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Schoisswohl S, Kanig C, Osnabruegge M, Agboada D, Langguth B, Rethwilm R, Hebel T, Abdelnaim MA, Mack W, Seiberl W, Kuder M, Schecklmann M. Monitoring Changes in TMS-Evoked EEG and EMG Activity During 1 Hz rTMS of the Healthy Motor Cortex. eNeuro 2024; 11:ENEURO.0309-23.2024. [PMID: 38565296 PMCID: PMC11015949 DOI: 10.1523/eneuro.0309-23.2024] [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: 08/18/2023] [Revised: 12/13/2023] [Accepted: 01/08/2024] [Indexed: 04/04/2024] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique capable of inducing neuroplasticity as measured by changes in peripheral muscle electromyography (EMG) or electroencephalography (EEG) from pre-to-post stimulation. However, temporal courses of neuromodulation during ongoing rTMS are unclear. Monitoring cortical dynamics via TMS-evoked responses using EMG (motor-evoked potentials; MEPs) and EEG (transcranial-evoked potentials; TEPs) during rTMS might provide further essential insights into its mode of action - temporal course of potential modulations. The objective of this study was to first evaluate the validity of online rTMS-EEG and rTMS-EMG analyses, and second to scrutinize the temporal changes of TEPs and MEPs during rTMS. As rTMS is subject to high inter-individual effect variability, we aimed for single-subject analyses of EEG changes during rTMS. Ten healthy human participants were stimulated with 1,000 pulses of 1 Hz rTMS over the motor cortex, while EEG and EMG were recorded continuously. Validity of MEPs and TEPs measured during rTMS was assessed in sensor and source space. Electrophysiological changes during rTMS were evaluated with model fitting approaches on a group- and single-subject level. TEPs and MEPs appearance during rTMS was consistent with past findings of single pulse experiments. Heterogeneous temporal progressions, fluctuations or saturation effects of brain activity were observed during rTMS depending on the TEP component. Overall, global brain activity increased over the course of stimulation. Single-subject analysis revealed inter-individual temporal courses of global brain activity. The present findings are in favor of dose-response considerations and attempts in personalization of rTMS protocols.
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Affiliation(s)
- Stefan Schoisswohl
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
- Department of Human Sciences, Institute of Psychology, Universität der Bundeswehr München, 85579 Neubiberg, Germany
| | - Carolina Kanig
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
- Department of Human Sciences, Institute of Psychology, Universität der Bundeswehr München, 85579 Neubiberg, Germany
| | - Mirja Osnabruegge
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
- Department of Human Sciences, Institute of Psychology, Universität der Bundeswehr München, 85579 Neubiberg, Germany
| | - Desmond Agboada
- Department of Human Sciences, Institute of Psychology, Universität der Bundeswehr München, 85579 Neubiberg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
| | - Roman Rethwilm
- Department of Human Sciences, Institute of Sport Science, Universität der Bundeswehr München, 85579 Neubiberg, Germany
| | - Tobias Hebel
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
| | - Mohamed A Abdelnaim
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
| | - Wolfgang Mack
- Department of Human Sciences, Institute of Psychology, Universität der Bundeswehr München, 85579 Neubiberg, Germany
| | - Wolfgang Seiberl
- Department of Human Sciences, Institute of Sport Science, Universität der Bundeswehr München, 85579 Neubiberg, Germany
| | - Manuel Kuder
- Department of Electrical Engineering, Universität der Bundeswehr München, 85579 Neubiberg, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
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Schmidgen J, Konrad K, Roessner V, Bender S. The external evocation and movement-related modulation of motor cortex inhibition in children and adolescents with Tourette syndrome - a TMS/EEG study. Front Neurosci 2023; 17:1209801. [PMID: 37928740 PMCID: PMC10620315 DOI: 10.3389/fnins.2023.1209801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 09/26/2023] [Indexed: 11/07/2023] Open
Abstract
Objective This study tested the reactivity of motor cortex inhibition to different intensities of external stimulation by transcranial magnetic stimulation (TMS) and its internal modulation during different motor states in children and adolescents with Tourette syndrome. Methods TMS-evoked N100 served as an indirect measure of GABAB receptor function which is related to cortical inhibition. Combined TMS/EEG was used to analyze the TMS-evoked N100 component evoked by different stimulation intensities as well as during resting condition, movement preparation (contingent negative variation task) and movement execution. The study included 18 early adolescents with Tourette syndrome and 15 typically developing control subjects. Results TMS-evoked N100 showed a less steep increase with increasing TMS intensity in Tourette syndrome together with less modulation (disinhibition) over the primary motor cortex during the motor states movement preparation and movement execution. Children with Tourette syndrome showed equally high N100 amplitudes at 110% resting motor threshold (RMT) intensity during resting condition and a parallel decline of RMT and N100 amplitude with increasing age as control subjects. Conclusion Our study yields preliminary evidence that modulation of motor cortical inhibitory circuits, during external direct stimulation by different TMS intensities and during volitional movement preparation and execution is different in children and adolescents with Tourette syndrome compared to controls. These results suggest that a reduced resting motor cortical inhibitory "reserve" could contribute to the production of unwanted movements. Our findings are compatible with increased regulation of motor cortex excitability by perception-action binding in Tourette syndrome instead of top-down / motor regulation and need to be replicated in further studies.
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Affiliation(s)
- Julia Schmidgen
- Department of Child and Adolescent Psychiatry, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany
| | - Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, RWTH Aachen, Aachen, Germany
- JARA-BRAIN Institute II, Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Jülich, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Custav Carus, TU, Dresden, Germany
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany
- Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Custav Carus, TU, Dresden, Germany
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Changes in the TMS-evoked potential N100 in the dorsolateral prefrontal cortex as a function of depression severity in adolescents. J Neural Transm (Vienna) 2022; 129:1339-1352. [PMID: 36029418 PMCID: PMC9550695 DOI: 10.1007/s00702-022-02539-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/12/2022] [Indexed: 12/03/2022]
Abstract
Studies using transcranial magnetic stimulation with simultaneous electroencephalography (TMS-EEG) revealed an imbalance between cortical excitation and inhibition (E/I) in the dorsolateral prefrontal cortex (DLPFC) in depression. As adolescence is a developmental period with an increase in depression prevalence and profound neural changes, it is crucial to study the relationship between depression and cortical excitability in adolescence. We aimed to investigate the cortical excitability of the DLPFC in adolescents with depression and a dependency of the TMS-evoked potential N100 on the depression severity. 36 clinical patients (12–18 years of age; 21 females) with a major depressive episode were assessed twice in a longitudinal design: shortly after admission (T0) and after six weeks of intervention (T1). GABA-B-mediated cortical inhibition in the left and right DLPFC, as assessed by the N100, was recorded with EEG. Significantly higher depression scores were reported at T0 compared to T1 (p < 0.001). N100 amplitudes were significantly increased (i.e., more negative) at T0 compared to T1 (p = 0.03). No significant hemispheric difference was found in the N100 component. The correlation between the difference in depression severity and the difference in N100 amplitudes (T0–T1) obtained during stimulation of the left DLPFC did not remain significant after correction for testing in both hemispheres. Higher N100 amplitudes during a state of greater depression severity are suggestive of an E/I imbalance in the DLPFC in adolescents with an acute depressive episode. The N100 reduction potentially reflects a normalization of DLPFC over inhibition in association with decreased depressive symptomatology, indicating severity dependency.
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