Theta Burst Stimulation of the Prefrontal Cortex: Safety and Impact on Cognition, Mood, and Resting Electroencephalogram

Großheinrich, Nicola; Rau, Anne; Pogarell, Oliver; Hennig-Fast, Kristina; Reinl, Maren; Karch, Susanne; Dieler, Alica C.; Leicht, Gregor; Mulert, Christoph; Sterr, Andrea; Padberg, Frank

doi:10.1016/j.biopsych.2008.10.029

Cited by 139 publications

(95 citation statements)

References 28 publications

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“…In the SCD0 condition, in which participants had to choose how to process two simultaneously triggered actions (stopping an ongoing response and changing to another response), iTBS of the rIFG induced a more efficient strategy of task goal activation, while cTBS of the rIFG induced a less efficient strategy of task goal activation compared with shamTBS. Although cTBS is thought to predominantly induce transient suppression and iTBS facilitation of neural circuits 11,12 , the effects of iTBS on the prefrontal cortex are less substantiated than the effects of cTBS 11,20 . Our data therefore suggest that the facilitation of neural processing in the rIFG promotes selection of a strategy that hierarchically structures actions, which in turn leads to a more efficient unfolding of multi-component behaviour, as reflected by the RT data.…”

Section: Discussionmentioning

confidence: 99%

A causal role of the right inferior frontal cortex in implementing strategies for multi-component behaviour

2015

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Everyday activities, such as, for example, driving a car or preparing a meal, require the hierarchical organization and processing of several individual actions. Currently, the neural mechanisms underlying the control of action sequences are not well understood. Here, the authors demonstrate that the right inferior frontal gyrus (rIFG) plays a key role in implementing the strategy used to cascade different actions. Continuous theta burst stimulation (TBS) applied to the rIFG results in a less efficient action cascading strategy, whereas intermittent TBS results in a more efficient strategy, compared with a shamTBS control condition. These effects are confirmed in electrophysiological data showing that activity differences in the rIFG are related to alterations in response selection processes. Overall, these results suggest that the neural dynamics of the rIFG determine the strategy used during some forms of everyday multi-component behaviour.

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Section: Discussionmentioning

confidence: 99%

A causal role of the right inferior frontal cortex in implementing strategies for multi-component behaviour

2015

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“…These effects were limited to brief periods of the stimulation and short after-effects (seconds) and did not alter sleep continuity. Other studies used transcranial magnetic stimulation (TMS) and demonstrated an increase in current density changes in the alpha2 band after intermittent theta burst stimulation of the left dorsolateral prefrontal cortex (Grossheinrich et al, 2009). To our knowledge, our study is the first to show relevant effects of non-invasive brain stimulation on sleep continuity.…”

Section: Discussionmentioning

confidence: 99%

Modulation of Total Sleep Time by Transcranial Direct Current Stimulation (tDCS)

Frase

Piosczyk

Zittel

et al. 2016

Neuropsychopharmacol

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Arousal and sleep are fundamental physiological processes, and their modulation is of high clinical significance. This study tested the hypothesis that total sleep time (TST) in humans can be modulated by the non-invasive brain stimulation technique transcranial direct current stimulation (tDCS) targeting a 'top-down' cortico-thalamic pathway of sleep-wake regulation. Nineteen healthy participants underwent a within-subject, repeated-measures protocol across five nights in the sleep laboratory with polysomnographic monitoring (adaptation, baseline, three experimental nights). tDCS was delivered via bi-frontal target electrodes and bi-parietal return electrodes before sleep (anodal 'activation', cathodal 'deactivation', and sham stimulation). Bi-frontal anodal stimulation significantly decreased TST, compared with cathodal and sham stimulation. This effect was location specific. Bi-frontal cathodal stimulation did not significantly increase TST, potentially due to ceiling effects in good sleepers. Exploratory resting-state EEG analyses before and after the tDCS protocols were consistent with the notion of increased cortical arousal after anodal stimulation and decreased cortical arousal after cathodal stimulation. The study provides proof-of-concept that TST can be decreased by non-invasive bi-frontal anodal tDCS in healthy humans. Further elucidating the 'top-down' pathway of sleep-wake regulation is expected to increase knowledge on the fundamentals of sleep-wake regulation and to contribute to the development of novel treatments for clinical conditions of disturbed arousal and sleep.

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“…Theta burst stimulation is one of them and involves the repetitive application of very short trains at high frequency (50 Hz) and very short intertrain intervals [49], which is therefore still different from our approach. Preliminary data suggest that theta burst stimulation is a safe method [50] and may have antidepressant effects [51,52]. …”

Section: Discussionmentioning

confidence: 99%

Ultra-High-Frequency Left Prefrontal Transcranial Magnetic Stimulation as Augmentation in Severely Ill Patients with Depression: A Naturalistic Sham-Controlled, Double-Blind, Randomized Trial

Ullrich¹,

Kranaster²,

Sigges³

et al. 2012

Neuropsychobiology

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Background and Aim: Repetitive transcranial magnetic stimulation (rTMS) is supposed to be not as effective in severe depression as it is in medium depression. We evaluated the treatment response to an ultra-high-frequency (UHF; 30 Hz) approach, which was used to maximize the rTMS efficacy in severely ill patients. Methods: 43 severely depressed patients were included in the randomized, double-blind study and received either rTMS with 30 Hz over the left dorsolateral prefrontal cortex or sham condition for 3 weeks as an add-on therapy to stable antidepressant medication. Hamilton Depression Rating Scale (HDRS) and cognitive performance were evaluated before and after the intervention. Results: In the active UHF group, the HRDS score was reduced by about 7.2, whereas the sham condition showed a smaller reduction of the HDRS score with 3.9. However, lithium as a covariant was responsible for the outcome difference, not the group of stimulation. No adverse events were reported. Comparing the differences of both groups in the pre- and post-study performance in a trail-making test, a group effect for the UHF group that was not influenced by the lithium intake was observed. Conclusion: A 30-Hz left prefrontal rTMS in severely depressed patients was safe and no adverse events occurred. Due to a strong effect of lithium as a covariate, we could not demonstrate favorable antidepressant effects of the UHF stimulation compared to sham. However, we found an improvement of processing speed performance in the UHF group, which covaried with improvement of psychomotor retardation.

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Theta Burst Stimulation of the Prefrontal Cortex: Safety and Impact on Cognition, Mood, and Resting Electroencephalogram

Cited by 139 publications

References 28 publications

A causal role of the right inferior frontal cortex in implementing strategies for multi-component behaviour

A causal role of the right inferior frontal cortex in implementing strategies for multi-component behaviour

Modulation of Total Sleep Time by Transcranial Direct Current Stimulation (tDCS)

Ultra-High-Frequency Left Prefrontal Transcranial Magnetic Stimulation as Augmentation in Severely Ill Patients with Depression: A Naturalistic Sham-Controlled, Double-Blind, Randomized Trial

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