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Assessing Low-frequency Repetitive Transcranial Magnetic Stimulation with Functional Magnetic Resonance Imaging: A Case Series.
MedLine Citation:
PMID:  21766399     Owner:  NLM     Status:  Publisher    
BACKGROUND AND PURPOSE: This case series assesses the effects of five consecutive days of low-frequency (1 Hz) repetitive transcranial magnetic stimulation (rTMS) with and without a 6-Hz primer. Although this paper studies able-bodied individuals, similar rTMS protocols are used to facilitate motor recovery in patients with hemiplegia following stroke. However, the cortical mechanisms associated with repeated daily doses of rTMS are not completely understood. CASE DESCRIPTION: Four right-handed healthy volunteers (two men, aged 20-50 years) participated in a double-blind case series of primed and unprimed rTMS. Functional magnetic resonance imaging was used to compare task-related haemodynamics during a simple motor task and resting-state cortical connectivity. Understanding the mechanisms of repeated rTMS sessions may serve as a precursor to development of rTMS paradigms involving motor cortex stimulation in patients with a range of neurologic dysfunction. OUTCOMES: Following five consecutive days of rTMS, all subjects had reduced task-related haemodynamics. Resting-state brain connectivity between motor regions was reduced only after primed rTMS. DISCUSSION: This is the first study to indicate that resting-state brain connectivity can distinguish the effect of primed and unprimed rTMS to a greater extent than task-related haemodynamics. Furthermore, priming may inhibit the connectivity between the area of the cortex underlying the rTMS site and remote brain regions. SIGNIFICANCE: These findings benefit rTMS rehabilitation studies by examining haemodynamics on repeated days of stimulation and incorporating resting-state brain connectivity analysis to further understand underlying neural mechanisms. Furthermore, this work encourages the utilization of resting connectivity in future rTMS studies. Copyright © 2011 John Wiley & Sons, Ltd.
Christopher B Glielmi; Andrew J Butler; Dmitriy M Niyazov; Warren G Darling; Charles M Epstein; Jay L Alberts; Xiaoping P Hu
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-18
Journal Detail:
Title:  Physiotherapy research international : the journal for researchers and clinicians in physical therapy     Volume:  -     ISSN:  1471-2865     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-7-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9612022     Medline TA:  Physiother Res Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 John Wiley & Sons, Ltd.
Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, GA, USA; Siemens Healthcare, Chicago, IL, USA.
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