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Olivia VR, Chira D, Chelaru VF, Diana CD, Livia LP, Buruiană AM, Mureşanu FD. QEEG indices in traumatic brain injury - insights from the CAPTAIN RTMS trial. J Med Life 2024; 17:318-325. [PMID: 39044922 PMCID: PMC11262599 DOI: 10.25122/jml-2024-0187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 04/09/2024] [Indexed: 07/25/2024] Open
Abstract
This secondary analysis of the CAPTAIN-RTMS trial data focused on the significance of quantitative electroencephalography (qEEG) indices as indicators of recovery in patients with traumatic brain injury (TBI). By focusing on the delta alpha ratio (DAR), delta theta/alpha beta ratio (DTABR), and theta beta ratio (TBR), this study explored the shifts in brainwave activity as a response to an integrative treatment regimen of repetitive transcranial magnetic stimulation (rTMS) combined with the neurotrophic agent Cerebrolysin. Findings revealed significant increases in DAR and DTABR, suggesting changes in neurophysiological dynamics after treatment. However, variations in TBR were inconclusive in providing clear electrophysiological insights. These results indicate that further research is necessary to describe and understand the underlying mechanisms of brain recovery and to develop refined treatment frameworks for patients with TBI.
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Affiliation(s)
- Verişezan Roşu Olivia
- Department of Neurosciences, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Diana Chira
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Vlad-Florin Chelaru
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
- Faculty of Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Chertic Dăbală Diana
- Department of Neurosciences, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Livinț Popa Livia
- Department of Neurosciences, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
- Neurology Clinic, Cluj County Emergency Clinical Hospital, Cluj-Napoca, Romania
| | - Ana-Maria Buruiană
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Fior Dafin Mureşanu
- Department of Neurosciences, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
- Neurology Clinic, Cluj County Emergency Clinical Hospital, Cluj-Napoca, Romania
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2
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Shanok NA, Rodriguez S, Muzac S, Del Pino CH, Brown L, Rodriguez R. Deep transcranial magnetic stimulation alters resting-state neurophysiological traits in major depressive disorder. J Affect Disord 2023:S0165-0327(23)00707-3. [PMID: 37230266 DOI: 10.1016/j.jad.2023.05.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Major depressive disorder (MDD) is one of the most prevalent and debilitating health conditions worldwide; unfortunately, many patients do not respond to traditional antidepressant medication or talk therapy approaches. Deep transcranial magnetic stimulation (Deep TMS) has emerged as an effective treatment option for such "treatmentresistant" cases; however, the mechanisms by which Deep TMS attenuates depressive symptoms are still ambiguous. METHODS In the current study, resting-state quantitative electroencephalography (QEEG) measures were assessed pre-and-post treatment to illustrate neurophysiological changes resulting from Deep TMS. RESULTS The results showed reduced slow-frequency brain activity (delta and theta waves) in the prefrontal cortex following 36 treatments. Additionally, baseline QEEG measures predicted treatment response with approximately 90 % accuracy. CONCLUSIONS These findings provide preliminary evidence that TMS improves depressive symptoms by mitigating slow-wave brain activity in the prefrontal cortex. SIGNIFICANCE Deep TMS paired with QEEG should continue to be utilized for treatment of MDD in clinical practice and future studies should explore its potential for other neuropsychiatric conditions.
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Affiliation(s)
- Nathaniel A Shanok
- Delray Center for Brain Sciences, 103 SE 4th St., Delray Beach, FL 33483, United States of America.
| | - Santiago Rodriguez
- Delray Center for Brain Sciences, 103 SE 4th St., Delray Beach, FL 33483, United States of America
| | - Sabrina Muzac
- Delray Center for Brain Sciences, 103 SE 4th St., Delray Beach, FL 33483, United States of America
| | - Carla Huertes Del Pino
- Delray Center for Brain Sciences, 103 SE 4th St., Delray Beach, FL 33483, United States of America
| | - Leah Brown
- Delray Center for Brain Sciences, 103 SE 4th St., Delray Beach, FL 33483, United States of America
| | - Raul Rodriguez
- Delray Center for Brain Sciences, 103 SE 4th St., Delray Beach, FL 33483, United States of America
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3
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Jiang L, He R, Li Y, Yi C, Peng Y, Yao D, Wang Y, Li F, Xu P, Yang Y. Predicting the long-term after-effects of rTMS in autism spectrum disorder using temporal variability analysis of scalp EEG. J Neural Eng 2022; 19. [PMID: 36223728 DOI: 10.1088/1741-2552/ac999d] [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: 07/19/2022] [Accepted: 10/12/2022] [Indexed: 12/24/2022]
Abstract
Objective.Repetitive transcranial magnetic stimulation (rTMS) emerges as a useful therapy for autism spectrum disorder (ASD) clinically. Whereas the mechanisms of action of rTMS on ASD are not fully understood, and no biomarkers until now are available to reliably predict the follow-up rTMS efficacy in clinical practice.Approach.In the current work, the temporal variability was investigated in resting-state electroencephalogram of ASD patients, and the nonlinear complexity of related time-varying networks was accordingly evaluated by fuzzy entropy.Main results.The results showed the hyper-variability in the resting-state networks of ASD patients, while three week rTMS treatment alleviates the hyper fluctuations occurring in the frontal-parietal and frontal-occipital connectivity and further contributes to the ameliorative ASD symptoms. In addition, the changes in variability network properties are closely correlated with clinical scores, which further serve as potential predictors to reliably track the long-term rTMS efficacy for ASD.Significance.The findings consistently demonstrated that the temporal variability of time-varying networks of ASD patients could be modulated by rTMS, and related variability properties also help predict follow-up rTMS efficacy, which provides the potential for formulating individualized treatment strategies for ASD (ChiCTR2000033586).
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Affiliation(s)
- Lin Jiang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, People's Republic of China.,School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu 611731, People's Republic of China
| | - Runyang He
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, People's Republic of China.,School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu 611731, People's Republic of China
| | - Yuqin Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, People's Republic of China.,School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu 611731, People's Republic of China
| | - Chanlin Yi
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, People's Republic of China.,School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu 611731, People's Republic of China
| | - Yueheng Peng
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, People's Republic of China.,School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu 611731, People's Republic of China
| | - Dezhong Yao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, People's Republic of China.,School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu 611731, People's Republic of China.,School of Electrical Engineering, Zhengzhou University, Zhengzhou 450001, People's Republic of China.,Research Unit of NeuroInformation, Chinese Academy of Medical Sciences, 2019RU035 Chengdu, People's Republic of China
| | - Yuping Wang
- Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, People's Republic of China.,Beijing Key Laboratory of Neuromodulation, Beijing, People's Republic of China.,Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, People's Republic of China
| | - Fali Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, People's Republic of China.,School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu 611731, People's Republic of China.,Research Unit of NeuroInformation, Chinese Academy of Medical Sciences, 2019RU035 Chengdu, People's Republic of China
| | - Peng Xu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, People's Republic of China.,School of Life Science and Technology, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu 611731, People's Republic of China.,Research Unit of NeuroInformation, Chinese Academy of Medical Sciences, 2019RU035 Chengdu, People's Republic of China.,Radiation Oncology Key Laboratory of Sichuan Province, 610041 Chengdu, People's Republic of China
| | - Yingxue Yang
- Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, People's Republic of China.,Beijing Key Laboratory of Neuromodulation, Beijing, People's Republic of China.,Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, People's Republic of China
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Franke LM, Gitchel GT, Perera RA, Hadimani RL, Holloway KL, Walker WC. Randomized trial of rTMS in traumatic brain injury: improved subjective neurobehavioral symptoms and increases in EEG delta activity. Brain Inj 2022; 36:683-692. [PMID: 35143365 DOI: 10.1080/02699052.2022.2033845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PRIMARY OBJECTIVE While repetitive transcranial magnetic stimulation (rTMS) has shown efficacy for cognitive difficulties accompanying depression, it is unknown if it can improve cognition in persons with traumatic brain injury. RESEARCH DESIGN Using a sham-controlled crossover design, we tested the capacity of high frequency rTMS of the prefrontal cortex to improve neuropsychological performance in attention, learning and memory, and executive function. METHODS Twenty-six participants with cognitive complaints and a history of mild-to-moderate traumatic brain injury were randomly assigned to receive first either active or sham 10 Hz stimulation for 20 minutes (1200 pulses) per session for five consecutive days. After a one-week washout, the other condition (active or sham) was applied. Pre- and post-treatment measures included neuropsychological tests, cognitive and emotional symptoms, and EEG. MAIN OUTCOMES AND RESULTS Results indicated no effect of treatment on cognitive function. Subjective measures of depression, sleep dysfunction, post-concussive symptoms (PCS), and executive function showed significant improvement with stimulation, retaining improved levels at two-week follow-up. EEG delta power exhibited elevation one week after stimulation cessation. CONCLUSIONS While there is no indication that rTMS is beneficial for neuropsychological performance, it may improve PCS and subjective cognitive dysfunction. Long-term alterations in cortical oscillations may underlie the therapeutic effects of rTMS.
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Affiliation(s)
- Laura M Franke
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia, USA.,Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia, USA
| | - George T Gitchel
- Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia, USA.,Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Robert A Perera
- Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Ravi L Hadimani
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Kathryn L Holloway
- Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia, USA.,Department of Neurosurgery, Virginia Commonwealth University, Richmond, Virginia, USA
| | - William C Walker
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia, USA.,Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia, USA
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5
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Hosseinian T, Yavari F, Kuo MF, Nitsche MA, Jamil A. Phase synchronized 6 Hz transcranial electric and magnetic stimulation boosts frontal theta activity and enhances working memory. Neuroimage 2021; 245:118772. [PMID: 34861393 DOI: 10.1016/j.neuroimage.2021.118772] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 10/30/2021] [Accepted: 11/29/2021] [Indexed: 11/26/2022] Open
Abstract
Network-level synchronization of theta oscillations in the cerebral cortex is linked to many vital cognitive functions across daily life, such as executive functions or regulation of arousal and consciousness. However, while neuroimaging has uncovered the ubiquitous functional relevance of theta rhythms in cognition, there remains a limited set of techniques for externally enhancing and stabilizing theta in the human brain non-invasively. Here, we developed and employed a new phase-synchronized low-intensity electric and magnetic stimulation technique to induce and stabilize narrowband 6-Hz theta oscillations in a group of healthy human adult participants, and then demonstrated how this technique also enhances cognitive processing by assaying working memory. Our findings demonstrate a technological advancement of brain stimulation methods, while also validating the causal link between theta activity and concurrent cognitive behavior, which may ultimately help to not only explain mechanisms, but offer perspectives for restoring deficient theta-band network activity observed in neuropsychiatric diseases.
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Affiliation(s)
- Tiam Hosseinian
- Department Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Ardeystrasse 67, Dortmund 44139, Germany
| | - Fatemeh Yavari
- Department Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Ardeystrasse 67, Dortmund 44139, Germany
| | - Min-Fang Kuo
- Department Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Ardeystrasse 67, Dortmund 44139, Germany
| | - Michael A Nitsche
- Department Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Ardeystrasse 67, Dortmund 44139, Germany; Department Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany.
| | - Asif Jamil
- Department Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Ardeystrasse 67, Dortmund 44139, Germany; Laboratory for Neuropsychiatry and Neuromodulation, Harvard Medical School, Massachusetts General Hospital, 149 Thirteenth Street, Boston, MA, USA.
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6
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Rustamov N, Sharma L, Chiang SN, Burk C, Haroutounian S, Leuthardt EC. Spatial and Frequency-specific Electrophysiological Signatures of Tonic Pain Recovery in Humans. Neuroscience 2021; 465:23-37. [PMID: 33894311 DOI: 10.1016/j.neuroscience.2021.04.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/19/2021] [Accepted: 04/12/2021] [Indexed: 11/18/2022]
Abstract
The objective of this study was to comprehensively investigate patterns of brain activities associated with pain recovery following experimental tonic pain in humans. Specific electrophysiological features of pain recovery may either be monitored or be modulated through neurofeedback (NF) as a novel chronic pain treatment. The cold pressor test was applied with simultaneous electroencephalogram (EEG) recording. EEG data were acquired, and analyzed to define: (1) EEG power topography patterns of pain recovery; (2) source generators of pain recovery at cortical level; (3) changes in functional connectivity associated with pain recovery; (4) features of phase-amplitude coupling (PAC) as it relates to pain recovery. The novel finding of this study is that recovery from pain was characterized by significant theta power rebound at the left fronto-central area. The sources of theta power over-recovery were located in the left dorsolateral prefrontal cortex (DLPFC), cingulate cortex, left insula and contralateral sensorimotor cortex. These effects were paralleled by theta band connectivity increase within hemispheres in a prefrontal-somatosensory network and interhemispherically between prefrontal and parietal areas. In addition, this study revealed significant reduction in PAC between theta/alpha and gamma oscillations during recovery period following tonic pain. These findings have largely been replicated across two identical sessions. Our study emphasizes the association between pain recovery and left lateral prefrontal theta power rebound, and significant over-recovery of functional connectivity in prefrontal-sensorimotor neural network synchronized at theta frequencies. These findings may provide basis for chronic pain treatment by modulating neural oscillations at theta frequencies in left prefrontal cortex.
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Affiliation(s)
- Nabi Rustamov
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA; Center for Innovation in Neuroscience and Technology, Washington University School of Medicine, St. Louis, MO, USA
| | - Lokesh Sharma
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Sarah N Chiang
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA; Center for Innovation in Neuroscience and Technology, Washington University School of Medicine, St. Louis, MO, USA
| | - Carrie Burk
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA; Washington University Pain Center, St. Louis, MO, USA
| | - Simon Haroutounian
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA; Washington University Pain Center, St. Louis, MO, USA.
| | - Eric C Leuthardt
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA; Center for Innovation in Neuroscience and Technology, Washington University School of Medicine, St. Louis, MO, USA; Department of Neuroscience, Washington University School of Medicine, St. Louis, MO, USA; Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, St. Louis, MO, USA; Department of Biomedical Engineering, Washington University in St. Louis, Louis, MO, USA
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7
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Frohlich J, Toker D, Monti MM. Consciousness among delta waves: a paradox? Brain 2021; 144:2257-2277. [PMID: 33693596 DOI: 10.1093/brain/awab095] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 02/12/2021] [Accepted: 02/25/2021] [Indexed: 01/29/2023] Open
Abstract
A common observation in EEG research is that consciousness vanishes with the appearance of delta (1 - 4 Hz) waves, particularly when those waves are high amplitude. High amplitude delta oscillations are very frequently observed in states of diminished consciousness, including slow wave sleep, anaesthesia, generalised epileptic seizures, and disorders of consciousness such as coma and vegetative state. This strong correlation between loss of consciousness and high amplitude delta oscillations is thought to stem from the widespread cortical deactivation that occurs during the "down states" or troughs of these slow oscillations. Recently, however, many studies have reported the presence of prominent delta activity during conscious states, which casts doubt on the hypothesis that high amplitude delta oscillations are an indicator of unconsciousness. These studies include work in Angelman syndrome, epilepsy, behavioural responsiveness during propofol anaesthesia, postoperative delirium, and states of dissociation from the environment such as dreaming and powerful psychedelic states. The foregoing studies complement an older, yet largely unacknowledged, body of literature that has documented awake, conscious patients with high amplitude delta oscillations in clinical reports from Rett syndrome, Lennox-Gastaut syndrome, schizophrenia, mitochondrial diseases, hepatic encephalopathy, and nonconvulsive status epilepticus. At the same time, a largely parallel body of recent work has reported convincing evidence that the complexity or entropy of EEG and magnetoencephalogram or MEG signals strongly relates to an individual's level of consciousness. Having reviewed this literature, we discuss plausible mechanisms that would resolve the seeming contradiction between high amplitude delta oscillations and consciousness. We also consider implications concerning theories of consciousness, such as integrated information theory and the entropic brain hypothesis. Finally, we conclude that false inferences of unconscious states can be best avoided by examining measures of electrophysiological complexity in addition to spectral power.
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Affiliation(s)
- Joel Frohlich
- Department of Psychology, University of California Los Angeles, 3423 Franz Hall, Los Angeles, California 90095, USA
| | - Daniel Toker
- Department of Psychology, University of California Los Angeles, 3423 Franz Hall, Los Angeles, California 90095, USA
| | - Martin M Monti
- Department of Psychology, University of California Los Angeles, 3423 Franz Hall, Los Angeles, California 90095, USA.,Department of Neurosurgery, UCLA Brain Injury Research Center, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California 90095, USA
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8
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Honda Y, Nakamura S, Ogawa K, Yoshino R, Tobler PN, Nishimura Y, Tsutsui KI. Changes in beta and high-gamma power in resting-state electrocorticogram induced by repetitive transcranial magnetic stimulation of primary motor cortex in unanesthetized macaque monkeys. Neurosci Res 2021; 171:41-48. [PMID: 33705847 DOI: 10.1016/j.neures.2021.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/25/2021] [Accepted: 02/25/2021] [Indexed: 02/06/2023]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is now widely used as a means of neuromodulation, but the details of the mechanisms by which rTMS works remain unclarified. As a step forward to unveiling the neural phenomena occurring underneath the TMS coil, we conducted an electrophysiological study using awake and unanesthetized monkeys with subdural electrocorticogram (ECoG) electrodes implanted over the primary motor cortex (MI). We evaluated the effects of low-frequency (1 Hz) and high-frequency (10 Hz) rTMS on the resting-state ECoG signals in the stimulated MI, as well as the motor evoked potentials (MEPs) in the contralateral hand. Following the 1-Hz rTMS application, the ECoG beta band power and the MEP amplitude were significantly decreased. Following the 10-Hz rTMS application, the ECoG high-gamma power and the MEP amplitude significantly increased. Given that beta and high-gamma activities in the ECoG reflect the synchronous firing and the firing frequency of cell assemblies, respectively, in local neural circuits, these results suggest that low-frequency rTMS inhibits neural activity by desynchronizing the firing activity of local circuits, whereas high-frequency rTMS facilitates neural activity by increasing the firing rate of cell assemblies in the local circuits.
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Affiliation(s)
- Yasutaka Honda
- Laboratory of Systems Neuroscience, Graduate School of Life Sciences, Tohoku University, Sendai, 980-8577, Japan
| | - Shinya Nakamura
- Laboratory of Systems Neuroscience, Graduate School of Life Sciences, Tohoku University, Sendai, 980-8577, Japan
| | - Kentaro Ogawa
- Laboratory of Systems Neuroscience, Graduate School of Life Sciences, Tohoku University, Sendai, 980-8577, Japan
| | - Rintaro Yoshino
- Laboratory of Systems Neuroscience, Graduate School of Life Sciences, Tohoku University, Sendai, 980-8577, Japan
| | - Philippe N Tobler
- Zurich Center for Neuroeconomics, Department of Economics, University of Zurich, 8006 Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich, Swiss Federal Institute of Technology Zurich, Switzerland
| | - Yukio Nishimura
- Neural Prosthetics Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, 156-8506, Japan
| | - Ken-Ichiro Tsutsui
- Laboratory of Systems Neuroscience, Graduate School of Life Sciences, Tohoku University, Sendai, 980-8577, Japan.
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9
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Barth B, Rohe T, Deppermann S, Fallgatter AJ, Ehlis AC. Neural oscillatory responses to performance monitoring differ between high- and low-impulsive individuals, but are unaffected by TMS. Hum Brain Mapp 2021; 42:2416-2433. [PMID: 33605509 PMCID: PMC8090766 DOI: 10.1002/hbm.25376] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/25/2021] [Accepted: 02/07/2021] [Indexed: 12/17/2022] Open
Abstract
Higher impulsivity may arise from neurophysiological deficits of cognitive control in the prefrontal cortex. Cognitive control can be assessed by time‐frequency decompositions of electrophysiological data. We aimed to clarify neuroelectric mechanisms of performance monitoring in connection with impulsiveness during a modified Eriksen flanker task in high‐ (n = 24) and low‐impulsive subjects (n = 21) and whether these are modulated by double‐blind, sham‐controlled intermittent theta burst stimulation (iTBS). We found a larger error‐specific peri‐response beta power decrease over fronto‐central sites in high‐impulsive compared to low‐impulsive participants, presumably indexing less effective motor execution processes. Lower parieto‐occipital theta intertrial phase coherence (ITPC) preceding correct responses predicted higher reaction time (RT) and higher RT variability, potentially reflecting efficacy of cognitive control or general attention. Single‐trial preresponse theta phase clustering was coupled to RT in correct trials (weighted ITPC), reflecting oscillatory dynamics that predict trial‐specific behavior. iTBS did not modulate behavior or EEG time‐frequency power. Performance monitoring was associated with time‐frequency patterns reflecting cognitive control (parieto‐occipital theta ITPC, theta weighted ITPC) as well as differential action planning/execution processes linked to trait impulsivity (frontal low beta power). Beyond that, results suggest no stimulation effect related to response‐locked time‐frequency dynamics with the current stimulation protocol. Neural oscillatory responses to performance monitoring differ between high‐ and low‐impulsive individuals, but are unaffected by iTBS.
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Affiliation(s)
- Beatrix Barth
- Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany
| | - Tim Rohe
- Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany.,Department of Psychology, Friedrich-Alexander University Erlangen-Nuernberg, Erlangen, Germany
| | - Saskia Deppermann
- Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany
| | - Andreas Jochen Fallgatter
- Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany.,LEAD Graduate School & Research Network, University of Tuebingen, Tuebingen, Germany.,Werner Reichardt Centre for Integrative Neuroscience (CIN), University of Tuebingen, Tuebingen, Germany
| | - Ann-Christine Ehlis
- Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany.,LEAD Graduate School & Research Network, University of Tuebingen, Tuebingen, Germany
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10
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Casanova MF, Shaban M, Ghazal M, El-Baz AS, Casanova EL, Opris I, Sokhadze EM. Effects of Transcranial Magnetic Stimulation Therapy on Evoked and Induced Gamma Oscillations in Children with Autism Spectrum Disorder. Brain Sci 2020; 10:E423. [PMID: 32635201 PMCID: PMC7408068 DOI: 10.3390/brainsci10070423] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 11/16/2022] Open
Abstract
Autism spectrum disorder (ASD) is a behaviorally diagnosed neurodevelopmental condition of unknown pathology. Research suggests that abnormalities of elecltroencephalogram (EEG) gamma oscillations may provide a biomarker of the condition. In this study, envelope analysis of demodulated waveforms for evoked and induced gamma oscillations in response to Kanizsa figures in an oddball task were analyzed and compared in 19 ASD and 19 age/gender-matched neurotypical children. The ASD group was treated with low frequency transcranial magnetic stimulation (TMS), (1.0 Hz, 90% motor threshold, 18 weekly sessions) targeting the dorsolateral prefrontal cortex. In ASD subjects, as compared to neurotypicals, significant differences in evoked and induced gamma oscillations were evident in higher magnitude of gamma oscillations pre-TMS, especially in response to non-target cues. Recordings post-TMS treatment in ASD revealed a significant reduction of gamma responses to task-irrelevant stimuli. Participants committed fewer errors post-TMS. Behavioral questionnaires showed a decrease in irritability, hyperactivity, and repetitive behavior scores. The use of a novel metric for gamma oscillations. i.e., envelope analysis using wavelet transformation allowed for characterization of the impedance of the originating neuronal circuit. The results suggest that gamma oscillations may provide a biomarker reflective of the excitatory/inhibitory balance of the cortex and a putative outcome measure for interventions in autism.
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Affiliation(s)
- Manuel F. Casanova
- Department of Biomedical Sciences, University of South Carolina School of Medicine-Greenville, 701 Grove Rd., Greenville, SC 29605, USA; (M.F.C.); (E.L.C.)
- Department of Psychiatry & Behavioral Sciences, University of Louisville, 401 E Chestnut Str., #600, Louisville, KY 40202, USA
| | - Mohamed Shaban
- Department of Electrical and Computer Engineering, University of South Alabama, Mobile, AL 36688, USA;
| | - Mohammed Ghazal
- BioImaging Research Lab, Electrical and Computer Engineering Abu Dhabi University, Abu Dhabi 59911, UAE;
| | - Ayman S. El-Baz
- Department of Bioengineering, University of Louisville, Louisville, KY 40202, USA;
| | - Emily L. Casanova
- Department of Biomedical Sciences, University of South Carolina School of Medicine-Greenville, 701 Grove Rd., Greenville, SC 29605, USA; (M.F.C.); (E.L.C.)
| | - Ioan Opris
- School of Medicine, University of Miami, Miami, FL 33136, USA;
| | - Estate M. Sokhadze
- Department of Biomedical Sciences, University of South Carolina School of Medicine-Greenville, 701 Grove Rd., Greenville, SC 29605, USA; (M.F.C.); (E.L.C.)
- Department of Psychiatry & Behavioral Sciences, University of Louisville, 401 E Chestnut Str., #600, Louisville, KY 40202, USA
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11
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Qiu S, Wang S, Yi W, Zhang C, He H. The lasting effects of 1Hz repetitive transcranial magnetic stimulation on resting state EEG in healthy subjects. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:5918-5922. [PMID: 31947196 DOI: 10.1109/embc.2019.8857184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Repetitive Transcranial magnetic stimulation (rTMS) is a noninvasive brain stimulation technique that able to influence cortical excitability. Low-frequency rTMS (stimulation frequency ≤1Hz) induces long-lasting inhibitory effects on cortical excitability. In order to study the effects of 1Hz rTMS of the motor cortex on neuronal activity, 20 healthy subjects were recruited to receive rTMS, and electroencephalography (EEG) in resting condition with eye open were recorded before rTMS, at 0min, 20min, 40min, 60min after rTMS. In multiple frequency bands, power values on each channel were calculated, and functional connectivity between two channels was assessed using phase synchronization. We found an increase in power of theta-band oscillations in the frontal and the central brain areas immediately after rTMS. And alpha resting power in the central-parietal brain area did not change immediately after rTMS, but increased at 20min after rTMS. Moreover, there is a widespread increase in functional connectivity after rTMS in the theta band, whereas widespread decreases in the functional connectivity were found in the alpha band after rTMS. At the same time, there was no significant recovery on power and functional connectivity at 60min after rTMS. These results provide an evidence for a transient reorganization of neuronal activity after 1Hz rTMS over the motor cortex. In addition, low-frequency rTMS produces widespread long-lasting alterations in cortical functional connectivity.
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12
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Qiu S, Yi W, Wang S, Zhang C, He H. The Lasting Effects of Low-Frequency Repetitive Transcranial Magnetic Stimulation on Resting State EEG in Healthy Subjects. IEEE Trans Neural Syst Rehabil Eng 2020; 28:832-841. [DOI: 10.1109/tnsre.2020.2977883] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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13
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Schuhmann T, Kemmerer SK, Duecker F, de Graaf TA, ten Oever S, De Weerd P, Sack AT. Left parietal tACS at alpha frequency induces a shift of visuospatial attention. PLoS One 2019; 14:e0217729. [PMID: 31774818 PMCID: PMC6881009 DOI: 10.1371/journal.pone.0217729] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 11/12/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Voluntary shifts of visuospatial attention are associated with a lateralization of parieto-occipital alpha power (7-13Hz), i.e. higher power in the hemisphere ipsilateral and lower power contralateral to the locus of attention. Recent noninvasive neuromodulation studies demonstrated that alpha power can be experimentally increased using transcranial alternating current stimulation (tACS). OBJECTIVE/HYPOTHESIS We hypothesized that tACS at alpha frequency over the left parietal cortex induces shifts of attention to the left hemifield. However, spatial attention shifts not only occur voluntarily (endogenous/ top-down), but also stimulus-driven (exogenous/ bottom-up). To study the task-specificity of the potential effects of tACS on attentional processes, we administered three conceptually different spatial attention tasks. METHODS 36 healthy volunteers were recruited from an academic environment. In two separate sessions, we applied either high-density tACS at 10Hz, or sham tACS, for 35-40 minutes to their left parietal cortex. We systematically compared performance on endogenous attention, exogenous attention, and stimulus detection tasks. RESULTS In the endogenous attention task, a greater leftward bias in reaction times was induced during left parietal 10Hz tACS as compared to sham. There were no stimulation effects in either the exogenous attention or the stimulus detection task. CONCLUSION The study demonstrates that high-density tACS at 10Hz can be used to modulate visuospatial attention performance. The tACS effect is task-specific, indicating that not all forms of attention are equally susceptible to the stimulation.
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Affiliation(s)
- Teresa Schuhmann
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Brain Imaging Center, Maastricht, The Netherlands
| | - Selma K. Kemmerer
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Brain Imaging Center, Maastricht, The Netherlands
| | - Felix Duecker
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Brain Imaging Center, Maastricht, The Netherlands
| | - Tom A. de Graaf
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Brain Imaging Center, Maastricht, The Netherlands
| | - Sanne ten Oever
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Brain Imaging Center, Maastricht, The Netherlands
| | - Peter De Weerd
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Brain Imaging Center, Maastricht, The Netherlands
| | - Alexander T. Sack
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Brain Imaging Center, Maastricht, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Brain + Nerve Centre, Maastricht University Medical Centre+ (MUMC+), Maastricht, The Netherlands
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14
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Riedel P, Heil M, Bender S, Dippel G, Korb FM, Smolka MN, Marxen M. Modulating functional connectivity between medial frontopolar cortex and amygdala by inhibitory and excitatory transcranial magnetic stimulation. Hum Brain Mapp 2019; 40:4301-4315. [PMID: 31268615 DOI: 10.1002/hbm.24703] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 06/20/2019] [Accepted: 06/21/2019] [Indexed: 12/24/2022] Open
Abstract
The prefrontal-limbic network in the human brain plays a major role in social cognition, especially cognitive control of emotion. The medial frontopolar cortex (mFP; Brodmann Area 10) and the amygdala are part of this network and display correlated neuronal activity in time, as measured by functional magnetic resonance imaging (fMRI). This functional connectivity is dynamic, sensitive to training, and affected in mental disorders. However, the effects of neurostimulation on functional connectivity within this network have not yet been systematically investigated. Here, we investigate the effects of both low- and high-frequency repetitive transcranial magnetic stimulation (rTMS) to the right mFP on functional connectivity between mFP and amygdala, as measured with resting state fMRI (rsfMRI). Three groups of healthy participants received either low-frequency rTMS (1 Hz; N = 18), sham TMS (1 Hz, subthreshold; N = 18) or high-frequency rTMS (20 Hz; N = 19). rsfMRI was acquired before and after (separate days). We hypothesized a modulation of functional connectivity in opposite directions compared to sham TMS through adjustment of the stimulation frequency. Groups differed in functional connectivity between mFP and amygdala after stimulation compared to before stimulation (low-frequency: decrease, high-frequency: increase). Motion or induced changes in neuronal activity were excluded as confounders. Results show that rTMS is effective for increasing and decreasing functional coherence between prefrontal and limbic regions. This finding is relevant for social and affective neuroscience as well as novel treatment approaches in psychiatry.
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Affiliation(s)
- Philipp Riedel
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Matthias Heil
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Stephan Bender
- Medical Faculty, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Cologne, Cologne, Germany
| | - Gabriel Dippel
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Franziska M Korb
- Department of General Psychology, Technische Universität Dresden, Dresden, Germany
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Michael Marxen
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
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Cernych M, Satas A, Brazaitis M. Post-sauna recovery enhances brain neural network relaxation and improves cognitive economy in oddball tasks. Int J Hyperthermia 2018; 35:375-382. [DOI: 10.1080/02656736.2018.1504992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Margarita Cernych
- Institute of Sport Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania
| | - Andrius Satas
- Institute of Sport Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania
| | - Marius Brazaitis
- Institute of Sport Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania
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Lebiecka K, Zuchowicz U, Wozniak-Kwasniewska A, Szekely D, Olejarczyk E, David O. Complexity Analysis of EEG Data in Persons With Depression Subjected to Transcranial Magnetic Stimulation. Front Physiol 2018; 9:1385. [PMID: 30323771 PMCID: PMC6172427 DOI: 10.3389/fphys.2018.01385] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 09/11/2018] [Indexed: 11/30/2022] Open
Abstract
Aim: The aim of this work was to study the neurophysiological effect of repetitive transcranial magnetic stimulation (rTMS) applied to the left dorsolateral prefrontal cortex (DLPFC) in 8 patients with major depression disorder (MDD) and 10 patients with bipolar disorder (BP), considering separately responders and non-responders to rTMS therapy in each of both groups. Methods: The Higuchi's Fractal Dimension (FD) was analyzed from 64-channels EEG signals in five physiological frequency bands and every channel separately. Changes of FD were analyzed before and after 1st, 10th, and 20th session of rTMS. Results: Some differences in response to the rTMS therapy was found across individual groups. In MDD responders, FD decreased in all bands after longer stimulation (20th session). Whereas, in BP non-responders, FD decreased after 1st session in all bands as well as after 10th session in lower frequencies (delta and theta). In MDD non-responders and BP responders FD increased at the beginning of the therapy (1st and 10th session, respectively), but the final FD value did not changed in comparison to the initial FD value, except the FD decrease for theta band in BP responders. Comparison between groups showed a higher FD in MDD responders than in MDD non-responders in every band before as well as after stimulation. In contrast to MDD patients, FD was lower in BP responders than in BP non-responders in higher frequency bands (alpha, beta, and gamma) in both conditions as well as in lower frequency bands (delta and theta) after stimulation. Comparing both groups of responders, FD was lower in MDD than in BP in every band, except alpha. In case of non-responders, FD was higher in BP than in MDD in all bands in both conditions. Conclusion: The results showed that FD may be useful marker for evaluation of the rTMS effectiveness and the therapy progress as well as for group differentiation between MDD and BP or between responders and non-responders. The changes of FD under the influence of rTMS allow to unambiguously conclude whether the effect of stimulation is positive or negative as well as allow to evaluate an optimal time of rTMS.
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Affiliation(s)
- Karolina Lebiecka
- Department of Automatics and Biomedical Engineering, AGH University of Science and Technology, Kraków, Poland
- Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - Urszula Zuchowicz
- Department of Automatics and Biomedical Engineering, AGH University of Science and Technology, Kraków, Poland
- Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - Agata Wozniak-Kwasniewska
- U1216, Inserm, Grenoble, France
- Grenoble Institut des Neurosciences, Université Grenoble Alpes, Grenoble, France
| | - David Szekely
- U1216, Inserm, Grenoble, France
- Grenoble Institut des Neurosciences, Université Grenoble Alpes, Grenoble, France
- Service de Psychiatrie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Elzbieta Olejarczyk
- Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - Olivier David
- U1216, Inserm, Grenoble, France
- Grenoble Institut des Neurosciences, Université Grenoble Alpes, Grenoble, France
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Dayan E, Herszage J, Laor-Maayany R, Sharon H, Censor N. Neuromodulation of reinforced skill learning reveals the causal function of prefrontal cortex. Hum Brain Mapp 2018; 39:4724-4732. [PMID: 30043536 DOI: 10.1002/hbm.24317] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 06/19/2018] [Accepted: 07/06/2018] [Indexed: 01/23/2023] Open
Abstract
Accumulating evidence has suggested functional interactions between prefrontal cortex (PFC) and dissociable large-scale networks. However, how these networks interact in the human brain to enable complex behaviors is not well-understood. Here, using a combination of behavioral, brain stimulation and neuroimaging paradigms, we tested the hypothesis that human PFC is required for successful reinforced skill formation. We additionally tested the extent to which PFC-dependent skill formation is related to intrinsic functional communication with this region. We report that inhibitory noninvasive transcranial magnetic stimulation over lateral PFC, a hub region with a diverse connectivity profile, causally modulated effective reinforcement-based motor skill acquisition. Furthermore, PFC-dependent skill formation was strongly related to the strength of functional connectivity between the PFC and regions in the sensorimotor network. These results point to the involvement of lateral PFC in the neural architecture that underlies the acquisition of complex skills, and suggest that, in relation to skill acquisition, this region may be involved in functional interactions with sensorimotor networks.
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Affiliation(s)
- Eran Dayan
- Department of Radiology, Biomedical Research Imaging Center and Neuroscience Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jasmine Herszage
- School of Psychological Sciences and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Rony Laor-Maayany
- School of Psychological Sciences and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Haggai Sharon
- Center for Brain Functions and Institute of Pain Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nitzan Censor
- School of Psychological Sciences and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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18
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Induction and Quantification of Excitability Changes in Human Cortical Networks. J Neurosci 2018; 38:5384-5398. [PMID: 29875229 DOI: 10.1523/jneurosci.1088-17.2018] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 04/01/2018] [Accepted: 04/09/2018] [Indexed: 11/21/2022] Open
Abstract
How does human brain stimulation result in lasting changes in cortical excitability? Uncertainty on this question hinders the development of personalized brain stimulation therapies. To characterize how cortical excitability is altered by stimulation, we applied repetitive direct electrical stimulation in eight human subjects (male and female) undergoing intracranial monitoring. We evaluated single-pulse corticocortical-evoked potentials (CCEPs) before and after repetitive stimulation across prefrontal (n = 4), temporal (n = 1), and motor (n = 3) cortices. We asked whether a single session of repetitive stimulation was sufficient to induce excitability changes across distributed cortical sites. We found a subset of regions at which 10 Hz prefrontal repetitive stimulation resulted in both potentiation and suppression of excitability that persisted for at least 10 min. We then asked whether these dynamics could be modeled by the prestimulation connectivity profile of each subject. We found that cortical regions (1) anatomically close to the stimulated site and (2) exhibiting high-amplitude CCEPs underwent changes in excitability following repetitive stimulation. We demonstrate high accuracy (72-95%) and discriminability (81-99%) in predicting regions exhibiting changes using individual subjects' prestimulation connectivity profile, and show that adding prestimulation connectivity features significantly improved model performance. The same features predicted regions of modulation following motor and temporal cortices stimulation in an independent dataset. Together, baseline connectivity profile can be used to predict regions susceptible to brain changes and provides a basis for personalizing brain stimulation.SIGNIFICANCE STATEMENT Brain stimulation is increasingly used to treat neuropsychiatric disorders by inducing excitability changes at specific brain regions. However, our understanding of how, when, and where these changes are induced is critically lacking. We inferred plasticity in the human brain after applying electrical stimulation to the brain's surface and measuring changes in excitability. We observed excitability changes in regions anatomically and functionally closer to the stimulation site. Those in responsive regions were accurately predicted using a classifier trained on baseline brain network characteristics. Finally, we showed that the excitability changes can potentially be monitored in real-time. These results begin to fill basic gaps in our understanding of stimulation-induced brain dynamics in humans and offer pathways to optimize stimulation protocols.
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19
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Valiulis V, Gerulskis G, Dapšys K, Valavičiūtė K, Šiurkutė A, Mačiulis V. The use of MR-less MNI based neuronavigation for 10 Hz rTMS depression therapy: electrophysiological and clinical implications. Acta Neurobiol Exp (Wars) 2018. [DOI: 10.21307/ane-2018-025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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20
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Urbano D. Assessing rTMS effects in MdDS: Cross-modal comparison between resting state EEG and fMRI connectivity. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2017:1950-1953. [PMID: 29060275 DOI: 10.1109/embc.2017.8037231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) has been increasingly explored for many neurological and neuropsychiatric conditions. However, the response rate is variable depending on baseline conditions. Optimizing rTMS protocols to improve treatment effects and response rates will depend on reliably assessing brain state conditions. In this regard, neural activity guided optimization has shown potential in several neuroimaging studies. In this paper, we present our ongoing work on optimizing rTMS treatment of a balance disorder called Mal de Debarquement Syndrome (MdDS), a motion perception disorder caused by entrainment to background motion. Our previous work has revealed that a neuroimaging marker of resting state functional connectivity may help predict therapeutic effect. Motivated by our previous pilot study with fMRI, the present study aims to extend the investigation to EEG data that were simultaneously acquired with fMRI, with the aim of transferring the fMRI imaging marker to a more accessible neural recording technology. Our current findings demonstrate that integrating EEG with fMRI measures of neural synchrony and functional connectivity may hold promise in optimizing rTMS protocols.
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21
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Giovanni A, Capone F, di Biase L, Ferreri F, Florio L, Guerra A, Marano M, Paolucci M, Ranieri F, Salomone G, Tombini M, Thut G, Di Lazzaro V. Oscillatory Activities in Neurological Disorders of Elderly: Biomarkers to Target for Neuromodulation. Front Aging Neurosci 2017; 9:189. [PMID: 28659788 PMCID: PMC5468377 DOI: 10.3389/fnagi.2017.00189] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 05/26/2017] [Indexed: 12/13/2022] Open
Abstract
Non-invasive brain stimulation (NIBS) has been under investigation as adjunct treatment of various neurological disorders with variable success. One challenge is the limited knowledge on what would be effective neuronal targets for an intervention, combined with limited knowledge on the neuronal mechanisms of NIBS. Motivated on the one hand by recent evidence that oscillatory activities in neural systems play a role in orchestrating brain functions and dysfunctions, in particular those of neurological disorders specific of elderly patients, and on the other hand that NIBS techniques may be used to interact with these brain oscillations in a controlled way, we here explore the potential of modulating brain oscillations as an effective strategy for clinical NIBS interventions. We first review the evidence for abnormal oscillatory profiles to be associated with a range of neurological disorders of elderly (e.g., Parkinson's disease (PD), Alzheimer's disease (AD), stroke, epilepsy), and for these signals of abnormal network activity to normalize with treatment, and/or to be predictive of disease progression or recovery. We then ask the question to what extent existing NIBS protocols have been tailored to interact with these oscillations and possibly associated dysfunctions. Our review shows that, despite evidence for both reliable neurophysiological markers of specific oscillatory dis-functionalities in neurological disorders and NIBS protocols potentially able to interact with them, there are few applications of NIBS aiming to explore clinical outcomes of this interaction. Our review article aims to point out oscillatory markers of neurological, which are also suitable targets for modification by NIBS, in order to facilitate in future studies the matching of technical application to clinical targets.
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Affiliation(s)
- Assenza Giovanni
- Clinical Neurology, Campus Biomedico University of RomeRome, Italy
| | | | - Lazzaro di Biase
- Clinical Neurology, Campus Biomedico University of RomeRome, Italy
- Nuffield Department of Clinical Neurosciences, University of OxfordOxford, United Kingdom
| | - Florinda Ferreri
- Clinical Neurology, Campus Biomedico University of RomeRome, Italy
- Department of Clinical Neurophysiology, Kuopio University Hospital, University of Eastern FinlandKuopio, Finland
| | - Lucia Florio
- Clinical Neurology, Campus Biomedico University of RomeRome, Italy
| | - Andrea Guerra
- Clinical Neurology, Campus Biomedico University of RomeRome, Italy
- Nuffield Department of Clinical Neurosciences, University of OxfordOxford, United Kingdom
| | - Massimo Marano
- Clinical Neurology, Campus Biomedico University of RomeRome, Italy
| | - Matteo Paolucci
- Clinical Neurology, Campus Biomedico University of RomeRome, Italy
| | - Federico Ranieri
- Clinical Neurology, Campus Biomedico University of RomeRome, Italy
| | - Gaetano Salomone
- Clinical Neurology, Campus Biomedico University of RomeRome, Italy
| | - Mario Tombini
- Clinical Neurology, Campus Biomedico University of RomeRome, Italy
| | - Gregor Thut
- Centre for Cognitive Neuroimaging (CCNi), Institute of Neuroscience and Psychology, University of GlasgowGlasgow, United Kingdom
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The Clinical Applicability of Functional Connectivity in Depression: Pathways Toward More Targeted Intervention. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016; 1:262-270. [PMID: 29560882 DOI: 10.1016/j.bpsc.2016.02.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 02/23/2016] [Accepted: 02/24/2016] [Indexed: 12/29/2022]
Abstract
Resting-state functional magnetic resonance imaging provides a noninvasive method to rapidly map large-scale brain networks affected in depression and other psychiatric disorders. Dysfunctional connectivity in large-scale brain networks has been consistently implicated in major depressive disorder (MDD). Although advances have been made in identifying neural circuitry implicated in MDD, this information has yet to be translated into improved diagnostic or treatment interventions. In the first section of this review, we discuss dysfunctional connectivity in affective salience, cognitive control, and default mode networks observed in MDD in association with characteristic symptoms of the disorder. In the second section, we address neurostimulation focusing on transcranial magnetic stimulation and evidence that this approach may directly modulate circuit abnormalities. Finally, we discuss possible avenues of future research to develop more precise diagnoses and targeted interventions within the heterogeneous diagnostic category of MDD as well as the methodological limitations to clinical implementation. We conclude by proposing, with cautious optimism, the future incorporation of neuroimaging into clinical practice as a tool to aid in more targeted diagnosis and treatment guided by circuit-level connectivity dysfunction in patients with depression.
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Veniero D, Vossen A, Gross J, Thut G. Lasting EEG/MEG Aftereffects of Rhythmic Transcranial Brain Stimulation: Level of Control Over Oscillatory Network Activity. Front Cell Neurosci 2015; 9:477. [PMID: 26696834 PMCID: PMC4678227 DOI: 10.3389/fncel.2015.00477] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 11/23/2015] [Indexed: 11/24/2022] Open
Abstract
A number of rhythmic protocols have emerged for non-invasive brain stimulation (NIBS) in humans, including transcranial alternating current stimulation (tACS), oscillatory transcranial direct current stimulation (otDCS), and repetitive (also called rhythmic) transcranial magnetic stimulation (rTMS). With these techniques, it is possible to match the frequency of the externally applied electromagnetic fields to the intrinsic frequency of oscillatory neural population activity (“frequency-tuning”). Mounting evidence suggests that by this means tACS, otDCS, and rTMS can entrain brain oscillations and promote associated functions in a frequency-specific manner, in particular during (i.e., online to) stimulation. Here, we focus instead on the changes in oscillatory brain activity that persist after the end of stimulation. Understanding such aftereffects in healthy participants is an important step for developing these techniques into potentially useful clinical tools for the treatment of specific patient groups. Reviewing the electrophysiological evidence in healthy participants, we find aftereffects on brain oscillations to be a common outcome following tACS/otDCS and rTMS. However, we did not find a consistent, predictable pattern of aftereffects across studies, which is in contrast to the relative homogeneity of reported online effects. This indicates that aftereffects are partially dissociated from online, frequency-specific (entrainment) effects during tACS/otDCS and rTMS. We outline possible accounts and future directions for a better understanding of the link between online entrainment and offline aftereffects, which will be key for developing more targeted interventions into oscillatory brain activity.
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Affiliation(s)
- Domenica Veniero
- Centre for Cognitive Neuroimaging, Institute of Neuroscience and Psychology, University of Glasgow Glasgow, UK
| | | | - Joachim Gross
- Centre for Cognitive Neuroimaging, Institute of Neuroscience and Psychology, University of Glasgow Glasgow, UK
| | - Gregor Thut
- Centre for Cognitive Neuroimaging, Institute of Neuroscience and Psychology, University of Glasgow Glasgow, UK
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24
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Synaptic plasticity model of therapeutic sleep deprivation in major depression. Sleep Med Rev 2015; 30:53-62. [PMID: 26803484 DOI: 10.1016/j.smrv.2015.11.003] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 10/26/2015] [Accepted: 11/19/2015] [Indexed: 01/01/2023]
Abstract
Therapeutic sleep deprivation (SD) is a rapid acting treatment for major depressive disorder (MDD). Within hours, SD leads to a dramatic decrease in depressive symptoms in 50-60% of patients with MDD. Scientifically, therapeutic SD presents a unique paradigm to study the neurobiology of MDD. Yet, up to now, the neurobiological basis of the antidepressant effect, which is most likely different from today's first-line treatments, is not sufficiently understood. This article puts the idea forward that sleep/wake-dependent shifts in synaptic plasticity, i.e., the neural basis of adaptive network function and behavior, represent a critical mechanism of therapeutic SD in MDD. Particularly, this article centers on two major hypotheses of MDD and sleep, the synaptic plasticity hypothesis of MDD and the synaptic homeostasis hypothesis of sleep-wake regulation, and on how they can be integrated into a novel synaptic plasticity model of therapeutic SD in MDD. As a major component, the model proposes that therapeutic SD, by homeostatically enhancing cortical synaptic strength, shifts the initially deficient inducibility of associative synaptic long-term potentiation (LTP) in patients with MDD in a more favorable window of associative plasticity. Research on the molecular effects of SD in animals and humans, including observations in the neurotrophic, adenosinergic, monoaminergic, and glutamatergic system, provides some support for the hypothesis of associative synaptic plasticity facilitation after therapeutic SD in MDD. The model proposes a novel framework for a mechanism of action of therapeutic SD that can be further tested in humans based on non-invasive indices and in animals based on direct studies of synaptic plasticity. Further determining the mechanisms of action of SD might contribute to the development of novel fast acting treatments for MDD, one of the major health problems worldwide.
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Bares M, Brunovsky M, Novak T, Kopecek M, Stopkova P, Sos P, Höschl C. QEEG Theta Cordance in the Prediction of Treatment Outcome to Prefrontal Repetitive Transcranial Magnetic Stimulation or Venlafaxine ER in Patients With Major Depressive Disorder. Clin EEG Neurosci 2015; 46:73-80. [PMID: 24711613 DOI: 10.1177/1550059413520442] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 12/22/2013] [Indexed: 11/15/2022]
Abstract
The aims of this double-blind study were to assess and compare the efficacy of quantitative electroencephalographic (QEEG) prefrontal theta band cordance in the prediction of response to 4-week, right, prefrontal, 1-Hz repetitive transcranial magnetic stimulation (rTMS) or venlafaxine ER in patients with major depressive disorder (MDD). Prefrontal QEEG cordance values of 50 inpatients (25 subjects in each group) completing 4 weeks of the study were obtained at baseline and after 1 week of treatment. Depressive symptoms were assessed using Montgomery-Åsberg Depression Rating Scale (MADRS) at baseline and at week 1 and 4. Treatment response was defined as a ≥50% reduction in baseline MADRS total score. All responders (n = 9) and 6 of 16 nonresponders in the rTMS group had reduced cordance at week 1 (P < .01). Reduction of theta cordance value at week 1 was detected in all responders (n = 10) to venlafaxine ER, but only in 4 of 15 nonresponders (P = .005). The comparison of the areas under the curve of cordance change for prediction of response between rTMS (0.75) and venlafaxine ER (0.89) treated groups yielded no significant difference (P = .27). Our study indicates that prefrontal QEEG cordance is a promising tool not only for predicting the response to certain antidepressants but also to rTMS treatment, with comparable predictive efficacy for both therapeutic interventions.
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Affiliation(s)
- Martin Bares
- Prague Psychiatric Center and National Institute of Mental Health, Prague, Czech Republic The Department of Psychiatry and Medical Psychology of Third Medical Faculty, Charles University, Prague, Czech Republic
| | - Martin Brunovsky
- Prague Psychiatric Center and National Institute of Mental Health, Prague, Czech Republic The Department of Psychiatry and Medical Psychology of Third Medical Faculty, Charles University, Prague, Czech Republic
| | - Tomas Novak
- Prague Psychiatric Center and National Institute of Mental Health, Prague, Czech Republic The Department of Psychiatry and Medical Psychology of Third Medical Faculty, Charles University, Prague, Czech Republic
| | - Miloslav Kopecek
- Prague Psychiatric Center and National Institute of Mental Health, Prague, Czech Republic The Department of Psychiatry and Medical Psychology of Third Medical Faculty, Charles University, Prague, Czech Republic
| | - Pavla Stopkova
- Prague Psychiatric Center and National Institute of Mental Health, Prague, Czech Republic The Department of Psychiatry and Medical Psychology of Third Medical Faculty, Charles University, Prague, Czech Republic
| | - Peter Sos
- Prague Psychiatric Center and National Institute of Mental Health, Prague, Czech Republic The Department of Psychiatry and Medical Psychology of Third Medical Faculty, Charles University, Prague, Czech Republic
| | - Cyril Höschl
- Prague Psychiatric Center and National Institute of Mental Health, Prague, Czech Republic The Department of Psychiatry and Medical Psychology of Third Medical Faculty, Charles University, Prague, Czech Republic
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Assenza G, Pellegrino G, Tombini M, Di Pino G, Di Lazzaro V. Wakefulness delta waves increase after cortical plasticity induction. Clin Neurophysiol 2014; 126:1221-1227. [PMID: 25631611 DOI: 10.1016/j.clinph.2014.09.029] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 09/23/2014] [Accepted: 09/27/2014] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Delta waves (DW) are present both during sleep and in wakefulness. In the first case, DW are considered effectors of synaptic plasticity, while in wakefulness, when they appear in the case of brain lesions, their functional meaning is not unanimously recognized. To throw light on the latter, we aimed to investigate the impact on DW exerted by the cortical plasticity-inducing protocol of intermittent theta burst stimulation (iTBS). METHODS Twenty healthy subjects underwent iTBS (11 real iTBS and nine sham iTBS) on the left primary motor cortex with the aim of inducing long-term potentiation (LTP)-like phenomena. Five-minute resting open-eye 32-channel EEG, right opponens pollicis motor-evoked potentials (MEPs), and alertness behavioral scales were collected before and up to 30 min after the iTBS. Power spectral density (PSD), interhemispheric coherence between homologous sensorimotor regions, and intrahemispheric coherence were calculated for the frequency bands ranging from delta to beta. RESULTS Real iTBS induced a significant increase of both MEP amplitude and DW PSD lasting up to 30 min after stimulation, while sham iTBS did not. The DW increase was evident over frontal areas ipsilateral and close to the stimulated cortex (electrode F3). Neither real nor sham iTBS induced significant modifications in the PSD of theta, alpha, and beta bands and in the interhemispheric coherence. Behavioral visuo-analogic scales score did not demonstrate changes in alertness after stimulations. No correlations were found between MEP amplitude and PSD changes in the delta band. CONCLUSIONS Our data showed that LTP induction in the motor cortex during wakefulness, by means of iTBS, is accompanied by a large and enduring increase of DW over the ipsilateral frontal cortex. SIGNIFICANCE The present results are strongly in favor of a prominent role of DW in the neural plasticity processes taking place during the awake state.
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Affiliation(s)
- G Assenza
- Dipartimento di Neurologia, Università Campus Biomedico di Roma, Rome, Italy.
| | - G Pellegrino
- Dipartimento di Neurologia, Università Campus Biomedico di Roma, Rome, Italy; Multimodal Functional Imaging Laboratory, Biomedical Engineering Department and Montreal Neurological Institute, McGill University, Montreal, Canada
| | - M Tombini
- Dipartimento di Neurologia, Università Campus Biomedico di Roma, Rome, Italy
| | - G Di Pino
- Dipartimento di Neurologia, Università Campus Biomedico di Roma, Rome, Italy
| | - V Di Lazzaro
- Dipartimento di Neurologia, Università Campus Biomedico di Roma, Rome, Italy
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A Local Signature of LTP-Like Plasticity Induced by Repetitive Paired Associative Stimulation. Brain Topogr 2014; 28:238-49. [DOI: 10.1007/s10548-014-0396-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 09/03/2014] [Indexed: 11/26/2022]
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28
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Accornero N, Capozza M, Pieroni L, Pro S, Davì L, Mecarelli O. EEG mean frequency changes in healthy subjects during prefrontal transcranial direct current stimulation. J Neurophysiol 2014; 112:1367-75. [PMID: 24920029 DOI: 10.1152/jn.00088.2014] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In this pilot study we evaluated electroencephalographic (EEG) mean frequency changes induced by prefrontal transcranial direct current stimulation (tDCS) and investigated whether they depended on tDCS electrode montage. Eight healthy volunteers underwent tDCS for 15 min during EEG recording. They completed six tDCS sessions, 1 wk apart, testing left and right direct current (DC) dipole directions with six different montages: four unipolar montages (one electrode on a prefrontal area, the other on the opposite wrist) and two bipolar montages (both electrodes on prefrontal areas), and a single sham session. EEG power spectra were assessed from four 1-min EEG epochs, before, during, and after tDCS. During tDCS the outcome variable, brain rate (fb), changed significantly, and the changes persisted for minutes after tDCS ended. With the DC dipole directed to the left (anode on the left prefrontal area or wrist), fb increased, and with the DC dipole directed to the right (anode on the right prefrontal area or wrist), fb decreased, suggesting asymmetric prefrontal cortex functional organization in the normal human brain. Anodal and cathodal effects were opposite but equally large. Gender left these effects unchanged.
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Affiliation(s)
- Neri Accornero
- Department of Neurological Sciences, "Sapienza" University, Rome, Italy; and
| | - Marco Capozza
- Department of Neurological Sciences, "Sapienza" University, Rome, Italy; and
| | - Laura Pieroni
- Department of Psychology, "Sapienza" University, Rome, Italy
| | - Stefano Pro
- Department of Neurological Sciences, "Sapienza" University, Rome, Italy; and
| | - Leonardo Davì
- Department of Neurological Sciences, "Sapienza" University, Rome, Italy; and
| | - Oriano Mecarelli
- Department of Neurological Sciences, "Sapienza" University, Rome, Italy; and
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29
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Ding L, Shou G, Yuan H, Urbano D, Cha YH. Lasting modulation effects of rTMS on neural activity and connectivity as revealed by resting-state EEG. IEEE Trans Biomed Eng 2014; 61:2070-80. [PMID: 24686227 DOI: 10.1109/tbme.2014.2313575] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The long-lasting neuromodulatory effects of repetitive transcranial magnetic stimulation (rTMS) are of great interest for therapeutic applications in various neurological and psychiatric disorders, due to which functional connectivity among brain regions is profoundly disturbed. Classic TMS studies selectively alter neural activity in specific brain regions and observe neural activity changes on nonperturbed areas to infer underlying connectivity and its changes. Less has been indicated in direct measures of functional connectivity and/or neural network and on how connectivity/network alterations occur. Here, we developed a novel analysis framework to directly investigate both neural activity and connectivity changes induced by rTMS from resting-state EEG (rsEEG) acquired in a group of subjects with a chronic disorder of imbalance, known as the mal de debarquement syndrome (MdDS). Resting-state activity in multiple functional brain areas was identified through a data-driven blind source separation analysis on rsEEG data, and the connectivity among them was characterized using a phase synchronization measure. Our study revealed that there were significant long-lasting changes in resting-state neural activity, in theta, low alpha, and high alpha bands and neural networks in theta, low alpha, high alpha and beta bands, over broad cortical areas 4 to 5 h after the last application of rTMS in a consecutive five-day protocol. Our results of rsEEG connectivity further indicated that the changes, mainly in the alpha band, over the parietal and occipital cortices from pre- to post-TMS sessions were significantly correlated, in both magnitude and direction, to symptom changes in this group of subjects with MdDS. This connectivity measure not only suggested that rTMS can generate positive treatment effects in MdDS patients, but also revealed new potential targets for future therapeutic trials to improve treatment effects. It is promising that the new connectivity measure from rsEEG can be used to understand the variability in treatment response to rTMS in brain disorders with impaired functional connectivity and, eventually, to determine individually tailored stimulation parameters and treatment procedures in rTMS.
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Woźniak-Kwaśniewska A, Szekely D, Aussedat P, Bougerol T, David O. Changes of oscillatory brain activity induced by repetitive transcranial magnetic stimulation of the left dorsolateral prefrontal cortex in healthy subjects. Neuroimage 2013; 88:91-9. [PMID: 24269574 DOI: 10.1016/j.neuroimage.2013.11.029] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 10/13/2013] [Accepted: 11/14/2013] [Indexed: 11/25/2022] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) modulates brain activity in different ways according to the stimulation parameters. Although the after-effects of rTMS over motor cortex are well documented in healthy individuals, less is known about the stimulation of dorso-lateral prefrontal cortex (DLPFC). Here, we studied in 20 healthy subjects how cortical oscillations are modulated by four different active rTMS protocols (1Hz, 10Hz, continuous and intermittent theta bursts - cTBS and iTBS) of the left DLPFC, and by a sham protocol used as a control condition, by comparing the spectral power of pre- and post-rTMS electroencephalographic (EEG) recordings of 15min duration. EEG spectrum was estimated with the fast Fourier transform (FFT) and partitioned using the common physiological frequency bands: delta (1-4Hz), theta (3.5-7Hz), alpha (7.5-13Hz), low beta (14-22Hz), high beta (22-30Hz) and gamma (30-45Hz). Statistical analyses of EEG changes induced by rTMS were computed with Statistical Parametric Mapping (SPM) for EEG, in every frequency band, at the scalp level and at the cortex level. We found for every active protocol a significant decrease of delta and theta power on left prefrontal electrodes, mainly localised in the left DLPFC. In higher frequency bands (beta and gamma), the decrease of power in the DLPFC was also observed contralaterally. Protocol-specific amplitude effects were found in the prefrontal cortex bilaterally in all frequency bands, but also in parietal and temporal regions in low EEG frequencies. In high frequencies, EEG power in the prefrontal cortex increased after rTMS for 10Hz and iTBS protocols, but this effect did not survive the comparison to Sham responses. Because large delta and theta activity is usually associated with cortical inhibition, observed rTMS-induced EEG changes in low frequencies suggest that rTMS of DLPFC transiently decreases local cortical inhibition. Importantly, local responses take place in association with other unknown mechanisms that modulate inter-hemispheric connectivity between homologous regions, resulting in the increase or decrease of fast activity in each prefrontal lobe, depending on the stimulation protocol. Only decreases of fast activity following active rTMS could be detected as significant when compared to Sham stimulation.
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Affiliation(s)
- Agata Woźniak-Kwaśniewska
- Fonctions Cérébrales et Neuromodulation, Grenoble Institut des Neurosciences, Université Joseph Fourier, Grenoble, France
| | - David Szekely
- Fonctions Cérébrales et Neuromodulation, Grenoble Institut des Neurosciences, Université Joseph Fourier, Grenoble, France; Clinique Universitaire de Psychiatrie, Pôle Psychiatrie Neurologie, Centre Hospitalier Universitaire, Grenoble, France
| | - Pierre Aussedat
- Fonctions Cérébrales et Neuromodulation, Grenoble Institut des Neurosciences, Université Joseph Fourier, Grenoble, France
| | - Thierry Bougerol
- Clinique Universitaire de Psychiatrie, Pôle Psychiatrie Neurologie, Centre Hospitalier Universitaire, Grenoble, France
| | - Olivier David
- Fonctions Cérébrales et Neuromodulation, Grenoble Institut des Neurosciences, Université Joseph Fourier, Grenoble, France; Clinique Universitaire de Psychiatrie, Pôle Psychiatrie Neurologie, Centre Hospitalier Universitaire, Grenoble, France.
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31
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Pripfl J, Tomova L, Riecansky I, Lamm C. Transcranial magnetic stimulation of the left dorsolateral prefrontal cortex decreases cue-induced nicotine craving and EEG delta power. Brain Stimul 2013; 7:226-33. [PMID: 24468092 DOI: 10.1016/j.brs.2013.11.003] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 11/08/2013] [Accepted: 11/11/2013] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND TMS has high potential as smoking cessation treatment. However, the neural mechanisms underlying TMS induced reduction of tobacco craving remain unclear. Electroencephalographic (EEG) delta frequency has been associated with the activity of the dopaminergic brain reward system, which is crucial for nicotine induced effects, and decreases after nicotine admission in smokers. OBJECTIVE The aim of this study was to investigate EEG delta power changes induced by hf rTMS of the left dorsolateral prefrontal cortex (DLPFC) in nicotine deprived smokers and it's relation to cue-induced nicotine craving. METHODS Fourteen healthy smokers meeting ICD-10 criteria for tobacco addiction participated in this within-subject sham controlled study. Participants had to abstain from smoking 6 h before the experiment. Effects of high-frequency repetitive TMS (hf rTMS) (10 Hz) for verum (left DLPFC) and sham (vertex) stimulations on cue-induced nicotine craving and resting state EEG delta power were assessed before and three times within 40 min after rTMS. RESULTS Both craving (P = 0.046) and EEG delta power (P = 0.048) were significantly lower after verum stimulation compared to sham stimulation across the whole post stimulation time period assessed. However, changes of craving ratings and delta power did not correlate. CONCLUSION Hf rTMS applied to the left DLPFC reduces nicotine craving in short-term abstinent smokers. Changes in delta activity support the idea that stimulation induced effects are mediated by the dopaminergic brain reward system, which presumably plays a prominent, but probably not exclusive, role in this stimulation induced behavioral modulation, making this method a promising smoking cessation treatment candidate.
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Affiliation(s)
- Jürgen Pripfl
- Social, Cognitive and Affective Neuroscience (SCAN) Unit, Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria.
| | - Livia Tomova
- Social, Cognitive and Affective Neuroscience (SCAN) Unit, Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Igor Riecansky
- Social, Cognitive and Affective Neuroscience (SCAN) Unit, Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria; Laboratory of Cognitive Neuroscience, Institute of Normal and Pathological Physiology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Claus Lamm
- Social, Cognitive and Affective Neuroscience (SCAN) Unit, Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria
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32
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Potentiation of quantitative electroencephalograms following prefrontal repetitive transcranial magnetic stimulation in patients with major depression. Neurosci Res 2013; 77:70-7. [DOI: 10.1016/j.neures.2013.06.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Revised: 06/12/2013] [Accepted: 06/15/2013] [Indexed: 11/20/2022]
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33
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Fautrelle L, Gueugnon M, Barbieri G, Bonnetblanc F. Inter-hemispheric remapping between arm proprioception and vision of the hand is disrupted by single pulse TMS on the left parietal cortex. Brain Cogn 2013; 82:146-51. [DOI: 10.1016/j.bandc.2013.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 02/22/2013] [Accepted: 03/19/2013] [Indexed: 10/26/2022]
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34
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Abstract
Major depressive disorder is a debilitating condition with a lifetime risk of ten percent. Most treatments take several weeks to achieve clinical efficacy, limiting the ability to bring instant relief needed in psychiatric emergencies. One intervention that rapidly alleviates depressive symptoms is sleep deprivation; however, its mechanism of action is unknown. Astrocytes regulate responses to sleep deprivation, raising the possibility that glial signaling mediates antidepressive-like actions of sleep deprivation. Here, we found that astrocytic signaling to adenosine (A1) receptors was required for the robust reduction of depressive-like behaviors following 12 hours of sleep deprivation. As sleep deprivation activates synaptic A1 receptors, we mimicked the effect of sleep deprivation on depression phenotypes by administration of the A1 agonist CCPA. These results provide the first mechanistic insight into how sleep deprivation impacts mood, and provide a novel pathway for rapid antidepressant development by modulation of glial signaling in the brain.
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35
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A neuronal network model for simulating the effects of repetitive transcranial magnetic stimulation on local field potential power spectra. PLoS One 2012; 7:e49097. [PMID: 23145082 PMCID: PMC3492306 DOI: 10.1371/journal.pone.0049097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Accepted: 10/07/2012] [Indexed: 11/19/2022] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) holds promise as a non-invasive therapy for the treatment of neurological disorders such as depression, schizophrenia, tinnitus, and epilepsy. Complex interdependencies between stimulus duration, frequency and intensity obscure the exact effects of rTMS stimulation on neural activity in the cortex, making evaluation of and comparison between rTMS studies difficult. To explain the influence of rTMS on neural activity (e.g. in the motor cortex), we use a neuronal network model. The results demonstrate that the model adequately explains experimentally observed short term effects of rTMS on the band power in common frequency bands used in electroencephalography (EEG). We show that the equivalent local field potential (eLFP) band power depends on stimulation intensity rather than on stimulation frequency. Additionally, our model resolves contradictions in experiments.
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Abstract
We often change our behavior to conform to real or imagined group pressure. Social influence on our behavior has been extensively studied in social psychology, but its neural mechanisms have remained largely unknown. Here we demonstrate that the transient downregulation of the posterior medial frontal cortex by theta-burst transcranial magnetic stimulation reduces conformity, as indicated by reduced conformal adjustments in line with group opinion. Both the extent and probability of conformal behavioral adjustments decreased significantly relative to a sham and a control stimulation over another brain area. The posterior part of the medial frontal cortex has previously been implicated in behavioral and attitudinal adjustments. Here, we provide the first interventional evidence of its critical role in social influence on human behavior.
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Baumgartner T, Knoch D, Hotz P, Eisenegger C, Fehr E. Dorsolateral and ventromedial prefrontal cortex orchestrate normative choice. Nat Neurosci 2011; 14:1468-74. [DOI: 10.1038/nn.2933] [Citation(s) in RCA: 207] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 08/08/2011] [Indexed: 12/12/2022]
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38
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Some evidence supporting the safety of quadripulse stimulation (QPS). Brain Stimul 2011; 4:303-5. [DOI: 10.1016/j.brs.2010.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Revised: 10/20/2010] [Accepted: 10/20/2010] [Indexed: 11/21/2022] Open
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Pascual-Leone A, Freitas C, Oberman L, Horvath JC, Halko M, Eldaief M, Bashir S, Vernet M, Shafi M, Westover B, Vahabzadeh-Hagh AM, Rotenberg A. Characterizing brain cortical plasticity and network dynamics across the age-span in health and disease with TMS-EEG and TMS-fMRI. Brain Topogr 2011; 24:302-15. [PMID: 21842407 PMCID: PMC3374641 DOI: 10.1007/s10548-011-0196-8] [Citation(s) in RCA: 217] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Accepted: 07/27/2011] [Indexed: 01/21/2023]
Abstract
Brain plasticity can be conceptualized as nature's invention to overcome limitations of the genome and adapt to a rapidly changing environment. As such, plasticity is an intrinsic property of the brain across the lifespan. However, mechanisms of plasticity may vary with age. The combination of transcranial magnetic stimulation (TMS) with electroencephalography (EEG) or functional magnetic resonance imaging (fMRI) enables clinicians and researchers to directly study local and network cortical plasticity, in humans in vivo, and characterize their changes across the age-span. Parallel, translational studies in animals can provide mechanistic insights. Here, we argue that, for each individual, the efficiency of neuronal plasticity declines throughout the age-span and may do so more or less prominently depending on variable 'starting-points' and different 'slopes of change' defined by genetic, biological, and environmental factors. Furthermore, aberrant, excessive, insufficient, or mistimed plasticity may represent the proximal pathogenic cause of neurodevelopmental and neurodegenerative disorders such as autism spectrum disorders or Alzheimer's disease.
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Affiliation(s)
- Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA.
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Reithler J, Peters J, Sack A. Multimodal transcranial magnetic stimulation: Using concurrent neuroimaging to reveal the neural network dynamics of noninvasive brain stimulation. Prog Neurobiol 2011; 94:149-65. [DOI: 10.1016/j.pneurobio.2011.04.004] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Revised: 03/31/2011] [Accepted: 04/06/2011] [Indexed: 10/18/2022]
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41
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Beam W, Borckardt JJ, Reeves ST, George MS. An efficient and accurate new method for locating the F3 position for prefrontal TMS applications. Brain Stimul 2010; 2:50-4. [PMID: 20539835 DOI: 10.1016/j.brs.2008.09.006] [Citation(s) in RCA: 347] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
The International 10-20 system is a method for standardized placement of electroencephalogram (EEG) electrodes. The 10-20 system correlates external skull locations with the underlying cortical areas. This system accounts for variability in patient skull size by using certain percentages of the circumference and distances between four basic anatomical landmarks. This 10-20 system has recently been used in transcranial magnetic stimulation (TMS) research for locating specific cortical areas. In the treatment of depression (and some types of pain), the desired placement of the TMS coil is often above the left dorsalateral prefrontal cortex (DLPFC) which corresponds to the F3 location given by the 10-20 system. However, for an administrator with little experience with the 10-20 system, the numerous measurements and calculations can be excessively time-consuming. Additionally, with more measurements comes more opportunity for human error. For this reason we have developed a new, simpler and faster way to find the F3 position using only three skull measurements. In this paper, we describe and illustrate the application of the new F3 location system, provide the formulas used in the calculation of the F3 position, and summarize data from 10 healthy adults. After using both the International 10-20 system and this new method, it appears that the new method is sufficiently accurate; however, future investigations may be warranted to conduct more in dept analyses of the method's utility and potential limitations. This system requires less time and training to find the optimal position for prefrontal coil placement and it saves considerable time compared to the 10-20 EEG system.
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Affiliation(s)
- William Beam
- Medical University of South Carolina, Charleston, 29425, USA.
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Piccione F, Cavinato M, Manganotti P, Formaggio E, Storti SF, Battistin L, Cagnin A, Tonin P, Dam M. Behavioral and neurophysiological effects of repetitive transcranial magnetic stimulation on the minimally conscious state: a case study. Neurorehabil Neural Repair 2010; 25:98-102. [PMID: 20647501 DOI: 10.1177/1545968310369802] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND In 2007, Schiff et al reported a patient in a minimally conscious state (MCS) who responded to deep brain stimulation (DBS), but clinicians cannot predict which patients might respond prior to the implantation of electrodes. METHODS A patient in a MCS for 5 years participated in an ABA design alternating between repetitive transcranial magnetic stimulation (rTMS) and peripheral nerve stimulation. rTMS (condition A) involved the delivery of 10 trains of 100 stimuli at 20 Hz using a stimulator with a 70-mm figure-of-eight coil to elicit a contraction of the abductor pollicis brevis. Condition B used median nerve electrical stimulation. RESULTS After peripheral stimulation, the patient did not exhibit clinical, behavioral, or electroencephalographic (EEG) changes. The frequency of specific and meaningful behaviors increased after rTMS, along with the absolute and relative power of the EEG δ, β, and α bands. CONCLUSION These results suggest that rTMS may improve awareness and arousal in MCS. If these results are reproducible, rTMS may identify subgroups of MCS patients who might benefit from DBS.
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Thut G, Pascual-Leone A. A review of combined TMS-EEG studies to characterize lasting effects of repetitive TMS and assess their usefulness in cognitive and clinical neuroscience. Brain Topogr 2009; 22:219-32. [PMID: 19862614 DOI: 10.1007/s10548-009-0115-4] [Citation(s) in RCA: 275] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2008] [Accepted: 10/03/2009] [Indexed: 10/20/2022]
Abstract
Transcranial magnetic stimulation (TMS) has developed into a powerful tool for studying human brain physiology and brain-behavior relations. When applied in sessions of repeated stimulation, TMS can lead to changes in neuronal activity/excitability that outlast the stimulation itself. Such aftereffects are at the heart of the offline TMS protocols in cognitive neuroscience and neurotherapeutics. However, whether these aftereffects are of applied interest critically depends on their magnitude and duration, which should fall within an experimentally or clinically useful range without increasing risks and adverse effects. In this short review, we survey combined TMS-EEG studies to characterize the TMS-aftereffects as revealed by EEG to contribute to the characterization of the most effective and promising repetitive TMS-parameters. With one session of conventional repetitive TMS (of fixed pulse frequency), aftereffects were consistently comparable in magnitude to EEG-changes reported after learning or with fatigue, and were short-lived (<70 min). The few studies using recently developed protocols (such as theta burst stimulation) suggest comparable effect-size but longer effect-durations. Based on the reviewed data, it is expected that TMS-efficacy can be further promoted by repeating TMS-sessions, by using EEG-gated TMS to tailor TMS to current neuronal state, or by other, non-conventional TMS-protocols. Newly emerging developments in offline TMS research for cognitive neuroscience and neurotherapeutics are outlined.
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Affiliation(s)
- Gregor Thut
- Centre for Cognitive Neuroimaging, Department of Psychology, University of Glasgow, UK.
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Thut G, Miniussi C. New insights into rhythmic brain activity from TMS-EEG studies. Trends Cogn Sci 2009; 13:182-9. [PMID: 19286414 DOI: 10.1016/j.tics.2009.01.004] [Citation(s) in RCA: 284] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2008] [Revised: 01/14/2009] [Accepted: 01/14/2009] [Indexed: 11/18/2022]
Abstract
There is renewed interest in the functional role of oscillatory brain activity in specific frequency bands, investigated in humans through electroencephalography (EEG) and magnetoencephalography (MEG) recordings. In parallel, there is a growing body of research on non-invasive direct stimulation of the human brain via repetitive (rhythmic) transcranial magnetic stimulation (TMS), and on those frequencies that have the strongest behavioural impact. There is, therefore, great potential in combining these two lines of research to foster knowledge on brain rhythms, in addition to potential therapeutic applications of rhythmic brain stimulation. Here, we review findings from this rapidly evolving field linking intrinsic brain oscillations to distinct sensory, motor and cognitive operations. The findings emphasize that brain rhythms are causally implicated in cognitive functions.
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Affiliation(s)
- Gregor Thut
- Centre for Cognitive Neuroimaging, Department of Psychology, 58 Hillhead Street, Glasgow G12 8QB, UK.
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Price GW, Lee JW, Garvey C, Gibson N. Appraisal of sessional EEG features as a correlate of clinical changes in an rTMS treatment of depression. Clin EEG Neurosci 2008; 39:131-8. [PMID: 18751562 DOI: 10.1177/155005940803900307] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Previous findings on electrophysiological features related to depression predict that these correlate with clinical assessment, and potentially act as proxy measures of state changes. We investigated selected electrophysiological features to evaluate their utility as proxies for clinical ratings and in prediction of treatment outcome. Using typical EEG data from an repetitive transcranial magnetic stimulation (rTMS) treatment regime, we analyzed individual alpha power and frequency, and asymmetry index from 39 patients with treatment resistant depression. The prognostic utility of these features was assessed in terms of group identification, correlation with clinical rating, or association with the time course of treatment. There was no significant group difference in asymmetry between depression patients and normal and clinical controls. Background alpha was significantly less in depression patients than controls, with the schizophrenia group midway between. There was no significant group change in asymmetry index or background alpha activity with treatment. There was a weak effect of rTMS over each session on alpha power and on asymmetry, but in the opposite direction to predictions. There was weak evidence of predicted correlation between asymmetry index change and clinical rating change, as well as in final scores that was opposite to predictions. Finally there was no strong evidence that either feature fitted a linear or more complex model of daily treatment. In conclusion, the findings are not sufficient, under our current clinical treatment regime, to support the use of background alpha activity or frontal asymmetry as proxies for clinical assessment. Several findings, however, provide support for further research in this direction.
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Affiliation(s)
- G W Price
- Clinical Research and Neurophysiology, North Metropolitan Area Health Service-Mental Health, Perth, Australia.
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Spronk D, Arns M, Bootsma A, van Ruth R, Fitzgerald PB. Long-term effects of left frontal rTMS on EEG and ERPs in patients with depression. Clin EEG Neurosci 2008; 39:118-24. [PMID: 18751560 DOI: 10.1177/155005940803900305] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) treatment for depression has been under investigation in many controlled studies over the last 20 years. Little is known about the neurobiological action of rTMS in patients. We therefore investigated pre- and post-treatment effects on QEEG, ERP's and behavior (BDI and NEO-FFI). rTMS treatment was applied in 8 subjects for an average of 21 sessions to the left Dorsolateral Prefrontal Cortex (left DLPFC). Clients were assessed on a QEEG and Oddball ERP evaluation pre- and post-treatment. Clients were stimulated over the left DLPFC with 10 Hz rTMS (100% MT). Furthermore, rTMS treatment was complimented by psychotherapy. All subjects showed full remission within 20 sessions and there was a significant reduction in depressive symptomatology (BDI score) after 10 and 15 sessions and a clear decrease in the Neuroticism and an increase on the extraversion scale of the NEO-FFI personality questionnaire. Pre- and post-QEEG measurements did not reveal treatment specific effects, but only an indirect right frontal increase in delta power. On the other hand, ERP measures did reveal treatment specific effects by showing an increased positivity in the post-treatment ERP's specifically left frontal. The P2 amplitude demonstrated a significant left frontal increase in amplitude, whereas for the negative N1 and N2 a significant decrease in amplitude was observed. The results of this pilot study demonstrate that rTMS can be a safe and efficacious treatment modality for depression. Furthermore, a specific left frontal increase in positivity for the ERP's was found (increased P2 and decreased N1 and N2 components) most likely related to the rTMS over the left DLPFC. Furthermore, there was no change in the alpha asymmetry lending support to the fact that frontal alpha asymmetry can be considered a trait marker for depression. The findings from this pilot study require future replication with larger sample sizes.
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Affiliation(s)
- Desirée Spronk
- Brainclinics Diagnostics B.V., Nijmegen, The Netherlands.
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Funk AP, George MS. Prefrontal EEG asymmetry as a potential biomarker of antidepressant treatment response with transcranial magnetic stimulation (TMS): a case series. Clin EEG Neurosci 2008; 39:125-30. [PMID: 18751561 DOI: 10.1177/155005940803900306] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
We review studies that have used EEG as a response biomarker in depression, and then present preliminary EEG change data from an ongoing TMS depression treatment trial. These data in 4 depressed subjects over 3 weeks of treatment suggest but do not prove that there may be asymmetry changes that occur both within a daily TMS session and over the course of several weeks that may be associated with antidepressant response. EEG shows potential as a biomarker of response for depression treatments, particularly the brain stimulation devices, which, unlike medications, can focally interact with neural tissue in specific frequency patterns.
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Affiliation(s)
- Agnes P Funk
- Brain Stimulation Laboratory, Psychiatry Department, Medical University of South Carolina (MUSC), Charleston, South Carolina, USA
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