Using Source Localization Method To Analyze The Effect Of Cortical Activity By RTMS Coupled With Motor Training

Stroke is a disease which always along with seriously motor dysfunction,to improve the motor function of patients is the goal of rehabilitation after stroke.Clinical studies have shown that,compared to the motor training,repetitive transcranial magnetic stimulation(rTMS)coupled with motor training can more effectively improve the motor function of stroke.And then,in order to apply rTMS coupled with motor training in better,the researchers used the scalp electroencephalography(EEG)to explore the effect of brain activity with this method.However,the scalp EEG is the results of the neural activity in the brain cortex superposed on EEG electrodes,which may not accurately reflect the activity of cortex.There fore,we used standardized low resolution electromagnetic tomography analysis(sLoreta)which has high positioning accuracy to explore the effect of cortical activity by rTMS coupled with motor training.In this study,we use the non-donminant hands of healthy subjects analogy to the affected hands of stroke,improve the the motor function of the non-donminant hands by rTMS coupled with motor training.19 healthy subjects were randomly assigned to the motor training group and rTMS coupled with motor training group.in the rTMS coupled with training group,rTMS applied on the primary motor cortex of the left brain,and then use non-donminant hand perform motor training and motor training group perform the same motor training,which last for 14 days,before and after the motor training and rTMS coupled with motor training,behavioral data,EEG and TMS evoked EEG were recorded separatly.Before and after the rTMS coupled with motor training,we get the cortical distribution of neural activity and the intensity of standardization current density values at each hemisphere using sLoreta to analyze the signal of EEG.And compared with the result of the motor training to explore the effect of cortical activity by rTMS coupled with training.The result of behavioral date showed that,motor training and rTMS coupled with motor training can improve the motor function of non-donminant hands.And compared to motor training,rTMS coupled with motor training has better advantages.The sloreta results of EEG showed that,motor training and rTMS coupled with motor training change the standardization current density values on parietal lobe and frontal lobe,affect the number of voxels on Brodmamn(BA)6,BA7,BA 19,BA40 at each hemisphere,make the right hemispheres intensity change is significantly higher than that of left hemisphere.Compared with motor training,rTMS coupled with motor training significantly enhance the intensity of BA6 at the right hemisphere.In addition,the standardization current density values change from high frequency to low frequency increase gradually,modulate the activity of gamma and beta frequency bands and also activate more cortical activity at theta frequency band.The sLoreta results of TMS evoked EEG showed that after rTMS and motor training,the standardization of current density value of the P30 composition has significantly decreased on BA45 at the right hemisphere and the alpha frequency band has significantly decreased on BA9 at the right hemisphere.In conclusion,in the process of the motor function of the non-donminant hands to the non-dominant hemisphere(right hemisphere)has better control effect by rTMS coupled with motor training.Compared with motor training,rTMS coupled with motor training may strengthen the related information exchange between the cortex and increase modulate the premotor cortex and the supplementary motor area(BA6)to improve the motor function.This study can provide a reference for understanding the the mechanism of neural activity by rTMS coupled with motor training.For the future motor function rehabilitation in stroke,our study has provided the beneficial help.