Theta-gamma transcranial alternating current stimulation enhances motor skill acquisition in healthy young and older adults

Theta-gamma transcranial alternating current stimulation (TG tACS) over primary motor cortex (M1) can improve motor skill acquisition in young adults, but the effect on older adults is unknown. This study investigated the effects of TG tACS on motor skill acquisition and M1 excitability in 18 young and 18 older adults. High-definition TG tACS (6 Hz theta, 75 Hz gamma) or sham tACS was applied over right M1 for 20 minutes during a ballistic left-thumb abduction motor training task performed in two experimental sessions. Motor skill acquisition was quantified as changes in movement acceleration during and up to 60 minutes after training. Transcranial magnetic stimulation (TMS) was used to assess changes in M1 excitability with motor-evoked potentials (MEP) and short-interval intracortical inhibition (SICI) before and after training. We found that TG tACS increased motor skill acquisition compared with sham tACS in young and older adults (P < 0.001), with greater effects for young adults (P = 0.01). The improved motor performance with TG tACS lasted at least 60 minutes after training in both age groups. Motor training was accompanied by greater MEP amplitudes with TG tACS compared to sham tACS in young and older adults (P < 0.001), but SICI did not vary between tACS sessions (P = 0.40). These findings indicate that TG tACS over M1 improves motor skill acquisition and alters training-induced changes in M1 excitability in healthy young and older adults. TG tACS may therefore be beneficial to alleviate motor deficits in the ageing population. Key Points SummaryO_LITheta-gamma transcranial alternating current stimulation (TG tACS) can improve motor function in healthy young adults, but the effect on older adults is unknown. C_LIO_LIWe found that TG tACS improved motor skill acquisition with long-lasting effects in healthy young and older adults, but effects were stronger in young adults. C_LIO_LITranscranial magnetic stimulation showed that TG tACS altered the training-induced changes in motor cortex excitability, but there was no effect of TG tACS on intracortical inhibition in young or older adults. C_LIO_LIOur data suggest that TG tACS represents a promising approach to improve motor skill acquisition throughout the lifespan, and may be beneficial in older patient populations that experience motor or cognitive deficits. C_LI