Effect of Transcutaneous Nerve Stimulation on Primary Motor Cortex to Modulate Cortical Excitability and Hemodynamic Response During Implicit Motor Learning: A TMS and NIRS Study

Study Overview
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Brief Summary
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Noninvasive brain stimulation was recently gradually be emphasized. The electrical current applied on scalp can effective modulate cortical excitability. Forms of Stimulation included transcranial direct current stimulation(tDCS) and transcranial alternating stimulation(tACS). tDCS had been proved the effect of cortical excitability modulation. The polarization effect of direct current stimulation can modulation specific brain area and enhance motor performance. tACS was still controversial about the effect on cortical excitability. Previous study show that the frequency dependent excitatory or inhibitory effect on cortex. The possible mechanism was to affect brain oscillation status by provided different frequency of stimulation. Transcutaneous nerve stimulation (TENS) was common used on management of chronic pain. Peripheral nerve stimulation can enhance pain or sensory evoked potential was noted. Effect of low frequency TENS on central nervous is unknown.

Conditions
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Transcutaneous Nerve Stimulation

Intervention / Treatment
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* Device: Enraf-Nonius Muscle stimulator


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Health Adult

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: E1<br>Experiment 1 will measure the cortical excitability change after TENS intervention. | Device: Enraf-Nonius Muscle stimulator<br>* The order 15Hz TENS stimulation session and sham stimulation session will also be randomized.<br>* Other names: Transcutaneous nerve stimulation;|
| Experimental: E2<br>Experiment 2 will measures implicit sequential motor task performance and cortical hemodynamic response using near infrared spectroscopy (NIRS) during motor execution. Cortical excitability will also be measured contemporary | Device: Enraf-Nonius Muscle stimulator<br>* The order 15Hz TENS stimulation session and sham stimulation session will also be randomized.<br>* Other names: Transcutaneous nerve stimulation;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Motor evoked potential | Use single-pulse TMS to assess Motor evoked potential change. | Baseline,0 minute,30 minutes,60 minutes. | 
| Intracortical inhibition & Intracortical facilitation | Use paired-pulse TMS to record pre-test and post-test change. | Baseline,0 minute,30 minutes,60 minutes. | 
| Blood oxygen dependent level | Use Near-infrared spectroscopy to record pre-test, in experiment, and post-test change | Baseline,in experiment,0 minute,30 minutes,60 minutes. | 
| Implicit sequential motor task performance | Change of Measure of Learning curve. | Baseline,in experiment,0 minute,30 minutes,60 minutes. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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functional near infrared spectroscopy, transcranial magnetic stimulation, Transcutaneous Nerve Stimulation, serial reaction time task