Cerebral Cortex Plasticity After 90 Days of Bed Rest: Data from TMS and fMRI

INTRODUCTION: Microgravity animal models have demonstrated corticospinal plasticity; however, little is understood of its functional significance. In this pilot study, we explored corticospinal plasticity in a bed rest model. We hypothesized that the lack of weight bearing would induce cortical reorganization correlating with performance. METHODS: Four subjects underwent functional MRI (fMRI), transcranial magnetic stimulation (TMS), and functional mobility testing (FMT) before and after 90 d of bed rest. Recruitment curves (RC) were created by measuring motor evoked potentials over a range of TMS intensities with changes in the slope of the RC reflecting changes in corticospinal excitability. RESULTS: Significant leg RC slope decreases were observed on post-bed rest day 1 (P1) (t(2805) = -4.14, P < 0.0001), P2 (t(2805) = -6.59, P < 0.0001), P3 (t(2805) = -6.15, P < 0.0001), P5 (t(2805) = -7.93, P <0.0001), P8 (t(2805) = -3.30, P = 0.001), and P12 (t(2805)= -3.33, P = 0.0009), suggesting a group decrease in corticospinal excitability in the immediate post-bed rest period with recovery approaching baseline over the following 2 wk. Significant effects were observed for hand RC slopes only for P2 (t(2916) = 1.97, P = 0.049), P3 (t(2916) = -2.12, P = 0.034), and P12 (t(2916) = -2.19, P = 0.029); no significant effects were observed for days P0 (t(2916) = -1.32, ns), P1 (t(2916) = 1.00, ns), P5 (t(2916) = -0.21, ns), or P8 (t(2916) = -0.27, ns). fMRI showed no change in activation for the hand but an increase in activation post-bed rest for the leg. On an individual basis, a more heterogeneous response was found which showed a potential association with performance on FMT. DISCUSSION: Results of this research include a better understanding of the cortical plasticity associated with leg disuse and may lead to applications in patient and astronaut rehabilitation.