Anodal transcranial patterned stimulation of the motor cortex during gait can induce activity-dependent corticospinal plasticity to alter human gait

PLoS One. 2018 Dec 21;13(12):e0208691. doi: 10.1371/journal.pone.0208691. eCollection 2018.

Abstract

The corticospinal system and local spinal circuits control human bipedal locomotion. The primary motor cortex is phase-dependently activated during gait; this cortical input is critical for foot flexor activity during the swing phase. We investigated whether gait-combined rhythmic brain stimulation can induce neuroplasticity in the foot area of the motor cortex and alter gait parameters. Twenty-one healthy subjects participated in the single-blinded, cross-over study. Each subject received anodal transcranial patterned direct current stimulation over the foot area of the right motor cortex during gait, sham stimulation during gait, and anodal transcranial patterned direct current stimulation during rest in a random order. Six subjects were excluded due to a failure in the experimental recording procedure. Complete-case analysis was performed using the data from the remaining 15 subjects. Self-paced gait speed and left leg stride length were significantly increased after the stimulation during gait, but not after the sham stimulation during gait or the stimulation during rest. In addition, a significant increase was found in the excitability of the corticospinal pathway of the left tibialis anterior muscle 30 min after stimulation during gait. Anodal transcranial patterned direct current stimulation during gait entrained the gait cycle to enhance motor cortical activity in some subjects. These findings suggest that the stimulation during gait induced neuroplasticity in corticospinal pathways driving flexor muscles during gait.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomechanical Phenomena
  • Cross-Over Studies
  • Electromyography
  • Evoked Potentials, Motor
  • Female
  • Gait / physiology*
  • Humans
  • Leg / physiology
  • Male
  • Motor Cortex / physiology*
  • Muscle, Skeletal / physiology
  • Neuronal Plasticity / physiology*
  • Periodicity
  • Pyramidal Tracts / physiology*
  • Rest
  • Single-Blind Method
  • Transcranial Direct Current Stimulation*
  • Transcranial Magnetic Stimulation
  • Young Adult

Grants and funding

This study was partly supported by a Grant-in-Aid for Scientific Research (C) (grant number 17K0145307), a Grant-in-Aid for Young Scientists (B) (26870321) from the Japan Society for the Promotion of Science, a research grant (2015) from the Nakatomi Foundation (to S.K.), a Grant-in-Aid for Scientific Research (B) 15H03044 and Grants-in-Aid for Scientific Research on Innovative Areas (15H05880, 15H05871) from the Japan Society for the Promotion of Science, Grants 27280201 and 2736040 from the Japan Agency for Medical Research and Development (AMED), and a research grant (2015) from the Brain Science Foundation (to T.M.).