Universität zu Köln

Diekhoff-Krebs, Svenja, Pool, Eva-Maria ORCID: 0000-0001-8007-9588, Sarfeld, Anna-Sophia, Rehme, Anne K., Eickhoff, Simon B. ORCID: 0000-0001-6363-2759, Fink, Gereon R. ORCID: 0000-0002-8230-1856 and Grefkes, Christian ORCID: 0000-0002-1656-720X (2017). Interindividual differences in motor network connectivity and behavioral response to iTBS in stroke patients. NeuroImage-Clin., 15. S. 559 - 572. OXFORD: ELSEVIER SCI LTD. ISSN 2213-1582

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Abstract

Cerebral plasticity-inducing approaches like repetitive transcranial magnetic stimulation (rTMS) are of high interest in situations where reorganization of neural networks can be observed, e.g., after stroke. However, an increasing number of studies suggest that improvements in motor performance of the stroke-affected hand following modulation of primary motor cortex (M1) excitability by rTMS shows a high interindividual variability. We here tested the hypothesis that in stroke patients the interindividual variability of behavioral response to excitatory rTMS is related to interindividual differences in network connectivity of the stimulated region. Chronic stroke patients (n= 14) and healthy controls (n = 12) were scanned with functional magnetic resonance imaging (fMRI) while performing a simple hand motor task. Dynamic causal modeling (DCM) was used to investigate effective connectivity of key motor regions. On two different days after the fMRI experiment, patients received either intermittent theta-burst stimulation (iTBS) over ipsilesional M1 or control stimulation over the parieto-occipital cortex. Motor performance and TMS parameters of cortical excitability were measured before and after iTBS. Our results revealed that patients with better motor performance of the affected hand showed stronger endogenous coupling between supplemental motor area (SMA) and M1 before starting the iTBS intervention. Applying iTBS to ipsilesional M1 significantly increased ipsilesional M1 excitability and decreased contralesional M1 excitability as compared to control stimulation. Individual behavioral improvements following iTBS specifically correlated with neural coupling strengths in the stimulated hemisphere prior to stimulation, especially for connections targeting the stimulated M1. Combining endogenous connectivity and behavioral parameters explained 82% of the variance in hand motor performance observed after iTBS. In conclusion, the data suggest that the individual susceptibility to iTBS after stroke is influenced by interindividual differences in motor network connectivity of the lesioned hemisphere.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Diekhoff-Krebs, Svenja UNSPECIFIED UNSPECIFIED UNSPECIFIED Pool, Eva-Maria UNSPECIFIED orcid.org/0000-0001-8007-9588 UNSPECIFIED Sarfeld, Anna-Sophia UNSPECIFIED UNSPECIFIED UNSPECIFIED Rehme, Anne K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Eickhoff, Simon B. UNSPECIFIED orcid.org/0000-0001-6363-2759 UNSPECIFIED Fink, Gereon R. UNSPECIFIED orcid.org/0000-0002-8230-1856 UNSPECIFIED Grefkes, Christian UNSPECIFIED orcid.org/0000-0002-1656-720X UNSPECIFIED
URN:	urn:nbn:de:hbz:38-243845
DOI:	10.1016/j.nicl.2017.06.006
Journal or Publication Title:	NeuroImage-Clin.
Volume:	15
Page Range:	S. 559 - 572
Date:	2017
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	2213-1582
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TRANSCRANIAL MAGNETIC STIMULATION; THETA-BURST-STIMULATION; NONINVASIVE CORTICAL STIMULATION; SUBCORTICAL STROKE; CORTICOCORTICAL CONNECTIONS; LONGITUDINAL FMRI; BRAIN-STIMULATION; CONTROLLED TRIAL; ISCHEMIC-STROKE; MACAQUE MONKEY Multiple languages Neuroimaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24384