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Updated: Jul 31, 2025
Bilateral Assessment of the Corticospinal Pathways of the Ankle Muscles Using Navigated Transcranial Magnetic Stimulation
Published on: February 19, 2019
Understanding the Interaction of Transcranial Direct Current Stimulation and Visual Feedback During an Ankle Movement
Mark Cummings1,2, Aditi Doshi1,3, Sangeetha Madhavan1
1Brain Plasticity Laboratory, Department of Physical Therapy, College of Applied Health Sciences, University of Illinois, Chicago, IL,USA.
Background:
Transcranial direct current stimulation (tDCS) has been demonstrated to facilitate motor performance in healthy individuals; however, results are variable. The neuromodulatory effects of tDCS during visuomotor tasks may be influenced by extrinsic visual feedback. However, this interaction between tDCS and visual feedback has not been explored for the lower limb. Hence, our objective was to explore if tDCS over the primary lower limb motor cortex differentially facilitates motor performance based on the availability of visual feedback.
Methods:
Twenty-two neurotypical adults performed ankle plantarflexion and dorsiflexion movements while tracking a sinusoidal target. Spatiotemporal, spatial, and temporal error were calculated between the ankle position and target. Participants attended two sessions, a week apart, with (Stim) and without (No-Stim) anodal tDCS. Sessions were divided into two blocks containing randomized visual feedback conditions: full, no, and blindfold. During Stim sessions, the first block included the application of tDCS to the lower limb M1.
Results:
Spatiotemporal and spatial error increased as feedback faded (p < .001). A two-way repeated-measures analysis of variance showed a significant interaction between tDCS and visual feedback (p < .05) on spatiotemporal error. Post hoc analyses revealed a significant improvement in spatiotemporal error when visual feedback was absent (p < .01). Spatial and temporal errors were not significantly affected by stimulation or visual feedback.
Discussion:
Our results suggest that tDCS enhances spatiotemporal ankle motor performance only when visual feedback is not available. These findings indicate that visual feedback may play an important role in demonstrating the effectiveness of tDCS.
