Dokument: Der Effekt der transkraniellen Gleichstromstimulation über dem primären motorischen Kortex auf nachfolgendes implizites motorisches Sequenzlernen

Titel:	Der Effekt der transkraniellen Gleichstromstimulation über dem primären motorischen Kortex auf nachfolgendes implizites motorisches Sequenzlernen
URL für Lesezeichen:	https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=49716
URN (NBN):	urn:nbn:de:hbz:061-20190531-104246-7
Kollektion:	Dissertationen
Sprache:	Deutsch
Dokumententyp:	Wissenschaftliche Abschlussarbeiten » Dissertation
Medientyp:	Text
Autor:	Kuntz, Thomas [Autor]
Dateien:	[Dateien anzeigen] Adobe PDF [Details] 3,96 MB in einer Datei [ZIP-Datei erzeugen] Dateien vom 27.05.2019 / geändert 27.05.2019
Beitragende:	Prof. Dr. med. Pollok, Bettina [Gutachter] Prof. Dr. med. Vesper, Jan [Gutachter]
Stichwörter:	tDCS, M1, motorisches Sequenzlernen
Dewey Dezimal-Klassifikation:	600 Technik, Medizin, angewandte Wissenschaften » 610 Medizin und Gesundheit
Beschreibungen:	Gegenstand der vorliegenden Arbeit ist die Untersuchung des Effekts der transkraniel- len Gleichstromstimulation (engl. transcranial Direct Current Stimulation (tDCS)) über dem primären motorischen Kortex (M1) auf das unmittelbar nachfolgende implizite motorische Sequenzlernen. Der M1, als Teil eines komplexen zentralen Netzwerks, nimmt eine wichtige Rolle in der Akquisitionsphase des impliziten motorischen Se- quenzlernens ein. Die tDCS ermöglicht die non-invasive Modulation der Exzitabilität kortikaler Areale und erlaubt somit eine Abschätzung des kausalen Beitrags des stimu- lierten Areals für die Verhaltenssteuerung. Die anodale tDCS geht mit der Zunahme der Exzitabilität einher, die kathodale tDCS mit deren Abnahme. Motorisches Lernen basiert auf synaptischer Plastizität des M1. Die anodale tDCS kann über die Erhöhung der Exzitabilität der Zielneurone additive neuroplastische Prozesse hervorrufen. Hieraus ergibt sich die Annahme, dass die anodale tDCS über M1 unmit- telbar vor dem Lernen einer Bewegungssequenz das nachfolgende Lernen durch eine Bahnung neuroplastischer Prozesse fazilitieren könnte. Zur Überprüfung dieser Frage wurden 18 gesunde Probanden unmittelbar vor der Akquisition einer impliziten motori- schen Sequenz anodal vs. kathodal vs. schein stimuliert. Aufgrund der Annahme, dass die tDCS neuronale Prozesse in M1 moduliert, welche relevant für das motorische Ler- nen sind, sollte die anodale tDCS das nachfolgende Lernen einer impliziten motorischen Sequenz fazilitieren. Um implizites motorisches Lernen zu induzieren wurde die serielle Reaktionszeitaufgabe (engl. Serial Reaction Time Task (SRTT)) genutzt. Zur Beurtei- lung des Lernerfolgs dienten die mittleren Reaktionszeiten unmittelbar am Ende des Trainings der SRTT im Vergleich zu denen vor Beginn des Trainings. Die Datenanalyse zeigte einen polaritätsspezifischen Effekt der tDCS: Die anodale tDCS ging mit signifi- kant schnelleren Reaktionszeiten zum Ende des Trainings im Vergleich zur kathodalen tDCS einher. Im Vergleich zur Schein-Stimulation zeigte sich ein Trend zu schnelleren Reaktionszeiten. Es zeigte sich kein signifikanter Effekt der tDCS auf die Reaktionszei- ten in einer randomisierten Kontrollbedingung – der Effekt war somit sequenzspezi- fisch. Diese Daten weisen somit auf einen fazilitierenden Effekt der anodalen tDCS auf die Akquisition einer impliziten motorischen Sequenz hin. Die Daten liefern Hinweise darauf, dass die anodale tDCS über M1 und nachfolgendes implizites motorisches Ler- nen synergistisch miteinander interagieren. Auch wenn die vorliegende Arbeit keine Aussagen zu den neurophysiologischen Prozessen des Verhaltenseffektes erlaubt, liefert sie Hinweise darauf, dass die anodale tDCS, die dem motorischen Lernen unmittelbar vorausgeht, neuroplastische Prozesse bahnen könnte, die das nachfolgende motorische Lernen fazilitieren. In the present study we examined the effect of transcranial direct current stimulation (tDCS) over the primary motor cortex (M1) immediately prior to implicit motor se- quence learning. M1 plays an important role for the implicit acquisition of newly learned motor sequences. TDCS is a non-invasive brain stimulation technique that al- lows the modulation of the excitability of cortical areas. Anodal tDCS leads to an en- hanced excitability, while cathodal tDCS yields its reduction. Motor learning is based on synaptic plasticity in M1. Anodal tDCS is able to facilitate such neuroplastic processes in the targeted neurons, due to enhanced excitability. Hence, tDCS applied to M1 potentially modulates subsequent motor learning. In order to test this hypothesis, 18 healthy subjects received anodal vs. cathodal vs. sham tDCS immediately prior to the acquisition of an implicit motor sequence. Based on the as- sumption that anodal tDCS may induce neuroplastic reorganization within M1, anodal tDCS should facilitate the acquisition of a subsequent implicit motor sequence. In order to initiate implicit motor sequence learning, we utilised the Serial Reaction Time Task (SRTT). Reaction times prior to training on the SRTT and at the end of acquisition served as outcome measures. The analysis showed a polarity-specific effect of tDCS: Anodal tDCS facilitated the acquisition of an implicit motor sequence as indicated by faster reaction times as compared to cathodal tDCS. Comparison with reaction times following sham stimulation revealed a trend towards superior learning. No significant effect of tDCS on reaction times in the random control condition was observed indicat- ing that the observed effect was sequence-specific. The present data suggest that preced- ing anodal tDCS and subsequent implicit motor sequence learning may interact syner- gistically. Anodal tDCS likely promoted neuroplastic changes in M1, facilitating subse- quent implicit motor sequence learning. Although the present data do not allow a con- clusion regarding the underlying brain processes due to a lack of neurophysiological recordings, the present findings nicely fit the hypothesis that preceding anodal tDCS over M1 may induce neuroplastic processes in M1 underlying successful motor learn- ing.
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Lizenz:	Urheberrechtsschutz
Fachbereich / Einrichtung:	Medizinische Fakultät
Dokument erstellt am:	31.05.2019
Dateien geändert am:	31.05.2019
Promotionsantrag am:	19.09.2018
Datum der Promotion:	09.05.2019