A comprehensive review of the effects of rTMS on motor cortical excitability and inhibition

@article{Fitzgerald2006ACR,
  title={A comprehensive review of the effects of rTMS on motor cortical excitability and inhibition},
  author={Paul B. Fitzgerald and Sarah I Fountain and Zafiris J. Daskalakis},
  journal={Clinical Neurophysiology},
  year={2006},
  volume={117},
  pages={2584-2596}
}
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The results do not suggest that there are systematic alterations of cortical excitability changes during rTMS treatment, which calls into question the practice of re-adjusting the stimulation intensity according to the motor threshold over the course of the treatment.
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Findings obtained with rat models indicate that distinct inhibitory cell classes, like the fast‐spiking cells characterized by parvalbumin expression, are most sensitive to certain stimulation protocols, e.g. intermittent theta burst stimulation.
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Head-to-head comparison of the different rTMS protocols enabled us to identify the most effective paradigms for modulating the excitatory and inhibitory circuits activated by TMS.
High-Frequency Repetitive Transcranial Magnetic Stimulation Effects on Motor Intracortical Neurophysiology: A Sham-Controlled Investigation
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  • Psychology, Biology
    Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society
  • 2015
TLDR
High-frequency rTMS significantly influences the excitatory and inhibitory outputs of motor intracortical networks, specifically increasing intracortsical facilitation and reducing ICI as compared with sham stimulation.
Magnetic stimulation intensity modulates motor inhibition
Magnetic stimulation intensity modulates motor inhibition
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The results indicate that when explaining the input–output relationship of motor cortex induced activation as an intensity-dependent function, there might be a need to split it into separate functions associated with separate processes mediated by different cell types such as interneurons, pyramidal neurons and others.
Potentiation of short-latency cortical responses by high-frequency repetitive transcranial magnetic stimulation.
TLDR
The present study investigates the modulation induced by high-frequency rTMS via EEG by evaluating changes in the latency and amplitude of TMS-evoked responses and provides the first direct, on-line evaluation of the effects of high- frequencies TMS on EEG activity.
Suppression of Motor Cortical Excitability in Anesthetized Rats by Low Frequency Repetitive Transcranial Magnetic Stimulation
TLDR
These are the first electrophysiological data showing depression of cortical excitability following LF rTMS in rats, and the first to demonstrate dependence of this form of cortical plasticity on the NMDAR.
Effects of repetitive transcranial magnetic stimulation on masseter motor-neuron pool excitability.
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References

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TLDR
Although the averaged group data showed a frequency-dependent increase in cortical excitability, each subject had a different pattern of frequency tuning curve, i.e. a different modulatory effect on cortex excitability at different rTMS frequencies, illustrating the degree of variability of the rT MS effects in the human brain.
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It is suggested that rTMS increases CI, particularly in subjects with reduced baseline inhibition, a finding consistent with the concept of homeostatic plasticity.
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It is shown that high-frequency rTMS of the dorsolateral prefrontal cortex can improve cognitive processing in normal subjects, raising the possibility of using such intervention in the rehabilitation of brain injuries.
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Transcranial magnetic stimulation (TMS) can be applied in different paradigms to obtain a measure of various aspects of cortical excitability. These different TMS paradigms provide information about…
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Abstract. Ten healthy subjects and two patients who had an electrode implanted into the cervical epidural space underwent repetitive transcranial magnetic stimulation (rTMS; 50 stimuli at 5 Hz at…
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Spread of excitation, which may be a warning sign for seizures, occurred in one subject and was not accompanied by increased MEP amplitude, suggesting that spread ofexcitation and amplitude changes are different phenomena and also indicating the need for adequate monitoring even with stimulations at low frequencies.
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Transcranial magnetic stimulation is a safe, noninvasive, and painless way to stimulate the human motor cortex in behaving human subjects and has therapeutic potential in psychiatric and neurological disorders.
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