Neuronal plasticity in developing brain: non-invasive brain stimulation modalities

Administrator: Hasan Tekgul, Turkey

Dr Esra Serdaroglu
Gazi University, Faculty of Medicine, Ankara, Turkey.
esra.serdaroglu@gmail.com
Neuronal Plasticity in Developing Brain
Neuronal plasticity is a phenomenon that aids brain recovery after the damage produced by events like hypoxic-ischemic or traumatic injury, and stroke. This introductory lecture will focus on neuronal plasticity types in the developing brain.Neuronal plasticity is achieved via the changes in the structure and/or reorganization of the neuronal connections. Neuronal plasticity is enhanced in the developing brain and is usually adaptive and beneficial, but it can also be maladaptive for neurological disorders. Excessive plasticity can be defined as a reorganization of new, maladaptive neuronal circuits that cause neurologic disorders such as epilepsy and cerebral palsy. However, impaired plasticity refers to situations in which genetic or acquired disorders disrupt molecular plasticity pathways that cause cognitive impairment in neurodegenerative disorders. Promising therapies like deep brain stimulation, non-invasive brain stimulation, neuropharmacology, exercise, cognitive training, or feedback using real-time functional magnetic resonance, are all based on our current understanding of brain plasticity.
Learning objectives;
- A better understanding of the mechanisms governing neuroplasticity after brain damage
- Increasing our understanding of how learning and memory processes are modified during development.

Prof Hasan Tekgul
Ege Children’s Hospital, Developing Brain Center, Ege University, Izmir, Turkey.
hasan.tekgul@ege.edu.tr
Neuronal Plasticity in Hypoxic-ischemic Encephalopathy: The Value of Trancranial Magnetic Stimulation
This lecture focuses on neuronal plasticity types in the developing brain and provide the use of transcranial magnetic stimulation (TMS) for the definition of neuronal plasticity and non-invasive brain stimulation in the rehabilitation of children with cerebral palsy.TMS is a non-invasive and painless technique that has provided new and fascinating avenues for the evaluation of neuronal plasticity. It may prove a useful tool for investigating the corticospinal pathway plasticity, healthy development, developmental disabilities, and neurodegenerative diseases in children. The neuronal plastic changes and capacity can also be detected with TMS. Recent TMS studies have demonstrated substantial plastic reorganization of the motor cortex and corticospinal projections following pre-or perinatal brain injury. The use of TMS in children with neurological disorders may lead to appropriate interventional treatment strategies. New MRI modalities ( functional MRI, Diffusion- Tensor Imaging, MR Spectroscopy, and Ultra Tesla MRI) have been extensively used to investigate the extent of brain injury affecting the corticospinal pathway.
Learning objectives:
- the application of new MRI modalities for neuronal plasticity in babies with HIE
- the values of TMS parameters (MEP latency/amplitude, CMCT, and the latency jump ) in children with cerebral palsy

Prof Adam Kirton
Professor of Pediatrics and Clinical Neurosciences, Dr. Robert Haslam Chair in Pediatric Neurology, Director of the Calgary Pediatric Stroke Program and Non-invasive Neurostimulation Network (N3), University of Calgary, Calgary, Canada.
Adam.Kirton@albertahealthservices.ca
Neuronal Plasticity in Perinatal Stroke
The talk will review neuronal plasticity in perinatal stroke. As a focal, unilateral, early brain injury, perinatal stroke is an ideal model of human developmental neuroplasticity. Mapping neurophysiology with robotic, neuronavigated transcranial magnetic stimulation (TMS) integrated with advanced imaging can create personalized models of brain development and targets for neuromodulation. Emerging clinical trial evidence supports the ability of modulatory stimulation (tDCS, rTMS) to alter motor learning with possible therapeutic benefits in children with hemiparesis after perinatal stroke.
Learning objectives:
-Understand mechanisms and outcomes of focal cerebrovascular perinatal brain
injury.
-Appreciate how transcranial magnetic stimulation can map the physiology of the developmental plasticity that occurs after perinatal stroke and how this relates to outcome.
-Describe how different modalities of non-invasive neurostimulation are being trialled to improve outcome in disabled children. and the developmental plasticity.

Prof Soumya Ghosh
Consultant Neurologist, Sir Charles Gairdner Hospital, Perth Childrens Hospital, and Perron Institute for Neurological and Translational Science, Clinical Professor, Centre for Neuromuscular and Neurological Disorders, University of Western Australia.
Soumya.Ghosh@health.wa.gov.au
Transcranial magnetic stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS) in Childhood Epilepsy
The talk will review the use of non-invasive brain stimulation (NIBS) in investigating cortical excitability and plasticity in children with epilepsy, and its role in understanding, prognostication and treatment of epilepsy.
Epilepsy is associated with hyperexcitable neurons and hypersynchrony of neural circuits. TMS and tDCS are common NIBS techniques used in research studies and clinical trials to investigate and modulate cortical excitability in epilepsy. These techniques can also be used to explore seizure susceptibility and effects of treatment. Cortical excitability changes are usually investigated in the motor cortex of patients with generalized and focal epilepsy (including focal epilepsy involving non-motor cortical areas). In comparison with adults, there are fewer TMS studies in children with epilepsy.
The capacity of non-invasive brain stimulation to induce lasting changes in brain excitability may be applied to modulate epilepsy networks. The use of Repetitive TMS (rTMS) and tDCS in epilepsy treatment trials are promising. Thus, NIBS has the potential to be used in the evaluation of children with epilepsy, and help with diagnosis, monitoring and treatment.
Learning objectives:
- Understand excitability changes in cortical neurons and networks in epilepsy
- Review the use of NIBS in exploring excitability changes in focal and generalized epilepsy
- Update on clinical trials using NIBS for treatment of epilepsy