时间间隔对持续性θ爆发刺激预调控间歇性θ爆发刺激诱导运动皮质可塑性的影响

doi:10.3969/j.issn.1006-9771.2025.05.014

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (5): 607-612.doi: 10.3969/j.issn.1006-9771.2025.05.014

时间间隔对持续性θ爆发刺激预调控间歇性θ爆发刺激诱导运动皮质可塑性的影响

耿阿燕¹^,², 王庆雷¹^,², 沈俊帆¹^,², 朱仕哲¹^,², 季盼盼³, 王彤¹^,²(), 郭川¹^,²()

1.南京医科大学康复医学院，江苏南京市 210029
2.南京医科大学第一附属医院，江苏南京市 210029
3.常州市德安医院，江苏常州市 213004

收稿日期:2025-02-25 修回日期:2025-04-14 出版日期:2025-05-25 发布日期:2025-05-26
通讯作者: 郭川(1988-)，男，汉族，江苏连云港市人，博士，副主任技师，主要研究方向：神经系统疾病康复治疗，E-mail： guochuan@njmu.edu.cn; 王彤(1960-)，女，汉族，江苏南京市人，教授，主任医师，博士研究生导师，主要研究方向：神经系统疾病康复。E-mail： wangtong60621@163.com
作者简介:耿阿燕(2001-)，女，汉族，陕西咸阳市人，硕士研究生，主要研究方向：神经系统疾病康复治疗。
基金资助:
国家自然科学基金青年项目(82302882)

Effect of time intervals of priming continuous theta burst stimulationon on cortical plasticity induced by intermittent theta burst stimulation

GENG Ayan¹^,², WANG Qinglei¹^,², SHEN Junfan¹^,², ZHU Shizhe¹^,², JI Panpan³, WANG Tong¹^,²(), GUO Chuan¹^,²()

1. School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu 210029, China
2. The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu 210029, China
3. Changzhou De'an Hospital, Changzhou, Jiangsu 213004, China

Received:2025-02-25 Revised:2025-04-14 Published:2025-05-25 Online:2025-05-26
Contact: GUO Chuan, E-mail: guochuan@njmu.edu.cn; WANG Tong, E-mail: wangtong60621@163.com
Supported by:
National Natural Science Foundation of China (Youth)(82302882)

摘要/Abstract

摘要：

目的探讨不同时间间隔的持续性-间歇性θ爆发刺激(cTBS-iTBS)预调控方案对初级运动皮质(M1)可塑性的影响。
方法 2024年3月至8月于常州市德安医院招募健康青年受试者39例。受试者随机交叉接受间隔5 min、10 min和15 min的cTBS-iTBS预调控方案，干预前和干预后0 min、10 min、20 min和30 min记录M1运动诱发电位(MEP)振幅。
结果刺激方案(F = 19.761, P < 0.001)和测量时间(F = 10.224, P < 0.001)的主效应均显著；干预后各时间点，间隔10 min时，MEP振幅高于间隔5 min和15 min的方案(t > 3.010, P < 0.05)。
结论 cTBS后10 min施加iTBS可更有效增强M1的可塑性。

关键词: θ爆发刺激, 可塑性, 运动诱发电位, 双向突触可塑性理论

Abstract:

Objective To investigate the effect of continuous theta burst stimulation-intermittent theta burst stimulation (cTBS-iTBS) priming protocols with different time intervals on the plasticity of primary motor cortex (M1).
Methods A total of 39 healthy young adults were recruited from Changzhou De'an Hospital from March to August, 2024. Participants received cTBS-iTBS priming protocols with intervals of 5 minutes, 10 minutes and 15 minutes using a randomized crossover design. Motor-evoked potential (MEP) amplitudes in M1 were recorded at baseline (before intervention) and 0 minute, 10 minutes, 20 minutes and 30 minutes after intervention.
Results The main effects of stimulation protocol (F = 19.761, P < 0.001) and measurement time (F = 10.224, P < 0.001) were significant. At each time point after intervention, the MEP amplitude was significantly higher under the 10-minute interval than under the 5-minute and 15-minute intervals (t > 3.010, P < 0.05).
Conclusion The 10-minute interval of cTBS-iTBS is more effective on M1 plasticity.

Key words: theta burst stimulation, plasticity, motor-evoked potential, Bienenstock-Cooper-Munro theory

中图分类号:

R493

耿阿燕, 王庆雷, 沈俊帆, 朱仕哲, 季盼盼, 王彤, 郭川. 时间间隔对持续性θ爆发刺激预调控间歇性θ爆发刺激诱导运动皮质可塑性的影响[J]. 《中国康复理论与实践》, 2025, 31(5): 607-612.

GENG Ayan, WANG Qinglei, SHEN Junfan, ZHU Shizhe, JI Panpan, WANG Tong, GUO Chuan. Effect of time intervals of priming continuous theta burst stimulationon on cortical plasticity induced by intermittent theta burst stimulation[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(5): 607-612.

图/表 3

参考文献 32

[1]	NGUYEN V T, WU C W, CHEN C A, et al. Modulation of interhemispheric synchronization and cortical activity in healthy subjects by high-definition theta-burst electrical stimulation[J]. Neural Plast, 2022, 2022: 3593262.
[2]	曹志刚, 冯海霞, 李亚斌, 等. 基于大脑半球之间多靶区间歇性θ爆发式磁刺激对脑卒中患者上肢功能的影响[J]. 中国康复理论与实践, 2022, 28(5): 502-507. doi: 10.3969/j.issn.1006-9771.2022.05.002
	CAO Z G, FENG H X, LI Y B, et al. Effects of interhemispheric multi-target intermittent theta burst stimulation on upper limb function in patients with stroke[J]. Chin J Rehabil Theory Pract, 2022, 28(5): 502-507.
[3]	HUANG Y Z, EDWARDS M J, ROUNIS E, et al. Theta burst stimulation of the human motor cortex[J]. Neuron, 2005, 45(2): 201-206.
[4]	OZDEMIR R A, BOUCHER P, FRIED P J, et al. Reproducibility of cortical response modulation induced by intermittent and continuous theta-burst stimulation of the human motor cortex[J]. Brain Stimul, 2021, 14(4): 949-964. doi: 10.1016/j.brs.2021.05.013 pmid: 34126233
[5]	CORP D T, BEREZNICKI H G K, CLARK G M, et al. Large-scale analysis of interindividual variability in theta-burst stimulation data: results from the 'Big TMS Data Collaboration'[J]. Brain Stimul, 2020, 13(5): 1476-1488. doi: S1935-861X(20)30216-3 pmid: 32758665
[6]	BOUCHER P O, OZDEMIR R A, MOMI D, et al. Sham-derived effects and the minimal reliability of theta burst stimulation[J]. Sci Rep, 2021, 11(1): 21170. doi: 10.1038/s41598-021-98751-w pmid: 34707206
[7]	LANG N, SIEBNER H R, ERNST D, et al. Preconditioning with transcranial direct current stimulation sensitizes the motor cortex to rapid-rate transcranial magnetic stimulation and controls the direction of after-effects[J]. Biol Psychiatry, 2004, 56(9): 634-639.
[8]	BIENENSTOCK E L, COOPER L N, MUNRO P W. Theory for the development of neuron selectivity: orientation specificity and binocular interaction in visual cortex[J]. J Neurosci, 1982, 2(1): 32-48. pmid: 7054394
[9]	COOPER L N, BEAR M F. The BCM theory of synapse modification at 30: interaction of theory with experiment[J]. Nat Rev Neurosci, 2012, 13(11): 798-810. doi: 10.1038/nrn3353 pmid: 23080416
[10]	OPIE G M, VOSNAKIS E, RIDDING M C, et al. Priming theta burst stimulation enhances motor cortex plasticity in young but not old adults[J]. Brain Stimul, 2017, 10(2): 298-304. doi: S1935-861X(17)30003-7 pmid: 28089653
[11]	HASSANZAHRAEE M, ZOGHI M, JABERZADEH S. How different priming stimulations affect the corticospinal excitability induced by noninvasive brain stimulation techniques: a systematic review and meta-analysis[J]. Rev Neurosci, 2018, 29(8): 883-899.
[12]	BIAN L, ZHANG L, HUANG G, et al. Effects of priming intermittent theta burst stimulation with high-definition tDCS on upper limb function in hemiparetic patients with stroke: a randomized controlled study[J]. Neurorehabil Neural Repair, 2024, 38(4): 268-278.
[13]	ZHANG J J, FONG K N K. The effects of priming intermittent theta burst stimulation on movement-related and mirror visual feedback-induced sensorimotor desynchronization[J]. Front Hum Neurosci, 2021, 15: 626887.
[14]	JANNATI A, OBERMAN L M, ROTENBERG A, et al. Assessing the mechanisms of brain plasticity by transcranial magnetic stimulation[J]. Neuropsychopharmacology, 2023, 48(1): 191-208. doi: 10.1038/s41386-022-01453-8 pmid: 36198876
[15]	OLDFIELD R C. The assessment and analysis of handedness: the Edinburgh Inventory[J]. Neuropsychologia, 1971, 9(1): 97-113. doi: 10.1016/0028-3932(71)90067-4 pmid: 5146491
[16]	KIM W S, PAIK N J. Safety review for clinical application of repetitive transcranial magnetic stimulation[J]. Brain Neurorehabil, 2021, 14(1): e6.
[17]	罗红, 徐丽. 重复经颅磁刺激联合重复外周磁刺激对脑出血患者上肢运动功能的效果:基于静息态功能磁共振成像的随机对照试验[J]. 中国康复理论与实践, 2024, 30(9): 1060-1068. doi: 10.3969/j.issn.1006-9771.2024.09.009
	LUO H, XU L. Effect of repetitive transcranial magnetic stimulation combined with repetitive peripheral magnetic stimulation on upper extremities motor function in patients with cerebral hemorrhage: a randomized controlled trial based on resting state-functional magenetic resonance imaging[J]. Chin J Rehabil Theory Pract, 2024, 30(9): 1060-1068.
[18]	HUANG Y Z, CHEN R S, FONG P Y, et al. Inter-cortical modulation from premotor to motor plasticity[J]. J Physiol, 2018, 596(17): 4207-4217.
[19]	HERMILLER M S. Effects of continuous versus intermittent theta-burst TMS on fMRI connectivity[J]. Front Hum Neurosci, 2024, 18: 1380583.
[20]	BAI Z, ZHANG J, FONG K N K. Effects of transcranial magnetic stimulation in modulating cortical excitability in patients with stroke: a systematic review and meta-analysis[J]. J Neuroeng Rehabil, 2022, 19(1): 24. doi: 10.1186/s12984-022-00999-4 pmid: 35193624
[21]	ROUNIS E, HUANG Y Z. Theta burst stimulation in humans: a need for better understanding effects of brain stimulation in health and disease[J]. Exp Brain Res, 2020, 238(7/8): 1707-1714.
[22]	MACDERMOTT A B, MAYER M L, WESTBROOK G L, et al. NMDA-receptor activation increases cytoplasmic calcium concentration in cultured spinal cord neurones[J]. Nature, 1986, 321(6069): 519-522.
[23]	VYKLICKY V, STANLEY C, HABRIAN C, et al. Conformational rearrangement of the NMDA receptor amino-terminal domain during activation and allosteric modulation[J]. Nat Commun, 2021, 12(1): 2694. doi: 10.1038/s41467-021-23024-z pmid: 33976221
[24]	MALENKA R C, BEAR M F. LTP and LTD: an embarrassment of riches[J]. Neuron, 2004, 44(1): 5-21. doi: 10.1016/j.neuron.2004.09.012 pmid: 15450156
[25]	MULLER-DAHLHAUS F, LUCKE C, LU M K, et al. Augmenting LTP-like plasticity in human motor cortex by spaced paired associative stimulation[J]. PLoS One, 2015, 10(6): e0131020.
[26]	ZHANG L, CHEN Y, HUANG G, et al. Immediate effects of preconditioning intermittent theta burst stimulation on lower extremity motor cortex excitability in healthy participants[J]. J Integr Neurosci, 2024, 23(8): 160. doi: 10.31083/j.jin2308160 pmid: 39207070
[27]	CHEN Y L, HUANG C C, HSU K S. Time-dependent reversal of long-term potentiation by low-frequency stimulation at the hippocampal mossy fiber-CA3 synapses[J]. J Neurosci, 2001, 21(11): 3705-3714. pmid: 11356857
[28]	THOMSON A C, KENIS G, TIELENS S, et al. Transcranial magnetic stimulation-induced plasticity mechanisms: TMS-related gene expression and morphology changes in a human neuron-like cell model[J]. Front Mol Neurosci, 2020, 13: 528396.
[29]	HUANG Y Z, ROTHWELL J C, EDWARDS M J, et al. Effect of physiological activity on an NMDA-dependent form of cortical plasticity in human[J]. Cereb Cortex, 2008, 18(3): 563-570.
[30]	GAMBOA O L, ANTAL A, LACZO B, et al. Impact of repetitive theta burst stimulation on motor cortex excitability[J]. Brain Stimul, 2011, 4(3): 145-151. doi: 10.1016/j.brs.2010.09.008 pmid: 21777874
[31]	GUERRA A, ASCI F, ZAMPOGNA A, et al. The effect of gamma oscillations in boosting primary motor cortex plasticity is greater in young than older adults[J]. Clin Neurophysiol, 2021, 132(6): 1358-1366.
[32]	ZHANG J J Y, ANG J, SAFFARI S E, et al. Repetitive transcranial magnetic stimulation for motor recovery after stroke: a systematic review and meta-analysis of randomized controlled trials with low risk of bias[J]. Neuromodulation, 2025, 28(1): 16-42.

测量时间	cTBS-10 min-iTBS vs. cTBS-5 min-iTBS		cTBS-10 min-iTBS vs. cTBS-15 min-iTBS
测量时间	t值	P值	t值	P值
0 min	4.189	< 0.001	4.675	< 0.001
10 min	4.285	< 0.001	5.395	< 0.001
20 min	3.560	0.004	3.675	0.003
30 min	3.010	0.015	4.340	< 0.001

组别	0 min vs. 基线		10 min vs. 基线		20 min vs. 基线		30 min vs. 基线
组别	t值	P值	t值	P值	t值	P值	t值	P值
cTBS-5 min-iTBS	5.327	< 0.001	5.523	< 0.001	4.490	< 0.001	3.365	0.002
cTBS-10 min-iTBS	8.340	< 0.001	7.924	< 0.001	7.371	< 0.001	8.376	< 0.001
cTBS-15 min-iTBS	5.180	< 0.001	5.462	< 0.001	4.627	< 0.001	3.144	0.003

时间间隔对持续性θ爆发刺激预调控间歇性θ爆发刺激诱导运动皮质可塑性的影响

Effect of time intervals of priming continuous theta burst stimulationon on cortical plasticity induced by intermittent theta burst stimulation

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