rTMS Induced Reduction in M1 Excitability

Indiana University

Status: Enrolling

Conditions: Primary Motor Cortex; Cortical Excitability; Motor Skills

Treatments: Device: rTMS

Study type: Interventional

Funder types: Other

Identifiers

NCT07588113

30610

Details and patient eligibility

About

When learning a new skill, much of the improvement comes from small alterations the brain makes with each repetition during practice, but this isn't the only time that improvements are made during the learning process. Individuals also get better at the motor skills during the time between practices, through a process called "consolidation." It is known that an area of the brain called the primary motor cortex is involved in learning during active practice, but the investigators want to study if the primary motor cortex is important for consolidation. The investigators will examine how lowering the activity in this brain region affects your ability to consolidate learning to play a song on the videogame Guitar Hero.

Full description

Research employing rTMS-induced reductions in excitability showed that M1 had a large role in consolidation after practice, but was not responsible for the improvements that occur during practice. Though this study used a simple finger tapping task, additional studies have shown the role of M1 in task consolidation with ballistic movements and dynamic force-field learning tasks, while using rTMS to reduce cortical excitability. The main issue with previous studies is that they have been limited to a single digit, single joint, or non-transferrable laboratory tasks. This limits the application of these studies to real world scenarios, and shows the need for further research into this interaction. Therefore, we intend to examine the effect of an rTMS-induced reduction in M1 excitability, on the learning of a dynamic, two-handed video game task (Guitar Hero). This is important because it will help explain the role of M1 in learning complex, bimanual tasks. Our study will also directly address how M1 contributes to the fast and slow consolidation of dynamic, coordinated actions that more closely resemble real-world activities (video games). Ultimately, this knowledge is crucial to the development of targeted non-invasive brain stimulation protocols that could aid in the rehabilitation of patients with motor dysfunction, in which relearning complex coordinated motor tasks is a primary goal.

Objective(s)

1. Primary Objective Our primary objective is to determine if short term inhibition of M1 with 1Hz rTMS (rTMS induced reductions in excitability) blocks the early online learning (fast and slow consolidation) that occurs when first playing a video game
2. Secondary Objective Our secondary objective is to compare the amount of rTMS-induced reductions in excitability, measured with single pulse TMS motor-evoked potential cortical excitability, with the amount of fast and slow consolidation observed in playing the video game.

Enrollment: 32 estimated patients

Sex: All

Ages: 18 to 45 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Between ages 18 and 45 years old (to avoid any changes in the developing brain, or with aging).
• Answer 'no' to questions 2 through 17 on the brain stimulation questionnaire as these factors can increase likelihood of adverse events with brain stimulation.
• No neurological damage, disease, or dysfunction (nerve damage, chronic pain disorders, diabetic neuropathy, epilepsy) that affect the upper limbs and limit the ability to complete the study, and/or compromise the objectives of the study
• No significant visual impairment that would prevent them from playing a video game.

Exclusion criteria

• Currently prescribed and taking stimulant medication (Adderall, Ritalin, Vyvanse, etc.)
• Consumption of over-the-counter stimulants such as caffeine or nicotine (coffee, soda, supplements, energy drinks, tobacco products, or other nicotine containing products such as gum, vape pens, etc...) 12 hours prior to entering the lab on the day of testing as this can directly affect cortical excitability. If a subject takes any of these substances 12 hours prior to the study visit they will be asked to reschedule for a later date.
• Have played a real stringed instrument in the last 12 months (e.g. guitar, bass, violin)
• Have played the videogame "Guitar Hero" on a traditional guitar controller in the last 12 months.

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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32 participants in 2 patient groups, including a placebo group

rTMS stimulation group

Experimental group

Description:

this group will receive 15 minutes of repetitive transcranial magnetic stimulation of the motor cortex while seated quietly

Treatment:

Device: rTMS

SHAM stimulation group

Placebo Comparator group

Description:

This group will have the same stimulating wand placed over the head, but at a distance far enough away as to not activate the cortical neurons.

Treatment:

Device: rTMS