Remediation of Sleep-Deprivation-Induced Working Memory Impairment with fMRI-Guided Transcranial Magnetic Stimulation

Abstract

Repetitive transcranial magnetic stimulation (rTMS) was applied to test the role of selected cortical regions in remediating sleep-deprivation-induced deficits in visual working memory (WM) performance. Three rTMS targets were chosen using a functional magnetic resonance imaging (fMRI)-identified network associated with sleep-deprivation-induced WM performance impairment: 2 regions from the network (upper left middle occipital gyrus and midline parietal cortex) and 1 nonnetwork region (lower left middle occipital gyrus). Fifteen participants underwent total sleep deprivation for 48 h. rTMS was applied at 5 Hz during a WM task in a within-subject sham-controlled design. The rTMS to the upper-middle occipital site resulted in a reduction of the sleep-induced reaction time deficit without a corresponding decrease in accuracy, whereas stimulation at the other sites did not. Each subject had undergone fMRI scanning while performing the task both pre- and postsleep deprivation, and the degree to which each individual activated the fMRI network was measured. The degree of performance enhancement with upper-middle occipital rTMS correlated with the degree to which each individual failed to sustain network activation. No effects were found in a subset of participants who performed the same rTMS procedure after recovering from sleep deprivation, suggesting that the performance enhancements seen following sleep deprivation were state dependent.

A systematic review of the effects of low-frequency repetitive transcranial magnetic stimulation on cognition

“…(Herwig et al 2003; Luber et al 2008; Smith et al 2007). Optical frameless stereotaxic systems incorporate imaging data and enable the coil to be positioned via three-dimensional navigation (Lefaucheur 2010; Sparing et al 2008).…”

Non-pharmacological cognitive enhancement

“…tDCS has been found able to enhance performance on working memory tasks (Fregni et al, 2005;Luber et al, 2007;Teo et al, 2011;Ohn et al, 2008). Sleepdeprivation induced impairment of a visual working memory task was reduced by rTMS (Luber et al, 2008). Low frequency TMS and tDCS applied to the temporal lobe can reduce the incidence of false memories Boggio et al, 2009).…”

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

“…We created a deficit in WM performance using sleep deprivation: sleep deprived individuals will typically exhibit response slowing and lapsing (missed responses) during the task (Lim and Dinges, 2008). We used fMRI-guided rTMS to find an appropriate cortical network (Habeck et al, 2004), test its amenability to enhancement with rTMS (Luber et al, 2008), and finally tested whether concurrent rTMS/task performance over multiple sessions would prolong the rTMS-caused enhancement (Luber et al, 2013). …”

“…fMRI-guided rTMS was then used to remediate performance in sleep deprived individuals (Luber et al, 2008). In subjects who had experienced total sleep deprivation for two days, 5Hz rTMS was applied during the retention phase of the WM task.…”