The Supplementary Motor Area as a Flexible Hub Mediating Behavioral and Neuroplastic Changes in Motor Sequence Learning: A TMS and TMS-EEG Study
Jing Chen1,2,3 · Yanzi Fan1,2,3 · Xize Jia1 · Fengmei Fan4 · Jinhui Wang5 · Qihong Zou6 · Bing Chen7 · Xianwei Che1,2,3 · Yating Lv1,2,31 Center for Cognition and Brain Disorders, The Afliated Hospital of Hangzhou Normal University, Hangzhou 311121, China
2 Institute of Psychological Science, Hangzhou Normal University, Hangzhou 311121, China
3 Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou 311121, China
4 Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing 100096, China
5 Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou 510631, China
6 Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
7 Jinghengyi Education College, Hangzhou Normal University, Hangzhou 311121, China
Abstract
Attempts have been made to modulate motor sequence learning (MSL) through repetitive transcranial magnetic stimulation, targeting different sites within the sensorimotor network. However, the target with the optimum modulatory effect on neural plasticity associated with MSL remains unclarified. This study was therefore designed to compare the role of the left primary motor cortex and the left supplementary motor area proper (SMAp) in modulating MSL across different complexity levels and for both hands, as well as the associated neuroplasticity by applying intermittent theta burst stimulation together with the electroencephalogram and concurrent transcranial magnetic stimulation. Our data demonstrated the role of SMAp stimulation in modulating neural communication to support MSL, which is achieved by facilitating regional activation and orchestrating neural coupling across distributed brain regions, particularly in interhemispheric connections. These findings may have important clinical implications, particularly for motor rehabilitation in populations such as post-stroke patients.
Keywords
Motor sequence learning; Intermittent theta burst stimulation; Concurrent transcranial magnetic stimulation and electroencephalogram; Neuroplasticity; Functional connectivity
