Abstract
BackgroundMotor cortex excitability was found to be changed after repetitive transcranial magnetic stimulation (rTMS) of the temporal cortex highlighting the occurrence of cross-modal plasticity in non-invasive brain stimulation. Here, we investigated the effects of temporal low-frequency rTMS on motor cortex plasticity in a large sample of tinnitus patients. In 116 patients with chronic tinnitus different parameters of cortical excitability were assessed before and after ten rTMS treatment sessions. Patients received one of three different protocols all including 1 Hz rTMS over the left temporal cortex. Treatment response was defined as improvement by at least five points in the tinnitus questionnaire (TQ). Variables of interest were resting motor threshold (RMT), short-interval intra-cortical inhibition (SICI), intracortical facilitation (ICF), and cortical silent period (CSP).ResultsAfter rTMS treatment RMT was decreased by about 1% of stimulator output near-significantly in the whole group of patients. SICI was associated with significant changes with respect to treatment response. The group of treatment responders showed a decrease of SICI over the course of treatment, the group of non-responders the reverse pattern.ConclusionsMinor RMT changes during rTMS treatment do not necessarily suggest the need for systematic re-examination of the RMT for safety and efficacy issues. Treatment response to rTMS was shown to be related to changes in SICI that might reflect modulation of GABAergic mechanisms directly or indirectly related to rTMS treatment effects.
Highlights
Motor cortex excitability was found to be changed after repetitive transcranial magnetic stimulation of the temporal cortex highlighting the occurrence of cross-modal plasticity in non-invasive brain stimulation
Firstly, repetitive transcranial magnetic stimulation (rTMS) resulted in a near significant decrease in resting motor threshold (RMT) in the whole study population (Table 1)
For RMT there was a tendency towards a reduction but
Summary
Motor cortex excitability was found to be changed after repetitive transcranial magnetic stimulation (rTMS) of the temporal cortex highlighting the occurrence of cross-modal plasticity in non-invasive brain stimulation. We investigated the effects of temporal low-frequency rTMS on motor cortex plasticity in a large sample of tinnitus patients. In 116 patients with chronic tinnitus different parameters of cortical excitability were assessed before and after ten rTMS treatment sessions. [2,3] seem to reflect pathologically altered brain networks [4,5] Based on these findings repetitive transcranial magnetic stimulation (rTMS) was introduced as a treatment approach in Repetitive transcranial magnetic stimulation (rTMS) as a therapeutic intervention consists of non-invasive repeated stimulation of neocortical areas for hundreds of times per daily sessions via principles of electromagnetic induction. Stimulation of the dorso-lateral prefrontal cortex is associated with blood flow changes in the anterior cingulate cortex [11,12] or dopamine release in the caudate nucleus [13]
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