TMS Advances

Using TMS to Study Fine Motor Skills

September 6, 2019

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Buttoning your shirt in the morning, using a fork to eat your lunch in the afternoon, opening your front door with a key when you get home—these are all things that you do everyday without thinking, but they’re also examples of fine motor skills that it takes years for your brain to master. 

The scientific community is constantly trying to learn more about the brain and how it works. This is a difficult task, as the brain is extremely complex and a lot about it is still unknown. Transcranial magnetic stimulation (TMS) is one of the tools that researchers frequently employ to study the brain and its capabilities. 

In order to better understand the motor system, a research team used TMS to map the brain as participants learned a new fine motor skill—playing the piano. 

Keep reading to find out more about:

  • The motor system
  • TMS: What it is, and what it can be used for
  • The study involving TMS and learning to play the piano 

The Motor System

The motor system is the section of the central nervous system that is responsible for movement. Different parts of the brain are used for different types of motion and thus require different types of learned skills to perform these motions. Motor skills are categorized as either gross or fine.

Diagram of the motor system and the parts of the brain involved in movement
The motor cortex, the somatosensory cortex, and the cerebellum are all major portions in the brain that are involved in movement. Image courtesy of MedWest

Gross Motor Skills

Gross motor skills utilize larger muscles, specifically those found in the arms and legs. Mastering these skills involves balance and stability, and examples of them include walking, running, jumping, throwing, and catching. As children develop, they learn gross motor skills first. 

Milestones for gross motor skills include:

  • Age 2 years: Walking smoothly; running; turning corners
  • Ages 3 – 4 years: Jumping with two feet
  • Ages 6 – 7: Riding a bike without training wheels

Fine Motor Skills 

Fine motor skills are dependent on smaller muscles and often involve coordinating different muscle groups to produce a singular action. Examples of fine motor skills include using scissors, writing, typing on a keyboard, and playing a musical instrument. Fine motor skills are more challenging to learn, and children will develop them gradually as they age. 

Milestones for fine motor skills include:

  • Ages 6 – 9 months: Grasping objects in hands; squeezing
  • Ages 5 – 6 years: Copying shapes and letters; using a fork and spoon with control
  • Ages 9 – 10 years: Drawing and using tools like rulers 

An Overview of TMS

What is it?

TMS uses magnetic pulses to stimulate a specifically targeted area of the brain. These pulses work in conjunction with the brain’s pre-existing electrical currents and can produce a variety of effects, depending on where they are channeled. 

Technician administers TMS using Neurostar TMS Machine
An electromagnetic coil is used to ensure precision when using TMS. Image courtesy of MedGadget

What are its applications?

In addition to being useful to scientific research, TMS can be utilized as a therapeutic treatment for psychiatric conditions. Currently, it is most commonly used to treat major depressive disorder. 

Because TMS is non-invasive, patients do not have to be sedated. Furthermore, TMS does not affect cognition, so after receiving a treatment, patients can return to their usual daily routine. 

In order to be effective as a treatment, TMS must be administered on a daily basis—usually five days a week—for around six weeks. Unlike antidepressants that are notorious for a long list of side effects, TMS has only one real side effect: headache or slight irritation around the treatment site. Though patients commonly report experiencing these symptoms during or after a session, any discomfort usually subsides within a couple of hours.

The lack of side effects that accompany TMS makes it ideal for patients who have struggled with negative side effects from antidepressants before. This also renders TMS an effective research tool because it can be used safely on participants in a study.  

TMS was approved by the FDA to treat depression in 2008 and was recently approved to treat obsessive compulsive disorder in 2018. However, researchers are optimistic that it can benefit a variety of conditions, including Parkinson’s disease, post-traumatic stress disorder, Asperger syndrome, and many more. 

The Study: Muscle Response and the Acquisition of Fine Motor Skills 

Researchers from the National Institute of Neurological Disorders and Stroke used TMS to investigate how the motor system changes when a person learns new fine motor skills, as well as the effectiveness of mental practice of the skill versus physical practice. 

In order to do this, participants were taught a one-handed, five-finger exercise on a piano. The researchers used TMS to map relevant parts of the participants’ brains as they learned the exercise and as they continued to practice it. 

Participants were randomly assigned to one of three groups: physical practice, mental practice, and control. The physical practice group manually rehearsed the piano exercise for two hours each day, while the mental practice group merely visualized themselves performing the exercise for two hours each day. The control group did not practice. 

Fine motor skills enhanced by physical practice versus mental practice
This figure represents the progression of participants’ cortical motor output maps throughout the study (from left to right: day 1 to day 5). Image courtesy of ResearchGate

The researchers found that “mental practice alone seems to be sufficient to promote the modulation of neural circuits involved in the early stages of motor skill learning” and that mental practice combined with physical practice is more effective than physical practice alone. 

This information is relevant for both learning a new motor skill and for maintaining an already learned skill, which is significant for fields such as rehabilitation and pediatric development. 

More About TMS 

Since its conception in the 1980s, TMS has been making substantial contributions to science, especially the science of the brain and the nervous system. 

As TMS continues to grow in popularity as a psychiatric treatment, it is becoming increasingly available at outpatient facilities and is covered by most insurances for treatment-resistant depression. 

If you have major depression disorder that has not responded to treatment with antidepressants and psychotherapy, TMS might be right for you—ask your doctor about it today.

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