Physiology of Interregional Connectivity in the Human Brain
| Status: | Recruiting |
|---|---|
| Conditions: | Healthy Studies, Neurology, Neurology, Neurology, Multiple Sclerosis |
| Therapuetic Areas: | Neurology, Other |
| Healthy: | No |
| Age Range: | 18 - 85 |
| Updated: | 10/31/2018 |
| Start Date: | May 31, 2017 |
| End Date: | November 2020 |
| Contact: | Tommi Raij, MD, PhD |
| Email: | tommi.raij@northwestern.edu |
| Phone: | 312-238-4401 |
The purpose of this study is to understand the physiology of connectivity between cortical
regions in the human brain in healthy participants and in patients with white matter lesions.
Specifically, the investigators will examine the effects of paired associative stimulation
(PAS) which consists in delivering brief (< 1 ms) current pulses separated by a short
millisecond-level time interval ("asynchrony") to two cortical areas. The used techniques are
all non-invasive and considered safe in humans: transcranial magnetic stimulation (TMS),
electroencephalography (EEG), magnetic resonance imaging (MRI), and functional MRI (fMRI).
Based on prior literature in animals and human studies, it is hypothesized that PAS may
increase or decrease effective connectivity between the stimulated areas depending on the
asynchrony value. The main outcome measure is source-resolved EEG responses evoked by
single-pulse TMS; this is a more direct measure of neuronal changes occurring at the targeted
cortical area than motor evoked potentials (MEPs) or sensor-level EEG responses used in
previous studies.
regions in the human brain in healthy participants and in patients with white matter lesions.
Specifically, the investigators will examine the effects of paired associative stimulation
(PAS) which consists in delivering brief (< 1 ms) current pulses separated by a short
millisecond-level time interval ("asynchrony") to two cortical areas. The used techniques are
all non-invasive and considered safe in humans: transcranial magnetic stimulation (TMS),
electroencephalography (EEG), magnetic resonance imaging (MRI), and functional MRI (fMRI).
Based on prior literature in animals and human studies, it is hypothesized that PAS may
increase or decrease effective connectivity between the stimulated areas depending on the
asynchrony value. The main outcome measure is source-resolved EEG responses evoked by
single-pulse TMS; this is a more direct measure of neuronal changes occurring at the targeted
cortical area than motor evoked potentials (MEPs) or sensor-level EEG responses used in
previous studies.
This study consists of two experiments.
In Experiment A, healthy participants without disorders or medications influencing brain
function (N=24) will be recruited. A range of negative and positive asynchronies (from minus
50 to + 50 ms) will be tested. To allow comparison with prior studies that used MEPs as
outcome measures, in 12 participants the primary motor cortex in the left and right
hemisphere will be targeted. In another 12 participants, two cortical areas within the same
hemisphere will be stimulated.
In Experiment B, participants with stroke, traumatic brain injury (TBI), or multiple
sclerosis (MS) (total maximum N across all such participants is 52) will be recruited. These
participants are required to have one or more subcortical white matter lesions, which would
be expected to result in cortico-cortical disconnections. Here, the investigators will only
test PAS with positive asynchronies, with the goal of testing if the findings observed in
healthy participants are similar in participants with white matter lesions. It will also be
examined if the PAS-induced connectivity changes persist beyond the stimulation sessions if
PAS is given repeatedly over several days. PAS will be applied to two cortical targets that
have been disconnected from each other. The rationale for including more than one disorder in
Experiment B is that the disconnections are in all cases caused by white matter lesions and
the results may therefore be similar. To detect possible differences between disorders, the
data from the three groups will also be analyzed separately.
In Experiment A, healthy participants without disorders or medications influencing brain
function (N=24) will be recruited. A range of negative and positive asynchronies (from minus
50 to + 50 ms) will be tested. To allow comparison with prior studies that used MEPs as
outcome measures, in 12 participants the primary motor cortex in the left and right
hemisphere will be targeted. In another 12 participants, two cortical areas within the same
hemisphere will be stimulated.
In Experiment B, participants with stroke, traumatic brain injury (TBI), or multiple
sclerosis (MS) (total maximum N across all such participants is 52) will be recruited. These
participants are required to have one or more subcortical white matter lesions, which would
be expected to result in cortico-cortical disconnections. Here, the investigators will only
test PAS with positive asynchronies, with the goal of testing if the findings observed in
healthy participants are similar in participants with white matter lesions. It will also be
examined if the PAS-induced connectivity changes persist beyond the stimulation sessions if
PAS is given repeatedly over several days. PAS will be applied to two cortical targets that
have been disconnected from each other. The rationale for including more than one disorder in
Experiment B is that the disconnections are in all cases caused by white matter lesions and
the results may therefore be similar. To detect possible differences between disorders, the
data from the three groups will also be analyzed separately.
Inclusion Criteria:
Inclusion Criteria for Healthy Participants:
- Age from 18 to 85 years
- Right-handed
- Normal hearing and (corrected) vision
- Able to understand and give informed consent
- English speaker
Inclusion Criteria for Patients:
- Age from 18 to 85 years
- Stroke (ischemic subcortical, intermediate level, chronic phase 3 weeks or more from
lesion)
- TBI (closed-skull, intermediate level, chronic phase 3 weeks or more from lesion)
- MS (white matter subcortical lesion)
- Clinical and radiological evidence supporting the above diagnoses
- One or more behavioral symptoms possibly linked to the white matter lesion(s)
- Stable medical condition
- English speaker
Exclusion Criteria:
Exclusion Criteria for Healthy Participants:
- Cardiac pacemaker or pacemaker wires; neurostimulators; implanted pumps
- Metal in the body (rods, plates, screws, shrapnel, dentures, IUD) or metallic
particles in the eye
- Surgical clips in the head or previous neurosurgery
- Any magnetic particles in the body
- Cochlear implants
- Prosthetic heart valves
- Epilepsy or any other type of seizure history
- Any neurological diagnoses or medications influencing brain function
- History of significant head trauma (i.e., extended loss of consciousness, neurological
sequelae)
- Known structural brain lesion
- Significant other disease (heart disease, malignant tumors, mental disorders)
- Significant claustrophobia; Ménière's disease
- Pregnancy (ruled out by urine ß-HCG if answers to screening questions suggest that
pregnancy is possible), breast feeding
- Non prescribed drug use
- Failure to perform the behavioral tasks or neuropsychological evaluation tests
- Prisoners
Exclusion Criteria for Patients:
- Same as above, excluding the requirement of no structural brain lesion, and
medications influencing brain function are allowed
- Patients with cortical lesions or CSF-filled cysts/cavities near the TMS sites
- MS patients with acute exacerbation
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