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Siviero I, Bonfanti D, Menegaz G, Savazzi S, Mazzi C, Storti SF. Graph Analysis of TMS-EEG Connectivity Reveals Hemispheric Differences following Occipital Stimulation. SENSORS (BASEL, SWITZERLAND) 2023; 23:8833. [PMID: 37960532 PMCID: PMC10650175 DOI: 10.3390/s23218833] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/23/2023] [Accepted: 10/28/2023] [Indexed: 11/15/2023]
Abstract
(1) Background: Transcranial magnetic stimulation combined with electroencephalography (TMS-EEG) provides a unique opportunity to investigate brain connectivity. However, possible hemispheric asymmetries in signal propagation dynamics following occipital TMS have not been investigated. (2) Methods: Eighteen healthy participants underwent occipital single-pulse TMS at two different EEG sites, corresponding to early visual areas. We used a state-of-the-art Bayesian estimation approach to accurately estimate TMS-evoked potentials (TEPs) from EEG data, which has not been previously used in this context. To capture the rapid dynamics of information flow patterns, we implemented a self-tuning optimized Kalman (STOK) filter in conjunction with the information partial directed coherence (iPDC) measure, enabling us to derive time-varying connectivity matrices. Subsequently, graph analysis was conducted to assess key network properties, providing insight into the overall network organization of the brain network. (3) Results: Our findings revealed distinct lateralized effects on effective brain connectivity and graph networks after TMS stimulation, with left stimulation facilitating enhanced communication between contralateral frontal regions and right stimulation promoting increased intra-hemispheric ipsilateral connectivity, as evidenced by statistical test (p < 0.001). (4) Conclusions: The identified hemispheric differences in terms of connectivity provide novel insights into brain networks involved in visual information processing, revealing the hemispheric specificity of neural responses to occipital stimulation.
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Affiliation(s)
- Ilaria Siviero
- Department of Computer Science, University of Verona, Strada Le Grazie 15, 37134 Verona, Italy;
| | - Davide Bonfanti
- Perception and Awareness (PandA) Lab., Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Piazzale Ludovico Antonio Scuro 10, 37124 Verona, Italy; (D.B.); (S.S.); (C.M.)
| | - Gloria Menegaz
- Department of Engineering for Innovation Medicine, University of Verona, Strada Le Grazie 15, 37134 Verona, Italy;
| | - Silvia Savazzi
- Perception and Awareness (PandA) Lab., Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Piazzale Ludovico Antonio Scuro 10, 37124 Verona, Italy; (D.B.); (S.S.); (C.M.)
| | - Chiara Mazzi
- Perception and Awareness (PandA) Lab., Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Piazzale Ludovico Antonio Scuro 10, 37124 Verona, Italy; (D.B.); (S.S.); (C.M.)
| | - Silvia Francesca Storti
- Department of Engineering for Innovation Medicine, University of Verona, Strada Le Grazie 15, 37134 Verona, Italy;
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2
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Gupta D, Du X, Summerfelt A, Hong LE, Choa FS. Brain Connectivity Signature Extractions from TMS Invoked EEGs. SENSORS (BASEL, SWITZERLAND) 2023; 23:4078. [PMID: 37112420 PMCID: PMC10146617 DOI: 10.3390/s23084078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 06/19/2023]
Abstract
(1) Background: The correlations between brain connectivity abnormality and psychiatric disorders have been continuously investigated and progressively recognized. Brain connectivity signatures are becoming exceedingly useful for identifying patients, monitoring mental health disorders, and treatment. By using electroencephalography (EEG)-based cortical source localization along with energy landscape analysis techniques, we can statistically analyze transcranial magnetic stimulation (TMS)-invoked EEG signals, for obtaining connectivity among different brain regions at a high spatiotemporal resolution. (2) Methods: In this study, we analyze EEG-based source localized alpha wave activity in response to TMS administered to three locations, namely, the left motor cortex (49 subjects), left prefrontal cortex (27 subjects), and the posterior cerebellum, or vermis (27 subjects) by using energy landscape analysis techniques to uncover connectivity signatures. We then perform two sample t-tests and use the (5 × 10-5) Bonferroni corrected p-valued cases for reporting six reliably stable signatures. (3) Results: Vermis stimulation invoked the highest number of connectivity signatures and the left motor cortex stimulation invoked a sensorimotor network state. In total, six out of 29 reliable, stable connectivity signatures are found and discussed. (4) Conclusions: We extend previous findings to localized cortical connectivity signatures for medical applications that serve as a baseline for future dense electrode studies.
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Affiliation(s)
- Deepa Gupta
- Computer Science and Electrical Engineering, University of Maryland Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21227, USA
| | - Xiaoming Du
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD 21201, USA
| | - Ann Summerfelt
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD 21201, USA
| | - L. Elliot Hong
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD 21201, USA
| | - Fow-Sen Choa
- Computer Science and Electrical Engineering, University of Maryland Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21227, USA
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3
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Bagherzadeh H, Meng Q, Lu H, Hong E, Yang Y, Choa FS. High-Performance Magnetic-core Coils for Targeted Rodent Brain Stimulations. BME FRONTIERS 2022; 2022:9854846. [PMID: 37850171 PMCID: PMC10521704 DOI: 10.34133/2022/9854846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 02/14/2022] [Indexed: 10/19/2023] Open
Abstract
Objective and Impact Statement. There is a need to develop rodent coils capable of targeted brain stimulation for treating neuropsychiatric disorders and understanding brain mechanisms. We describe a novel rodent coil design to improve the focality for targeted stimulations in small rodent brains. Introduction. Transcranial magnetic stimulation (TMS) is becoming increasingly important for treating neuropsychiatric disorders and understanding brain mechanisms. Preclinical studies permit invasive manipulations and are essential for the mechanistic understanding of TMS effects and explorations of therapeutic outcomes in disease models. However, existing TMS tools lack focality for targeted stimulations. Notably, there has been limited fundamental research on developing coils capable of focal stimulation at deep brain regions on small animals like rodents. Methods. In this study, ferromagnetic cores are added to a novel angle-tuned coil design to enhance the coil performance regarding penetration depth and focality. Numerical simulations and experimental electric field measurements were conducted to optimize the coil design. Results. The proposed coil system demonstrated a significantly smaller stimulation spot size and enhanced electric field decay rate in comparison to existing coils. Adding the ferromagnetic core reduces the energy requirements up to 60% for rodent brain stimulation. The simulated results are validated with experimental measurements and demonstration of suprathreshold rodent limb excitation through targeted motor cortex activation. Conclusion. The newly developed coils are suitable tools for focal stimulations of the rodent brain due to their smaller stimulation spot size and improved electric field decay rate.
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Affiliation(s)
- Hedyeh Bagherzadeh
- Department of Computer Science and Electrical Engineering, University of Maryland, Baltimore County, Baltimore, MD 21250, USA
| | - Qinglei Meng
- Neuroimaging Research Branch, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA
| | - Hanbing Lu
- Neuroimaging Research Branch, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA
| | - Elliott Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Yihong Yang
- Neuroimaging Research Branch, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA
| | - Fow-Sen Choa
- Department of Computer Science and Electrical Engineering, University of Maryland, Baltimore County, Baltimore, MD 21250, USA
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4
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Wang Y, Bai Y, Xia X, Niu Z, Yang Y, He J, Li X. Comparison of synchrosqueezing transform to alternative methods for time-frequency analysis of TMS-evoked EEG oscillations. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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5
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The Effects of 1 mA tACS and tRNS on Children/Adolescents and Adults: Investigating Age and Sensitivity to Sham Stimulation. Neural Plast 2020; 2020:8896423. [PMID: 32855633 PMCID: PMC7443018 DOI: 10.1155/2020/8896423] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/10/2020] [Accepted: 07/14/2020] [Indexed: 12/24/2022] Open
Abstract
The aim of this study was to investigate the effect of transcranial random noise (tRNS) and transcranial alternating current (tACS) stimulation on motor cortex excitability in healthy children and adolescents. Additionally, based on our recent results on the individual response to sham in adults, we explored this effect in the pediatric population. We included 15 children and adolescents (10-16 years) and 28 adults (20-30 years). Participants were stimulated four times with 20 Hz and 140 Hz tACS, tRNS, and sham stimulation (1 mA) for 10 minutes over the left M1HAND. Single-pulse MEPs (motor evoked potential), short-interval intracortical inhibition, and facilitation were measured by TMS before and after stimulation (baseline, 0, 30, 60 minutes). We also investigated aspects of tolerability. According to the individual MEPs response immediately after sham stimulation compared to baseline (Wilcoxon signed-rank test), subjects were regarded as responders or nonresponders to sham. We did not find a significant age effect. Regardless of age, 140 Hz tACS led to increased excitability. Incidence and intensity of side effects did not differ between age groups or type of stimulation. Analyses on responders and nonresponders to sham stimulation showed effects of 140 Hz, 20 Hz tACS, and tRNS on single-pulse MEPs only for nonresponders. In this study, children and adolescents responded to 1 mA tRNS and tACS comparably to adults regarding the modulation of motor cortex excitability. This study contributes to the findings that noninvasive brain stimulation is well tolerated in children and adolescents including tACS, which has not been studied before. Finally, our study supports a modulating role of sensitivity to sham stimulation on responsiveness to a broader stimulation and age range.
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6
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Noda Y. Toward the establishment of neurophysiological indicators for neuropsychiatric disorders using transcranial magnetic stimulation-evoked potentials: A systematic review. Psychiatry Clin Neurosci 2020; 74:12-34. [PMID: 31587446 DOI: 10.1111/pcn.12936] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 08/14/2019] [Accepted: 09/23/2019] [Indexed: 12/24/2022]
Abstract
Transcranial magnetic stimulation (TMS) can depolarize the neurons directly under the coil when applied to the cerebral cortex, and modulate the neural circuit associated with the stimulation site, which makes it possible to measure the neurophysiological index to evaluate excitability and inhibitory functions. Concurrent TMS and electroencephalography (TMS-EEG) has been developed to assess the neurophysiological characteristics of cortical regions other than the motor cortical region noninvasively. The aim of this review is to comprehensively discuss TMS-EEG research in the healthy brain focused on excitability, inhibition, and plasticity following neuromodulatory TMS paradigms from a neurophysiological perspective. A search was conducted in PubMed to identify articles that examined humans and that were written in English and published by September 2018. The search terms were as follows: (TMS OR 'transcranial magnetic stimulation') AND (EEG OR electroencephalog*) NOT (rTMS OR 'repetitive transcranial magnetic stimulation' OR TBS OR 'theta burst stimulation') AND (healthy). The study presents an overview of TMS-EEG methodology and neurophysiological indices and reviews previous findings from TMS-EEG in healthy individuals. Furthermore, this review discusses the potential application of TMS-EEG neurophysiology in the clinical setting to study healthy and diseased brain conditions in the future. Combined TMS-EEG is a powerful tool to probe and map neural circuits in the human brain noninvasively and represents a promising approach for determining the underlying pathophysiology of neuropsychiatric disorders.
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Affiliation(s)
- Yoshihiro Noda
- Multidisciplinary Translational Research Lab, Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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7
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Saari J, Kallioniemi E, Tarvainen M, Julkunen P. Oscillatory TMS-EEG-Responses as a Measure of the Cortical Excitability Threshold. IEEE Trans Neural Syst Rehabil Eng 2019; 26:383-391. [PMID: 29432109 DOI: 10.1109/tnsre.2017.2779135] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Transcranial magnetic stimulation (TMS) is a non-invasive tool to perturb brain activity. In TMS studies, the stimulation intensity (SI) is commonly normalized to the resting motor threshold (rMT) that produces muscle responses in 50% of stimulations applied to the motor cortex (M1). Since rMT is influenced by spinal excitability and coil-to-cortex distance, responses recorded from the cortex, instead of a peripheral muscle, could provide a more accurate marker for cortical excitability. Combining TMS with electroencephalography (EEG) enables the measurement of brain-wide cortical reactivity to TMS. We quantified TMS-induced changes in oscillatory power and the phase of EEG with event-related spectral perturbation (ERSP) and inter-trial coherence (ITC). We studied the SI-dependency of ERSP and ITC responses by stimulating the dominant M1 of ten healthy volunteers using single-pulse TMS with 150 pulses at 60%, 80%, 100%, and 120% of rMT. We found SI-dependent ERSP and ITC responses in M1, most notably with the wide-band (8-70 Hz) early ITC responses averaged 20-60 ms after TMS. With approximately linear SI-dependence, the early ITC response was consistent between SIs (intraclass correlation = 0.78, ). Our results reveal the potential of oscillatory EEG responses, in place of rMT, as a measure of the cortical excitability threshold in M1.
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8
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Haberbosch L, Schmidt S, Jooss A, Köhn A, Kozarzewski L, Rönnefarth M, Scholz M, Brandt SA. Rebound or Entrainment? The Influence of Alternating Current Stimulation on Individual Alpha. Front Hum Neurosci 2019; 13:43. [PMID: 30809139 PMCID: PMC6380175 DOI: 10.3389/fnhum.2019.00043] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 01/25/2019] [Indexed: 01/11/2023] Open
Abstract
Alternating current stimulation (ACS) is an established means to manipulate intrinsic cortical oscillations. While working towards clinical impact, ACS mechanisms of action remain unclear. For ACS’s well-documented influence on occipital alpha, hypotheses include neuronal entrainment as well as rebound phenomena. As a retinal origin is also discussed, we employed a novel form of ACS with the advantage that it specifically targets occipital alpha-oscillations via retinofugal pathways retinofugal ACS (rACS). We aimed to confirm alpha-enhancement outlasting the duration of stimulation with 10 Hz rACS. To distinguish entrainment from rebound effects, we investigated the correlation between alpha peak frequency change and alpha-enhancement strength. We quantified the alpha band power before and after 10 Hz rACS in 15 healthy subjects. Alpha power enhancement and alpha peak frequency change were assessed over the occipital electrodes and compared to sham stimulation. RACS significantly enhanced occipital alpha power in comparison to sham stimulation (p < 0.05). Alpha peak frequency changed by a mean 0.02 Hz (± 0.04). A greater change in alpha peak frequency did not correlate with greater effects on alpha power. Our findings show an alpha-enhancement consistent with studies conducted for transcranial ACS (tACS) and contribute evidence for a retinal involvement in tACS effects on occipital alpha. Furthermore, the lack of correlation between alpha peak frequency change and alpha-enhancement strength provides an argument against entrainment effects and in favor of a rebound phenomenon.
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Affiliation(s)
- Linus Haberbosch
- Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Sein Schmidt
- Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Jooss
- Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Arvid Köhn
- Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Leonard Kozarzewski
- Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Maria Rönnefarth
- Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Michael Scholz
- Neural Information Processing Group, University of Technology Berlin, Berlin, Germany
| | - Stephan A Brandt
- Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany
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9
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Fresnoza S, Christova M, Feil T, Gallasch E, Körner C, Zimmer U, Ischebeck A. The effects of transcranial alternating current stimulation (tACS) at individual alpha peak frequency (iAPF) on motor cortex excitability in young and elderly adults. Exp Brain Res 2018; 236:2573-2588. [PMID: 29943239 PMCID: PMC6153871 DOI: 10.1007/s00221-018-5314-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 06/14/2018] [Indexed: 11/28/2022]
Abstract
Transcranial alternating current stimulation (tACS) can modulate brain oscillations, cortical excitability and behaviour. In aging, the decrease in EEG alpha activity (8–12 Hz) in the parieto-occipital and mu rhythm in the motor cortex are correlated with the decline in cognitive and motor functions, respectively. Increasing alpha activity using tACS might therefore improve cognitive and motor function in the elderly. The present study explored the influence of tACS on cortical excitability in young and old healthy adults. We applied tACS at individual alpha peak frequency for 10 min (1.5 mA) to the left motor cortex. Transcranial magnetic stimulation was used to assess the changes in cortical excitability as measured by motor-evoked potentials at rest, before and after stimulation. TACS increased cortical excitability in both groups. However, our results also suggest that the mechanism behind the effects was different, as we observed an increase and decrease in intracortical inhibition in the old group and young group, respectively. Our results indicate that both groups profited similarly from the stimulation. There was no indication that tACS was more effective in conditions of low alpha power, that is, in the elderly.
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Affiliation(s)
- Shane Fresnoza
- Institute of Psychology, University of Graz, Graz, Austria. .,Institute of Physiology, Medical University of Graz, Graz, Austria.
| | - Monica Christova
- Otto Loewi Research Center, Physiology Section, Medical University of Graz, Graz, Austria.,Department of Physiotherapy, University of Applied Sciences FH-Joanneum Graz, Graz, Austria
| | - Theresa Feil
- Institute of Psychology, University of Graz, Graz, Austria
| | - Eugen Gallasch
- Institute of Physiology, Medical University of Graz, Graz, Austria.,BioTechMed, Graz, Austria
| | - Christof Körner
- Institute of Psychology, University of Graz, Graz, Austria.,BioTechMed, Graz, Austria
| | - Ulrike Zimmer
- Institute of Psychology, University of Graz, Graz, Austria.,Faculty of Human Sciences, Medical School Hamburg (MSH), Hamburg, Germany
| | - Anja Ischebeck
- Institute of Psychology, University of Graz, Graz, Austria.,BioTechMed, Graz, Austria
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10
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Löfberg O, Julkunen P, Kallioniemi E, Pääkkönen A, Karhu J. Modulation of motor cortical excitability with auditory stimulation. J Neurophysiol 2018; 120:920-925. [PMID: 29742032 DOI: 10.1152/jn.00186.2017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Loud sounds have been demonstrated to increase motor cortex excitability when transcranial magnetic stimulation (TMS) is synchronized with auditory evoked N100 potential measured from electroencephalography (EEG). The N100 potential is generated by an afferent response to sound onset and feature analysis, and upon novel sound it is also related to the arousal reaction. The arousal reaction is known to originate from the ascending reticular activating system of the brain stem and to modulate neuronal activity throughout the central nervous system. In this study we investigated the difference in motor evoked potentials (MEPs) when deviant and novelty stimuli were randomly interspersed in a train of standard tones. Twelve healthy subjects participated in this study. Three types of sound stimuli were used: 1) standard stimuli (800 Hz), 2) deviant stimuli (560 Hz), and 3) novelty stimuli (12 different sounds). In each stimulus sequence 600 stimuli were given. Of these, 90 were deviant stimuli randomly placed between the standard stimuli. Each of 12 novel sounds was presented once in pseudorandomized order. TMS was randomly mixed with the sound stimuli so that it was either synchronized with the individual N100 or trailed the sound onset by 200 ms. All sounds elicited an increase in motor cortex excitability. The type of sound had no significant effect. We also demonstrated that TMS timed at 200-ms intervals caused a significant increment of MEPs. This contradicted our hypothesis that MEP amplitudes to TMS synchronized with N100 would be greater than those to TMS at 200 ms after a sound and remains unexplained. NEW & NOTEWORTHY We demonstrated modulation of motor cortical excitability with parallel auditory stimulus by combining navigated transcranial magnetic stimulation (TMS) with auditory stimuli. TMS was synchronized with auditory evoked potentials considered to be generated by the unconscious attention call process in the auditory system.
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Affiliation(s)
- Olli Löfberg
- Department of Clinical Neurophysiology, Kuopio University Hospital , Kuopio , Finland
| | - Petro Julkunen
- Department of Clinical Neurophysiology, Kuopio University Hospital , Kuopio , Finland.,Department of Applied Physics, University of Eastern Finland , Kuopio , Finland
| | - Elisa Kallioniemi
- Department of Clinical Neurophysiology, Kuopio University Hospital , Kuopio , Finland.,Department of Clinical Radiology, Kuopio University Hospital , Kuopio , Finland
| | - Ari Pääkkönen
- Department of Clinical Neurophysiology, Kuopio University Hospital , Kuopio , Finland
| | - Jari Karhu
- Nexstim Plc, Helsinki , Finland.,Department of Physiology, Institute of Biomedicine, University of Eastern Finland , Kuopio , Finland
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11
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Quantification of Upper Limb Motor Recovery and EEG Power Changes after Robot-Assisted Bilateral Arm Training in Chronic Stroke Patients: A Prospective Pilot Study. Neural Plast 2018; 2018:8105480. [PMID: 29780410 PMCID: PMC5892248 DOI: 10.1155/2018/8105480] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 09/01/2017] [Accepted: 11/20/2017] [Indexed: 11/17/2022] Open
Abstract
Background Bilateral arm training (BAT) has shown promise in expediting progress toward upper limb recovery in chronic stroke patients, but its neural correlates are poorly understood. Objective To evaluate changes in upper limb function and EEG power after a robot-assisted BAT in chronic stroke patients. Methods In a within-subject design, seven right-handed chronic stroke patients with upper limb paresis received 21 sessions (3 days/week) of the robot-assisted BAT. The outcomes were changes in score on the upper limb section of the Fugl-Meyer assessment (FM), Motricity Index (MI), and Modified Ashworth Scale (MAS) evaluated at the baseline (T0), posttraining (T1), and 1-month follow-up (T2). Event-related desynchronization/synchronization were calculated in the upper alpha and the beta frequency ranges. Results Significant improvement in all outcomes was measured over the course of the study. Changes in FM were significant at T2, and in MAS at T1 and T2. After training, desynchronization on the ipsilesional sensorimotor areas increased during passive and active movement, as compared with T0. Conclusions A repetitive robotic-assisted BAT program may improve upper limb motor function and reduce spasticity in the chronically impaired paretic arm. Effects on spasticity were associated with EEG changes over the ipsilesional sensorimotor network.
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12
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Naro A, Bramanti A, Leo A, Manuli A, Sciarrone F, Russo M, Bramanti P, Calabrò RS. Effects of cerebellar transcranial alternating current stimulation on motor cortex excitability and motor function. Brain Struct Funct 2017; 222:2891-2906. [PMID: 28064346 DOI: 10.1007/s00429-016-1355-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 12/17/2016] [Indexed: 10/20/2022]
Abstract
The cerebellum regulates several motor functions through two main mechanisms, the cerebellum-brain inhibition (CBI) and the motor surround inhibition (MSI). Although the exact cerebellar structures and functions involved in such processes are partially known, Purkinje cells (PC) and their surrounding interneuronal networks may play a pivotal role concerning CBI and MSI. Cerebellar transcranial alternating current stimulation (tACS) has been proven to shape specific cerebellar components in a feasible, safe, effective, and non-invasive manner. The aim of our study was to characterize the cerebellar structures and functions subtending CBI and MSI using a tACS approach. Fifteen healthy individuals underwent a cerebellar tACS protocol at 10, 50, and 300 Hz, or a sham-tACS over the right cerebellar hemisphere. We measured the tACS aftereffects on motor-evoked potential (MEP) amplitude, CBI induced by tACS (tiCBI) at different frequencies, MSI, and hand motor task performance. None of the participants had any side effect related to tACS. After 50-Hz tACS, we observed a clear tiCBI-50Hz weakening (about +30%, p < 0.001) paralleled by a MEP amplitude increase (about +30%, p = 0.001) and a reduction of the time required to complete some motor task (about -20%, p = 0.01), lasting up to 30 min. The 300-Hz tACS induced a selective, specific tiCBI-300Hz and tiCBI-50Hz modulation in surrounding muscles (about -15%, p = 0.01) and MSI potentiation (about +40%, p < 0.001). The 10-Hz tACS and the sham-tACS were ineffective (p > 0.6). Our preliminary data suggest that PC may represent the last mediator of tiCBI and that the surrounding interneuronal network may have an important role in updating MSI, tiCBI, and M1 excitability during tonic muscle contraction, by acting onto the PC. The knowledge of these neurophysiological issues offers new cues to design innovative, non-invasive neuromodulation protocols to shape cerebellar-cerebral functions.
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Affiliation(s)
- Antonino Naro
- IRCCS Centro Neurolesi "Bonino-Pulejo", Via Palermo, Contrada Casazza, S.S. 113, 98124, Messina, Italy
| | - Alessia Bramanti
- IRCCS Centro Neurolesi "Bonino-Pulejo", Via Palermo, Contrada Casazza, S.S. 113, 98124, Messina, Italy
| | - Antonino Leo
- IRCCS Centro Neurolesi "Bonino-Pulejo", Via Palermo, Contrada Casazza, S.S. 113, 98124, Messina, Italy
| | - Alfredo Manuli
- IRCCS Centro Neurolesi "Bonino-Pulejo", Via Palermo, Contrada Casazza, S.S. 113, 98124, Messina, Italy
| | - Francesca Sciarrone
- IRCCS Centro Neurolesi "Bonino-Pulejo", Via Palermo, Contrada Casazza, S.S. 113, 98124, Messina, Italy
| | - Margherita Russo
- IRCCS Centro Neurolesi "Bonino-Pulejo", Via Palermo, Contrada Casazza, S.S. 113, 98124, Messina, Italy
| | - Placido Bramanti
- IRCCS Centro Neurolesi "Bonino-Pulejo", Via Palermo, Contrada Casazza, S.S. 113, 98124, Messina, Italy
| | - Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi "Bonino-Pulejo", Via Palermo, Contrada Casazza, S.S. 113, 98124, Messina, Italy.
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13
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Cash RFH, Noda Y, Zomorrodi R, Radhu N, Farzan F, Rajji TK, Fitzgerald PB, Chen R, Daskalakis ZJ, Blumberger DM. Characterization of Glutamatergic and GABA A-Mediated Neurotransmission in Motor and Dorsolateral Prefrontal Cortex Using Paired-Pulse TMS-EEG. Neuropsychopharmacology 2017; 42:502-511. [PMID: 27461082 PMCID: PMC5399228 DOI: 10.1038/npp.2016.133] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 06/22/2016] [Accepted: 07/10/2016] [Indexed: 12/26/2022]
Abstract
Short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF) are noninvasive transcranial magnetic stimulation (TMS) measures of GABAA receptor-mediated inhibition and glutamatergic excitatory transmission, respectively. Conventionally these measures have been restricted to the motor cortex. We investigated whether SICI and ICF could be recorded from the dorsolateral prefrontal cortex (DLPFC) using combined TMS and electroencephalography (TMS-EEG). We first characterized the neural signature of SICI and ICF in M1 in terms of TMS-evoked potentials (TEPs) and spectral power modulation. Subsequently, these paradigms were applied in the DLPFC to determine whether similar neural signatures were evident. With TMS at M1, SICI and ICF led to bidirectional modulation (inhibition and facilitation, respectively) of P30 and P60 TEP amplitude, which correlated with MEP amplitude changes. With DLPFC stimulation, P60 was bidirectionally modulated by SICI and ICF in the same manner as for M1 stimulation, whereas P30 was absent. The sole modulation of early TEP components is in contradistinction to other measures such as long-interval intracortical inhibition and may reflect modulation of short latency excitatory and inhibitory postsynaptic potentials (EPSPs and IPSPs). Overall, the data suggest that SICI and ICF can be recorded using TMS-EEG in DLPFC providing noninvasive measures of glutamatergic and GABAA receptor-mediated neurotransmission. This may facilitate future research attempting to ascertain the role of these neurotransmitters in the pathophysiology and treatment of neurological and psychiatric disorders.
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Affiliation(s)
- Robin F H Cash
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada,Division of Neurology, Department of Medicine, University of Toronto, Division of Brain, Imaging and Behaviour—Systems Neuroscience, Toronto Western Research Institute, University Health Network, Toronto, ON, Canada,Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and The Alfred, Melbourne, VIC, Australia
| | - Yoshihiro Noda
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Reza Zomorrodi
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Natasha Radhu
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada,Division of Neurology, Department of Medicine, University of Toronto, Division of Brain, Imaging and Behaviour—Systems Neuroscience, Toronto Western Research Institute, University Health Network, Toronto, ON, Canada
| | - Faranak Farzan
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Tarek K Rajji
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and The Alfred, Melbourne, VIC, Australia
| | - Robert Chen
- Division of Neurology, Department of Medicine, University of Toronto, Division of Brain, Imaging and Behaviour—Systems Neuroscience, Toronto Western Research Institute, University Health Network, Toronto, ON, Canada
| | - Zafiris J Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Daniel M Blumberger
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada,Temerty Centre for Therapeutic Brain Intervention, Head, Late-Life Mood Disorders Clinic, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, 1001 Queen St. W. Unit 4-115, Toronto, ON M6J 1H4, Canada, Tel: +1 416 535 8501, Fax: +1 416 583 4613, E-mail:
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14
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Noh NA. Exploring Cortical Plasticity and Oscillatory Brain Dynamics via Transcranial Magnetic Stimulation and Resting-State Electroencephalogram. Malays J Med Sci 2016; 23:5-16. [PMID: 27660540 DOI: 10.21315/mjms2016.23.4.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 04/21/2016] [Indexed: 01/08/2023] Open
Abstract
Transcranial magnetic stimulation (TMS) is a non-invasive, non-pharmacological technique that is able to modulate cortical activity beyond the stimulation period. The residual aftereffects are akin to the plasticity mechanism of the brain and suggest the potential use of TMS for therapy. For years, TMS has been shown to transiently improve symptoms of neuropsychiatric disorders, but the underlying neural correlates remain elusive. Recently, there is evidence that altered connectivity of brain network dynamics is the mechanism underlying symptoms of various neuropsychiatric illnesses. By combining TMS and electroencephalography (EEG), the functional connectivity patterns among brain regions, and the causal link between function or behaviour and a specific brain region can be determined. Nonetheless, the brain network connectivity are highly complex and involve the dynamics interplay among multitude of brain regions. In this review article, we present previous TMS-EEG co-registration studies, which explore the functional connectivity patterns of human cerebral cortex. We argue the possibilities of neural correlates of long-term potentiation/depression (LTP-/LTD)-like mechanisms of synaptic plasticity that drive the TMS aftereffects as shown by the dissociation between EEG and motor evoked potentials (MEP) cortical output. Here, we also explore alternative explanations that drive the EEG oscillatory modulations post TMS. The precise knowledge of the neurophysiological mechanisms underlying TMS will help characterise disturbances in oscillatory patterns, and the altered functional connectivity in neuropsychiatric illnesses.
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Affiliation(s)
- Nor Azila Noh
- Department of Medical Science I, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Pandan Indah, 55100 Kuala Lumpur, Malaysia
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15
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Assessment of Event-Related EEG Power After Single-Pulse TMS in Unresponsive Wakefulness Syndrome and Minimally Conscious State Patients. Brain Topogr 2015; 29:322-33. [DOI: 10.1007/s10548-015-0461-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 11/07/2015] [Indexed: 11/26/2022]
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16
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Pisani LR, Naro A, Leo A, Aricò I, Pisani F, Silvestri R, Bramanti P, Calabrò RS. Repetitive transcranial magnetic stimulation induced slow wave activity modification: A possible role in disorder of consciousness differential diagnosis? Conscious Cogn 2015; 38:1-8. [PMID: 26496476 DOI: 10.1016/j.concog.2015.09.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 09/07/2015] [Accepted: 09/29/2015] [Indexed: 10/22/2022]
Abstract
Slow wave activity (SWA) generation depends on cortico-thalamo-cortical loops that are disrupted in patients with chronic Disorders of Consciousness (DOC), including the Unresponsive Wakefulness Syndrome (UWS) and the Minimally Conscious State (MCS). We hypothesized that the modulation of SWA by means of a repetitive transcranial magnetic stimulation (rTMS) could reveal residual patterns of connectivity, thus supporting the DOC clinical differential diagnosis. We enrolled 10 DOC individuals who underwent a 24hh polysomnography followed by a real or sham 5Hz-rTMS over left primary motor area, and a second polysomnographic recording. A preserved sleep-wake cycle, a standard temporal progression of sleep stages, and a SWA perturbation were found in all of the MCS patients and in none of the UWS individuals, only following the real-rTMS. In conclusion, our combined approach may improve the differential diagnosis between MCS patients, who show a partial preservation of cortical plasticity, and UWS individuals, who lack such properties.
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Affiliation(s)
| | - Antonino Naro
- IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Italy
| | - Antonino Leo
- IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Italy
| | - Irene Aricò
- Department of Neuroscience, University of Messina, Messina, Italy
| | - Francesco Pisani
- Department of Neuroscience, University of Messina, Messina, Italy
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17
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Moliadze V, Andreas S, Lyzhko E, Schmanke T, Gurashvili T, Freitag CM, Siniatchkin M. Ten minutes of 1 mA transcranial direct current stimulation was well tolerated by children and adolescents: Self-reports and resting state EEG analysis. Brain Res Bull 2015; 119:25-33. [PMID: 26449209 DOI: 10.1016/j.brainresbull.2015.09.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 09/25/2015] [Accepted: 09/28/2015] [Indexed: 11/18/2022]
Abstract
Transcranial direct current stimulation (tDCS) is a promising and well-tolerated method of non-invasive brain stimulation, by which cortical excitability can be modulated. However, the effects of tDCS on the developing brain are still unknown, and knowledge about its tolerability in children and adolescents is still lacking. Safety and tolerability of tDCS was assessed in children and adolescents by self-reports and spectral characteristics of electroencephalogram (EEG) recordings. Nineteen typically developing children and adolescents aged 11-16 years participated in the study. Anodal and cathodal tDCS as well as sham stimulation were applied for a duration of 10 min over the left primary motor cortex (M1), each with an intensity of 1 mA. Subjects were unable to identify whether they had received active or sham stimulation, and all participants tolerated the stimulation well with a low rate of adverse events in both groups and no serious adverse events. No pathological oscillations, in particular, no markers of epileptiform activity after 1mA tDCS were detected in any of the EEG analyses. In summary, our study demonstrates that tDCS with 1mA intensity over 10 min is well tolerated, and thus may be used as an experimental and treatment method in the pediatric population.
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Affiliation(s)
- Vera Moliadze
- Department of Medical Psychology and Medical Sociology, University Hospital of Schleswig-Holstein (UK-SH), Campus Kiel, Preußerstraße 1-9, 24105 Kiel, Germany; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy Goethe-University, Deutschordenstr. 50, D-60528 Frankfurt am Main, Germany.
| | - Saskia Andreas
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy Goethe-University, Deutschordenstr. 50, D-60528 Frankfurt am Main, Germany
| | - Ekaterina Lyzhko
- Department of Medical Psychology and Medical Sociology, University Hospital of Schleswig-Holstein (UK-SH), Campus Kiel, Preußerstraße 1-9, 24105 Kiel, Germany; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy Goethe-University, Deutschordenstr. 50, D-60528 Frankfurt am Main, Germany; Institute of Mathematical Problems of Biology, Pushchino, Moscow Region, Russia
| | - Till Schmanke
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy Goethe-University, Deutschordenstr. 50, D-60528 Frankfurt am Main, Germany
| | - Tea Gurashvili
- Department of Medical Psychology and Medical Sociology, University Hospital of Schleswig-Holstein (UK-SH), Campus Kiel, Preußerstraße 1-9, 24105 Kiel, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy Goethe-University, Deutschordenstr. 50, D-60528 Frankfurt am Main, Germany
| | - Michael Siniatchkin
- Department of Medical Psychology and Medical Sociology, University Hospital of Schleswig-Holstein (UK-SH), Campus Kiel, Preußerstraße 1-9, 24105 Kiel, Germany; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy Goethe-University, Deutschordenstr. 50, D-60528 Frankfurt am Main, Germany
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18
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Mathon B, Bédos-Ulvin L, Baulac M, Dupont S, Navarro V, Carpentier A, Cornu P, Clemenceau S. Évolution des idées et des techniques, et perspectives d’avenir en chirurgie de l’épilepsie. Rev Neurol (Paris) 2015; 171:141-56. [DOI: 10.1016/j.neurol.2014.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 08/10/2014] [Accepted: 09/30/2014] [Indexed: 10/24/2022]
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19
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Pastena L, Formaggio E, Storti SF, Faralli F, Melucci M, Gagliardi R, Ricciardi L, Ruffino G. Tracking EEG changes during the exposure to hyperbaric oxygen. Clin Neurophysiol 2015; 126:339-47. [DOI: 10.1016/j.clinph.2014.05.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 04/19/2014] [Accepted: 05/05/2014] [Indexed: 11/26/2022]
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20
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Bortoletto M, Veniero D, Thut G, Miniussi C. The contribution of TMS-EEG coregistration in the exploration of the human cortical connectome. Neurosci Biobehav Rev 2014; 49:114-24. [PMID: 25541459 DOI: 10.1016/j.neubiorev.2014.12.014] [Citation(s) in RCA: 140] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 10/14/2014] [Accepted: 12/11/2014] [Indexed: 12/14/2022]
Abstract
Recent developments in neuroscience have emphasised the importance of integrated distributed networks of brain areas for successful cognitive functioning. Our current understanding is that the brain has a modular organisation in which segregated networks supporting specialised processing are linked through a few long-range connections, ensuring processing integration. Although such architecture is structurally stable, it appears to be flexible in its functioning, enabling long-range connections to regulate the information flow and facilitate communication among the relevant modules, depending on the contingent cognitive demands. Here we show how insights brought by the coregistration of transcranial magnetic stimulation and electroencephalography (TMS-EEG) integrate and support recent models of functional brain architecture. Moreover, we will highlight the types of data that can be obtained through TMS-EEG, such as the timing of signal propagation, the excitatory/inhibitory nature of connections and causality. Last, we will discuss recent emerging applications of TMS-EEG in the study of brain disorders.
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Affiliation(s)
- Marta Bortoletto
- Cognitive Neuroscience Section, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
| | - Domenica Veniero
- Centre for Cognitive Neuroimaging, Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
| | - Gregor Thut
- Centre for Cognitive Neuroimaging, Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
| | - Carlo Miniussi
- Cognitive Neuroscience Section, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy; Neuroscience Section, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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21
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A Local Signature of LTP-Like Plasticity Induced by Repetitive Paired Associative Stimulation. Brain Topogr 2014; 28:238-49. [DOI: 10.1007/s10548-014-0396-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 09/03/2014] [Indexed: 11/26/2022]
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22
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Formaggio E, Storti SF, Boscolo Galazzo I, Gandolfi M, Geroin C, Smania N, Fiaschi A, Manganotti P. Time–Frequency Modulation of ERD and EEG Coherence in Robot-Assisted Hand Performance. Brain Topogr 2014; 28:352-63. [DOI: 10.1007/s10548-014-0372-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Accepted: 04/27/2014] [Indexed: 01/19/2023]
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23
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Krieg SM, Sollmann N, Hauck T, Ille S, Meyer B, Ringel F. Repeated mapping of cortical language sites by preoperative navigated transcranial magnetic stimulation compared to repeated intraoperative DCS mapping in awake craniotomy. BMC Neurosci 2014; 15:20. [PMID: 24479694 PMCID: PMC3909378 DOI: 10.1186/1471-2202-15-20] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Accepted: 01/17/2014] [Indexed: 11/10/2022] Open
Abstract
Background Repetitive navigated transcranial magnetic stimulation (rTMS) was recently described for mapping of human language areas. However, its capability of detecting language plasticity in brain tumor patients was not proven up to now. Thus, this study was designed to evaluate such data in order to compare rTMS language mapping to language mapping during repeated awake surgery during follow-up in patients suffering from language-eloquent gliomas. Methods Three right-handed patients with left-sided gliomas (2 opercular glioblastomas, 1 astrocytoma WHO grade III of the angular gyrus) underwent preoperative language mapping by rTMS as well as intraoperative language mapping provided via direct cortical stimulation (DCS) for initial as well as for repeated Resection 7, 10, and 15 months later. Results Overall, preoperative rTMS was able to elicit clear language errors in all mappings. A good correlation between initial rTMS and DCS results was observed. As a consequence of brain plasticity, initial DCS and rTMS findings only corresponded with the results obtained during the second examination in one out of three patients thus suggesting changes of language organization in two of our three patients. Conclusions This report points out the usefulness but also the limitations of preoperative rTMS language mapping to detect plastic changes in language function or for long-term follow-up prior to DCS even in recurrent gliomas. However, DCS still has to be regarded as gold standard.
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Affiliation(s)
| | | | | | | | | | - Florian Ringel
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, Munich, 81675, Germany.
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Manganotti P, Formaggio E, Del Felice A, Storti SF, Zamboni A, Bertoldo A, Fiaschi A, Toffolo GM. Time-frequency analysis of short-lasting modulation of EEG induced by TMS during wake, sleep deprivation and sleep. Front Hum Neurosci 2013; 7:767. [PMID: 24302903 PMCID: PMC3831717 DOI: 10.3389/fnhum.2013.00767] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 10/24/2013] [Indexed: 12/15/2022] Open
Abstract
The occurrence of dynamic changes in spontaneous electroencephalogram (EEG) rhythms in the awake state or sleep is highly variable. These rhythms can be externally modulated during transcranial magnetic stimulation (TMS) with a perturbation method to trigger oscillatory brain activity. EEG-TMS co-registration was performed during standard wake, during wake after sleep deprivation and in sleep in six healthy subjects. Dynamic changes in the regional neural oscillatory activity of the cortical areas were characterized using time-frequency analysis based on the wavelet method, and the modulation of induced oscillations were related to different vigilance states. A reciprocal synchronizing/desynchronizing effect on slow and fast oscillatory activity was observed in response to focal TMS after sleep deprivation and sleep. We observed a sleep-related slight desynchronization of alpha mainly over the frontal areas, and a widespread increase in theta synchronization. These findings could be interpreted as proof of the interference external brain stimulation can exert on the cortex, and how this could be modulated by the vigilance state. Potential clinical applications may include evaluation of hyperexcitable states such as epilepsy or disturbed states of consciousness such as minimal consciousness.
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Affiliation(s)
- Paolo Manganotti
- Clinical Neurophysiology and Functional Neuroimaging Unit, Section of Neurology, Department of Neurological and Movement Sciences, University of Verona Verona, Italy ; Department of Neurophysiology, Foundation IRCCS San Camillo Hospital Venice, Italy
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Effect of High-Frequency Repetitive Transcranial Magnetic Stimulation on Brain Excitability in Severely Brain-Injured Patients in Minimally Conscious or Vegetative State. Brain Stimul 2013; 6:913-21. [DOI: 10.1016/j.brs.2013.06.006] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 05/30/2013] [Accepted: 06/30/2013] [Indexed: 11/18/2022] Open
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26
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Fuggetta G, Noh NA. A neurophysiological insight into the potential link between transcranial magnetic stimulation, thalamocortical dysrhythmia and neuropsychiatric disorders. Exp Neurol 2013; 245:87-95. [DOI: 10.1016/j.expneurol.2012.10.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Revised: 08/06/2012] [Accepted: 10/05/2012] [Indexed: 01/08/2023]
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