Effects of online repetitive transcranial magnetic stimulation (rTMS) on cognitive processing: A meta-analysis and recommendations for future studies

Beynel, Lysianne; Appelbaum, Lawrence G.; Luber, Bruce; Crowell, Courtney A.; Hilbig, Susan; Lim, Wesley; Nguyen, Duy; Chrapliwy, Nicolas A.; Davis, Simon W.; Cabeza, Roberto; Lisanby, Sarah H.; Deng, Zhi‐De

doi:10.1016/j.neubiorev.2019.08.018

Cited by 96 publications

(114 citation statements)

References 39 publications

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“…While the current sample of 15 individuals who completed all study activities is larger than average sample size of 11, reported in a recent meta-analysis of online TMS studies published last year (Beynel et al, 2019), future studies should continue to strive for even larger sample sizes. Figure 1.…”

Section: Future Directions and Conclusionmentioning

confidence: 88%

“…Here, single pulse TMS was applied at two latencies relative to the onset of psychometrically-calibrated, near-threshold, motion stimuli to assess the behavioral and electrophysiological changes due to TMS. It was hypothesized that stimulation would lead to greater behavioral disruption in motion direction discrimination when stimulated at the onset of the N2 component, given the critical links between this component and motion perception, and the past reports of acute perceptual disruption due to online TMS (Beynel et al, 2019). This was expected to interact with stimulus intensities such that higher intensities would induce greater behavioral effects.…”

Section: Discussionmentioning

confidence: 99%

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Dose-dependent enhancement of motion direction discrimination with transcranial magnetic stimulation of visual cortex

Gamboa

Palmer

Dannhauer

et al. 2020

Preprint

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Despite the widespread use of transcranial magnetic stimulation (TMS) in research and clinical care, the underlying mechanisms-of-actions that mediate modulatory effects remain poorly understood. To fill this gap, we studied dose-response functions of TMS for modulation of visual processing. Our approach combined electroencephalography (EEG) with application of single pulse TMS to visual cortex as participants performed a motion perception task. During participants' first visit, motion coherence thresholds, 64-channel visual evoked potentials (VEPs), and TMS resting motor thresholds (RMT) were measured. In second and third visits, single pulse TMS was delivered 30 ms before the onset of motion or at the onset latency of the N2 VEP component derived from the first session. TMS was delivered at 0%, 80%, 100%, or 120% of RMT over the site of N2 peak activity, or at 120% over vertex. Behavioral results demonstrated a significant main effect of TMS timing on accuracy, with better performance when TMS was applied at N2-Onset timing versus Pre-Onset, as well as a significant interaction, indicating that 80% intensity produced higher accuracy than other conditions. TMS effects on VEPs showed reduced amplitudes in the 80% Pre-Onset condition, an increase for the 120% N2-Onset condition, and monotonic amplitude scaling with stimulation intensity. The N2 component was not affected by TMS. These findings reveal dose-response relationships between intensity and timing of TMS on visual perception and electrophysiological brain activity, generally indicating greater facilitation at stimulation intensities below RMT.

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Section: Future Directions and Conclusionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Dose-dependent enhancement of motion direction discrimination with transcranial magnetic stimulation of visual cortex

Gamboa

Palmer

Dannhauer

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

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“…126 Targeting based on fMRI guidance has been shown to produce stronger online rTMS effects compared to other targeting strategies. 127 The use of neuronavigation systems can greatly improve the spatial precision of TMS. Furthermore, robotic coil-holder systems can provide millimeter accuracy and continuous tracking of the TMS coil.…”

Section: Convulsive Modalitiesmentioning

confidence: 99%

Precision non-implantable neuromodulation therapies: a perspective for the depressed brain

Borrione

Bellini

Razza

et al. 2020

Braz. J. Psychiatry

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Current first-line treatments for major depressive disorder (MDD) include pharmacotherapy and cognitive-behavioral therapy. However, one-third of depressed patients do not achieve remission after multiple medication trials, and psychotherapy can be costly and time-consuming. Although nonimplantable neuromodulation (NIN) techniques such as transcranial magnetic stimulation, transcranial direct current stimulation, electroconvulsive therapy, and magnetic seizure therapy are gaining momentum for treating MDD, the efficacy of non-convulsive techniques is still modest, whereas use of convulsive modalities is limited by their cognitive side effects. In this context, we propose that NIN techniques could benefit from a precision-oriented approach. In this review, we discuss the challenges and opportunities in implementing such a framework, focusing on enhancing NIN effects via a combination of individualized cognitive interventions, using closed-loop approaches, identifying multimodal biomarkers, using computer electric field modeling to guide targeting and quantify dosage, and using machine learning algorithms to integrate data collected at multiple biological levels and identify clinical responders. Though promising, this framework is currently limited, as previous studies have employed small samples and did not sufficiently explore pathophysiological mechanisms Brazilian Psychiatric Association 0 0 0 0 0 0 0 0 -0 0 0 2 -7 3 1 6 -1 1 8 5 associated with NIN response and side effects. Moreover, cost-effectiveness analyses have not been performed. Nevertheless, further advancements in clinical trials of NIN could shift the field toward a more ''precision-oriented'' practice. DisclosureZ-DD is listed as inventor on patents/patent applications related to brain stimulation technology, assigned to Columbia University and NEVA Electromagnetics, not licensed, and with no remuneration. Although he is an employee of the U.S. government, the views expressed Braz J Psychiatry. 2020;00 (00) Precision NIN for depression

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“…The problem of temporal synchronization is particularly relevant for such NIBS techniques as high-frequency rTMS (HF rTMS) or intermittent theta-burst stimulation (iTBS), where the stimuli are applied in short trains lasting several seconds separated by intertrain intervals (ITIs) [16]. The temporal pattern of DLPFC activation could influence the effects of stimulation and should be taken into consideration in the interpretation of the effects of patterned rTMS protocols on cognitive functions [32]. A combination of the Sternberg task with HF rTMS can be used to enable a relatively precise and reproducible temporal synchronization of TMS trains with ongoing cognitive activity, which is particularly valuable for investigation of WM in cognitive neuroscience: it might lead to more consistent stimulation effects and enables more accurate determination of a functional role of stimulated cortical areas in WM processes.…”

Section: Introductionmentioning

confidence: 99%

Combining HF rTMS over the Left DLPFC with Concurrent Cognitive Activity for the Offline Modulation of Working Memory in Healthy Volunteers: A Proof-of-Concept Study

et al. 2020

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It has been proposed that the effectiveness of non-invasive brain stimulation (NIBS) as a cognitive enhancement technique may be enhanced by combining the stimulation with concurrent cognitive activity. However, the benefits of such a combination in comparison to protocols without ongoing cognitive activity have not yet been studied. In the present study, we investigate the effects of fMRI-guided high-frequency repetitive transcranial magnetic stimulation (HF rTMS) over the left dorsolateral prefrontal cortex (DLPFC) on working memory (WM) in healthy volunteers, using an n-back task with spatial and verbal stimuli and a spatial span task. In two combined protocols (TMS + WM + (maintenance) and TMS + WM + (rest)) trains of stimuli were applied in the maintenance and rest periods of the modified Sternberg task, respectively. We compared them to HF rTMS without a cognitive load (TMS + WM −) and control stimulation (TMS − WM + (maintenance)). No serious adverse effects appeared in this study. Among all protocols, significant effects on WM were shown only for the TMS + WM − with oppositely directed influences of this protocol on storage and manipulation in spatial WM. Moreover, there was a significant difference between the effects of TMS + WM − and TMS + WM + (maintenance), suggesting that simultaneous cognitive activity does not necessarily lead to an increase in TMS effects.

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Effects of online repetitive transcranial magnetic stimulation (rTMS) on cognitive processing: A meta-analysis and recommendations for future studies

Cited by 96 publications

References 39 publications

Dose-dependent enhancement of motion direction discrimination with transcranial magnetic stimulation of visual cortex

Dose-dependent enhancement of motion direction discrimination with transcranial magnetic stimulation of visual cortex

Precision non-implantable neuromodulation therapies: a perspective for the depressed brain

Combining HF rTMS over the Left DLPFC with Concurrent Cognitive Activity for the Offline Modulation of Working Memory in Healthy Volunteers: A Proof-of-Concept Study

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