Abstract
The cerebellum plays a critical role in promoting learning of new motor tasks, which is an essential function for motor recovery. Repetitive transcranial magnetic stimulation (rTMS) of the cerebellum can be used to enhance learning. In this study, we investigated the effects of cerebellar intermittent theta burst stimulation (c-iTBS), a high-frequency rTMS protocol, on visuo-motor learning in a sample of hemiparetic patients due to recent stroke in the territory of the contralateral middle cerebral artery. Eight stroke patients were enrolled for the purposes of the study in the chronic stage of recovery (i.e., at least 6 months after stroke). In two sessions, Patients were randomly assigned to treatment with real or sham c-iTBS applied over the cerebellar hemisphere ipsilateral to the affected body side. c-iTBS was applied immediately before the learning phase of a visuo-motor adaptation task. Real, but not sham, c-iTBS improved visuo-motor learning as revealed by an increased performance in of the learning phase of the visuo-moto adaptation task. Moreover, we also found that real but not sham c-iTBS induced a sustained improvement in the re-adaptation of the recently learned skill (i.e., when patients were re-tested after 30 min). Taken together, these data point to c-iTBS as a potential novel strategy to promote motor learning in patients with stroke.
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Abbreviations
- TBS:
-
Theta burst stimulation
- VAT:
-
Visuo-motor adaptation task
- iTBS:
-
Intermittent theta burst stimulation
- cTBS:
-
Continuous theta burst stimulation
- TMS:
-
Transcranial magnetic stimulation
- LTP:
-
Long-term potentiation
- LTD:
-
Long-term depression
- CTC:
-
Cerebello-thalamo-cortical network
- AMT:
-
Active motor threshold
- RMT:
-
Resting motor threshold
- EEG:
-
Electroencephalography
- TEP:
-
TMS-evoked potential
- TRSP:
-
TMS-related spectral perturbation.
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Acknowledgements
The authors thank all the study participants and their families.
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This work was supported by grant of the Italian Ministry of Health (grant number GR-2013-02358852 to SB and MCP).
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This study was approved by the local Institutional Review Board and conducted according to the Declaration of Helsinki. All subjects provided written informed consent.
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Bonnì, S., Motta, C., Pellicciari, M.C. et al. Intermittent Cerebellar Theta Burst Stimulation Improves Visuo-motor Learning in Stroke Patients: a Pilot Study. Cerebellum 19, 739–743 (2020). https://doi.org/10.1007/s12311-020-01146-2
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DOI: https://doi.org/10.1007/s12311-020-01146-2