Similarly, another important TMS/PET study (Chouinard et al., 2006) explored the effects of physical therapy on brain connectivity, as measured via TMS-induced blood flow changes in the resting state. The authors applied rTMS trains to both ipsilesional and contralesional M1, before and after three weeks of constraint-induced movement therapy. Improvements in motor performance were negatively correlated with local cerebral blood flow changes when rTMS was delivered to both ipsilesional and contralesional M1. There were also changes in the cerebral blood flow response to rTMS in the cingulate motor area, basal ganglia and thalamus that correlated with motor performance. Thus, the authors utilized the combination of brain stimulation and PET to demonstrate that the motor performance changes produced by physical therapy are associated with changes in cortical effective connectivity.
