The Impact of Transcranial Magnetic Stimulation on Reading Processes: A Systematic Review

A new era of current and future treatment applications of transcranial magnetic stimulation

Background

Transcranial magnetic stimulation (TMS) equipment has advanced dramatically over the years thanks to considerable advancements in signal motors, coils, placement devices, and modeling, optimization, and treatment scheduling programs. In this review, a primary assessment of the impact of transcranial magnetic stimulation (TMS) on seizure course in people with and without epilepsy has been done through search in the Embase, PubMed, Scopus, and Web of Science databases. Other proposed roles of TMS in various studies has been reported. The features of TMS protocols for several potential disorders was assessed and the key TMS findings has been documented starting from 1985 until 2023.

Results

More than 500 papers were found that describe various research populations, TMS techniques, and TMS functions in 16 various medical conditions.

Conclusion

After reviewing recent updates in TMS, further researches are needed to improve the technical part of the used TMS protocols and to have definitive results not experimental one with regard to TMS usage in various psychiatric and neurological disorders.

Music literacy improves reading skills via bilateral orthographic development

Considerable evidence suggests that musical education induces structural and functional neuroplasticity in the brain. This study aimed to explore the potential impact of such changes on word-reading proficiency. We investigated whether musical training promotes the development of uncharted orthographic regions in the right hemisphere leading to better reading abilities. A total of 60 healthy, right-handed culturally matched professional musicians and controls took part in this research. They were categorised as normo-typical readers based on their reading speed (syl/sec) and subdivided into two groups of relatively good and poor readers. High density EEG/ERPs were recorded while participants engaged in a note or letter detection task. Musicians were more fluent in word, non-word and text reading tests, and faster in detecting both notes and words. They also exhibited greater N170 and P300 responses, and target-non target differences for words than controls. Similarly, good readers showed larger N170 and P300 responses than poor readers. Increased reading skills were associated to a bilateral activation of the occipito/temporal cortex, during music and word reading. Source reconstruction also showed a reduced activation of the left fusiform gyrus, and of areas devoted to attentional/ocular shifting in poor vs. good readers, and in controls vs. musicians. Data suggest that music literacy acquired early in time can shape reading circuits by promoting the specialization of a right-sided reading area, whose activity was here associated with enhanced reading proficiency. In conclusion, music literacy induces measurable neuroplastic changes in the left and right OT cortex responsible for improved word reading ability.

Abnormal Topological Organization of White Matter Structural Networks in Normal Tension Glaucoma Revealed via Diffusion Tensor Tractography

BACKGROUND

Normal tension glaucoma (NTG) is considered a neurodegenerative disease with glaucomatous damage extending to diffuse brain areas. Therefore, this study aims to explore the abnormalities in the NTG structural network to help in the early diagnosis and course evaluation of NTG.

METHODS

The structural networks of 46 NTG patients and 19 age- and sex-matched healthy controls were constructed using diffusion tensor imaging, followed by graph theory analysis and correlation analysis of small-world properties with glaucoma clinical indicators. In addition, the network-based statistical analysis (NBS) method was used to compare structural network connectivity differences between NTG patients and healthy controls.

RESULTS

Structural brain networks in both NTG and NC groups exhibited small-world properties. However, the small-world index in the severe NTG group was reduced and correlated with a mean deviation of the visual field (MDVF) and retinal nerve fiber layer (RNFL) thickness. When compared to healthy controls, degree centrality and nodal efficiency in visual brain areas were significantly decreased, and betweenness centrality and nodal local efficiency in both visual and nonvisual brain areas were also significantly altered in NTG patients (all p < 0.05, FDR corrected). Furthermore, NTG patients exhibited increased structural connectivity in the occipitotemporal area, with the left fusiform gyrus (FFG.L) as the hub (p < 0.05).

CONCLUSIONS

NTG exhibited altered global properties and local properties of visual and cognitive-emotional brain areas, with enhanced structural connections within the occipitotemporal area. Moreover, the disrupted small-world properties of white matter might be imaging biomarkers for assessing NTG progression.

Preliminary evidence of prolonged timing effects of theta-burst stimulation in the reading system

Theta-burst stimulation (TBS) is a repetitive transcranial magnetic stimulation technique that can be used to upregulate or downregulate different brain regions. However, the timing of its effects and the differing effects of continuous TBS (cTBS) versus intermittent TBS (iTBS) in the reading system have not been explored. This study assessed how stimulation type and post-stimulation timing affected change in performance during a phonological discrimination and sight word recognition task after stimulation of supramarginal gyrus (SMG). Fourteen right-handed young adults (age 18-27 years; 44% male) were block-randomized to receive either iTBS or cTBS to the supramarginal gyrus. Participants then performed a pseudoword discrimination task and an orthographic awareness task (behavioral control) at four different time points and change in reaction time compared to baseline was measured from each time point. There was no effect of stimulation type on change in reaction time [t(16) = -0.2, p = 0.9], suggesting that both types of TBS caused similar effects. Percent change in reaction time decreased over time in the pseudoword task [t(50) = -5.9, p < 0.001], indicating faster pseudoword processing speed with better performance 60-70 min after stimulation. In contrast, no change was demonstrated over time for the behavioral control task [t(43) = -0.6, p = 0.6], suggesting that the change over time seen in the test condition was not a learning effect. These findings provide insight into the effects of TBS on the reading system and can guide future study designs.

Verb and sentence processing with TMS: A systematic review and meta-analysis

Transcranial magnetic stimulation (TMS) has provided relevant evidence regarding the neural correlates of language. The aim of the present study is to summarize and assess previous findings regarding linguistic levels (i.e., semantic and morpho-syntactic) and brain structures utilized during verb and sentence processing. To do that, we systematically reviewed TMS research on verb and sentence processing in healthy speakers, and meta-analyzed TMS-induced effects according to the region of stimulation and experimental manipulation. Findings from 45 articles show that approximately half of the reviewed work focuses on the embodiment of action verbs. The majority of studies (60%) target only one cortical region in relation to a specific linguistic process. Frontal areas are most frequently stimulated in connection to morphosyntactic processes and action verb semantics, and temporoparietal regions in relation to integration of sentential meaning and thematic role assignment. A meta-analysis of 72 effect sizes of the reviewed papers indicates that TMS has a small overall effect size, but effect sizes for anterior compared to posterior regions do not differ for semantic or morphosyntactic contrasts. Our findings stress the need to increase the number of targeted areas, while using the same linguistic contrasts in order to disentangle the contributions of different cortical regions to distinct linguistic processes.

Multiple functions of the angular gyrus at high temporal resolution

Here, the functions of the angular gyrus (AG) are evaluated in the light of current evidence from transcranial magnetic/electric stimulation (TMS/TES) and EEG/MEG studies. 65 TMS/TES and 52 EEG/MEG studies were examined in this review. TMS/TES literature points to a causal role in semantic processing, word and number processing, attention and visual search, self-guided movement, memory, and self-processing. EEG/MEG studies reported AG effects at latencies varying between 32 and 800 ms in a wide range of domains, with a high probability to detect an effect at 300-350 ms post-stimulus onset. A three-phase unifying model revolving around the process of sensemaking is then suggested: (1) early AG involvement in defining the current context, within the first 200 ms, with a bias toward the right hemisphere; (2) attention re-orientation and retrieval of relevant information within 200-500 ms; and (3) cross-modal integration at late latencies with a bias toward the left hemisphere. This sensemaking process can favour accuracy (e.g. for word and number processing) or plausibility (e.g. for comprehension and social cognition). Such functions of the AG depend on the status of other connected regions. The much-debated semantic role is also discussed as follows: (1) there is a strong TMS/TES evidence for a causal semantic role, (2) current EEG/MEG evidence is however weak, but (3) the existing arguments against a semantic role for the AG are not strong. Some outstanding questions for future research are proposed. This review recognizes that cracking the role(s) of the AG in cognition is possible only when its exact contributions within the default mode network are teased apart.

Neuronal Hyperexcitability and Free Radical Toxicity in Amyotrophic Lateral Sclerosis: Established and Future Targets

Amyotrophic lateral sclerosis (ALS) is a devastating disease with evidence of degeneration involving upper and lower motor neuron compartments of the nervous system. Presently, two drugs, riluzole and edaravone, have been established as being useful in slowing disease progression in ALS. Riluzole possesses anti-glutamatergic properties, while edaravone eliminates free radicals (FRs). Glutamate is the excitatory neurotransmitter in the brain and spinal cord and binds to several inotropic receptors. Excessive activation of these receptors generates FRs, inducing neurodegeneration via damage to intracellular organelles and upregulation of proinflammatory mediators. FRs bind to intracellular structures, leading to cellular impairment that contributes to neurodegeneration. As such, excitotoxicity and FR toxicities have been considered as key pathophysiological mechanisms that contribute to the cascade of degeneration that envelopes neurons in ALS. Recent advanced technologies, including neurophysiological, imaging, pathological and biochemical techniques, have concurrently identified evidence of increased excitability in ALS. This review focuses on the relationship between FRs and excitotoxicity in motor neuronal degeneration in ALS and introduces concepts linked to increased excitability across both compartments of the human nervous system. Within this cellular framework, future strategies to promote therapeutic development in ALS, from the perspective of neuronal excitability and function, will be critically appraised.