Investigating neurometabolite changes in response to median nerve stimulation

Abstract

BackgroundRhythmic median nerve stimulation (MNS) at 10Hz has been shown to cause a substantial reduction in tic frequency in individuals with Tourette Syndrome. The mechanism of action is currently unknown, but is hypothesised to involve entrainment of oscillations within the sensorimotor cortex. ObjectiveWe used functional magnetic resonance spectroscopy (fMRS) to explore the dynamic effects of MNS on neurometabolite concentrations. MethodsHere, we investigated the effects of rhythmic and arrhythmic 10Hz MNS on glutamate (Glu) and GABA concentrations in the contralateral sensorimotor cortex in 15 healthy controls, using a blocked fMRS design. We used a Mescher-Garwood-semi-localised by adiabatic selective refocusing (MEGA-sLASER) sequence at 7T. ResultsOur results show no difference in the difference-from-baseline measures between the two stimulation conditions. Looking at the effect of MNS over both conditions there is a trend for an initial increase in Glu/tCr (total creatine) followed by a decrease over time, whereas GABA/tCr decreased during each stimulation block. ConclusionThese results suggest that despite entrainment of oscillations during rhythmic MNS, there are no significant differences in the tonic neuromodulatory effects of rhythmic and arrhythmic stimulation. The reduction in glutamate over the course of stimulation may reflect a decrease in glutamatergic firing due to adaptation. This may make it less likely that an involuntary movement is generated during continuous stimulation.