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

Abstract

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

CLC Number:

R493

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.

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[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

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

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