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Hawco C, Steeves JKE, Voineskos AN, Blumberger DM, Daskalakis ZJ. Within-subject reliability of concurrent TMS-fMRI during a single session. Psychophysiology 2023:e14252. [PMID: 36694109 DOI: 10.1111/psyp.14252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/03/2022] [Accepted: 12/06/2022] [Indexed: 01/26/2023]
Abstract
Concurrent transcranial magnetic stimulation with functional MRI (concurrent TMS-fMRI) allows real-time causative probing of brain connectivity. However, technical challenges, safety, and tolerability may limit the number of trials employed during a concurrent TMS-fMRI experiment. We leveraged an existing data set with 100 trials of active TMS compared to a sub-threshold control condition to assess the reliability of the evoked BOLD response during concurrent TMS-fMRI. This data will permit an analysis of the minimum number of trials that should be employed in a concurrent TMS-fMRI protocol in order to achieve reliable spatial changes in activity. Single-subject maps of brain activity were created by splitting the trials within the same experimental session into groups of 50, 40, 30, 25, 20, 15, or 10 trials, correlations (R) between t-maps derived from paired subsets of trials within the same individual were calculated as reliability. R was moderate-high for 50 trials (mean R = .695) and decreased as the number of trials decreased. Consistent with previous findings of high individual variability in the spatial patterns of evoked neuronal changes following a TMS pulse, the spatial pattern of Rs differed across participants, but regional R was correlated with the magnitude of TMS-evoked activity. These results demonstrate concurrent TMS-fMRI produces a reliable pattern of activity at the individual level at higher trial numbers, particularly within localized regions. The spatial pattern of reliability is individually idiosyncratic and related to the individual pattern of evoked changes.
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Affiliation(s)
- Colin Hawco
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer K E Steeves
- Centre for Vision Research and Department of Psychology, York University, Toronto, Ontario, Canada
| | - Aristotle N Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Daniel M Blumberger
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Temerty Centre for Therapeutic Brain Intervention, Toronto, Ontario, Canada
| | - Zafiris J Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Toronto, Ontario, Canada.,Department of Psychiatry, University of California, San Diego, California, USA
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Mizutani-Tiebel Y, Tik M, Chang KY, Padberg F, Soldini A, Wilkinson Z, Voon CC, Bulubas L, Windischberger C, Keeser D. Concurrent TMS-fMRI: Technical Challenges, Developments, and Overview of Previous Studies. Front Psychiatry 2022; 13:825205. [PMID: 35530029 PMCID: PMC9069063 DOI: 10.3389/fpsyt.2022.825205] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/09/2022] [Indexed: 11/13/2022] Open
Abstract
Transcranial magnetic stimulation (TMS) is a promising treatment modality for psychiatric and neurological disorders. Repetitive TMS (rTMS) is widely used for the treatment of psychiatric and neurological diseases, such as depression, motor stroke, and neuropathic pain. However, the underlying mechanisms of rTMS-mediated neuronal modulation are not fully understood. In this respect, concurrent or simultaneous TMS-fMRI, in which TMS is applied during functional magnetic resonance imaging (fMRI), is a viable tool to gain insights, as it enables an investigation of the immediate effects of TMS. Concurrent application of TMS during neuroimaging usually causes severe artifacts due to magnetic field inhomogeneities induced by TMS. However, by carefully interleaving the TMS pulses with MR signal acquisition in the way that these are far enough apart, we can avoid any image distortions. While the very first feasibility studies date back to the 1990s, recent developments in coil hardware and acquisition techniques have boosted the number of TMS-fMRI applications. As such, a concurrent application requires expertise in both TMS and MRI mechanisms and sequencing, and the hurdle of initial technical set up and maintenance remains high. This review gives a comprehensive overview of concurrent TMS-fMRI techniques by collecting (1) basic information, (2) technical challenges and developments, (3) an overview of findings reported so far using concurrent TMS-fMRI, and (4) current limitations and our suggestions for improvement. By sharing this review, we hope to attract the interest of researchers from various backgrounds and create an educational knowledge base.
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Affiliation(s)
- Yuki Mizutani-Tiebel
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany.,Neuroimaging Core Unit Munich - NICUM, University Hospital LMU, Munich, Germany
| | - Martin Tik
- High Field MR Center, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Kai-Yen Chang
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany.,Neuroimaging Core Unit Munich - NICUM, University Hospital LMU, Munich, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany.,Neuroimaging Core Unit Munich - NICUM, University Hospital LMU, Munich, Germany
| | - Aldo Soldini
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany.,Neuroimaging Core Unit Munich - NICUM, University Hospital LMU, Munich, Germany.,International Max Planck Research School for Translational Psychiatry, Munich, Germany
| | - Zane Wilkinson
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany.,Neuroimaging Core Unit Munich - NICUM, University Hospital LMU, Munich, Germany
| | - Cui Ci Voon
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany.,Neuroimaging Core Unit Munich - NICUM, University Hospital LMU, Munich, Germany
| | - Lucia Bulubas
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany.,Neuroimaging Core Unit Munich - NICUM, University Hospital LMU, Munich, Germany.,International Max Planck Research School for Translational Psychiatry, Munich, Germany
| | - Christian Windischberger
- High Field MR Center, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany.,Neuroimaging Core Unit Munich - NICUM, University Hospital LMU, Munich, Germany.,Department of Radiology, University Hospital LMU, Munich, Germany
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Beynel L, Dannhauer M, Palmer H, Hilbig SA, Crowell CA, Wang JE, Michael AM, Wood EA, Luber B, Lisanby SH, Peterchev AV, Cabeza R, Davis SW, Appelbaum LG. Network-based rTMS to modulate working memory: The difficult choice of effective parameters for online interventions. Brain Behav 2021; 11:e2361. [PMID: 34651464 PMCID: PMC8613413 DOI: 10.1002/brb3.2361] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 08/06/2021] [Accepted: 09/06/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Online repetitive transcranialmagnetic stimulation (rTMS) has been shown to modulate working memory (WM) performance in a site-specific manner, with behavioral improvements due to stimulation of the dorsolateral prefrontal cortex (DLPFC), and impairment from stimulation to the lateral parietal cortex (LPC). Neurobehavioral studies have demonstrated that subprocesses of WM allowing for the maintenance and manipulation of information in the mind involve unique cortical networks. Despite promising evidence of modulatory effects of rTMS on WM, no studies have yet demonstrated distinct modulatory control of these two subprocesses. The current study therefore sought to explore this possibility through site-specific stimulation during an online task invoking both skills. METHODS Twenty-nine subjects completed a 4-day protocol, in which active or sham 5Hz rTMS was applied over the DLPFC and LPC in separate blocks of trials while participants performed tasks that required either maintenance alone, or both maintenance and manipulation (alphabetization) of information. Stimulation targets were defined individually based on fMRI activation and structural network properties. Stimulation amplitude was adjusted using electric field modeling to equate induced current in the target region across participants. RESULTS Despite the use of advanced techniques, no significant differences or interactions between active and sham stimulation were found. Exploratory analyses testing stimulation amplitude, fMRI activation, and modal controllability showed nonsignificant but interesting trends with rTMS effects. CONCLUSION While this study did not reveal any significant behavioral changes in WM, the results may point to parameters that contribute to positive effects, such as stimulation amplitude and functional activation.
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Affiliation(s)
- Lysianne Beynel
- Department of Psychiatry and Behavioral ScienceDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Moritz Dannhauer
- Department of Psychiatry and Behavioral ScienceDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Hannah Palmer
- Department of Psychiatry and Behavioral ScienceDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Susan A. Hilbig
- Department of Psychiatry and Behavioral ScienceDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Courtney A. Crowell
- Department of Psychiatry and Behavioral ScienceDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Joyce E‐H. Wang
- Department of Psychiatry and Behavioral ScienceDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Andrew M. Michael
- Duke Institute for Brain SciencesDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Eleanor A. Wood
- Department of Psychiatry and Behavioral ScienceDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Bruce Luber
- Noninvasive Neuromodulation UnitExperimental Therapeutics and Pathophysiology BranchNational Institute of Mental HealthBethesdaMarylandUSA
| | - Sarah H. Lisanby
- Noninvasive Neuromodulation UnitExperimental Therapeutics and Pathophysiology BranchNational Institute of Mental HealthBethesdaMarylandUSA
| | - Angel V. Peterchev
- Department of Psychiatry and Behavioral ScienceDuke University School of MedicineDurhamNorth CarolinaUSA
- Department of Biomedical EngineeringDuke University School of MedicineDurhamNorth CarolinaUSA
- Department of Electrical and Computer EngineeringDuke University School of MedicineDurhamNorth CarolinaUSA
- Department of NeurosurgeryDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Roberto Cabeza
- Center for Cognitive NeuroscienceDuke UniversityDurhamNorth CarolinaUSA
- Department of Psychology & NeuroscienceDuke UniversityDurhamNorth CarolinaUSA
| | - Simon W. Davis
- Center for Cognitive NeuroscienceDuke UniversityDurhamNorth CarolinaUSA
- Department of NeurologyDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Lawrence G. Appelbaum
- Department of Psychiatry and Behavioral ScienceDuke University School of MedicineDurhamNorth CarolinaUSA
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