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), pp. 457-463. Elsevier 10.1016/j.brs.2019.12.013

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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 TULIAtotal (F [3, 28] = 4.118, p = .009), but did not affect TULIApantomime. The beneficial effect was driven by the cTBS over IPL-R, which improved TULIAimitation (p = .038). Furthermore, TULIAimitation 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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Translational Research Center
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DCR Unit Sahli Building > Forschungsgruppe Neurologie
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Gerontechnology and Rehabilitation

UniBE Contributor:

Vanbellingen, Tim; Wapp, Manuela; Nyffeler, Thomas; Kiefer, Claus; Walther, Sebastian and Bohlhalter, Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1935-861X

Publisher:

Elsevier

Language:

English

Submitter:

Angela Amira Botros

Date Deposited:

03 Feb 2020 10:57

Last Modified:

03 Feb 2020 11:05

Publisher DOI:

10.1016/j.brs.2019.12.013

PubMed ID:

31911072

BORIS DOI:

10.7892/boris.138014

URI:

https://boris.unibe.ch/id/eprint/138014

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