Transcranial magnetic stimulation selectively impairs interhemispheric transfer of visuo-motor information in humans

A structured ICA-based process for removing auditory evoked potentials

Transcranial magnetic stimulation (TMS)-evoked potentials (TEPs), recorded using electroencephalography (EEG), reflect a combination of TMS-induced cortical activity and multi-sensory responses to TMS. The auditory evoked potential (AEP) is a high-amplitude sensory potential-evoked by the "click" sound produced by every TMS pulse-that can dominate the TEP and obscure observation of other neural components. The AEP is peripherally evoked and therefore should not be stimulation site specific. We address the problem of disentangling the peripherally evoked AEP of the TEP from components evoked by cortical stimulation and ask whether removal of AEP enables more accurate isolation of TEP. We hypothesized that isolation of the AEP using Independent Components Analysis (ICA) would reveal features that are stimulation site specific and unique individual features. In order to improve the effectiveness of ICA for removal of AEP from the TEP, and thus more clearly separate the transcranial-evoked and non-specific TMS-modulated potentials, we merged sham and active TMS datasets representing multiple stimulation conditions, removed the resulting AEP component, and evaluated performance across different sham protocols and clinical populations using reduction in Global and Local Mean Field Power (GMFP/LMFP) and cosine similarity analysis. We show that removing AEPs significantly reduced GMFP and LMFP in the post-stimulation TEP (14 to 400 ms), driven by time windows consistent with the N100 and P200 temporal characteristics of AEPs. Cosine similarity analysis supports that removing AEPs reduces TEP similarity between subjects and reduces TEP similarity between stimulation conditions. Similarity is reduced most in a mid-latency window consistent with the N100 time-course, but nevertheless remains high in this time window. Residual TEP in this window has a time-course and topography unique from AEPs, which follow-up exploratory analyses suggest could be a modulation in the alpha band that is not stimulation site specific but is unique to individual subject. We show, using two datasets and two implementations of sham, evidence in cortical topography, TEP time-course, GMFP/LMFP and cosine similarity analyses that this procedure is effective and conservative in removing the AEP from TEP, and may thus better isolate TMS-evoked activity. We show TEP remaining in early, mid and late latencies. The early response is site and subject specific. Later response may be consistent with TMS-modulated alpha activity that is not site specific but is unique to the individual. TEP remaining after removal of AEP is unique and can provide insight into TMS-evoked potentials and other modulated oscillatory dynamics.

The role of the right posterior parietal cortex in prism adaptation and its aftereffects

Adaptation to optical prisms (Prismatic Adaptation, PA) displacing the visual scene laterally, on one side of visual space, is both a procedure for investigating visuo-motor plasticity and a powerful tool for the rehabilitation of Unilateral Spatial Neglect (USN). Two processes are involved in PA: i) recalibration (the reduction of the error of manual pointings toward the direction of the prism-induced displacement of the visual scene); ii) the successive realignment after prisms' removal, indexed by the Aftereffects (AEs, in egocentric straight-ahead pointing tasks, the deviation in a direction opposite to the visual displacement previously induced by prisms). This study investigated the role of the posterior parietal cortex (PPC) of the right hemisphere in PA and AEs, by means of low frequency repetitive Transcranial Magnetic Stimulation (rTMS). Proprioceptive and Visuo-proprioceptive egocentric straight-ahead pointing tasks were used to assess the presence and magnitude of AEs. The primary right visual cortex (V1) was also stimulated, to assess the selectivity of the PPC effects on the two processes of PA (recalibration and realignment) in comparison with a cortical region involved in visual processing. Results showed a slower adaptation to prisms when rTMS was delivered before PA, regardless of target site (right PPC or V1). AEs were reduced only by PPC rTMS applied before or after PA, as compared to a sham stimulation. These findings suggest a functional and neural dissociation between realignment and recalibration. Indeed, PA interference was induced by rTMS to both the PPC and V1, indicating that recalibration is supported by a parieto-occipital network. Conversely, AEs were disrupted only by rTMS delivered to the PPC, thus unveiling a relevant role of this region in the development and maintenance of the realignment.

The Causal Role of the Lateral Prefrontal Cortex for Task-order Coordination in Dual-task Situations: A Study with Transcranial Magnetic Stimulation

Dual tasks are characterized by the requirement for additional task-order coordination processes that schedule the processing order of two temporally overlapping tasks. Preliminary evidence from functional imaging studies suggests that lateral pFC (lPFC) activation correlates with implementing these task-order coordination processes. However, so far, it is unclear whether the lPFC is also causally involved in coordinating task order during dual-task performance and which exact mechanisms are implemented by this brain region. In this study, we addressed these open issues by applying online TMS during a dual-task situation. For this purpose, participants performed a dual task in fixed-order blocks with a constant order of tasks and in random-order block, in which the order of tasks varied randomly and thus demands on task-order coordination were increased. In Experiment 1, TMS of the lPFC compared with control TMS conditions impaired dual-task performance in random-order blocks, whereas performance in fixed-order blocks was unaffected by TMS. In Experiment 2, we tested for the specificity of the lPFC TMS effect on task-order coordination by applying TMS over the preSMA. We showed that preSMA TMS did not affect dual-task performance, neither in fixed-order nor in random-order blocks. Results of this study indicate that the lPFC, but not the preSMA, is causally involved in implementing task-order coordination processes in dual-task situations.

Taking Attention Out of Context: Frontopolar Transcranial Magnetic Stimulation Abolishes the Formation of New Context Memories in Visual Search

This study investigates the causal contribution of the left frontopolar cortex (FPC) to the processing of violated expectations from learned target-distractor spatial contingencies during visual search. The experiment consisted of two phases: learning and test. Participants searched for targets presented either among repeated or nonrepeated target-distractor configurations. Prior research showed that repeated encounters of identically arranged displays lead to memory about these arrays, which then can come to guide search (contextual cueing effect). The crucial manipulation was a change of the target location, in a nevertheless constant distractor layout, at the transition from learning to test. In addition to this change, we applied repetitive transcranial magnetic stimulation (rTMS) over the left lateral FPC, over a posterior control site, or no rTMS at all (baseline; between-group manipulation) to see how FPC rTMS influences the ability of observers to adapt context-based memories acquired in the training phase. The learning phase showed expedited search in repeated relative to nonrepeated displays, with this context-based facilitation being comparable across all experimental groups. For the test phase, the recovery of cueing was critically dependent on the stimulation site: Although there was evidence of context adaptation toward the end of the experiment in the occipital and no-rTMS conditions, observers with FPC rTMS showed no evidence of relearning at all after target location changes. This finding shows that FPC plays an important role in the regulation of prediction errors in statistical context learning, thus contributing to an update of the spatial target-distractor contingencies after target position changes in learned spatial arrays.

TMS SMART - Scalp mapping of annoyance ratings and twitches caused by Transcranial Magnetic Stimulation

BACKGROUND

The magnetic pulse generated during transcranial magnetic stimulation (TMS) also stimulates cutaneous nerves and muscle fibres, with the most commonly reported side effect being muscle twitches and sometimes painful sensations. These sensations affect behaviour during experimental tasks, presenting a potential confound for 'online' TMS studies.

NEW METHOD

Our objective was to systematically map the degree of disturbance (ratings of annoyance, pain, and muscle twitches) caused by TMS at 43 locations across the scalp. Ten participants provided ratings whilst completing a choice reaction time task, and ten different participants provided ratings whilst completing a 'flanker' reaction time task.

RESULTS

TMS over frontal and inferior regions resulted in the highest ratings of annoyance, pain, and muscle twitches caused by TMS. We predicted the difference in reaction times (RT) under TMS by scalp location and subjective ratings. Frontal and inferior scalp locations showed the greatest cost to RTs under TMS (i.e., slowing), with midline sites showing no or minimal slowing. Increases in subjective ratings of disturbance predicted longer RTs under TMS. Critically, ratings were a better predictor of the cost of TMS than scalp location or scalp-to-cortex distance. The more difficult 'flanker' task showed a greater effect of subjective disturbance.

COMPARISON WITH EXISTING METHODS

We provide the data as an online resource (www.tms-smart.info) so that researchers can select control sites that account for the level of general interference in task performance caused by online single-pulse TMS.

CONCLUSIONS

The peripheral sensations and discomfort caused by TMS pulses significantly and systematically influence RTs during single-pulse, online TMS experiments.

Noninvasive Brain Stimulation Techniques Can Modulate Cognitive Processing

Recent methods that allow a noninvasive modulation of brain activity are able to modulate human cognitive behavior. Among these methods are transcranial electric stimulation and transcranial magnetic stimulation that both come in multiple variants. A property of both types of brain stimulation is that they modulate brain activity and in turn modulate cognitive behavior. Here, we describe the methods with their assumed neural mechanisms for readers from the economic and social sciences and little prior knowledge of these techniques. Our emphasis is on available protocols and experimental parameters to choose from when designing a study. We also review a selection of recent studies that have successfully applied them in the respective field. We provide short pointers to limitations that need to be considered and refer to the relevant papers where appropriate.

Multisensory signalling enhances pupil dilation

Detecting and integrating information across the senses is an advantageous mechanism to efficiently respond to the environment. In this study, a simple auditory-visual detection task was employed to test whether pupil dilation, generally associated with successful target detection, could be used as a reliable measure for studying multisensory integration processing in humans. We recorded reaction times and pupil dilation in response to a series of visual and auditory stimuli, which were presented either alone or in combination. The results indicated faster reaction times and larger pupil diameter to the presentation of combined auditory and visual stimuli than the same stimuli when presented in isolation. Moreover, the responses to the multisensory condition exceeded the linear summation of the responses obtained in each unimodal condition. Importantly, faster reaction times corresponded to larger pupil dilation, suggesting that also the latter can be a reliable measure of multisensory processes. This study will serve as a foundation for the investigation of auditory-visual integration in populations where simple reaction times cannot be collected, such as developmental and clinical populations.

The role of the dorsal medial frontal cortex in central processing limitation: a transcranial magnetic stimulation study

When humans perform two tasks simultaneously, responses to the second task are increasingly delayed as the interval between the two tasks decreases (psychological refractory period). This delay of the second task is thought to reflect a central processing limitation at the response selection stage. However, the neural mechanisms underlying this central processing limitation remain unclear. Using transcranial magnetic stimulation (TMS), we examined the role of the dorsal medial frontal cortex (dMFC) in a dual-task paradigm in which participants performed an auditory task 1 and a visual task 2. We found that dMFC TMS, relative to control conditions, reduced the psychological refractory period for task 2 processing, whereas we observed no dMFC TMS effects on task 1 processing. This suggests a causal role of the dMFC in coordinating response selection processes at the central bottleneck.

Enhanced awareness followed reversible inhibition of human visual cortex: a combined TMS, MRS and MEG study

This series of experiments investigated the neural basis of conscious vision in humans using a form of transcranial magnetic stimulation (TMS) known as continuous theta burst stimulation (cTBS). Previous studies have shown that occipital TMS, when time-locked to the onset of visual stimuli, can induce a phenomenon analogous to blindsight in which conscious detection is impaired while the ability to discriminate ‘unseen’ stimuli is preserved above chance. Here we sought to reproduce this phenomenon using offline occipital cTBS, which has been shown to induce an inhibitory cortical aftereffect lasting 45–60 minutes. Contrary to expectations, our first experiment revealed the opposite effect: cTBS enhanced conscious vision relative to a sham control. We then sought to replicate this cTBS-induced potentiation of consciousness in conjunction with magnetoencephalography (MEG) and undertook additional experiments to assess its relationship to visual cortical excitability and levels of the inhibitory neurotransmitter γ-aminobutyric acid (GABA; via magnetic resonance spectroscopy, MRS). Occipital cTBS decreased cortical excitability and increased regional GABA concentration. No significant effects of cTBS on MEG measures were observed, although the results provided weak evidence for potentiation of event related desynchronisation in the β band. Collectively these experiments suggest that, through the suppression of noise, cTBS can increase the signal-to-noise ratio of neural activity underlying conscious vision. We speculate that gating-by-inhibition in the visual cortex may provide a key foundation of consciousness.

Time- and task-dependent non-neural effects of real and sham TMS

Transcranial magnetic stimulation (TMS) is widely used in experimental brain research to manipulate brain activity in humans. Next to the intended neural effects, every TMS pulse produces a distinct clicking sound and sensation on the head which can also influence task performance. This necessitates careful consideration of control conditions in order to ensure that behavioral effects of interest can be attributed to the neural consequences of TMS and not to non-neural effects of a TMS pulse. Surprisingly, even though these non-neural effects of TMS are largely unknown, they are often assumed to be unspecific, i.e. not dependent on TMS parameters. This assumption is inherent to many control strategies in TMS research but has recently been challenged on empirical grounds. Here, we further develop the empirical basis of control strategies in TMS research. We investigated the time-dependence and task-dependence of the non-neural effects of TMS and compared real and sham TMS over vertex. Critically, we show that non-neural TMS effects depend on a complex interplay of these factors. Although TMS had no direct neural effects, both pre- and post-stimulus TMS time windows modulated task performance on both a sensory detection task and a cognitive angle judgment task. For the most part, these effects were quantitatively similar across tasks but effect sizes were clearly different. Moreover, the effects of real and sham TMS were almost identical with interesting exceptions that shed light on the relative contribution of auditory and somato-sensory aspects of a TMS pulse. Knowledge of such effects is of critical importance for the interpretation of TMS experiments and helps deciding what constitutes an appropriate control condition. Our results broaden the empirical basis of control strategies in TMS research and point at potential pitfalls that should be avoided.

Involvement of the larynx motor area in singing-voice perception: a TMS study(†)

Recent evidence has reported that the motor system has a role in speech or emotional vocalization discrimination. In the present study we investigated the involvement of the larynx motor representation in singing perception. Twenty-one non-musicians listened to short tones sung by a human voice or played by a machine and performed a categorization task. Thereafter continuous theta-burst transcranial magnetic stimulation was applied over the right larynx premotor area or on the vertex and the test administered again. Overall, reaction times (RTs) were shorter after stimulation over both sites. Nonetheless and most importantly, RTs became longer for sung than for "machine" sounds after stimulation on the larynx area. This effect suggests that the right premotor region is functionally involved in singing perception and that sound humanness modulates motor resonance.

Interhemispheric vs. stimulus-response spatial compatibility effects in bimanual reaction times to lateralized visual stimuli

In the present study, we tested right- and left-handed participants in a Poffenberger paradigm with bimanual responses and hands either in an anatomical or in a left-right inverted posture. We observed a significant positive crossed-uncrossed difference (CUD) in RTs for both manual dominance groups and both response postures. These results rule out an explanation of the CUD in terms of stimulus-response spatial compatibility (SRSC) and provide convincing evidence on the important role of interhemispheric callosal transfer in bimanual responding in right- as well as left-handed individuals.

Dissociable networks control conflict during perception and response selection: a transcranial magnetic stimulation Study

Current models of conflict processing propose that cognitive control resolves conflict in the flanker task by enhancing task-relevant stimulus processing at a perceptual level. However, because conflicts occur at both a perceptual and a response selection level in that task, we tested the hypothesis of conflict-specific control networks for perceptual and response selection conflicts using transcranial magnetic stimulation (TMS). TMS of the presupplementary motor area selectively disrupted the processing of response selection conflict, whereas TMS of the posterior intraparietal sulcus/inferior parietal lobule interfered with perceptual conflict processing. In more detail, the presupplementary motor area seems to resolve response selection conflict mainly when no conflicts have occurred in the previous trial. In contrast, the posterior intraparietal sulcus/inferior parietal lobule may resolve perceptual conflicts selectively when a conflict has occurred in the previous trial. The current data show the need for revising models of cognitive control by providing evidence for the existence of conflict-specific control networks resolving conflict at different processing levels.

Pre-stimulus sham TMS facilitates target detection

Transcranial magnetic stimulation (TMS) allows non-invasive manipulation of brain activity during active task performance. Because every TMS pulse is accompanied by non-neural effects such as a clicking sound and somato-sensation on the head, control conditions are required to ensure that changes in task behavior are indeed due to the induced neural effects. However, the non-neural effects of TMS in the context of a given task performance are largely unknown and, consequently, it is unclear what constitutes a valid control condition. We explored the non-neural effects of TMS on visual target detection. Participants received single pulse sham TMS to each hemisphere at different time points prior to target appearance during a visual target detection task. It was hypothesized that the clicking sound of a sham TMS pulse differentially affects performance depending on the location of the coil and the timing of the pulse.Our results show that, first, sham TMS caused a facilitation of reaction times when preceding the target stimulus by 150, 200, and 250 ms, whereas earlier and later time windows were not effective. Second, positioning the TMS coil ipsilateral instead of contralateral relative to the target stimulus improved reaction times. Third, infrequent noTMS trials that were interleaved with sham TMS trials had oddball-like properties resulting in increased reaction times during noTMS. The clicking sound produced by sham TMS influences task performance in multiple ways. These non-neural effects of TMS need to be controlled for in TMS research and the present findings provide an empirical basis for deciding what constitutes a valid control condition.

Overlapping representations of numerical magnitude and motion direction in the posterior parietal cortex: a TMS-adaptation study

The human posterior parietal cortex (PPC) is involved in the encoding of both visual motion and numerical magnitude. In non human primates, neurons have been found in PPC that are selective for both motion direction and magnitude. Whether such neurons also exist in human PPC is not known. Here we investigated this hypothesis using state-dependent transcranial magnetic stimulation (TMS). Participants were adapted to a specific motion direction (either leftward or rightward), after which they performed a magnitude comparison task, with TMS applied at the onset of each trial. Our hypothesis was that neurons tuned to leftward motion may also be sensitive to small magnitudes and neurons tuned to rightward motion may also be sensitive to large magnitudes, a mapping that may have developed via spatial attentional mechanisms. Our results supported this view by showing that the effect of PPC TMS on small and large numbers depended on the motion direction being adapted, thus suggesting that there may be a functional overlap in neuronal representations of motion direction and numerical magnitude in human PPC.

Suppressing sensorimotor activity modulates the discrimination of auditory emotions but not speaker identity

Our ability to recognize the emotions of others is a crucial feature of human social cognition. Functional neuroimaging studies indicate that activity in sensorimotor cortices is evoked during the perception of emotion. In the visual domain, right somatosensory cortex activity has been shown to be critical for facial emotion recognition. However, the importance of sensorimotor representations in modalities outside of vision remains unknown. Here we use continuous theta-burst transcranial magnetic stimulation (cTBS) to investigate whether neural activity in the right postcentral gyrus (rPoG) and right lateral premotor cortex (rPM) is involved in nonverbal auditory emotion recognition. Three groups of participants completed same-different tasks on auditory stimuli, discriminating between the emotion expressed and the speakers' identities, before and following cTBS targeted at rPoG, rPM, or the vertex (control site). A task-selective deficit in auditory emotion discrimination was observed. Stimulation to rPoG and rPM resulted in a disruption of participants' abilities to discriminate emotion, but not identity, from vocal signals. These findings suggest that sensorimotor activity may be a modality-independent mechanism which aids emotion discrimination.

The use of transcranial magnetic stimulation in cognitive neuroscience: a new synthesis of methodological issues

Transcranial magnetic stimulation (TMS) has become a mainstay of cognitive neuroscience, thus facing new challenges due to its widespread application on behaviorally silent areas. In this review we will summarize the main technical and methodological considerations that are necessary when using TMS in cognitive neuroscience, based on a corpus of studies and technical improvements that has become available in most recent years. Although TMS has been applied only relatively recently on a large scale to the study of higher functions, a range of protocols that elucidate how this technique can be used to investigate a variety of issues is already available, such as single pulse, paired pulse, dual-site, repetitive and theta burst TMS. Finally, we will touch on recent promising approaches that provide powerful new insights about causal interactions among brain regions (i.e., TMS with other neuroimaging techniques) and will enable researchers to enhance the functional resolution of TMS (i.e., state-dependent TMS). We will end by briefly summarizing and discussing the implications of the newest safety guidelines.

The time course of ventrolateral prefrontal cortex involvement in memory formation

Human neuroimaging studies have implicated a number of brain regions in long-term memory formation. Foremost among these is ventrolateral prefrontal cortex. Here, we used double-pulse transcranial magnetic stimulation (TMS) to assess whether the contribution of this part of cortex is crucial for laying down new memories and, if so, to examine the time course of this process. Healthy adult volunteers performed an incidental encoding task (living/nonliving judgments) on sequences of words. In separate series, the task was performed either on its own or while TMS was applied to one of two sites of experimental interest (left/right anterior inferior frontal gyrus) or a control site (vertex). TMS pulses were delivered at 350, 750, or 1,150 ms following word onset. After a delay of 15 min, memory for the items was probed with a recognition memory test including confidence judgments. TMS to all three sites nonspecifically affected the speed and accuracy with which judgments were made during the encoding task. However, only TMS to prefrontal cortex affected later memory performance. Stimulation of left or right inferior frontal gyrus at all three time points reduced the likelihood that a word would later be recognized by a small, but significant, amount (∼4%). These findings indicate that bilateral ventrolateral prefrontal cortex plays an essential role in memory formation, exerting its influence between ≥350 and 1,150 ms after an event is encountered.

Subsecond changes in top down control exerted by human medial frontal cortex during conflict and action selection: a combined transcranial magnetic stimulation electroencephalography study

Action selection requires choosing one of all the possible conflicting action plans that are available. There is currently a debate as to whether the dorsal medial frontal cortex (dMFC) merely detects or actively resolves response conflict. We used combined on-line transcranial magnetic stimulation and electroencephalographic recording (TMS-EEG) to test whether human dMFC plays a critical causal role in conflict resolution, and whether the mechanism for such a function is via interactions with primary motor cortex. In an Eriksen flanker task, subjects discriminated the direction of the centermost arrow in an array of five, responding with the left or right hand. The lateralized readiness potential (LRP), a measure of relative levels of activity in left and right motor cortices, was also recorded. Reaction times and error rates were higher on incongruent than congruent trials, and incongruent trials produced a positive LRP deflection reflecting initial partial activation of the incorrect response. On one-half of trials, repetitive TMS was applied to left dMFC starting 100 ms before visual stimulus onset and ending 100 ms afterward. TMS disrupted performance by selectively increasing error rates on contralateral (right hand) incongruent trials. TMS also only modulated the LRP on incongruent trials, causing an increased positive deflection (associated with preparation of the incorrect response) starting 180 ms after visual stimulus onset. TMS of a control site did not interfere with behavior or motor cortical activity. dMFC has a direct causal role in resolving conflict during action selection, and the mechanism involves the top-down modulation of primary motor cortical activity.

Occipital transcranial magnetic stimulation has opposing effects on visual and auditory stimulus detection: implications for multisensory interactions

Multisensory interactions occur early in time and in low-level cortical areas, including primary cortices. To test current models of early auditory-visual (AV) convergence in unisensory visual brain areas, we studied the effect of transcranial magnetic stimulation (TMS) of visual cortex on behavioral responses to unisensory (auditory or visual) or multisensory (simultaneous auditory-visual) stimulus presentation. Single-pulse TMS was applied over the occipital pole at short delays (30-150 ms) after external stimulus onset. Relative to TMS over a control site, reactions times (RTs) to unisensory visual stimuli were prolonged by TMS at 60-75 ms poststimulus onset (visual suppression effect), confirming stimulation of functional visual cortex. Conversely, RTs to unisensory auditory stimuli were significantly shortened when visual cortex was stimulated by TMS at the same delays (beneficial interaction effect of auditory stimulation and occipital TMS). No TMS-effect on RTs was observed for AV stimulation. The beneficial interaction effect of combined unisensory auditory and TMS-induced visual cortex stimulation matched and was correlated with the RT-facilitation after external multisensory AV stimulation without TMS, suggestive of multisensory interactions between the stimulus-evoked auditory and TMS-induced visual cortex activities. A follow-up experiment showed that auditory input enhances excitability within visual cortex itself (using phosphene-induction via TMS as a measure) over a similarly early time-window (75-120 ms). The collective data support a mechanism of early auditory-visual interactions that is mediated by auditory-driven sensitivity changes in visual neurons that coincide in time with the initial volleys of visual input.

The time course of idiom processing

Recent neuropsychological and neurophysiological studies have suggested that the neural correlates of idiom processing are predominantly located in the left Brodmann's area (BA) 22 and, to some extent, in the prefrontal cortex. The present study explores the temporal dynamics of left prefrontal and temporal cortex in idiom processing by using repetitive transcranial magnetic stimulation (rTMS) in normal subjects. Forty-five opaque highly familiar idioms and 45 literal sentences were used. Forty-three subjects completed 5 blocks of 18 trials (9 idioms, 9 literal sentences) corresponding to 4 stimulation conditions (left prefrontal, left temporal, vertex, no-stimulation baseline). Each subject was assigned to one of three groups, which differed in the timing of stimulation delivery. A selective impairment in accuracy for idioms was found when rTMS was applied to the prefrontal and temporal cortex 80ms after picture presentation, confirming the role of these regions in this task. Moreover, rTMS to the prefrontal cortex, but not to the temporal cortex, continued to affect the performance with idiomatic sentences at the later time of 120ms. The results seem to suggest that the prefrontal region is involved in both the retrieval of the figurative meaning from semantic memory and the monitoring of the response by inhibiting alternative interpretations when a picture-matching task is used.

Magnetic Stimulation of the Left Visual Cortex Impairs Expert Word Recognition

One of the hallmarks of expert reading is the ability to identify arrays of several letters quickly and in parallel. Such length-independent reading has only been found for word stimuli appearing in the right visual hemifield (RVF). With left hemifield presentation (LVF), response times increase as a function of word length. Here we investigated the comparative efficiency with which the two hemispheres are able to recognize visually presented words, as measured by word length effects. Repetitive transcranial magnetic stimulation (rTMS) of the left occipital cortex disrupted expert processing of the RVF such that a length effect was created (Experiment 1). Right occipital rTMS, on the other hand, had no such effect on RVF words and nor did it modulate the length effect already present in the LVF. Experiment 2 explored the time course of these TMS-induced effects by applying single pulses of TMS at various stimulus-onset asynchronies for the same task. We replicated the TMS-induced length effect for RVF words, but only when a single pulse was applied to the left visual cortex 80 msec after target presentation. This is the first demonstration of TMS-induced impairment producing a word length effect, and as such confirms the specialization of the left hemisphere in word recognition. It is likely that anatomical differences in the pathway linking retinal input to higher level cortical processing drive this effect.

Handedness effects on interhemispheric transfer time: A TMS study

The crossed-uncrossed difference (CUD) estimates the interhemispheric transfer time (ITT) through the corpus callosum. Previous research has shown that transcranial magnetic stimulation (TMS) to the occipital cortex determines an increased CUD during cognitive tasks. The aim of the present study was to investigate whether TMS stimulation applied at a motor stage can interfere with the ITT, comparing the performance of left- and right-handed people. Results showed a significant TMS effect, i.e. increasing reaction times were reported when stimulation was delivered on the left primary motor area. Effects were more evident when information was primarily perceived through the dominant hemisphere. Both left and right stimulations increased CUD times in right-handed subjects; however, left-handed subjects showed significant effects associated with left stimulation only. Furthermore, in both groups, TMS produced larger effects in the crossed than in the uncrossed condition. TMS stimulation increased reaction times, thus supporting the idea that the interhemispheric transfer of visuo-motor information occurs at a motor processing stage. The dominant hemisphere seems to play a major role within this process: our data indicates that left- and right-handed people have different ITT latencies associated with the transfer of information to the contralateral hemisphere.

Handedness and Asymmetry of Motor Skill Learning in Right-handers

Background and Purpose

The most remarkable behavioral asymmetry is handedness. The preferred hand often has better performance, motor strength, nonpreferred hand. However, whether these components are associated with skill learning is not clear.

Methods

We evaluated healthy right-handers by setting a series of motor-performance tasks including skill learning, grip strength, and speed.

Results

The preferred hand showed better skill performance and learning rate. However, the degree of the right-left difference in grip strength or speed difference did not correlate with the asymmetry in skill-learning rate. Therefore, although the preferred hand exhibits a better skill-learning capacity than the nonpreferred hand, asymmetry in skill learning cannot be explained by motor strength or speed.

Conclusions

Our findings suggest that better skill performance of the right hand in right-handers cannot be attributed to the degree of hand preference score, strength, or motor speed.

Linking out-of-body experience and self processing to mental own-body imagery at the temporoparietal junction

The spatial unity of self and body is challenged by various philosophical considerations and several phenomena, perhaps most notoriously the "out-of-body experience" (OBE) during which one's visual perspective and one's self are experienced to have departed from their habitual position within one's body. Although researchers started examining isolated aspects of the self, the neurocognitive processes of OBEs have not been investigated experimentally to further our understanding of the self. With the use of evoked potential mapping, we show the selective activation of the temporoparietal junction (TPJ) at 330-400 ms after stimulus onset when healthy volunteers imagined themselves in the position and visual perspective that generally are reported by people experiencing spontaneous OBEs. Interference with the TPJ by transcranial magnetic stimulation (TMS) at this time impaired mental transformation of one's own body in healthy volunteers relative to TMS over a control site. No such TMS effect was observed for imagined spatial transformations of external objects, suggesting the selective implication of the TPJ in mental imagery of one's own body. Finally, in an epileptic patient with OBEs originating from the TPJ, we show partial activation of the seizure focus during mental transformations of her body and visual perspective mimicking her OBE perceptions. These results suggest that the TPJ is a crucial structure for the conscious experience of the normal self, mediating spatial unity of self and body, and also suggest that impaired processing at the TPJ may lead to pathological selves such as OBEs.

TMS in cognitive plasticity and the potential for rehabilitation

Cognitive neuroscientists use transcranial magnetic stimulation (TMS) in several ways, from aiming to increase understanding of brain-behavior relationships to transiently improving performance, both in normals and in patients with neurological and neuropsychological deficits. Different types of TMS (single-pulse, paired-pulse, repetitive) are able to interfere with higher brain functions that require the cooperation of different brain areas and complex neuronal networks. Currently, behavioral TMS effects on the brain are usually short-lived and their underlying mechanisms not yet wholly understood. However, the aim of using TMS to develop rehabilitative strategies for motor, perceptive and cognitive functions represents an intriguing challenge.

Magnetic stimulation and the crossed?uncrossed difference (CUD) paradigm: selective effects in the ipsilateral and contralateral hemispheres

When a visual target is presented to one hemifield, manual responses made to the target using the ipsilateral hand (uncrossed responses) are faster than responses using the contralateral hand (crossed response), because there is no need for visuomotor information to be transferred between the hemispheres. This difference in response times is termed the crossed-uncrossed difference (CUD) and is a valuable means of estimating interhemispheric transfer time. We aimed to investigate the CUD by applying repetitive transcranial magnetic stimulation (rTMS) over the left and right occipital cortex during a lateralized target-detection task. Eleven neurologically healthy subjects, all right-handed, participated in the study. Relative to sham TMS we increased the CUD, by inhibiting the crossed latencies, but only when rTMS was applied to the hemisphere receiving visual information. These results replicate and extend previous findings and suggest the inhibitory rTMS effect under the crossed condition might be because the weak visual output is unable to activate the crossed pathway.

Interhemispheric Transmission of Visuomotor Information for Motor Implementation

Using transcranial magnetic stimulation (TMS), we addressed the contribution of both hemispheres to the visuomotor control of each hand. The subjects had to press one of two buttons as quickly as possible after the go-signal. A precue preceding this conveyed full, partial or no advance information (hand and/or button), such that reaction time (RT) shortened with increasing amount of information. We gave TMS over each hemisphere at various time intervals (100-350 ms) after the go-signal and before the expected onset of response, and measured its effect on RT, movement time (MT) and error rate. At short intervals (100-200 ms), left hemisphere TMS delayed RT and prolonged MT of both hands, while right hemisphere TMS delayed RT only of the right hand, without affecting error rates. At long intervals (250-350 ms), TMS produced slightly more pronounced RT delays of the contralateral hand. RT was delayed more if the precues were less informative. The results suggest the importance of interhemispheric transmission of visuomotor information for motor implementation. The right hemisphere may play a role mainly in calculating target and effector information, determining RT, while the left hemisphere may play a role in elaborating the motor program and determining MT.

The Inferior Frontal Gyrus and Phonological Processing: An Investigation using rTMS

Repetitive transcranial magnetic stimulation (rTMS) offers a powerful new technique for investigating the distinct contributions of the cortical language areas. We have used this method to examine the role of the left inferior frontal gyrus (IFG) in phonological processing and verbal working memory. Functional neuroimaging studies have implicated the posterior part of the left IFG in both phonological decision making and subvocal rehearsal mechanisms, but imaging is a correlational method and it is therefore necessary to determine whether this region is essential for such processes. In this paper we present the results of two experiments in which rTMS was applied over the frontal operculum while subjects performed a delayed phonological matching task. We compared the effects of disrupting this area either during the delay (memory) phase or at the response (decision) phase of the task. Delivered at a time when subjects were required to remember the sound of a visually presented word, rTMS impaired the accuracy with which they subsequently performed the task. However, when delivered later in the trial, as the subjects compared the remembered word with a given pseudoword, rTMS did not impair accuracy. Performance by the same subjects on a control task that required the processing of nonverbal visual stimuli was unaffected by the rTMS. Similarly, performance on both tasks was unaffected by rTMS delivered over a more anterior site (pars triangularis). We conclude that the opercular region of the IFG is necessary for the normal operation of phonologically based working memory mechanisms. Furthermore, this study shows that rTMS can shed further light on the precise role of cortical language areas in humans.

Cortical interactions in vision and awareness: hierarchies in reverse

The anatomical connections between visual areas can be organized in 'feedforward', 'feedback' or 'horizontal' laminar patterns. We report here four experiments that test the function of some of the feedback projections in visual cortex. Projections from V5 to V1 have been suggested to be important in visual awareness, and in the first experiment we show this to be the case in the blindsight patient GY. This demonstration is replicated, in principle, in the second experiment and we also show the timing of the V5-V1 interaction to correspond to findings from single unit physiology. In the third experiment we show that V1 is important for stimulus detection in visual search arrays and that the timing of V1 interference with TMS is late (up to 240 ms after the onset of the visual array). Finally we report an experiment showing that the parietal cortex is not involved in visual motion priming, whereas V5 is, suggesting that the parietal cortex does not modulate V5 in this task. We interpret the data in terms of Bullier's recent physiological recordings and Ahissar and Hochstein's reverse hierarchy theory of vision.

Differential effects of low-frequency rTMS at the occipital pole on visual-induced alpha desynchronization and visual-evoked potentials

Visual-induced alpha desynchronization (VID) and visual-evoked potentials (VEPs) characterize occipital activation in response to visual stimulation but their exact relationship is unclear. Here, we tested the hypothesis that VID and VEPs reflect different aspects of cortical activation. For this purpose, we determined whether VID and VEPs are differentially modulated by low-frequency repetitive transcranial magnetic stimulation (rTMS) over the occipital pole. Scalp EEG responses to visual stimuli (flashed either to the left or to the right visual field) were recorded for 8 min in six healthy subjects (1) before, (2) immediately following, and (3) 20 min after left occipital rTMS (1 Hz, 10 min). The parameters aimed to reduce cortical excitability beyond the end of the TMS train. In addition, simple reaction times to visual stimulation were recorded (left or right hand in separate blocks). In all subjects, VID was significantly and prominently reduced by rTMS (P = 0.0001). In contrast, rTMS failed to modulate early VEP components (P1/N1). A moderate effect was found on a late VEP component close to manual response onset (P = 0.014) but this effect was in the opposite direction to the VID change. All changes were restricted to the targeted left occipital cortex. The effects were present only after right visual field stimulation when a right hand response was required, were associated with a behavioral effect, and had washed out 20 min after rTMS. We conclude that VID and early VEPs represent different aspects of cortical activation. The findings that rTMS did not change early VEPs and selectively affected VID and late VEPs in conditions where the visual input must be transferred intrahemispherically for visuomotor integration (right visual field/right hand) are suggestive of rTMS interference with higher-order visual functions beyond visual input. This is consistent with the idea that alpha desynchronization serves an integrative role through a corticocortical "gating function."

Orienting visuospatial attention generates manual reaction time asymmetries in target detection and pointing

Right-handers exhibit a left hand advantage in response preparation when pointing to targets. These manual asymmetries are generally attributed to a right hemisphere specialization for spatial processing. More precisely, the left hand reaction time (RT) advantage was recently supposed to reflect specifically the right hemisphere superiority for movement planning. This study proposes to investigate a possible attentional origin for manual RT asymmetries. In a first experiment, we used the covert orienting of attention paradigm to measure subjects' RTs when reaching at targets (pointing task) both in valid, neutral and invalid conditions, either in the left or in the right visual fields and with the left and the right hand. In a second experiment, we applied the same paradigm to a detection task (key-pressing). Results revealed that orienting of attention to spatial locations was more time consuming when responding with the right than with the left hand, whether movement planning was required or not. It is suggested that the right hemisphere dominance for orienting of visuospatial attention account, partly at least, for the RT asymmetries classically observed in manual aiming.

Role of the human medial frontal cortex in task switching: a combined fMRI and TMS study

We used event-related functional magnetic resonance imaging (fMRI) to measure brain activity when subjects were performing identical tasks in the context of either a task-set switch or a continuation of earlier performance. The context, i.e., switching or staying with the current task, influenced medial frontal cortical activation; the medial frontal cortex is transiently activated at the time that subjects switch from one way of performing a task to another. Two types of task-set-switching paradigms were investigated. In the response-switching (RS) paradigm, subjects switched between different rules for response selection and had to choose between competing responses. In the visual-switching (VS) paradigm, subjects switched between different rules for stimulus selection and had to choose between competing visual stimuli. The type of conflict, sensory (VS) or motor (RS), involved in switching was critical in determining medial frontal activation. Switching in the RS paradigm was associated with clear blood-oxygenation-level-dependent signal increases ("activations") in three medial frontal areas: the rostral cingulate zone, the caudal cingulate zone, and the presupplementary motor area (pre-SMA). Switching in the VS task was associated with definite activation in just one medial frontal area, a region on the border between the pre-SMA and the SMA. Subsequent to the fMRI session, we used MRI-guided frameless stereotaxic procedures and repetitive transcranial magnetic stimulation (rTMS) to test the importance of the medial frontal activations for task switching. Applying rTMS over the pre-SMA disrupted subsequent RS performance but only when it was applied in the context of a switch. This result shows, first, that the pre-SMA is essential for task switching and second that its essential role is transient and limited to just the time of behavioral switching. The results are consistent with a role for the pre-SMA in selecting between response sets at a superordinate level rather than in selecting individual responses. The effect of the rTMS was not simply due to the tactile and auditory artifacts associated with each pulse; rTMS over several control regions did not selectively disrupt switching. Applying rTMS over the SMA/pre-SMA area activated in the VS paradigm did not disrupt switching. This result, first, confirms the limited importance of the medial frontal cortex for sensory attentional switching. Second, the VS rTMS results suggest that just because an area is activated in two paradigms does not mean that it plays the same essential role in both cases.

The mental number line and the human angular gyrus

To investigate the hemispheric organization of a language-independent spatial representation of number magnitude in the human brain we applied focal repetitive transcranial magnetic stimulation (rTMS) to the right or left angular gyrus while subjects performed a number comparison task with numbers between 31 and 99. Repetitive TMS over the angular gyrus disrupted performance of a visuospatial search task, and rTMS at the same site disrupted organization of the putative "number line." In some cases the pattern of disruption caused by angular gyrus rTMS suggested that this area normally mediates a spatial representation of number. The effect of angular gyrus rTMS on the number line task was specific. rTMS had no disruptive effect when delivered over another parietal region, the supramarginal gyrus, in either the left or the right hemisphere.

Complementary localization and lateralization of orienting and motor attention

It is widely agreed that the right posterior parietal cortex has a preeminent role in visuospatial and orienting attention. A number of lines of evidence suggest that although orienting and the preparation of oculomotor responses are dissociable from each other, the two are intimately related. If this is true, then it should be possible to identify other attentional mechanisms tied to other response modalities. We used repetitive transcranial magnetic stimulation (rTMS) to demonstrate the existence of a distinct anterior parietal mechanism of motor attention. The critical area for motor attention is anterior to the one concerned with orienting, and it is lateralized to the left hemisphere in humans.

Visuo-spatial neural response interactions in early cortical processing during a simple reaction time task: a high-density electrical mapping study

The timecourse and scalp topography of interactions between neural responses to stimuli in different visual quadrants, straddling either the vertical or horizontal meridian, were studied in 15 subjects. Visual evoked potentials (VEPs) were recorded from 64 electrodes during a simple reaction time (RT) task. VEPs to single stimuli displayed in different quadrants were summed ('sum') and compared to the VEP response from simultaneous stimulation of the same two quadrants ('pair'). These responses would be equivalent if the neural responses to the single stimuli were independent. Divergence between the 'pair' and 'sum' VEPs indicates a neural response interaction. In each visual field, interactions occurred within 72-86 ms post-stimulus over parieto-occipital brain regions. Independent of visual quadrant, RTs were faster for stimulus pairs than single stimuli. This replicates the redundant target effect (RTE) observed for bilateral stimulus pairs and generalizes the RTE to unilateral stimulus pairs. Using Miller's 'race' model inequality (Miller J. Divided attention: evidence for coactivation with redundant signals, Cognitive Psychology 1982;14:247-79), we found that probability summation could fully account for the RTE in each visual field. Although measurements from voltage waveforms replicated the observation of earlier peak P1 latencies for the 'pair' versus 'sum' comparison (Miniussi C, Girelli M, Marzi CA. Neural site of the redundant target effect: electrophysiological evidence. Journal of Cognitive Neuroscience 1998;10:216-30), this did not hold with measurements taken from second derivative (scalp current density) waveforms. Since interaction effects for bilateral stimulus pairs occurred within 86 ms and require interhemispheric transfer, transcallosal volleys must arrive within 86 ms, which is earlier than previously calculated. Interaction effects for bilateral conditions were delayed by approximately 10 ms versus unilateral conditions, consistent with current estimates of interhemispheric transmission time. Interaction effects place an upper limit on the time required for neuronal ensembles to combine inputs from different quadrants of visual space ( approximately 72 ms for unilateral and approximately 82 ms for bilateral conditions).

Coil design for real and sham transcranial magnetic stimulation

Transcranial magnetic stimulation (TMS) can be used to excite the human cortex noninvasively. TMS also activates scalp muscles and sensory receptors; additionally, the loud sound from the stimulating coil activates auditory pathways. These side effects complicate the interpretation of the results of TMS studies. For control experiments, we have designed a coil that can produce both real and sham stimulation without moving the coil. The sham TMS is similar to the real TMS, except for the different relative direction of the currents in the two loops of the figure-of-eight coil. While the real TMS elicited activation of hand muscles, sham TMS had no such effect; however, the auditory-evoked potentials were similar.

The role of the coil click in TMS assessed with simultaneous EEG

OBJECTIVE

We have used EEG to measure effects of air- and bone-conducted sound from the coil in transcranial magnetic stimulation (TMS).

METHODS

Auditory-evoked potentials to TMS were recorded in three different experimental conditions: (1) the coil 2 cm above the head, (2) the coil 2 cm above the head but rigidly connected by a plastic piece to the scalp, (3) the coil pressed against the scalp over the motor cortex.

RESULTS

The acoustical click from the TMS coil evoked large auditory potentials, whose amplitude depended critically on the mechanical contact of the coil with the head.

CONCLUSION

Both air- and bone-conducted sounds have to be taken into account in the design and interpretation of TMS experiments.

Event-related magnetic fields in the auditory cortex of man during unilateral movements: a discriminant function analysis

It is often assumed that sensorimotor coordination is a feature of the sensorimotor areas of the neocortex only. The purpose of the present study was to examine how this phenomenon is reflected in the auditory cortex of man. Ten subjects were engaged in a stimulus-reaction paradigm, in which each of two acoustical tones was associated to either of two motor reactions. Magnetic fields recorded with a 122-channel magnetometer were modelled by current dipoles. The spatial coordinates as well as the amplitudes of the dipoles were analyzed from 90 to 110 ms after stimulus onset using discriminant analysis. The results suggest that the dipole trajectory in the auditory cortex of the right hemisphere and amplitudes of the dipoles in the auditory cortex of the left hemisphere already 90-110 ms after the beginning of the stimulus could be affected not only by physical features of the stimulus, but also by the motor task required as a reaction.