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Ten Years of Theta Burst Stimulation in Humans: Established Knowledge, Unknowns and Prospects
Open accessAbstract
Background/objectives Over the last ten years, an increasing number of authors have used the theta burst stimulation (TBS) protocol to investigate long-term potentiation (LTP) and long-term depression (LTD)-like plasticity non-invasively in the primary motor cortex (M1) in healthy humans and in patients with various types of movement disorders. We here provide a comprehensive review of the LTP/LTD-like plasticity induced by TBS in the human M1. Methods A workgroup of researchers expert in this research field review and discuss critically ten years of experimental evidence from TBS studies in humans and in animal models. The review also includes the discussion of studies assessing responses to TBS in patients with movement disorders. Main findings/discussion We discuss experimental studies applying TBS over the M1 or in other cortical regions functionally connected to M1 in healthy subjects and in patients with various types of movement disorders. We also review experimental evidence coming from TBS studies in animals. Finally, we clarify the status of TBS as a possible new non-invasive therapy aimed at improving symptoms in various neurological disorders.
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“This stimulation paradigm mimics endogenous patterns of neural firing associated with induction of LTP (Larson and Lynch, 1986;Suppa et al., 2016) and may modulate networks involved in the pathophysiology of depression (Li et al., 2018).”
From Neurocognitive effects of theta burst stimulation for treatment-resistant depression in adults: A systematic review and recommendations for future research (2025) · cites this paper as Suppa et al., 2016
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Restoration of motor inhibition through an abnormal premotor‐motor connection in dystonia
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“In 2010, Mix et al. [Mix et al., 2010; 117] demonstrated that iTBS, but not cTBS, improved the ability of rats to learn a tactile discrimination task in darkness (Figure 4F1).”
Self-citationEffects of theta burst stimulation on motor cortex excitability in Parkinson’s disease
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Self-citationGenetic variants of the NMDA receptor influence cortical excitability and plasticity in humans
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Self-citationTreatment of chronic tinnitus with theta burst stimulation
Plewnia, C., Vonthein, R., Wasserka, B., Arfeller, C., Naumann, A., Schraven, S. P., & Plontke, S. K. (2012) · Neurology · doi:10.1212/wnl.0b013e3182574ef9 · Cited by 58
Time-course of changes in neuronal activity markers following iTBS-TMS of the rat neocortex.
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Physiological Evidence Consistent with Reduced Neuroplasticity in Human Adolescents Born Preterm
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Self-citationTheta‐burst stimulation over primary motor cortex degrades early motor learning
Iezzi, E., Suppa, A., Conte, A., Agostino, R., Nardella, A., & Berardelli, A. (2010) · European Journal of Neuroscience · doi:10.1111/j.1460-9568.2010.07090.x · Cited by 54
Self-citationAbnormal cortical and brain stem plasticity in Gilles de la Tourette syndrome
Suppa, A., Belvisi, D., Bologna, M., Marsili, L., Berardelli, I., Moretti, G., Pasquini, M., Fabbrini, G., & Berardelli, A. (2011) · Movement Disorders · doi:10.1002/mds.23706 · Cited by 52
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Self-citationKatayama, T., Suppa, A., & Rothwell, J. C. (2010) · Clinical Neurophysiology · doi:10.1016/j.clinph.2010.05.014 · Cited by 50
Self-citationShort-term and long-term plasticity interaction in human primary motor cortex
Iezzi, E., Suppa, A., Conte, A., Voti, P. L., Bologna, M., & Berardelli, A. (2011) · European Journal of Neuroscience · doi:10.1111/j.1460-9568.2011.07674.x · Cited by 50
Self-citationAbnormal experimentally- and behaviorally-induced LTP-like plasticity in focal hand dystonia
Belvisi, D., Suppa, A., Marsili, L., Stasio, F. D., Parvez, A. K., Agostino, R., Fabbrini, G., & Berardelli, A. (2012) · Experimental Neurology · doi:10.1016/j.expneurol.2012.11.003 · Cited by 49
Self-citationMix, A., Hoppenrath, K., & Funke, K. (2015) · Developmental Neurobiology · doi:10.1002/dneu.22205 · Cited by 48
Self-citationA case report of cTBS for the treatment of auditory hallucinations in a patient with schizophrenia
Poulet, E., Brunelin, J., Makhlouf, W. B., d’Amato, T., & Saoud, M. (2009) · Brain stimulation · doi:10.1016/j.brs.2008.09.008 · Cited by 47
Priming the Brain to Capitalize on Metaplasticity in Stroke Rehabilitation
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Jacobs, M. F., Tsang, P., Lee, K. G. H., Asmussen, M. J., Zapallow, C. M., & Nelson, A. J. (2013) · Brain stimulation · doi:10.1016/j.brs.2013.12.009 · Cited by 45
Different responses to facilitatory rTMS according to BDNF genotype
Hwang, J. M., Kim, Y., Yoon, K. J., Uhm, K. E., & Chang, W. H. (2014) · Clinical Neurophysiology · doi:10.1016/j.clinph.2014.09.028 · Cited by 45
Cortical and brainstem plasticity in Tourette syndrome and obsessive‐compulsive disorder
Suppa, A., Marsili, L., Stasio, F. D., Berardelli, I., Roselli, V., Pasquini, M., Cardona, F., & Berardelli, A. (2014) · Movement Disorders · doi:10.1002/mds.25960 · Cited by 43
Self-citationStefan, K., Kunesch, E., Benecke, R., Cohen, L. G., & Claßen, J. (2002) · Cited by 43
Agostino, R., Iezzi, E., Dinapoli, L., Suppa, A., Conte, A., & Berardelli, A. (2008) · European Journal of Neuroscience · doi:10.1111/j.1460-9568.2008.06373.x · Cited by 41
Self-citationThimm, A., & Funke, K. (2014) · The Journal of Physiology · doi:10.1113/jphysiol.2014.282467 · Cited by 41
Self-citationPriming sensorimotor cortex to enhance task-specific training after subcortical stroke
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Are studies of motor cortex plasticity relevant in human patients with Parkinson’s disease?
Bologna, M., Suppa, A., Conte, A., Latorre, A., Rothwell, J. C., & Berardelli, A. (2015) · Clinical Neurophysiology · doi:10.1016/j.clinph.2015.02.009 · Cited by 39
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Primary motor cortex long‐term plasticity in multiple system atrophy
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Self-citationDopamine in Motor Cortex Is Necessary for Skill Learning
Molina-Luna, K., Pekanovic, A., Hertler, B., Schubring-Giese, M., Rioult-Pedotti, M.-S., & Luft, A. R. (2009) · Cited by 33
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Theta-burst stimulation and striatal plasticity in experimental parkinsonism
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Self-citationPrimary motor cortex LTP/LTD-like plasticity in probable corticobasal syndrome
Suppa, A., Stasio, F. D., Marsili, L., Upadhyay, N., Belvisi, D., Conte, A., Modugno, N., Colosimo, C., & Berardelli, A. (2015) · Journal of Neurophysiology · doi:10.1152/jn.00755.2015 · Cited by 19
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Self-citationFurther insights into the effect of BDNF genotype on non-invasive brain stimulation
Suppa, A., & Cheeran, B. (2014) · Clinical Neurophysiology · doi:10.1016/j.clinph.2014.10.003 · Cited by 7
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Metadata
- Authors
- Suppa, A., Huang, Y.-Z., Funke, K., Ridding, M. C., Cheeran, B., Di Lazzaro, V., Ziemann, U., & Rothwell, J. C.
- Affiliations
- Istituto Neurologico Mediterraneo (IT)
- Chang Gung University (TW)
- Ruhr University Bochum (DE)
- The University of Adelaide (AU)
- University of Oxford (GB)
- Hertie Institute for Clinical Brain Research (DE)
- National Hospital for Neurology and Neurosurgery (GB)
- Corresponding author
- Suppa, A.
- Venue
- Brain Stimulation
- Publisher
- Elsevier BV
- Published
- 2016-05
- Volume
- 9
- Issue
- 3
- Pages
- 323-335
- ISSN
- 1876-4754 (ISSN-L)
- 1935-861X
- OpenAlex
- W2287057286
- Cited by
- 609
- References
- 159
- Citations by year
- 2026: 76 · 2025: 84 · 2024: 82 · 2023: 58 · 2022: 74 · 2021: 71 · 2020: 44 · 2019: 38 · 2018: 38 · 2017: 32 · 2016: 9
- FWCI
- 3.39
- Type
- journal article
- Language
- en
- Open access
- green
- doaj.org
- Licence
- Locations
- Brain stimulation (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UCL Discovery (University College London) (submittedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neuropharmacology Research
- Health Sciences › Medicine › Clinical Neurology › Deep Brain Stimulation and Movement Disorders
- Keywords
- theta burst stimulation, long-term potentiation, long-term depression, synaptic plasticity, primary motor cortex, non-invasive brain stimulation, movement disorders, animal models, non-invasive treatment
- MeSH terms
- Adult, Animals, Female, Humans, Health Knowledge, Attitudes, Practice, Motor Cortex, Movement Disorders, Neuronal Plasticity, Theta Rhythm, Long-Term Potentiation, Evoked Potentials, Motor, Transcranial Magnetic Stimulation
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