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Xia AWL, Jin M, Qin PPI, Kan RLD, Zhang BBB, Giron CG, Lin TTZ, Li ASM, Kranz GS. Instantaneous effects of prefrontal transcranial magnetic stimulation on brain oxygenation: A systematic review. Neuroimage 2024; 293:120618. [PMID: 38636640 DOI: 10.1016/j.neuroimage.2024.120618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 04/20/2024] Open
Abstract
This systematic review investigates how prefrontal transcranial magnetic stimulation (TMS) immediately influences neuronal excitability based on oxygenation changes measured by functional magnetic resonance imaging (fMRI) or functional near-infrared spectroscopy (fNIRS). A thorough understanding of TMS-induced excitability changes may enable clinicians to adjust TMS parameters and optimize treatment plans proactively. Five databases were searched for human studies evaluating brain excitability using concurrent TMS/fMRI or TMS/fNIRS. Thirty-seven studies (13 concurrent TMS/fNIRS studies, 24 concurrent TMS/fMRI studies) were included in a qualitative synthesis. Despite methodological inconsistencies, a distinct pattern of activated nodes in the frontoparietal central executive network, the cingulo-opercular salience network, and the default-mode network emerged. The activated nodes included the prefrontal cortex (particularly dorsolateral prefrontal cortex), insula cortex, striatal regions (especially caudate, putamen), anterior cingulate cortex, and thalamus. High-frequency repetitive TMS most consistently induced expected facilitatory effects in these brain regions. However, varied stimulation parameters (e.g., intensity, coil orientation, target sites) and the inter- and intra-individual variability of brain state contribute to the observed heterogeneity of target excitability and co-activated regions. Given the considerable methodological and individual variability across the limited evidence, conclusions should be drawn with caution.
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Affiliation(s)
- Adam W L Xia
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Minxia Jin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China; Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Penny P I Qin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Rebecca L D Kan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Bella B B Zhang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Cristian G Giron
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Tim T Z Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Ami S M Li
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Georg S Kranz
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China; Mental Health Research Center (MHRC), The Hong Kong Polytechnic University, Hong Kong, China; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
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2
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Wang JB, Hassan U, Bruss JE, Oya H, Uitermarkt BD, Trapp NT, Gander PE, Howard MA, Keller CJ, Boes AD. Effects of transcranial magnetic stimulation on the human brain recorded with intracranial electrocorticography. Mol Psychiatry 2024; 29:1228-1240. [PMID: 38317012 DOI: 10.1038/s41380-024-02405-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/19/2023] [Accepted: 01/02/2024] [Indexed: 02/07/2024]
Abstract
Transcranial magnetic stimulation (TMS) is increasingly used as a noninvasive technique for neuromodulation in research and clinical applications, yet its mechanisms are not well understood. Here, we present the neurophysiological effects of TMS using intracranial electrocorticography (iEEG) in neurosurgical patients. We first evaluated safety in a gel-based phantom. We then performed TMS-iEEG in 22 neurosurgical participants with no adverse events. We next evaluated intracranial responses to single pulses of TMS to the dorsolateral prefrontal cortex (dlPFC) (N = 10, 1414 electrodes). We demonstrate that TMS is capable of inducing evoked potentials both locally within the dlPFC and in downstream regions functionally connected to the dlPFC, including the anterior cingulate and insular cortex. These downstream effects were not observed when stimulating other distant brain regions. Intracranial dlPFC electrical stimulation had similar timing and downstream effects as TMS. These findings support the safety and promise of TMS-iEEG in humans to examine local and network-level effects of TMS with higher spatiotemporal resolution than currently available methods.
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Affiliation(s)
- Jeffrey B Wang
- Biophysics Graduate Program, Stanford University Medical Center, Stanford, CA, 94305, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Stanford, CA, 94305, USA
| | - Umair Hassan
- Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Stanford, CA, 94305, USA
- Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Palo Alto, CA, 94305, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
| | - Joel E Bruss
- Department of Neurology, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
- Department of Pediatrics, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Hiroyuki Oya
- Department of Neurosurgery, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Brandt D Uitermarkt
- Department of Pediatrics, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Nicholas T Trapp
- Department of Psychiatry, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
- Iowa Neuroscience Institute, University of Iowa, Iowa City, IA, 52242, USA
| | - Phillip E Gander
- Department of Neurosurgery, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
- Department of Radiology, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Matthew A Howard
- Department of Neurosurgery, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Corey J Keller
- Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Stanford, CA, 94305, USA
- Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Palo Alto, CA, 94305, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
| | - Aaron D Boes
- Department of Neurology, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA.
- Department of Pediatrics, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA.
- Department of Psychiatry, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA.
- Iowa Neuroscience Institute, University of Iowa, Iowa City, IA, 52242, USA.
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Riddle J, Scimeca JM, Pagnotta MF, Inglis B, Sheltraw D, Muse-Fisher C, D’Esposito M. A guide for concurrent TMS-fMRI to investigate functional brain networks. Front Hum Neurosci 2022; 16:1050605. [PMID: 36590069 PMCID: PMC9799237 DOI: 10.3389/fnhum.2022.1050605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Transcranial Magnetic Stimulation (TMS) allows for the direct activation of neurons in the human neocortex and has proven to be fundamental for causal hypothesis testing in cognitive neuroscience. By administering TMS concurrently with functional Magnetic Resonance Imaging (fMRI), the effect of cortical TMS on activity in distant cortical and subcortical structures can be quantified by varying the levels of TMS output intensity. However, TMS generates significant fluctuations in the fMRI time series, and their complex interaction warrants caution before interpreting findings. We present the methodological challenges of concurrent TMS-fMRI and a guide to minimize induced artifacts in experimental design and post-processing. Our study targeted two frontal-striatal circuits: primary motor cortex (M1) projections to the putamen and lateral prefrontal cortex (PFC) projections to the caudate in healthy human participants. We found that TMS parametrically increased the BOLD signal in the targeted region and subcortical projections as a function of stimulation intensity. Together, this work provides practical steps to overcome common challenges with concurrent TMS-fMRI and demonstrates how TMS-fMRI can be used to investigate functional brain networks.
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Affiliation(s)
- Justin Riddle
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States
| | - Jason M. Scimeca
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, United States
| | - Mattia F. Pagnotta
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, United States
| | - Ben Inglis
- Henry H. Wheeler Jr. Brain Imaging Center, University of California, Berkeley, Berkeley, CA, United States
| | - Daniel Sheltraw
- Henry H. Wheeler Jr. Brain Imaging Center, University of California, Berkeley, Berkeley, CA, United States
| | - Chris Muse-Fisher
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, United States
| | - Mark D’Esposito
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, United States
- Henry H. Wheeler Jr. Brain Imaging Center, University of California, Berkeley, Berkeley, CA, United States
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4
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3D-printed stand, timing interface, and coil localization tools for concurrent TMS-fMRI experiments. Brain Stimul 2022; 15:1290-1291. [PMID: 36115660 DOI: 10.1016/j.brs.2022.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 07/28/2022] [Accepted: 08/31/2022] [Indexed: 01/09/2023] Open
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Rafiei F, Rahnev D. TMS Does Not Increase BOLD Activity at the Site of Stimulation: A Review of All Concurrent TMS-fMRI Studies. eNeuro 2022; 9:ENEURO.0163-22.2022. [PMID: 35981879 PMCID: PMC9410768 DOI: 10.1523/eneuro.0163-22.2022] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/14/2022] [Accepted: 06/30/2022] [Indexed: 11/21/2022] Open
Abstract
Transcranial magnetic stimulation (TMS) is widely used for understanding brain function in neurologically intact subjects and for the treatment of various disorders. However, the precise neurophysiological effects of TMS at the site of stimulation remain poorly understood. The local effects of TMS can be studied using concurrent TMS-functional magnetic resonance imaging (fMRI), a technique where TMS is delivered during fMRI scanning. However, although concurrent TMS-fMRI was developed over 20 years ago and dozens of studies have used this technique, there is still no consensus on whether TMS increases blood oxygen level-dependent (BOLD) activity at the site of stimulation. To address this question, here we review all previous concurrent TMS-fMRI studies that reported analyses of BOLD activity at the target location. We find evidence that TMS increases local BOLD activity when stimulating the primary motor (M1) and visual (V1) cortices but that these effects are likely driven by the downstream consequences of TMS (finger twitches and phosphenes). However, TMS does not appear to increase BOLD activity at the site of stimulation for areas outside of the M1 and V1 when conducted at rest. We examine the possible reasons for such lack of BOLD signal increase based on recent work in nonhuman animals. We argue that the current evidence points to TMS inducing periods of increased and decreased neuronal firing that mostly cancel each other out and therefore lead to no change in the overall BOLD signal.
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Affiliation(s)
- Farshad Rafiei
- School of Psychology, Georgia Institute of Technology, Atlanta, GA 30313
| | - Dobromir Rahnev
- School of Psychology, Georgia Institute of Technology, Atlanta, GA 30313
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Siddiqi SH, Kording KP, Parvizi J, Fox MD. Causal mapping of human brain function. Nat Rev Neurosci 2022; 23:361-375. [PMID: 35444305 PMCID: PMC9387758 DOI: 10.1038/s41583-022-00583-8] [Citation(s) in RCA: 108] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2022] [Indexed: 12/11/2022]
Abstract
Mapping human brain function is a long-standing goal of neuroscience that promises to inform the development of new treatments for brain disorders. Early maps of human brain function were based on locations of brain damage or brain stimulation that caused a functional change. Over time, this approach was largely replaced by technologies such as functional neuroimaging, which identify brain regions in which activity is correlated with behaviours or symptoms. Despite their advantages, these technologies reveal correlations, not causation. This creates challenges for interpreting the data generated from these tools and using them to develop treatments for brain disorders. A return to causal mapping of human brain function based on brain lesions and brain stimulation is underway. New approaches can combine these causal sources of information with modern neuroimaging and electrophysiology techniques to gain new insights into the functions of specific brain areas. In this Review, we provide a definition of causality for translational research, propose a continuum along which to assess the relative strength of causal information from human brain mapping studies and discuss recent advances in causal brain mapping and their relevance for developing treatments.
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Affiliation(s)
- Shan H Siddiqi
- Center for Brain Circuit Therapeutics, Brigham & Women's Hospital, Boston, MA, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Konrad P Kording
- Department of Neuroscience, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Josef Parvizi
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Michael D Fox
- Center for Brain Circuit Therapeutics, Brigham & Women's Hospital, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
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7
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Vergara VM, Rafiei F, Wokke ME, Lau H, Rahnev D, Calhoun VD. Evidence for Transcranial Magnetic Stimulation Induced Functional Connectivity Oscillations in the Brain. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:1407-1411. [PMID: 34891548 DOI: 10.1109/embc46164.2021.9629899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Transcranial magnetic stimulation (TMS) is an effective research tool to elucidate mechanisms of function in the brain. Despite its widespread use, very few studies have looked at dynamic functional connectivity responses to TMS. This work performs an exploratory analysis of dynamic functional network connectivity (dynFNC) to evaluate evidence of brain response to TMS. Results show clear functional dynamic patterns categorized by frequency. Some patterns appear to be more directly linked to TMS, but there is one pattern that might be a TMS-independent response to the excitation. This first look presents an analysis methodology and important results to consider in future research.
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Gann MA, King BR, Dolfen N, Veldman MP, Davare M, Swinnen SP, Mantini D, Robertson EM, Albouy G. Prefrontal stimulation prior to motor sequence learning alters multivoxel patterns in the striatum and the hippocampus. Sci Rep 2021; 11:20572. [PMID: 34663890 PMCID: PMC8523553 DOI: 10.1038/s41598-021-99926-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/24/2021] [Indexed: 11/09/2022] Open
Abstract
Motor sequence learning (MSL) is supported by dynamical interactions between hippocampal and striatal networks that are thought to be orchestrated by the prefrontal cortex. In the present study, we tested whether individually-tailored theta-burst stimulation of the dorsolateral prefrontal cortex (DLPFC) prior to MSL can modulate multivoxel response patterns in the stimulated cortical area, the hippocampus and the striatum. Response patterns were assessed with multivoxel correlation structure analyses of functional magnetic resonance imaging data acquired during task practice and during resting-state scans before and after learning/stimulation. Results revealed that, across stimulation conditions, MSL induced greater modulation of task-related DLPFC multivoxel patterns than random practice. A similar learning-related modulatory effect was observed on sensorimotor putamen patterns under inhibitory stimulation. Furthermore, MSL as well as inhibitory stimulation affected (posterior) hippocampal multivoxel patterns at post-intervention rest. Exploratory analyses showed that MSL-related brain patterns in the posterior hippocampus persisted into post-learning rest preferentially after inhibitory stimulation. These results collectively show that prefrontal stimulation can alter multivoxel brain patterns in deep brain regions that are critical for the MSL process. They also suggest that stimulation influenced early offline consolidation processes as evidenced by a stimulation-induced modulation of the reinstatement of task pattern into post-learning wakeful rest.
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Affiliation(s)
- Mareike A Gann
- Department of Movement Sciences, Movement Control and Neuroplasticity Research Group, KU Leuven, 3001, Leuven, Belgium
- LBI - KU Leuven Brain Institute, KU Leuven, 3001, Leuven, Belgium
| | - Bradley R King
- Department of Health and Kinesiology, College of Health, University of Utah, Salt Lake City, UT, 84112, USA
| | - Nina Dolfen
- Department of Movement Sciences, Movement Control and Neuroplasticity Research Group, KU Leuven, 3001, Leuven, Belgium
- LBI - KU Leuven Brain Institute, KU Leuven, 3001, Leuven, Belgium
| | - Menno P Veldman
- Department of Movement Sciences, Movement Control and Neuroplasticity Research Group, KU Leuven, 3001, Leuven, Belgium
- LBI - KU Leuven Brain Institute, KU Leuven, 3001, Leuven, Belgium
| | - Marco Davare
- Department of Clinical Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, UB8 3PN, UK
| | - Stephan P Swinnen
- Department of Movement Sciences, Movement Control and Neuroplasticity Research Group, KU Leuven, 3001, Leuven, Belgium
- LBI - KU Leuven Brain Institute, KU Leuven, 3001, Leuven, Belgium
| | - Dante Mantini
- Department of Movement Sciences, Movement Control and Neuroplasticity Research Group, KU Leuven, 3001, Leuven, Belgium
- Brain Imaging and Neural Dynamics Research Group, IRCCS San Camillo Hospital, 30126, Venice, Italy
| | - Edwin M Robertson
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, G12 8QB, UK
| | - Geneviève Albouy
- Department of Movement Sciences, Movement Control and Neuroplasticity Research Group, KU Leuven, 3001, Leuven, Belgium.
- LBI - KU Leuven Brain Institute, KU Leuven, 3001, Leuven, Belgium.
- Department of Health and Kinesiology, College of Health, University of Utah, Salt Lake City, UT, 84112, USA.
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Rafiei F, Safrin M, Wokke ME, Lau H, Rahnev D. Transcranial magnetic stimulation alters multivoxel patterns in the absence of overall activity changes. Hum Brain Mapp 2021; 42:3804-3820. [PMID: 33991165 PMCID: PMC8288086 DOI: 10.1002/hbm.25466] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/07/2021] [Accepted: 04/26/2021] [Indexed: 01/18/2023] Open
Abstract
Transcranial magnetic stimulation (TMS) has become one of the major tools for establishing the causal role of specific brain regions in perceptual, motor, and cognitive processes. Nevertheless, a persistent limitation of the technique is the lack of clarity regarding its precise effects on neural activity. Here, we examined the effects of TMS intensity and frequency on concurrently recorded blood‐oxygen‐level‐dependent (BOLD) signals at the site of stimulation. In two experiments, we delivered TMS to the dorsolateral prefrontal cortex in human subjects of both sexes. In Experiment 1, we delivered a series of pulses at high (100% of motor threshold) or low (50% of motor threshold) intensity, whereas, in Experiment 2, we always used high intensity but delivered stimulation at four different frequencies (5, 8.33, 12.5, and 25 Hz). We found that the TMS intensity and frequency could be reliably decoded using multivariate analysis techniques even though TMS had no effect on the overall BOLD activity at the site of stimulation in either experiment. These results provide important insight into the mechanisms through which TMS influences neural activity.
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Affiliation(s)
- Farshad Rafiei
- School of Psychology, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Martin Safrin
- School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Martijn E Wokke
- Programs in Psychology and Biology, The Graduate Center of the City University of New York, New York, New York, USA
| | - Hakwan Lau
- Department of Psychology, University of California Los Angeles, Los Angeles, California, USA.,The Brain Research Institute, University of California, Los Angeles, Los Angeles, California, USA
| | - Dobromir Rahnev
- School of Psychology, Georgia Institute of Technology, Atlanta, Georgia, USA
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