Repetitive transcranial magnetic stimulation of the primary motor cortex improves movement performance by regulating neural oscillations

ISRCTN ISRCTN12867198
DOI https://doi.org/10.1186/ISRCTN12867198
Submission date
07/10/2024
Registration date
11/10/2024
Last edited
10/10/2024
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Nervous System Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
Transcranial magnetic stimulation (TMS) could improve motor cortical excitability and balance dysfunction. However, the underlying neurophysiological mechanism of repetitive TMS (rTMS) combined with task-related brain state (TCBS) intervention remains unclear. This study investigates which brain oscillatory activities in which brain regions are involved in the TCBS intervention.

Who can participate?
Healthy adult volunteers aged between 20 and 75 years old

What does the study involve?
To investigate the neurophysiological mechanisms, rTMS will be applied to the motor cortex of subjects during movement tasks. Multichannel electroencephalography (EEG) signals in various frequency bands (θ, α, β, γ) will be obtained before, during, and after the intervention. The phase-locking value, conventional entropy, and coupling entropy will be introduced to investigate cross-frequency coupling characteristics (CFCC), within-frequency dynamic characteristics (WFDC), and cross-frequency coupling dynamic characteristics (CFCDC) respectively.

What are the possible benefits and risks of participating?
The study aims to quantify TMS-induced coupling and differences in dynamic characteristics and objectively evaluate the effects of TCBS. These calculations are significant for understanding the coupling characteristics and neurodynamic characteristics after TCBS modulation, potentially guiding the TCBS treatment of movement-related diseases.

The risk of rTMS in inducing a seizure is low ranging from 1/100,000 to 33/100,000, even in patient populations taking drugs acting on the central nervous system, at least with the use of traditional stimulation parameters and focal coils for which large data sets are available. While this is reassuring and helpful information for subjects, it remains necessary to be prepared to deal with a seizure that might arise in any experimental protocol.

Where is the study run from?
Key Laboratory of Intelligent Rehabilitation and Neuromodulation of Hebei Province, Yanshan University, China

When is the study starting and how long is it expected to run for?
September 2021 to August 2023

Who is funding the study?
1. National Key Research and Development Program of China
2. National Natural Science Foundation of China
3. Outstanding Youth of Hebei Natural Science Foundation
4. Hebei Key Research and Development Program
5. Hebei Province of Introduction of Overseas Talent
6. Central Government Guides Local Projects
7. Hebei Innovation Capability Improvement Plan Project

Who is the main contact?
Dr Lingdi Fu, ldfu@ysu.edu.cn

Contact information

Dr Lingdi fu
Public, Scientific, Principal Investigator

No.438 Hebei Street West Section
Qinhuangdao City, Hebei Province
066000
China

ORCiD logoORCID ID 0000-0002-6608-7124
Phone +86 15022071790
Email lingdifu123@126.com

Study information

Study designRandomized controlled study
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Laboratory
Study typeEfficacy
Participant information sheet Not available in web format, please use the contact details below to request participantt information sheet
Scientific titleTMPRNO: rTMS of M1 improves movement performance by regulating neural oscillations
Study acronymTMPRNO
Study objectivesThe present study aims to explore the regulator mechanism and look for potential biomarkers of repetitive transracial magnetic stimulation (TMS) intervention when combined with movement-related brain state.
Ethics approval(s)

Approved 03/03/2022, First Hospital of Qinhuangdao Research Ethics Committee (The First Hospital of Qinhuangdao, 258 Wenhua Road, Qinhuangdao, 066005, China; +86-18830466169; 895638791@qq.com), ref: 2022A107

Health condition(s) or problem(s) studiedImprove motor cortical excitability and balance dysfunction to provide practical guidance for the task-related brain state (TCBS) treatment of movement-related diseases, such as stroke
InterventionElectroencephalography (EEG) signals were collected from 32 Ag-AgCl scalp electrodes located according to the International 10-10 system using a BrainAmp system (Brain Products, Gilching, Germany). The experimental sessions began with a resting state with eyes open (pre-REST), followed by task familiarization and 30 additional trials before intervention (TASK), 5 minutes after intervention (TASK5), and 20 minutes after intervention (TASK20). Movement-related EMG signals were recorded to estimate the participants’ reaction time (RT) and monitor their movement performance during the three task-related periods. Transcranial magnetic stimulation (TMS)-evoked EEG responses were collected before intervention (PRE), immediately after intervention (POST0), and 15 minutes after intervention (POST15) using 100 TMS pulses. Stimulus intensity was set at 120% of the resting motor threshold (RMT). Sessions concluded with a resting state 25 minutes after intervention (post-REST).

The intervention provider has over 10 years of experience using TMS, EEG, and electromyography (EMG) technology. Throughout the experiment, participants sat in a comfortable chair and rested their right-hand index finger on a keypad without electronic devices. EMG signals were recorded from the right hand's first dorsal interosseous (FDI) and abductor digiti minimi (ADM) muscles. Repetitive TMS (rTMS) was administered at a frequency of 10Hz, with 1200 pulses delivered over a 10-minute stimulation duration. TMS pulses were delivered over the M1 of the FDI “hot spot” where the largest motor-evoked potentials (MEPs) could be acquired. The interventions consisted of 90 trials of a movement task, during which 10Hz rTMS at 80% of the RMT with 1200 pulses over a 10-minute stimulation duration was implemented.
Intervention typeDevice
Pharmaceutical study type(s)Not Applicable
PhaseNot Applicable
Drug / device / biological / vaccine name(s)Transcranial magnetic stimulation device
Primary outcome measureThe following primary outcome measures were assessed using electromyography before intervention (TASK), 5 min after intervention (TASK5), and 20 min after intervention (TASK 20):
1. Reaction time, characterized between the ‘0’ cue and feedback
2. Movement performance, defined as the percentage of the sum of OK and GOOD among total trials
Secondary outcome measuresMotor cortical excitability measured using electroencephalography (EEG) during a resting state with eye open (pre-REST), 0 min after intervention (POST0) and with a resting state 25 min after intervention (post-REST)
Overall study start date05/09/2021
Completion date16/08/2023

Eligibility

Participant type(s)Healthy volunteer
Age groupMixed
Lower age limit20 Years
Upper age limit75 Years
SexBoth
Target number of participants25
Total final enrolment24
Key inclusion criteria1. Criteria specified in the TMS safety guidelines
2. Right-handed hand
3. Age range: 20-75 years old
4. No metal implants on the head
5. Healthy, No neurological or psychiatric disorders
6. No severe visceral diseases such as liver, lung, heart, kidney, etc
7. Voluntarily participate and sign an informed consent form
8. No severe motor function and able to complete exercise tests
9. Not receiving any drug treatment
Key exclusion criteria1. A history of neurological or psychiatric disorders
2. Receiving any drug treatment
3. Unwilling to have TMS
4. Unwilling to record EEG
5. Contraindications to magnetic stimulation
Date of first enrolment05/04/2022
Date of final enrolment09/08/2023

Locations

Countries of recruitment

  • China

Study participating centre

Key Laboratory of Intelligent Rehabilitation and Neuromodulation of Hebei Province
Institute of Electrical Engineering, Yanshan University
Qinhuangdao
066000
China

Sponsor information

Yanshan University
University/education

Key Laboratory of Intelligent Rehabilitation and Neuromodulation of Hebei Province, No.438 Hebei Street West Section
Qinhuangdao City, Hebei Province
066000
China

Phone +86 15022071790
Email ldfu@ysu.edu.cn
Website https://www.ysu.edu.cn/
ROR logo "ROR" https://ror.org/02txfnf15

Funders

Funder type

Government

National Key Research and Development Program of China
Government organisation / National government
Alternative name(s)
重点基础研究发展计划, National Basic Research Program of China (973 Program), Special Fund for the National Key Research and Development Plan, China National Key Research and Development Plan Project, National Key Research and Development of China, National Key Research and Development Program, National Key R&D Program of China, National Key R&D Programmes of China, China's National Key R&D Programmes, National Basic Research Program of China, 973 Program, National Program on Key Basic Research Project (973 Program), National Plan on Key Basic Research and Development, National Basic Research Program, NKRDPC, NKPs
Location
China
National Natural Science Foundation of China
Government organisation / National government
Alternative name(s)
Chinese National Science Foundation, Natural Science Foundation of China, National Science Foundation of China, NNSF of China, NSF of China, 国家自然科学基金委员会, National Nature Science Foundation of China, Guójiā Zìrán Kēxué Jījīn Wěiyuánhuì, NSFC, NNSF, NNSFC
Location
China
Outstanding Youth of Hebei Natural Science Foundation

No information available

Hebei Key Research and Development Program

No information available

Hebei Province of Introduction of Overseas Talent

No information available

Central Government Guides Local Projects

No information available

Hebei Innovation Capability Improvement Plan Project

No information available

Results and Publications

Intention to publish date12/11/2024
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planThe data is owned by the Sponsor and Key Laboratory of Intelligent Rehabilitation and Neuromodulation of Hebei Province.

Scientific audience
The protocol for the study will be published in a peer-reviewed journal and the results of the study presented at National and International meetings on behalf of Key Laboratory of Intelligent Rehabilitation and Neuromodulation of Hebei Province. These publications and presentations will acknowledge the sponsor and funder of the study. On completion of the trial, the data will be analysed, and tabulated, and final study reports will be sent to the relevant authorities (funder, Ethics Committee of the First Hospital of Qinhuangdao). The primary outcome paper will be submitted to an open-access peer-reviewed journal.
IPD sharing planThe datasets generated during and analysed during the current study will be available upon reasonable request at the end of the study from Dr Lingdi Fu, ldfu@ysu.edu.cn.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol file 10/10/2024 No No

Additional files

46178_Protocol.pdf

Editorial Notes

10/10/2024: Study's existence confirmed by the Ethics Committee of First Hospital of Qinhuangdao.