Modulation of motor cortex neuronal networks by rTMS: comparison of local and remote effects of six different protocols of stimulation
Abstract
Repetitive transcranial magnetic stimulation (rTMS) of human motor cortex can produce long-lasting changes in the excitability of excitatory and inhibitory neuronal networks. The effects of rTMS depend critically on stimulus frequency. The aim of our present study was to compare the effects of different rTMS protocols. We compared the aftereffects of 6 different rTMS protocols [paired associative stimulation at interstimulus intervals of 25 (PAS 25 ) and 10 ms (PAS 10 ); theta burst stimulation delivered as continuous (cTBS) or intermittent delivery pattern (iTBS); 1- and 5-Hz rTMS] on the excitability of stimulated and contralateral motor cortex in 10 healthy subjects. A pronounced increase of cortical excitability, evaluated by measuring the amplitude of motor evoked potentials (MEPs), was produced by iTBS (+56%) and PAS 25 (+45%). Five-hertz rTMS did not produce a significant increase of MEPs. A pronounced decrease of cortical excitability was produced by PAS 10 (−31%), cTBS (−29%), and 1-Hz rTMS (−20%). Short-interval intracortical inhibition was suppressed by PAS 10 . Cortical silent period duration was increased by 1-Hz stimulation. No significant effect was observed in the contralateral hemisphere. Head-to-head comparison of the different protocols enabled us to identify the most effective paradigms for modulating the excitatory and inhibitory circuits activated by TMS.
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Preclinical research suggests that theta burst stimulation can achieve similar or more potent effects on neural plasticity, with durable effects ensuing from 600 pulses of intermittent TBS over 3 minutes or 600 pulses of continuous TBS over 40 seconds.
“Preclinical research suggests that TBS can achieve similar or more potent effects on neural plasticity, with durable effects ensuing from 600 pulses of intermittent TBS (iTBS) over 3 minutes or 600 pulses of continuous TBS (cTBS) over 40 seconds.10”
The finding of sustained and progressive improvement is consistent with the possibility that TBS induces greater brain plasticity than standard rTMS protocols.
“This finding of sustained and progressive improvement is consistent with the possibility that TBS induces greater brain plasticity than standard rTMS protocols.10”
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References 36 · Cited by 303
- Authors
- Di Lazzaro, V., Dileone, M., Pilato, F., Capone, F., Musumeci, G., Ranieri, F., Ricci, V., Bria, P., Di Iorio, R., de Waure, C., Pasqualetti, P., & Profice, P.
- Affiliations
- Institute of Neurology, Università Cattolica, Rome;
- Università Cattolica del Sacro Cuore (IT)
- Institute of Hygiene, Catholic University of the Sacred Heart, Rome, Italy
- Fatebenefratelli Hospital (IT)
- Venue
- Journal of Neurophysiology
- Publisher
- American Physiological Society
- Published
- 2011-05
- Volume
- 105
- Issue
- 5
- Pages
- 2150-2156
- ISSN
- 0022-3077 (ISSN-L)
- 1522-1598
- OpenAlex
- W2036630871
- Cited by
- 303
- References
- 36
- Citations by year
- 2026: 10 · 2025: 21 · 2024: 23 · 2023: 28 · 2022: 23 · 2021: 29 · 2020: 19 · 2019: 16 · 2018: 8 · 2017: 21 · 2016: 19 · 2015: 23 · 2014: 19 · 2013: 22 · 2012: 18
- FWCI
- 10.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Neurophysiology (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neuropharmacology Research
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Keywords
- repetitive transcranial magnetic stimulation, motor cortex, paired associative stimulation, theta burst stimulation, cortical excitability, short-interval intracortical inhibition, motor evoked potentials, cortical silent period, stimulation frequency, long-term potentiation, long-term depression
- MeSH terms
- Adult, Humans, Motor Cortex, Nerve Net, Neural Inhibition, Evoked Potentials, Motor, Transcranial Magnetic Stimulation, Young Adult
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