TMS in cognitive plasticity and the potential for rehabilitation

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Abstract

Cognitive neuroscientists use transcranial magnetic stimulation (TMS) in several ways, from aiming to increase understanding of brain–behavior relationships to transiently improving performance, both in normals and in patients with neurological and neuropsychological deficits. Different types of TMS (single-pulse, paired-pulse, repetitive) are able to interfere with higher brain functions that require the cooperation of different brain areas and complex neuronal networks. Currently, behavioral TMS effects on the brain are usually short-lived and their underlying mechanisms not yet wholly understood. However, the aim of using TMS to develop rehabilitative strategies for motor, perceptive and cognitive functions represents an intriguing challenge.

Section snippets

TMS and motor imagery

Neuroimaging has shown that the anatomical neural substrates of motor imagery, a complex cognitive phenomenon, partly coincide with those of actual movement execution [24]. TMS provides clues about the temporal dynamics of the brain activity underlying motor imagery. Indeed, following single-pulse TMS over contralateral M1, the amplitude of the motor evoked potential (MEP) of those muscles acting as ‘prime movers’ within the motor program is increased, both when wrist movements 25, 26 or more

Sensory functions and neglect

Following earlier studies 50, 51, recent research has focused on TMS effects on somatosensory areas, to investigate whether interfering with one hemisphere could significantly affect ipsilateral and contralateral sensory perception during a unimanual or a bimanual stimulation task (Figure 1, square 2). Several recent observations are relevant to the prospect of rehabilitation.

In healthy subjects, single-pulse TMS delivered to the right parietal cortex, 20–40 ms after bimanual stimulation,

Reasoning, memory and other cognitive activities

It is known that rTMS of the dorsolateral prefrontal cortex transiently impairs encoding and retrieval mechanisms in human memory when TMS is coincident with either visuo-spatial [61] or verbal stimuli 62, 63, suggesting a causal role for this region in the long-term memory process. Interference with rTMS is therefore complementary to more traditional neuroimaging studies based on haemodynamic (fMRI) or metabolic (PET) approaches to cognitive challenges. However, it should be kept in mind that

Conclusions

There are exciting prospects for the use of TMS as a tool to promote changes of brain activity paralleled by behavioral improvements, although, at present, these are generally short-lived. However, a growing body of evidence is converging on the possibility that TMS induces an exogenous plastic rearrangement of synaptic efficacy in the stimulated network. Most evidence comes from studies on sensorimotor areas, but the principles are probably equally applicable to networks subserving cognition,

References (75)

  • P.M. Rossini

    Brain excitability and electroencephalographic activation: non-invasive evaluation in healthy humans via transcranial magnetic stimulation

    Brain Res

    (1991)
  • L. Strens

    The ipsilateral human motor cortex can functionally compensate for acute contralateral motor cortex dysfunction

    Curr. Biol

    (2003)
  • W. Muellbacher

    Effects of low-frequency transcranial magnetic stimulation on motor excitability and basic motor behaviour

    Clin. Neurophysiol

    (2000)
  • M. Cincotta

    Suprathreshold 0.3 Hz repetitive TMS prolongs the cortical silent period: potential implications for therapeutic trials in epilepsy

    Clin. Neurophysiol

    (2003)
  • L.G. Cohen

    Attenuation in detection of somatosensory stimuli by transcranial magnetic stimulation

    Electroenceph. Clin. Neurophysiol

    (1991)
  • F. Brighina

    1 Hz repetitive transcranial magnetic stimulation of the unaffected hemisphere ameliorates contralesional visuospatial neglect in humans

    Neurosci. Lett

    (2003)
  • L. Rami

    Effects of repetitive transcranial magnetic stimulation on memory subtypes: a controlled study

    Neuropsychologia

    (2003)
  • A. Ellison

    The effect of expectation on facilitation of colour/form conjunction tasks by TMS over area V5

    Neuropsychologia

    (2003)
  • A. Post et al.

    Transcranial magnetic stimulation as a therapeutic tool in psychiatry: what do we know about the neurobiological mechanisms?

    J. Psychiatr. Res

    (2001)
  • Y. Tamura

    Effects of 1-Hz repetitive transcranial magnetic stimulation on acute pain induced by capsaicin

    Pain

    (2004)
  • P. Eichhammer

    Neuronavigated repetitive transcranial magnetic stimulation in patients with tinnitus: a short case series

    Biol. Psychiatry

    (2003)
  • V. Walsh et al.

    Transcranial magnetic stimulation and cognitive neuroscience

    Nat. Rev. Neurosci

    (2000)
  • M. Hallett

    Transcranial magnetic stimulation and the human brain

    Nature

    (2000)
  • V. Di Lazzaro

    Corticospinal volleys evoked by transcranial stimulation of the brain in conscious humans

    Neurol. Res

    (2003)
  • T. Kujirai

    Corticocortical inhibition in human motor cortex

    J. Physiol

    (1993)
  • Boniface, S. and Ziemann, U. eds (2001) Plasticity in the Human Nervous System. Investigations with Transcranial...
  • R.E. Hoffman et al.

    Slow transcranial magnetic stimulation, long-term depotentiation, and brain hyperexcitability disorders

    Am. J. Psychiatry

    (2002)
  • F. Maeda

    Interindividual variability of the modulatory effects of repetitive transcranial magnetic stimulation on cortical excitability

    Exp. Brain Res

    (2000)
  • M.B. Iyer

    Priming stimulation enhances the depressant effect of low-frequency repetitive transcranial magnetic stimulation

    J. Neurosci

    (2003)
  • C.C. Hilgetag

    Enhanced visual spatial attention ipsilateral to rTMS-induced “virtual lesions” of human parietal cortex

    Nat. Neurosci

    (2001)
  • B. Boroojerdi

    Reduction of human visual cortex excitability using 1-Hz transcranial magnetic stimulation

    Neurology

    (2000)
  • B. Fierro

    1 Hz rTMS enhances extrastriate cortex activity in migraine: Evidence of a reduced inhibition?

    Neurology

    (2003)
  • E.M. Robertson

    Studies in cognition: the problems solved and created by transcranial magnetic stimulation

    J. Cogn. Neurosci

    (2003)
  • A. Pascual-Leone

    Transcranial magnetic stimulation and neuroplasticity

    Neuropsychologia

    (1999)
  • Gow, D. et al. (2001) Rehabilitation. In Plasticity in the Human Nervous System (Boniface, S. and Ziemann, U. eds), pp....
  • T. Hanakawa

    Functional properties of brain areas associated with motor execution and imagery

    J. Neurophysiol

    (2003)
  • S. Rossi

    Corticospinal excitability modulation during mental simulation of wrist movements in normal subjects

    Neurosci. Lett

    (1998)
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