Title: Increased motor cortex excitability improves skilled task learning – effects of intermittent theta burst stimulation
Background and aims: Primary motor cortex is critically involved in motor learning. Intermittent theta burst stimulation (iTBS) is a non-invasive neuromodulatory method that induces transient increase in excitability of the targeted cortical area. In this study we aimed to check whether a session of iTBS can improve learning of a skilled movement with non-dominant hand.
Patients and methods: Twenty healthy subjects (mean age 26±3y) were studied. Half of the subjects received real iTBS (600 pulses, 80% active motor threshold), another half placebo stimulation. Motor cortex hand area for the non-dominant side was targeted. Motor performance was evaluated using Purdue peg-board (PPB) and simple reaction time (RT) before (B), immediately after (T0), and at 30 (T30) minutes following iTBS. Motor cortex excitability was assessed by measuring motor evoked potentials (MEP).
Results: In comparison to time B, following real iTBS MEP increased significantly while following sham they remained unchanged. Following real iTBS number of pegs positioned on PBB test increased significantly at times T0 and T30 in comparison to B, while following sham the increase was significant only at T30. At T30, real and sham stimulated groups had similar results. RT did not change following either of the stimulation procedures.
Conclusion: Although both tested groups eventually reached the same level of performance improvement of the skilled hand movement tested, the increase in motor cortex excitability induced by iTBS was associated with faster learning of the skilled movement. The results suggest possible use of iTBS for promotion of motor learning in neurorehabilitation.
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