Brain research · 2025
Evidence of widespread brain inhibition following conventional but not individualised non-motor repetitive transcranial magnetic stimulation: A multimodal study.
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Houde Francis, Butler Russell, Martel Marylie, Descoteaux Maxime, Whittingstall Kevin, Leonard Guillaume
Аннотация
BACKGROUND: Studies using repetitive transcranial magnetic stimulation (rTMS) frequently target non-motor brain areas to treat various conditions, including pain. However, whether and how non-motor rTMS affects neural activity is still debated in the scientific community.
OBJECTIVE: Characterize the local and global inhibitory effects of 2 non-motor rTMS protocols on brain activity.
METHODS: Participant's (n = 13) functional magnetic resonance imaging (fMRI) signal associated with a painful electrical paradigm was measured before and after 2 distinct low-frequency rTMS protocols (target: left superior temporal gyrus [STG]) with different intensities (conventional protocol: 90% resting motor threshold (rMT); individualized protocol: based on field-modeling). The target and the painful electrical paradigm were selected based on prior findings highlighting the role of the STG in pain memory. The size of activation clusters before and after the 2 rTMS protocols was compared using non-parametric tests. Field-modeling and state of the art white matter (WM) tractography were also used to document spatial effects of rTMS on brain activity.
RESULTS: rTMS targeting the STG significantly decreased BOLD activation in a widespread and long-lasting (∼ 10 min) manner, affecting both local (precentral gyrus, inferior parietal lobule and post central gyrus) and distant (inferior frontal gyrus, paracentral lobule, and insular gyrus and thalamus) brain areas for the conventional protocol. In contrast, no changes were observed for the individualized protocol. The distant rTMS effects observed in the left-hemisphere could be accounted for by structural connectivity, as revealed by tractography-based pathway analyses.
CONCLUSIONS: These exploratory findings suggest that, unlike the individualized protocol, conventional non-motor low-frequency rTMS protocol can induce widespread and long-lasting cortical inhibition via multiple pathways. These results open promising avenues for neurostimulation approaches targeting comparable effects in various clinical contexts. Additional research involving larger sample sizes is essential to validate these initial findings and confirm their broader applicability.
OBJECTIVE: Characterize the local and global inhibitory effects of 2 non-motor rTMS protocols on brain activity.
METHODS: Participant's (n = 13) functional magnetic resonance imaging (fMRI) signal associated with a painful electrical paradigm was measured before and after 2 distinct low-frequency rTMS protocols (target: left superior temporal gyrus [STG]) with different intensities (conventional protocol: 90% resting motor threshold (rMT); individualized protocol: based on field-modeling). The target and the painful electrical paradigm were selected based on prior findings highlighting the role of the STG in pain memory. The size of activation clusters before and after the 2 rTMS protocols was compared using non-parametric tests. Field-modeling and state of the art white matter (WM) tractography were also used to document spatial effects of rTMS on brain activity.
RESULTS: rTMS targeting the STG significantly decreased BOLD activation in a widespread and long-lasting (∼ 10 min) manner, affecting both local (precentral gyrus, inferior parietal lobule and post central gyrus) and distant (inferior frontal gyrus, paracentral lobule, and insular gyrus and thalamus) brain areas for the conventional protocol. In contrast, no changes were observed for the individualized protocol. The distant rTMS effects observed in the left-hemisphere could be accounted for by structural connectivity, as revealed by tractography-based pathway analyses.
CONCLUSIONS: These exploratory findings suggest that, unlike the individualized protocol, conventional non-motor low-frequency rTMS protocol can induce widespread and long-lasting cortical inhibition via multiple pathways. These results open promising avenues for neurostimulation approaches targeting comparable effects in various clinical contexts. Additional research involving larger sample sizes is essential to validate these initial findings and confirm their broader applicability.