Transcranial direct current stimulation (tDCS) to the supplementary motor area (SMA) influences performance on motor tasks

Hupfeld, Kathleen E.; Ketcham, Caroline J.; Schneider, Harry D.

doi:10.1007/s00221-016-4848-5

Cited by 55 publications

(47 citation statements)

References 52 publications

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“…Although there have been few studies observing the metabolic and functional changes following M1-M1 tDCS, the current study is the first to incorporate the SMA as a potential target for bihemispheric tDCS. The SMA has been studied as a potential tDCS target in behavioural studies of posture and visuomotor learning (28, 52). Its anatomical positioning and strong connections to M1 make it a well-suited target for motor network modulation.…”

Section: Discussionmentioning

confidence: 99%

“…With its strongest efferent projections to M1 and the corticospinal tract, SMA is a unique target for tDCS (27). Support for this notion comes from a recent study that showed enhanced motor performance by targeting the left SMA with 0.4 mA of anodal tDCS for 90 min over three days (28). By targeting both SMA and M1 with 2mA of tDCS, it may be possible to induce additive effects on M1 excitability via interhemispheric connections, which are thought to be more focal than those associated with M1-supraortibal stimulation (19, 20).…”

Section: Introductionmentioning

confidence: 99%

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¹H MR Spectroscopy of the Motor Cortex Immediately following Transcranial Direct Current Stimulation at 7 Tesla

Ryan

Wawrzyn

Gati

et al. 2018

Preprint

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23Transcranial direct current stimulation (tDCS) is a form of non-invasive brain stimulation that 24 may modulate cortical excitability, metabolite concentration, and human behaviour. The 25 supplementary motor area (SMA) has been largely ignored as a potential target for tDCS 26 neurorehabilitation but is an important region in motor compensation after brain injury with 27 strong efferent connections to the primary motor cortex (M1). The objective of this work was to 28 measure tissue metabolite changes in the human motor cortex immediately following tDCS. We 29 hypothesized that bihemispheric tDCS would change levels of metabolites involved in 30 neuromodulation including N-acetylaspartate, glutamate, and creatine. In this single-blind, 31 randomized, cross-over study, fifteen healthy adults aged 21-60 participated in two 7T MRI 32 sessions, to identify changes in metabolite concentrations by magnetic resonance spectroscopy. 33Immediately after 20 minutes of tDCS, there were no significant changes in metabolite levels or 34 metabolite ratios comparing tDCS to sham. However there was a trend toward increased 35 NAA/tCr concentration (p=0.08) in M1 under the stimulating cathode. There was a strong, 36 positive correlation between the change in the absolute concentration of NAA and the change in 37 the absolute concentration of tCr (p<0.001) suggesting an effect of tDCS. Both NAA and 38 creatine are important markers of neurometabolism. Our findings provide novel insight into the 39 modulation of neural metabolites in the motor cortex immediately following application of 40 bihemispheric tDCS. 2 42 3 65 concentration of phosphocreatine in the left temporo-frontal region following anodal tDCS to the 66 left dorsolateral prefrontal cortex (17). In another study, 2mA of anodal tDCS to the right 67 parietal cortex caused an increase in both Glx and total N-aceytl-aspartate (NAA + NAAG) 68 relative to sham, measured from the parietal cortex (10), while a study by Stagg and colleagues 69 found that 1 mA of cathodal stimulation to left M1 decreased Glx under the electrode(7). Other 70 studies have found no effect. For example, Kim et. al. found no changes after 1.5 mA of 71 cathodal tDCS to left M1 in any metabolite measured under the stimulating electrode (18). 72 Similarly, using 1mA of current in an M1-M1 bihemispheric montage, Tremblay et. al. found no 73 significant changes in any metabolite in left M1 (19). These conflicting results are difficult to 74 interpret, and leads to uncertainty with regards to the implementation of an optimum stimulation 75 paradigm. 76 The application of tDCS to improve motor performance and recovery in neurological 77 disorders requires optimization of stimulation parameters. Bihemispheric tDCS can enhance both 78 behaviour and physiological responses in healthy and neurologically injured individuals (20-22). 79The supplementary motor area (SMA) has proven to be an important area of the brain during the 80 execution of bimanual hand movements (23), and plays a compensatory role durin...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

¹H MR Spectroscopy of the Motor Cortex Immediately following Transcranial Direct Current Stimulation at 7 Tesla

Ryan

Wawrzyn

Gati

et al. 2018

Preprint

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“…Areas SMA and pre-SMA are involved in a variety of functions related with motor sequence processing, planning and executing (Hoshi and Tanji 2004; Cona et al 2016; Hupfeld et al 2016), as well as temporal and spatial processing of movements (Mita et al 2009; Kotz and Schwartze 2011). Furthermore, pre-SMA and SMA also contribute to motor learning, speech and language processing (Seitz et al 2006; Kim and Shin 2014; Hertrich et al 2016).…”

Section: Introductionmentioning

confidence: 99%

Cytoarchitecture, probability maps, and functions of the human supplementary and pre-supplementary motor areas

et al. 2018

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The dorsal mesial frontal cortex contains the supplementary motor area (SMA) and the pre-supplementary motor area (pre-SMA), which play an important role in action and cognition. Evidence from cytoarchitectonic, stimulation, and functional studies suggests structural and functional divergence between the two subregions. However, a microstructural map of these areas obtained in a representative sample of brains in a stereotaxic reference space is still lacking. In the present study we show that the dorsal mesial frontal motor cortex comprises two microstructurally different brain regions: area SMA and area pre-SMA. Area-specific cytoarchitectonic patterns were studied in serial histological sections stained for cell bodies of ten human postmortem brains. Borders of the two cortical areas were identified using image analysis and statistical features. The 3D reconstructed areas were transferred to a common reference space, and probabilistic maps were calculated by superimposing the individual maps. A coordinate-based meta-analysis of functional imaging data was subsequently performed using the two probabilistic maps as microstructurally defined seed regions. It revealed that areas SMA and pre-SMA were strongly co-activated with areas in precentral, supramarginal and superior frontal gyri, Rolandic operculum, thalamus, putamen and cerebellum. Both areas were related to motor functions, but area pre-SMA was involved in more complex processes such as learning, cognitive processes and perception. The here described subsequent analyses led to converging evidence supporting the microstructural, and functional segregation of areas SMA and pre-SMA, and maps will be made available to the scientific community to further elucidate the microstructural substrates of motor and cognitive control.Electronic supplementary materialThe online version of this article (10.1007/s00429-018-1738-6) contains supplementary material, which is available to authorized users.

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“…prior tDCS studies have shown that stimulation of the SMA can increase performance on simple and complex motor tasks [33].…”

Section: Introductionmentioning

confidence: 99%

Utilizing Transcranial Direct Current Stimulation to Enhance Laparoscopic Technical Skills Training: A Randomized Controlled Trial

Cox

Deng²,

Palmer

et al. 2018

Preprint

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This study aimed to test the efficacy of transcranial direct current stimulation (tDCS) during laparoscopic skill training to determine if it has the capacity to accelerate technical skill acquisition. tDCS is a non-invasive brain stimulation technique that delivers constant, low electrical current resulting in changes to cortical excitability and prior work suggests it may enhance motor learning. We evaluate for the first time the potential of tDCS, coupled with motor skill training, to accelerate the development of laparoscopic technical skills. In this pre-registered, double-blinded and sham-controlled study, 60 healthy subjects were randomized into sham or active tDCS in either bilateral primary motor cortex (bM1) or supplementary motor area (SMA) electrode configurations. All subjects practiced the Fundamental of Laparoscopic Surgery Peg Transfer Task during a pre-test, six 20-minute training sessions, and a post-test. The primary outcome was change in laparoscopic skill performance over time, quantified by improvement in performance according to a seconds-per-object calculated score accounting for errors. Sixty participants were randomized equally into the three training cohorts (active bM1, active SMA, sham). The active groups had significantly greater improvement in performance from pre-test to post-test compared to the sham groups (108 vs 76 seconds, p = 0.018). Both bM1 and SMA active cohorts had significantly greater improvement in learning (p < 0.01), achieving the same skill level in 4 sessions compared to the 6 sessions required of the sham cohort. The SMA cohort had more variability in performance compared to the bM1 and control cohorts. Laparoscopic skill training with active, bM1 or SMA, tDCS exhibited significantly greater learning relative to training with sham tDCS. The potential for tDCS to enhance the training of surgical skills merits further investigation to determine if these preliminary results may be replicated.

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Transcranial direct current stimulation (tDCS) to the supplementary motor area (SMA) influences performance on motor tasks

Cited by 55 publications

References 52 publications

¹H MR Spectroscopy of the Motor Cortex Immediately following Transcranial Direct Current Stimulation at 7 Tesla

¹H MR Spectroscopy of the Motor Cortex Immediately following Transcranial Direct Current Stimulation at 7 Tesla

Cytoarchitecture, probability maps, and functions of the human supplementary and pre-supplementary motor areas

Utilizing Transcranial Direct Current Stimulation to Enhance Laparoscopic Technical Skills Training: A Randomized Controlled Trial

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Transcranial direct current stimulation (tDCS) to the supplementary motor area (SMA) influences performance on motor tasks

Cited by 55 publications

References 52 publications

1H MR Spectroscopy of the Motor Cortex Immediately following Transcranial Direct Current Stimulation at 7 Tesla

1H MR Spectroscopy of the Motor Cortex Immediately following Transcranial Direct Current Stimulation at 7 Tesla

Cytoarchitecture, probability maps, and functions of the human supplementary and pre-supplementary motor areas

Utilizing Transcranial Direct Current Stimulation to Enhance Laparoscopic Technical Skills Training: A Randomized Controlled Trial

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Product

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¹H MR Spectroscopy of the Motor Cortex Immediately following Transcranial Direct Current Stimulation at 7 Tesla

¹H MR Spectroscopy of the Motor Cortex Immediately following Transcranial Direct Current Stimulation at 7 Tesla