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Huo C, Xu G, Xie H, Chen T, Shao G, Wang J, Li W, Wang D, Li Z. Functional near-infrared spectroscopy in non-invasive neuromodulation. Neural Regen Res 2024; 19:1517-1522. [PMID: 38051894 PMCID: PMC10883499 DOI: 10.4103/1673-5374.387970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 08/14/2023] [Indexed: 12/07/2023] Open
Abstract
ABSTRACT Non-invasive cerebral neuromodulation technologies are essential for the reorganization of cerebral neural networks, which have been widely applied in the field of central neurological diseases, such as stroke, Parkinson's disease, and mental disorders. Although significant advances have been made in neuromodulation technologies, the identification of optimal neurostimulation parameters including the cortical target, duration, and inhibition or excitation pattern is still limited due to the lack of guidance for neural circuits. Moreover, the neural mechanism underlying neuromodulation for improved behavioral performance remains poorly understood. Recently, advancements in neuroimaging have provided insight into neuromodulation techniques. Functional near-infrared spectroscopy, as a novel non-invasive optical brain imaging method, can detect brain activity by measuring cerebral hemodynamics with the advantages of portability, high motion tolerance, and anti-electromagnetic interference. Coupling functional near-infrared spectroscopy with neuromodulation technologies offers an opportunity to monitor the cortical response, provide real-time feedback, and establish a closed-loop strategy integrating evaluation, feedback, and intervention for neurostimulation, which provides a theoretical basis for development of individualized precise neurorehabilitation. We aimed to summarize the advantages of functional near-infrared spectroscopy and provide an overview of the current research on functional near-infrared spectroscopy in transcranial magnetic stimulation, transcranial electrical stimulation, neurofeedback, and brain-computer interfaces. Furthermore, the future perspectives and directions for the application of functional near-infrared spectroscopy in neuromodulation are summarized. In conclusion, functional near-infrared spectroscopy combined with neuromodulation may promote the optimization of central neural reorganization to achieve better functional recovery from central nervous system diseases.
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Affiliation(s)
- Congcong Huo
- Beijing Advanced Innovation Center for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China
| | - Gongcheng Xu
- Beijing Advanced Innovation Center for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China
| | - Hui Xie
- Beijing Advanced Innovation Center for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China
| | - Tiandi Chen
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China
| | - Guangjian Shao
- School of Mechatronic Engineering and Automation, Foshan University, Foshan, Guangdong Province, China
| | - Jue Wang
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China
- Key Laboratory of Neuro-functional Information and Rehabilitation Engineering of the Ministry of Civil Affairs, Beijing, China
| | - Wenhao Li
- School of Rehabilitation Engineering, Beijing College of Social Administration, Beijing, China
| | - Daifa Wang
- Beijing Advanced Innovation Center for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Zengyong Li
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China
- Key Laboratory of Neuro-functional Information and Rehabilitation Engineering of the Ministry of Civil Affairs, Beijing, China
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Gorban C, Zhang Z, Mensen A, Khatami R. The Comparison of Early Hemodynamic Response to Single-Pulse Transcranial Magnetic Stimulation following Inhibitory or Excitatory Theta Burst Stimulation on Motor Cortex. Brain Sci 2023; 13:1609. [PMID: 38002568 PMCID: PMC10670137 DOI: 10.3390/brainsci13111609] [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: 10/12/2023] [Revised: 11/14/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023] Open
Abstract
We present a new study design aiming to enhance the understanding of the mechanism by which continuous theta burst stimulation (cTBS) or intermittent theta burst stimulation (iTBS) paradigms elicit cortical modulation. Using near-infrared spectroscopy (NIRS), we compared the cortical hemodynamics of the previously inhibited (after cTBS) or excited (after iTBS) left primary motor cortex (M1) as elicited by single-pulse TMS (spTMS) in a cross-over design. Mean relative changes in hemodynamics within 6 s of the stimulus were compared using a two-sample t-test (p < 0.05) and linear mixed model between real and sham stimuli and between stimuli after cTBS and iTBS. Only spTMS after cTBS resulted in a significant increase (p = 0.04) in blood volume (BV) compared to baseline. There were no significant changes in other hemodynamic parameters (oxygenated/deoxygenated hemoglobin). spTMS after cTBS induced a larger increase in BV than spTMS after iTBS (p = 0.021) and sham stimulus after cTBS (p = 0.009). BV showed no significant difference between real and sham stimuli after iTBS (p = 0.37). The greater hemodynamic changes suggest increased vasomotor reactivity after cTBS compared to iTBS. In addition, cTBS could decrease lateral inhibition, allowing activation of surrounding areas after cTBS.
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Affiliation(s)
- Corina Gorban
- Center for Sleep Medicine, Sleep Research and Epileptology, Clinic Barmelweid, 5017 Barmelweid, Switzerland; (C.G.); (A.M.); (R.K.)
- Department of Neurology, Bern University Hospital, University of Bern, 3012 Bern, Switzerland
| | - Zhongxing Zhang
- Center for Sleep Medicine, Sleep Research and Epileptology, Clinic Barmelweid, 5017 Barmelweid, Switzerland; (C.G.); (A.M.); (R.K.)
| | - Armand Mensen
- Center for Sleep Medicine, Sleep Research and Epileptology, Clinic Barmelweid, 5017 Barmelweid, Switzerland; (C.G.); (A.M.); (R.K.)
| | - Ramin Khatami
- Center for Sleep Medicine, Sleep Research and Epileptology, Clinic Barmelweid, 5017 Barmelweid, Switzerland; (C.G.); (A.M.); (R.K.)
- Department of Neurology, Bern University Hospital, University of Bern, 3012 Bern, Switzerland
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3
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Harrington RM, Krishnamurthy LC, Ossowski A, Jeter M, Davis A, Bledniak E, Ware AL, Morris R, Arrington CN. Preliminary evidence of prolonged timing effects of theta-burst stimulation in the reading system. Front Hum Neurosci 2023; 17:1227194. [PMID: 37706172 PMCID: PMC10496289 DOI: 10.3389/fnhum.2023.1227194] [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: 05/22/2023] [Accepted: 07/31/2023] [Indexed: 09/15/2023] Open
Abstract
Theta-burst stimulation (TBS) is a repetitive transcranial magnetic stimulation technique that can be used to upregulate or downregulate different brain regions. However, the timing of its effects and the differing effects of continuous TBS (cTBS) versus intermittent TBS (iTBS) in the reading system have not been explored. This study assessed how stimulation type and post-stimulation timing affected change in performance during a phonological discrimination and sight word recognition task after stimulation of supramarginal gyrus (SMG). Fourteen right-handed young adults (age 18-27 years; 44% male) were block-randomized to receive either iTBS or cTBS to the supramarginal gyrus. Participants then performed a pseudoword discrimination task and an orthographic awareness task (behavioral control) at four different time points and change in reaction time compared to baseline was measured from each time point. There was no effect of stimulation type on change in reaction time [t(16) = -0.2, p = 0.9], suggesting that both types of TBS caused similar effects. Percent change in reaction time decreased over time in the pseudoword task [t(50) = -5.9, p < 0.001], indicating faster pseudoword processing speed with better performance 60-70 min after stimulation. In contrast, no change was demonstrated over time for the behavioral control task [t(43) = -0.6, p = 0.6], suggesting that the change over time seen in the test condition was not a learning effect. These findings provide insight into the effects of TBS on the reading system and can guide future study designs.
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Affiliation(s)
- Rachael M. Harrington
- Center for Research on the Challenges of Acquiring Language and Literacy, Georgia State University, Atlanta, GA, United States
- Department of Communication Sciences and Disorders, Georgia State University, Atlanta, GA, United States
- Center for Advanced Brain Imaging, Georgia State University, Atlanta, GA, United States
| | - Lisa C. Krishnamurthy
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Decatur, GA, United States
- Center for Translational Research in Neuroimaging and Data Science, Georgia State University, Atlanta, GA, United States
- Department of Physics and Astronomy, Georgia State University, Atlanta, GA, United States
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, United States
| | - Alexandra Ossowski
- Center for Advanced Brain Imaging, Georgia State University, Atlanta, GA, United States
- Department of Psychology, Georgia State University, Atlanta, GA, United States
| | - Mykayla Jeter
- Center for Advanced Brain Imaging, Georgia State University, Atlanta, GA, United States
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Decatur, GA, United States
| | - Adriane Davis
- Center for Advanced Brain Imaging, Georgia State University, Atlanta, GA, United States
| | - Ewelina Bledniak
- Center for Advanced Brain Imaging, Georgia State University, Atlanta, GA, United States
- Department of Psychology, Georgia State University, Atlanta, GA, United States
| | - Ashley L. Ware
- Center for Advanced Brain Imaging, Georgia State University, Atlanta, GA, United States
- Department of Psychology, Georgia State University, Atlanta, GA, United States
- Department of Neurology, University of Utah, Salt Lake City, UT, United States
| | - Robin Morris
- Center for Research on the Challenges of Acquiring Language and Literacy, Georgia State University, Atlanta, GA, United States
- Center for Advanced Brain Imaging, Georgia State University, Atlanta, GA, United States
- Center for Translational Research in Neuroimaging and Data Science, Georgia State University, Atlanta, GA, United States
- Department of Psychology, Georgia State University, Atlanta, GA, United States
| | - C. Nikki Arrington
- Center for Advanced Brain Imaging, Georgia State University, Atlanta, GA, United States
- Center for Translational Research in Neuroimaging and Data Science, Georgia State University, Atlanta, GA, United States
- Department of Psychology, Georgia State University, Atlanta, GA, United States
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Li C, Zhang N, Han Q, Zhang L, Xu S, Tu S, Xie Y, Wang Z. Prolonged Continuous Theta Burst Stimulation Can Regulate Sensitivity on Aβ Fibers: An Functional Near-Infrared Spectroscopy Study. Front Mol Neurosci 2022; 15:887426. [PMID: 35493324 PMCID: PMC9039327 DOI: 10.3389/fnmol.2022.887426] [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: 03/01/2022] [Accepted: 03/16/2022] [Indexed: 11/13/2022] Open
Abstract
Objective High-frequency repetitive transcranial magnetic stimulation (rTMS) induces analgesic effects in both experimental pain and clinical pain conditions. However, whether rTMS can modulate sensory and pain thresholds on sensory fibers is still unclear. Here, we compared the effects of three rTMS paradigms on sensory and pain thresholds conducted by different sensory fibers (Aβ, Aδ, and C fibers) with sham stimulation and investigate the potential brain activation using functional near-infrared spectroscopy (fNIRS). Methods Forty right-handed healthy subjects were randomly allocated into one of four groups. Each subject received one session rTMS [prolonged continuous theta-burst stimulation (pcTBS), intermittent theta-burst stimulation (iTBS), 10 Hz rTMS or sham]. Current perception threshold (CPT), pain tolerance threshold (PTT), and fNIRS were measured at baseline, immediately after stimulation, and 1 h after stimulation, respectively. Results Significant differences between treatments were observed for changes for CPT 2,000 Hz between baseline and 1 h after rTMS (F = 6.551, P < 0.001): pcTBS versus sham (P = 0.004) and pcTBS versus 10 Hz rTMS (P = 0.007). There were significant difference in average HbO μm in the right frontopolar cortex (FPC) [channel 23: P = 0.030 (pcTBS versus sham: P = 0.036)], left dorsolateral prefrontal cortex (DLPFC) [channel 7: P = 0.006 (pcTBS versus sham: P = 0.004)], left FPC [channel 17: P = 0.014 (pcTBS versus sham: P = 0.046), channel 22: P = 0.004 (pcTBS versus sham: P = 0.004)] comparing four group in 1 h after stimulation in PTT 2000 Hz (Aβ-fiber). Conclusion Prolonged continuous theta-burst stimulation can regulate sensitivity on Aβ fibers. In addition, single-session pcTBS placed on left M1 can increase the excitability of DLPFC and FPC, indicating the interaction between M1 and prefrontal cortex may be a potential mechanism of analgesic effect of rTMS. Studies in patients with central post-stroke pain are required to confirm the potential clinical applications of pcTBS.
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Kan RLD, Mak ADP, Chan SKW, Zhang BBB, Fong KNK, Kranz GS. Protocol for a prospective open-label clinical trial to investigate the utility of concurrent TBS/fNIRS for antidepressant treatment optimisation. BMJ Open 2022; 12:e053896. [PMID: 35144953 PMCID: PMC8845219 DOI: 10.1136/bmjopen-2021-053896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Repetitive transcranial magnetic stimulation (rTMS) with theta burst stimulation (i.e. TBS) of the dorsolateral prefrontal cortex (DLPFC) is an innovative treatment for major depressive disorder (MDD). However, fewer than 50% of patients show sufficient response to this treatment; markers for response prediction are urgently needed. Research shows considerable individual variability in the brain responses to rTMS. However, whether differences in individual DLPFC modulation by rTMS can be used as a predictive marker for treatment response remains to be investigated. Here, we present a research programme that will exploit the combination of functional near-infrared spectroscopy (fNIRS) with brain stimulation. Concurrent TBS/fNIRS will allow us to systematically investigate TBS-induced modulation of blood oxygenation as a proxy for induced brain activity changes. The findings from this study will (1) elucidate the immediate effects of excitatory and inhibitory TBS on prefrontal activity in TBS treatment-naïve patients with MDD and (2) validate the potential utility of TBS-induced brain modulation at baseline for the prediction of antidepressant response to 4 weeks of daily TBS treatment. METHODS AND ANALYSIS Open-label, parallel-group experiment consisting of two parts. In part 1, 70 patients and 37 healthy controls will be subjected to concurrent TBS/fNIRS. Intermittent TBS (iTBS) and continuous TBS (cTBS) will be applied on the left and right DLPFC, respectively. fNIRS data will be acquired before, during and several minutes after stimulation. In part 2, patients who participated in part 1 will receive a 4 week iTBS treatment of the left DLPFC, performed daily for 5 days per week. Psychometric evaluation will be performed periodically and at 1 month treatment follow-up. Statistical analysis will include a conventional, as well as a machine learning approach. ETHICS AND DISSEMINATION Ethics approval was obtained from the Institutional Review Board. Findings will be disseminated through scientific journals, conferences and university courses. TRIAL REGISTRATION NUMBER NCT04526002.
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Affiliation(s)
- Rebecca L D Kan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Arthur D P Mak
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China
| | - Sherry K W Chan
- Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Bella B B Zhang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Kenneth N K Fong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Georg S Kranz
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Wien, Austria
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, People's Republic of China
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6
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Struckmann W, Persson J, Weigl W, Gingnell M, Bodén R. Modulation of the prefrontal blood oxygenation response to intermittent theta-burst stimulation in depression: A sham-controlled study with functional near-infrared spectroscopy. World J Biol Psychiatry 2021; 22:247-256. [PMID: 32640854 DOI: 10.1080/15622975.2020.1785007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To better understand the neural mechanisms behind the effect of intermittent theta-burst stimulation (iTBS), we investigated how the prefrontal blood oxygenation response measured by changes in oxygenated haemoglobin (oxy-Hb) was modulated during a sham-controlled iTBS treatment course, and whether this was related to depressive symptom change. METHODS In this randomised, double-blind study, patients with ongoing treatment-resistant depression received either active (n = 18) or sham (n = 21) iTBS over the dorsomedial prefrontal cortex for ten to fifteen days with two sessions daily. Event-related functional near-infrared spectroscopy (fNIRS) was measured during each iTBS train, and resting-state oxy-Hb was compared before and after each iTBS session at the first, fifth, and last treatment day. RESULTS Patients receiving active iTBS had an increase of the event-related oxy-Hb response compared to the sham group on the fifth (bilateral prefrontal cortices p < .001) and last (left prefrontal p = .007, right prefrontal p = .025) treatment day. Resting-state analysis showed suppressed oxy-Hb change in active iTBS compared to sham iTBS on the last treatment day (p = .024). Oxy-Hb change was unrelated to depressive symptom change (p = .474). CONCLUSIONS This study describes a modulation of the blood oxygenation response over the prefrontal cortex that was built up during the course of active iTBS treatment in depression.
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Affiliation(s)
- Wiebke Struckmann
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Jonas Persson
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Wojciech Weigl
- Department of Surgical Science, Anaesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden
| | - Malin Gingnell
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden.,Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Robert Bodén
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
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Pinto N, Gonçalves H, Silva R, Duarte M, Gama J, Vaz Pato M. Theta burst stimulation over the prefrontal cortex: Effects on cerebral oximetry and cardiovascular measures in healthy humans. Neurosci Lett 2021; 752:135792. [PMID: 33652088 DOI: 10.1016/j.neulet.2021.135792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/10/2021] [Accepted: 02/24/2021] [Indexed: 01/26/2023]
Abstract
Theta Burst Stimulation (TBS) is a non-invasive neurophysiological technique, able to induce changes in synaptic activity. Research suggests that TBS may induce changes in cerebral oxygenation, cerebral blood flow, blood pressure and heart rate but there are conflicting results across studies. Thus, the objective of our sham-controlled study is to evaluate if TBS applied to the dorsolateral prefrontal cortex (DLPFC) of healthy volunteers produces changes in cerebral oximetry, heart rate and blood pressure. Forty-nine volunteers of both sexes were randomly allocated to one of five stimulation groups. Before and after real TBS or sham stimulation, blood pressure, heart rate, and cerebral oxygenation of the volunteers were measured. Cerebral oxygenation values were obtained with a near infra-red spectroscopy system. We found a significant reduction in left cortex oximetry after continuous TBS (cTBS) over the left DLPFC (p = 0.039) and a non-significant reduction in right cortex oximetry (p = 0.052). Right hemisphere inhibition (using cTBS) seemed to originate a significant reduction of 8 mmHg in systolic arterial pressure. No other changes were seen in oximetry, cardiac frequency and diastolic arterial pressure. In our group of normal subjects, cTBS applied to the left DLPFC was able to reduce oxygenation in the left cortex. Right hemisphere inhibition was associated with a significant reduction in systolic pressure.
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Affiliation(s)
- Nuno Pinto
- Faculty of Health Sciences, University of Beira Interior, Covilhã, 6200-506, Portugal; CICS-Health Sciences Research Centre, University of Beira Interior, Covilhã, 6200-506, Portugal.
| | - Helena Gonçalves
- Faculty of Health Sciences, University of Beira Interior, Covilhã, 6200-506, Portugal.
| | - Ricardo Silva
- Faculty of Health Sciences, University of Beira Interior, Covilhã, 6200-506, Portugal.
| | - Marta Duarte
- Faculty of Health Sciences, University of Beira Interior, Covilhã, 6200-506, Portugal.
| | - Jorge Gama
- Faculty of Health Sciences, University of Beira Interior, Covilhã, 6200-506, Portugal; University of Beira Interior, Department of Mathematics, Covilhã, 6200-506, Portugal.
| | - Maria Vaz Pato
- Faculty of Health Sciences, University of Beira Interior, Covilhã, 6200-506, Portugal; CICS-Health Sciences Research Centre, University of Beira Interior, Covilhã, 6200-506, Portugal.
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8
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Friehs MA, Klaus J, Singh T, Frings C, Hartwigsen G. Perturbation of the right prefrontal cortex disrupts interference control. Neuroimage 2020; 222:117279. [PMID: 32828926 DOI: 10.1016/j.neuroimage.2020.117279] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/11/2020] [Accepted: 08/14/2020] [Indexed: 01/06/2023] Open
Abstract
Resolving cognitive interference is central for successful everyday cognition and behavior. The Stroop task is a classical measure of cognitive interference. In this task, participants have to resolve interference on a trial-by-trial basis and performance is also influenced by the trial history, as reflected in sequence effects. Previous neuroimaging studies have associated the left and right prefrontal cortex with successful performance in the Stroop task. Yet, the causal relevance of both regions for interference processing remains largely unclear. We probed the functional relevance of the left and right prefrontal cortex for interference control. In three sessions, 25 healthy participants received online repetitive transcranial magnetic stimulation (rTMS) over the left and right dorsolateral prefrontal cortex, and sham stimulation over the vertex. During each session, participants completed a verbal-response Stroop task. Relative to sham rTMS and rTMS over the left prefrontal cortex, rTMS over the right prefrontal cortex selectively disrupted the Stroop sequence effect (i.e., the congruency sequence effect; CSE). This effect was specific to sequential modulations of interference since rTMS did not affect the Stroop performance in the ongoing trial. Our results demonstrate the functional relevance of the right dorsolateral prefrontal cortex for the processing of interference control. This finding points towards process-specific lateralization within the prefrontal cortex. The observed process- and site-specific TMS effect provides new insights into the neurophysiological underpinnings of Stroop task performance and more general, the role of the prefrontal cortex in the processing of interference control.
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Affiliation(s)
- Maximilian A Friehs
- Department of Cognitive Psychology and Methodology, Trier University, Germany.
| | - Jana Klaus
- Department of Experimental Psychology, Utrecht University, the Netherlands
| | - Tarini Singh
- Department of Experimental Psychology, Halle University, Germany
| | - Christian Frings
- Department of Cognitive Psychology and Methodology, Trier University, Germany
| | - Gesa Hartwigsen
- Lise Meitner Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences, Germany
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Examining the Role of Lateral Parietal Cortex in Emotional Distancing Using TMS. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2020; 20:1090-1102. [DOI: 10.3758/s13415-020-00821-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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10
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López-Caballero F, Martin-Trias P, Ribas-Prats T, Gorina-Careta N, Bartrés-Faz D, Escera C. Effects of cTBS on the Frequency-Following Response and Other Auditory Evoked Potentials. Front Hum Neurosci 2020; 14:250. [PMID: 32733220 PMCID: PMC7360924 DOI: 10.3389/fnhum.2020.00250] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 06/04/2020] [Indexed: 01/22/2023] Open
Abstract
The frequency-following response (FFR) is an auditory evoked potential (AEP) that follows the periodic characteristics of a sound. Despite being a widely studied biosignal in auditory neuroscience, the neural underpinnings of the FFR are still unclear. Traditionally, FFR was associated with subcortical activity, but recent evidence suggested cortical contributions which may be dependent on the stimulus frequency. We combined electroencephalography (EEG) with an inhibitory transcranial magnetic stimulation protocol, the continuous theta burst stimulation (cTBS), to disentangle the cortical contribution to the FFR elicited to stimuli of high and low frequency. We recorded FFR to the syllable /ba/ at two fundamental frequencies (Low: 113 Hz; High: 317 Hz) in healthy participants. FFR, cortical potentials, and auditory brainstem response (ABR) were recorded before and after real and sham cTBS in the right primary auditory cortex. Results showed that cTBS did not produce a significant change in the FFR recorded, in any of the frequencies. No effect was observed in the ABR and cortical potentials, despite the latter known contributions from the auditory cortex. Possible reasons behind the negative results include compensatory mechanisms from the non-targeted areas, intraindividual variability of the cTBS effectiveness, and the particular location of our target area, the primary auditory cortex.
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Affiliation(s)
- Fran López-Caballero
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Cognitive Neuroscience Research Group, Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Pablo Martin-Trias
- Medical Psychology Unit, Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Teresa Ribas-Prats
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Cognitive Neuroscience Research Group, Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain
| | - Natàlia Gorina-Careta
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Cognitive Neuroscience Research Group, Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain
| | - David Bartrés-Faz
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Medical Psychology Unit, Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Carles Escera
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Cognitive Neuroscience Research Group, Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain
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11
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Jost LB, Pestalozzi MI, Cazzoli D, Mouthon M, Müri RM, Annoni JM. Effects of Continuous Theta Burst Stimulation Over the Left Dlpfc on Mother Tongue and Second Language Production In Late Bilinguals: A Behavioral and ERP Study. Brain Topogr 2020; 33:504-518. [DOI: 10.1007/s10548-020-00779-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 05/28/2020] [Indexed: 01/21/2023]
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12
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Chen L, Chung SW, Hoy KE, Fitzgerald PB. Is theta burst stimulation ready as a clinical treatment for depression? Expert Rev Neurother 2019; 19:1089-1102. [PMID: 31282224 DOI: 10.1080/14737175.2019.1641084] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction: Major depression is a common and debilitating mental disorder that can be difficult to treat. Substantive evidence over the past two decades has established repetitive transcranial magnetic stimulation (rTMS) as an effective antidepressant therapy, although scope exists to improve its efficacy and efficiency. Theta burst stimulation (TBS) is a novel rTMS pattern attracting much research interest as a tool to study neurophysiology and treat neuropsychiatric disorders. Areas covered: This article outlines rTMS' state of development and explores the physiology studies underpinning TBS development and its observable neuronal conditioning and metabolic effects. We present a systematic review of studies that applied TBS to treat depression, followed by commentary on safety and practical considerations. Expert opinion: Much experimental and clinical research have advanced our understanding of the antidepressant effects of TBS, although unanswered questions remain relating to its physiological effects, response variability and optimal parameters for therapeutic purposes. A small number of sham-controlled trials, and one large comparative trial, support the therapeutic efficacy of TBS and demonstrates its non-inferiority relative to traditional rTMS. In this light, TBS can reasonably be offered as an alternative to rTMS in treatment-resistant depression, while ongoing research is likely to inform its therapeutic potential.
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Affiliation(s)
- Leo Chen
- Monash Alfred Psychiatry Research Centre, Monash University , Melbourne , VIC , Australia.,Epworth Centre for Innovation in Mental Health, Epworth Health Care , Camberwell , VIC , Australia.,Alfred Mental and Addiction Health, Alfred Health , Melbourne , Australia
| | - Sung Wook Chung
- Monash Alfred Psychiatry Research Centre, Monash University , Melbourne , VIC , Australia
| | - Kate E Hoy
- Monash Alfred Psychiatry Research Centre, Monash University , Melbourne , VIC , Australia.,Epworth Centre for Innovation in Mental Health, Epworth Health Care , Camberwell , VIC , Australia
| | - Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Monash University , Melbourne , VIC , Australia.,Epworth Centre for Innovation in Mental Health, Epworth Health Care , Camberwell , VIC , Australia
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13
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Riedel P, Heil M, Bender S, Dippel G, Korb FM, Smolka MN, Marxen M. Modulating functional connectivity between medial frontopolar cortex and amygdala by inhibitory and excitatory transcranial magnetic stimulation. Hum Brain Mapp 2019; 40:4301-4315. [PMID: 31268615 DOI: 10.1002/hbm.24703] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 06/20/2019] [Accepted: 06/21/2019] [Indexed: 12/24/2022] Open
Abstract
The prefrontal-limbic network in the human brain plays a major role in social cognition, especially cognitive control of emotion. The medial frontopolar cortex (mFP; Brodmann Area 10) and the amygdala are part of this network and display correlated neuronal activity in time, as measured by functional magnetic resonance imaging (fMRI). This functional connectivity is dynamic, sensitive to training, and affected in mental disorders. However, the effects of neurostimulation on functional connectivity within this network have not yet been systematically investigated. Here, we investigate the effects of both low- and high-frequency repetitive transcranial magnetic stimulation (rTMS) to the right mFP on functional connectivity between mFP and amygdala, as measured with resting state fMRI (rsfMRI). Three groups of healthy participants received either low-frequency rTMS (1 Hz; N = 18), sham TMS (1 Hz, subthreshold; N = 18) or high-frequency rTMS (20 Hz; N = 19). rsfMRI was acquired before and after (separate days). We hypothesized a modulation of functional connectivity in opposite directions compared to sham TMS through adjustment of the stimulation frequency. Groups differed in functional connectivity between mFP and amygdala after stimulation compared to before stimulation (low-frequency: decrease, high-frequency: increase). Motion or induced changes in neuronal activity were excluded as confounders. Results show that rTMS is effective for increasing and decreasing functional coherence between prefrontal and limbic regions. This finding is relevant for social and affective neuroscience as well as novel treatment approaches in psychiatry.
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Affiliation(s)
- Philipp Riedel
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Matthias Heil
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Stephan Bender
- Medical Faculty, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Cologne, Cologne, Germany
| | - Gabriel Dippel
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Franziska M Korb
- Department of General Psychology, Technische Universität Dresden, Dresden, Germany
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Michael Marxen
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
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14
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Roesmann K, Dellert T, Junghoefer M, Kissler J, Zwitserlood P, Zwanzger P, Dobel C. The causal role of prefrontal hemispheric asymmetry in valence processing of words – Insights from a combined cTBS-MEG study. Neuroimage 2019; 191:367-379. [DOI: 10.1016/j.neuroimage.2019.01.057] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 01/18/2019] [Accepted: 01/21/2019] [Indexed: 10/27/2022] Open
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15
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Curtin A, Tong S, Sun J, Wang J, Onaral B, Ayaz H. A Systematic Review of Integrated Functional Near-Infrared Spectroscopy (fNIRS) and Transcranial Magnetic Stimulation (TMS) Studies. Front Neurosci 2019; 13:84. [PMID: 30872985 PMCID: PMC6403189 DOI: 10.3389/fnins.2019.00084] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 01/25/2019] [Indexed: 01/10/2023] Open
Abstract
Background: The capacity for TMS to elicit neural activity and manipulate cortical excitability has created significant expectation regarding its use in both cognitive and clinical neuroscience. However, the absence of an ability to quantify stimulation effects, particularly outside of the motor cortex, has led clinicians and researchers to pair noninvasive brain stimulation with noninvasive neuroimaging techniques. fNIRS, as an optical and wearable neuroimaging technique, is an ideal candidate for integrated use with TMS. Together, TMS+fNIRS may offer a hybrid alternative to "blind" stimulation to assess NIBS in therapy and research. Objective: In this systematic review, the current body of research into the transient and prolonged effects of TMS on fNIRS-based cortical hemodynamic measures while at rest and during tasks are discussed. Additionally, studies investigating the relation of fNIRS to measures of cortical excitability as produced by TMS-evoked Motor-Evoked-Potential (MEP) are evaluated. The aim of this review is to outline the integrated use of TMS+fNIRS and consolidate findings related to use of fNIRS to monitor changes attributed to TMS and the relationship of fNIRS to cortical excitability itself. Methods: Key terms were searched in PubMed and Web-of-Science to identify studies investigating the use of both fNIRS and TMS. Works from Google-Scholar and referenced works in identified papers were also assessed for relevance. All published experimental studies using both fNIRS and TMS techniques in the study methodology were included. Results: A combined literature search of neuroimaging and neurostimulation studies identified 53 papers detailing the joint use of fNIRS and TMS. 22/53 investigated the immediate effects of TMS at rest in the DLPFC and M1 as measured by fNIRS. 21/22 studies reported a significant effect in [HbO] for 40/54 stimulation conditions with 14 resulting an increase and 26 in a decrease. While 15/22 studies also reported [HbR], only 5/37 conditions were significant. Task effects of fNIRS+TMS were detailed in 16 studies, including 10 with clinical populations. Most studies only reported significant changes in [HbO] related measures. Studies comparing fNIRS to changes in MEP-measured cortical excitability suggest that fNIRS measures may be spatially more diffuse but share similar traits. Conclusion: This review summarizes the progress in the development of this emerging hybrid neuroimaging & neurostimulation methodology and its applications. Despite encouraging progress and novel applications, a lack of replicated works, along with highly disparate methodological approaches, highlight the need for further controlled studies. Interpretation of current research directions, technical challenges of TMS+fNIRS, and recommendations regarding future works are discussed.
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Affiliation(s)
- Adrian Curtin
- Drexel University, School of Biomedical Engineering, Science and Health Systems, Philadelphia, PA, United States.,School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Shanbao Tong
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Junfeng Sun
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Jijun Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Banu Onaral
- Drexel University, School of Biomedical Engineering, Science and Health Systems, Philadelphia, PA, United States
| | - Hasan Ayaz
- Drexel University, School of Biomedical Engineering, Science and Health Systems, Philadelphia, PA, United States.,Department of Family and Community Health, University of Pennsylvania, Philadelphia, PA, United States.,Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, United States
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16
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Forgiveness and cognitive control – Provoking revenge via theta-burst-stimulation of the DLPFC. Neuroimage 2018; 183:769-775. [DOI: 10.1016/j.neuroimage.2018.08.065] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/23/2018] [Accepted: 08/27/2018] [Indexed: 11/22/2022] Open
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17
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Keuper K, Terrighena EL, Chan CCH, Junghoefer M, Lee TMC. How the Dorsolateral Prefrontal Cortex Controls Affective Processing in Absence of Visual Awareness - Insights From a Combined EEG-rTMS Study. Front Hum Neurosci 2018; 12:412. [PMID: 30386222 PMCID: PMC6198096 DOI: 10.3389/fnhum.2018.00412] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 09/24/2018] [Indexed: 11/25/2022] Open
Abstract
The dorsolateral prefrontal cortex (DLPFC) plays a key role in the modulation of affective processing. However, its specific role in the regulation of neurocognitive processes underlying the interplay of affective perception and visual awareness has remained largely unclear. Using a mixed factorial design, this study investigated effects of inhibitory continuous theta-burst stimulation (cTBS) of the right DLPFC (rDLPFC) compared to an Active Control condition on behavioral (N = 48) and electroencephalographic (N = 38) correlates of affective processing in healthy Chinese participants. Event-related potentials (ERPs) in response to passively viewed subliminal and supraliminal negative and neutral natural scenes were recorded before and after cTBS application. We applied minimum-norm approaches to estimate the corresponding neuronal sources. On a behavioral level, we found evidence for reduced emotional interference by, and less negative and aroused ratings of negative supraliminal stimuli following rDLPFC inhibition. We found no evidence for stimulation effects on self-reported mood or the behavioral discrimination of subliminal stimuli. On a neurophysiological level, rDLPFC inhibition relatively enhanced occipito-parietal brain activity for both subliminal and supraliminal negative compared to neutral images (112–268 ms; 320–380 ms). The early onset and localization of these effects suggests that rDLPFC inhibition boosts automatic processes of “emotional attention” independently of visual awareness. Further, our study reveals the first available evidence for a differential influence of rDLPFC inhibition on subliminal versus supraliminal neural emotion processing. Explicitly, our findings indicate that rDLPFC inhibition selectively enhances late (292–360 ms) activity in response to supraliminal negative images. We tentatively suggest that this differential frontal activity likely reflects enhanced awareness-dependent down-regulation of negative scene processing, eventually leading to facilitated disengagement from and less negative and aroused evaluations of negative supraliminal stimuli.
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Affiliation(s)
- Kati Keuper
- Institute of Biomagnetism and Biosignalanalysis, University Hospital Münster, University of Münster, Münster, Germany.,Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster, Germany.,Laboratory of Neuropsychology, The University of Hong Kong, Pokfulam, Hong Kong.,Laboratory of Social Cognitive Affective Neuroscience, The University of Hong Kong, Pokfulam, Hong Kong
| | - Esslin L Terrighena
- Laboratory of Neuropsychology, The University of Hong Kong, Pokfulam, Hong Kong.,Laboratory of Social Cognitive Affective Neuroscience, The University of Hong Kong, Pokfulam, Hong Kong
| | - Chetwyn C H Chan
- Applied Cognitive Neuroscience Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Markus Junghoefer
- Institute of Biomagnetism and Biosignalanalysis, University Hospital Münster, University of Münster, Münster, Germany.,Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster, Germany
| | - Tatia M C Lee
- Laboratory of Neuropsychology, The University of Hong Kong, Pokfulam, Hong Kong.,Laboratory of Social Cognitive Affective Neuroscience, The University of Hong Kong, Pokfulam, Hong Kong.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong.,Institute of Clinical Neuropsychology, The University of Hong Kong, Pokfulam, Hong Kong
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18
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Continuous theta-burst stimulation over the dorsolateral prefrontal cortex inhibits improvement on a working memory task. Sci Rep 2018; 8:14835. [PMID: 30287868 PMCID: PMC6172210 DOI: 10.1038/s41598-018-33187-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 09/24/2018] [Indexed: 01/12/2023] Open
Abstract
Theta-burst stimulation (TBS) over the dorsolateral prefrontal cortex (DLPFC) may be more effective for modulating cortical excitability compared to standard repetitive transcranial magnetic stimulation. However, the impact of intermittent (iTBS) and continuous TBS (cTBS) on working memory (WM) is poorly studied. The aim of our study was to compare the effects of iTBS and cTBS on WM over the left and right DLPFC. iTBS, cTBS or sham stimulation was administered over the right and left hemisphere of fifty-one healthy human subjects. WM was assessed before and after TBS using the 1-back, 2-back, and 3-back tasks. We found classical practice effects in the iTBS and the sham group: WM performance improved following stimulation as measured by the discriminability index. However, this effect could not be observed in the cTBS group. We did not find any hemisphere-dependent effects, suggesting that the practice effect is not lateralized, and TBS affects WM performance in a comparable manner if administered either over the left or the right hemisphere. We propose that our findings represent a useful addition to the literature of TBS-induced effects on WM. Moreover, these results indicate the possibility of clarifying processes underlying WM performance changes by using non-invasive brain stimulation.
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19
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Effects of prefrontal theta-burst stimulation on brain function in treatment-resistant depression: A randomized sham-controlled neuroimaging study. Brain Stimul 2018; 11:1054-1062. [DOI: 10.1016/j.brs.2018.04.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 03/08/2018] [Accepted: 04/19/2018] [Indexed: 11/19/2022] Open
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20
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Lowe CJ, Staines WR, Manocchio F, Hall PA. The neurocognitive mechanisms underlying food cravings and snack food consumption. A combined continuous theta burst stimulation (cTBS) and EEG study. Neuroimage 2018; 177:45-58. [DOI: 10.1016/j.neuroimage.2018.05.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 05/01/2018] [Accepted: 05/03/2018] [Indexed: 01/13/2023] Open
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21
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Weintraub-Brevda RR, Chua EF. The role of the ventrolateral prefrontal cortex in emotional enhancement of memory: A TMS study. Cogn Neurosci 2018; 9:116-126. [PMID: 29987973 DOI: 10.1080/17588928.2018.1496905] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Negative stimuli are often remembered better than neutral stimuli, which is called the emotional enhancement of memory (EEM). We tested whether the role of the ventrolateral prefrontal cortex (VLPFC) in the EEM depended on stimulus valence and/or arousal, and attentional resources. Continuous theta burst stimulation (cTBS) was applied over the left VLPFC, right VLPFC and vertex before encoding 'negative arousing,' 'negative nonarousing,' and 'neutral' words under full and divided attention, followed by a recognition test. The vertex condition showed the EEM effect for 'negative arousing' and 'negative nonarousing' words. However, the right VLPFC condition showed no evidence of the EEM effect for 'negative arousing' or 'negative nonarousing' words, under full attention. In contrast, the left VLPFC condition showed the EEM effect for 'negative arousing' words, but not 'negative nonarousing' words, under full attention. Thus, the left and right VLPFC have different roles in the EEM, depending on valence and arousal.
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Affiliation(s)
- R Rachel Weintraub-Brevda
- a Department of Psychology , Brooklyn College of the City University of New York , Brooklyn , NY , USA.,b Department of Psychology , Graduate Center of the City University of New York , New York , NY , USA
| | - Elizabeth F Chua
- a Department of Psychology , Brooklyn College of the City University of New York , Brooklyn , NY , USA.,b Department of Psychology , Graduate Center of the City University of New York , New York , NY , USA
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22
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van Holstein M, Froböse MI, O'Shea J, Aarts E, Cools R. Controlling striatal function via anterior frontal cortex stimulation. Sci Rep 2018; 8:3312. [PMID: 29459720 PMCID: PMC5818614 DOI: 10.1038/s41598-018-21346-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 02/01/2018] [Indexed: 11/21/2022] Open
Abstract
Motivational, cognitive and action goals are processed by distinct, topographically organized, corticostriatal circuits. We aimed to test whether processing in the striatum is under causal control by cortical regions in the human brain by investigating the effects of offline transcranial magnetic stimulation (TMS) over distinct frontal regions associated with motivational, cognitive and action goal processing. Using a three-session counterbalanced within-subject crossover design, continuous theta burst stimulation was applied over the anterior prefrontal cortex (aPFC), dorsolateral prefrontal cortex, or premotor cortex, immediately after which participants (N = 27) performed a paradigm assessing reward anticipation (motivation), task (cognitive) switching, and response (action) switching. Using task-related functional magnetic resonance imaging (fMRI), we assessed the effects of stimulation on processing in distinct regions of the striatum. To account for non-specific effects, each session consisted of a baseline (no-TMS) and a stimulation (post-TMS) fMRI run. Stimulation of the aPFC tended to decrease reward-related processing in the caudate nucleus, while stimulation of the other sites was unsuccessful. A follow-up analysis revealed that aPFC stimulation also decreased processing in the putamen as a function of the interaction between all factors (reward, cognition and action), suggesting stimulation modulated the transfer of motivational information to cortico-striatal circuitry associated with action control.
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Affiliation(s)
- Mieke van Holstein
- Radboud University, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands. .,Department of Psychology and Brain Research Center, University of British Columbia, Vancouver, BC, Canada.
| | - Monja I Froböse
- Radboud University, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Jacinta O'Shea
- Radboud University, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands.,Wellcome Centre for Integrative Neuroimaging (WIN), Oxford Centre for Functional MRI of the Brain (FMRIB), Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Headington, Oxford, OX3 9DU, UK
| | - Esther Aarts
- Radboud University, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Roshan Cools
- Radboud University, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands.,Radboud University Medical Center, Department of Psychiatry, Nijmegen, The Netherlands
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23
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Lowe CJ, Manocchio F, Safati AB, Hall PA. The effects of theta burst stimulation (TBS) targeting the prefrontal cortex on executive functioning: A systematic review and meta-analysis. Neuropsychologia 2018; 111:344-359. [PMID: 29438672 DOI: 10.1016/j.neuropsychologia.2018.02.004] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 02/02/2018] [Accepted: 02/03/2018] [Indexed: 12/16/2022]
Abstract
Theta burst stimulation (TBS) is a highly efficient repetitive transcranial magnetic stimulation (rTMS) variant employed in experimental and clinical treatment paradigms. Despite widespread usage of TBS targeting the prefrontal cortex (PFC), there has been no systematic review of the evidence linking TBS protocols to changes in task performance on common measures of prefrontal function in general, and executive functions specifically. A systematic review of the literature was conducted using PsycINFO, PubMed, Web of Science and Scopus databases to identify articles examining the effects of TBS targeting the PFC on executive function task performance. Both the up-regulating (intermittent theta burst stimulation; iTBS) and down-regulating (continuous theta burst stimulation; cTBS) variants of TBS were considered. 32 (29 cTBS; 8 iTBS) studies met the inclusion criteria. Participants (n = 759; 51.41% female) were primarily young adults (Mage = 26), with one study examining the effects of cTBS and iTBS in older adults. Results from individual studies were converted to Hedge's g and random-effects models were used to estimate the overall effect size for each protocol. Age, biological sex, and control methodology were examined as potential moderators of the cTBS effect on executive function test performance. Findings indicated a- reliable attentuating effect of cTBS on executive function task performance (g = -.244, Z = -5.920, p < .001); this effect was relatively uniform across included studies (Q= 24.178, p = .838, I2 = 0). Although no significant moderators of the cTBS effect were identified, laterality sub analyses indicated that the magnitude of the effect was significantly higher (Mdiff = .213, Zdiff = 2.546, p = .011) for left-sided (g = -.358, Z = -5.816, p < .001) relative to right-sided (g = -.145, Z = -2.552, p = .011) PFC stimulation. A systematic review of iTBS studies revealed variability in reliability of effects though most were in the theorized direction. TBS protocols appear to be effective in modulating prefrontal cortical excitability in previously theorized directions.
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Affiliation(s)
- Cassandra J Lowe
- Prevention Neuroscience Lab, School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada N2L 3G1
| | - Felicia Manocchio
- Prevention Neuroscience Lab, School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada N2L 3G1
| | - Adrian B Safati
- Prevention Neuroscience Lab, School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada N2L 3G1
| | - Peter A Hall
- Prevention Neuroscience Lab, School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada N2L 3G1.
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24
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Deppermann S, Vennewald N, Diemer J, Sickinger S, Haeussinger FB, Dresler T, Notzon S, Laeger I, Arolt V, Ehlis AC, Fallgatter AJ, Zwanzger P. Neurobiological and clinical effects of fNIRS-controlled rTMS in patients with panic disorder/agoraphobia during cognitive-behavioural therapy. Neuroimage Clin 2017; 16:668-677. [PMID: 29085773 PMCID: PMC5650598 DOI: 10.1016/j.nicl.2017.09.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 09/01/2017] [Accepted: 09/19/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND A relevant proportion of patients with panic disorder (PD) does not improve even though they receive state of the art treatment for anxiety disorders such as cognitive-behavioural therapy (CBT). At the same time, it is known, that from a neurobiological point of view, PD patients are often characterised by prefrontal hypoactivation. Intermittent Theta Burst Stimulation (iTBS) is a non-invasive type of neurostimulation which can modulate cortical activity and thus has the potential to normalise prefrontal hypoactivity found in PD. We therefore aimed at investigating the effects of iTBS as an innovative add-on to CBT in the treatment for PD. METHODS In this double-blind, bicentric study, 44 PD patients, randomised to sham or verum stimulation, received 15 sessions of iTBS over the left prefrontal cortex (PFC) in addition to 9 weeks of group CBT. Cortical activity during a cognitive as well as an emotional (Emotional Stroop) paradigm was assessed both at baseline and post-iTBS treatment using functional near-infrared spectroscopy (fNIRS) and compared to healthy controls. RESULTS In this manuscript we only report the results of the emotional paradigm; for the results of the cognitive paradigm please refer to Deppermann et al. (2014). During the Emotional Stroop test, PD patients showed significantly reduced activation to panic-related compared to neutral stimuli for the left PFC at baseline. Bilateral prefrontal activation for panic-related stimuli significantly increased after verum iTBS only. Clinical ratings significantly improved during CBT and remained stable at follow-up. However, no clinical differences between the verum- and sham-stimulated group were identified, except for a more stable reduction of agoraphobic avoidance during follow-up in the verum iTBS group. LIMITATIONS Limitations include insufficient blinding, the missing control for possible state-dependent iTBS effects, and the timing of iTBS application during CBT. CONCLUSION Prefrontal hypoactivity in PD patients was normalised by add-on iTBS. Clinical improvement of anxiety symptoms was not affected by iTBS.
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Key Words
- ANOVA, analysis of variance
- CAQ, Cardiac Anxiety Questionnaire
- CBSI, correlation-based signal improvement
- CBT, cognitive-behavioural therapy
- Cognitive-behavioural therapy
- ER, error rate
- Emotion regulation
- Functional near-infrared spectroscopy
- HAM-A, Hamilton Anxiety Rating Scale
- HHb, deoxyhemoglobin
- Intermittent Theta Burst Stimulation
- LOCF, last observation carried forward
- O2Hb, oxyhemoglobin
- PAS, Panic and Agoraphobia Scale
- PD, panic disorder
- PFC, prefrontal cortex
- Panic disorder
- RM-ANOVA, repeated-measures analysis of variance
- ROI, region of interest
- RT, reaction time
- fNIRS, functional near-infrared spectroscopy
- iTBS, intermittent Theta Burst Stimulation
- rTMS, repetitive Transcranial Magnetic Stimulation
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Affiliation(s)
- Saskia Deppermann
- Department of Psychiatry and Psychotherapy, Calwerstr. 14, University of Tuebingen, 72076 Tuebingen, Germany
| | - Nadja Vennewald
- Mood and Anxiety Disorders Research Unit, Department of Psychiatry and Psychotherapy, Albert-Schweitzer-Campus 1, University of Muenster, Muenster, Germany
| | - Julia Diemer
- Mood and Anxiety Disorders Research Unit, Department of Psychiatry and Psychotherapy, Albert-Schweitzer-Campus 1, University of Muenster, Muenster, Germany
- kbo-Inn-Salzach-Hospital, Gabersee 7, 83512 Wasserburg am Inn, Germany
| | - Stephanie Sickinger
- Department of Psychiatry and Psychotherapy, Calwerstr. 14, University of Tuebingen, 72076 Tuebingen, Germany
| | - Florian B. Haeussinger
- Department of Psychiatry and Psychotherapy, Calwerstr. 14, University of Tuebingen, 72076 Tuebingen, Germany
| | - Thomas Dresler
- Department of Psychiatry and Psychotherapy, Calwerstr. 14, University of Tuebingen, 72076 Tuebingen, Germany
- Graduate School LEAD, Europastr. 6, University of Tuebingen, 72072 Tuebingen, Germany
| | - Swantje Notzon
- Mood and Anxiety Disorders Research Unit, Department of Psychiatry and Psychotherapy, Albert-Schweitzer-Campus 1, University of Muenster, Muenster, Germany
| | - Inga Laeger
- Mood and Anxiety Disorders Research Unit, Department of Psychiatry and Psychotherapy, Albert-Schweitzer-Campus 1, University of Muenster, Muenster, Germany
- Department of Psychiatry and Psychotherapy, Albert-Schweitzer-Campus 1, University of Muenster, Muenster, Germany
| | - Volker Arolt
- Mood and Anxiety Disorders Research Unit, Department of Psychiatry and Psychotherapy, Albert-Schweitzer-Campus 1, University of Muenster, Muenster, Germany
| | - Ann-Christine Ehlis
- Department of Psychiatry and Psychotherapy, Calwerstr. 14, University of Tuebingen, 72076 Tuebingen, Germany
| | - Andreas J. Fallgatter
- Department of Psychiatry and Psychotherapy, Calwerstr. 14, University of Tuebingen, 72076 Tuebingen, Germany
- Graduate School LEAD, Europastr. 6, University of Tuebingen, 72072 Tuebingen, Germany
- Cluster of Excellence CIN, Otfried-Mueller-Str. 25, University of Tuebingen, 72076 Tuebingen, Germany
| | - Peter Zwanzger
- Mood and Anxiety Disorders Research Unit, Department of Psychiatry and Psychotherapy, Albert-Schweitzer-Campus 1, University of Muenster, Muenster, Germany
- kbo-Inn-Salzach-Hospital, Gabersee 7, 83512 Wasserburg am Inn, Germany
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Viejo-Sobera R, Redolar-Ripoll D, Boixadós M, Palaus M, Valero-Cabré A, Marron EM. Impact of Prefrontal Theta Burst Stimulation on Clinical Neuropsychological Tasks. Front Neurosci 2017; 11:462. [PMID: 28867993 PMCID: PMC5563370 DOI: 10.3389/fnins.2017.00462] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 08/03/2017] [Indexed: 11/15/2022] Open
Abstract
Theta burst stimulation (TBS) protocols hold high promise in neuropsychological rehabilitation. Nevertheless, their ability to either decrease (continuous, cTBS) or increase (intermittent, iTBS) cortical excitability in areas other than the primary motor cortex, and their consistency modulating human behaviors with clinically relevant tasks remain to be fully established. The behavioral effects of TBS over the dorsolateral prefrontal cortex (dlPFC) are particularly interesting given its involvement in working memory (WM) and executive functions (EF), often impaired following frontal brain damage. We aimed to explore the ability of cTBS and iTBS to modulate WM and EF in healthy individuals, assessed with clinical neuropsychological tests (Digits Backward, 3-back task, Stroop Test, and Tower of Hanoi). To this end, 36 participants were assessed using the four tests 1 week prior to stimulation and immediately following a single session of either cTBS, iTBS, or sham TBS, delivered to the left dlPFC. No significant differences were found across stimulation conditions in any of the clinical tasks. Nonetheless, in some of them, active stimulation induced significant pre/post performance modulations, which were not found for the sham condition. More specifically, sham stimulation yielded improvements in the 3-back task and the Color, Color-Word, and Interference Score of the Stroop Test, an effect likely caused by task practice. Both, iTBS and cTBS, produced improvements in Digits Backward and impairments in 3-back task accuracy. Moreover, iTBS increased Interference Score in the Stroop Test in spite of the improved word reading and impaired color naming, whereas cTBS decreased the time required to complete the Tower of Hanoi. Differing from TBS outcomes reported for cortico-spinal measures on the primary motor cortex, our analyses did not reveal any of the expected performance differences across stimulation protocols. However, if one considers independently pre/post differences for each individual outcome measure and task, either one or both of the active protocols appeared to modulate WM and EF. We critically discuss the value, potential explanations, and some plausible interpretations for this set of subtle impacts of left dlPFC TBS in humans.
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Affiliation(s)
- Raquel Viejo-Sobera
- Cognitive NeuroLab, Faculty of Health Sciences, Universitat Oberta de CatalunyaBarcelona, Spain.,Laboratory for Neuropsychiatry and Neuromodulation, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical SchoolBoston, MA, United States
| | - Diego Redolar-Ripoll
- Cognitive NeuroLab, Faculty of Health Sciences, Universitat Oberta de CatalunyaBarcelona, Spain
| | - Mercè Boixadós
- Cognitive NeuroLab, Faculty of Health Sciences, Universitat Oberta de CatalunyaBarcelona, Spain
| | - Marc Palaus
- Cognitive NeuroLab, Faculty of Health Sciences, Universitat Oberta de CatalunyaBarcelona, Spain
| | - Antoni Valero-Cabré
- Cognitive NeuroLab, Faculty of Health Sciences, Universitat Oberta de CatalunyaBarcelona, Spain.,Cerebral Dynamics Plasticity and Rehabilitation Group, Frontlab, Institut du Cerveau et la Moelle Centre National de la Recherche Scientifique UMR 725, Institut National de la Santé et de la Recherche Médicale 1127 and UPMCParis, France.,Laboratory for Cerebral Dynamics Plasticity and Rehabilitation, Boston University School of MedicineBoston, MA, United States
| | - Elena M Marron
- Cognitive NeuroLab, Faculty of Health Sciences, Universitat Oberta de CatalunyaBarcelona, Spain
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Effects of Moderate Exercise on Cortical Resilience: A Transcranial Magnetic Stimulation Study Targeting the Dorsolateral Prefrontal Cortex. Psychosom Med 2017; 79:143-152. [PMID: 27359179 DOI: 10.1097/psy.0000000000000361] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The beneficial effects of exercise on the brain regions that support cognitive control and memory are well documented. However, examination of the capacity of acute exercise to promote cortical resilience-the ability to recover from temporary pertubation-has been largely unexplored. The present study sought to determine whether single session of moderate-intensity aerobic exercise can accelerate recovery of inhibitory control centers in the dorsolateral prefrontal cortex after transient perturbation via continuous theta burst stimulation (cTBS). METHODS In a within-participants experimental design, 28 female participants aged 18 to 26 years (mean [standard deviation] = 20.32 [1.79] years) completed a session each of moderate-intensity and very light-intensity exercise, in a randomized order. Before each exercise session, participants received active cTBS to the left dorsolateral prefrontal cortex. A Stroop task was used to quantify both the initial perturbation and subsequent recovery effects on inhibitory control. RESULTS Results revealed a significant exercise condition (moderate-intensity exercise, very light-intensity exercise) by time (prestimulation, poststimulation, postexercise) interaction (F(2,52) = 5.93, p = .005, d = 0.38). Specifically, the proportion of the cTBS-induced decrement in inhibition restored at 40 minutes postexercise was significantly higher after a bout of moderate-intensity exercise (101.26%) compared with very light-intensity exercise (18.36%; t(27) = -2.17, p = .039, d = -.57, 95% confidence interval = -161.40 to -4.40). CONCLUSION These findings support the hypothesis that exercise promotes cortical resilience, specifically in relation to the brain regions that support inhibitory control. The resilience-promoting effects of exercise have empirical and theoretical implications for how we conceptualize the neuroprotective effects of exercise.
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Schecklmann M, Giani A, Tupak S, Langguth B, Raab V, Polak T, Várallyay C, Großmann W, Herrmann MJ, Fallgatter AJ. Neuronavigated left temporal continuous theta burst stimulation in chronic tinnitus. Restor Neurol Neurosci 2016; 34:165-75. [PMID: 26890094 DOI: 10.3233/rnn-150518] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE Clinical effects of repetitive transcranial magnetic stimulation (rTMS) in chronic tinnitus are moderate. More precise coil localisation strategies, innovative stimulation protocols, and identification of predictors for treatment response were proposed as promising attempts to enhance treatment efficacy. In this pilot study we investigated neuronavigated continuous theta burst TMS (cTBS). METHODS Twenty-three patients received neuronavigated cTBS over the left primary auditory cortex in a randomized sham-controlled trial (verum = 12; sham = 11). Treatment response was evaluated with tinnitus questionnaires and numeric rating scales. Immediate change in numeric rating scales during the first session was used as predictor for treatment response. RESULTS Tinnitus was significantly reduced after treatment, but there were no superior effects between verum vs. sham treatment. Immediate change in the first treatment session predicted the response to treatment only in the verum group. CONCLUSIONS In our study, verum cTBS was not superior to sham which highlights the persistent need for improving non-invasive brain stimulation techniques for the treatment of tinnitus. Future research should focus on the transfer of positive single session effects to daily treatment trials.
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Affiliation(s)
- Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Anette Giani
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Sara Tupak
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Vincent Raab
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Thomas Polak
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Csanád Várallyay
- Department of Neuroradiology, University of Würzburg, Würzburg, Germany.,Departments of Neurology/Radiology, Oregon Health and Science University, Portland, OR, USA
| | - Wilma Großmann
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Würzburg, Germany
| | - Martin J Herrmann
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
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Emotional processing and rTMS: does inhibitory theta burst stimulation affect the human startle reflex? J Neural Transm (Vienna) 2016; 123:1121-31. [DOI: 10.1007/s00702-016-1568-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 04/30/2016] [Indexed: 12/21/2022]
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30
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Schneider S, Wagels L, Haeussinger FB, Fallgatter AJ, Ehlis AC, Rapp AM. Haemodynamic and electrophysiological markers of pragmatic language comprehension in schizophrenia. World J Biol Psychiatry 2015; 16:398-410. [PMID: 25816925 DOI: 10.3109/15622975.2015.1019359] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The present study aimed at investigating neurophysiological markers of language perception in schizophrenia using simultaneous near-infrared spectroscopy (NIRS) and event-related potentials (ERPs), which have been proven to be useful for studying language processing abilities in psychiatric patients. The study shall help to integrate previous findings from ERP and fMRI studies on figurative language comprehension in schizophrenia and elucidate how electrophysiological and haemodynamic markers of language processing are related. METHODS Twenty-two healthy subjects and 22 schizophrenia patients judged 120 sentences regarding their meaningfulness. Phrases were literal, metaphoric, or meaningless. EEG-fNIRS signals were recorded throughout the entire experiment. RESULTS Schizophrenia patients showed deficient and delayed sentence comprehension. Both the early N400 and left-hemispheric activation during language comprehension were altered in patients. Correlation analyses showed that metaphor-related ERPs were strongly linked to haemodynamic cortical activity in healthy subjects, but not in patients. CONCLUSIONS Our results indicate group differences in cortical electrophysiological and haemodynamic activation that represent rather general impairments in the processing of complex language. Simultaneous EEG/NIRS applications are useful to depict these neural markers and to investigate their relationship. Future studies are needed to clarify the nature of respective anomalies and their potential as putative neural markers in schizophrenia research.
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Affiliation(s)
- Sabrina Schneider
- a Department of Psychiatry and Psychotherapy , University of Tuebingen , Tuebingen , Germany
| | - Lisa Wagels
- b Department of Psychiatry , Psychotherapy and Psychosomatics, University of Aachen , Aachen , Germany
| | - Florian B Haeussinger
- a Department of Psychiatry and Psychotherapy , University of Tuebingen , Tuebingen , Germany
| | - Andreas J Fallgatter
- a Department of Psychiatry and Psychotherapy , University of Tuebingen , Tuebingen , Germany
| | - Ann-Christine Ehlis
- a Department of Psychiatry and Psychotherapy , University of Tuebingen , Tuebingen , Germany
| | - Alexander M Rapp
- a Department of Psychiatry and Psychotherapy , University of Tuebingen , Tuebingen , Germany
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Painter DR, Dux PE, Mattingley JB. Causal involvement of visual area MT in global feature-based enhancement but not contingent attentional capture. Neuroimage 2015; 118:90-102. [DOI: 10.1016/j.neuroimage.2015.06.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 05/25/2015] [Accepted: 06/04/2015] [Indexed: 12/17/2022] Open
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Hurlemann R, Arndt S, Schlaepfer TE, Reul J, Maier W, Scheele D. Diminished appetitive startle modulation following targeted inhibition of prefrontal cortex. Sci Rep 2015; 5:8954. [PMID: 25752944 PMCID: PMC4354029 DOI: 10.1038/srep08954] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 02/10/2015] [Indexed: 01/16/2023] Open
Abstract
From an evolutionary perspective the startle eye-blink response forms an integral part of the human avoidance behavioral repertoire and is typically diminished by pleasant emotional states. In major depressive disorder (MDD) appetitive motivation is impaired, evident in a reduced interference of positive emotion with the startle response. Given the pivotal role of frontostriatal neurocircuitry in orchestrating appetitive motivation, we hypothesized that inhibitory transcranial magnetic stimulation (TMS) would reduce appetitive neuromodulation in a manner similar to MDD. Based on a pre-TMS functional MRI (fMRI) experiment we selected the left dorsolateral and dorsomedial prefrontal cortices as target regions for subsequent sham-controlled inhibitory theta-burst TMS (TBS) in 40 healthy male volunteers. Consistent with our hypothesis, between-group comparisons revealed a TBS-induced inhibition of appetitive neuromodulation, manifest in a diminished startle response suppression by hedonic stimuli. Collectively, our results suggest that functional integrity of left dorsolateral and dorsomedial prefrontal cortex is critical for mediating a pleasure-induced down-regulation of avoidance responses which may protect the brain from a depressogenic preponderance of defensive stress.
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Affiliation(s)
- René Hurlemann
- 1] Department of Psychiatry, University of Bonn, 53105 Bonn, Germany [2] Division of Medical Psychology, University of Bonn, 53105 Bonn, Germany
| | - Stephan Arndt
- 1] Department of Psychiatry, University of Bonn, 53105 Bonn, Germany [2] Division of Medical Psychology, University of Bonn, 53105 Bonn, Germany
| | - Thomas E Schlaepfer
- 1] Department of Psychiatry, University of Bonn, 53105 Bonn, Germany [2] Department of Psychiatry &Behavioral Medicine, The Johns Hopkins Hospital, Baltimore, Maryland, 21287, USA
| | | | - Wolfgang Maier
- 1] Department of Psychiatry, University of Bonn, 53105 Bonn, Germany [2] German Center for Neurodegenerative Diseases (DZNE), 53175 Bonn, Germany
| | - Dirk Scheele
- 1] Department of Psychiatry, University of Bonn, 53105 Bonn, Germany [2] Division of Medical Psychology, University of Bonn, 53105 Bonn, Germany
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Chung SW, Hoy KE, Fitzgerald PB. Theta-burst stimulation: a new form of TMS treatment for depression? Depress Anxiety 2015; 32:182-92. [PMID: 25450537 DOI: 10.1002/da.22335] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 09/17/2014] [Accepted: 10/21/2014] [Indexed: 12/13/2022] Open
Abstract
Major depressive disorder (MDD) is a common debilitating condition where only one third of patients achieve remission after the first antidepressant treatment. Inadequate efficacy and adverse effects of current treatment strategies call for more effective and tolerable treatment options. Transcranial magnetic stimulation (TMS) is a noninvasive approach to manipulate brain activity and alter cortical excitability. There has been more than 15 years of research on the use of repetitive form of TMS (rTMS) for the treatment of patients with depression, which has shown it to be an effective antidepressant treatment. Even though rTMS treatment has shown efficacy in treating depression, there is a high degree of interindividual variability in response. A newer form of rTMS protocol, known as theta-burst stimulation (TBS), has been shown to produce similar if not greater effects on brain activity than standard rTMS. TBS protocols have a major advantage over standard rTMS approaches in their reduced administration duration. Conventional rTMS procedures last between 20 and 45 min, as compared to TBS paradigms that require 1 to 3 min of stimulation. Recently, a small number of studies have suggested that TBS has similar or better efficacy in treating depression compared to rTMS. Optimization, identification of response predictors, and clarification of neurobiological mechanisms of TBS is required if it is to be further developed as a less time intensive, safe, and effective treatment for MDD.
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Affiliation(s)
- Sung Wook Chung
- Monash Alfred Psychiatry Research Centre, Central Clinical School, The Alfred and Monash University, Melbourne, Australia
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The effects of continuous theta burst stimulation to the left dorsolateral prefrontal cortex on executive function, food cravings, and snack food consumption. Psychosom Med 2014; 76:503-11. [PMID: 25215552 DOI: 10.1097/psy.0000000000000090] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Prior research has demonstrated that executive function (EF) strength is positively associated with dietary self-control. As such, the differential operation of the brain centers underlying EFs (i.e., dorsolateral prefrontal cortex [DLPFC]) may explain controlled aspects of dietary self-control. The present study was designed to examine the causal relationship between DLPFC function and two aspects of dietary self-control: visceral cravings and actual consumptive behaviors. METHODS The research was conducted using a within-participant design. A sample of 21 healthy female young adults aged 19 to 26 years (mean [M; standard deviation] = 21.10 [1.86] years) received both active and sham continuous theta burst stimulation (cTBS) to the left DLPFC. Before and after each session, subjective food cravings were assessed using the Food Craving Questionnaire-State. After each stimulation session, participants competed three measures of EF (Stroop, Go/No-Go, and Stop-Signal) and a bogus taste test. RESULTS Participants reported larger increases in snack food cravings after active stimulation (M = 9.98% change, standard error [SE] = 0.45) than after sham stimulation (M = -3.46, SE = 0.39, p = .012) on the reinforcement anticipation dimension of Food Craving Questionnaire-State. Likewise, participants consumed significantly more snack foods after active stimulation (M = 70.62 grams, SE = 5.17) than after sham stimulation (M = 61.33, SE = 3.56, p = .006). Finally, performance on the Stroop task was reduced more after active (M = 71.56 milliseconds, SE = 25.18) than after sham stimulation (M = 20.16, SE = 13.32, p = .033); reduction in Stroop performance mediated the effect of active stimulation on increased appetitive food consumption. CONCLUSION These results support the contention that EF strength, as modulated by DLPFC activity, is causally associated with effective dietary self-control.
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Plewnia C, Pasqualetti P, Große S, Schlipf S, Wasserka B, Zwissler B, Fallgatter A. Treatment of major depression with bilateral theta burst stimulation: a randomized controlled pilot trial. J Affect Disord 2014; 156:219-23. [PMID: 24411682 DOI: 10.1016/j.jad.2013.12.025] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 12/12/2013] [Accepted: 12/13/2013] [Indexed: 01/17/2023]
Abstract
BACKGROUND Current efforts to improve clinical effectiveness and utility of repetitive transcranial magnetic stimulation (rTMS) in the treatment of major depression (MD) include theta burst stimulation (TBS), a patterned form of rTMS. Here, we investigated the efficacy of bilateral TBS to the dorsolateral prefrontal cortex (dlPFC) in patients with MD in additon to ongoing medication and psychotherapy. METHODS In this randomized-controlled trial, thirty-two patients with MD were treated for six weeks (thirty sessions) with either successively intermittent, activity enhancing TBS (iTBS) to the left and continuous, inhibiting TBS (cTBS) to the right dlPFC or with bilateral sham stimulation. Primary outcome measure was the proportion of treatment response defined as a Montgomery-Åsberg Depression Rating Scale (MADRS)≤50% compared to baseline. Secondary outcomes comprised response and remission rates of the Hamilton Depression Rating Scale (HAMD) and the Beck Depression Inventory (BDI). RESULTS A larger number of responders were found in the cTBS (n=9) compared to the sham-stimulation (n=4) group (odds ratio: 3.86; Wald χ(2)=3.9, p=0.048). On secondary endpoint analysis, patient-reported outcome as assessed by the BDI, pointed towards a higher rate of remitters in the cTBS (n=6) than in the sham (n=1) group (odds ratio: 9; Wald χ(2)=3.5, p=0.061). LIMITATIONS With regard to the pilot character of the study and the small sample size, the results have to be considered as preliminary. CONCLUSIONS These findings provide first evidence that six weeks treatment of MDD with iTBS to the left and cTBS to the right dlPFC for six weeks is safe, feasible and superior to sham stimulation applied add-on to pharmacological and psychotherapeutic treatment.
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Affiliation(s)
- Christian Plewnia
- Department of Psychiatry and Psychotherapy, Neurophysiology & Interventional Neuropsychiatry, University of Tübingen, Calwerstrasse 14, Tübingen D-72076, Germany.
| | - Patrizio Pasqualetti
- Medical Statistics & Information Technology, AFaR, Fatebenefratelli Hospital, Isola Tiberina, Rome
| | - Stephan Große
- Department of Psychiatry and Psychotherapy, Neurophysiology & Interventional Neuropsychiatry, University of Tübingen, Calwerstrasse 14, Tübingen D-72076, Germany
| | - Sarah Schlipf
- Department of Psychiatry and Psychotherapy, Neurophysiology & Interventional Neuropsychiatry, University of Tübingen, Calwerstrasse 14, Tübingen D-72076, Germany
| | - Barbara Wasserka
- Department of Psychiatry and Psychotherapy, Neurophysiology & Interventional Neuropsychiatry, University of Tübingen, Calwerstrasse 14, Tübingen D-72076, Germany
| | - Bastian Zwissler
- Department of Psychiatry and Psychotherapy, Neurophysiology & Interventional Neuropsychiatry, University of Tübingen, Calwerstrasse 14, Tübingen D-72076, Germany
| | - Andreas Fallgatter
- Department of Psychiatry and Psychotherapy, Neurophysiology & Interventional Neuropsychiatry, University of Tübingen, Calwerstrasse 14, Tübingen D-72076, Germany
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Guhn A, Dresler T, Andreatta M, Müller LD, Hahn T, Tupak SV, Polak T, Deckert J, Herrmann MJ. Medial prefrontal cortex stimulation modulates the processing of conditioned fear. Front Behav Neurosci 2014; 8:44. [PMID: 24600362 PMCID: PMC3927128 DOI: 10.3389/fnbeh.2014.00044] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 01/29/2014] [Indexed: 01/26/2023] Open
Abstract
The extinction of conditioned fear depends on an efficient interplay between the amygdala and the medial prefrontal cortex (mPFC). In rats, high-frequency electrical mPFC stimulation has been shown to improve extinction by means of a reduction of amygdala activity. However, so far it is unclear whether stimulation of homologues regions in humans might have similar beneficial effects. Healthy volunteers received one session of either active or sham repetitive transcranial magnetic stimulation (rTMS) covering the mPFC while undergoing a 2-day fear conditioning and extinction paradigm. Repetitive TMS was applied offline after fear acquisition in which one of two faces (CS+ but not CS-) was associated with an aversive scream (UCS). Immediate extinction learning (day 1) and extinction recall (day 2) were conducted without UCS delivery. Conditioned responses (CR) were assessed in a multimodal approach using fear-potentiated startle (FPS), skin conductance responses (SCR), functional near-infrared spectroscopy (fNIRS), and self-report scales. Consistent with the hypothesis of a modulated processing of conditioned fear after high-frequency rTMS, the active group showed a reduced CS+/CS- discrimination during extinction learning as evident in FPS as well as in SCR and arousal ratings. FPS responses to CS+ further showed a linear decrement throughout both extinction sessions. This study describes the first experimental approach of influencing conditioned fear by using rTMS and can thus be a basis for future studies investigating a complementation of mPFC stimulation to cognitive behavioral therapy (CBT).
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Affiliation(s)
- Anne Guhn
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of WürzburgWürzburg, Germany
| | - Thomas Dresler
- Department of Psychiatry and Psychotherapy, University of TübingenTübingen, Germany
- LEAD Graduate School, University of TuebingenTuebingen, Germany
| | - Marta Andreatta
- Department of Psychology, University of WürzburgWürzburg, Germany
| | - Laura D. Müller
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of WürzburgWürzburg, Germany
| | - Tim Hahn
- Department of Cognitive Psychology II, University of Frankfurt/MainFrankfurt, Germany
| | - Sara V. Tupak
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of WürzburgWürzburg, Germany
- Institute of Medical Psychology and Systems Neuroscience, University of MünsterMünster, Germany
| | - Thomas Polak
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of WürzburgWürzburg, Germany
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of WürzburgWürzburg, Germany
| | - Martin J. Herrmann
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of WürzburgWürzburg, Germany
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A Near Infra-Red Study of Blood Oxygenation Changes Resulting From High and Low Frequency Repetitive Transcranial Magnetic Stimulation. Brain Stimul 2013; 6:922-4. [DOI: 10.1016/j.brs.2013.04.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 04/18/2013] [Accepted: 04/18/2013] [Indexed: 11/30/2022] Open
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Show me how you walk and I tell you how you feel - a functional near-infrared spectroscopy study on emotion perception based on human gait. Neuroimage 2013; 85 Pt 1:380-90. [PMID: 23921096 DOI: 10.1016/j.neuroimage.2013.07.078] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 07/22/2013] [Accepted: 07/29/2013] [Indexed: 11/20/2022] Open
Abstract
The ability to recognize and adequately interpret emotional states in others plays a fundamental role in regulating social interaction. Body language presents an essential element of nonverbal communication which is often perceived prior to mimic expression. However, the neural networks that underlie the processing of emotionally expressive body movement and body posture are poorly understood. 33 healthy subjects have been investigated using the optically based imaging method functional near-infrared spectroscopy (fNIRS) during the performance of a newly developed emotion discrimination paradigm consisting of faceless avatars expressing fearful, angry, sad, happy or neutral gait patterns. Participants were instructed to judge (a) the presented emotional state (emotion task) and (b) the observed walking speed of the respective avatar (speed task). We measured increases in cortical oxygenated haemoglobin (O2HB) in response to visual stimulation during emotion discrimination. These O2HB concentration changes were enhanced for negative emotions in contrast to neutral gait sequences in right occipito-temporal and left temporal and temporo-parietal brain regions. Moreover, fearful and angry bodies elicited higher activation increases during the emotion task compared to the speed task. Haemodynamic responses were correlated with a number of behavioural measures, whereby a positive relationship between emotion regulation strategy preference and O2HB concentration increases after sad walks was mediated by the ability to accurately categorize sad walks. Our results support the idea of a distributed brain network involved in the recognition of bodily emotion expression that comprises visual association areas as well as body/movement perception specific cortical regions that are also sensitive to emotion. This network is activated less when the emotion is not intentionally processed (i.e. during the speed task). Furthermore, activity of this perceptive network is, mediated by the ability to correctly recognize emotions, indirectly connected to active emotion regulation processes. We conclude that a full understanding of emotion perception and its neural substrate requires the investigation of dynamic representations and means of expression other than the face.
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McKenna JT, Kocsis B, McCarley RW. Aberrant cortical neuroplasticity in the OSA patient (Commentary on Opie et al.). Eur J Neurosci 2013; 37:1843. [DOI: 10.1111/ejn.12221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- James T. McKenna
- Department of Psychiatry; VA Boston Healthcare System/Harvard Medical School; Brockton; MA; 02301; USA
| | - Bernat Kocsis
- Department of Psychiatry; Harvard Medical School; Beth Israel Deaconess Medical Center; Boston; MA; 02215; USA
| | - Robert W. McCarley
- Department of Psychiatry; VA Boston Healthcare System/Harvard Medical School; Brockton; MA; 02301; USA
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Dresler T, Hindi Attar C, Spitzer C, Löwe B, Deckert J, Büchel C, Ehlis AC, Fallgatter AJ. Neural correlates of the emotional Stroop task in panic disorder patients: an event-related fMRI study. J Psychiatr Res 2012; 46:1627-34. [PMID: 23058446 DOI: 10.1016/j.jpsychires.2012.09.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 08/21/2012] [Accepted: 09/10/2012] [Indexed: 02/07/2023]
Abstract
Although being a standard tool to assess interference effects of disorder-specific words in clinical samples, the neural underpinnings of the emotional Stroop task are still not well understood and have hardly been investigated in experimental case-control studies. We therefore used functional magnetic resonance imaging (fMRI) to examine the attentional bias toward panic-related words in panic disorder (PD) patients and healthy controls. Twenty PD patients (with or without agoraphobia) and 23 healthy controls matched for age and gender performed an event-related emotional Stroop task with panic-related and neutral words while undergoing 3 Tesla fMRI. On the behavioral level, PD patients showed a significant emotional Stroop effect, i.e. color-naming of panic-related words was prolonged compared to neutral words. This effect was not observed in the control group. PD patients further differed from controls on the neural level in showing increased BOLD activity in the left inferior frontal gyrus in response to panic-related relative to neutral words. PD patients showed the expected attentional bias, i.e. an altered processing of disorder-specific stimuli. This emotional Stroop effect was paralleled by increased activation in the left prefrontal cortex which may indicate altered processing of emotional stimulus material.
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Affiliation(s)
- Thomas Dresler
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Germany.
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Neuropeptide S receptor gene: fear-specific modulations of prefrontal activation. Neuroimage 2012; 66:353-60. [PMID: 23103692 DOI: 10.1016/j.neuroimage.2012.10.033] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Revised: 10/12/2012] [Accepted: 10/19/2012] [Indexed: 01/08/2023] Open
Abstract
Since central administration of neuropeptide S (NPS) has been shown to exert anxiolytic effects on rodent behavior in a number of studies, genetic variants of its cognate G-protein coupled receptor (NPSR1) became the focus of several recent human studies on anxiety and anxiety disorders. The T allele of rs324981, which goes along with enhanced receptor function, was associated with panic disorder, increased anxiety sensitivity in healthy subjects, attenuated prefrontal brain activation and elevated amygdala responses to fear-relevant stimuli. To investigate whether prefrontal attenuations in rs324981 T allele carriers are specific to fear-relevant stimulus content and cannot be attributed to a generally higher interference of emotional stimuli, 92 subjects performed a combined cognitive and emotional Stroop task while oxygenation changes in the prefrontal cortex were recorded using functional near-infrared spectroscopy. Results showed a specific NPSR1 gene activation modulation in response to fear-relevant word stimuli. Only A-homozygotes displayed an emotional Stroop effect in terms of increased activation to fear-relevant stimuli in medial and dorsolateral prefrontal cortex. Specifically, activation in the fear-relevant condition was higher in A-homozygotes as compared to T allele carriers while no group differences were found during neutral, congruent or highly interfering incongruent color word presentation. The current results are in line with earlier imaging genetic studies and suggest a potential protective function of the NPSR1 rs324981 A/A genotype against pathologically enhanced anxiety that might be explained by stronger reflective prefrontal regulation over the subcortical fear response.
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