Intermittent theta burst stimulation (iTBS) delivered by transcranial magnetic stimulation (TMS) produces a long-term potentiation (LTP)-like after-effect useful for investigations of cortical function and of potential therapeutic value. However, the iTBS after-effect over the primary motor cortex (M1) as measured by changes in motor evoked potential (MEP) amplitude exhibits a largely unexplained variability across individuals. Here, we present evidence that individual differences in white and gray matter microstructural properties revealed by fractional anisotropy (FA) predict the magnitude of the iTBS-induced after-effect over M1. The MEP amplitude change in the early phase (5–10 min post-iTBS) was associated with FA values in white matter tracts such as right superior longitudinal fasciculus and corpus callosum. In contrast, the MEP amplitude change in the late phase (15–30 min post-iTBS) was associated with FA in gray matter, primarily in right frontal cortex. These results suggest that the microstructural properties of regions connected directly or indirectly to the target region (M1) are crucial determinants of the iTBS after-effect. FA values indicative of these microstructural differences can predict the potential effectiveness of rTMS for both investigational use and clinical application.
Erdheim-Chester disease (ECD) is a rare, non-Langerhans cell histiocytosis characterized by the infiltration of foamy histiocytes into multiple organs. We herein report a case of ECD with central nervous system (CNS) involvement in a 63-year-old man who also presented a positive result for Toxoplasma gondii nested polymerase chain reaction testing of cerebrospinal fluid. Since anti-Toxoplasma treatment proved completely ineffective, we presumed latent infection of the CNS with T. gondii. This case suggests the difficulty of distinguishing ECD with CNS involvement from toxoplasmic encephalitis and the possibility of a relationship between the pathogeneses of ECD and infection with T. gondii.
This systematic review and meta-analysis examined the effects of neurofeedback training (NFT) on attentional performance in healthy adults. Six databases (PubMed, Scopus, Web of Science, PsycInfo, JDreamⅢ, and Ichu-shi) were searched up to June 2022 for randomized controlled trials (RCTs) comparing attentional performance following NFT to a control group. Risk of bias was determined using the Cochrane Collaboration's tool. We identified 41 RCTs for qualitative synthesis and 15 RCTs without high risk of bias (including 569 participants) for meta-analysis using a random-effects model. The overall effect of NFT on attentional performance was significant (standardized mean difference = 0.27, 95% confidence interval = 0.10–0.44). However, approximately half of the studies did not compare its effects with sham-NFT, and no significant pooled effect of NFT was found in the studies compared to a sham-NFT group. Furthermore, subgroup analyses revealed variable effects on individual attentional performance subsets (executive function, spatial orientation, and arousal). Future large-scale sham-controlled RCTs are needed to confirm the efficacy of NFT for improving attentional performance.
Quadripulse stimulation (QPS) is a promising patterned repetitive transcranial magnetic stimulation protocol, which allows the modulation of brain activity for over one hour after the stimulation. Recently, Deymed Diagnostic developed a new stimulator specifically designed to deliver QPS (DuoMAG MP-Quad, https://deymed.com/duomag-qps). The properties of the after-effect with this new stimulator were expected to parallel those obtained with another stimulator, the Magstim stimulator, which is currently used in the psychological and clinical research but not commercially available anymore. Nevertheless, experimental validation of DuoMAG MP-Quad was still warranted. We thus studied the QPS after-effect induced by this stimulator. As a result, motor evoked potentials were found to be bidirectionally modulated by the QPS for more than one hour, consistent with previous studies using the Magstim stimulator. Moreover, the degree of the after-effect was comparable to the after-effect induced by the other stimulator. Taken together, we conclude that the newly developed QPS stimulator is as effective as the Magstim stimulator.
Intermittent theta burst stimulation (iTBS) delivered by transcranial magnetic stimulation (TMS) produces a long term potentiation (LTP)-like after-effect useful for investigations of cortical function and of potential therapeutic value. However, the iTBS-evoked after-effect over the primary motor cortex (M1) as measured by changes in motor evoked potential (MEP) amplitude exhibits a largely unexplained variability across individuals. Here, we present evidence that individual differences in white and grey matter microstructural properties revealed by fractional anisotropy (FA) predict the magnitude of the iTBS-induced after-effect over M1. The MEP amplitude change in the early phase (5–10 min) post-iTBS was associated with FA values in white matter tracts such as right superior longitudinal fasciculus and corpus callosum. In contrast, the MEP amplitude change in the late phase (15–30 min) post-iTBS was associated with FA in grey matter, primarily in right frontal cortex. These results suggest that the microstructural properties of regions connected directly or indirectly to the target region (M1) are crucial determinants of the iTBS after-effect. FA values indicative of these microstructural differences can predict the potential effectiveness of rTMS for both investigational use and clinical application.
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