Header

UZH-Logo

Maintenance Infos

Interhemispheric facilitation of gesturing: A combined theta burst stimulation and diffusion tensor imaging study


Vanbellingen, Tim; Pastore-Wapp, Manuela; Kübel, Stefanie; Nyffeler, Thomas; Schüpfer, Anne-Catherine; Kiefer, Claus; Zizlsperger, Leopold; Lutz, Kai; Luft, Andreas R; Walther, Sebastian; Bohlhalter, Stephan (2020). Interhemispheric facilitation of gesturing: A combined theta burst stimulation and diffusion tensor imaging study. Brain Stimulation, 13(2):457-463.

Abstract

BACKGROUND

Imaging studies point to a posture (finger vs. hand) and domain-specific neural basis of gestures. Furthermore, modulation of gestures by theta burst stimulation (TBS) may depend on interhemispheric disinhibition.

OBJECTIVE/HYPOTHESIS

In this randomized sham-controlled study, we hypothesized that dual site continuous TBS over left inferior frontal gyrus (IFG-L) and right inferior parietal gyrus (IPL-R) predominantly affects pantomime of finger postures. Furthermore, we predicted that dual cTBS improves imitation of hand gestures if the effect correlates with measures of callosal connectivity.

METHODS

Forty-six healthy subjects participated in this study and were targeted with one train of TBS in different experimental sessions: baseline, sham, single site IFG-L, dual IFG-L/IPL-R, single site IPL-R. Gestures were evaluated by blinded raters using the Test for Upper Limb Apraxia (TULIA) and Postural Imitation Test (PIT). Callosal connectivity was analyzed by diffusion tensor imaging (DTI).

RESULTS

Dual cTBS significantly improved TULIA$_{total}$ (F [3, 28] = 4.118, p = .009), but did not affect TULIA$_{pantomime}$. The beneficial effect was driven by the cTBS over IPL-R, which improved TULIA$_{imitation}$ (p = .038). Furthermore, TULIA$_{imitation}$ significantly correlated with the microstructure (fractional anisotropy) of the splenium (r = 0.420, p = .026), corrected for age and whole brain volume.

CONCLUSIONS

The study suggests that inhibition of IPL-R largely accounted for improved gesturing, possibly through transcallosal facilitation of IPL-L. Therefore, the findings may be relevant for the treatment of apraxic stroke patients. Gesture pantomime and postural gestures escaped the modulation by dual cTBS, suggesting a more widespread and/or variable neural representation.

Abstract

BACKGROUND

Imaging studies point to a posture (finger vs. hand) and domain-specific neural basis of gestures. Furthermore, modulation of gestures by theta burst stimulation (TBS) may depend on interhemispheric disinhibition.

OBJECTIVE/HYPOTHESIS

In this randomized sham-controlled study, we hypothesized that dual site continuous TBS over left inferior frontal gyrus (IFG-L) and right inferior parietal gyrus (IPL-R) predominantly affects pantomime of finger postures. Furthermore, we predicted that dual cTBS improves imitation of hand gestures if the effect correlates with measures of callosal connectivity.

METHODS

Forty-six healthy subjects participated in this study and were targeted with one train of TBS in different experimental sessions: baseline, sham, single site IFG-L, dual IFG-L/IPL-R, single site IPL-R. Gestures were evaluated by blinded raters using the Test for Upper Limb Apraxia (TULIA) and Postural Imitation Test (PIT). Callosal connectivity was analyzed by diffusion tensor imaging (DTI).

RESULTS

Dual cTBS significantly improved TULIA$_{total}$ (F [3, 28] = 4.118, p = .009), but did not affect TULIA$_{pantomime}$. The beneficial effect was driven by the cTBS over IPL-R, which improved TULIA$_{imitation}$ (p = .038). Furthermore, TULIA$_{imitation}$ significantly correlated with the microstructure (fractional anisotropy) of the splenium (r = 0.420, p = .026), corrected for age and whole brain volume.

CONCLUSIONS

The study suggests that inhibition of IPL-R largely accounted for improved gesturing, possibly through transcallosal facilitation of IPL-L. Therefore, the findings may be relevant for the treatment of apraxic stroke patients. Gesture pantomime and postural gestures escaped the modulation by dual cTBS, suggesting a more widespread and/or variable neural representation.

Statistics

Citations

Dimensions.ai Metrics
4 citations in Web of Science®
6 citations in Scopus®
Google Scholar™

Altmetrics

Downloads

4 downloads since deposited on 11 Jan 2021
4 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurology
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Life Sciences > Biophysics
Life Sciences > General Neuroscience
Health Sciences > Neurology (clinical)
Language:English
Date:2020
Deposited On:11 Jan 2021 07:09
Last Modified:12 Jan 2021 21:00
Publisher:Elsevier
ISSN:1876-4754
OA Status:Hybrid
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1016/j.brs.2019.12.013
PubMed ID:31911072

Download

Hybrid Open Access

Download PDF  'Interhemispheric facilitation of gesturing: A combined theta burst stimulation and diffusion tensor imaging study'.
Preview
Content: Published Version
Filetype: PDF
Size: 749kB
View at publisher
Licence: Creative Commons: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)