Localizing central swallowing functions by combining non-invasive brain stimulation with neuroimaging

Li, Shasha; Eshghi, Marziye; Khan, Sheraz; Tian, Qiyuan; Joutsa, Juho; Ou, Yangming; Wang, Qing Mei; Kong, Jian; Rosen, Bruce R.; Ahveninen, Jyrki; Nummenmaa, Aapo

doi:10.1016/j.brs.2020.06.003

Cited by 2 publications

(3 citation statements)

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“…Recent studies have also attempted to achieve swallowing related target in a multimodal fashion by integrating fMRI and MEP recordings for the lip orbicularis oris muscle ( Li et al, 2020 ). Cricothyroid muscle-targeting for Broca’s area mapping ( Rogiæ et al, 2014 ) is a highly sensitive and specific recording method that uses intramuscular wire electrodes.…”

Section: Discussionmentioning

confidence: 99%

“…After the motor cortical point was registered on the reconstructed 3D MRI images, Euclidian distances between the mylohyoid and FDI were calculated via the NBS (mm). When appropriate stimulation was delivered to the representative areas of M1, MEPs could be observed from the respective mylohyoid and FDI hot spots ( Hannula et al, 2005 ; Macrae et al, 2014 ; Li et al, 2020 ). In accordance with previous report for FDI-MEPs ( Hamada et al, 2008 ), AMT for conditioning of mylohyoid motor hotspot was defined as the lowest intensity to evoke mylohyoid MEPs (>100 μV) with weak (5–10% of maximal) jaw contraction maintenance.…”

Section: Methodsmentioning

confidence: 99%

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Monophasic-quadri-burst stimulation robustly activates bilateral swallowing motor cortices

et al. 2023

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A stable, reliable, non-invasive, quantitative assessment of swallowing function remains to be established. Transcranial magnetic stimulation (TMS) is commonly used to aid in the diagnosis of dysphagia. Most diagnostic applications involve single-pulse TMS and motor evoked potential (MEP) recordings, the use of which is not clinically suitable in patients with severe dysphagia given the large variability in MEPs measured from the muscles involved in swallowing. Previously, we developed a TMS device that can deliver quadripulse theta-burst stimulation in 16 monophasic magnetic pulses through a single coil, enabling the measurement of MEPs related to hand function. We applied a system for MEP conditioning that relies on a 5 ms interval-monophasic quadripulse magnetic stimulation (QPS5) paradigm to produce 5 ms interval-four sets of four burst trains; quadri-burst stimulation (QBS5), which is expected to induce long-term potentiation (LTP) in the stroke patient motor cortex. Our analysis indicated that QBS5 conditioned left motor cortex induced robust facilitation in the bilateral mylohyoid MEPs. Swallowing dysfunction scores after intracerebral hemorrhage were significantly correlated with QBS5 conditioned-MEP parameters, including resting motor threshold and amplitude. The degree of bilateral mylohyoid MEP facilitation after left side motor cortical QBS5 conditioning and the grade of severity of swallowing dysfunction exhibited a significant linear correlation (r = −0.48/−0.46 and 0.83/0.83; R2 = 0.23/0.21 and 0.68/0.68, P < 0.001; Rt./Lt. side MEP-RMT and amplitudes, respectively). The present results indicate that RMT and amplitude of bilateral mylohyoid-MEPs after left motor cortical QBS5 conditioning as surrogate quantitative biomarkers for swallowing dysfunction after ICH. Thus, the safety and limitations of QBS5 conditioned-MEPs in this population should be further explored.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Monophasic-quadri-burst stimulation robustly activates bilateral swallowing motor cortices

et al. 2023

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“…However, M1 area covers multiple neurological functions, and how to precisely locate the functional area of M1 swallowing becomes a major obstacle. Until Li S. et al (2020) used functional MRI (fMRI)-guided TMS in the motor cortex of the brain to excite surface electromyography of the labial orbicularis muscle and detected motor evoked potentials (MEPs) in the submandibular complex (SMC) muscle as a way to locate MSC targets in the M1 swallowing functional area. This study provides a more precise target stimulation site for TMS to improve post-stroke swallowing dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Current evidence, clinical applications, and future directions of transcranial magnetic stimulation as a treatment for ischemic stroke

Zhou

Jin

et al. 2023

Front. Neurosci.

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Transcranial magnetic stimulation (TMS) is a non-invasive brain neurostimulation technique that can be used as one of the adjunctive treatment techniques for neurological recovery after stroke. Animal studies have shown that TMS treatment of rats with middle cerebral artery occlusion (MCAO) model reduced cerebral infarct volume and improved neurological dysfunction in model rats. In addition, clinical case reports have also shown that TMS treatment has positive neuroprotective effects in stroke patients, improving a variety of post-stroke neurological deficits such as motor function, swallowing, cognitive function, speech function, central post-stroke pain, spasticity, and other post-stroke sequelae. However, even though numerous studies have shown a neuroprotective effect of TMS in stroke patients, its possible neuroprotective mechanism is not clear. Therefore, in this review, we describe the potential mechanisms of TMS to improve neurological function in terms of neurogenesis, angiogenesis, anti-inflammation, antioxidant, and anti-apoptosis, and provide insight into the current clinical application of TMS in multiple neurological dysfunctions in stroke. Finally, some of the current challenges faced by TMS are summarized and some suggestions for its future research directions are made.

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Localizing central swallowing functions by combining non-invasive brain stimulation with neuroimaging

Cited by 2 publications

References 10 publications

Monophasic-quadri-burst stimulation robustly activates bilateral swallowing motor cortices

Monophasic-quadri-burst stimulation robustly activates bilateral swallowing motor cortices

Current evidence, clinical applications, and future directions of transcranial magnetic stimulation as a treatment for ischemic stroke

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