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Liao WY, Opie GM, Ziemann U, Semmler JG. The effects of intermittent theta burst stimulation over dorsal premotor cortex on primary motor cortex plasticity in young and older adults. Eur J Neurosci 2024. [PMID: 38757748 DOI: 10.1111/ejn.16395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 04/15/2024] [Accepted: 05/02/2024] [Indexed: 05/18/2024]
Abstract
Previous transcranial magnetic stimulation (TMS) research suggests that the dorsal premotor cortex (PMd) influences neuroplasticity within the primary motor cortex (M1) through indirect (I) wave interneuronal circuits. However, it is unclear how the influence of PMd on the plasticity of M1 I-waves changes with advancing age. This study therefore investigated the neuroplastic effects of intermittent theta burst stimulation (iTBS) to M1 early and late I-wave circuits when preceded by iTBS (PMd iTBS-M1 iTBS) or sham stimulation (PMd sham-M1 iTBS) to PMd in 15 young and 16 older adults. M1 excitability was assessed with motor evoked potentials (MEP) recorded from the right first dorsal interosseous using posterior-anterior (PA) and anterior-posterior (AP) current TMS at standard stimulation intensities (PA1mV, AP1mV) and reduced stimulation intensities (PA0.5mV, early I-waves; AP0.5mV, late I-waves). PMd iTBS-M1 iTBS lowered the expected facilitation of PA0.5mV (to M1 iTBS) in young and older adults (P = 0.009), whereas the intervention had no effect on AP0.5mV facilitation in either group (P = 0.305). The modulation of PA0.5mV following PMd iTBS-M1 iTBS may reflect a specific influence of PMd on different I-wave circuits that are involved in M1 plasticity within young and older adults.
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Affiliation(s)
- Wei-Yeh Liao
- Discipline of Physiology, School of Biomedicine, The University of Adelaide, Adelaide, Australia
| | - George M Opie
- Discipline of Physiology, School of Biomedicine, The University of Adelaide, Adelaide, Australia
| | - Ulf Ziemann
- Department of Neurology & Stroke, Eberhard Karls University of Tübingen, Tübingen, Germany
- Hertie-Institute for Clinical Brain Research, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - John G Semmler
- Discipline of Physiology, School of Biomedicine, The University of Adelaide, Adelaide, Australia
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Aceves-Serrano L, Neva JL, Munro J, Vavasour IM, Parent M, Boyd LA, Doudet DJ. Evaluation of microglia activation related markers following a clinical course of TBS: A non-human primate study. PLoS One 2024; 19:e0301118. [PMID: 38753646 PMCID: PMC11098425 DOI: 10.1371/journal.pone.0301118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 03/11/2024] [Indexed: 05/18/2024] Open
Abstract
While the applicability and popularity of theta burst stimulation (TBS) paradigms remain, current knowledge of their neurobiological effects is still limited, especially with respect to their impact on glial cells and neuroinflammatory processes. We used a multimodal imaging approach to assess the effects of a clinical course of TBS on markers for microglia activation and tissue injury as an indirect assessment of neuroinflammatory processes. Healthy non-human primates received continuous TBS (cTBS), intermittent TBS (iTBS), or sham stimulation over the motor cortex at 90% of resting motor threshold. Stimulation was delivered to the awake subjects 5 times a week for 3-4 weeks. Translocator protein (TSPO) expression was evaluated using Positron Emission Tomography and [11C]PBR28, and myo-inositol (mI) and N-acetyl-aspartate (NAA) concentrations were assessed with Magnetic Resonance Spectroscopy. Animals were then euthanized, and immunofluorescence staining was performed using antibodies against TSPO. Paired t-tests showed no significant changes in [11C]PBR28 measurements after stimulation. Similarly, no significant changes in mI and NAA concentrations were found. Post-mortem TSPO evaluation showed comparable mean immunofluorescence intensity after active TBS and sham delivery. The current study suggests that in healthy brains a clinical course of TBS, as evaluated with in-vivo imaging techniques (PET and MRS), did not measurably modulate the expression of glia related markers and metabolite associated with neural viability.
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Affiliation(s)
- Lucero Aceves-Serrano
- Department of Medicine, Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jason L. Neva
- Faculté de Médecine, École de Kinésiologie et des Sciences de l’activité Physique, Université de Montréal, Montreal, Quebec, Canada
- Centre de Recherche de l’institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Jonathan Munro
- CERVO Brain Research Centre, Laval University, Quebec City, Quebec, Canada
| | - Irene M. Vavasour
- Faculty of Medicine, UBC MRI Research Center, University of British Columbia, Vancouver, British Columbia, Canada
| | - Martin Parent
- CERVO Brain Research Centre, Laval University, Quebec City, Quebec, Canada
| | - Lara A. Boyd
- Faculty of Medicine, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Faculty of Medicine, Graduate Program of Rehabilitation Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Doris J. Doudet
- Department of Medicine, Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada
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3
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Madeo G, Bonci A. Driving innovation in addiction treatment: role of transcranial magnetic stimulation. J Neural Transm (Vienna) 2024; 131:505-508. [PMID: 38233662 DOI: 10.1007/s00702-023-02734-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 12/20/2023] [Indexed: 01/19/2024]
Abstract
Addictions comprises heterogenous psychiatric conditions caused by the complex interaction of genetic, neurobiological, psychological, and environmental factors with a chronic relapsing-remitting pattern. Despite the long-standing efforts of preclinical and clinical research studies, addiction field has seen relatively slow progress when it comes to the development of new therapeutic interventions, most of which failed to demonstrate a significant efficacy. This is likely due to the very complex interplay of many factors that contribute to both the development and expression of addictions. The imbalance between the salience and the reward brain network circuitry has been proposed as the neurobiological mechanisms explaining the pathognomonic symptoms of addictions.Non-invasive neuromodulation techniques have been proposed as a promising therapeutic intervention to restore these brain circuits dysfunctions. Here, we propose a multi-level strategy to innovate the diagnosis and the treatment of addictive disorders.
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Affiliation(s)
| | - Antonello Bonci
- Brain & Care Group, Rimini, Italy
- GIA Healthcare, 1501 Biscayne Blvd, Miami, 33137, USA
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Dong MS, Rokicki J, Dwyer D, Papiol S, Streit F, Rietschel M, Wobrock T, Müller-Myhsok B, Falkai P, Westlye LT, Andreassen OA, Palaniyappan L, Schneider-Axmann T, Hasan A, Schwarz E, Koutsouleris N. Multimodal workflows optimally predict response to repetitive transcranial magnetic stimulation in patients with schizophrenia: a multisite machine learning analysis. Transl Psychiatry 2024; 14:196. [PMID: 38664377 PMCID: PMC11045783 DOI: 10.1038/s41398-024-02903-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
The response variability to repetitive transcranial magnetic stimulation (rTMS) challenges the effective use of this treatment option in patients with schizophrenia. This variability may be deciphered by leveraging predictive information in structural MRI, clinical, sociodemographic, and genetic data using artificial intelligence. We developed and cross-validated rTMS response prediction models in patients with schizophrenia drawn from the multisite RESIS trial. The models incorporated pre-treatment sMRI, clinical, sociodemographic, and polygenic risk score (PRS) data. Patients were randomly assigned to receive active (N = 45) or sham (N = 47) rTMS treatment. The prediction target was individual response, defined as ≥20% reduction in pre-treatment negative symptom sum scores of the Positive and Negative Syndrome Scale. Our multimodal sequential prediction workflow achieved a balanced accuracy (BAC) of 94% (non-responders: 92%, responders: 95%) in the active-treated group and 50% in the sham-treated group. The clinical, clinical + PRS, and sMRI-based classifiers yielded BACs of 65%, 76%, and 80%, respectively. Apparent sadness, inability to feel, educational attainment PRS, and unemployment were most predictive of non-response in the clinical + PRS model, while grey matter density reductions in the default mode, limbic networks, and the cerebellum were most predictive in the sMRI model. Our sequential modelling approach provided superior predictive performance while minimising the diagnostic burden in the clinical setting. Predictive patterns suggest that rTMS responders may have higher levels of brain grey matter in the default mode and salience networks which increases their likelihood of profiting from plasticity-inducing brain stimulation methods, such as rTMS. The future clinical implementation of our models requires findings to be replicated at the international scale using stratified clinical trial designs.
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Grants
- FA-210/1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- SCHW 1768/1-1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- FA-210/1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- SCHW 1768/1-1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- FA-210/1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- SCHW 1768/1-1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- FA-210/1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- 01ZX1904A Bundesministerium für Bildung, Wissenschaft, Forschung und Technologie (Federal Ministry for Education, Science, Research and Technology)
- 01KU1905A Bundesministerium für Bildung, Wissenschaft, Forschung und Technologie (Federal Ministry for Education, Science, Research and Technology)
- 01ZX1904A Bundesministerium für Bildung, Wissenschaft, Forschung und Technologie (Federal Ministry for Education, Science, Research and Technology)
- 01KU1905A Bundesministerium für Bildung, Wissenschaft, Forschung und Technologie (Federal Ministry for Education, Science, Research and Technology)
- 01ZX1904A Bundesministerium für Bildung, Wissenschaft und Kultur (Federal Ministry of Education, Science and Culture)
- ENP-161423 Gouvernement du Canada | Canadian Institutes of Health Research (Instituts de Recherche en Santé du Canada)
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Affiliation(s)
- Mark Sen Dong
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University of Munich, Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Jaroslav Rokicki
- Centre of Research and Education in Forensic Psychiatry, Oslo Univerisity Hospital, Oslo, Norway
| | - Dominic Dwyer
- The University of Melbourne, Melbourne, VIC, Australia
| | - Sergi Papiol
- Max Planck Institute of Psychiatry, Munich, Germany
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Fabian Streit
- Department for Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Hector Institute for Artificial Intelligence in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marcella Rietschel
- Department for Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Thomas Wobrock
- Centre for Mental Health, Darmstadt-Dieburg District Clinic, Gross-Umstadt, Germany
| | | | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University of Munich, Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
- Partner site Munich-Augsburg, DZPG (German Centre for Mental Health), Munich / Augsburg, Germany
| | | | - Ole A Andreassen
- Centre for Precision Psychiatry, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Lena Palaniyappan
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, QC, Canada
- Robarts Research Institute, Western University, London Ontario, Canada
| | - Thomas Schneider-Axmann
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University of Munich, Munich, Germany
| | - Alkomiet Hasan
- Partner site Munich-Augsburg, DZPG (German Centre for Mental Health), Munich / Augsburg, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Emanuel Schwarz
- Department for Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Hector Institute for Artificial Intelligence in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University of Munich, Munich, Germany.
- Max Planck Institute of Psychiatry, Munich, Germany.
- Partner site Munich-Augsburg, DZPG (German Centre for Mental Health), Munich / Augsburg, Germany.
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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Cai G, Xu J, Ding Q, Lin T, Chen H, Wu M, Li W, Chen G, Xu G, Lan Y. Electroencephalography oscillations can predict the cortical response following theta burst stimulation. Brain Res Bull 2024; 208:110902. [PMID: 38367675 DOI: 10.1016/j.brainresbull.2024.110902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/28/2024] [Accepted: 02/14/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Continuous theta burst stimulation and intermittent theta burst stimulation are clinically popular models of repetitive transcranial magnetic stimulation. However, they are limited by high variability between individuals in cortical excitability changes following stimulation. Although electroencephalography oscillations have been reported to modulate the cortical response to transcranial magnetic stimulation, their association remains unclear. This study aims to explore whether machine learning models based on EEG oscillation features can predict the cortical response to transcranial magnetic stimulation. METHOD Twenty-three young, healthy adults attended two randomly assigned sessions for continuous and intermittent theta burst stimulation. In each session, ten minutes of resting-state electroencephalography were recorded before delivering brain stimulation. Participants were classified as responders or non-responders based on changes in resting motor thresholds. Support vector machines and multi-layer perceptrons were used to establish predictive models of individual responses to transcranial magnetic stimulation. RESULT Among the evaluated algorithms, support vector machines achieved the best performance in discriminating responders from non-responders for intermittent theta burst stimulation (accuracy: 91.30%) and continuous theta burst stimulation (accuracy: 95.66%). The global clustering coefficient and global characteristic path length in the beta band had the greatest impact on model output. CONCLUSION These findings suggest that EEG features can serve as markers of cortical response to transcranial magnetic stimulation. They offer insights into the association between neural oscillations and variability in individuals' responses to transcranial magnetic stimulation, aiding in the optimization of individualized protocols.
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Affiliation(s)
- Guiyuan Cai
- Department of Rehabilitation Medicine, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, 510013 China
| | - Jiayue Xu
- Department of Rehabilitation Medicine, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, 510013 China
| | - Qian Ding
- Department of Rehabilitation Medicine, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, 510013 China; Department of Rehabilitation Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 519041 China
| | - Tuo Lin
- Department of Rehabilitation Medicine, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, 510013 China
| | - Hongying Chen
- Department of Rehabilitation Medicine, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, 510013 China
| | - Manfeng Wu
- Department of Rehabilitation Medicine, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, 510013 China
| | - Wanqi Li
- Department of Rehabilitation Medicine, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, 510013 China
| | - Gengbin Chen
- Department of Rehabilitation Medicine, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, 510013 China; Postgraduate Research Institute, Guangzhou Sport University, Guangzhou, 510500 China
| | - Guangqing Xu
- Department of Rehabilitation Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 519041 China.
| | - Yue Lan
- Department of Rehabilitation Medicine, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, 510013 China; Guangzhou Key Laboratory of Aging Frailty and Neurorehabilitation, Guangzhou 510013, China.
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Olğun Y, Aksoy Poyraz C, Bozluolçay M, Gündüz A, Poyraz BÇ. A comparative transcranial magnetic stimulation study: Assessing cortical excitability and plasticity in Alzheimer's disease, dementia with Lewy bodies and Frontotemporal dementia. Psychogeriatrics 2024; 24:272-280. [PMID: 38131520 DOI: 10.1111/psyg.13070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/28/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Here, we aimed to investigate the roles of long-term potentiation-like (LTP-like) plasticity using intermittent theta burst (iTBS) protocol and resting motor threshold (rMT) in the differential diagnosis of Alzheimer's disease (AD), diffuse dementia with Lewy bodies (DLB) and frontotemporal dementia (FTD). METHOD We enrolled 21 subjects with AD, 28 subjects with DLB, 14 subjects with FTD, and 33 elderly subjects with normal cognitive functions into the study. We recorded rMT and percentage amplitude change of motor evoked potentials (MEPs) after the iTBS protocol in each group. RESULTS In patients with AD and DLB, the percentage amplitude change of MEPs, and rMTs were significantly lower than in healthy subjects. However, no significant difference was observed in individuals with FTD. CONCLUSION Our findings showed that transcranial magnetic stimulation measures, particularly rMTs and LTP-like plasticity, may be potential biomarkers to distinguish between different dementia subtypes. Impaired motor cortical excitability and synaptic plasticity were more prominent in AD and DLB than in FTD. This aligns with the evidence that cortical motor networks are usually spared in FTDs in early-to-middle stages.
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Affiliation(s)
- Yeşim Olğun
- Cerrahpaşa Medical Faculty, Department of Psychiatry, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Cana Aksoy Poyraz
- Cerrahpaşa Medical Faculty, Department of Psychiatry, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Melda Bozluolçay
- Cerrahpaşa Medical Faculty, Department of Neurology, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Ayşegül Gündüz
- Cerrahpaşa Medical Faculty, Department of Neurology, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Burç Çağrı Poyraz
- Cerrahpaşa Medical Faculty, Department of Psychiatry, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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Hamzei F, Ritter A, Pohl K, Stäps P, Wieduwild E. Different Effect Sizes of Motor Skill Training Combined with Repetitive Transcranial versus Trans-Spinal Magnetic Stimulation in Healthy Subjects. Brain Sci 2024; 14:165. [PMID: 38391739 PMCID: PMC10887384 DOI: 10.3390/brainsci14020165] [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: 12/19/2023] [Revised: 01/14/2024] [Accepted: 01/31/2024] [Indexed: 02/24/2024] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is used to enhance motor training (MT) performance. The use of rTMS is limited under certain conditions, such as after a stroke with severe damage to the corticospinal tract. This raises the question as to whether repetitive trans-spinal magnetic stimulation (rSMS) can also be used to improve MT. A direct comparison of the effect size between rTMS and rSMS on the same MT is still lacking. Before conducting the study in patients, we determined the effect sizes of different stimulation approaches combined with the same motor training in healthy subjects. Two experiments (E1 and E2) with 96 subjects investigated the effect size of combining magnetic stimulation with the same MT. In E1, high-frequency rTMS, rSMS, and spinal sham stimulation (sham-spinal) were applied once in combination with MT, while one group only received the same MT (without stimulation). In E2, rTMS, rSMS, and sham-spinal were applied in combination with MT over several days. In all subjects, motor tests and motor-evoked potentials were evaluated before and after the intervention period. rTMS had the greatest effect on MT, followed by rSMS and then sham-spinal. Daily stimulation resulted in additional training gains. This study suggests that rSMS increases excitability and also enhances MT performance. This current study provides a basis for further research to discover whether patients who cannot be treated effectively with rTMS would benefit from rSMS.
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Affiliation(s)
- Farsin Hamzei
- Section of Neurological Rehabilitation, Hans-Berger-Hospital of Neurology, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
- Department of Neurology, Moritz Klinik, Hermann-Sachse-Straße 46, 07639 Bad Klosterlausnitz, Germany
| | - Alexander Ritter
- Section of Neurological Rehabilitation, Hans-Berger-Hospital of Neurology, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
| | - Kristin Pohl
- Section of Neurological Rehabilitation, Hans-Berger-Hospital of Neurology, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
- Department of Neurology, Moritz Klinik, Hermann-Sachse-Straße 46, 07639 Bad Klosterlausnitz, Germany
| | - Peggy Stäps
- Department of Neurology, Moritz Klinik, Hermann-Sachse-Straße 46, 07639 Bad Klosterlausnitz, Germany
| | - Eric Wieduwild
- Section of Neurological Rehabilitation, Hans-Berger-Hospital of Neurology, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
- Department of Neurology, Moritz Klinik, Hermann-Sachse-Straße 46, 07639 Bad Klosterlausnitz, Germany
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Rösch J, Emanuel Vetter D, Baldassarre A, Souza VH, Lioumis P, Roine T, Jooß A, Baur D, Kozák G, Blair Jovellar D, Vaalto S, Romani GL, Ilmoniemi RJ, Ziemann U. Individualized treatment of motor stroke: A perspective on open-loop, closed-loop and adaptive closed-loop brain state-dependent TMS. Clin Neurophysiol 2024; 158:204-211. [PMID: 37945452 DOI: 10.1016/j.clinph.2023.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/11/2023] [Accepted: 10/18/2023] [Indexed: 11/12/2023]
Affiliation(s)
- Johanna Rösch
- Department of Neurology and Stroke, University of Tübingen, Tübingen, Germany; Hertie-Institute for Clinical Brain Research, Tübingen, Germany
| | - David Emanuel Vetter
- Department of Neurology and Stroke, University of Tübingen, Tübingen, Germany; Hertie-Institute for Clinical Brain Research, Tübingen, Germany
| | - Antonello Baldassarre
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Victor H Souza
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki, Aalto University and Helsinki University Hospital, Helsinki, Finland
| | - Pantelis Lioumis
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki, Aalto University and Helsinki University Hospital, Helsinki, Finland
| | - Timo Roine
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki, Aalto University and Helsinki University Hospital, Helsinki, Finland
| | - Andreas Jooß
- Department of Neurology and Stroke, University of Tübingen, Tübingen, Germany; Hertie-Institute for Clinical Brain Research, Tübingen, Germany
| | - David Baur
- Department of Neurology and Stroke, University of Tübingen, Tübingen, Germany; Hertie-Institute for Clinical Brain Research, Tübingen, Germany
| | - Gábor Kozák
- Department of Neurology and Stroke, University of Tübingen, Tübingen, Germany; Hertie-Institute for Clinical Brain Research, Tübingen, Germany
| | - D Blair Jovellar
- Department of Neurology and Stroke, University of Tübingen, Tübingen, Germany; Hertie-Institute for Clinical Brain Research, Tübingen, Germany
| | - Selja Vaalto
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; HUS Diagnostic Center, Clinical Neurophysiology, Clinical Neurosciences, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Gian Luca Romani
- Institute for Advanced Biomedical Technologies, University of Chieti-Pescara, Chieti, Italy
| | - Risto J Ilmoniemi
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki, Aalto University and Helsinki University Hospital, Helsinki, Finland
| | - Ulf Ziemann
- Department of Neurology and Stroke, University of Tübingen, Tübingen, Germany; Hertie-Institute for Clinical Brain Research, Tübingen, Germany.
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Murakami T, Abe M, Tiksnadi A, Nemoto A, Futamura M, Yamakuni R, Kubo H, Kobayashi N, Ito H, Hanajima R, Hashimoto Y, Ugawa Y. Abnormal motor cortical plasticity as a useful neurophysiological biomarker for Alzheimer's disease pathology. Clin Neurophysiol 2024; 158:170-179. [PMID: 38219406 DOI: 10.1016/j.clinph.2023.12.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 11/27/2023] [Accepted: 12/15/2023] [Indexed: 01/16/2024]
Abstract
OBJECTIVE Amyloid-beta (Aβ) and tau accumulations impair long-term potentiation (LTP) induction in animal hippocampi. We investigated relationships between motor-cortical plasticity and biomarkers for Alzheimer's disease (AD) diagnosis in subjects with cognitive decline. METHODS Twenty-six consecutive subjects who complained of memory problems participated in this study. We applied transcranial quadripuse stimulation with an interstimulus interval of 5 ms (QPS5) to induce LTP-like plasticity. Motor-evoked potentials were recorded from the right first-dorsal interosseous muscle before and after QPS5. Cognitive functions, Aβ42 and tau levels in the cerebrospinal fluid (CSF) were measured. Amyloid positron-emission tomography (PET) with11C-Pittsburg compound-B was also conducted. We studied correlations of QPS5-induced plasticity with cognitive functions or AD-related biomarkers. RESULTS QPS5-induced LTP-like plasticity positively correlated with cognitive scores. The degree of LTP-like plasticity negatively correlated with levels of CSF-tau, and the amount of amyloid-PET accumulation at the precuneus, and correlated with the CSF-Aβ42 level positively. In the amyloid-PET positive subjects, non-responder rate of QPS5 was higher than the CSF-tau positive rate. CONCLUSIONS Findings suggest that QPS5-induced LTP-like plasticity is a functional biomarker of AD. QPS5 could detect abnormality at earlier stages than CSF-tau in the amyloid-PET positive subjects. SIGNIFICANCE Assessing motor-cortical plasticity could be a useful neurophysiological biomarker for AD pathology.
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Affiliation(s)
- Takenobu Murakami
- Department of Neurology, Faculty of Medicine, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan; Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Nishimachi 36-1, Yonago 683-8504, Japan.
| | - Mitsunari Abe
- Center for Neurological Disorders, Faculty of Medicine, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan
| | - Amanda Tiksnadi
- Department of Neurology, Faculty of Medicine, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan; Department of Neurology, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Salemba Raya No. 6, Jakarta 10430, Indonesia
| | - Ayaka Nemoto
- Advanced Clinical Research Center, Faculty of Medicine, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan
| | - Miyako Futamura
- Rehabilitation Center, Faculty of Medicine, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan
| | - Ryo Yamakuni
- Department of Radiology, Faculty of Medicine, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan
| | - Hitoshi Kubo
- Advanced Clinical Research Center, Faculty of Medicine, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan; Department of Radiological Sciences, Faculty of Medicine, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan
| | - Naoto Kobayashi
- Azuma Street Clinic, Sakaemachi 1-28, Fukushima 960-8031, Japan
| | - Hiroshi Ito
- Advanced Clinical Research Center, Faculty of Medicine, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan; Department of Radiology, Faculty of Medicine, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan
| | - Ritsuko Hanajima
- Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Nishimachi 36-1, Yonago 683-8504, Japan
| | - Yasuhiro Hashimoto
- Department of Biochemistry, Faculty of Medicine, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan
| | - Yoshikazu Ugawa
- Department of Neurology, Faculty of Medicine, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan; Department of Human Neurophysiology, Faculty of Medicine, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan
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10
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Humaidan D, Xu J, Kirchhoff M, Romani GL, Ilmoniemi RJ, Ziemann U. Towards real-time EEG-TMS modulation of brain state in a closed-loop approach. Clin Neurophysiol 2024; 158:212-217. [PMID: 38160069 DOI: 10.1016/j.clinph.2023.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 11/21/2023] [Accepted: 12/15/2023] [Indexed: 01/03/2024]
Affiliation(s)
- Dania Humaidan
- Department of Neurology & Stroke, University of Tübingen, Tübingen, Germany; Hertie-Institute for Clinical Brain Research, Tübingen, Germany
| | - Jiahua Xu
- Department of Neurology & Stroke, University of Tübingen, Tübingen, Germany; Hertie-Institute for Clinical Brain Research, Tübingen, Germany
| | - Miriam Kirchhoff
- Department of Neurology & Stroke, University of Tübingen, Tübingen, Germany; Hertie-Institute for Clinical Brain Research, Tübingen, Germany
| | - Gian Luca Romani
- Institute for Advanced Biomedical Technologies, University of Chieti-Pescara, Chieti, Italy
| | - Risto J Ilmoniemi
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki, Aalto University and Helsinki University Hospital, Helsinki, Finland
| | - Ulf Ziemann
- Department of Neurology & Stroke, University of Tübingen, Tübingen, Germany; Hertie-Institute for Clinical Brain Research, Tübingen, Germany.
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11
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Berger T, Xu T, Opitz A. Systematic cross-species comparison of prefrontal cortex functional networks targeted via Transcranial Magnetic Stimulation. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.12.20.572653. [PMID: 38187657 PMCID: PMC10769354 DOI: 10.1101/2023.12.20.572653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Transcranial Magnetic Stimulation (TMS) is a non-invasive brain stimulation method that safely modulates neural activity in vivo. Its precision in targeting specific brain networks makes TMS invaluable in diverse clinical applications. For example, TMS is used to treat depression by targeting prefrontal brain networks and their connection to other brain regions. However, despite its widespread use, the underlying neural mechanisms of TMS are not completely understood. Non-human primates (NHPs) offer an ideal model to study TMS mechanisms through invasive electrophysiological recordings. As such, bridging the gap between NHP experiments and human applications is imperative to ensure translational relevance. Here, we systematically compare the TMS-targeted functional networks in the prefrontal cortex in humans and NHPs. To conduct this comparison, we combine TMS electric field modeling in humans and macaques with resting-state functional magnetic resonance imaging (fMRI) data to compare the functional networks targeted via TMS across species. We identified distinct stimulation zones in macaque and human models, each exhibiting variations in the impacted networks (macaque: Frontoparietal Network, Somatomotor Network; human: Frontoparietal Network, Default Network). We identified differences in brain gyrification and functional organization across species as the underlying cause of found network differences. The TMS-network profiles we identified will allow researchers to establish consistency in network activation across species, aiding in the translational efforts to develop improved TMS functional network targeting approaches.
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12
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Safdar A, Smith MC, Byblow WD, Stinear CM. Applications of Repetitive Transcranial Magnetic Stimulation to Improve Upper Limb Motor Performance After Stroke: A Systematic Review. Neurorehabil Neural Repair 2023; 37:837-849. [PMID: 37947106 PMCID: PMC10685705 DOI: 10.1177/15459683231209722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
BACKGROUND Noninvasive brain stimulation (NIBS) is a promising technique for improving upper limb motor performance post-stroke. Its application has been guided by the interhemispheric competition model and typically involves suppression of contralesional motor cortex. However, the bimodal balance recovery model prompts a more tailored application of NIBS based on ipsilesional corticomotor function. OBJECTIVE To review and assess the application of repetitive transcranial magnetic stimulation (rTMS) protocols that aimed to improve upper limb motor performance after stroke. METHODS A PubMed search was conducted for studies published between 1st January 2005 and 1st November 2022 using rTMS to improve upper limb motor performance of human adults after stroke. Studies were grouped according to whether facilitatory or suppressive rTMS was applied to the contralesional hemisphere. RESULTS Of the 492 studies identified, 70 were included in this review. Only 2 studies did not conform to the interhemispheric competition model, and facilitated the contralesional hemisphere. Only 21 out of 70 (30%) studies reported motor evoked potential (MEP) status as a biomarker of ipsilesional corticomotor function. Around half of the studies (37/70, 53%) checked whether rTMS had the expected effect by measuring corticomotor excitability (CME) after application. CONCLUSION The interhemispheric competition model dominates the application of rTMS post-stroke. The majority of recent and current studies do not consider bimodal balance recovery model for the application of rTMS. Evaluating CME after the application rTMS could confirm that the intervention had the intended neurophysiological effect. Future studies could select patients and apply rTMS protocols based on ipsilesional MEP status.
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Affiliation(s)
- Afifa Safdar
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Marie-Claire Smith
- Department of Exercise Sciences, University of Auckland, Auckland, New Zealand
| | - Winston D. Byblow
- Department of Exercise Sciences, University of Auckland, Auckland, New Zealand
| | - Cathy M. Stinear
- Department of Medicine, University of Auckland, Auckland, New Zealand
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13
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Dufor T, Lohof AM, Sherrard RM. Magnetic Stimulation as a Therapeutic Approach for Brain Modulation and Repair: Underlying Molecular and Cellular Mechanisms. Int J Mol Sci 2023; 24:16456. [PMID: 38003643 PMCID: PMC10671429 DOI: 10.3390/ijms242216456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
Neurological and psychiatric diseases generally have no cure, so innovative non-pharmacological treatments, including non-invasive brain stimulation, are interesting therapeutic tools as they aim to trigger intrinsic neural repair mechanisms. A common brain stimulation technique involves the application of pulsed magnetic fields to affected brain regions. However, investigations of magnetic brain stimulation are complicated by the use of many different stimulation parameters. Magnetic brain stimulation is usually divided into two poorly connected approaches: (1) clinically used high-intensity stimulation (0.5-2 Tesla, T) and (2) experimental or epidemiologically studied low-intensity stimulation (μT-mT). Human tests of both approaches are reported to have beneficial outcomes, but the underlying biology is unclear, and thus optimal stimulation parameters remain ill defined. Here, we aim to bring together what is known about the biology of magnetic brain stimulation from human, animal, and in vitro studies. We identify the common effects of different stimulation protocols; show how different types of pulsed magnetic fields interact with nervous tissue; and describe cellular mechanisms underlying their effects-from intracellular signalling cascades, through synaptic plasticity and the modulation of network activity, to long-term structural changes in neural circuits. Recent advances in magneto-biology show clear mechanisms that may explain low-intensity stimulation effects in the brain. With its large breadth of stimulation parameters, not available to high-intensity stimulation, low-intensity focal magnetic stimulation becomes a potentially powerful treatment tool for human application.
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Affiliation(s)
- Tom Dufor
- Department of Cell and Developmental Biology, University College London, London WC1E 6BT, UK
| | - Ann M. Lohof
- Sorbonne Université and CNRS, UMR8256 Biological Adaptation and Ageing, 75005 Paris, France;
| | - Rachel M. Sherrard
- Sorbonne Université and CNRS, UMR8256 Biological Adaptation and Ageing, 75005 Paris, France;
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14
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Hodkinson DJ, Drabek MM, Jung J, Lankappa ST, Auer DP. Theta Burst Stimulation of the Human Motor Cortex Modulates Secondary Hyperalgesia to Punctate Mechanical Stimuli. Neuromodulation 2023:S1094-7159(23)00755-9. [PMID: 37952136 DOI: 10.1016/j.neurom.2023.10.007] [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: 07/12/2023] [Revised: 09/19/2023] [Accepted: 10/03/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVES Many chronic pain conditions show evidence of dysregulated synaptic plasticity, including the development and maintenance of central sensitization. This provides a strong rationale for neuromodulation therapies for the relief of chronic pain. However, variability in responses and low fidelity across studies remain an issue for both clinical trials and pain management, demonstrating insufficient mechanistic understanding of effective treatment protocols. MATERIALS AND METHODS In a randomized counterbalanced crossover designed study, we evaluated two forms of patterned repetitive transcranial magnetic stimulation, known as continuous theta burst stimulation (TBS) and intermittent TBS, during normal and central sensitization states. Secondary hyperalgesia (a form of use-dependent central sensitization) was induced using a well-established injury-free pain model and assessed by standardized quantitative sensory testing involving light touch and pinprick pain thresholds in addition to stimulus-response functions. RESULTS We found that continuous TBS of the human motor cortex has a facilitatory (pronociceptive) effect on the magnitude of perceived pain to secondary hyperalgesia, which may rely on induction and expression of neural plasticity through heterosynaptic long-term potentiation-like mechanisms. CONCLUSIONS By defining the underlying mechanisms of TBS-driven synaptic plasticity in the nociceptive system, we offer new insight into disease mechanisms and provide targets for promoting functional recovery and repair in chronic pain. For clinical applications, this knowledge is critical for development of more efficacious and mechanisms-based neuromodulation protocols, which are urgently needed to address the chronic pain and opioid epidemics.
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Affiliation(s)
- Duncan J Hodkinson
- Division of Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK; Sir Peter Mansfield Imaging Center, School of Medicine, University of Nottingham, Nottingham, UK; National Institute for Health Research, Nottingham Biomedical Research Center, Queens Medical Center, Nottingham, UK.
| | - Marianne M Drabek
- Division of Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK; Sir Peter Mansfield Imaging Center, School of Medicine, University of Nottingham, Nottingham, UK; National Institute for Health Research, Nottingham Biomedical Research Center, Queens Medical Center, Nottingham, UK
| | - JeYoung Jung
- School of Psychology, University of Nottingham, Nottingham, UK
| | - Sudheer T Lankappa
- Nottinghamshire Healthcare National Health Service Foundation Trust, Nottingham, UK
| | - Dorothee P Auer
- Division of Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK; Sir Peter Mansfield Imaging Center, School of Medicine, University of Nottingham, Nottingham, UK; National Institute for Health Research, Nottingham Biomedical Research Center, Queens Medical Center, Nottingham, UK
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15
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Rodionov A, Ozdemir RA, Benwell CSY, Fried PJ, Boucher P, Momi D, Ross JM, Santarnecchi E, Pascual-Leone A, Shafi MM. Reliability of resting-state EEG modulation by continuous and intermittent theta burst stimulation of the primary motor cortex: a sham-controlled study. Sci Rep 2023; 13:18898. [PMID: 37919322 PMCID: PMC10622440 DOI: 10.1038/s41598-023-45512-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/20/2023] [Indexed: 11/04/2023] Open
Abstract
Theta burst stimulation (TBS) is a form of repetitive transcranial magnetic stimulation designed to induce changes of cortical excitability that outlast the period of TBS application. In this study, we explored the effects of continuous TBS (cTBS) and intermittent TBS (iTBS) versus sham TBS stimulation, applied to the left primary motor cortex, on modulation of resting state electroencephalography (rsEEG) power. We first conducted hypothesis-driven region-of-interest (ROI) analyses examining changes in alpha (8-12 Hz) and beta (13-21 Hz) bands over the left and right motor cortex. Additionally, we performed data-driven whole-brain analyses across a wide range of frequencies (1-50 Hz) and all electrodes. Finally, we assessed the reliability of TBS effects across two sessions approximately 1 month apart. None of the protocols produced significant group-level effects in the ROI. Whole-brain analysis revealed that cTBS significantly enhanced relative power between 19 and 43 Hz over multiple sites in both hemispheres. However, these results were not reliable across visits. There were no significant differences between EEG modulation by active and sham TBS protocols. Between-visit reliability of TBS-induced neuromodulatory effects was generally low-to-moderate. We discuss confounding factors and potential approaches for improving the reliability of TBS-induced rsEEG modulation.
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Affiliation(s)
- Andrei Rodionov
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Recep A Ozdemir
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Christopher S Y Benwell
- Division of Psychology, School of Humanities, Social Sciences and Law, University of Dundee, Dundee, UK
| | - Peter J Fried
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Pierre Boucher
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Davide Momi
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, Canada
| | - Jessica M Ross
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Research, Education, and Clinical Center, Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford Medical School, Stanford, CA, USA
| | - Emiliano Santarnecchi
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Precision Neuroscience and Neuromodulation Program, Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Deanna and Sidney Wolk Center for Memory Health, Hebrew Senior Life, Hinda and Arthur Marcus Institute for Aging Research, Boston, MA, USA
| | - Mouhsin M Shafi
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
- Department of Neurology, Harvard Medical School, Boston, MA, USA.
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16
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Szücs-Bencze L, Vékony T, Pesthy O, Szabó N, Kincses TZ, Turi Z, Nemeth D. Modulating Visuomotor Sequence Learning by Repetitive Transcranial Magnetic Stimulation: What Do We Know So Far? J Intell 2023; 11:201. [PMID: 37888433 PMCID: PMC10607545 DOI: 10.3390/jintelligence11100201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/23/2023] [Accepted: 10/09/2023] [Indexed: 10/28/2023] Open
Abstract
Predictive processes and numerous cognitive, motor, and social skills depend heavily on sequence learning. The visuomotor Serial Reaction Time Task (SRTT) can measure this fundamental cognitive process. To comprehend the neural underpinnings of the SRTT, non-invasive brain stimulation stands out as one of the most effective methodologies. Nevertheless, a systematic list of considerations for the design of such interventional studies is currently lacking. To address this gap, this review aimed to investigate whether repetitive transcranial magnetic stimulation (rTMS) is a viable method of modulating visuomotor sequence learning and to identify the factors that mediate its efficacy. We systematically analyzed the eligible records (n = 17) that attempted to modulate the performance of the SRTT with rTMS. The purpose of the analysis was to determine how the following factors affected SRTT performance: (1) stimulated brain regions, (2) rTMS protocols, (3) stimulated hemisphere, (4) timing of the stimulation, (5) SRTT sequence properties, and (6) other methodological features. The primary motor cortex (M1) and the dorsolateral prefrontal cortex (DLPFC) were found to be the most promising stimulation targets. Low-frequency protocols over M1 usually weaken performance, but the results are less consistent for the DLPFC. This review provides a comprehensive discussion about the behavioral effects of six factors that are crucial in designing future studies to modulate sequence learning with rTMS. Future studies may preferentially and synergistically combine functional neuroimaging with rTMS to adequately link the rTMS-induced network effects with behavioral findings, which are crucial to develop a unified cognitive model of visuomotor sequence learning.
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Affiliation(s)
- Laura Szücs-Bencze
- Department of Neurology, University of Szeged, Semmelweis utca 6, H-6725 Szeged, Hungary
| | - Teodóra Vékony
- Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, INSERM, CNRS, Université Claude Bernard Lyon 1, 95 Boulevard Pinel, F-69500 Bron, France
| | - Orsolya Pesthy
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Izabella utca 46, H-1064 Budapest, Hungary
- Brain, Memory and Language Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Magyar Tudósok Körútja 2, H-1117 Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd Universiry, Izabella utca 46, H-1064 Budapest, Hungary
| | - Nikoletta Szabó
- Department of Neurology, University of Szeged, Semmelweis utca 6, H-6725 Szeged, Hungary
| | - Tamás Zsigmond Kincses
- Department of Neurology, University of Szeged, Semmelweis utca 6, H-6725 Szeged, Hungary
- Department of Radiology, University of Szeged, Semmelweis utca 6, H-6725 Szeged, Hungary
| | - Zsolt Turi
- Department of Neuroanatomy, Institute of Anatomy and Cell Biology, Faculty of Medicine, University of Freiburg, Albertstrasse 17, D-79104 Freiburg, Germany
| | - Dezso Nemeth
- Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, INSERM, CNRS, Université Claude Bernard Lyon 1, 95 Boulevard Pinel, F-69500 Bron, France
- BML-NAP Research Group, Institute of Psychology & Institute of Cognitive Neuroscience and Psychology, ELTE Eötvös Loránd University & Research Centre for Natural Sciences, Damjanich utca 41, H-1072 Budapest, Hungary
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17
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Hand BJ, Merkin A, Opie GM, Ziemann U, Semmler JG. Repetitive paired-pulse TMS increases motor cortex excitability and visuomotor skill acquisition in young and older adults. Cereb Cortex 2023; 33:10660-10675. [PMID: 37689833 PMCID: PMC10560576 DOI: 10.1093/cercor/bhad315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/13/2023] [Accepted: 08/15/2023] [Indexed: 09/11/2023] Open
Abstract
Transcranial magnetic stimulation (TMS) over primary motor cortex (M1) recruits indirect (I) waves that can be modulated by repetitive paired-pulse TMS (rppTMS). The purpose of this study was to examine the effect of rppTMS on M1 excitability and visuomotor skill acquisition in young and older adults. A total of 37 healthy adults (22 young, 18-32 yr; 15 older, 60-79 yr) participated in a study that involved rppTMS at early (1.4 ms) and late (4.5 ms) interstimulus intervals (ISIs), followed by the performance of a visuomotor training task. M1 excitability was examined with motor-evoked potential (MEP) amplitudes and short-interval intracortical facilitation (SICF) using posterior-anterior (PA) and anterior-posterior (AP) TMS current directions. We found that rppTMS increased M1 excitability in young and old adults, with the greatest effects for PA TMS at the late ISI (4.5 ms). Motor skill acquisition was improved by rppTMS at an early (1.4 ms) but not late (4.5 ms) ISI in young and older adults. An additional study using a non-I-wave interval (3.5 ms) also showed increased M1 excitability and visuomotor skill acquisition. These findings show that rppTMS at both I-wave and non-I-wave intervals can alter M1 excitability and improve visuomotor skill acquisition in young and older adults.
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Affiliation(s)
- Brodie J Hand
- Discipline of Physiology, School of Biomedicine, The University of Adelaide, Adelaide 5005, Australia
| | - Ashley Merkin
- Discipline of Physiology, School of Biomedicine, The University of Adelaide, Adelaide 5005, Australia
| | - George M Opie
- Discipline of Physiology, School of Biomedicine, The University of Adelaide, Adelaide 5005, Australia
| | - Ulf Ziemann
- Department of Neurology & Stroke, and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen 72076, Germany
| | - John G Semmler
- Discipline of Physiology, School of Biomedicine, The University of Adelaide, Adelaide 5005, Australia
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18
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Manjarrez E, Curia G, Stecina K, Lopez Valdes A. Editorial: Bridging the gap between integrative neuroscience and translational neuroscience. Front Integr Neurosci 2023; 17:1296701. [PMID: 37869447 PMCID: PMC10585253 DOI: 10.3389/fnint.2023.1296701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 09/19/2023] [Indexed: 10/24/2023] Open
Affiliation(s)
- Elias Manjarrez
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México
| | - Giulia Curia
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Katinka Stecina
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Alejandro Lopez Valdes
- Department of Electronic and Electrical Engineering, Trinity College Dublin, Dublin, Ireland
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- Trinity Centre for Biomedical Engineering, Trinity College Dublin, Dublin, Ireland
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19
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Kanig C, Osnabruegge M, Schwitzgebel F, Litschel K, Seiberl W, Mack W, Schoisswohl S, Schecklmann M. Retest reliability of repetitive transcranial magnetic stimulation over the healthy human motor cortex: a systematic review and meta-analysis. Front Hum Neurosci 2023; 17:1237713. [PMID: 37771347 PMCID: PMC10525715 DOI: 10.3389/fnhum.2023.1237713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/08/2023] [Indexed: 09/30/2023] Open
Abstract
Introduction Repetitive transcranial magnetic stimulation (rTMS) is used to induce long-lasting changes (aftereffects) in cortical excitability, which are often measured via single-pulse TMS (spTMS) over the motor cortex eliciting motor-evoked potentials (MEPs). rTMS includes various protocols, such as theta-burst stimulation (TBS), paired associative stimulation (PAS), and continuous rTMS with a fixed frequency. Nevertheless, subsequent aftereffects of rTMS are variable and seem to fail repeatability. We aimed to summarize standard rTMS procedures regarding their test-retest reliability. Hereby, we considered influencing factors such as the methodological quality of experiments and publication bias. Methods We conducted a literature search via PubMed in March 2023. The inclusion criteria were the application of rTMS, TBS, or PAS at least twice over the motor cortex of healthy subjects with measurements of MEPs via spTMS as a dependent variable. The exclusion criteria were measurements derived from the non-stimulated hemisphere, of non-hand muscles, and by electroencephalography only. We extracted test-retest reliability measures and aftereffects from the eligible studies. With the Rosenthal fail-safe N, funnel plot, and asymmetry test, we examined the publication bias and accounted for influential factors such as the methodological quality of experiments measured with a standardized checklist. Results A total of 15 studies that investigated test-retest reliability of rTMS protocols in a total of 291 subjects were identified. Reliability measures, i.e., Pearson's r and intraclass correlation coefficient (ICC) applicable from nine studies, were mainly in the small to moderate range with two experiments indicating good reliability of 20 Hz rTMS (r = 0.543) and iTBS (r = 0.55). The aftereffects of rTMS procedures seem to follow the heuristics of respective inhibition or facilitation, depending on the protocols' frequency, and application pattern. There was no indication of publication bias and the influence of methodological quality or other factors on the reliability of rTMS. Conclusion The reliability of rTMS appears to be in the small to moderate range overall. Due to a limited number of studies reporting test-retest reliability values and heterogeneity of dependent measures, we could not provide generalizable results. We could not identify any protocol as superior to the others.
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Affiliation(s)
- Carolina Kanig
- Institute of Psychology, University of the Bundeswehr Munich, Neubiberg, Germany
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Mirja Osnabruegge
- Institute of Psychology, University of the Bundeswehr Munich, Neubiberg, Germany
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Florian Schwitzgebel
- Department of Electrical Engineering, University of the Bundeswehr Munich, Neubiberg, Germany
| | - Karsten Litschel
- Department of Electrical Engineering, University of the Bundeswehr Munich, Neubiberg, Germany
| | - Wolfgang Seiberl
- Institute of Sport Science, University of the Bundeswehr Munich, Neubiberg, Germany
| | - Wolfgang Mack
- Institute of Psychology, University of the Bundeswehr Munich, Neubiberg, Germany
| | - Stefan Schoisswohl
- Institute of Psychology, University of the Bundeswehr Munich, Neubiberg, Germany
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
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20
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Veldema J. Non-Invasive Brain Stimulation and Sex/Polypeptide Hormones in Reciprocal Interactions: A Systematic Review. Biomedicines 2023; 11:1981. [PMID: 37509620 PMCID: PMC10377221 DOI: 10.3390/biomedicines11071981] [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: 06/07/2023] [Revised: 06/30/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
A better understanding of interindividual differences and the development of targeted therapies is one of the major challenges of modern medicine. The sex of a person plays a crucial role in this regard. This systematic review aimed to summarise and analyse available evidence on the mutual interactions between non-invasive brain stimulation and sex/polypeptide hormones. The PubMed database was searched from its inception to 31 March 2023, for (i) studies that investigated the impact of sex and/or polypeptide hormones on the effects induced by non-invasive brain stimulation, or (ii) studies that investigated non-invasive brain stimulation in the modulation of sex and/or polypeptide hormones. Eighteen studies (319 healthy and 96 disabled participants) were included. Most studies focused on female sex hormone levels during the menstrual cycle. The later follicular phase is associated with a weak between hemispheric and intracortical inhibition, strong intracortical facilitation, and high stimulation-induced neural and behavioural changes. The opposite effects are observed during the luteal phase. In addition, the participant's sex, presence and/or absence of real ovulation and increase in oestradiol level by chorionic gonadotropin injection influence the stimulation-induced neurophysiological and behavioural effects. In Parkinson's disease and consciousness disorders, the repetitive application of non-invasive brain stimulation increases oestradiol and dehydroepiandrosterone levels and reduces disability. To date, male hormones have not been sufficiently included in these studies. Here, we show that the sex and/or polypeptide hormones and non-invasive brain stimulation methods are in reciprocal interactions. This may be used to create a more effective and individualised approach for healthy individuals and individuals with disabilities.
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Affiliation(s)
- Jitka Veldema
- Department of Sport Science, Bielefeld University, 33501 Bielefeld, Germany
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21
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Spampinato DA, Ibanez J, Rocchi L, Rothwell J. Motor potentials evoked by transcranial magnetic stimulation: interpreting a simple measure of a complex system. J Physiol 2023; 601:2827-2851. [PMID: 37254441 PMCID: PMC10952180 DOI: 10.1113/jp281885] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 05/18/2023] [Indexed: 06/01/2023] Open
Abstract
Transcranial magnetic stimulation (TMS) is a non-invasive technique that is increasingly used to study the human brain. One of the principal outcome measures is the motor-evoked potential (MEP) elicited in a muscle following TMS over the primary motor cortex (M1), where it is used to estimate changes in corticospinal excitability. However, multiple elements play a role in MEP generation, so even apparently simple measures such as peak-to-peak amplitude have a complex interpretation. Here, we summarize what is currently known regarding the neural pathways and circuits that contribute to the MEP and discuss the factors that should be considered when interpreting MEP amplitude measured at rest in the context of motor processing and patients with neurological conditions. In the last part of this work, we also discuss how emerging technological approaches can be combined with TMS to improve our understanding of neural substrates that can influence MEPs. Overall, this review aims to highlight the capabilities and limitations of TMS that are important to recognize when attempting to disentangle sources that contribute to the physiological state-related changes in corticomotor excitability.
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Affiliation(s)
- Danny Adrian Spampinato
- Department of Clinical and Movement NeurosciencesUniversity College LondonLondonUK
- Department of Human NeurosciencesSapienza University of RomeRomeItaly
- Department of Clinical and Behavioral NeurologyIRCCS Santa Lucia FoundationRomeItaly
| | - Jaime Ibanez
- Department of Clinical and Movement NeurosciencesUniversity College LondonLondonUK
- BSICoS group, I3A Institute and IIS AragónUniversity of ZaragozaZaragozaSpain
- Department of Bioengineering, Centre for NeurotechnologiesImperial College LondonLondonUK
| | - Lorenzo Rocchi
- Department of Clinical and Movement NeurosciencesUniversity College LondonLondonUK
- Department of Medical Sciences and Public HealthUniversity of CagliariCagliariItaly
| | - John Rothwell
- Department of Clinical and Movement NeurosciencesUniversity College LondonLondonUK
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Wendt K, Sorkhabi MM, Stagg CJ, Fleming MK, Denison T, O'Shea J. The effect of pulse shape in theta-burst stimulation: Monophasic vs biphasic TMS. Brain Stimul 2023; 16:1178-1185. [PMID: 37543172 PMCID: PMC10444700 DOI: 10.1016/j.brs.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/30/2023] [Accepted: 08/02/2023] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND Intermittent theta-burst stimulation (i) (TBS) is a transcranial magnetic stimulation (TMS) plasticity protocol. Conventionally, TBS is applied using biphasic pulses due to hardware limitations. However, monophasic pulses are hypothesised to recruit cortical neurons more selectively than biphasic pulses, predicting stronger plasticity effects. Monophasic and biphasic TBS can be generated using a custom-made pulse-width modulation-based TMS device (pTMS). OBJECTIVE Using pTMS, we tested the hypothesis that monophasic iTBS would induce a stronger plasticity effect than biphasic, measured as induced increases in motor corticospinal excitability. METHODS In a repeated-measures design, thirty healthy volunteers participated in three separate sessions, where monophasic and biphasic iTBS was applied to the primary motor cortex (M1 condition) or the vertex (control condition). Plasticity was quantified as increases in motor corticospinal excitability after versus before iTBS, by comparing peak-to-peak amplitudes of motor evoked potentials (MEP) measured at baseline and over 60 min after iTBS. RESULTS Both monophasic and biphasic M1 iTBS led to significant increases in MEP amplitude. As predicted, linear mixed effects (LME) models showed that the iTBS condition had a significant effect on the MEP amplitude (χ2 (1) = 27.615, p < 0.001) with monophasic iTBS leading to significantly stronger plasticity than biphasic iTBS (t (693) = 2.311, p = 0.021). Control vertex iTBS had no effect. CONCLUSIONS In this study, monophasic iTBS induced a stronger motor corticospinal excitability increase than biphasic within participants. This greater physiological effect suggests that monophasic iTBS may also have potential for greater functional impact, of interest for future fundamental and clinical applications of TBS.
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Affiliation(s)
- Karen Wendt
- MRC Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX1 3TH, UK; Department of Engineering Science, University of Oxford, Oxford, OX1 3PJ, UK.
| | - Majid Memarian Sorkhabi
- MRC Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX1 3TH, UK
| | - Charlotte J Stagg
- MRC Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX1 3TH, UK; Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Melanie K Fleming
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Timothy Denison
- MRC Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX1 3TH, UK; Department of Engineering Science, University of Oxford, Oxford, OX1 3PJ, UK
| | - Jacinta O'Shea
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity (OHBA), University of Oxford Department of Psychiatry, Warneford Hospital, Warneford Lane, Oxford, UK
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Liao W, Opie GM, Ziemann U, Semmler JG. Modulation of dorsal premotor cortex differentially influences I-wave excitability in primary motor cortex of young and older adults. J Physiol 2023; 601:2959-2974. [PMID: 37194369 PMCID: PMC10952229 DOI: 10.1113/jp284204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 05/12/2023] [Indexed: 05/18/2023] Open
Abstract
Previous research using transcranial magnetic stimulation (TMS) has demonstrated weakened connectivity between dorsal premotor cortex (PMd) and motor cortex (M1) with age. While this alteration is probably mediated by changes in the communication between the two regions, the effect of age on the influence of PMd on specific indirect (I) wave circuits within M1 remains unclear. The present study therefore investigated the influence of PMd on early and late I-wave excitability in M1 of young and older adults. Twenty-two young (mean ± SD, 22.9 ± 2.9 years) and 20 older (66.6 ± 4.2 years) adults participated in two experimental sessions involving either intermittent theta burst stimulation (iTBS) or sham stimulation over PMd. Changes within M1 following the intervention were assessed with motor-evoked potentials (MEPs) recorded from the right first dorsal interosseous muscle. We applied posterior-anterior (PA) and anterior-posterior (AP) current single-pulse TMS to assess corticospinal excitability (PA1mV ; AP1mV ; PA0.5mV , early; AP0.5mV , late), and paired-pulse TMS short intracortical facilitation for I-wave excitability (PA SICF, early; AP SICF, late). Although PMd iTBS potentiated PA1mV and AP1mV MEPs in both age groups (both P < 0.05), the time course of this effect was delayed for AP1mV in older adults (P = 0.001). Furthermore, while AP0.5mV , PA SICF and AP SICF were potentiated in both groups (all P < 0.05), potentiation of PA0.5mV was only apparent in young adults (P < 0.0001). While PMd influences early and late I-wave excitability in young adults, direct PMd modulation of the early circuits is specifically reduced in older adults. KEY POINTS: Interneuronal circuits responsible for late I-waves within primary motor cortex (M1) mediate projections from dorsal premotor cortex (PMd), but this communication probably changes with advancing age. We investigated the effects of intermittent theta burst stimulation (iTBS) to PMd on transcranial magnetic stimulation (TMS) measures of M1 excitability in young and older adults. We found that PMd iTBS facilitated M1 excitability assessed with posterior-anterior (PA, early I-waves) and anterior-posterior (AP, late I-waves) current TMS in young adults, with a stronger effect for AP TMS. M1 excitability assessed with AP TMS also increased in older adults following PMd iTBS, but there was no facilitation for PA TMS responses. We conclude that changes in M1 excitability following PMd iTBS are specifically reduced for the early I-waves in older adults, which could be a potential target for interventions that enhance cortical excitability in older adults.
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Affiliation(s)
- Wei‐Yeh Liao
- Discipline of Physiology, School of BiomedicineThe University of AdelaideAdelaideAustralia
| | - George M. Opie
- Discipline of Physiology, School of BiomedicineThe University of AdelaideAdelaideAustralia
| | - Ulf Ziemann
- Department of Neurology & StrokeEberhard Karls University of TübingenTübingenGermany
- Hertie‐Institute for Clinical Brain ResearchEberhard Karls University of TübingenTübingenGermany
| | - John G. Semmler
- Discipline of Physiology, School of BiomedicineThe University of AdelaideAdelaideAustralia
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Barquero C, Chen JT, Munoz DP, Wang CA. Human microsaccade cueing modulation in visual- and memory-delay saccade tasks after theta burst transcranial magnetic stimulation over the frontal eye field. Neuropsychologia 2023; 187:108626. [PMID: 37336260 DOI: 10.1016/j.neuropsychologia.2023.108626] [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: 02/09/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 06/21/2023]
Abstract
Microsaccades that occur during periods of fixation are modulated by various cognitive processes and have an impact on visual processing. A network of brain areas is involved in microsaccade generation, including the superior colliculus and frontal eye field (FEF) which are involved in modulating microsaccade rate and direction after the appearance of a visual cue (referred to as microsaccade cueing modulation). Although the neural mechanisms underlying microsaccade cueing modulations have been demonstrated in monkeys, limited research has investigated a causal role of these areas in humans. By applying continuous theta-burst transcranial magnetic stimulation (cTBS) over the right FEF and vertex, we investigated the role of human FEF in modulating microsaccade responses after the appearance of a visual target in a visual- and memory-delay saccade task. After target appearance, microsaccade rate was initially suppressed but then increased in both cTBS conditions. More importantly, in the visual-delay task, microsaccades after target appearance were directed to the ipsilateral side more often with FEF, compared to vertex stimulation. Moreover, microsaccades were directed towards the target location, then to the opposite location of the target in both tasks, with larger effects in the visual-, compared to, memory-delay task. This microsaccade direction modulation was delayed after FEF stimulation in the memory-delay task. Overall, some microsaccade cueing modulations were moderately disrupted after FEF cTBS, suggesting a causal role for involvement of the human FEF in microsaccade generation after presentation of salient stimuli.
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Affiliation(s)
- Cesar Barquero
- Eye-Tracking Laboratory, Brain and Consciousness Research Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Institute of Cognitive Neuroscience, College of Health Science and Technology, National Central University, Taoyuan City, Taiwan; Department of Physical Activity and Sport Science, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Jui-Tai Chen
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan; Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Douglas P Munoz
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Chin-An Wang
- Eye-Tracking Laboratory, Brain and Consciousness Research Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Institute of Cognitive Neuroscience, College of Health Science and Technology, National Central University, Taoyuan City, Taiwan; Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan; Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
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25
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Menon P, Pavey N, Aberra AS, van den Bos MAJ, Wang R, Kiernan MC, Peterchev AV, Vucic S. Dependence of cortical neuronal strength-duration properties on TMS pulse shape. Clin Neurophysiol 2023; 150:106-118. [PMID: 37060842 PMCID: PMC10280814 DOI: 10.1016/j.clinph.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 02/13/2023] [Accepted: 03/08/2023] [Indexed: 04/17/2023]
Abstract
OBJECTIVE The aim of present study was to explore the effects of different combinations of transcranial magnetic stimulation (TMS) pulse width and pulse shape on cortical strength-duration time constant (SDTC) and rheobase measurements. METHODS Resting motor thresholds (RMT) at pulse widths (PW) of 30, 45, 60, 90 and 120 µs and M-ratios of 0.2, 0.1 and 0.025 were determined using figure-of-eight coil with initial posterior-to-anterior induced current. The M-ratio indicates the relative phases of the induced current with lower values signifying a more unidirectional stimulus. Strength-duration time constant (SDTC) and rheobase were estimated for each M-ratio and various PW combinations. Simulations of biophysically realistic cortical neuron models assessed underlying neuronal populations and physiological mechanisms mediating pulse shape effects on strength-duration properties. RESULTS The M-ratio exerted significant effect on SDTC (F(2,44) = 4.386, P = 0.021), which was longer for M-ratio of 0.2 (243.4 ± 61.2 µs) compared to 0.025 (186.7 ± 52.5 µs, P = 0.034). Rheobase was significantly smaller when assessed with M-ratio 0.2 compared to 0.025 (P = 0.026). SDTC and rheobase values were most consistent with pulse width sets of 30/45/60/90/120 µs, 30/60/90/120 µs, and 30/60/120 µs. Simulation studies indicated that isolated pyramidal neurons in layers 2/3, 5, and large basket-cells in layer 4 exhibited SDTCs comparable to experimental results. Further, simulation studies indicated that reducing transient Na+ channel conductance increased SDTC with larger increases for higher M-ratios. CONCLUSIONS Cortical strength-duration curve properties vary with pulse shape, and the modulating effect of the hyperpolarising pulse phase on cortical axonal transient Na+ conductances could account for these changes, although a shift in the recruited neuronal populations may contribute as well. SIGNIFICANCE The dependence of the cortical strength-duration curve properties on the TMS pulse shape and pulse width selection underscores the need for consistent measurement methods across studies and the potential to extract information about pathophysiological processes.
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Affiliation(s)
- Parvathi Menon
- Brain and Nerve Research Centre, Concord Clinical School, University of Sydney, Concord Hospital, Sydney, Australia
| | - Nathan Pavey
- Brain and Nerve Research Centre, Concord Clinical School, University of Sydney, Concord Hospital, Sydney, Australia
| | - Aman S Aberra
- Department of Biological Sciences, Dartmouth College, Hanover, NH, USA
| | - Mehdi A J van den Bos
- Brain and Nerve Research Centre, Concord Clinical School, University of Sydney, Concord Hospital, Sydney, Australia
| | - Ruochen Wang
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | | | - Angel V Peterchev
- Department of Biomedical Engineering, Duke University, Durham, NC, USA; Department of Psychiatry and Behavioural Sciences, Duke University, Durham, NC, USA; Department of Electrical and Computer Engineering, Duke University, Durham, NC, USA; Department of Neurosurgery, Duke University, Durham, NC, USA.
| | - Steve Vucic
- Brain and Nerve Research Centre, Concord Clinical School, University of Sydney, Concord Hospital, Sydney, Australia.
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Rodionov A, Ozdemir RA, Benwell CS, Fried PJ, Boucher P, Momi D, Ross JM, Santarnecchi E, Pascual-Leone A, Shafi MM. Reliability of resting-state EEG modulation by continuous and intermittent theta burst stimulation of the primary motor cortex: A sham-controlled study. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.05.12.540024. [PMID: 37215043 PMCID: PMC10197617 DOI: 10.1101/2023.05.12.540024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Theta burst stimulation (TBS) is a form of repetitive transcranial magnetic stimulation designed to induce changes of cortical excitability that outlast the period of TBS application. In this study, we explored the effects of continuous TBS (cTBS) and intermittent TBS (iTBS) versus sham TBS stimulation, applied to the primary motor cortex, on modulation of resting state electroencephalography (rsEEG) power. We first conducted hypothesis-driven region-of-interest (ROI) analyses examining changes in alpha (8-12 Hz) and beta (13-21 Hz) bands over the left and right motor cortex. Additionally, we performed data-driven whole-brain analyses across a wide range of frequencies (1-50 Hz) and all electrodes. Finally, we assessed the reliability of TBS effects across two sessions approximately 1 month apart. None of the protocols produced significant group-level effects in the ROI. Whole-brain analysis revealed that cTBS significantly enhanced relative power between 19-43 Hz over multiple sites in both hemispheres. However, these results were not reliable across visits. There were no significant differences between EEG modulation by active and sham TBS protocols. Between-visit reliability of TBS-induced neuromodulatory effects was generally low-to-moderate. We discuss confounding factors and potential approaches for improving the reliability of TBS-induced rsEEG modulation.
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Affiliation(s)
- Andrei Rodionov
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Recep A. Ozdemir
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Christopher S.Y. Benwell
- Division of Psychology, School of Humanities, Social Sciences and Law, University of Dundee, Dundee, UK
| | - Peter J. Fried
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Pierre Boucher
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Davide Momi
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Krembil Centre for Neuroinformatics, Centre for Addiction & Mental Health, Toronto
| | - Jessica M. Ross
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center, Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford Medical School, Stanford, CA, USA
| | - Emiliano Santarnecchi
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Precision Neuroscience & Neuromodulation Program, Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Hinda and Arthur Marcus Institute for Aging Research, Deanna and Sidney Wolk Center for Memory Health, Hebrew Senior Life, Boston, MA, USA
| | - Mouhsin M. Shafi
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
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Veldema J, Nowak DA, Bösl K, Gharabaghi A. Hemispheric Differences of 1 Hz rTMS over Motor and Premotor Cortex in Modulation of Neural Processing and Hand Function. Brain Sci 2023; 13:brainsci13050752. [PMID: 37239224 DOI: 10.3390/brainsci13050752] [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: 02/12/2023] [Revised: 04/26/2023] [Accepted: 04/29/2023] [Indexed: 05/28/2023] Open
Abstract
INTRODUCTION Non-invasive brain stimulation can modulate both neural processing and behavioral performance. Its effects may be influenced by the stimulated area and hemisphere. In this study (EC no. 09083), repetitive transcranial magnetic stimulation (rTMS) was applied to the primary motor cortex (M1) or dorsal premotor cortex (dPMC) of either the right or left hemisphere, while evaluating cortical neurophysiology and hand function. METHODS Fifteen healthy subjects participated in this placebo-controlled crossover study. Four sessions of real 1 Hz rTMS (110% of rMT, 900 pulses) over (i) left M1, (ii) right M1, (iii) left dPMC, (iv) right dPMC, and one session of (v) placebo 1 Hz rTMS (0% of rMT, 900 pulses) over the left M1 were applied in randomized order. Motor function of both hands (Jebsen-Taylor Hand Function Test (JTHFT)) and neural processing within both hemispheres (motor evoked potentials (MEPs), cortical silent period (CSP), and ipsilateral silent period (ISP)) were evaluated prior and after each intervention session. RESULTS A lengthening of CSP and ISP durations within the right hemisphere was induced by 1 Hz rTMS over both areas and hemispheres. No such intervention-induced neurophysiological changes were detected within the left hemisphere. Regarding JTHFT and MEP, no intervention-induced changes ensued. Changes of hand function correlated with neurophysiological changes within both hemispheres, more often for the left than the right hand. CONCLUSIONS Effects of 1 Hz rTMS can be better captured by neurophysiological than behavioral measures. Hemispheric differences need to be considered for this intervention.
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Affiliation(s)
- Jitka Veldema
- Department of Sport Science, Bielefeld University, 33615 Bielefeld, Germany
| | - Dennis Alexander Nowak
- Department of Neurology, VAMED Hospital Kipfenberg, 85110 Kipfenberg, Germany
- Department of Neurology, University Hospital Marburg, 35043 Marburg, Germany
| | - Kathrin Bösl
- Department of Neurology, VAMED Hospital Kipfenberg, 85110 Kipfenberg, Germany
| | - Alireza Gharabaghi
- Institute for Neuromodulation and Neurotechnology, University Hospital and University of Tübingen, 72076 Tübingen, Germany
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Kirkovski M, Donaldson PH, Do M, Speranza BE, Albein-Urios N, Oberman LM, Enticott PG. A systematic review of the neurobiological effects of theta-burst stimulation (TBS) as measured using functional magnetic resonance imaging (fMRI). Brain Struct Funct 2023; 228:717-749. [PMID: 37072625 PMCID: PMC10113132 DOI: 10.1007/s00429-023-02634-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/20/2023] [Indexed: 04/20/2023]
Abstract
Theta burst stimulation (TBS) is associated with the modulation of a range of clinical, cognitive, and behavioural outcomes, but specific neurobiological effects remain somewhat unclear. This systematic literature review investigated resting-state and task-based functional magnetic resonance imaging (fMRI) outcomes post-TBS in healthy human adults. Fifty studies that applied either continuous-or intermittent-(c/i) TBS, and adopted a pretest-posttest or sham-controlled design, were included. For resting-state outcomes following stimulation applied to motor, temporal, parietal, occipital, or cerebellar regions, functional connectivity generally decreased in response to cTBS and increased in response to iTBS, though there were some exceptions to this pattern of response. These findings are mostly consistent with the assumed long-term depression (LTD)/long-term potentiation (LTP)-like plasticity effects of cTBS and iTBS, respectively. Task-related outcomes following TBS were more variable. TBS applied to the prefrontal cortex, irrespective of task or state, also produced more variable responses, with no consistent patterns emerging. Individual participant and methodological factors are likely to contribute to the variability in responses to TBS. Future studies assessing the effects of TBS via fMRI must account for factors known to affect the TBS outcomes, both at the level of individual participants and of research methodology.
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Affiliation(s)
- Melissa Kirkovski
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia.
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, VIC, Australia.
| | - Peter H Donaldson
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Michael Do
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Bridgette E Speranza
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Natalia Albein-Urios
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Lindsay M Oberman
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Peter G Enticott
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, VIC, Australia
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Wrightson JG, Cole J, Sohn MN, McGirr A. The effects of D-Cycloserine on corticospinal excitability after repeated spaced intermittent theta-burst transcranial magnetic stimulation: A randomized controlled trial in healthy individuals. Neuropsychopharmacology 2023:10.1038/s41386-023-01575-7. [PMID: 37041205 PMCID: PMC10267195 DOI: 10.1038/s41386-023-01575-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 04/13/2023]
Abstract
Repeated spaced TMS protocols, also termed accelerated TMS protocols, are of increasing therapeutic interest. The long-term potentiation (LTP)-like effects of repeated spaced intermittent theta-burst transcranial magnetic stimulation (iTBS) are presumed to be N-Methyl-D-Aspartate receptor (NMDA-R) dependent; however, this has not been tested. We tested whether the LTP-like effects of repeated spaced iTBS are influenced by low-dose D-Cycloserine (100 mg), an NMDA-R partial-agonist. We conducted a randomized, double-blind, placebo-controlled crossover trial in 20 healthy adults from August 2021-Feb 2022. Participants received repeated spaced iTBS, consisting of two iTBS sessions 60 minutes apart, to the primary motor cortex. The peak-to-peak amplitude of the motor evoked potentials (MEP) at 120% resting motor threshold (RMT) was measured after each iTBS. The TMS stimulus-response (TMS-SR; 100-150% RMT) was measured at baseline, +30 min, and +60 min after each iTBS. We found evidence for a significant Drug*iTBS effect in MEP amplitude, revealing that D-Cycloserine enhanced MEP amplitudes relative to the placebo. When examining TMS-SR, pairing iTBS with D-Cycloserine increased the TMS-SR slope relative to placebo after both iTBS tetani, and this was due to an increase in the upper bound of the TMS-SR. This indicates that LTP-like and metaplastic effects of repeated-spaced iTBS involve NMDA-R, as revealed by two measures of corticospinal excitability, and that low-dose D-Cycloserine facilitates the physiological effects of repeated spaced iTBS. However, extension of these findings to clinical populations and therapeutic protocols targeting non-motor regions of cortex requires empirical validation.
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Affiliation(s)
- James G Wrightson
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Jaeden Cole
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada
| | - Maya N Sohn
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada
| | - Alexander McGirr
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
- Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada.
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Sachdeva A, Mehta UM, Thirthalli J. A pilot-study to examine motor cortical plasticity as a neuro-marker of antipsychotic treatment response in schizophrenia. Asian J Psychiatr 2023; 82:103515. [PMID: 36812761 DOI: 10.1016/j.ajp.2023.103515] [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: 11/14/2022] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/13/2023]
Abstract
In a pilot study on 15 untreated first-episode schizophrenia participants, we examined how pre-treatment motor cortical plasticity - the brain's ability to change in response to an external perturbation - induced with intermittent theta burst stimulation, predicted prospectively ascertained (in 4-to-6 weeks) response to antipsychotic medications. We observed that participants with cortical plasticity in the opposite direction (possibly compensatory) had significantly greater improvements in their positive symptoms. This association persisted after correcting for multiple comparisons and controlling for potential confounders via linear regression. Inter-individual variability in cortical plasticity is a potential predictive biomarker in schizophrenia requiring further investigation and replication.
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Affiliation(s)
- Aishwarya Sachdeva
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore 560029, India
| | - Urvakhsh Meherwan Mehta
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore 560029, India.
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore 560029, India
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Van Dam JM, Graetz L, Pitcher JB, Goldsworthy MR. The effects of age and biological sex on the association between I-wave recruitment and the response to cTBS: an exploratory study. Brain Res 2023; 1810:148359. [PMID: 37030620 DOI: 10.1016/j.brainres.2023.148359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 03/24/2023] [Accepted: 04/04/2023] [Indexed: 04/09/2023]
Abstract
The neuroplastic response to continuous theta burst stimulation (cTBS) is inherently variable. The measurement of I-wave latencies has been shown to strongly predict the magnitude and direction of the response to cTBS, whereby longer latencies are associated with stronger long-term depression-like responses. However, potential differences in this association relating to age and sex have not been explored. We performed cTBS and measured I-wave recruitment (via MEP latencies) in 66 participants (31 female) ranging in age from 11 to 78 years. The influence of age and sex on the association between I-wave recruitment and the response to cTBS was tested using linear regression models. In contrast to previous studies, there was not a significant association between I-wave latencies and cTBS response at the group level (p = 0.142, R2 = 0.033). However, there were interactions between I-waves and both age and sex when predicting cTBS response. Subgroup analysis revealed that preferential late I-wave recruitment predicted cTBS response in adolescent females, but not in adolescent or adult males or adult females. These data suggest that the generalisability of I-wave measurement in predicting the response to cTBS may be lower than initially believed. Prediction models should include age and sex, rather than I-wave latencies alone, as our findings suggest that, while each factor alone is not a strong predictor, these factors interact to influence the response to cTBS.
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Affiliation(s)
- Jago M Van Dam
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia 5005, Australia; Lifespan Human Neurophysiology Group, School of Biomedicine, University of Adelaide, Adelaide, South Australia 5000, Australia; Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia 5000, Australia
| | - Lynton Graetz
- Lifespan Human Neurophysiology Group, School of Biomedicine, University of Adelaide, Adelaide, South Australia 5000, Australia; Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia 5000, Australia
| | - Julia B Pitcher
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia 5005, Australia; Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria 3220, Australia
| | - Mitchell R Goldsworthy
- Lifespan Human Neurophysiology Group, School of Biomedicine, University of Adelaide, Adelaide, South Australia 5000, Australia; Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia 5000, Australia.
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Staat C, Gattinger N, Gleich B. PLUSPULS: A transcranial magnetic stimulator with extended pulse protocols. HARDWAREX 2023; 13:e00380. [PMID: 36578972 PMCID: PMC9791927 DOI: 10.1016/j.ohx.2022.e00380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Transcranial magnetic stimulation (TMS) is increasingly applied in basic neuroscience while its field of usage for diagnosing and treating various neurological diseases broadens steadily. A TMS device generates a current pulse in the reach of several thousand ampére to produce a magnetic pulse which induces an electric field around neurons. This electric field, if high enough to depolarize the neuron membrane, generates an action potential at the neuron which travels down the neurons connected to it. The PLUSPULS TMS generates this magnetic pulse by pre-charging a pulse capacitor C with the voltage V C 0 and connecting it with a stimulation coil L . The oscillation of the resonance circuit is cut off after one period and is called a biphasic pulse. PLUSPULS is a high frequency stimulator with inter stimulus intervals (ISI) down to 1ms which enables different pulse protocols as paired pulse or quadri theta burst stimulation. A GUI on PC allows a flexible control of PLUSPULS with varying amplitudes and ISI in one burst. The modular hardware and the control via GUI on PC allows for an easier adjustment on requirements to come. The article provides design considerations, hardware, firmware and software to reconstruct a modular biphasic TMS with enhanced charging network to enable extended pulse protocols.
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Hobot J, Skóra Z, Wierzchoń M, Sandberg K. Continuous Theta Burst Stimulation to the left anterior medial prefrontal cortex influences metacognitive efficiency. Neuroimage 2023; 272:119991. [PMID: 36858333 DOI: 10.1016/j.neuroimage.2023.119991] [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: 11/30/2022] [Revised: 02/04/2023] [Accepted: 02/25/2023] [Indexed: 03/03/2023] Open
Abstract
The contribution of the prefrontal areas to visual awareness is critical for the Global Neuronal Workspace Theory and higher-order theories of consciousness. The goal of the present study was to test the potential engagement of the anterior medial prefrontal cortex (aMPFC) in visual awareness judgements. We aimed to temporarily influence the neuronal dynamics of the left aMPFC via neuroplasticity-like mechanisms. We used different Theta Burst Stimulation (TBS) protocols in combination with a visual identification task and visual awareness ratings. Either continuous TBS (cTBS), intermittent TBS (iTBS), or sham TBS was applied prior to the experimental paradigm in a within-participant design. Compared with sham TBS, we observed an increase in participants' ability to judge their perception adequately (metacognitive efficiency) following cTBS but not iTBS. The effect was accompanied by lower visual awareness ratings in incorrect responses. No significant differences in the identification task performance were observed. We interpret these results as evidence of the involvement of PFC in the brain network that underlies metacognition. Further, we discuss whether the results of TMS studies on perceptual metacognition can be taken as evidence for PFC involvement in awareness itself.
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Affiliation(s)
- Justyna Hobot
- Consciousness Lab, Psychology Institute, Jagiellonian University, Krakow, Poland; Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark.
| | - Zuzanna Skóra
- Colourlab, Department of Computer Science, Norwegian University of Science and Technology, Gjøvik, Norway
| | - Michał Wierzchoń
- Consciousness Lab, Psychology Institute, Jagiellonian University, Krakow, Poland
| | - Kristian Sandberg
- Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark; Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Aarhus, Denmark
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Therrien-Blanchet JM, Ferland MC, Badri M, Rousseau MA, Merabtine A, Boucher E, Hofmann LH, Lepage JF, Théoret H. The neurophysiological aftereffects of brain stimulation in human primary motor cortex: a Sham-controlled comparison of three protocols. Cereb Cortex 2023:7030623. [PMID: 36749004 DOI: 10.1093/cercor/bhad021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/14/2023] [Accepted: 01/15/2023] [Indexed: 02/08/2023] Open
Abstract
Paired associative stimulation (PAS), transcranial direct current stimulation (tDCS), and transcranial alternating current stimulation (tACS) are non-invasive brain stimulation methods that are used to modulate cortical excitability. Whether one technique is superior to the others in achieving this outcome and whether individuals that respond to one intervention are more likely to respond to another remains largely unknown. In the present study, the neurophysiological aftereffects of three excitatory neurostimulation protocols were measured with transcranial magnetic stimulation (TMS). Twenty minutes of PAS at an ISI of 25 ms, anodal tDCS, 20-Hz tACS, and Sham stimulation were administered to 31 healthy adults in a repeated measures design. Compared with Sham, none of the stimulation protocols significantly modulated corticospinal excitability (input/ouput curve and slope, TMS stimulator intensity required to elicit MEPs of 1-mV amplitude) or intracortical excitability (short- and long-interval intracortical inhibition, intracortical facilitation, cortical silent period). Sham-corrected responder analysis estimates showed that an average of 41 (PAS), 39 (tDCS), and 39% (tACS) of participants responded to the interventions with an increase in corticospinal excitability. The present data show that three stimulation protocols believed to increase cortical excitability are associated with highly heterogenous and variable aftereffects that may explain a lack of significant group effects.
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Affiliation(s)
| | | | - Meriem Badri
- Département de psychologie, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | | | - Amira Merabtine
- Département de psychologie, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - Emelie Boucher
- Département de psychologie, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - Lydia Helena Hofmann
- Department of Psychology and Neuroscience, Maastricht University, Maastricht 6229, The Netherlands
| | - Jean-François Lepage
- Département de Pédiatrie, Faculté de Médecine et des Sciences de la Santé de l'Université de Sherbrooke, Centre de Recherche du CHU Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
| | - Hugo Théoret
- Département de psychologie, Université de Montréal, Montréal, QC H3C 3J7, Canada
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Liu Y, Lim K, Sundman MH, Ugonna C, Ton That V, Cowen S, Chou YH. Association Between Responsiveness to Transcranial Magnetic Stimulation and Interhemispheric Functional Connectivity of Sensorimotor Cortex in Older Adults. Brain Connect 2023; 13:39-50. [PMID: 35620910 PMCID: PMC9942174 DOI: 10.1089/brain.2021.0180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Repetitive transcranial magnetic stimulation (rTMS) is a promising therapeutic technique, and is believed to accomplish its effect by influencing the stimulated and remotely connected areas. However, responsiveness to rTMS shows high interindividual variability, and this intersubject variability is particularly high in older adults. It remains unclear whether baseline resting-state functional connectivity (rsFC) contributes to this variability in older adults. The aims of this study are to (1) examine rTMS effects over the primary motor cortex (M1) in older adults, and (2) identify baseline network properties that may contribute to the interindividual variability. Methods: We tested response to intermittent theta burst stimulation (iTBS), an effective rTMS protocol, over M1 by using both electromyography and resting-state functional magnetic resonance imaging in older adults. Outcome measures included motor-evoked potential (MEP) elicited by single-pulse transcranial magnetic stimulation and rsFC before and after an iTBS session. Results: iTBS significantly increased MEP amplitudes and rsFC between the stimulation site, sensorimotor cortex, and supplementary motor area (SMA) in older adults. iTBS-induced changes in MEP amplitude were positively correlated with increases in interhemispheric rsFC after iTBS. Furthermore, older adults with lower baseline interhemispheric rsFC between sensorimotor cortex and SMA exhibited stronger MEP response after iTBS. Discussion: Findings of the study suggest that different levels of interhemispheric communication during resting state might contribute to the response heterogeneity to iTBS in older adults. Interhemispheric rsFC may have great potential serving as a useful marker for predicting iTBS responsiveness in older adults. ClinicalTrials.gov ID: 1707654427 Impact statement Factors contributing to interindividual variability of the responsive to repetitive transcranial magnetic stimulation (rTMS) in older adults remain poorly understood. In this study, we examined the effects of rTMS over the primary motor cortex in older adults, and found that response to rTMS is associated with prestimulation interhemispheric connectivity in the sensorimotor and premotor areas. Findings of the study have great potential to be translated into a connectivity-based strategy for identification of responders for rTMS in older adults.
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Affiliation(s)
- Yilin Liu
- Department of Psychology and University of Arizona, Tucson, Arizona, USA
| | - Koeun Lim
- Department of Psychology and University of Arizona, Tucson, Arizona, USA
| | - Mark H. Sundman
- Department of Psychology and University of Arizona, Tucson, Arizona, USA
| | - Chidi Ugonna
- Department of Psychology and University of Arizona, Tucson, Arizona, USA
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona, USA
| | - Viet Ton That
- Department of Psychology and University of Arizona, Tucson, Arizona, USA
| | - Stephen Cowen
- Department of Psychology and University of Arizona, Tucson, Arizona, USA
- Evelyn F McKnight Brain Institute, Arizona Center on Aging, and BIO5 Institute, University of Arizona, Tucson, Arizona, USA
| | - Ying-hui Chou
- Department of Psychology and University of Arizona, Tucson, Arizona, USA
- Evelyn F McKnight Brain Institute, Arizona Center on Aging, and BIO5 Institute, University of Arizona, Tucson, Arizona, USA
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Ma W, Nemdharry S, Elgueta Cancino E, Chiou SY. Influence of coil orientation on corticospinal excitability of trunk muscles during postural and volitional tasks in healthy adults. Front Hum Neurosci 2023; 17:1108169. [PMID: 36816500 PMCID: PMC9929149 DOI: 10.3389/fnhum.2023.1108169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 01/16/2023] [Indexed: 02/04/2023] Open
Abstract
Introduction Trunk muscles play a role in maintaining postural stability and performing goal-directed voluntary movements in activities of daily living. Evidence has shown that the primary motor cortex (M1) is involved in modulation of postural control and voluntary movements of the trunk. However, it remains unknown whether the neural circuits within the M1 were recruited to the same extent between a postural task and a goal-directed voluntary task. Methods To address this, we examined latencies and amplitudes of motor evoked potentials (MEPs) of the erector spinae (ES) with transcranial magnetic stimulation (TMS) figure-of-eight coil oriented to induce latero-medial (LM), posterior-anterior (PA), and anterior-posterior (AP) currents in the M1 in twenty healthy participants during a dynamic shoulder flexion (DSF) task, a postural task requiring anticipatory postural adjustments (APAs), and during a static trunk extension (STE) task, a voluntary task without involvement of APAs. Results We found that differences in the AP-LM latency of ES MEP were longer compared with the PA-LM latency in both tasks. Corticospinal excitability was overall greater during the DSF task than during the STE task irrespective of the coil orientation. Discussion Our findings suggest that while the same neural circuits in the M1 were recruited to modulate both postural and voluntary control of the trunk, the contribution was greater to the postural task than the voluntary task, possibly due to the requirement of APAs in the task.
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Affiliation(s)
- Wesley Ma
- School of Sport, Exercise and Rehabilitation Science, University of Birmingham, Birmingham, United Kingdom
| | - Sheanil Nemdharry
- School of Sport, Exercise and Rehabilitation Science, University of Birmingham, Birmingham, United Kingdom
| | - Edith Elgueta Cancino
- School of Sport, Exercise and Rehabilitation Science, University of Birmingham, Birmingham, United Kingdom,Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Science, Universidad Andrés Bello, Santiago, Chile
| | - Shin-Yi Chiou
- School of Sport, Exercise and Rehabilitation Science, University of Birmingham, Birmingham, United Kingdom,*Correspondence: Shin-Yi Chiou ✉
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Revisiting the Rotational Field TMS Method for Neurostimulation. J Clin Med 2023; 12:jcm12030983. [PMID: 36769630 PMCID: PMC9917411 DOI: 10.3390/jcm12030983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
Transcranial magnetic stimulation (TMS) is a non-invasive technique that has shown high efficacy in the treatment of major depressive disorder (MDD) and is increasingly utilized for various neuropsychiatric disorders. However, conventional TMS is limited to activating only a small fraction of neurons that have components parallel to the induced electric field. This likely contributes to the significant variability observed in clinical outcomes. A novel method termed rotational field TMS (rfTMS or TMS 360°) enables the activation of a greater number of neurons by reducing the sensitivity to orientation. Recruitment of a larger number of neurons offers the potential to enhance efficacy and reduce variability in the treatment of clinical indications for which neuronal recruitment and organization may play a significant role, such as MDD and stroke. The potential of the method remains to be validated in clinical trials. Here, we revisit and describe in detail the rfTMS method, its principles, mode of operation, effects on the brain, and potential benefits for clinical TMS.
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Atilgan H, Koi JXJ, Wong E, Laakso I, Matilainen N, Pasqualotto A, Tanaka S, Chen SHA, Kitada R. Functional relevance of the extrastriate body area for visual and haptic object recognition: a preregistered fMRI-guided TMS study. Cereb Cortex Commun 2023; 4:tgad005. [PMID: 37188067 PMCID: PMC10176024 DOI: 10.1093/texcom/tgad005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 03/22/2023] [Accepted: 03/27/2023] [Indexed: 05/17/2023] Open
Abstract
The extrastriate body area (EBA) is a region in the lateral occipito-temporal cortex (LOTC), which is sensitive to perceived body parts. Neuroimaging studies suggested that EBA is related to body and tool processing, regardless of the sensory modalities. However, how essential this region is for visual tool processing and nonvisual object processing remains a matter of controversy. In this preregistered fMRI-guided repetitive transcranial magnetic stimulation (rTMS) study, we examined the causal involvement of EBA in multisensory body and tool recognition. Participants used either vision or haptics to identify 3 object categories: hands, teapots (tools), and cars (control objects). Continuous theta-burst stimulation (cTBS) was applied over left EBA, right EBA, or vertex (control site). Performance for visually perceived hands and teapots (relative to cars) was more strongly disrupted by cTBS over left EBA than over the vertex, whereas no such object-specific effect was observed in haptics. The simulation of the induced electric fields confirmed that the cTBS affected regions including EBA. These results indicate that the LOTC is functionally relevant for visual hand and tool processing, whereas the rTMS over EBA may differently affect object recognition between the 2 sensory modalities.
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Affiliation(s)
- Hicret Atilgan
- Psychology, School of Social Sciences, Nanyang Technological University, 48 Nanyang Avenue, Singapore 639818, Singapore
| | - J X Janice Koi
- Psychology, School of Social Sciences, Nanyang Technological University, 48 Nanyang Avenue, Singapore 639818, Singapore
| | - Ern Wong
- IMT School for Advanced Studies Lucca, Piazza S. Francesco, 19, 55100 Lucca LU, Italy
| | - Ilkka Laakso
- Department of Electrical Engineering and Automation, Aalto University, Otakaari 3, 02150 Espoo, Finland
| | - Noora Matilainen
- Department of Electrical Engineering and Automation, Aalto University, Otakaari 3, 02150 Espoo, Finland
| | - Achille Pasqualotto
- Faculty of Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8577, Japan
| | - Satoshi Tanaka
- Department of Psychology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka 431-3192, Japan
| | - S H Annabel Chen
- Psychology, School of Social Sciences, Nanyang Technological University, 48 Nanyang Avenue, Singapore 639818, Singapore
- Centre for Research and Development in Learning, Nanyang Technological University, 61 Nanyang Drive, Singapore 637335, Singapore
- Lee Kong Chian School of Medicine (LKCMedicine), Nanyang Technological University, 11 Mandalay Road, Singapore 308232, Singapore
| | - Ryo Kitada
- Corresponding author: Graduate School of Intercultural Studies, Kobe University, 12-1 Tsurukabuto, Nada Ward, Kobe, Hyogo 657-0013, Japan.
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Jannati A, Oberman LM, Rotenberg A, Pascual-Leone A. Assessing the mechanisms of brain plasticity by transcranial magnetic stimulation. Neuropsychopharmacology 2023; 48:191-208. [PMID: 36198876 PMCID: PMC9700722 DOI: 10.1038/s41386-022-01453-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 11/10/2022]
Abstract
Transcranial magnetic stimulation (TMS) is a non-invasive technique for focal brain stimulation based on electromagnetic induction where a fluctuating magnetic field induces a small intracranial electric current in the brain. For more than 35 years, TMS has shown promise in the diagnosis and treatment of neurological and psychiatric disorders in adults. In this review, we provide a brief introduction to the TMS technique with a focus on repetitive TMS (rTMS) protocols, particularly theta-burst stimulation (TBS), and relevant rTMS-derived metrics of brain plasticity. We then discuss the TMS-EEG technique, the use of neuronavigation in TMS, the neural substrate of TBS measures of plasticity, the inter- and intraindividual variability of those measures, effects of age and genetic factors on TBS aftereffects, and then summarize alterations of TMS-TBS measures of plasticity in major neurological and psychiatric disorders including autism spectrum disorder, schizophrenia, depression, traumatic brain injury, Alzheimer's disease, and diabetes. Finally, we discuss the translational studies of TMS-TBS measures of plasticity and their therapeutic implications.
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Affiliation(s)
- Ali Jannati
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
- F. M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Lindsay M Oberman
- Center for Neuroscience and Regenerative Medicine, Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Alexander Rotenberg
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- F. M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Department of Neurology, Harvard Medical School, Boston, MA, USA.
- Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, USA.
- Guttmann Brain Health Institute, Institut Guttmann, Barcelona, Spain.
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Qu X, Wang Z, Cheng Y, Xue Q, Li Z, Li L, Feng L, Hartwigsen G, Chen L. Neuromodulatory effects of transcranial magnetic stimulation on language performance in healthy participants: Systematic review and meta-analysis. Front Hum Neurosci 2022; 16:1027446. [PMID: 36545349 PMCID: PMC9760723 DOI: 10.3389/fnhum.2022.1027446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
Background The causal relationships between neural substrates and human language have been investigated by transcranial magnetic stimulation (TMS). However, the robustness of TMS neuromodulatory effects is still largely unspecified. This study aims to systematically examine the efficacy of TMS on healthy participants' language performance. Methods For this meta-analysis, we searched PubMed, Web of Science, PsycINFO, Scopus, and Google Scholar from database inception until October 15, 2022 for eligible TMS studies on language comprehension and production in healthy adults published in English. The quality of the included studies was assessed with the Cochrane risk of bias tool. Potential publication biases were assessed by funnel plots and the Egger Test. We conducted overall as well as moderator meta-analyses. Effect sizes were estimated using Hedges'g (g) and entered into a three-level random effects model. Results Thirty-seven studies (797 participants) with 77 effect sizes were included. The three-level random effects model revealed significant overall TMS effects on language performance in healthy participants (RT: g = 0.16, 95% CI: 0.04-0.29; ACC: g = 0.14, 95% CI: 0.04-0.24). Further moderator analyses indicated that (a) for language tasks, TMS induced significant neuromodulatory effects on semantic and phonological tasks, but didn't show significance for syntactic tasks; (b) for cortical targets, TMS effects were not significant in left frontal, temporal or parietal regions, but were marginally significant in the inferior frontal gyrus in a finer-scale analysis; (c) for stimulation parameters, stimulation sites extracted from previous studies, rTMS, and intensities calibrated to the individual resting motor threshold are more prone to induce robust TMS effects. As for stimulation frequencies and timing, both high and low frequencies, online and offline stimulation elicited significant effects; (d) for experimental designs, studies adopting sham TMS or no TMS as the control condition and within-subject design obtained more significant effects. Discussion Overall, the results show that TMS may robustly modulate healthy adults' language performance and scrutinize the brain-and-language relation in a profound fashion. However, due to limited sample size and constraints in the current meta-analysis approach, analyses at a more comprehensive level were not conducted and results need to be confirmed by future studies. Systematic review registration [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=366481], identifier [CRD42022366481].
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Affiliation(s)
- Xingfang Qu
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China
| | - Zichao Wang
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China
| | - Yao Cheng
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China
| | - Qingwei Xue
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China
| | - Zimu Li
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China
| | - Lu Li
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China
| | - Liping Feng
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China
| | - Gesa Hartwigsen
- Lise Meitner Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Luyao Chen
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China,*Correspondence: Luyao Chen,
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Moriyasu S, Shimizu T, Honda M, Ugawa Y, Hanajima R. Motor cortical plasticity and its correlation with motor symptoms in Parkinson's disease. eNeurologicalSci 2022; 29:100422. [PMID: 36097517 PMCID: PMC9463550 DOI: 10.1016/j.ensci.2022.100422] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 08/06/2022] [Accepted: 08/31/2022] [Indexed: 11/17/2022] Open
Abstract
Background The relationship between abnormal cortical plasticity and parkinsonian symptoms remains unclear in Parkinson's disease (PD). Objective We studied the relationship between their symptoms and degree of Long-term potentiation (LTP)-like effects induced by quadripulse magnetic stimulation (QPS) over the primary motor cortex, which has a small inter-individual variability in humans. Methods Participants were 16 PD patients (drug-naïve or treated with L-DOPA monotherapy) and 13 healthy controls (HC). LTP-like effects by QPS were compared between three conditions (HC、PD with or without L-DOPA). In PD, correlation analyses were performed between clinical scores (MDS-UPDRS, MMSE and MoCA-J) and the degree of LTP-like effects induced by QPS. Results In PD, QPS-induced LTP-like effect was reduced and restored by L-DOPA. The degree of the LTP was negatively correlated with MDS-UPDRS Part I and III scores, but not with MMSE and MoCA-J. In the sub-scores, upper limb bradykinesia and rigidity showed a negative correlation with the LTP-like effect whereas the tremor had no correlation. Conclusions Our results suggest that motor cortical plasticity relate with mechanisms underlying bradykinesia and rigidity in the upper limb muscles. LTP induced by QPS may be used as an objective marker of parkinsonian symptoms. Quadripulse magnetic stimulation (QPS) was applied to early PD patients. L-DOPA restored QPS-induced LTP of the primary motor cortex in early PD patients. The degree of LTP was negatively correlated with the severity of motor symptoms. Upper limb bradykinesia and rigidity had a strong negative correlation with LTP.
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Neige C, Ciechelski V, Lebon F. The recruitment of indirect waves within primary motor cortex during motor imagery: A directional transcranial magnetic stimulation study. Eur J Neurosci 2022; 56:6187-6200. [PMID: 36215136 PMCID: PMC10092871 DOI: 10.1111/ejn.15843] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 09/15/2022] [Accepted: 09/28/2022] [Indexed: 12/29/2022]
Abstract
Motor imagery (MI) refers to the mental simulation of an action without overt movement. While numerous transcranial magnetic stimulation (TMS) studies provided evidence for a modulation of corticospinal excitability and intracortical inhibition during MI, the neural signature within the primary motor cortex is not clearly established. In the current study, we used directional TMS to probe the modulation of the excitability of early and late indirect waves (I-waves) generating pathways during MI. Corticospinal responses evoked by TMS with posterior-anterior (PA) and anterior-posterior (AP) current flow within the primary motor cortex evoke preferentially early and late I-waves, respectively. Seventeen participants were instructed to stay at rest or to imagine maximal isometric contractions of the right flexor carpi radialis. We demonstrated that the increase of corticospinal excitability during MI is greater with PA than AP orientation. By using paired-pulse stimulations, we confirmed that short-interval intracortical inhibition (SICI) increased during MI in comparison to rest with PA orientation, whereas we found that it decreased with AP orientation. Overall, these results indicate that the pathways recruited by PA and AP orientations that generate early and late I-waves are differentially modulated by MI.
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Affiliation(s)
- Cécilia Neige
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, Dijon, France.,Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, INSERM, CNRS, CRNL U1028 UMR5292, PsyR2 Team, Bron, France
| | - Valentin Ciechelski
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, Dijon, France
| | - Florent Lebon
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, Dijon, France
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43
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Sasaki R, Hand BJ, Semmler JG, Opie GM. Modulation of I-Wave Generating Pathways With Repetitive Paired-Pulse Transcranial Magnetic Stimulation: A Transcranial Magnetic Stimulation–Electroencephalography Study. Neuromodulation 2022:S1094-7159(22)01353-8. [DOI: 10.1016/j.neurom.2022.10.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/11/2022] [Accepted: 10/30/2022] [Indexed: 12/03/2022]
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Maiella M, Casula EP, Borghi I, Assogna M, D’Acunto A, Pezzopane V, Mencarelli L, Rocchi L, Pellicciari MC, Koch G. Simultaneous transcranial electrical and magnetic stimulation boost gamma oscillations in the dorsolateral prefrontal cortex. Sci Rep 2022; 12:19391. [PMID: 36371451 PMCID: PMC9653481 DOI: 10.1038/s41598-022-23040-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 10/25/2022] [Indexed: 11/13/2022] Open
Abstract
Neural oscillations in the gamma frequency band have been identified as a fundament for synaptic plasticity dynamics and their alterations are central in various psychiatric and neurological conditions. Transcranial magnetic stimulation (TMS) and alternating electrical stimulation (tACS) may have a strong therapeutic potential by promoting gamma oscillations expression and plasticity. Here we applied intermittent theta-burst stimulation (iTBS), an established TMS protocol known to induce LTP-like cortical plasticity, simultaneously with transcranial alternating current stimulation (tACS) at either theta (θtACS) or gamma (γtACS) frequency on the dorsolateral prefrontal cortex (DLPFC). We used TMS in combination with electroencephalography (EEG) to evaluate changes in cortical activity on both left/right DLPFC and over the vertex. We found that simultaneous iTBS with γtACS but not with θtACS resulted in an enhancement of spectral gamma power, a trend in shift of individual peak frequency towards faster oscillations and an increase of local connectivity in the gamma band. Furthermore, the response to the neuromodulatory protocol, in terms of gamma oscillations and connectivity, were directly correlated with the initial level of cortical excitability. These results were specific to the DLPFC and confined locally to the site of stimulation, not being detectable in the contralateral DLPFC. We argue that the results described here could promote a new and effective method able to induce long-lasting changes in brain plasticity useful to be clinically applied to several psychiatric and neurological conditions.
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Affiliation(s)
- Michele Maiella
- grid.417778.a0000 0001 0692 3437Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, 00179 Rome, Italy
| | - Elias Paolo Casula
- grid.417778.a0000 0001 0692 3437Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, 00179 Rome, Italy ,grid.7841.aDepartment of Psychology, La Sapienza University, Rome, Italy
| | - Ilaria Borghi
- grid.417778.a0000 0001 0692 3437Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, 00179 Rome, Italy ,grid.25786.3e0000 0004 1764 2907Center for Translational Neurophysiology of Speech and Communication, Istituto Italiano di Tecnologia (IIT), Ferrara, Italy
| | - Martina Assogna
- grid.417778.a0000 0001 0692 3437Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, 00179 Rome, Italy
| | - Alessia D’Acunto
- grid.417778.a0000 0001 0692 3437Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, 00179 Rome, Italy
| | - Valentina Pezzopane
- grid.417778.a0000 0001 0692 3437Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, 00179 Rome, Italy
| | - Lucia Mencarelli
- grid.417778.a0000 0001 0692 3437Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, 00179 Rome, Italy
| | - Lorenzo Rocchi
- grid.7763.50000 0004 1755 3242Department of Medical Sciences and Public Health, Institute of Neurology, University of Cagliari, Cagliari, Italy
| | - Maria Concetta Pellicciari
- grid.417778.a0000 0001 0692 3437Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, 00179 Rome, Italy
| | - Giacomo Koch
- grid.417778.a0000 0001 0692 3437Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, 00179 Rome, Italy ,grid.8484.00000 0004 1757 2064Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
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van den Bos MAJ, Menon P, Vucic S. Cortical hyperexcitability and plasticity in Alzheimer's disease: developments in understanding and management. Expert Rev Neurother 2022; 22:981-993. [PMID: 36683586 DOI: 10.1080/14737175.2022.2170784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Transcranial magnetic stimulation (TMS) is a non-invasive neurophysiological tool that provides important insights into Alzheimer's Disease (AD). A significant body of work utilizing TMS techniques has explored the pathophysiological relevance of cortical hyperexcitability and plasticity in AD and their modulation in novel therapies. AREAS COVERED This review examines the technique of TMS, the use of TMS to examine specific features of cortical excitability and the use of TMS techniques to modulate cortical function. A search was performed utilizing the PubMed database to identify key studies utilizing TMS to examine cortical hyperexcitability and plasticity in Alzheimer's dementia. We then translate this understanding to the study of Alzheimer's disease pathophysiology, examining the underlying neurophysiologic links contributing to these twin signatures, cortical hyperexcitability and abnormal plasticity, in the cortical dysfunction characterizing AD. Finally, we examine utilization of TMS excitability to guide targeted therapies and, through the use of repetitive TMS (rTMS), modulate cortical plasticity. EXPERT OPINION The examination of cortical hyperexcitability and plasticity with TMS has potential to optimize and expand the window of therapeutic interventions in AD, though remains at relatively early stage of development.
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Affiliation(s)
- Mehdi A J van den Bos
- Brain and Nerve Research Centre, Concord Repatriation General Hospital, Sydney, Australia
| | - Parvathi Menon
- Brain and Nerve Research Centre, Concord Repatriation General Hospital, Sydney, Australia
| | - Steve Vucic
- Brain and Nerve Research Centre, Concord Repatriation General Hospital, Sydney, Australia
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Pitts M, Nee DE. Generalizing the control architecture of the lateral prefrontal cortex. Neurobiol Learn Mem 2022; 195:107688. [PMID: 36265793 DOI: 10.1016/j.nlm.2022.107688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/07/2022] [Accepted: 10/08/2022] [Indexed: 11/17/2022]
Abstract
Cognitive control guides non-habitual, goal directed behaviors allowing us to flexibly adapt to ongoing demands. Previous work has suggested that multiple cognitive control processes exist that can be classed according to their action on present-oriented/external information versus future-oriented/internal information. These processes can be mapped onto the lateral prefrontal cortex (LPFC) such that increasingly rostral areas are involved in increasingly future-oriented/internal control processes. Whether and how such processes are organized to support goal-directed behavior remains unclear. On the one hand, the LPFC may flexibly adapt based upon demands. On the other hand, there may be a consistent control architecture such as a control hierarchy that generalizes across demands. Previous work using fMRI in humans during a comprehensive control task that engaged several control processes at once found that an area in mid-LPFC consistently exerted widespread influence throughout the LPFC. These data suggested that the mid-LPFC forms an apex of a putative control hierarchy. However, whether such an architecture generalizes across tasks remains to be tested. Here, we utilized a modified comprehensive control task designed to alter how control processes influence one another to test the generalizability of the LPFC control architecture. Univariate fMRI activations revealed distinct control-related activations relative to past work. Despite these changes, effective connectivity modeling revealed a directed architecture similar to previous findings with the mid-LPFC exerting the most widespread influences throughout LPFC. These results suggest that the fundamental control architecture of the LPFC is relatively fixed, and that different demands are accommodated through modulations of this fixed architecture.
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Affiliation(s)
- McKinney Pitts
- Department of Psychology, Florida State University, Tallahassee, FL 32306-4301, United States
| | - Derek Evan Nee
- Department of Psychology, Florida State University, Tallahassee, FL 32306-4301, United States.
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Hand choice is unaffected by high frequency continuous theta burst transcranial magnetic stimulation to the posterior parietal cortex. PLoS One 2022; 17:e0275262. [PMID: 36227882 PMCID: PMC9560494 DOI: 10.1371/journal.pone.0275262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 09/13/2022] [Indexed: 11/21/2022] Open
Abstract
The current study used a high frequency TMS protocol known as continuous theta burst stimulation (cTBS) to test a model of hand choice that relies on competing interactions between the hemispheres of the posterior parietal cortex. Based on the assumption that cTBS reduces cortical excitability, the model predicts a significant decrease in the likelihood of selecting the hand contralateral to stimulation. An established behavioural paradigm was used to estimate hand choice in each individual, and these measures were compared across three stimulation conditions: cTBS to the left posterior parietal cortex, cTBS to the right posterior parietal cortex, or sham cTBS. Our results provide no supporting evidence for the interhemispheric competition model. We find no effects of cTBS on hand choice, independent of whether the left or right posterior parietal cortex was stimulated. Our results are nonetheless of value as a point of comparison against prior brain stimulation findings that, in contrast, provide evidence for a causal role for the posterior parietal cortex in hand choice.
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48
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Hu YS, Yue J, Ge Q, Feng ZJ, Wang J, Zang YF. Test-retest reliability of peak location in the sensorimotor network of resting state fMRI for potential rTMS targets. Front Neuroinform 2022; 16:882126. [PMID: 36262839 PMCID: PMC9574049 DOI: 10.3389/fninf.2022.882126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 09/15/2022] [Indexed: 11/27/2022] Open
Abstract
Most stroke repetitive transcranial magnetic stimulation (rTMS) studies have used hand motor hotspots as rTMS stimulation targets; in addition, recent studies demonstrated that functional magnetic resonance imaging (fMRI) task activation could be used to determine suitable targets due to its ability to reveal individualized precise and stronger functional connectivity with motor-related brain regions. However, rTMS is unlikely to elicit motor evoked potentials in the affected hemisphere, nor would activity be detected when stroke patients with severe hemiplegia perform an fMRI motor task using the affected limbs. The current study proposed that the peak voxel in the resting-state fMRI (RS-fMRI) motor network determined by independent component analysis (ICA) could be a potential stimulation target. Twenty-one healthy young subjects underwent RS-fMRI at three visits (V1 and V2 on a GE MR750 scanner and V3 on a Siemens Prisma) under eyes-open (EO) and eyes-closed (EC) conditions. Single-subject ICA with different total number of components (20, 30, and 40) were evaluated, and then the locations of peak voxels on the left and right sides of the sensorimotor network (SMN) were identified. While most ICA RS-fMRI studies have been carried out on the group level, that is, Group-ICA, the current study performed individual ICA because only the individual analysis could guide the individual target of rTMS. The intra- (test-retest) and inter-scanner reliabilities of the peak location were calculated. The use of 40 components resulted in the highest test-retest reliability of the peak location in both the left and right SMN compared with that determined when 20 and 30 components were used for both EC and EO conditions. ICA with 40 components might be another way to define a potential target in the SMN for poststroke rTMS treatment.
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Affiliation(s)
- Yun-Song Hu
- Center for Cognition and Brain Disorders, The Affiliated Hospital Hangzhou Normal University, Hangzhou, China
- Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
- Institutes of Psychological Sciences, Hangzhou Normal University, Hangzhou, China
| | - Juan Yue
- Center for Cognition and Brain Disorders, The Affiliated Hospital Hangzhou Normal University, Hangzhou, China
- Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
- Institutes of Psychological Sciences, Hangzhou Normal University, Hangzhou, China
| | - Qiu Ge
- Center for Cognition and Brain Disorders, The Affiliated Hospital Hangzhou Normal University, Hangzhou, China
- Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
- Institutes of Psychological Sciences, Hangzhou Normal University, Hangzhou, China
| | - Zi-Jian Feng
- Center for Cognition and Brain Disorders, The Affiliated Hospital Hangzhou Normal University, Hangzhou, China
- Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
- Institutes of Psychological Sciences, Hangzhou Normal University, Hangzhou, China
| | - Jue Wang
- Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu, China
- *Correspondence: Jue Wang
| | - Yu-Feng Zang
- Center for Cognition and Brain Disorders, The Affiliated Hospital Hangzhou Normal University, Hangzhou, China
- Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
- Institutes of Psychological Sciences, Hangzhou Normal University, Hangzhou, China
- Yu-Feng Zang
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Romero MC, Merken L, Janssen P, Davare M. Neural effects of continuous theta-burst stimulation in macaque parietal neurons. eLife 2022; 11:65536. [PMID: 36097816 PMCID: PMC9470151 DOI: 10.7554/elife.65536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 08/10/2022] [Indexed: 11/13/2022] Open
Abstract
Theta-burst transcranial magnetic stimulation (TBS) has become a standard non-invasive technique to induce offline changes in cortical excitability in human volunteers. Yet, TBS suffers from a high variability across subjects. A better knowledge about how TBS affects neural activity in vivo could uncover its mechanisms of action and ultimately allow its mainstream use in basic science and clinical applications. To address this issue, we applied continuous TBS (cTBS, 300 pulses) in awake behaving rhesus monkeys and quantified its after-effects on neuronal activity. Overall, we observed a pronounced, long-lasting, and highly reproducible reduction in neuronal excitability after cTBS in individual parietal neurons, with some neurons also exhibiting periods of hyperexcitability during the recovery phase. These results provide the first experimental evidence of the effects of cTBS on single neurons in awake behaving monkeys, shedding new light on the reasons underlying cTBS variability.
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Affiliation(s)
- Maria C Romero
- Laboratorium voor Neuro- en Psychofysiologie, The Leuven Brain Institute, Leuven, Belgium
| | - Lara Merken
- Laboratorium voor Neuro- en Psychofysiologie, The Leuven Brain Institute, Leuven, Belgium
| | - Peter Janssen
- Laboratorium voor Neuro- en Psychofysiologie, The Leuven Brain Institute, Leuven, Belgium
| | - Marco Davare
- Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
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Neurochemical profiles of the anterior temporal lobe predict response of repetitive transcranial magnetic stimulation on semantic processing. Neuroimage 2022; 258:119386. [PMID: 35709948 DOI: 10.1016/j.neuroimage.2022.119386] [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: 01/24/2022] [Revised: 05/23/2022] [Accepted: 06/12/2022] [Indexed: 10/18/2022] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive technique used to modulate cortical excitability in the human brain. However, one major challenge with rTMS is that the responses to stimulation are highly variable across individuals. The underlying reasons why responses to rTMS are highly variable between individuals still remain unclear. Here, we investigated whether the response to continuous theta-burst stimulation (cTBS) - an effective rTMS protocol for decreasing cortical excitability - is related to individual differences in glutamate and GABA neurotransmission. We acquired resting-state magnetic resonance spectroscopy (MRS) and functional magnetic resonance imaging (fMRI) during semantic processing. Then, we applied cTBS over the anterior temporal lobe (ATL), a hub for semantic representation, to explore the relationship between the baseline neurochemical profiles in this region and the response to cTBS. We found that the baseline excitation-inhibition balance (glutamate + glutamine/GABA ratio) in the ATL was associated with individual cTBS responsiveness during semantic processing. Specifically, individuals with lower excitation-inhibition balance showed stronger inhibitory effect - poorer semantic performance. Our results revealed that non-responders (subjects who did not show an inhibitory effect of cTBS on subsequent semantic performance) had higher excitatory-inhibitory balance in the ATL, which led to up-regulated task-induced regional activity as well as increased ATL-connectivity with other semantic regions compared to responders. These results disclose that the baseline neurochemical state of a cortical region can be a significant factor in predicting responses to cTBS.
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