Theta Burst Stimulation of the Human Motor Cortex

Chang Gung Memorial Hospital, T’ai-pei, Taipei, Taiwan
Neuron (Impact Factor: 15.05). 02/2005; 45(2):201-6. DOI: 10.1016/j.neuron.2004.12.033
Source: PubMed


It has been 30 years since the discovery that repeated electrical stimulation of neural pathways can lead to long-term potentiation in hippocampal slices. With its relevance to processes such as learning and memory, the technique has produced a vast literature on mechanisms of synaptic plasticity in animal models. To date, the most promising method for transferring these methods to humans is repetitive transcranial magnetic stimulation (rTMS), a noninvasive method of stimulating neural pathways in the brain of conscious subjects through the intact scalp. However, effects on synaptic plasticity reported are often weak, highly variable between individuals, and rarely last longer than 30 min. Here we describe a very rapid method of conditioning the human motor cortex using rTMS that produces a controllable, consistent, long-lasting, and powerful effect on motor cortex physiology and behavior after an application period of only 20-190 s.

Full-text preview

Available from:
  • Source
    • "An intensity of 80% AMT was used. We applied the iTBS protocol in which 10 bursts of high frequency stimulation (3 pulses at 50 Hz) are delivered at 5 Hz every 10 s, for a total of 600 pulses (Huang et al., 2005). iTBS effects on both hemispheres were assessed by evaluating the changes of the RMT, AMT, and MEP amplitude stimulating the AH and UH, before and immediately after iTBS. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The acute phase of stroke is accompanied by functional changes in the activity and interplay of both hemispheres. In healthy subjects, gender is known to impact the functional brain organization. We investigated whether gender influences also acute stroke functional changes. In thirty-five ischemic stroke patients, we evaluated the excitability of the affected (AH) and unaffected hemisphere (UH) by measuring resting and active motor threshold and motor-evoked potential amplitude under baseline conditions and after intermittent theta burst stimulation (iTBS) of AH. We also computed an index of the excitability balance between the hemispheres, laterality indexes (LI), to evidence hemispheric asymmetry. Active motor threshold differed significantly between AH and UH only in the male group (p=0.004), not in females (p>0.200), and both LIAMT and LIRMT were significantly higher in males than in females (respectively p=0.033 and p=0.042). LTP-like activity induced by iTBS in AH was more frequent in females. Gender influences the functional excitability changes that take place after human stroke and the level of LTP that can be induced by repetitive stimulation. This knowledge is of high value in the attempt of individualizing to different genders any non-invasive stimulation strategy designed to foster stroke recovery.
    Full-text · Article · Jan 2016 · Frontiers in Neuroscience
    • "High-frequency rTMS (>5 Hz) typically induces facilitation or LTP-like plasticity, whereas low-frequency rTMS (≤1 Hz) typically induces inhibition or LTD-like plasticity (Wassermann and Zimmermann 2012). More recently developed patterned protocols such as theta burst protocols , based on the endogenous neural theta rhythm, have also shown frequency-specific effects with intermittent theta burst (iTBS) inducing facilitation or LTP-like plasticity , whereas continuous theta burst (cTBS) induces inhibition or LTD-like plasticity (Huang and others 2005). Although not discussed here, recent human studies have shown a wide range of inter-subject variability to specific rTMS frequencies, such that some subjects show inhibition with LTP-like inducing rTMS protocols and vice versa (Hamada and others 2013). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Since the development of transcranial magnetic stimulation (TMS) in the early 1980s, a range of repetitive TMS (rTMS) protocols are now available to modulate neuronal plasticity in clinical and non-clinical populations. However, despite the wide application of rTMS in humans, the mechanisms underlying rTMS-induced plasticity remain uncertain. Animal and in vitro models provide an adjunct method of investigating potential synaptic and non-synaptic mechanisms of rTMS-induced plasticity. This review summarizes in vitro experimental studies, in vivo studies with intact rodents, and preclinical models of selected neurological disorders—Parkinson’s disease, depression, and stroke. We suggest that these basic research findings can contribute to the understanding of how rTMS-induced plasticity can be modulated, including novel mechanisms such as neuroprotection and neurogenesis that have significant therapeutic potential.
    No preview · Article · Dec 2015 · The Neuroscientist
    • "We opted for vertex control stimulation, as right or left parietal control regions would have introduced the danger of unspecific functional and/or structural connectivity effects infeasible to disentangle from experimental stimulation effects [see Bestmann et al., 2005 or Nettekoven et al., 2014 for TMS effects on associated neural networks]. The duration of cTBS effects in disrupting activity in the stimulated brain region was expected to last at least 25 to 45 min [Huang et al., 2005]. The total length of both tasks performed after the stimulation was restricted to a maximum length of 20 min based on a conservative estimation of the duration of the cTBS effects [Young et al., 2010a]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The right temporoparietal junction (rTPJ) has been associated with the ability to reorient attention to unexpected stimuli and the capacity to understand others' mental states (theory of mind [ToM]/false belief). Using activation likelihood estimation meta-analysis we previously unraveled that the anterior rTPJ is involved in both, reorienting of attention and ToM, possibly indicating a more general role in attention shifting. Here, we used neuronavigated transcranial magnetic stimulation to directly probe the role of the rTPJ across attentional reorienting and false belief. Task performance in a visual cueing paradigm and false belief cartoon task was investigated after application of continuous theta burst stimulation (cTBS) over anterior rTPJ (versus vertex, for control). We found that attentional reorienting was significantly impaired after rTPJ cTBS compared with control. For the false belief task, error rates in trials demanding a shift in mental state significantly increased. Of note, a significant positive correlation indicated a close relation between the stimulation effect on attentional reorienting and false belief trials. Our findings extend previous neuroimaging evidence by indicating an essential overarching role of the anterior rTPJ for both cognitive functions, reorienting of attention and ToM. Hum Brain Mapp, 2015. © 2015 Wiley Periodicals, Inc.
    No preview · Article · Nov 2015 · Human Brain Mapping
Show more