The Ipsilateral Silent Period as a Measure of Transcallosal Inhibition: An Investigation of Individual and Methodological Factors Influencing Interhemispheric Inhibition between Motor Cortices
Creators: name: Davidson, Travis
Publisher: name: Université d'Ottawa / University of Ottawa
Year: 2016
Subjects: Transcallosal inhibition
Transcranial magnetic stimulation
Concussion
Handedness
Aging
Ipsilateral silent period

description: The corpus callosum provides a physical and functional connection between the two hemispheres of the brain allowing interactions between homologous cognitive, sensory and motor areas. In humans, the integrity of transcallosal connections between motor cortices can be evaluated quickly and non-invasively using transcranial magnetic stimulation (TMS) via the ipsilateral silent period (iSP). While the technique has been known for 20 years, many issues remain unsolved regarding which methods are best to elicit the iSP as an index of transcallosal inhibition. In addition, there is still limited information regarding the influence of individualized factors such as age on iSP measurements. This thesis investigates how common physiological and methodological factors influence the iSP in order to establish this method as a reliable index to assess the integrity of the transcallosal pathway linking primary motor cortices. In the first series of experiments, we used a previously described TMS protocol to elicit iSPs [1] to investigate changes in motor transcallosal inhibition in relation to individual factors linked to age, hand preference and history of concussions. A second series of methodological experiments examined the effects of stimulation intensity on the iSP and to determine its inter-session reliability. Our first series of experiments provided evidence that advancing age and history of concussions in young athletes were each independently associated with alterations in transcallosal inhibition. This was evidenced by changes in the duration of transcallosal inhibition (DTI) and in the latency of transcallosal inhibition (LTI) derived from iSP measurements. These experiments also revealed that the degree of hand preference in young adults was reflected in measures of transcallosal inhibition, so that mixed-handed individuals (i.e., ambidextrous) exhibited evidence of more efficient transcallosal transmission than either strong right or left handed individuals. The second series of experiments focusing on methodological aspects showed that the iSP duration (though not its onset) was influenced by stimulation intensity, increasing linearly with intensity up to 140% of the resting motor threshold (RMT). Our analysis further revealed that the probability of eliciting detectable iSP also increased with increasing intensity up to 130% RMT before reaching a plateau. A stimulation intensity of 130% of RMT appears to be optimal to elicit iSPs in healthy participants. In a subsequent study, we showed that iSP elicited at this stimulation intensity (i.e., 130% RMT) had good inter-session reliability. In light of these investigations, we recommend for future studies that, in addition to contraction of the homologous muscles of the opposite hand as proposed by Giovannelli et al 2009, that an intensity of 130% RMT should be used to elicit the iSP when assessing transcallosal inhibition between motor cortices.