Abstract
The potential benefits of priming intermittent theta burst stimulation (iTBS) with continuous theta burst stimulation (cTBS) have not been examined in regard to sensorimotor oscillatory activities recorded in electroencephalography (EEG). The objective of this study was to investigate the modulatory effect of priming iTBS (cTBS followed by iTBS) delivered to the motor cortex on movement-related and mirror visual feedback (MVF)-induced sensorimotor event-related desynchronization (ERD), compared with iTBS alone, on healthy adults. Twenty participants were randomly allocated into Group 1: priming iTBS—cTBS followed by iTBS, and Group 2: non-priming iTBS—sham cTBS followed by iTBS. The stimulation was delivered to the right primary motor cortex daily for 4 consecutive days. EEG was measured before and after 4 sessions of stimulation. Movement-related ERD was evaluated during left-index finger tapping and MVF-induced sensorimotor ERD was evaluated by comparing the difference between right-index finger tapping with and without MVF. After stimulation, both protocols increased movement-related ERD and MVF-induced sensorimotor ERD in high mu and low beta bands, indicated by significant time effects. A significant interaction effect favoring Group 1 in enhancing movement-related ERD was observed in the high mu band [F(1,18) = 4.47, p = 0.049], compared with Group 2. Our experiment suggests that among healthy adults priming iTBS with cTBS delivered to the motor cortex yields similar effects with iTBS alone on enhancing ERD induced by MVF-based observation, while movement-related ERD was more enhanced in the priming iTBS condition, specifically in the high mu band.
Highlights
Theta burst stimulation (TBS) is an accelerated form of repetitive transcranial magnetic stimulation, which has been extensively employed in human studies after the first human experiment (Huang and Rothwell, 2004)
TBS is an accelerated form of excitatory repetitive transcranial magnetic stimulation (rTMS) that may lead to superior clinical outcomes, a recent experiment showed that the response rate to intermittent theta burst stimulation (iTBS) or continuous theta burst stimulation (cTBS) is around 60% (Mc Calley et al, 2019) and did not improve along with more delivered doses of the same stimulation, indicating that TBS has no effects on a substantial number of subjects
Our study found that: (1) both stimulation protocols increased movement-related event-related desynchronization (ERD) in high mu and low beta bands, with a superior effect in regard to enhancing movement-related high mu ERD in participants who received priming iTBS; and (2) both protocols were equivalent in enhancing mirror visual feedback (MVF)-induced ERD in the high mu and low beta bands
Summary
Theta burst stimulation (TBS) is an accelerated form of repetitive transcranial magnetic stimulation (rTMS), which has been extensively employed in human studies after the first human experiment (Huang and Rothwell, 2004). TBS is an accelerated form of excitatory rTMS that may lead to superior clinical outcomes, a recent experiment showed that the response rate to iTBS or cTBS (i.e., the percentage of participants who presented increased or decreased MEP upon completion of the stimulation) is around 60% (Mc Calley et al, 2019) and did not improve along with more delivered doses of the same stimulation, indicating that TBS has no effects on a substantial number of subjects. The inconsistency of the response to TBS may limit its utility in both research and clinical interventions (Schilberg et al, 2017)
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