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After the embargo period via non-commercial hosting platforms such as their institutional repository via commercial sites with which Elsevier has an agreement In all cases accepted manuscripts should: link to the formal publication via its DOI bear a CC-BY-NC-ND license -this is easy to do, click here to find out how if aggregated with other manuscripts, for example in a repository or other site, be shared in alignment with our hosting policy not be added to or enhanced in any way to appear more like, or to substitute for, the published journal article This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.Page 1 Page 2 Investigating TMS-EEG indices of long-interval intracortical inhibition at different interstimulus intervals Highlights TMS-evoked EEG potentials were reduced after long-interval intracortical inhibition (LICI) with interstimulus intervals (ISIs) of 100 ms and 150 ms Inhibition of P30 was observed following LICI at 100 ms, but was absent following LICI at 150 ms Topographical analyses suggested that global inhibition of P30, N40 and P180, but not N100, differed between ISIs Our findings suggest that LICI at different ISIs likely has complex contributions from common mechanisms AbstractBackground: Long-interval intracortical inhibition (LICI) is a transcranial magnetic
After the embargo period via non-commercial hosting platforms such as their institutional repository via commercial sites with which Elsevier has an agreement In all cases accepted manuscripts should: link to the formal publication via its DOI bear a CC-BY-NC-ND license -this is easy to do, click here to find out how if aggregated with other manuscripts, for example in a repository or other site, be shared in alignment with our hosting policy not be added to or enhanced in any way to appear more like, or to substitute for, the published journal article This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.Page 1 Page 2 Investigating TMS-EEG indices of long-interval intracortical inhibition at different interstimulus intervals Highlights TMS-evoked EEG potentials were reduced after long-interval intracortical inhibition (LICI) with interstimulus intervals (ISIs) of 100 ms and 150 ms Inhibition of P30 was observed following LICI at 100 ms, but was absent following LICI at 150 ms Topographical analyses suggested that global inhibition of P30, N40 and P180, but not N100, differed between ISIs Our findings suggest that LICI at different ISIs likely has complex contributions from common mechanisms AbstractBackground: Long-interval intracortical inhibition (LICI) is a transcranial magnetic
IMPORTANCE Magnetic seizure therapy (MST) is a novel therapeutic option for treatment-resistant depression (TRD). Suicidal ideation is often associated with TRD and contributes to the increased mortality and morbidity of the disorder. OBJECTIVE To identify a biomarker that may serve as an indicator of remission of suicidal ideation following a course of MST by using cortical inhibition measures from interleaved transcranial magnetic stimulation and electroencephalography (TMS-EEG). DESIGN, SETTING, AND PARTICIPANTS Thirty-three patients with TRD were part of an open-label clinical trial of MST treatment. Data from 27 patients (82%) were available for analysis in this study. Baseline TMS-EEG measures were assessed within 1 week before the initiation of MST treatment using the TMS-EEG measures of cortical inhibition (ie, N100 and long-interval cortical inhibition [LICI]) from the left dorsolateral prefrontal cortex and the left motor cortex, with the latter acting as a control site. INTERVENTIONS The MST treatments were administered under general anesthesia, and a stimulator coil consisting of 2 individual cone-shaped coils was used. MAIN OUTCOMES AND MEASURES Suicidal ideation was evaluated before initiation and after completion of MST using the Scale for Suicide Ideation (SSI). Measures of cortical inhibition (ie, N100 and LICI) from the left dorsolateral prefrontal cortex were selected. N100 was quantified as the amplitude of the negative peak around 100 milliseconds in the TMS-evoked potential (TEP) after a single TMS pulse. LICI was quantified as the amount of suppression in the double-pulse TEP relative to the single-pulse TEP. RESULTS Of the 27 patients included in the analyses, 15 (56%) were women; mean (SD) age of the sample was 46.0 (15.3) years. At baseline, patients had a mean SSI score of 9.0 (6.8), with 8 of 27 patients (30%) having a score of 0. After completion of MST, patients had a mean SSI score of 4.2 (6.3) (pre-post treatment mean difference, 4.8 [6.7]; paired t 26 = 3.72; P = .001), and 18 of 27 individuals (67%) had a score of 0 for a remission rate of 53%. The N100 and LICI in the frontal cortex-but not in the motor cortex-were indicators of remission of suicidal ideation with 89% accuracy, 90% sensitivity, and 89% specificity (area under the curve, 0.90; P = .003). CONCLUSIONS AND RELEVANCE These results suggest that cortical inhibition may be used to identify patients with TRD who are most likely to experience remission of suicidal ideation following a course of MST. Stronger inhibitory neurotransmission at baseline may reflect the integrity of transsynaptic networks that are targeted by MST for optimal therapeutic response.
Objective Neuronal excitation/inhibition (E/I) imbalance is a potential cause of neuronal network malfunctioning in Alzheimer's disease (AD), contributing to cognitive dysfunction. Here, we used a novel approach combining transcranial magnetic stimulation (TMS) and electroencephalography (EEG) to probe cortical excitability in different brain areas known to be directly involved in AD pathology. Methods We performed TMS‐EEG recordings targeting the left dorsolateral prefrontal cortex (l‐DLPFC), the left posterior parietal cortex (l‐PPC), and the precuneus (PC) in a large sample of patients with mild‐to‐moderate AD (n = 65) that were compared with a group of age‐matched healthy controls (n = 21). Results We found that patients with AD are characterized by a regional cortical hyperexcitability in the PC and, to some extent, in the frontal lobe, as measured by TMS‐evoked potentials. Notably, cortical excitability assessed over the l‐PPC was comparable between the 2 groups. Furthermore, we found that the individual level of PC excitability was associated with the level of cognitive impairment, as measured with Mini‐Mental State Examination, and with corticospinal fluid levels of Aβ42. Interpretation Our data provide novel evidence that precuneus cortical hyperexcitability is a key feature of synaptic dysfunction in patients with AD. The current results point to the combined approach of TMS and EEG as a novel promising technique to measure hyperexcitability in patients with AD. This index could represent a useful biomarker to stage disease severity and evaluate response to novel therapies. ANN NEUROL 2023;93:371–383
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