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Characterizing the application of transcranial direct current stimulation in human pharyngeal motor cortex.

Abstract

Transcranial direct current stimulation (tDCS) is a novel intervention that can modulate brain excitability in health and disease; however, little is known about its effects on bilaterally innervated systems such as pharyngeal motor cortex. Here, we assess the effects of differing doses of tDCS on the physiology of healthy human pharyngeal motor cortex as a prelude to designing a therapeutic intervention in dysphagic patients. Healthy subjects (n = 17) underwent seven regimens of tDCS (anodal 10 min 1 mA, cathodal 10 min 1 mA, anodal 10 min 1.5 mA, cathodal 10 min 1.5 mA, anodal 20 min 1 mA, cathodal 20 min 1 mA, Sham) on separate days, in a double blind randomized order. Bihemispheric motor evoked potential (MEP) responses to single-pulse transcranial magnetic stimulation (TMS) as well as intracortical facilitation (ICF) and inhibition (ICI) were recorded using a swallowed pharyngeal catheter before and up to 60 min following the tDCS. Compared with sham, both 10 min 1.5 mA and 20 min 1 mA anodal stimulation induced increases in cortical excitability in the stimulated hemisphere (+44 +/- 17% and +59 +/- 16%, respectively; P < 0.005) whereas only 10 min 1.5 mA cathodal stimulation induced inhibition (-26 +/- 4%, P = 0.02). There were neither contralateral hemisphere changes nor any evidence for ICI or ICF in driving the ipsilateral effects. In conclusion, anodal tDCS can alter pharyngeal motor cortex excitability in an intensity-dependent manner, with little evidence for transcallosal spread. Anodal stimulation may therefore provide a useful means of stimulating pharyngeal cortex and promoting recovery in dysphagic patients.

Authors+Show Affiliations

Department of Gastrointestinal Sciences, Salford Royal Foundation Trust, University of Manchester, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19815630

Citation

Jefferson, Samantha, et al. "Characterizing the Application of Transcranial Direct Current Stimulation in Human Pharyngeal Motor Cortex." American Journal of Physiology. Gastrointestinal and Liver Physiology, vol. 297, no. 6, 2009, pp. G1035-40.
Jefferson S, Mistry S, Singh S, et al. Characterizing the application of transcranial direct current stimulation in human pharyngeal motor cortex. Am J Physiol Gastrointest Liver Physiol. 2009;297(6):G1035-40.
Jefferson, S., Mistry, S., Singh, S., Rothwell, J., & Hamdy, S. (2009). Characterizing the application of transcranial direct current stimulation in human pharyngeal motor cortex. American Journal of Physiology. Gastrointestinal and Liver Physiology, 297(6), pp. G1035-40. doi:10.1152/ajpgi.00294.2009.
Jefferson S, et al. Characterizing the Application of Transcranial Direct Current Stimulation in Human Pharyngeal Motor Cortex. Am J Physiol Gastrointest Liver Physiol. 2009;297(6):G1035-40. PubMed PMID: 19815630.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characterizing the application of transcranial direct current stimulation in human pharyngeal motor cortex. AU - Jefferson,Samantha, AU - Mistry,Satish, AU - Singh,Salil, AU - Rothwell,John, AU - Hamdy,Shaheen, Y1 - 2009/10/08/ PY - 2009/10/10/entrez PY - 2009/10/10/pubmed PY - 2009/12/18/medline SP - G1035 EP - 40 JF - American journal of physiology. Gastrointestinal and liver physiology JO - Am. J. Physiol. Gastrointest. Liver Physiol. VL - 297 IS - 6 N2 - Transcranial direct current stimulation (tDCS) is a novel intervention that can modulate brain excitability in health and disease; however, little is known about its effects on bilaterally innervated systems such as pharyngeal motor cortex. Here, we assess the effects of differing doses of tDCS on the physiology of healthy human pharyngeal motor cortex as a prelude to designing a therapeutic intervention in dysphagic patients. Healthy subjects (n = 17) underwent seven regimens of tDCS (anodal 10 min 1 mA, cathodal 10 min 1 mA, anodal 10 min 1.5 mA, cathodal 10 min 1.5 mA, anodal 20 min 1 mA, cathodal 20 min 1 mA, Sham) on separate days, in a double blind randomized order. Bihemispheric motor evoked potential (MEP) responses to single-pulse transcranial magnetic stimulation (TMS) as well as intracortical facilitation (ICF) and inhibition (ICI) were recorded using a swallowed pharyngeal catheter before and up to 60 min following the tDCS. Compared with sham, both 10 min 1.5 mA and 20 min 1 mA anodal stimulation induced increases in cortical excitability in the stimulated hemisphere (+44 +/- 17% and +59 +/- 16%, respectively; P < 0.005) whereas only 10 min 1.5 mA cathodal stimulation induced inhibition (-26 +/- 4%, P = 0.02). There were neither contralateral hemisphere changes nor any evidence for ICI or ICF in driving the ipsilateral effects. In conclusion, anodal tDCS can alter pharyngeal motor cortex excitability in an intensity-dependent manner, with little evidence for transcallosal spread. Anodal stimulation may therefore provide a useful means of stimulating pharyngeal cortex and promoting recovery in dysphagic patients. SN - 1522-1547 UR - https://www.unboundmedicine.com/medline/citation/19815630/Characterizing_the_application_of_transcranial_direct_current_stimulation_in_human_pharyngeal_motor_cortex_ L2 - http://www.physiology.org/doi/full/10.1152/ajpgi.00294.2009?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -