The purpose of this study is to understand how the sensory and motor areas of the brain work together to keep a person's hand movements accurate (sensorimotor learning). The investigators hope this information may be useful one day to improve rehabilitation techniques in patients with brain lesions.
To make accurate movements, the brain needs to compensate for the frequent changes in the environment one experiences (lighting conditions, slippery floors, etc). For example, when one reaches to grab an object underwater, there are significant challenges the brain must overcome. Water is more viscous than air, so motor planning must take the increased resistance into account. In addition, light is bent by water, so one sees the underwater hand in a different location from where one feels it with body position sense (proprioception, from sensors in the joints and muscles). While initially movement errors occur in a situation like this, a healthy person quickly learns to compensate. This compensation can take different forms. The brain can shift the proprioceptive estimate closer to the visual estimate of hand position or vice versa (sensory realignment), or the brain can compensate for any movement errors by altering the motor commands to the arm (motor adaptation). Failure to compensate for such changes results in inaccurate movement, raising the potential for accidents and injuries, but how the healthy brain carries out these functions, and how they could be strengthened in populations with sensory and motor deficits (e.g. stroke), is unknown. With greater understanding of these processes in the healthy brain, it may one day be possible to develop rehabilitation strategies that target a patient's unique mix of sensory and motor deficits. A robust way to identify whether a brain region plays a role in a behavior is to temporarily modulate its excitability in healthy people using non-invasive brain stimulation. This is commonly done in research with a short sequence of low-intensity transcranial magnetic stimulation (TMS), also known as repetitive TMS (rTMS). rTMS is used clinically to treat conditions such as depression and is considered very low risk provided the generally-accepted screening criteria are met. In the research setting, this technique is widely used not only in healthy adults (as in this study) but also in children and people with concussion, stroke, Parkinson's disease, and more. In separate groups of subjects, the investigators will use a 40-second sequence of rTMS called continuous theta burst stimulation (cTBS) over one of several brain regions of interest before the subject performs a reaching task known to involve sensory realignment (learning). If performance of the task is affected by cTBS for a given group (relative to the sham, or control, group), it means that brain region plays some role in that type of reaching task.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
DOUBLE
Enrollment
300
Real or sham continuous theta burst TMS (cTBS) will be delivered to a location on the head, determined by randomized group assignment. cTBS consists of 600 low-intensity TMS pulses delivered over 40 seconds in a pattern of 50 Hz triplets delivered at 5 Hz.
Indiana University Bloomington
Bloomington, Indiana, United States
RECRUITINGRealignment
Measured by comparing where the subject points on a touchscreen when indicating perceived position of visual and proprioceptive targets early vs. late in the behavioral task.
Time frame: 1 day
Visuo-proprioceptive weighting
The degree to which participant relies on vision vs. proprioception when both are available. Measured by comparing where the subject points on a touchscreen when indicating perceived position of visual vs. proprioceptive targets.
Time frame: 1 day
Target hand reaching
Location participant points at with no performance feedback.
Time frame: 1 day.
Target estimation variance
Variance with which participant estimate visual and proprioceptive target positions. Computed from where subjects point at targets on a touchscreen.
Time frame: 1 day
Motor cortex excitability (arms 1-3)
mean motor evoked potential amplitude at SI1mV (stimulus intensity that elicits 1 mV response). Measured pre- and post-cTBS in Arms 1-3 only.
Time frame: 1 day
Tactile sensitivity (arms 1-3)
Two-point discrimination threshold on the target index fingertip. Measured pre- and post-cTBS in Arms 1-3 only.
Time frame: 1 day
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