Reliability and Variability of tDCS Induced Changes in the Lower Limb Motor Cortex

Background: Transcranial direct current stimulation (tDCS) is emerging as a promising adjuvant to enhance motor function. However, there has been increasing reservations about the reliability and variability of the neuromodulatory effects evoked by tDCS. Objective/Hypothesis: The main purpose of thi...

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Main Authors: Sangeetha Madhavan, Aishwarya Sriraman, Sally Freels
Format: Article
Language:English
Published: MDPI AG 2016-07-01
Series:Brain Sciences
Subjects:
Online Access:http://www.mdpi.com/2076-3425/6/3/26
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author Sangeetha Madhavan
Aishwarya Sriraman
Sally Freels
author_facet Sangeetha Madhavan
Aishwarya Sriraman
Sally Freels
author_sort Sangeetha Madhavan
collection DOAJ
description Background: Transcranial direct current stimulation (tDCS) is emerging as a promising adjuvant to enhance motor function. However, there has been increasing reservations about the reliability and variability of the neuromodulatory effects evoked by tDCS. Objective/Hypothesis: The main purpose of this study was to explore the test-retest reliability and inter-individual variability of tDCS of the lower limb M1 and the relationship between transcranial magnetic stimulation (TMS)-related measures and tDCS-induced changes. Methods: Fifteen healthy participants received anodal tDCS of the lower limb M1 either when performing a lower limb motor task or when the limb was at rest. Each condition was tested twice. tDCS induced changes in corticomotor excitability of the tibialis anterior muscle were measured using TMS. A repeated measures ANOVA was performed to examine efficacy of tDCS between the two task conditions. Intraclass correlation coefficients (ICC) and variance component analyses were performed to examine reliability and variability respectively. Results: A significant increase in in corticomotor excitability was noted for the tDCS-task condition at 140% active motor threshold (AMT) and when comparing recruitment curve slopes, but not at 120% and 130% AMT. Overall, ICC values between testing days for each stimulation condition ranged from 0.6–0.9. Higher ICCs were seen for higher TMS intensities (140% AMT) and recruitment curve slopes. Inter-individual variability contributed to 34% of the exhibited variance. Conclusions: Our data suggest that the TMS-related measure used to assess neuromodulation after tDCS has an effect on its perceived test-retest reliability and inter-individual variability. Importantly, we noticed that a high reliability and low variability does not necessarily indicate clinical efficacy of tDCS as some participants showed little to no modulation of corticomotor excitability consistently.
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spelling doaj.art-5e200596f8ff4674aaec83a25e4e05a62022-12-22T02:31:23ZengMDPI AGBrain Sciences2076-34252016-07-01632610.3390/brainsci6030026brainsci6030026Reliability and Variability of tDCS Induced Changes in the Lower Limb Motor CortexSangeetha Madhavan0Aishwarya Sriraman1Sally Freels2Department of Physical Therapy, University of Illinois at Chicago, 1919 W. Taylor St., Chicago, IL 60612, USADepartment of Physical Therapy, University of Illinois at Chicago, 1919 W. Taylor St., MC 898, Chicago, IL 60612, USADepartment of Epidemiology and Biostatistics, University of Illinois at Chicago, 1603 W. Taylor Street, Chicago, IL 60612, USABackground: Transcranial direct current stimulation (tDCS) is emerging as a promising adjuvant to enhance motor function. However, there has been increasing reservations about the reliability and variability of the neuromodulatory effects evoked by tDCS. Objective/Hypothesis: The main purpose of this study was to explore the test-retest reliability and inter-individual variability of tDCS of the lower limb M1 and the relationship between transcranial magnetic stimulation (TMS)-related measures and tDCS-induced changes. Methods: Fifteen healthy participants received anodal tDCS of the lower limb M1 either when performing a lower limb motor task or when the limb was at rest. Each condition was tested twice. tDCS induced changes in corticomotor excitability of the tibialis anterior muscle were measured using TMS. A repeated measures ANOVA was performed to examine efficacy of tDCS between the two task conditions. Intraclass correlation coefficients (ICC) and variance component analyses were performed to examine reliability and variability respectively. Results: A significant increase in in corticomotor excitability was noted for the tDCS-task condition at 140% active motor threshold (AMT) and when comparing recruitment curve slopes, but not at 120% and 130% AMT. Overall, ICC values between testing days for each stimulation condition ranged from 0.6–0.9. Higher ICCs were seen for higher TMS intensities (140% AMT) and recruitment curve slopes. Inter-individual variability contributed to 34% of the exhibited variance. Conclusions: Our data suggest that the TMS-related measure used to assess neuromodulation after tDCS has an effect on its perceived test-retest reliability and inter-individual variability. Importantly, we noticed that a high reliability and low variability does not necessarily indicate clinical efficacy of tDCS as some participants showed little to no modulation of corticomotor excitability consistently.http://www.mdpi.com/2076-3425/6/3/26TMStDCSlower limbmotor cortextibialis anteriorreliabilityvariability
spellingShingle Sangeetha Madhavan
Aishwarya Sriraman
Sally Freels
Reliability and Variability of tDCS Induced Changes in the Lower Limb Motor Cortex
Brain Sciences
TMS
tDCS
lower limb
motor cortex
tibialis anterior
reliability
variability
title Reliability and Variability of tDCS Induced Changes in the Lower Limb Motor Cortex
title_full Reliability and Variability of tDCS Induced Changes in the Lower Limb Motor Cortex
title_fullStr Reliability and Variability of tDCS Induced Changes in the Lower Limb Motor Cortex
title_full_unstemmed Reliability and Variability of tDCS Induced Changes in the Lower Limb Motor Cortex
title_short Reliability and Variability of tDCS Induced Changes in the Lower Limb Motor Cortex
title_sort reliability and variability of tdcs induced changes in the lower limb motor cortex
topic TMS
tDCS
lower limb
motor cortex
tibialis anterior
reliability
variability
url http://www.mdpi.com/2076-3425/6/3/26
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AT sallyfreels reliabilityandvariabilityoftdcsinducedchangesinthelowerlimbmotorcortex