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Zhang J, McClean ZJ, Khaledi N, Morgan SJ, Millet GY, Aboodarda SJ. Reliability of transcranial magnetic stimulation-evoked responses on knee extensor muscles during cycling. Exp Brain Res 2024; 242:1681-1695. [PMID: 38806709 DOI: 10.1007/s00221-024-06859-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/19/2024] [Indexed: 05/30/2024]
Abstract
Transcranial magnetic stimulation (TMS) measures the excitability and inhibition of corticomotor networks. Despite its task-specificity, few studies have used TMS during dynamic movements and the reliability of TMS paired pulses has not been assessed during cycling. This study aimed to evaluate the reliability of motor evoked potentials (MEP) and short- and long-interval intracortical inhibition (SICI and LICI) on vastus lateralis and rectus femoris muscle activity during a fatiguing single-leg cycling task. Nine healthy adults (2 female) performed two identical sessions of counterweighted single-leg cycling at 60% peak power output until failure. Five single pulses and ten paired pulses were delivered to the motor cortex, and two maximal femoral nerve stimulations (Mmax) were administered during two baseline cycling bouts (unfatigued) and every 5 min throughout cycling (fatigued). When comparing both baseline bouts within the same session, MEP·Mmax-1 and LICI (both ICC: >0.9) were rated excellent while SICI was rated good (ICC: 0.7-0.9). At baseline, between sessions, in the vastus lateralis, Mmax (ICC: >0.9) and MEP·Mmax-1 (ICC: 0.7) demonstrated good reliability; LICI was moderate (ICC: 0.5), and SICI was poor (ICC: 0.3). Across the fatiguing task, Mmax demonstrated excellent reliability (ICC > 0.8), MEP·Mmax-1 ranged good to excellent (ICC: 0.7-0.9), LICI was moderate to excellent (ICC: 0.5-0.9), and SICI remained poorly reliable (ICC: 0.3-0.6). These results corroborate the cruciality of retaining mode-specific testing measurements and suggest that during cycling, Mmax, MEP·Mmax-1, and LICI measures are reliable whereas SICI, although less reliable across days, can be reliable within the same session.
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Affiliation(s)
- Jenny Zhang
- Faculty of Kinesiology, University of Calgary, KNB 420, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Zachary J McClean
- Faculty of Kinesiology, University of Calgary, KNB 420, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Neda Khaledi
- Faculty of Kinesiology, University of Calgary, KNB 420, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
- Faculty of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran
| | - Sophie-Jayne Morgan
- Faculty of Kinesiology, University of Calgary, KNB 420, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Guillaume Y Millet
- Inter-university Laboratory of Human Movement Biology, Université Jean Monnet Saint-Etienne, Université Savoie Mont-Blanc, Lyon 1, Saint-Etienne, F-42023, France
| | - Saied Jalal Aboodarda
- Faculty of Kinesiology, University of Calgary, KNB 420, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
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2
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Marzetti L, Basti A, Guidotti R, Baldassarre A, Metsomaa J, Zrenner C, D’Andrea A, Makkinayeri S, Pieramico G, Ilmoniemi RJ, Ziemann U, Romani GL, Pizzella V. Exploring Motor Network Connectivity in State-Dependent Transcranial Magnetic Stimulation: A Proof-of-Concept Study. Biomedicines 2024; 12:955. [PMID: 38790917 PMCID: PMC11118810 DOI: 10.3390/biomedicines12050955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/19/2024] [Accepted: 04/20/2024] [Indexed: 05/26/2024] Open
Abstract
State-dependent non-invasive brain stimulation (NIBS) informed by electroencephalography (EEG) has contributed to the understanding of NIBS inter-subject and inter-session variability. While these approaches focus on local EEG characteristics, it is acknowledged that the brain exhibits an intrinsic long-range dynamic organization in networks. This proof-of-concept study explores whether EEG connectivity of the primary motor cortex (M1) in the pre-stimulation period aligns with the Motor Network (MN) and how the MN state affects responses to the transcranial magnetic stimulation (TMS) of M1. One thousand suprathreshold TMS pulses were delivered to the left M1 in eight subjects at rest, with simultaneous EEG. Motor-evoked potentials (MEPs) were measured from the right hand. The source space functional connectivity of the left M1 to the whole brain was assessed using the imaginary part of the phase locking value at the frequency of the sensorimotor μ-rhythm in a 1 s window before the pulse. Group-level connectivity revealed functional links between the left M1, left supplementary motor area, and right M1. Also, pulses delivered at high MN connectivity states result in a greater MEP amplitude compared to low connectivity states. At the single-subject level, this relation is more highly expressed in subjects that feature an overall high cortico-spinal excitability. In conclusion, this study paves the way for MN connectivity-based NIBS.
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Affiliation(s)
- Laura Marzetti
- Department of Neuroscience, Imaging and Clinical Sciences, G. d’Annunzio University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
- Institute for Advanced Biomedical Technologies, G. d’Annunzio University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy;
| | - Alessio Basti
- Department of Neuroscience, Imaging and Clinical Sciences, G. d’Annunzio University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Roberto Guidotti
- Department of Neuroscience, Imaging and Clinical Sciences, G. d’Annunzio University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Antonello Baldassarre
- Department of Neuroscience, Imaging and Clinical Sciences, G. d’Annunzio University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
- Institute for Advanced Biomedical Technologies, G. d’Annunzio University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy;
| | - Johanna Metsomaa
- Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany (U.Z.)
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, P.O. Box 12200, 00076 Aalto, Finland
| | - Christoph Zrenner
- Department of Neurology & Stroke, University of Tübingen, 72076 Tübingen, Germany
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON M5T 1R8, Canada
- Institute for Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON M6J 1H1, Canada
| | - Antea D’Andrea
- Department of Neuroscience, Imaging and Clinical Sciences, G. d’Annunzio University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Saeed Makkinayeri
- Department of Neuroscience, Imaging and Clinical Sciences, G. d’Annunzio University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Giulia Pieramico
- Department of Neuroscience, Imaging and Clinical Sciences, G. d’Annunzio University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Risto J. Ilmoniemi
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, P.O. Box 12200, 00076 Aalto, Finland
| | - Ulf Ziemann
- Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany (U.Z.)
- Department of Neurology & Stroke, University of Tübingen, 72076 Tübingen, Germany
| | - Gian Luca Romani
- Institute for Advanced Biomedical Technologies, G. d’Annunzio University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy;
| | - Vittorio Pizzella
- Department of Neuroscience, Imaging and Clinical Sciences, G. d’Annunzio University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
- Institute for Advanced Biomedical Technologies, G. d’Annunzio University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy;
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Bigoni C, Pagnamenta S, Cadic-Melchior A, Bevilacqua M, Harquel S, Raffin E, Hummel FC. MEP and TEP features variability: is it just the brain-state? J Neural Eng 2024; 21:016011. [PMID: 38211341 DOI: 10.1088/1741-2552/ad1dc2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/11/2024] [Indexed: 01/13/2024]
Abstract
Objective.The literature investigating the effects of alpha oscillations on corticospinal excitability is divergent. We believe inconsistency in the findings may arise, among others, from the electroencephalography (EEG) processing for brain-state determination. Here, we provide further insights in the effects of the brain-state on cortical and corticospinal excitability and quantify the impact of different EEG processing.Approach.Corticospinal excitability was measured using motor evoked potential (MEP) peak-to-peak amplitudes elicited with transcranial magnetic stimulation (TMS); cortical responses were studied through TMS-evoked potentials' TEPs features. A TMS-EEG-electromyography (EMG) dataset of 18 young healthy subjects who received 180 single-pulse (SP) and 180 paired pulses (PP) to determine short-intracortical inhibition (SICI) was investigated. To study the effect of different EEG processing, we compared the brain-state estimation deriving from three published methods. The influence of presence of neural oscillations was also investigated. To evaluate the effect of the brain-state on MEP and TEP features variability, we defined the brain-state based on specific EEG phase and power combinations, only in trials where neural oscillations were present. The relationship between TEPs and MEPs was further evaluated.Main results.The presence of neural oscillations resulted in more consistent results regardless of the EEG processing approach. Nonetheless, the latter still critically affected the outcomes, making conclusive claims complex. With our approach, the MEP amplitude was positively modulated by the alpha power and phase, with stronger responses during the trough phase and high power. Power and phase also affected TEP features. Importantly, similar effects were observed in both TMS conditions.Significance.These findings support the view that the brain state of alpha oscillations is associated with the variability observed in cortical and corticospinal responses to TMS, with a tight correlation between the two. The results further highlight the importance of closed-loop stimulation approaches while underlining that care is needed in designing experiments and choosing the analytical approaches, which should be based on knowledge from offline studies to control for the heterogeneity originating from different EEG processing strategies.
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Affiliation(s)
- Claudia Bigoni
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva 1202, Switzerland
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL Valais), Sion 1951, Switzerland
| | - Sara Pagnamenta
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva 1202, Switzerland
| | - Andéol Cadic-Melchior
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva 1202, Switzerland
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL Valais), Sion 1951, Switzerland
| | - Michele Bevilacqua
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva 1202, Switzerland
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL Valais), Sion 1951, Switzerland
| | - Sylvain Harquel
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva 1202, Switzerland
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL Valais), Sion 1951, Switzerland
| | - Estelle Raffin
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva 1202, Switzerland
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL Valais), Sion 1951, Switzerland
| | - Friedhelm C Hummel
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva 1202, Switzerland
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX), Ecole Polytechnique Fédérale de Lausanne (EPFL Valais), Sion 1951, Switzerland
- Clinical Neuroscience, University of Geneva Medical School, 1202 Geneva, Switzerland
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4
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Rodionov A, Ozdemir RA, Benwell CSY, Fried PJ, Boucher P, Momi D, Ross JM, Santarnecchi E, Pascual-Leone A, Shafi MM. Reliability of resting-state EEG modulation by continuous and intermittent theta burst stimulation of the primary motor cortex: a sham-controlled study. Sci Rep 2023; 13:18898. [PMID: 37919322 PMCID: PMC10622440 DOI: 10.1038/s41598-023-45512-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/20/2023] [Indexed: 11/04/2023] Open
Abstract
Theta burst stimulation (TBS) is a form of repetitive transcranial magnetic stimulation designed to induce changes of cortical excitability that outlast the period of TBS application. In this study, we explored the effects of continuous TBS (cTBS) and intermittent TBS (iTBS) versus sham TBS stimulation, applied to the left primary motor cortex, on modulation of resting state electroencephalography (rsEEG) power. We first conducted hypothesis-driven region-of-interest (ROI) analyses examining changes in alpha (8-12 Hz) and beta (13-21 Hz) bands over the left and right motor cortex. Additionally, we performed data-driven whole-brain analyses across a wide range of frequencies (1-50 Hz) and all electrodes. Finally, we assessed the reliability of TBS effects across two sessions approximately 1 month apart. None of the protocols produced significant group-level effects in the ROI. Whole-brain analysis revealed that cTBS significantly enhanced relative power between 19 and 43 Hz over multiple sites in both hemispheres. However, these results were not reliable across visits. There were no significant differences between EEG modulation by active and sham TBS protocols. Between-visit reliability of TBS-induced neuromodulatory effects was generally low-to-moderate. We discuss confounding factors and potential approaches for improving the reliability of TBS-induced rsEEG modulation.
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Affiliation(s)
- Andrei Rodionov
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Recep A Ozdemir
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Christopher S Y Benwell
- Division of Psychology, School of Humanities, Social Sciences and Law, University of Dundee, Dundee, UK
| | - Peter J Fried
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Pierre Boucher
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Davide Momi
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, Canada
| | - Jessica M Ross
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Research, Education, and Clinical Center, Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford Medical School, Stanford, CA, USA
| | - Emiliano Santarnecchi
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Precision Neuroscience and Neuromodulation Program, Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Deanna and Sidney Wolk Center for Memory Health, Hebrew Senior Life, Hinda and Arthur Marcus Institute for Aging Research, Boston, MA, USA
| | - Mouhsin M Shafi
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
- Department of Neurology, Harvard Medical School, Boston, MA, USA.
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5
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Rodionov A, Ozdemir RA, Benwell CS, Fried PJ, Boucher P, Momi D, Ross JM, Santarnecchi E, Pascual-Leone A, Shafi MM. Reliability of resting-state EEG modulation by continuous and intermittent theta burst stimulation of the primary motor cortex: A sham-controlled study. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.05.12.540024. [PMID: 37215043 PMCID: PMC10197617 DOI: 10.1101/2023.05.12.540024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Theta burst stimulation (TBS) is a form of repetitive transcranial magnetic stimulation designed to induce changes of cortical excitability that outlast the period of TBS application. In this study, we explored the effects of continuous TBS (cTBS) and intermittent TBS (iTBS) versus sham TBS stimulation, applied to the primary motor cortex, on modulation of resting state electroencephalography (rsEEG) power. We first conducted hypothesis-driven region-of-interest (ROI) analyses examining changes in alpha (8-12 Hz) and beta (13-21 Hz) bands over the left and right motor cortex. Additionally, we performed data-driven whole-brain analyses across a wide range of frequencies (1-50 Hz) and all electrodes. Finally, we assessed the reliability of TBS effects across two sessions approximately 1 month apart. None of the protocols produced significant group-level effects in the ROI. Whole-brain analysis revealed that cTBS significantly enhanced relative power between 19-43 Hz over multiple sites in both hemispheres. However, these results were not reliable across visits. There were no significant differences between EEG modulation by active and sham TBS protocols. Between-visit reliability of TBS-induced neuromodulatory effects was generally low-to-moderate. We discuss confounding factors and potential approaches for improving the reliability of TBS-induced rsEEG modulation.
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Affiliation(s)
- Andrei Rodionov
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Recep A. Ozdemir
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Christopher S.Y. Benwell
- Division of Psychology, School of Humanities, Social Sciences and Law, University of Dundee, Dundee, UK
| | - Peter J. Fried
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Pierre Boucher
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Davide Momi
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Krembil Centre for Neuroinformatics, Centre for Addiction & Mental Health, Toronto
| | - Jessica M. Ross
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center, Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford Medical School, Stanford, CA, USA
| | - Emiliano Santarnecchi
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Precision Neuroscience & Neuromodulation Program, Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Hinda and Arthur Marcus Institute for Aging Research, Deanna and Sidney Wolk Center for Memory Health, Hebrew Senior Life, Boston, MA, USA
| | - Mouhsin M. Shafi
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
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Accelerated intermittent theta burst stimulation in smoking cessation: No differences between active and placebo stimulation when using advanced placebo coil technology. A double-blind follow-up study. Int J Clin Health Psychol 2023; 23:100351. [PMID: 36415606 PMCID: PMC9663325 DOI: 10.1016/j.ijchp.2022.100351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/02/2022] [Indexed: 11/13/2022] Open
Abstract
Objective This study aims to investigate the longer-term effects of accelerated intermittent theta burst stimulation (aiTBS) in smoking cessation and to examine whether there is a difference in outcome between active and placebo stimulation. The present study constitutes an ancillary study from a main Randomized Controlled Trial (RCT) evaluating the acute effects of aiTBS in smoking reduction. Method A double-blind randomized control trial was conducted where 89 participants were randomly allocated to three groups (transcranial magnetic stimulation (TMS)&N group: active aiTBS stimulation combined with neutral videos; TMS&S group: active aiTBS stimulation combined with smoking-related videos; Placebo group: placebo stimulation combined with smoking-related videos). Nicotine dependence, tobacco craving, perceived stress and motivation to quit smoking were measured after completion of 20 aiTBS sessions and during various follow ups (post one week, post one month and post six months). Results Our results show that the positive effect on nicotine dependence and tobacco craving that occurred at the end of treatment lasts at least one month post treatment. This effect seems to dissipate six months post treatment. No significant differences were found between the three groups. Conclusion Both active and placebo stimulation were equally effective in reducing nicotine dependence and tobacco craving up to one month after the end of treatment.
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Bigoni C, Cadic-Melchior A, Morishita T, Hummel FC. Optimization of phase prediction for brain-state dependent stimulation: a grid-search approach. J Neural Eng 2023; 20. [PMID: 36626830 DOI: 10.1088/1741-2552/acb1d8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 01/10/2023] [Indexed: 01/11/2023]
Abstract
Objective.Sources of heterogeneity in non-invasive brain stimulation literature can be numerous, with underlying brain states and protocol differences at the top of the list. Yet, incoherent results from brain-state-dependent stimulation experiments suggest that there are further factors adding to the variance. Hypothesizing that different signal processing pipelines might be partly responsible for heterogeneity; we investigated their effects on brain-state forecasting approaches.Approach.A grid-search was used to determine the fastest and most-accurate combination of preprocessing parameters and phase-forecasting algorithms. The grid-search was applied on a synthetic dataset and validated on electroencephalographic (EEG) data from a healthy (n= 18) and stroke (n= 31) cohort.Main results.Differences in processing pipelines led to different results; the grid-search chosen pipelines significantly increased the accuracy of published forecasting methods. The accuracy achieved in healthy was comparably high in stroke patients.Significance.This systematic offline analysis highlights the importance of the specific EEG processing and forecasting pipelines used for online state-dependent setups where precision in phase prediction is critical. Moreover, successful results in the stroke cohort pave the way to test state-dependent interventional treatment approaches.
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Affiliation(s)
- Claudia Bigoni
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland.,Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne (EPFL Valais), Clinique Romande de Réadaptation, 1951 Sion, Switzerland
| | - Andéol Cadic-Melchior
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland.,Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne (EPFL Valais), Clinique Romande de Réadaptation, 1951 Sion, Switzerland
| | - Takuya Morishita
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland.,Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne (EPFL Valais), Clinique Romande de Réadaptation, 1951 Sion, Switzerland
| | - Friedhelm C Hummel
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland.,Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Ecole Polytechnique Fédérale de Lausanne (EPFL Valais), Clinique Romande de Réadaptation, 1951 Sion, Switzerland.,Clinical Neuroscience, University of Geneva Medical School, 1202 Geneva, Switzerland
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8
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Ozdemir RA, Kirkman S, Magnuson JR, Fried PJ, Pascual-Leone A, Shafi MM. Phase matters when there is power: Phasic modulation of corticospinal excitability occurs at high amplitude sensorimotor mu-oscillations. NEUROIMAGE. REPORTS 2022; 2:100132. [PMID: 36570046 PMCID: PMC9784422 DOI: 10.1016/j.ynirp.2022.100132] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Prior studies have suggested that oscillatory activity in cortical networks can modulate stimulus-evoked responses through time-varying fluctuations in neural excitation-inhibition dynamics. Studies combining transcranial magnetic stimulation (TMS) with electromyography (EMG) and electroencephalography (EEG) can provide direct measurements to examine how instantaneous fluctuations in cortical oscillations contribute to variability in TMS-induced corticospinal responses. However, the results of these studies have been conflicting, as some reports showed consistent phase effects of sensorimotor mu-rhythms with increased excitability at the negative mu peaks, while others failed to replicate these findings or reported unspecific mu-phase effects across subjects. Given the lack of consistent results, we systematically examined the modulatory effects of instantaneous and pre-stimulus sensorimotor mu-rhythms on corticospinal responses with offline EEG-based motor evoked potential (MEP) classification analyses across five identical visits. Instantaneous sensorimotor mu-phase or pre-stimulus mu-power alone did not significantly modulate MEP responses. Instantaneous mu-power analyses showed weak effects with larger MEPs during high-power trials at the overall group level analyses, but this trend was not reproducible across visits. However, TMS delivered at the negative peak of high magnitude mu-oscillations generated the largest MEPs across all visits, with significant differences compared to other peak-phase combinations. High power effects on MEPs were only observed at the trough phase of ongoing mu oscillations originating from the stimulated region, indicating site and phase specificity, respectively. More importantly, such phase-dependent power effects on corticospinal excitability were reproducible across multiple visits. We provide further evidence that fluctuations in corticospinal excitability indexed by MEP amplitudes are partially driven by dynamic interactions between the magnitude and the phase of ongoing sensorimotor mu oscillations at the time of TMS, and suggest promising insights for (re)designing neuromodulatory TMS protocols targeted to specific cortical oscillatory states.
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Affiliation(s)
- Recep A. Ozdemir
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA,Department of Neurology, Harvard Medical School, Boston, MA, USA,Corresponding author. Mouhsin Shafi Berenson-Allen Center for Non-Invasive Brain Stimulation, Beth Israel Medical Center, Harvard Medical School, Boston, MA, USA. (R.A. Ozdemir)
| | - Sofia Kirkman
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Justine R. Magnuson
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA,Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Peter J. Fried
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA,Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Department of Neurology, Harvard Medical School, Boston, MA, USA,Hinda and Arthur Marcus Institute for Aging Research and Deanne and Sidney Wolk Center for Memory Health, Hebrew Senior Life, Boston, MA, USA,Guttmann Brain Health Institute, Institut Guttmann de Neurorehabilitació, Universitat Autonoma de Barcelona, Badalona, Spain
| | - Mouhsin M. Shafi
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA,Department of Neurology, Harvard Medical School, Boston, MA, USA,Corresponding author. Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA. (M.M. Shafi)
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9
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Gassmann L, Gordon PC, Ziemann U. Assessing effective connectivity of the cerebellum with cerebral cortex using TMS-EEG. Brain Stimul 2022; 15:1354-1369. [PMID: 36180039 DOI: 10.1016/j.brs.2022.09.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/25/2022] [Accepted: 09/25/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The cerebellum provides important input to the cerebral cortex but its assessment is difficult. Cerebellar brain inhibition tested by paired-coil transcranial magnetic stimulation (TMS) is limited to the motor cortex. Here we sought to measure responses to cerebellar TMS (cbTMS) throughout the cerebral cortex using electroencephalography (EEG). METHODS Single-pulse TMS was applied with an induced upward current to the right cerebellar hemisphere in 46 healthy volunteers while recording EEG. Multiple control conditions, including TMS of right occipital cortex, cbTMS with induced downward current, and a sham condition modified specifically for cbTMS were tested to provide evidence for the specificity of the EEG responses evoked by cbTMS with an upward induced current. RESULTS Distinct EEG response components could be specifically attributed to cbTMS, namely a left-hemispheric prefrontal positive deflection 25 ms after cbTMS, and a subsequent left-hemispheric parietal negative deflection peaking at 45 ms. In the time-frequency-response analysis, cbTMS induced a left-hemispheric prefrontal power increase in the high-beta frequency band. These responses were not seen in the control and sham conditions. CONCLUSIONS The EEG responses observed in this highly controlled experimental design may cautiously be attributed to reflect specific signatures of the activation of the cerebello-dentato-thalamo-cortical pathway by cbTMS. Therefore, these responses may provide biomarkers for assessing the integrity of this pathway, a proposition that will need further testing in clinical populations.
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Affiliation(s)
- Lukas Gassmann
- Department of Neurology & Stroke, University of Tübingen, Germany; Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
| | - Pedro Caldana Gordon
- Department of Neurology & Stroke, University of Tübingen, Germany; Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
| | - Ulf Ziemann
- Department of Neurology & Stroke, University of Tübingen, Germany; Hertie Institute for Clinical Brain Research, University of Tübingen, Germany.
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10
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van den Bos MAJ, Menon P, Vucic S. Cortical hyperexcitability and plasticity in Alzheimer's disease: developments in understanding and management. Expert Rev Neurother 2022; 22:981-993. [PMID: 36683586 DOI: 10.1080/14737175.2022.2170784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Transcranial magnetic stimulation (TMS) is a non-invasive neurophysiological tool that provides important insights into Alzheimer's Disease (AD). A significant body of work utilizing TMS techniques has explored the pathophysiological relevance of cortical hyperexcitability and plasticity in AD and their modulation in novel therapies. AREAS COVERED This review examines the technique of TMS, the use of TMS to examine specific features of cortical excitability and the use of TMS techniques to modulate cortical function. A search was performed utilizing the PubMed database to identify key studies utilizing TMS to examine cortical hyperexcitability and plasticity in Alzheimer's dementia. We then translate this understanding to the study of Alzheimer's disease pathophysiology, examining the underlying neurophysiologic links contributing to these twin signatures, cortical hyperexcitability and abnormal plasticity, in the cortical dysfunction characterizing AD. Finally, we examine utilization of TMS excitability to guide targeted therapies and, through the use of repetitive TMS (rTMS), modulate cortical plasticity. EXPERT OPINION The examination of cortical hyperexcitability and plasticity with TMS has potential to optimize and expand the window of therapeutic interventions in AD, though remains at relatively early stage of development.
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Affiliation(s)
- Mehdi A J van den Bos
- Brain and Nerve Research Centre, Concord Repatriation General Hospital, Sydney, Australia
| | - Parvathi Menon
- Brain and Nerve Research Centre, Concord Repatriation General Hospital, Sydney, Australia
| | - Steve Vucic
- Brain and Nerve Research Centre, Concord Repatriation General Hospital, Sydney, Australia
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11
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Iwata GZ, Hu Y, Wickenbrock A, Sander T, Muthuraman M, Chirumamilla VC, Groppa S, Liu Q, Budker D. Biomagnetic signals recorded during transcranial magnetic stimulation (TMS)-evoked peripheral muscular activity. BIOMED ENG-BIOMED TE 2022; 67:333-344. [PMID: 35960879 DOI: 10.1515/bmt-2021-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 07/11/2022] [Indexed: 11/15/2022]
Abstract
Transcranial magnetic stimulation (TMS) has widespread clinical applications from diagnosis to treatment. We combined TMS with non-contact magnetic detection of TMS-evoked muscle activity in peripheral limbs to explore a new diagnostic modality that enhances the utility of TMS as a clinical tool by leveraging technological advances in magnetometry. We recorded measurements in a regular hospital room using an array of optically pumped magnetometers (OPMs) inside a portable shield that encloses only the forearm and hand of the subject. We present magnetomyograms (MMG)s of TMS-evoked movement in a human hand, together with a simultaneous surface electromyograph (EMG) data. The biomagnetic signals recorded in the MMG provides detailed spatial and temporal information that is complementary to that of the electric signal channels. Moreover, we identify features in the magnetic recording beyond that of the EMG. This system demonstrates the value of biomagnetic signals in TMS-based clinical approaches and widens its availability and practical potential.
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Affiliation(s)
- Geoffrey Z Iwata
- Johannes Gutenberg-Universität Mainz, Mainz, Germany.,Helmholtz-Institut Mainz, GSI Helmholtzzentrum für Schwerionenforschung Mainz, Germany
| | - Yinan Hu
- Johannes Gutenberg-Universität Mainz, Mainz, Germany.,Helmholtz-Institut Mainz, GSI Helmholtzzentrum für Schwerionenforschung Mainz, Germany
| | - Arne Wickenbrock
- Johannes Gutenberg-Universität Mainz, Mainz, Germany.,Helmholtz-Institut Mainz, GSI Helmholtzzentrum für Schwerionenforschung Mainz, Germany
| | | | - Muthuraman Muthuraman
- Department of Neurology, Biomedical Statistics and Multimodal Signal Processing Unit, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Venkata Chaitanya Chirumamilla
- Department of Neurology, Biomedical Statistics and Multimodal Signal Processing Unit, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Sergiu Groppa
- Department of Neurology, Biomedical Statistics and Multimodal Signal Processing Unit, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Qishan Liu
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - Dmitry Budker
- Johannes Gutenberg-Universität Mainz, Mainz, Germany.,Helmholtz-Institut Mainz, GSI Helmholtzzentrum für Schwerionenforschung Mainz, Germany.,Department of Physics, University of California, Berkeley, CA, USA
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12
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The phase of sensorimotor mu and beta oscillations has the opposite effect on corticospinal excitability. Brain Stimul 2022; 15:1093-1100. [PMID: 35964870 DOI: 10.1016/j.brs.2022.08.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 08/05/2022] [Accepted: 08/06/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Neural oscillations in the primary motor cortex (M1) shape corticospinal excitability. Power and phase of ongoing mu (8-13 Hz) and beta (14-30 Hz) activity may mediate motor cortical output. However, the functional dynamics of both mu and beta phase and power relationships and their interaction, are largely unknown. OBJECTIVE Here, we employ recently developed real-time targeting of the mu and beta rhythm, to apply phase-specific brain stimulation and probe motor corticospinal excitability non-invasively. For this, we used instantaneous read-out and analysis of ongoing oscillations, targeting four different phases (0°, 90°, 180°, and 270°) of mu and beta rhythms with suprathreshold single-pulse transcranial magnetic stimulation (TMS) to M1. Ensuing motor evoked potentials (MEPs) in the right first dorsal interossei muscle were recorded. Twenty healthy adults took part in this double-blind randomized crossover study. RESULTS Mixed model regression analyses showed significant phase-dependent modulation of corticospinal output by both mu and beta rhythm. Strikingly, these modulations exhibit a double dissociation. MEPs are larger at the mu trough and rising phase and smaller at the peak and falling phase. For the beta rhythm we found the opposite behavior. Also, mu power, but not beta power, was positively correlated with corticospinal output. Power and phase effects did not interact for either rhythm, suggesting independence between these aspects of oscillations. CONCLUSION Our results provide insights into real-time motor cortical oscillation dynamics, which offers the opportunity to improve the effectiveness of TMS by specifically targeting different frequency bands.
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13
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Zhang M, Frohlich F. Cell type-specific excitability probed by optogenetic stimulation depends on the phase of the alpha oscillation. Brain Stimul 2022; 15:472-482. [PMID: 35219922 PMCID: PMC8975618 DOI: 10.1016/j.brs.2022.02.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/30/2022] [Accepted: 02/21/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Alpha oscillations have been proposed to provide phasic inhibition in the brain. Yet, pinging alpha oscillations with transcranial magnetic stimulation (TMS) to examine phase-dependent network excitability has resulted in conflicting findings. At the cellular level, such gating by the alpha oscillation remains poorly understood. OBJECTIVE We examine how the excitability of pyramidal cells and presumed fast-spiking inhibitory interneurons depends on the phase of the alpha oscillation. METHODS Optogenetic stimulation pulses were administered at random phases of the alpha oscillation in the posterior parietal cortex (PPC) of two adult ferrets that expressed channelrhodopsin in pyramidal cells. Post-stimulation firing probability was calculated as a function of the stimulation phase of the alpha oscillation for both verum and sham stimulation. RESULTS The excitability of pyramidal cells depended on the alpha phase, in anticorrelation with their intrinsic phase preference; pyramidal cells were more responsive to optogenetic stimulation at the alpha phase with intrinsically low firing rates. In contrast, presumed fast-spiking inhibitory interneurons did not show such a phase dependency despite their stronger intrinsic phase preference. CONCLUSIONS Alpha oscillations gate input to PPC in a phase-dependent manner such that low intrinsic activity was associated with higher responsiveness to input. This finding supports a model of cortical oscillation, in which internal processing and communication are limited to the depolarized half-cycle, whereas the other half-cycle serves as a signal detector for unexpected input. The functional role of different parts of the alpha cycle may vary across the cortex depending on local neuronal firing properties.
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Affiliation(s)
- Mengsen Zhang
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA; Carolina Center for Neurostimulation, University of North Carolina, Chapel Hill, NC, USA; Neuroscience Center, University of North Carolina, Chapel Hill, NC, USA; Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC, USA; Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, USA; Department of Neurology, University of North Carolina, Chapel Hill, NC, USA.
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14
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Janssens SEW, Sack AT. Spontaneous Fluctuations in Oscillatory Brain State Cause Differences in Transcranial Magnetic Stimulation Effects Within and Between Individuals. Front Hum Neurosci 2021; 15:802244. [PMID: 34924982 PMCID: PMC8674306 DOI: 10.3389/fnhum.2021.802244] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 11/16/2021] [Indexed: 01/01/2023] Open
Abstract
Transcranial magnetic stimulation (TMS) can cause measurable effects on neural activity and behavioral performance in healthy volunteers. In addition, TMS is increasingly used in clinical practice for treating various neuropsychiatric disorders. Unfortunately, TMS-induced effects show large intra- and inter-subject variability, hindering its reliability, and efficacy. One possible source of this variability may be the spontaneous fluctuations of neuronal oscillations. We present recent studies using multimodal TMS including TMS-EMG (electromyography), TMS-tACS (transcranial alternating current stimulation), and concurrent TMS-EEG-fMRI (electroencephalography, functional magnetic resonance imaging), to evaluate how individual oscillatory brain state affects TMS signal propagation within targeted networks. We demonstrate how the spontaneous oscillatory state at the time of TMS influences both immediate and longer-lasting TMS effects. These findings indicate that at least part of the variability in TMS efficacy may be attributable to the current practice of ignoring (spontaneous) oscillatory fluctuations during TMS. Ignoring this state-dependent spread of activity may cause great individual variability which so far is poorly understood and has proven impossible to control. We therefore also compare two technical solutions to directly account for oscillatory state during TMS, namely, to use (a) tACS to externally control these oscillatory states and then apply TMS at the optimal (controlled) brain state, or (b) oscillatory state-triggered TMS (closed-loop TMS). The described multimodal TMS approaches are paramount for establishing more robust TMS effects, and to allow enhanced control over the individual outcome of TMS interventions aimed at modulating information flow in the brain to achieve desirable changes in cognition, mood, and behavior.
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Affiliation(s)
- Shanice E. W. Janssens
- Section Brain Stimulation and Cognition, Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
- Maastricht Brain Imaging Centre (MBIC), Maastricht, Netherlands
| | - Alexander T. Sack
- Section Brain Stimulation and Cognition, Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
- Maastricht Brain Imaging Centre (MBIC), Maastricht, Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Brain + Nerve Centre, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
- Centre for Integrative Neuroscience (CIN), Maastricht University, Maastricht, Netherlands
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