Theta Burst Stimulation of the Prefrontal Cortex: Safety and Impact on Cognition, Mood, and Resting Electroencephalogram
Theta Burst Stimulation of the Prefrontal Cortex: Safety and Impact on Cognition, Mood, and Resting Electroencephalogram
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DOI：
10.1016/j.biopsych.2008.10.029
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发表时间：
2009-05-01
影响因子：
10.6
通讯作者：
Padberg, Frank
中科院分区：
文献类型：
--
作者：
Grossheinrich, Nicola;Rau, Anne;Padberg, Frank
背景资料：由于标准重复经颅磁刺激（rTMS）方案表现出短持续时间的刺激后效应，新的协议，如θ波群刺激（TBS），是有前途的方法，以提高rTMS的有效性。然而，很少有人知道这种协议的副作用。因此，本研究探讨TBS是否安全，特别是在健康受试者的认知，情绪和脑电图（EEG）测量方面的影响。方法：24名健康志愿者参加了2项随机、安慰剂对照、交叉实验，并在左侧背外侧前额叶皮质上进行了连续TBS（cTBS）、间歇TBS（iTBS）和假TBS。（DLPFC，n = 12）或内侧前额叶皮质（mPFC，n = 12）。记录临床副作用、神经心理学成套测试中的表现、情绪变化和静息EEG。结果：未观察到癫痫发作或癫痫样脑电图活动。最突出的副作用是在TBS期间迷走神经反应的发生;否则没有严重的副作用被发现。标准化的低分辨率脑电磁断层扫描显示电流密度的变化，在α 2带iTBS后的DLPFC，这仍然是可检测到的刺激后50分钟。少数神经心理学表现的改变与刺激部位一致。没有对情绪的影响detected.Conclusions：虽然TBS协议的人类前额叶皮层似乎是安全的健康受试者，未来的研究需要解决迷走神经反应的发生。运动皮质TBS的兴奋和抑制特性可能无法转移到前额部位，并且在临床应用之前需要进一步研究特定TBS协议的作用。
Background: Because standard repetitive transcranial magnetic stimulation (rTMS) protocols exhibit post-stimulus effects of short duration, novel protocols such as theta burst stimulation (TBS), are promising approaches to enhance the effectiveness of rTMS. However, little is known about the side effect profile of such protocols. Thus, the present study explores whether TBS is safe particularly in terms of effects on cognition, mood, and electroencephalogram (EEG) measures in healthy subjects.Methods: Twenty-four healthy volunteers participated in 2 randomized, placebo-controlled, cross-over experiments and underwent continuous TBS (cTBS), intermittent TBS (iTBS), and sham TBS either over the left dorsolateral prefrontal cortex (DLPFC, n = 12) or the medial prefrontal cortices (mPFC, n = 12). Clinical side effects, performance in a neuropsychological battery, mood changes, and resting EEG were recorded.,Results: Neither a seizure nor epileptiform EEG activity was observed. The most prominent side effect was the occurrence of vagal reactions during TBS; otherwise no serious side effects were found. Standardized low-resolution brain electromagnetic tomography showed current density changes in the alpha 2 band after iTBS of the DLPFC, which remained detectable up to SO min after stimulation. The few changes in neuropsychological performance were concordant with stimulation site. No impact on mood was detected.Conclusions: Although TBS protocols of the human prefrontal cortex seem to be safe in healthy subjects, future studies need to address the occurrence of vagal reactions. Excitatory and inhibitory properties of motor cortex TBS might not be transferable to prefrontal sites, and the action of specific TBS protocols needs to be further investigated prior to clinical application.