Abstract
Theta burst stimulation is increasingly growing in popularity as a non-invasive method of moderating corticospinal networks. Theta burst stimulation uses gamma frequency trains applied at the rhythm of theta, thus, mimicking theta–gamma coupling involved in cognitive processes. The dorsolateral prefrontal cortex has been found to play a crucial role in numerous cognitive processes. Here, we include 25 studies for review to determine the cognitive effects of continuous theta burst stimulation over the dorsolateral prefrontal cortex; 20 of these studies are healthy participant and five are patient (pharmacotherapy-resistant depression) studies. Due to the heterogeneous nature of the included studies, only a descriptive approach is used and meta-analytics ruled out. The cognitive effect is measured on various cognitive domains: attention, working memory, planning, language, decision making, executive function, and inhibitory and cognitive control. We conclude that continuous theta burst stimulation over the dorsolateral prefrontal cortex mainly inhibits cognitive performance. However, in some instances, it can lead to improved performance by inhibiting the effect of distractors or other competing irrelevant cognitive processes. To be precise, continuous theta burst stimulation over the right dorsolateral prefrontal cortex impaired attention, inhibitory control, planning, and goal-directed behavior in decision making but also improved decision making by reducing impulsivity. Conversely, continuous theta burst stimulation over the left dorsolateral prefrontal cortex impaired executive function, working, auditory feedback regulation, and cognitive control but accelerated the planning, decision-making process. These findings constitute a useful contribution to the literature on the cognitive effects of continuous theta burst stimulation over the dorsolateral prefrontal cortex.
Highlights
Transcranial magnetic stimulation (TMS) is a method that non-invasively facilitates neural modulation of the specific targeted cortical brain areas and, makes it possible to examine their functional roles (Guse et al, 2010; Kaminski et al, 2011; Chung et al, 2018b)
We systematically review studies that have investigated the effects of continuous TBS (cTBS) over the dorsolateral prefrontal cortex (DLPFC) on cognitive processes in healthy participants
The main elements included in our analysis are cognitive effects of theta burst stimulation (TBS) stimulation, the motor threshold, the number of pulses per session, and the cognitive domains, such as working memory and executive function
Summary
Transcranial magnetic stimulation (TMS) is a method that non-invasively facilitates neural modulation of the specific targeted cortical brain areas and, makes it possible to examine their functional roles (Guse et al, 2010; Kaminski et al, 2011; Chung et al, 2018b). Bolognini and Ro (2010) suggest that higher frequency rTMS is typically applied as single short trains having different intertrain intervals, and lower frequency rTMS is applied for a longer duration as continuous stimulation. It has been established that the rTMS stimulation effects can extend to the distant interlinked cortical regions and are not entirely restricted to the stimulated site (Guse et al, 2010). This suggests that the possible cognitive effects after stimulation could be partly due to the secondary rTMS effects
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