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- Julio C Hernandez-Pavon, Nils Schneider-Garces, John Patrick Begnoche, Lee E Miller, and Tommi Raij.
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Center for Brain Stimulation, Shirley Ryan AbilityLab, Chicago, IL, USA; Legs + Walking Lab, Shirley Ryan AbilityLab, Chicago, IL, USA.
- Neuromodulation. 2023 Jun 1; 26 (4): 745754745-754.
ObjectiveThe ability to selectively up- or downregulate interregional brain connectivity would be useful for research and clinical purposes. Toward this aim, cortico-cortical paired associative stimulation (ccPAS) protocols have been developed in which two areas are repeatedly stimulated with a millisecond-level asynchrony. However, ccPAS results in humans using bifocal transcranial magnetic stimulation (TMS) have been variable, and the mechanisms remain unproven. In this study, our goal was to test whether ccPAS mechanism is spike-timing-dependent plasticity (STDP).Materials And MethodsEleven healthy participants received ccPAS to the left primary motor cortex (M1) → right M1 with three different asynchronies (5 milliseconds shorter, equal to, or 5 milliseconds longer than the 9-millisecond transcallosal conduction delay) in separate sessions. To observe the neurophysiological effects, single-pulse TMS was delivered to the left M1 before and after ccPAS while cortico-cortical evoked responses were extracted from the contralateral M1 using source-resolved electroencephalography.ResultsConsistent with STDP mechanisms, the effects on synaptic strengths flipped depending on the asynchrony. Further implicating STDP, control experiments suggested that the effects were unidirectional and selective to the targeted connection.ConclusionThe results support the idea that ccPAS induces STDP and may selectively up- or downregulate effective connectivity between targeted regions in the human brain.Copyright © 2022 International Neuromodulation Society. Published by Elsevier Inc. All rights reserved.
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