Functional neuronal anisotropy assessed with neuronavigated transcranial magnetic stimulation.
BACKGROUND
Transcranial magnetic stimulation (TMS) can evaluate cortical excitability and integrity of motor pathways via TMS-induced responses. The responses are affected by the orientation of the stimulated neurons with respect to the direction of the TMS-induced electric field. Therefore, besides being a functional imaging tool, TMS may potentially assess the local structural properties. Yet, TMS has not been used for this purpose.


METHODS
A novel principle to evaluate the relation between function and structure of the motor cortex is presented. This functional anisotropy is evaluated by an anisotropy index (AI), based on motor evoked potential amplitudes induced with different TMS coil orientations, i.e. different electric field directions at a cortical target. To compare the AI with anatomical anisotropy in an explorative manner, diffusion tensor imaging-derived fractional anisotropy (FA) was estimated at different depths near the stimulation site.


RESULTS
AI correlated inversely with cortical excitability through the TMS-induced electric field at motor threshold level. Further, there was a trend of negative correlation between AI and FA.


METHODS
None of the existing methods alone can detect the relationship between direct motor cortex activation and local neuronal structure.


CONCLUSIONS
The AI appears to provide information on the functional neuronal anisotropy of the motor cortex by coupling neurophysiology and neuroanatomy within the stimulated cortical region. The AI could prove useful in the evaluation of neurological disorders and traumas involving concurrent structural and functional changes in the motor cortex. Further studies on patients are needed to confirm the usability of AI.
Department of Clinical Neurophysiology, Kuopio University Hospital, P.O. Box 100, FI-70029 KYS, Finland; Department of Applied Physics, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland. Electronic address: elisa.kallioniemi@kuh.fi.
Elisa
E
Kallioniemi
Department of Clinical Neurophysiology, Kuopio University Hospital, P.O. Box 100, FI-70029 KYS, Finland; Department of Clinical Radiology, Kuopio University Hospital, P.O. Box 100, FI-70029 KYS, Finland.
Mervi
M
Könönen
Department of Clinical Neurophysiology, Kuopio University Hospital, P.O. Box 100, FI-70029 KYS, Finland; Institute of Clinical Medicine, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland.
Laura
L
Säisänen
Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, P.O. Box 100, FI-70029 KYS, Finland.
Heidi
H
Gröhn
Department of Clinical Neurophysiology, Kuopio University Hospital, P.O. Box 100, FI-70029 KYS, Finland; Department of Applied Physics, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland.
Petro
P
Julkunen
D000328:Adult; D016880:Anisotropy; D056324:Diffusion Tensor Imaging / Q000379:methods; D019054:Evoked Potentials, Motor / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000033:anatomy & histology* / Q000502:physiology; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D055815:Young Adult
Diffusion tensor imaging; Motor cortex; Motor evoked potential; Neuroanatomy; Neurophysiology; Transcranial magnetic stimulation