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      Corticomotor reorganization during short‐term visuomotor training in the lower back: A randomized controlled study

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          Abstract

          Introduction

          Accumulating evidence suggests that motor skill training is associated with structural and functional reorganization of the primary motor cortex. However, previous studies have focussed primarily upon the upper limb, and it is unclear whether comparable reorganization occurs following training of other regions, such as the lower back. Although this holds important implications for rehabilitation, no studies have examined corticomotor adaptations following short‐term motor training in the lower back.

          Method

          The aims of this study were to (a) determine whether a short‐term lumbopelvic tilt visuomotor task induced reorganization of the corticomotor representations of lower back muscles, (b) quantify the variability of corticomotor responses to motor training, and (c) determine whether any improvements in task performance were correlated with corticomotor reorganization. Participants were allocated randomly to perform a lumbopelvic tilt motor training task ( n = 15) or a finger abduction control task involving no lumbopelvic movement ( n = 15). Transcranial magnetic stimulation was used to map corticomotor representations of the lumbar erector spinae before, during, and after repeated performance of the allocated task.

          Results

          No relationship between corticomotor reorganization and improved task performance was identified. Substantial variability was observed in terms of corticomotor responses to motor training, with approximately 50% of participants showing no corticomotor reorganization despite significant improvements in task performance.

          Conclusion

          These findings suggest that short‐term improvements in lower back visuomotor task performance may be driven by changes in remote subcortical and/or spinal networks rather than adaptations in corticomotor pathways. However, further research using tasks of varying complexities and durations is required to confirm this hypothesis.

          Abstract

          Accumulating evidence suggests that motor skill training is associated with structural and functional reorganization of the primary motor cortex. However, previous studies have focussed primarily upon the upper limb, and it is unclear whether comparable reorganization occurs following training of other regions, such as the lower back. The aims of this study were therefore to (a) determine whether a lumbopelvic tilt motor training task induced reorganization of the corticomotor representations of lower back muscles, (b) quantify the variability of corticomotor responses to motor training, and (c) determine whether any improvements in task performance were correlated with corticomotor reorganization. No relationship between corticomotor reorganization and improvements in task performance was identified, suggesting that short‐term improvements in lower back performance may be driven by changes in remote subcortical and/or spinal networks rather than adaptations in corticomotor pathways.

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          Most cited references69

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          Variability in response to transcranial direct current stimulation of the motor cortex.

          Responses to a number of different plasticity-inducing brain stimulation protocols are highly variable. However there is little data available on the variability of response to transcranial direct current stimulation (TDCS). We tested the effects of TDCS over the motor cortex on corticospinal excitability. We also examined whether an individual's response could be predicted from measurements of onset latency of motor evoked potential (MEP) following stimulation with different orientations of monophasic transcranial magnetic stimulation (TMS). Fifty-three healthy subjects participated in a crossover-design. Baseline latency measurements with different coil orientations and MEPs were recorded from the first dorsal interosseous muscle prior to the application of 10 min of 2 mA TDCS (0.057 mA/cm2). Thirty MEPs were measured every 5 min for up to half an hour after the intervention to assess after-effects on corticospinal excitability. Anodal TDCS at 2 mA facilitated MEPs whereas there was no significant effect of 2 mA cathodal TDCS. A two-step cluster analysis suggested that approximately 50% individuals had only a minor, or no response to TDCS whereas the remainder had a facilitatory effect to both forms of stimulation. There was a significant correlation between the latency difference of MEPs (anterior-posterior stimulation minus latero-medial stimulation) and the response to anodal, but not cathodal TDCS. The large variability in response to these TDCS protocols is in line with similar studies using other forms of non-invasive brain stimulation. The effects highlight the need to develop more robust protocols, and understand the individual factors that determine responsiveness. Copyright © 2014. Published by Elsevier Inc.
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            Determinants of the induction of cortical plasticity by non-invasive brain stimulation in healthy subjects.

            The ability to induce cortical plasticity with non-invasive brain stimulation (NBS) techniques has provided novel and exciting opportunities for examining the role of the human cortex during a variety of behaviours. Additionally, and importantly, the induction of lasting changes in cortical excitability can, under some conditions, reversibly modify behaviour and interact with normal learning. Such findings have driven a large number of recent studies examining whether by using such approaches it might be possible to induce functionally significant changes in patients with a large variety of neurological and psychiatric conditions including stroke, Parkinson's disease and depression. However, even in neurologically normal subjects the variability in the neurophysiological and behavioural response to such brain stimulation techniques is high. This variability at present limits the therapeutic usefulness of these techniques. The cause of this variability is multifactorial and to some degree still unknown. However, a number of factors that can influence the induction of plasticity have been identified. This review will summarise what is known about the causes of variability in healthy subjects and propose additional factors that are likely to be important determinants. A greater understanding of these determinants is critical for optimising the therapeutic applications of non-invasive brain stimulation techniques.
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              Motor cortex is required for learning but not for executing a motor skill.

              Motor cortex is widely believed to underlie the acquisition and execution of motor skills, but its contributions to these processes are not fully understood. One reason is that studies on motor skills often conflate motor cortex's established role in dexterous control with roles in learning and producing task-specific motor sequences. To dissociate these aspects, we developed a motor task for rats that trains spatiotemporally precise movement patterns without requirements for dexterity. Remarkably, motor cortex lesions had no discernible effect on the acquired skills, which were expressed in their distinct pre-lesion forms on the very first day of post-lesion training. Motor cortex lesions prior to training, however, rendered rats unable to acquire the stereotyped motor sequences required for the task. These results suggest a remarkable capacity of subcortical motor circuits to execute learned skills and a previously unappreciated role for motor cortex in "tutoring" these circuits during learning.
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                Author and article information

                Contributors
                R.Cavaleri@westernsydney.edu.au
                Journal
                Brain Behav
                Brain Behav
                10.1002/(ISSN)2157-9032
                BRB3
                Brain and Behavior
                John Wiley and Sons Inc. (Hoboken )
                2162-3279
                07 July 2020
                August 2020
                : 10
                : 8 ( doiID: 10.1002/brb3.v10.8 )
                : e01702
                Affiliations
                [ 1 ] School of Health Sciences Western Sydney University Campbelltown New South Wales Australia
                [ 2 ] College of Nursing and Health Sciences Flinders University Adelaide South Australia Australia
                [ 3 ] CIRRIS Research Centre Department of Rehabilitation Laval University Quebec Canada
                [ 4 ] Faculty of Health and Behavioural Sciences The University of Queensland Brisbane Queensland Australia
                [ 5 ] Neuroscience Research Australia Randwick New South Wales Australia
                Author notes
                [*] [* ] Correspondence

                Rocco Cavaleri, School of Health Sciences, Western Sydney University, Campbelltown, New South Wales 2560, Australia.

                Email: R.Cavaleri@ 123456westernsydney.edu.au

                Author information
                https://orcid.org/0000-0001-9499-1703
                https://orcid.org/0000-0002-9083-3107
                Article
                BRB31702
                10.1002/brb3.1702
                7428511
                32633899
                4b20ceb1-873d-43d4-8f92-c89ff9b1b3ca
                © 2020 The Authors. Brain and Behavior published by Wiley Periodicals LLC.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 January 2020
                : 29 April 2020
                : 17 May 2020
                Page count
                Figures: 5, Tables: 1, Pages: 13, Words: 9565
                Funding
                Funded by: National Health and Medical Research Council , open-funder-registry 10.13039/501100000925;
                Award ID: APP105040
                Award ID: APP1091302
                Award ID: APP1102905
                Funded by: Medical Research Council , open-funder-registry 10.13039/501100000265;
                Award ID: APP105040
                Award ID: APP1102905
                Categories
                Original Research
                Original Research
                Custom metadata
                2.0
                August 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.6 mode:remove_FC converted:15.08.2020

                Neurosciences
                corticomotor reorganization,lower back,motor learning,tms
                Neurosciences
                corticomotor reorganization, lower back, motor learning, tms

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