High frequency repetitive transcranial magnetic stimulation decreases cerebral vasomotor reactivity

Vernieri, Fabrizio; Maggio, Paola; Tibuzzi, Francesco; Filippi, M; Pasqualetti, Patrizio; Melgari, Jean Marc; Altamura, Claudia; Palazzo, Paola; Giorgio, Marina Di; Rossini, Paolo Maria

doi:10.1016/j.clinph.2009.03.021

Cited by 34 publications

(27 citation statements)

References 37 publications

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“…In one study, high frequency rTMS (10 and 20 Hz) induced a stable condition of bilateral pupillary dilatation via activation of the sympathetic system when it was applied above the motor threshold [21] . Additionally, Vernieri et al [14] examined the effects of high-frequency rTMS (17-Hz) on cerebral vasomotor reactivity (VMR) in a sample of healthy subjects and patients with acute stroke, and found that real rTMS applied to the M1 and calcarine cortex resulted in a deceased VMR in both groups. These authors concluded that high-frequency rTMS reduces cerebral VMR, possibly as a secondary effect on the autonomic control of cerebral hemodynamics.…”

Section: Discussionmentioning

confidence: 99%

“…Real rTMS was applied to the M1 in the left hemisphere with a Magstim-Rapid2 Stimulator (Magstim Company Ltd., London, UK), as previously described [14] . The TMS was delivered through a figure-of-eight focal coil oriented so that the induced electric current flowed in a posteroanterior direction over the left M1 based on the resting motor threshold (RMT).…”

Section: Design and Stimulation Proceduresmentioning

confidence: 99%

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Effects of High-Frequency Repetitive Transcranial Magnetic Stimulation on Cerebral Hemodynamics in Patients with Disorders of Consciousness: A Sham-Controlled Study

Liu

Gao²,

Pan³

et al. 2016

Eur Neurol

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Objective: This study aimed to determine the effects of high-frequency repetitive transcranial magnetic stimulation (rTMS) on cerebral hemodynamics in patients with disorders of consciousness (DOC). Methods: In this sham-controlled study, 20-Hz and sham rTMS were applied over the left primary motor cortex (M1) of 5 patients in a vegetative state (VS) and 5 patients in a minimally conscious state (MCS). The clinical behavior and cerebral blood flow (CBF) velocity in the bilateral middle cerebral artery (MCA) of the patients were evaluated before and after rTMS. Results: Compared with the VS group, the MCS group exhibited significant increases in peak systolic velocity (PSV; p = 0.024) and mean flow velocity (MFV) of the left MCA that were temporally related to the rTMS (p = 0.042). There were no significant effects on CBF velocity in the sham-stimulation group or the right MCA. Conclusions: High-frequency rTMS exerts different effects on CBF depending on the level of consciousness in patients with DOC such that it increased PSV and MFV in patients in a MCS. These effects may be related to the varying degrees of disrupted neurovascular coupling and the autonomic control of the cerebral hemodynamics in patients in a VS or MCS.

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Section: Discussionmentioning

confidence: 99%

Section: Design and Stimulation Proceduresmentioning

confidence: 99%

Effects of High-Frequency Repetitive Transcranial Magnetic Stimulation on Cerebral Hemodynamics in Patients with Disorders of Consciousness: A Sham-Controlled Study

Liu

Gao²,

Pan³

et al. 2016

Eur Neurol

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“…As in other studies using rTMS [17] and even hypercapnia [7,8,19], PI was also unchanged in the present study indicating that the observed changes were not the result of a direct vasoconstricting effect on the MCA. Although the exact dynamics of the effect of rTMS are incompletely understood, it is likely mediated by a change in small arteriolar diameter paralleling oxygen consumption as suggested by PET studies showing an increase in regional CBF following rTMS [23,24], and by an observed decrease in capacity for further reactivity to a CO 2 stimulus after rTMS [25]. …”

Section: Discussionmentioning

confidence: 99%

Differential Hemodynamic Response to Repetitive Transcranial Magnetic Stimulation in Acute Stroke Patients with Cortical versus Subcortical Infarcts

et al. 2010

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Objective: To assess the cerebral vasomotor response to ipsilesional repetitive transcranial magnetic stimulation (rTMS) on transcranial Doppler (TCD) in patients with recent ischemic stroke without carotid occlusive disease, and to compare this response in patients with cortical and subcortical infarcts. Methods: Consecutive patients with first-ever anterior circulation acute ischemic stroke (<3 days) and no extra- or intracranial arterial stenosis were prospectively recruited. Patients were divided into 2 groups: cortical infarct (CI, n = 15) and subcortical infarct (SI, n = 16). TCD cerebral blood flow velocity (CBFV) and pulsatility index were measured before and after 10-Hz suprathreshold rTMS over the dorsolateral prefrontal cortex. Results: ANOVA showed a greater percentage increase in middle cerebral artery (MCA) CBFV in the SI group than in the CI group following rTMS (p = 0.01). The percentage change in CBFV was significantly correlated between both MCAs in SI patients but not in CI patients (r = 0.8, p < 0.001 vs. r = 0.05, p = 0.9, respectively). Conclusions: 10-Hz rTMS induces significant bilateral hemodynamic changes in patients with acute ischemic stroke, which appear to be less prominent and less synchronous in patients with cortical infarcts. These findings may allow optimization of the use of TMS in acute stroke.

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“…7 Mean flow velocity (MFV) in the middle cerebral arteries was recorded at rest condition (MFV baseline) and after the inhalation of a mixture of 7% CO 2 /air (MFV CO 2 ). VMR values were obtained according to the formula:…”

Section: Evaluation Before Tdcsmentioning

confidence: 99%

“…5,6 We recently demonstrated that repetitive transcranial magnetic stimulation can reduce VMR in stroke patients. 7 The present study aimed to investigate the tDCS effect on cerebral VMR.…”

mentioning

confidence: 99%

Cortical Neuromodulation Modifies Cerebral Vasomotor Reactivity

Vernieri

Assenza

Maggio

et al. 2010

Stroke

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Background and Purpose-Cerebral vasomotor reactivity (VMR) is a capability of cerebral vessels to dilate in response to hypercapnia. Transcranial direct current stimulation (tDCS) effects on cerebral hemodynamics have been poorly studied. Methods and Results-Ten healthy subjects underwent anodal/cathodal tDCS on the left motor cortex. Before and after tDCS, VMR assessment by transcranial Doppler and an electrocardiogram were performed. Normalized low-frequency band power of heart rate variability and its reactivity from basal to VMR condition (LFN react ) were estimated as relative markers of sympathetic activation. tDCS exerted a polarity-specific effect on both VMR (Pϭ0.0001) and LFN react (Pϭ0.001). Anodal tDCS decreased VMR by 3.4%/mm Hg CO 2 bilaterally and increased LFN react , whereas cathodal tDCS increased VMR by 0.8%/mm Hg CO 2 bilaterally and reduced LFN react . Conclusions-Cerebral VMR is modified by tDCS. Based on the consensual changes with heart rate variability, we can hypothesize that the sympathetic nervous system could modulate the bihemispheric modification of VMR. Further studies are needed to confirm this hypothesis.

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High frequency repetitive transcranial magnetic stimulation decreases cerebral vasomotor reactivity

Cited by 34 publications

References 37 publications

Effects of High-Frequency Repetitive Transcranial Magnetic Stimulation on Cerebral Hemodynamics in Patients with Disorders of Consciousness: A Sham-Controlled Study

Effects of High-Frequency Repetitive Transcranial Magnetic Stimulation on Cerebral Hemodynamics in Patients with Disorders of Consciousness: A Sham-Controlled Study

Differential Hemodynamic Response to Repetitive Transcranial Magnetic Stimulation in Acute Stroke Patients with Cortical versus Subcortical Infarcts

Cortical Neuromodulation Modifies Cerebral Vasomotor Reactivity

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