State-dependent modulation of cortico-spinal networks

Abstract

Beta-band rhythm (13-30 Hz) is a dominant oscillatory activity in the sensorimotor system. Numerous studies reported on links between motor performance and the cortical and cortico-spinal beta rhythm. However, these studies report divergent beta-band frequencies and are, additionally, based on differently performed motor-tasks (e.g., motor imagination, muscle contraction, reach, grasp, and attention). This diversity blurs the role of beta in the sensorimotor system. It consequently challenges the development of beta-band activity-dependent stimulation protocols in the sensorimotor system. In this vein, we studied the functional role of beta-band cortico-cortical and cortico-spinal networks during a motor learning task. We studied how the contribution of cortical and spinal beta changes in the course of learning, and how this modulation is affected by afferent feedback to the sensorimotor system. We furthermore researched the relationship to motor performance. Consider that we made our study in the absence of any residual movement to allow our findings to be translated into rehabilitation programs for severely affected stroke patients. This thesis, at first, investigates evoked responses after transcranial magnetic stimulation (TMS). This revealed two different beta-band networks, i.e., in the low and high beta-band reflecting cortical and cortico-spinal activity. We, then, used a broader frequency range in the beta-band to trigger passive opening of the hand (peripheral feedback) or cortical stimulation (cortical feedback). While a unilateral hemispheric increase in cortico-spinal synchronization was observed in the group with peripheral feedback, a bilateral hemispheric increase in cortico-cortical and cortico-spinal synchronization was observed for the group with cortical feedback. An improvement in motor performance was found in the peripheral group only. Additionally, an enhancement in the directed cortico-spinal synchronization from cortex to periphery was observed for the peripheral group. Similar neurophysiological and behavioral changes were observed for stroke patients receiving peripheral feedback. The results 6 suggest two different mechanisms for beta-band activity-dependent protocols depending on the feedback modality. While the peripheral feedback appears to increase the synchronization among neural groups, cortical stimulation appears to recruit dormant neurons and to extend the involved motor network. These findings may provide insights regarding the mechanism behind novel activity-dependent protocols. It also highlights the importance of afferent feedback for motor restoration in beta-band activity-dependent rehabilitation programs.