title: Focal and bi-directional modulation of lower limb motor cortex using anodal transcranial direct current stimulation.
abstract: BACKGROUND
  Because we are interested in non-invasive transcranial brain stimulation as an adjuvant to post-stroke walking therapy, we applied direct current stimulation (tDCS) preferentially to either the left or right lower limb motor cortex (M1) in two separate sessions and assessed the resulting modulation in both cortices.
  
  
  OBJECTIVE
  We hypothesized that tDCS applied preferentially to one lower limb M1 of healthy subjects would induce between-hemisphere opposite sign modulation.
  
  
  METHODS
  Transcranial magnetic stimulation (TMS) with the coil offset 2 cm either side of vertex was used to assess the percent change in rectified motor evoked potential (MEP) area recorded bilaterally from vastus lateralis (VL) and tibialis anterior (TA) of 10 subjects during weak tonic contraction.
  
  
  RESULTS
  ANOVA revealed an up-regulation of the target cortex and a down-regulation of the non-target cortex (p = 0.001) and no effects of hemisphere (left, right) or muscle (TA, VL). Significant modulation was evident in 78% of VL and TA muscles (all p < 0.05). Excitability increased in 60%, but decreased in 18%. For 43% when excitability increased, a simultaneous decrease in excitability was evident in homologous muscle responses providing support for our hypothesis.
  
  
  CONCLUSIONS
  The results indicate a modest effectiveness and focality of anodal tDCS when applied to lower limb M1, suggesting in a human model that the strength and depth of polarizing cortical currents induced by tDCS likely depend on inter-individual differences in the electrical properties of superficial brain structures.
authors.affiliation: Sensory Motor Performance Program, Rehabilitation Institute of Chicago, 345 E. Superior Street, Chicago, IL 60611, USA. s-madhavan@northwestern.edu
authors.forename: Sangeetha
authors.initials: S
authors.lastname: Madhavan
authors.forename: James W
authors.initials: JW
authors.lastname: Stinear
mesh_terms: D004566:Electrodes; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000294:innervation*; D008297:Male; D009044:Motor Cortex / Q000502:physiology*; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D055815:Young Adult