The effects of repetitive transcranial magnetic stimulation on the whole-brain functional network of postherpetic neuralgia patients

Abstract

The effects of repetitive transcranial magnetic stimulation (rTMS), the clinical treatment for postherpetic neuralgia (PHN), on whole-brain functional network of PHN patients is not fully understood. To explore the effects of rTMS on the whole-brain functional network of PHN patients. 10 PHN patients (male/female: 5/5 Age: 63–79 years old) who received rTMS treatment were recruited in this study. High-resolution T1-weighted and functional Magnetic Resonance Imaging (fMRI) were acquired before and after 10 consecutive rTMS sessions. The whole-brain functional connectivity networks were constructed by Pearson correlation. Global and node-level network parameters, which can reflect the topological organization of the brain network, were calculated to investigate the characteristics of whole-brain functional networks. Non-parametric paired signed rank tests were performed for the above network parameters with sex and age as covariates. P < .05 (with FDR correction for multi-comparison analysis) indicated a statistically significant difference. Correlation analysis was performed between the network parameters and clinical variables. The rTMS showed significant increase in characteristic path length and decrease of clustering coefficient, global, and local efficiency derived from the networks at some specific network sparsity, but it showed no significant difference for small-worldness. rTMS treatment showed significant differences in the brain regions related to sensory-motor, emotion, cognition, affection, and memory, as observed by changes in node degree, node betweenness, and node efficiency. Besides, node-level network parameters in some brain areas showed significant correlations with clinical variables including visual analog scales (VAS) and pain duration. rTMS has significant effects on the whole-brain functional network of PHN patients with a potential for suppression of sensory-motor function and improvement of emotion, cognition, affection, and memory functions.

High-Frequency rTMS of the Motor Cortex Modulates Cerebellar and Widespread Activity as Revealed by SVM

“…The motor cortex is one of the most frequently reported stimulation targets for rTMS modulation in both healthy populations (Hartwigsen and Siebner, 2015;Cona et al, 2017) and those with brain disorders including movement disorders (Wagle Shukla et al, 2016;Brabenec et al, 2019), stroke rehabilitation (Ludemann-Podubecka et al, 2016;Lee et al, 2019), and other disorders (Siebner et al, 2003;Odorfer et al, 2019;Pei et al, 2019;Zhang et al, 2019). Some of these studies performed RS-fMRI before and after modulation and analyzed the network changes.…”

“…However, there is large variation in the analytical methods applied from study to study. These included voxel-to-voxel based dynamic FC , graph theory using 24 ROIs (Lee et al, 2019), whole-brain graph theory (Pei et al, 2019), and seed-based FC (Brabenec et al, 2019). While it could be concluded that rTMS of the motor cortex modulates the motor network, such a conclusion appears too general since it is difficult to identify which specific brain areas are modulated.…”

Cellular Mechanism Underlying rTMS Treatment for the Neural Plasticity of Nervous System in Drosophila Brain

“…Particularly, it is ambiguous that how rTMS with different intensities, at different frequencies, can modulate the neural circuit activities, such as the neural plasticity which is one of the most important characters of the neural function, because of the limitation of animal models. Cultured neurons [10,11] and hippocampal slices [12] from rats and even humans [13,14] have been utilized to study the role of rTMS. However, these models are difficult to present a complete loop neural circuit.…”

Changes of Structural Brain Network Following Repetitive Transcranial Magnetic Stimulation in Children With Bilateral Spastic Cerebral Palsy: A Diffusion Tensor Imaging Study

“…The thalamus is the information integration center in the brain and is in the cortical-striatum-thalamus pathway ( 48 ). Therefore, impaired nodal metrics of basal ganglia and thalamus might be indirectly modulated by the stimulation of the cortical areas ( 49 ). The treatment of rTMS could modulate brain structural networks in children with BSCP and the modulated brain regions were associated with the improved motor and cognitive symptoms.…”