion. We propose that involvement of the ipsilateral hemisphere can be (i) of the premotor type, i.e. without ipsilateral motor projections but with significant activation of ipsilateral premotor areas, or (ii) of the primary motor type, i.e. with abnormal ipsilateral cortico-spinal projections to the paretic hand.

Adolescent↗

PubMed2002

Movement rate effect on activation and functional coupling of motor cortical areas.

We investigated changes in the activation and functional coupling of bilateral primary sensorimotor (SM1) and supplementary motor (SMA) areas with different movement rates in eight normal volunteers. An auditory-cued repetitive right-thumb movement was performed at rates of 0.5, 0.75, 1, 2, 3, and 4 Hz. As a control condition, subjects listened to pacing tones with no movements. Electroencephalogram (EEG) was recorded from 28 scalp electrodes and electromyogram was obtained from the hand muscles. The event-related changes in EEG band-power (ERpow: activation of each area) and correlation (ERcor: functional coupling between each pair of cortical areas) were computed every 32 ms. Modulations of ERpow and ERcor were inspected in alpha (8-12 Hz) and beta (16-20 Hz) bands. Motor cortical activation and coupling was greater for faster movements. With increasing movement rate, the timing relationship between movement and tone switched from synchronization (for 0.5-1 Hz) to syncopation (for 3-4 Hz). The results suggested that for slow repetitive movements (0.5-1 Hz), each individual movement is separately controlled, and EEG activation and coupling of the motor cortical areas were immediately followed by transient deactivation and decoupling, having clear temporal modulation locked to each movement. In contrast, for fast repetitive movements (3-4 Hz), it appears that the rhythm is controlled and the motor cortices showed sustained EEG activation and continuous coupling.

Adult↗