Enhancement of human cognitive performance using transcranial magnetic stimulation (TMS)

Abstract

Here we review the usefulness of transcranial magnetic stimulation (TMS) in modulating cortical networks in ways that might produce performance enhancements in healthy human subjects. To date over sixty studies have reported significant improvements in speed and accuracy in a variety of tasks involving perceptual, motor, and executive processing. Two basic categories of enhancement mechanisms are suggested by this literature: direct modulation of a cortical region or network that leads to more efficient processing, and addition-by-subtraction, which is disruption of processing which competes or distracts from task performance. Potential applications of TMS cognitive enhancement, including research into cortical function, rehabilitation therapy in neurological and psychiatric illness, and accelerated skill acquisition in healthy individuals are discussed, as are methods of optimizing the magnitude and duration of TMS-induced performance enhancement, such as improvement of targeting through further integration of brain imaging with TMS. One technique, combining multiple sessions of TMS with concurrent TMS/task performance to induce Hebbian-like learning, appears to be promising for prolonging enhancement effects. While further refinements in the application of TMS to cognitive enhancement can still be made, and questions remain regarding the mechanisms underlying the observed effects, this appears to be a fruitful area of investigation that may shed light on the basic mechanisms of cognitive function and their therapeutic modulation.

The Right Angular Gyrus Combines Perceptual and Response-related Expectancies in Visual Search: TMS-EEG Evidence

“…Our pattern of results fits well the growing literature of cognitive enhancement effects of TMS [35,36]. Although TMS has been compared to a "virtual lesion", it is increasingly used as a tool to modulate cortical dynamics [37].…”

Theta burst magnetic stimulation over the pre-supplementary motor area improves motor inhibition

“…Our behavioural results showing that cTBS over the pre-SMA speeded up SSRTs have potential implications for future rehabilitation programs for patients with impaired decision-making and impulsivity, such as those with compulsive eating or shopping, pathological gambling or frontal-like disinhibited behaviours. Specifically, disorders with altered pre-SMA activity (both at rest and task-related) may benefit from similar pre-SMA cTBS as the one used here as previously suggested [65,66]. …”

Neural dissociation of automatic and controlled temporal preparation by transcranial magnetic stimulation

“…Although the current design did not include a neutral cue condition to elucidate whether larger validity effects were due to smaller costs or larger benefits, planned comparisons revealed that frontal TMS reduced RTs on the valid as compared to the invalid condition. An explanation for this counterintuitive result relies on recent conceptions on the neural effects of TMS that go beyond the 'virtual lesion' approach (Luber and Lisanby, 2014;Pascual-Leone et al, 2000;Silvanto and Muggleton, 2008). Traditionally, the effects of TMS have been associated with disrupted performance by assuming a direct relationship between cortical excitability and behaviour.…”