Studies of mechanisms of theta burst stimulation and other repetitive TMS using non-invasive neuroimaging methods

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Effects of theta burst TMS measured by NIRSCerebral blood flow (CBF) changes induced by TBS over the primary motor cortex were measured by near infrared spectroscopic recording in normal volunteers. TBS over M1 induced CBF decrease at the contralateral motor cortex and increase at the contralateral sensory cortex. They indicate the mutual inhibitory interaction between bilateral motor cortices and between ipsilateral sensori-motor cortices. These interactions may explain some beneficial remote effects in rTMS. treatment.Comparisons of the long lasting after effects between monophasic and biphasic rTMS in humansWe compared the after effects induced by monopahsic and biphasic rTMS over the primary motor cortex in humans using several neurophysiological measures. Monophasic rTMS elicited greater and longer facilitatory short lasting after effects on the primary motor cortex as compared with widely used biphasic rTMS. This suggests that rTMS using monophasic pulses may be superior to the w … More idely used biphasic rTMS in the treatment of several disorders.The origin of facilitation induced by repetitive paired pulse TMS over the M1Several measures of cortical and spinal excitability were obtained before and after the repetitive paired pulse TMS (rPPS) of the primary motor cortex. The motor cortical excitability was increased by rPPS of M1 without any changes in the spinal motoneuronal excitability. It indicates that rPPS produces motor cortical facilitation. Physiological results suggest that this facilitation is not due to the membrane excitability changes, but may be due to synaptic efficacy changes at the motor cortex.The repetitive, monophasic quadric-pulse TMSWe proposed a brand new repetitive TMS stimulation method to induce a long term after effects. One train consists of four monophasic TMS pulses. We gave a train every five seconds for thirty minutes (total 1440 pulses) (repetitive quadric-pulse TMS (rQPS)) over the primary motor cortex. The after effects induced by rQPS were much greater and lasted much longer than those induced by rPPS. Several physiological parameters to estimate motor cortical excitability and synaptic efficacy were compared between after rPPS and rQPS. These results suggest that QPS had powerful effects on the motor cortical synaptic efficacy.Based on the above results, we conclude that the QPS is the best method of TMS for the treatment for neurological disorders. Less