Driving plasticity in human adult motor cortex is associated with improved motor function after brain injury.
Changes in somatosensory input can remodel human cortical motor organization, yet the input characteristics that promote reorganization and their functional significance have not been explored. Here we show with transcranial magnetic stimulation that sensory-driven reorganization of human motor cortex is highly dependent upon the frequency, intensity, and duration of stimulus applied. Those patterns of input associated with enhanced excitability (5 Hz, 75% maximal tolerated intensity for 10 min) induce stronger cortical activation to fMRI. When applied to acutely dysphagic stroke patients, swallowing corticobulbar excitability is increased mainly in the undamaged hemisphere, being strongly correlated with an improvement in swallowing function. Thus, input to the human adult brain can be programmed to promote beneficial changes in neuroplasticity and function after cerebral injury.
Fraser
Chris
C
University Department of Gastroenterology, Salford M6 8HD, United Kingdom.
Power
Maxine
M
Hamdy
Shaheen
S
Rothwell
John
J
Hobday
David
D
Hollander
Igor
I
Tyrell
Pippa
P
Hobson
Anthony
A
Williams
Steven
S
Thompson
David
D
D000328:Adult; D000344:Afferent Pathways / Q000502:physiology; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000473:pathology / Q000503:physiopathology / Q000534:rehabilitation*; D001931:Brain Mapping; D001933:Brain Stem / Q000502:physiology; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008280:Magnetics / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000293:injuries* / Q000473:pathology / Q000503:physiopathology; D009069:Movement Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D009473:Neuronal Plasticity / Q000502:physiology*; D010614:Pharynx / Q000294:innervation / Q000503:physiopathology; D010812:Physical Stimulation; D011712:Pyramidal Tracts / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology*; D020521:Stroke / Q000473:pathology / Q000503:physiopathology; D000071939:Stroke Rehabilitation