Target Engagement and Brain State Dependence of Transcranial Magnetic Stimulation: Implications for Clinical Practice

Sack, Alexander T.; Paneva, Jasmina; Küthe, Tara; Dijkstra, Eva; Zwienenberg, Lauren; Arns, Martijn; Schuhmann, Teresa

doi:10.1016/j.biopsych.2023.09.011

Cited by 21 publications

(16 citation statements)

References 85 publications

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“…These changes facilitate the visual system to manage limited resources and adjust to current environmental demands. In this study, we capitalized on previous findings showing that TMS 22,24 , exogenous covert attention 10 and adaptation 18,19 , each alter brain state in early visual cortex. Here, to investigate the relation between adaptation and attention in the early visual cortex, we manipulated brain state through visual adaptation and attention in a psychophysical experiment while applying TMS.…”

Section: Discussionmentioning

confidence: 99%

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Adaptation and exogenous attention interact in the early visual cortex: A TMS study

Lee,

Fernández,

Carrasco

2023

Preprint

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SummaryOur capacity to process information is constrained by the limited energy available to the brain and the high energy cost of cortical computation [1]. To help manage limited resources and optimize our sensitivity to visual information, adaptation diminishes sensitivity for repetitive stimuli, whereas attention enhances the representation of relevant information [2]. Transcranial magnetic stimulation (TMS) to early visual cortex (V1/V2) eliminates the response-gain effect of exogenous (involuntary) attention on contrast sensitivity: the benefit at the attended location and the cost at the unattended location [3]. Here we investigate whether adaptation modulates the exogenous attentional effect on perception under TMS to V1/V2. Observers performed an orientation discrimination task while attending to one of two stimuli, with or without adaptation. Following a valid, neutral or invalid attentional cue, two cortically-magnified Gabor patches were presented in the stimulated region (matching each observer’s phosphene location) and its contralateral symmetric region. A response cue indicated the patch whose orientation observers had to discriminate. The response cue either matched—target stimulated—or did not match— distractor stimulated—the stimulated side. Without adaptation, the exogenous attention response-gain effect emerged in the distractor-stimulated condition–increased contrast sensitivity at the attended location and decreased at the unattended location–but these effects were eliminated in the target-stimulated condition, consistent with our previous findings. Critically, after adaptation, response gain of exogenous attention was observed in both distractor-stimulated and target-stimulated conditions. These results reveal that (1) adaptation and attention interact in the early visual cortex, (2) adaptation shields exogenous attention from TMS effects.

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Section: Discussionmentioning

confidence: 99%

“…Adaptation 18,19 , exogenous attention 10 and TMS 22 each alter activity in early visual cortex. Here, we investigated whether adaptation and attention are independent or interactive by examining if TMS eliminates exogenous attentional effects after adaptation.…”

Section: Introductionmentioning

confidence: 99%

Adaptation and exogenous attention interact in the early visual cortex: A TMS study

Lee,

Fernández,

Carrasco

2023

Preprint

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“…Online tools, such as TMS-SMART (Meteyard & Holmes, 2018), and simulation tools such as sim-NIBS (Saturnino et al, 2019), can help researchers make more informed decisions regarding their TMS parameters. Further, closed looped TMS designs (e.g., through concurrent electroencephalography or functional magnetic resonance imaging) may enhance the reliability and effectiveness of TMS and rTMS procedures (Peters et al, 2020; Sack et al, 2023).…”

Section: Discussionmentioning

confidence: 99%

“…The choice of excluding studies focusing on the damaged brain was based on findings that physical, mental, and/or neurological pathology can affect cortical excitability as revealed by TMS measures (e.g., Brigo et al, 2013; Schabrun & Hodges, 2012). However, the question of whether rMT and PT can be used as global measures of cortical excitability is as important for clinically relevant applications, considering the wide use of TMS in applied clinical work (see Lefaucheur et al, 2014; Sack et al, 2023). Given that this was, to the best of our knowledge, the first attempt to systematically identify and analyze studies that measured the relationship of PT and rMT, our meta-analysis serves as a foundation for further exploration.…”

Section: Discussionmentioning

confidence: 99%

“…Since its introduction over three decades ago (Barker et al, 1985) transcranial magnetic stimulation (TMS) – a non-invasive brain stimulation technique – has been extensively utilized in research to study the nervous system (for recent reviews see Jannati et al, 2023; Sack et al, 2023). Through a coil placed over the scalp, TMS non-invasively delivers magnetic pulses, which induce changes in the ion flow of the underlaying neurons (Barker, 1991).…”

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confidence: 99%

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Phosphene and Motor Transcranial Magnetic Stimulation Thresholds Are Correlated: A Meta-Analytic Investigation

Phylactou,

Pham,

Narskhani

et al. 2023

Preprint

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Transcranial magnetic stimulation (TMS) is commonly delivered at an intensity defined by the resting motor threshold (rMT), which is thought to represent cortical excitability, even if the TMS target area falls outside of the motor cortex. This approach rests on the assumption that cortical excitability, as measured through the motor cortex, represents a ‘global’ measure of excitability. Another common approach to measure cortical excitability relies on the phosphene threshold (PT), measured through the visual cortex of the brain. However, it remains unclear whether either estimate can serve as a singular measure of global cortical excitability. If PT and rMT indeed reflect global cortical excitability, they should be correlated. To test this, we systematically identified previous studies that measured PT and rMT to calculate an overall correlation between the two estimates. Our results, based on 16 effect sizes from eight studies, indicated that PT and rMT are correlated (ρ = .4), and thus one measure could potentially serve as a global cortical excitability measure. Three exploratory meta-analyses revealed that the strength of the correlation is affected by different methodologies, and that PT intensities are higher than rMT. Evidence for a PT-rMT correlation remained robust across all analyses. Further research is necessary for an in-depth understanding of how cortical excitability is reflected through TMS.

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rTMS for Co-occurring Psychiatric and Substance Use Disorders: Narrative Review and Future Directions

Blyth,

Zabik,

Krosche

et al. 2024

Curr Addict Rep

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Target Engagement and Brain State Dependence of Transcranial Magnetic Stimulation: Implications for Clinical Practice

Cited by 21 publications

References 85 publications

Adaptation and exogenous attention interact in the early visual cortex: A TMS study

Adaptation and exogenous attention interact in the early visual cortex: A TMS study

Phosphene and Motor Transcranial Magnetic Stimulation Thresholds Are Correlated: A Meta-Analytic Investigation

rTMS for Co-occurring Psychiatric and Substance Use Disorders: Narrative Review and Future Directions

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