• Korean Journal of Acupuncture
• /
• v.35 no.4
• /
• pp.187-202
• /
• 2018

Objectives : Non-invasive transcranial electrical stimulation is one of therapeutic interventions to change in neural excitability of the cortex. Transcranial electro-acupuncture (TEA) can modulate brain functions through changes in cortical excitability as a model of non-invasive transcranial electrical stimulation. Some composites of fermented Scutellaria baicalenis (FSB) can activate intercellular signaling pathways for activation of brain-derived neurotrophic factor that is critical for formation of neural plasticity in stroke patients. This study was aimed at evaluation of combinatory treatment of TEA and FSB on behavior recovery and cortical neural excitability in rodent focal stroke model. Methods : Focal ischemic stroke was induced by photothrombotic injury to the motor cortex of adult rats. Application of TEA with 20 Hz and $200{\mu}A$ in combination with daily oral treatment of FBS was given to stroke animals for 3 weeks. Motor recovery was evaluated by rotating bean test and ladder working test. Electrical activity of cortical pyramidal neurons of stroke model was evaluated by using multi-channel extracellular recording technique and thallium autometallography. Results : Compared with control stroke group who did not receive any treatment, Combination of TEA and FSB treatment resulted in more rapid recovery of forelimb movement following focal stroke. This combination treatment also elicited increase in spontaneous firing rate of putative pyramidal neurons. Furthermore expression of metabolic marker for neural excitability was upregulated in peri-infract area under thallium autometallography. Conclusions : These results suggest that combination treatment of TEA and FSB can be a possible remedy for motor recovery in focal stroke.

• Annals of Clinical Neurophysiology
• /
• v.23 no.2
• /
• pp.69-81
• /
• 2021

Cortico-cortical evoked potential (CCEP) mapping is a rapidly developing method for visualizing the brain network and estimating cortical excitability. The CCEP comprises the early N1 component the occurs at 10-30 ms poststimulation, indicating anatomic connectivity, and the late N2 component that appears at < 200 ms poststimulation, suggesting long-lasting effective connectivity. A later component at 200-1,000 ms poststimulation can also appear as a delayed response in some studied areas. Such delayed responses occur in areas with changed excitability, such as an epileptogenic zone. CCEP mapping has been used to examine the brain connections causally in functional systems such as the language, auditory, and visual systems as well as in anatomic regions including the frontoparietal neocortices and hippocampal limbic areas. Task-based CCEPs can be used to measure behavior. In addition to evaluations of the brain connectome, single-pulse electrical stimulation (SPES) can reflect cortical excitability, and so it could be used to predict a seizure onset zone. CCEP brain mapping and SPES investigations could be applied both extraoperatively and intraoperatively. These underused electrophysiologic tools in basic and clinical neuroscience might be powerful methods for providing insight into measures of brain connectivity and dynamics. Analyses of CCEPs might enable us to identify causal relationships between brain areas during cortical processing, and to develop a new paradigm of effective therapeutic neuromodulation in the future.

• Sleep Medicine and Psychophysiology
• /
• v.28 no.2
• /
• pp.53-69
• /
• 2021

Sleep disorders, increasingly prevalent in the general population, induce impairment in daytime functioning and other clinical problems. As changes in cortical excitability have been reported as potential pathophysiological mechanisms underlying sleep disorders, multiple studies have explored clinical effects of modulating cortical excitability through non-invasive brain stimulation in treating sleep disorders. In this study, we critically reviewed clinical studies using non-invasive brain stimulation, particularly transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), for treatment of sleep disorders. Previous studies have reported inconsistent therapeutic effects of TMS and tDCS for various kinds of sleep disorders. Specifically, low-frequency repetitive TMS (rTMS) and cathodal tDCS, both of which exert an inhibitory effect on cortical excitability, have shown inconsistent therapeutic effects for insomnia. On the other hand, high-frequency rTMS and anodal tDCS, both of which facilitate cortical excitability, have improved the symptoms of hypersomnia. In studies of restless legs syndrome, high-frequency rTMS and anodal tDCS induced inconsistent therapeutic effects. Single TMS and rTMS have shown differential therapeutic effects for obstructive sleep apnea. These inconsistent findings indicate that the distinctive characteristics of each non-invasive brain stimulation method and specific pathophysiological mechanisms underlying particular sleep disorders should be considered in an integrated manner for treatment of various sleep disorders. Future studies are needed to provide optimized TMS and tDCS protocols for each sleep disorder, considering distinctive effects of non-invasive brain stimulation and pathophysiology of each sleep disorder.

• The Journal of Korean Physical Therapy
• /
• v.23 no.1
• /
• pp.77-82
• /
• 2011

Purpose: Recently, many studies have demonstrated that application of external stimulation can modulate cortical excitability of the human brain. We attempted to observe cortical excitability using functional magnetic resonance imaging (fMRI) during the application of transcranial direct current stimulation (tDCS) or functional electrical stimulation (FES). Methods: We recruited two healthy subjects without a history of neurological or psychiatric problems. fMRI scanning was done during? each constant anodal tDCS and FES session, and each session was repeated three times. The tDCS session consisted of three successive phases (resting phase: 60sec dummy cycle: 10sec tDCS phase: 60sec). The FES session involved stimulation of wrist extensor muscles over two successive phase (resting phase: 15sec FES phase: 15sec). Results: The average map of the tDCS and FES analyses showed that the primary sensory-motor cortex area was activated in all subjects. Conclusion: Our findings show that cortical activation can be induced by constant anodal tDCS and FES. They suggest that the above stimuli have the potential for facilitating brain plasticity and modulating neural excitability if applied as specific therapeutic interventions for brain injured patients.

• The Journal of Korean Physical Therapy
• /
• v.21 no.4
• /
• pp.73-79
• /
• 2009

Purpose: Recently, neurostimulation studies involving manipulation of cortical excitability of the human brain have been increasingly attempted. We investigated whether transcranial direct current stimulation (tDCS) applied to the underlying cerebral cortex, directly induces cortical activation during fMRI scanning. Methods: We recently recruited five healthy subjects without a neurological or psychiatric history and who were right-handed, as verified by the modified Edinburg Handedness Inventory. fMRI was done while constant anodal tDCS was delivered to the underlying SM1 area?? immediately after the pre-stimulation for eighteen minutes. Results: Group analysis yielded an averaged map that showed that the SM1 area and the superior parietal cortex in the ipsilateral hemisphere were activated. The voxel size and peak intensity were, respectively, 82 and 5.22 in the SM1, and 85 and 5.77 in the superior parietal cortex. Conclusion: Cortical activation can be induced by constant anodal tDCS of the underlying motor cortex. This suggests that tDCS may be an effective therapeutic device for enhancing? physical motor function by modulating neural excitability of the motor cortex.

• Journal of Magnetics
• /
• v.19 no.2
• /
• pp.192-196
• /
• 2014

The aim of the present study was to examine the effects of high and low frequency repetitive transcranial magnetic stimulation on motor cortical excitability and the balance function in subacute stroke patients. Twenty-four subjects were randomly assigned to either the high frequency (HF) rTMS group, or the low frequency (LF) rTMS group, with 12 subjects each. All subjects received routine physical therapy. In addition, both groups performed a total of 20 sessions of rTMS for 20 minutes, once a day, 5 times per week, for a 4-week period. In the HF rTMS group, 10 Hz rTMS was applied daily to the hotspot of the lesional hemisphere; and in the LF rTMS group, 1 Hz rTMS was applied daily to the hotspot of the nonlesional hemisphere. Motor cortex excitability was determined by motor evoked potentials, and the balance function was evaluated by use of the Balance Index (BI) and the Berg Balance Scale (BBS), before and after the intervention. The change rate in the value of each variable differed significantly between the two groups (p<0.05). Furthermore, significant differences were observed between all post-test variables of the two groups (p<0.05). In the HF rTMS, significant differences were found in all the pre- and post-test variables (p<0.05). On the other hand, in the LF rTMS, significant difference was observed only between the pre- and post-test results of BI and BBS (p<0.05). The findings demonstrate that HF rTMS can be more helpful in improving the motor cortical excitability and balance function of patients with subacute stroke treatment than LF rTMS, and that it may be used as a practical adjunct to routine rehabilitation.

• BMB Reports
• /
• v.51 no.1
• /
• pp.3-4
• /
• 2018

Parkinson's disease (PD) is a debilitating disorder resulting from loss of dopamine neurons. In dopamine deficient state, the basal ganglia increases inhibitory synaptic outputs to the thalamus. This increased inhibition by the basal ganglia output is known to reduce firing rate of thalamic neurons that relay motor signals to the motor cortex. This 'rate model' suggests that the reduced excitability of thalamic neurons is the key for inducing motor abnormalities in PD patients. We reveal that in response to inhibition, thalamic neurons generate rebound firing at the end of inhibition. This rebound firing increases motor cortical activity and induces muscular responses that triggers Parkinsonian motor dysfunction. Genetic and optogenetic intervention of the rebound firing prevent motor dysfunction in a mouse model of PD. Our results suggest that inhibitory synaptic mechanism mediates motor dysfunction by generating rebound excitability in the thalamocortical pathway.

• The Journal of Korean Physical Therapy
• /
• v.24 no.4
• /
• pp.262-267
• /
• 2012

Purpose: This study was designed to analyze the differences in cerebral cortex activity of the elderly after extracting the movement related cortical potentials (MRCPs) from electroencephalogram (EEG) during a concentric and eccentric contraction of the elbow joint flexors, and entering them into the brain-mapping program to make the images. Methods: Right-dominant normal elderly people were divided into an eccentric contraction group and a concentric contraction group. Then, their MRCPs were measured using EEG and sEMG, during an eccentric and concentric contraction. Then, they were converted into images using the brain-mapping program. Results: Eccentric contraction group's $C_3$ and Cz showed statistically higher mean values of MRCP positive potential than the concentric contraction group. Conclusion: Researching a cerebral cortex activity, using MRCP, would provide basic data for clinical neuro-physiological researches on aging or neural plasticity of patients with a central nervous system injury.

• The Journal of Korean Physical Therapy
• /
• v.23 no.6
• /
• pp.49-53
• /
• 2011

Purpose: The purpose of this study is to investigate whether dual-hemisphere transcranial direct current stimulation (tDCS) could induce more cortical activity, compared to single-hemisphere, using functional MRI (fMRI). Methods: One right-handed healthy subject was recruited. Three phases of dual-hemisphere tDCS (i.e. anodal tDCS over the left-dominant primary sensoriomotor cortex (SM1) and cathodal tDCS over the right-non dominant SM(1) were consecutively delivered on to a subject, during fMRI scanning. The voxel count and the intensity index in the averaged cortical map were analyzed among the three tDCS phases. Results: Our result showed that cortical activation was observed on all the three phases of the dual-hemisphere tDCS. Voxel count and intensity index were as following; 912 and 4.07 in the first phase, 1102 and 3.90 in the second phase, 1031 and 3.80 in the third phase. Conclusion: This study demonstrated that application of the dual-hemisphere tDCS could induce cortical activity and maintain to recruit cortical neurons. Our findings suggested that application of dual-hemisphere tDCS could produce efficiency of the ongoing tDCS effect to facilitate cortical excitability.

• The Korean Journal of Physiology and Pharmacology
• /
• v.10 no.1
• /
• pp.13-17
• /
• 2006

Experimentally induced cortical disorganization exhibits many anatomical features which are characteristic of cortical malformations in children with early-onset epilepsy. We used an immunocytochemical technique and extracellular field potential recordings from the dorsal hippocampus to determine whether the excitability of the CA1 pyramidal cells was enhanced in rats with exnerimentallv induced hippocampal dysplasia. Compared with control rats, the MAM-treated rats displayed a decrease of paired pulse inhibition. When $GABA_A$ receptor antagonists were blocked with $10{\mu}M$ bicuculline the amplitude of the second population spike of the MAM-treated of rats was similar to that of the first population spike, as was in the control rats. The MAM-treated rats had fewer somatostatin and parvalbumin-immunoreactive neurons than the control rats. These results suggest that the enhanced neuronal responsiveness of the in vivo recording of the CA1 in this animal model may involve a reduction of CA1 inhibition.