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Abstract
Noninvasive brain stimulation to enhance cognition is an area of increasing research interest. Theta burst stimulation (TBS) is a novel accelerated form of stimulation, which more closely mimics the brain’s natural firing patterns and may have greater effects on cognitive performance. We report here the comparative assessment of the effect of conventional high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) protocols and TBS protocols on cognition enhancement in healthy controls. Sixty healthy adults (34 males and 26 females) were randomized and counterbalanced and assigned to HF-rTMS (n = 20), TBS (n = 20), or sham (n = 20) groups. The promotion effects of different parameters of prefrontal stimulation on working memory and executive function were compared, as assessed by performance in N-back tasks and the Wisconsin Card Sorting Test (WCST). Both HF-rTMS and intermittent TBS (iTBS) groups displayed a significant improvement in N-back tasks, with an effect size of 0.79 and 1.50, respectively. Furthermore, the iTBS group displayed a significant improvement in the WCST, with an effect size of 0.84. The iTBS group demonstrated higher effect sizes than the HF-rTMS group (t = 2.68, p = 0.011), with an effect size of 0.85. However, no improvement in other tasks was observed (p > 0.05). Intermittent TBS has a stronger cognitive promoting effect than conventional rTMS. In summary, our findings provide direct evidence that iTBS may be a superior protocol for cognitive promotion.
Highlights
Cognitive deficits can be caused by numerous neuropsychiatric disorders, such as Alzheimer’s disease, Parkinson’s disease, major depression disease (MDD) and schizophrenia (Iimori et al, 2019; Chou et al, 2020)
This study demonstrated that intermittent TBS (iTBS) has a stronger cognitive promoting effect than 20-Hz Repetitive transcranial magnetic stimulation (rTMS) and provided direct evidence that iTBS may be a better protocol for cognitive promotion
This study presents a randomized, double-blinded, shamcontrolled design comparing the effects of sham stimulation, 20-Hz rTMS and iTBS, applied over the dorsolateral prefrontal cortex (DLPFC), on working memory and executive functions in HC
Summary
Cognitive deficits can be caused by numerous neuropsychiatric disorders, such as Alzheimer’s disease, Parkinson’s disease, major depression disease (MDD) and schizophrenia (Iimori et al, 2019; Chou et al, 2020). Various studies have demonstrated that high-frequency rTMS (HFrTMS) stimulation of the left dorsolateral prefrontal cortex (DLPFC) improves cognitive functions in healthy adults and neuropsychiatric patients, such as working memory, attention, and executive control (Curtin et al, 2019; Iimori et al, 2019). Guse and colleagues found that rTMS at 20 Hz, applied over the left DLPFC, is more likely to cause significant cognitive improvement than 10- and 15-Hz rTMS (Guse et al, 2010)
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