{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T23:13:55Z","timestamp":1768000435588,"version":"3.49.0"},"reference-count":40,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2019,12,19]],"date-time":"2019-12-19T00:00:00Z","timestamp":1576713600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004694","name":"Kaohsiung Medical University","doi-asserted-by":"publisher","award":["KMU-M105006, KMU-M106027, KMU-M108012, and KMU-TP104A14"],"award-info":[{"award-number":["KMU-M105006, KMU-M106027, KMU-M108012, and KMU-TP104A14"]}],"id":[{"id":"10.13039\/501100004694","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Stroke rehabilitation using alternate hot and cold thermal stimulation (altTS) has been reported to improve motor function in hemiplegia; however, the influence of brain excitability induced by altTS remains unclear. This study examined cortical activation induced by altTS in healthy adults, focusing on motor-related areas. This involved a repeated crossover experimental design with two temperature settings (innocuous altTS with alternate heat-pain and cold-pain thermal and noxious altTS with alternate heat and cold thermal) testing both arms (left side and right side). Thirty-one healthy, right-handed participants received four episodes of altTS on four separate days. Functional magnetic resonance imaging scans were performed both before and after each intervention to determine whether altTS intervention affects cortical excitability, while participants performed a finger-tapping task during scanning. The findings revealed greater response intensity of cortical excitability in participants who received noxious altTS in the primary motor cortex, supplementary motor cortex, and somatosensory cortex than in those who received innocuous altTS. Moreover, there was more motor-related excitability in the contra-lateral brain when heat was applied to the dominant arm, and more sensory-associated excitability in the contra-lateral brain when heat was applied to the nondominant arm. The findings highlight the effect of heat on cortical excitability and provide insights into the application of altTS in stroke rehabilitation.<\/jats:p>","DOI":"10.3390\/jcm9010018","type":"journal-article","created":{"date-parts":[[2019,12,23]],"date-time":"2019-12-23T03:23:12Z","timestamp":1577071392000},"page":"18","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Influence of Alternate Hot and Cold Thermal Stimulation in Cortical Excitability in Healthy Adults: An fMRI Study"],"prefix":"10.3390","volume":"9","author":[{"given":"Sharon Chia-Ju","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung 80708, Taiwan"},{"name":"Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8681-8505","authenticated-orcid":false,"given":"Jau-Hong","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan"},{"name":"Department of Physical Therapy, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 80708, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jui-Sheng","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiu-Ming","family":"Shih","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jui-Jen","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4944-9920","authenticated-orcid":false,"given":"Miao-Ju","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan"},{"name":"Department of Physical Therapy, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 80708, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,12,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1002\/ddrr.64","article-title":"Plasticity in the Developing Brain: Implications for Rehabilitation","volume":"15","author":"Johnston","year":"2009","journal-title":"Dev. 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