Stimulus intensity and coil characteristics influence the efficacy of rTMS to suppress cortical excitability

Lang, N.; Harms, Jochen; Weyh, Thomas; Lemon, Roger; Paulus, Walter; Rothwell, John C.; Siebner, Hartwig R.

doi:10.1016/j.clinph.2006.05.030

Cited by 130 publications

(91 citation statements)

References 36 publications

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“…The primary purposes of included studies with healthy adult participants were to investigate the mechanisms underlying the effect of rTMS stimuli on transmission in corticospinal pathways 27,28,41,46 ; the effects of a specific dose of rTMS on transmission in corticospinal pathways 15,16,[32][33][34]36,42,45,47 ; the effects of different doses of rTMS on transmission in corticospinal pathways 21,30,38,39,40,43,44,50 ; the effects of 2 waveforms of rTMS 22,26,51 ; whether rTMSinduced changes in transmission in corticospinal pathways last beyond application of stimuli 31 ; the effects on movement control of using rTMS 35,42,48,52,53 ; the differences in response to rTMS between healthy adults and people with actual or potential movement disorder. [17][18][19][20] The primary purpose of the included study with participants after stroke was to investigate the effects of rTMS on recovery of movement after stroke.…”

Section: Resultsmentioning

confidence: 99%

“…However, it is also apparent that facilitation has been found at lower frequencies, including 1 Hz, and that the variation found might be explained by the variety of combinations of frequency and the other parameters of rTMS that contribute to dose, including intensity, resting/active target muscle, number of stimuli, number of trains, and intertrain interval. In addition, there are some indications that response to rTMS might be influenced by the provision of monophasic or biphasic stimuli, 22,26,51 the type of coil produced by different manufacturers, 38 and whether rTMS is delivered in the presence or absence of voluntary muscle activity 20,22 (Table 1). Interestingly, there is a suggestion from the present review that increasing the numbers of rTMS stimuli and decreasing the intensity produces an increase in spinal cord excitability as measured by the H reflex (Table 7).…”

Section: Discussionmentioning

confidence: 99%

“…Only 8 of the 37 included studies aimed to do this. 21,30,[38][39][40]43,44,50 Furthermore, none of the 8 studies investigated effects on movement control or functional ability. A way forward could be to undertake systematic evaluation of the effects on motor function (transmission in corticospinal pathways, movement control, and functional use of contralateral limbs) of different doses of rTMS in healthy adults.…”

Section: Discussionmentioning

confidence: 99%

“…The primary direction of the induced current may also affect response 22 (Table 1). Furthermore, the type of coil, as judged by manufacturer, may influence the response to rTMS 38 (Table 1).…”

Section: Healthy Volunteers Effects Of Different Doses Of Rtms On Trmentioning

confidence: 99%

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Informing Dose-Finding Studies of Repetitive Transcranial Magnetic Stimulation to Enhance Motor Function: A Qualitative Systematic Review

Hiscock

Miller

Rothwell³

et al. 2008

Neurorehabil Neural Repair

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Objective. Repetitive transcranial magnetic stimulation (rTMS) of the lesioned hemisphere might enhance motor recovery after stroke, but the appropriate dose (parameters of rTMS) remains uncertain. The present review collates evidence of the effect of rTMS on corticospinal pathway excitability and motor function in healthy adults and in people after stroke. Methods. The authors searched MEDLINE and EMBASE (1996 to April 2007), their own collection of peer-reviewed articles, and the reference lists of included studies. They included healthy adults or people with stroke who received rTMS to the primary motor cortex to facilitate or inhibit contralateral corticospinal excitability or movement control. Findings. Of the 625 references identified, 37 studies were included with 455 healthy adults (34 studies) and 69 people with stroke (3 studies). For healthy adults, the effects of rTMS on corticospinal pathway excitability varied within each frequency, for example, 1 Hz rTMS was found to facilitate, inhibit, and have no effect on amplitude of motor-evoked potentials (MEPs). After stroke there was a trend for recovery of MEPs (ie, presence of MEPs) after 10 daily sessions of 3 Hz rTMS (one study). Motor function in healthy adults might be adversely affected by 1 Hz rTMS (two studies), whereas combined frequency rTMS was found to have no effect (one study). Interpretation. There is as yet insufficient published evidence to guide the dose of rTMS to the lesioned hemisphere after stroke to improve recovery of a paretic limb. Moreover, it is apparent that there is variability in response to rTMS in healthy adults. Dose-finding studies in groups of well-characterized stroke patients are needed.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Healthy Volunteers Effects Of Different Doses Of Rtms On Trmentioning

confidence: 99%

See 2 more Smart Citations

Informing Dose-Finding Studies of Repetitive Transcranial Magnetic Stimulation to Enhance Motor Function: A Qualitative Systematic Review

Hiscock

Miller

Rothwell³

et al. 2008

Neurorehabil Neural Repair

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show abstract

“…The subject-to-subject variability of the effects of rTMS over the M1 on motor responses was repeatedly exhibited (Maeda et al, 2000a;Sommer et al, 2002), and thus more reliable and stable rTMS protocols have been searched for (Paulus, 2005). Each individual's optimum motor responses may depend on various stimulation parameters, including the frequency (Rounis et al, 2005), intensity, and coil type (Lang et al, 2006). Moreover, the degree of modulation of the brain is likely to be different depending on the functional state of the targeted cortex at the time of stimulation (Bestmann et al, 2008).…”

Section: Figmentioning

confidence: 99%

Brain Topological Correlates of Motor Performance Changes After Repetitive Transcranial Magnetic Stimulation

Park

Chang²,

Yoo³

et al. 2014

Brain Connectivity

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Repetitive transcranial magnetic stimulation (rTMS) influences the brain temporally beyond the stimulation period and spatially beyond the stimulation site. Application of rTMS over the primary motor cortex (M1) has been shown to lead to plastic changes in interregional connectivity over the motor system as well as alterations in motor performance. With a sequential combination of rTMS over the M1 and functional magnetic resonance imaging (fMRI), we sought changes in the topology of brain networks and specifically the association of brain topological changes with motor performance changes. In a sham-controlled parallel group experimental design, real or sham rTMS was administered to each of the 15 healthy subjects without prior motor-related dysfunctions, over the right M1 at a high frequency of 10 Hz. Before and after the intervention, fMRI data were acquired during a sequential finger motor task using the left, nondominant hand. Changes in the topology of brain networks were assessed in terms of global and local efficiency, which measures the efficiency in transporting information at global and local scales, respectively, provided by graph-theoretical analysis. Greater motor performance changes toward improvements after real rTMS were shown in individuals who exhibited more increases in global efficiency and more decreases in local efficiency. The enhancement of motor performance after rTMS is supposed to be associated with brain topological changes, such that global information exchange is facilitated, while local information exchange is restricted.

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Dysphonia as an unusual debut of parsonage–Turner syndrome

2012

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Stimulus intensity and coil characteristics influence the efficacy of rTMS to suppress cortical excitability

Cited by 130 publications

References 36 publications

Informing Dose-Finding Studies of Repetitive Transcranial Magnetic Stimulation to Enhance Motor Function: A Qualitative Systematic Review

Informing Dose-Finding Studies of Repetitive Transcranial Magnetic Stimulation to Enhance Motor Function: A Qualitative Systematic Review

Brain Topological Correlates of Motor Performance Changes After Repetitive Transcranial Magnetic Stimulation

Dysphonia as an unusual debut of parsonage–Turner syndrome

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