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Mechanistic link between right prefrontal cortical activity and anxious arousal revealed using transcranial magnetic stimulation in healthy subjects. Neuropsychopharmacology 2020; 45:694-702. [PMID: 31791039 PMCID: PMC7021903 DOI: 10.1038/s41386-019-0583-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/08/2019] [Accepted: 11/19/2019] [Indexed: 02/07/2023]
Abstract
Much of the mechanistic research on anxiety focuses on subcortical structures such as the amygdala; however, less is known about the distributed cortical circuit that also contributes to anxiety expression. One way to learn about this circuit is to probe candidate regions using transcranial magnetic stimulation (TMS). In this study, we tested the involvement of the dorsolateral prefrontal cortex (dlPFC), in anxiety expression using 10 Hz repetitive TMS (rTMS). In a within-subject, crossover experiment, the study measured anxiety in healthy subjects before and after a session of 10 Hz rTMS to the right dorsolateral prefrontal cortex (dlPFC). It used threat of predictable and unpredictable shock to induce anxiety and anxiety potentiated startle to assess anxiety. Counter to our hypotheses, results showed an increase in anxiety-potentiated startle following active but not sham rTMS. These results suggest a mechanistic link between right dlPFC activity and physiological anxiety expression. This result supports current models of prefrontal asymmetry in affect, and lays the groundwork for further exploration into the cortical mechanisms mediating anxiety, which may lead to novel anxiety treatments.
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Cao D, Li Y, Niznikiewicz MA, Tang Y, Wang J. The theta burst transcranial magnetic stimulation over the right PFC affects electroencephalogram oscillation during emotional processing. Prog Neuropsychopharmacol Biol Psychiatry 2018; 82:21-30. [PMID: 29241839 DOI: 10.1016/j.pnpbp.2017.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 12/08/2017] [Accepted: 12/08/2017] [Indexed: 10/18/2022]
Abstract
Prefrontal cortex (PFC) plays an important role in emotional processing and therefore is one of the most frequently targeted regions for non-invasive brain stimulation such as repetitive transcranial magnetic stimulation (rTMS) in clinical trials, especially in the treatment of emotional disorders. As an approach to enhance the effectiveness of rTMS, continuous theta burst stimulation (cTBS) has been demonstrated to be efficient and safe. However, it is unclear how cTBS affects brain processes related to emotion. In particular, psychophysiological studies on the underlying neural mechanisms are sparse. In the current study, we investigated how the cTBS influences emotional processing when applied over the right PFC. Participants performed an emotion recognition Go/NoGo task, which asked them to select a GO response to either happy or fearful faces after the cTBS or after sham stimulation, while 64-channel electroencephalogram (EEG) was recorded. EEG oscillation was examined using event-related spectral perturbation (ERSP) in a time-interval between 170 and 310ms after face stimuli onset. In the sham group, we found a significant difference in the alpha band between response to happy and fearful stimuli but that effect did not exist in the cTBS group. The alpha band activity at the scalp was reduced suggesting the excitatory effect at the brain level. The beta and gamma band activity was not sensitive to cTBS intervention. The results of the current study demonstrate that cTBS does affect emotion processing and the effect is reflected in changes in EEG oscillations in the alpha band specifically. The results confirm the role of prefrontal cortex in emotion processing. We also suggest that this pattern of cTBS results elucidates mechanisms by which mood improvement in depressive disorders is achieved using cTBS intervention.
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Affiliation(s)
- Dan Cao
- School of Communication and Information Engineering, Qianweichang College, Shanghai University, Shanghai 200444, China
| | - Yingjie Li
- School of Communication and Information Engineering, Qianweichang College, Shanghai University, Shanghai 200444, China.
| | - Margaret A Niznikiewicz
- Laboratory of Cognitive Neuroscience, Boston VA Healthcare System, Brockton Division and Department of Psychiatry, Harvard Medical School, Boston, MA 02301, United States.
| | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, China; Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai 200030, China; Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiaotong University, Shanghai 200030, China.
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Notzon S, Vennewald N, Gajewska A, Klahn AL, Diemer J, Winter B, Fohrbeck I, Arolt V, Pauli P, Domschke K, Zwanzger P. Is prepulse modification altered by continuous theta burst stimulation? DAT1 genotype and motor threshold interact on prepulse modification following brain stimulation. Eur Arch Psychiatry Clin Neurosci 2017; 267:767-779. [PMID: 28337537 DOI: 10.1007/s00406-017-0786-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 03/13/2017] [Indexed: 12/14/2022]
Abstract
Previous studies suggest an inhibitory top-down control of the amygdala by the prefrontal cortex (PFC). Both brain regions play a role in the modulation of prepulse modification (PPM) of the acoustic startle response by a pre-stimulus. Repetitive transcranial magnetic stimulation (rTMS) can modulate the activity of the PFC and might thus affect PPM. This study tested the effect of inhibitory rTMS on PPM accounting for a genetic variant of the dopamine transporter gene (DAT1). Healthy participants (N = 102) were stimulated with continuous theta burst stimulation (cTBS, an intense form of inhibitory rTMS) or sham treatment over the right PFC. Afterwards, during continuous presentation of a background white noise a louder noise burst was presented either alone (control startle) or preceded by a prepulse. Participants were genotyped for a DAT1 variable number tandem repeat (VNTR) polymorphism. Two succeeding sessions of cTBS over the right PFC (2 × 600 stimuli with a time lag of 15 min) attenuated averaged prepulse inhibition (PPI) in participants with a high resting motor threshold. An attenuation of PPI induced by prepulses with great distances to the pulse (480, 2000 ms) was observed following active cTBS in participants that were homozygous carriers of the 10-repeat-allele of the DAT1 genotype and had a high resting motor threshold. Our results confirm the importance of the prefrontal cortex for the modulation of PPM. The effects were observed in participants with a high resting motor threshold only, probably because they received a higher dose of cTBS. The effects in homozygous carriers of the DAT1 10-repeat allele confirm the relevance of dopamine for PPM. Conducting an exploratory study we decided against the use of a correction for multiple testing.
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Affiliation(s)
- S Notzon
- Department of Psychiatry and Psychotherapy, University of Münster, Albert-Schweitzer-Campus 1, Gebäude A9, 48149, Münster, Germany.
| | - N Vennewald
- School of Health, Münster University of Applied Sciences, Leonardo Campus 8, 48149, Münster, Germany
| | - A Gajewska
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - A L Klahn
- Department of Psychiatry and Psychotherapy, University of Münster, Albert-Schweitzer-Campus 1, Gebäude A9, 48149, Münster, Germany
| | - J Diemer
- kbo-Inn-Salzach-Hospital, Gabersee 7, 83512, Wasserburg am Inn, Germany
| | - B Winter
- Catholic University of Applied Sciences North Rhine-Westphalia, Münster, Piusallee 89, 48147, Münster, Germany
| | - I Fohrbeck
- Department of Psychiatry and Psychotherapy, University of Münster, Albert-Schweitzer-Campus 1, Gebäude A9, 48149, Münster, Germany
| | - V Arolt
- Department of Psychiatry and Psychotherapy, University of Münster, Albert-Schweitzer-Campus 1, Gebäude A9, 48149, Münster, Germany
| | - P Pauli
- Department of Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Marcusstraße 9-11, 97070, Würzburg, Germany
| | - K Domschke
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
- Department of Psychiatry and Psychotherapy, University of Freiburg, Hauptstrasse 5, 79104, Freiburg, Germany
| | - P Zwanzger
- Department of Psychiatry and Psychotherapy, University of Münster, Albert-Schweitzer-Campus 1, Gebäude A9, 48149, Münster, Germany
- kbo-Inn-Salzach-Hospital, Gabersee 7, 83512, Wasserburg am Inn, Germany
- Department of Psychiatry und Psychotherapy, Ludwig Maximilians University, Munich, Germany
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