Kompleksna modulacijа sila tokom preciznog hvata šake primenom ponavljane transkranijalne magnetne stimulacije pražnjenjima u teta frekvenciji iznad dorzalnog premotornog korteksa
Sažetak
Uvod/Cilj. Adaptivna kontrola i sinhronizacija sila prstiju šake tokom preciznog hvata pri manipulisanju malim predmetima jednom rukom predstavlja ilustrativni primer visoko frakcionisanih pokreta koji predstavljaju temelj motorne kontrole preciznih pokreta. Pretpostavlja se da ovim procesom upravlјa nekoliko motornih oblasti frontalnog režnja, i to prvenstveno primarni motorni (M-1) i dorzalni premotorni korteks (PMd). Cilj istraživanja bio je ispitivanje uloge PMd-a tokom vršenja pokreta koji zahtevaju finu koordinaciju sila prstiju šake. U istraživanju smo primenili ponavljanu magnetnu stimulaciju pražnjenjima u teta frekvenciji, kako bi ometali neuralno procesiranje u toj oblasti moždane kore. Metode. Primenom jednostrano slepe studije, uz nasumičnu raspodelu i ukršteni dizajn, 10 zdravih ispitanika (29 ± 3,9 godina) bilo je izloženo pojedinačnim sesijama kontinuirane magnetne stimulacije (cTBS600), ili intermitentne ponavljane magnetne stimulacije (iTBS600), pražnjenjima u teta frekvenciji kao i prividnoj stimulaciji iznad PMd regiona dominantne hemisfere, odvojenih međusobno, najkraće nedelju dana. Precizanost hvata šake i podizanja procenjivani su uređajem koji je registrovao silu stiska (G) i silu podizanja (L) prilikom izvođenja tri zadatka (zadatak sa zadatim profilom L, zadatak sa oscilatornim variranjem nivoa L i zadatak sa podizanjem), koji su izvođeni sa obe ruke odvojeno, i to pre i nakon svake intervencije. Rezultati. Nakon primene iTBS protokola zabeleženo je poboljšanje izvođenja iskazano konstantnom greškom (CE) u zadatku sa oscilatornim variranjem nivoa L, kada je izvođen dominantnom rukom (DH), p = 0.009. Suprotno tome, primena cTBS protokola dovela je do smanjenja promenjive greške (VE) za nedominantnu ruku (NH), p = 0.005. Sa aspekta koordinacije sila utvrđeno je da je iTBS protokol doveo do pogoršanja rezultata praćenih pokazatelja za nedominantnu ruku (G/L odnos, p = 0.017; korelacija G i L, p = 0.047; prirast sile p = 0.047). Zaključak. Rezultati našeg istraživanja ukazuju na mogućnost modulacije sila prstiju šake tokom preciznog hvata i podizanja, ukoliko se TBS primeni iznad PMd-a. Dobijeni nalazi podržavaju ulogu PMd u motornoj kontroli i generisanju sila neophodnih za stabilno držanje malih predmeta kod ljudi.
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