TMS-EEG in the Investigation of Excitation-Inhibition Imbalance in Psychosis and Cognition
TMS-EEG in the Investigation of Excitation-Inhibition Imbalance in Psychosis and Cognition
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DOI：
10.1192/bjo.2023.217
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发表时间：
2023-07-07
期刊：
影响因子：
5.4
通讯作者：
Shergill, Sukhi S.
中科院分区：
文献类型：
--
作者：
Michalopoulou, Panayiota G.;Chow, Rachel T. S.;Farooq, Nimra;Szentgyorgyi, Timea;Mohammed-Akram, Maryam;Rocchi, Lorenzo;Shergill, Sukhi S.
经颅磁刺激（TMS）是一种体内、非侵入性和安全的方法，可探测与皮质兴奋性（兴奋性）和GABA能（抑制性）神经传递相关的神经生理学特性。TMS与脑电图（EEG）的结合使我们能够直接从大脑活动中测量TMS诱发的皮层反应，并且它独特地用于阐明体内皮层兴奋/抑制过程。精神分裂症与兴奋/抑制（E/I）失衡有关。精神分裂症中几乎普遍存在的认知障碍与精神分裂症中观察到的E/I异常有关。在TMS-EEG诱发电位（TEP）中，N100被认为反映了抑制性GABA-B皮层回路的激活，并与健康个体的注意力过程、注意缺陷多动障碍（ADHD）和抑郁症相关。我们的目的是调查与运动皮层刺激后N100的产生相关的皮层过程及其与精神分裂症患者和健康对照组的注意力测量的相关性。在两个大脑部位上以90%的静息运动阈值施加150个TMS脉冲后记录TEP，即，稳定期精神分裂症患者（n = 9）和健康对照组（n = 9）左侧初级运动皮层（M1）和背外侧前额叶皮层（DLPFC）。根据既往文献进行感兴趣区（ROI）分析，以计算M1和DLPFC中N100峰值振幅的区域平均值。注意力评估与持续性能任务（CPT）。我们发现患者组M1的N100振幅与CPT评分之间存在显著负相关（rho =-0.73，p = 0.026）。患者DLPFC的N100成分与CPT评分无关（rho =-0.034，p = 0.93），这可能表明精神分裂症患者注意力中M1抑制过程的区域特异性。N100被认为与受皮质-纹状体-丘脑-皮质回路影响的皮质抑制过程有关，皮质抑制活性越大，N100振幅越大。我们的初步研究结果表明GABA-B能TEP N100与M1的注意过程相关，可能代表精神分裂症患者的皮质抑制超过运动抑制。总之，TMS-EEG提供了潜在的调查精神分裂症和认知的E/I失衡的状态和动力学。
Transcranial Magnetic Stimulation (TMS) is an in-vivo, non-invasive, and safe method that probes neurophysiological properties associated with cortical glutamatergic (excitatory) and GABAergic (inhibitory) neurotransmission. The combination of TMS with Electroencephalography (EEG) allows us to measure TMS-evoked cortical responses directly from brain activity and it is uniquely placed to elucidate in-vivo cortical Excitatory/Inhibitory processes. Schizophrenia has been associated with Excitation/Inhibition (E/I) imbalance. Cognitive impairment, which is almost ubiquitous in schizophrenia, has been linked with the E/I abnormalities observed in schizophrenia. Among the TMS-EEG evoked potentials (TEPs), the N100 is thought to reflect activation of inhibitory GABA-B cortical circuits and has been associated with attentional processes in healthy individuals, attention deficit hyperactivity disorder (ADHD) and depression. Our aim was to investigate the cortical processes related to the generation of N100 after motor cortex stimulation and its association with attention measures in patients with schizophrenia and healthy controls. TEPs were recorded following application of 150 TMS pulses at 90% of resting motor threshold on two brain sites, i.e., left primary motor cortex (M1) and dorsolateral prefrontal cortex (DLPFC) in stable patients with schizophrenia (n = 9) and healthy controls (n = 9). Region of Interest (ROI) analysis was performed to calculate the regional average of the N100 peak amplitude in M1 and DLPFC based on previous literature. Attention was assessed with a Continuous Performance Task (CPT). We found a significant negative correlation between the amplitude of N100 from M1 and CPT score in the patient group (rho = -0.73, p = 0.026). The N100 component from DLPFC in patients did not correlate with the CPT score (rho = -0.034, p = 0.93), which may suggest regional specificity of M1 inhibitory processes in attention in patients with schizophrenia. N100 is considered to be related to cortical inhibitory processes influenced by cortico–striato–thalamo–cortical loops, with greater cortical inhibitory activity producing a larger N100 amplitude. Our preliminary results suggest association of the GABA-B-ergic TEP N100 with attentional processes in M1 and may represent cortical inhibition beyond motor inhibition in patients with schizophrenia. Overall, TMS-EEG offers the potential to investigate the state and dynamics of E/I imbalance in schizophrenia and cognition.