Reproducibility of cortical response modulation induced by intermittent and continuous theta-burst stimulation of the human motor cortex
Ozdemir, Recep A. (Department of Neurology, Harvard Medical School)
Boucher, Pierre (Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA)
Fried, Peter J. (Department of Neurology, Harvard Medical School)
Momi, Davide (Department of Neurology, Harvard Medical School)
Jannati, Ali (Boston Children's Hospital (Boston, Estats Units d'Amèrica))
Pascual Leone, Álvaro (Institut Germans Trias i Pujol. Institut Guttmann)
Santarnecchi, Emiliano (Department of Medicine, Surgery and Neuroscience, University of Siena, Italy)
Shafi, Mouhsin M. (Department of Neurology, Harvard Medical School)

Fecha:	2021
Resumen:	Over the past decade, the number of experimental and clinical studies using theta-burststimulation (TBS) protocols of transcranial magnetic stimulation (TMS) to modulate brain activity has risen substantially. The use of TBS is motivated by the assumption that these protocols can reliably and lastingly modulate cortical excitability despite their short duration and low number of stimuli. However, this assumption, and thus the experimental validity of studies using TBS, is challenged by recent work showing large inter- and intra-subject variability in response to TBS protocols. To date, the reproducibility of TBS effects in humans has been exclusively assessed with motor evoked potentials (MEPs), which provide an indirect and limited measure of cortical excitability. Here we combined TMS with electroencephalography (TMS-EEG) and report the first comprehensive investigation of (1) direct TMS-evoked cortical responses to intermittent (iTBS) and continuous TBS (cTBS) of the human motor cortex, and (2) reproducibility of both iTBS- and cTBS-induced cortical response modulation against a robust sham control across repeat visits with commonly used cortical responsivity metrics. We show that although single pulse TMS generates stable and reproducible cortical responses across visits, the modulatory effects of TBS vary substantially both between and within individuals. Overall, at the group level, most measures of the iTBS and cTBS-induced effects were not significantly different from sham-TBS. Most importantly, none of the significant TBS-induced effects observed in visit1 were reproduced in visit-2. Our findings suggest that the generally accepted mechanisms of TBS-induced neuromodulation, i. e. through changes in cortical excitability, may not be accurate. Future research is needed to determine the mechanisms underlying the established therapeutic effects of TBS in neuropsychiatry and examine reproducibility of TBS-induced neuromodulation through oscillatory response dynamics.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	TMS-EEG ; Theta burst stimulation ; Transcranial evoked potentials (TEPs) ; Reliability
Publicado en:	Brain stimulation, Vol. 14 (june 2021) , p. 949-964, ISSN 1876-4754

DOI: 10.1016/j.brs.2021.05.013
PMID: 34126233

33 p, 5.8 MB

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Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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