Neural and behavioral effects of theta burst stimulation priming on processing of affective and neutral information in working memory

Lais B Razza,Sara De Witte,Stefanie De Smet,Kate Hoy,Andre R Brunoni,Marie-Anne Vanderhasselt,Chris Baeken,Deborah C.W Klooster

doi:10.1016/j.brs.2021.10.472

Lais B Razza, Sara De Witte + Show 6 more

Open Access

https://doi.org/10.1016/j.brs.2021.10.472

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Abstract

Abstract Theta-burst stimulation (TBS) has been increasingly used to target prefrontal brain regions, such as the dorsolateral prefrontal cortex (DLPFC), to improve neurocognitive and emotional functioning. However, despite the promising outcomes, there is still a lot of variability in responses and the clinical efficacy remains rather modest. Interestingly, fundamental research targeting the motor cortex has suggested the use of priming techniques to enhance TBS-related changes in cortical excitability. Hence, TBS priming - using a prime TBS protocol to enhance the effects of a subsequent test TBS protocol - can yield improved TBS efficacy when applied over the prefrontal cortex. Moreover, recent developments in the field indicate that stimulation priming can be highly efficacious in reducing depressive symptoms. In this within-subjects, sham-controlled study, we investigated how different TBS priming protocols over the left DLPFC affect cognitive performance and task-related brain activity in a sample of fifty healthy adults. Participants performed a verbal working memory task, consisting of affective and neutral word stimuli, during functional magnetic resonance imaging (fMRI) after receiving one of four TBS priming combinations (i.e., a prime followed by a test protocol); (1) sham TBS + sham TBS, (2) sham TBS + intermittent TBS, (3) intermittent TBS + intermittent TBS, (4) continuous TBS + intermittent TBS. Each prime and test protocol was separated by a 15-minute break and there was one week in between each experimental session. Task performance and participants’ activation patterns elicited by the task following the different TBS priming conditions were assessed. During this talk, the behavioral and neural findings will be presented. Moreover, implications of the study findings for further studies evaluating the neurobehavioral effects of TBS priming on emotional working memory, in healthy and neuropsychiatric samples, will be discussed. Keywords: Theta Burst Stimulation (TBS), functional magnetic resonance imaging (fMRI), Stimulation Priming, Working Memory

Highlights

Major Depressive Disorder (MDD) and chronic pain are frequently co-occurring, and the onset of either condition can either precede or follow the onset of the other
Clinical outcome for pharmacological and repetitive transcranial magnetic stimulation (rTMS) treatment for depression is significantly worse in the presence of chronic pain symptoms
We examined whether a multi-target rTMS protocol including stimulation of the left dorsolateral prefrontal cortex (DLPFC) and primary motor cortex (M1) would improve depressive and chronic pain symptoms more than a standard single-target rTMS protocol

Summary

Introduction

Major Depressive Disorder (MDD) and chronic pain are frequently co-occurring, and the onset of either condition can either precede or follow the onset of the other. Objective: We examined whether a multi-target rTMS protocol including stimulation of the left dorsolateral prefrontal cortex (DLPFC) and primary motor cortex (M1) would improve depressive and chronic pain symptoms more than a standard single-target rTMS protocol. MOTOR CORTICAL TREATMENT TARGETS FOR CHRONIC PELVIC PAIN: BIG DATA, SMALL DATA, AND CLINICAL TRIALS

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