Interaction of motor training and intermittent theta burst stimulation in modulating motor cortical plasticity: influence of BDNF Val66Met polymorphism

PLoS One. 2013;8(2):e57690. doi: 10.1371/journal.pone.0057690. Epub 2013 Feb 25.

Abstract

Cortical physiology in human motor cortex is influenced by behavioral motor training (MT) as well as repetitive transcranial magnetic stimulation protocol such as intermittent theta burst stimulation (iTBS). This study aimed to test whether MT and iTBS can interact with each other to produce additive changes in motor cortical physiology. We hypothesized that potential interaction between MT and iTBS would be dependent on BDNF Val66Met polymorphism, which is known to affect neuroplasticity in the human motor cortex. Eighty two healthy volunteers were genotyped for BDNF polymorphism. Thirty subjects were assigned for MT alone, 23 for iTBS alone, and 29 for MT + iTBS paradigms. TMS indices for cortical excitability and motor map areas were measured prior to and after each paradigm. MT alone significantly increased the motor cortical excitability and expanded the motor map areas. The iTBS alone paradigm also enhanced excitability and increased the motor map areas to a slightly greater extent than MT alone. A combination of MT and iTBS resulted in the largest increases in the cortical excitability, and the representational motor map expansion of MT + iTBS was significantly greater than MT or iTBS alone only in Val/Val genotype. As a result, the additive interaction between MT and iTBS was highly dependent on BDNF Val66Met polymorphism. Our results may have clinical relevance in designing rehabilitative strategies that combine therapeutic cortical stimulation and physical exercise for patients with motor disabilities.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brain-Derived Neurotrophic Factor / genetics*
  • DNA / blood
  • DNA / genetics
  • Female
  • Humans
  • Male
  • Motor Cortex / physiology*
  • Neuronal Plasticity / genetics*
  • Polymorphism, Single Nucleotide
  • Transcranial Magnetic Stimulation / methods*
  • Young Adult

Substances

  • Brain-Derived Neurotrophic Factor
  • BDNF protein, human
  • DNA

Grants and funding

This work was supported by the Chronic Inflammatory Disease Research Center through the National Research Foundation of Korea (http://www.nrf.re.kr/html/en/) funded by the Ministry of Education, Science and Technology 2012051429) to BGK, and by the Ewha Global Top 5 Grant 2011 of Ewha Womans University and by the Korean Science and Engineering Foundation Grant (http://www.kosef.re.kr/) funded by the South Korean government (MOST) (R01-2007-000-11080-0), and by the Basic Science Research Program through the National Research Foundation of Korea (http://www.nrf.re.kr/html/en/) funded by the Ministry of Education, Science and Technology (R01-2001-0015788, KRF-2009-006-5721 and 2009-007-2164) to HWL. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.