Low frequency repetitive transcranial magnetic stimulation to the right dorsolateral prefrontal cortex engages thalamus, striatum, and the default mode network

Caparelli, Elisabeth de Castro; Abulseoud, Osama A.; Gu, Hong; Zhai, Tianye; Schleyer, Brooke; Yang, Yihong

doi:10.3389/fnins.2022.997259

Cited by 8 publications

(5 citation statements)

References 59 publications

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“…Similar effects are seen with rTMS. For example, right compared to left HF-rTMS is associated with greater dACC and dmPFC responses [69], and lf-rTMS can increase brain activity at the striatum, thalamus, and areas of the default mode network when applied to the right, but not to the left DLPFC [70]. Finally, TMSevoked responses collected during unpredictable threat, show that the right dlPFC seems to regulate activity in regions important to emotion This BOLD deactivation is attenuated by exogenous shock threat [71].…”

Section: Discussionmentioning

confidence: 97%

Interleaved TMS/fMRI shows that threat decreases dlPFC-mediated top-down regulation of emotion processing

Patel,

Teferi,

Gura

et al. 2024

NPP—Digit Psychiatry Neurosci

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The dorsolateral prefrontal cortex (dlPFC) is thought to be a key site in the brain’s cognitive control network, supporting cognitive processes like attention and working memory [1–7]. There is also evidence that the dlPFC is engaged during anxiety regulation tasks, suggesting that anxiety regulation may be mediated in part by dlPFC activity [8–15]. However, the degree to which these two domains of processing overlap is unclear. Therefore, in the current study, we tested the hypothesis that the dlPFC regulates brain regions critical for the expression of anxiety. To do so, we used interleaved TMS/fMRI to record TMS-evoked BOLD responses during periods of threat compared to periods of safety. We hypothesized that TMS pulses would reduce activity in anxiety expression regions during threat. Forty-four healthy controls (no current or history of psychiatric disorders) were recruited to take part in a broader study. Participants completed the neutral, predictable, and unpredictable (NPU) threat task while receiving TMS pulses to either the right dlPFC or a control region. A whole brain analysis identified regions showing significant BOLD responses evoked by dlPFC stimulation. We then extracted these responses and compared those evoked during safe blocks to those evoked during unpredictable threat. We found that responses in the left insula (LI), right sensory/motor cortex (RSM), and a region encompassing the bilateral SMA regions (BSMA) showed significantly different responses during the safe blocks compare to the threat. During the safe periods, these regions showed significant BOLD deactivations. These deactivations were reduced during the threat blocks. Overall, these findings are largely consistent with the hypothesis that the dlPFC plays a role in the top-down control of emotion and suggest that dlPFC activity reduces downstream activity in emotional expression regions, but that this effect is reduced under threat.

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Section: Discussionmentioning

confidence: 97%

Interleaved TMS/fMRI shows that threat decreases dlPFC-mediated top-down regulation of emotion processing

Patel,

Teferi,

Gura

et al. 2024

NPP—Digit Psychiatry Neurosci

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“…Consistent with a role in CUD, left DLPFC function predicted cannabis versus money choice (Bedi et al, 2015). Combining positron emission tomography or fMRI with left DLPFC TMS has demonstrated that stimulating this region causes molecular and functional changes, respectively, in executive control and striatal brain regions (Strafella et al, 2001;Pogarell et al, 2007;Cho and Strafella, 2009;Hanlon et al, 2013;Gorelick et al, 2014;Caparelli et al, 2022). The ability of TMS to modulate glutamate and dopamine function in mesocorticolimbic circuits is consistent with its use as a tool to link brain activity with abuse-related behavior and as a potential treatment for drug use disorder, including CUD (Gorelick et al, 2014;Hanlon et al, 2018;Steele, 2020b;Kearney-Ramos and Haney, 2021).…”

Section: Intervention Protocolsmentioning

confidence: 89%

Combining noninvasive brain stimulation with behavioral pharmacology methods to study mechanisms of substance use disorder

Wesley

Lile

2023

Front. Neurosci.

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Psychotropic drugs and transcranial magnetic stimulation (TMS) are effective for treating certain psychiatric conditions. Drugs and TMS have also been used as tools to explore the relationship between brain function and behavior in humans. Combining centrally acting drugs and TMS has proven useful for characterizing the neural basis of movement. This combined intervention approach also holds promise for improving our understanding of the mechanisms underlying disordered behavior associated with psychiatric conditions, including addiction, though challenges exist. For example, altered neocortical function has been implicated in substance use disorder, but the relationship between acute neuromodulation of neocortex with TMS and direct effects on addiction-related behaviors is not well established. We propose that the combination of human behavioral pharmacology methods with TMS can be leveraged to help establish these links. This perspective article describes an ongoing study that combines the administration of delta-9-tetrahydrocannabinol (THC), the main psychoactive compound in cannabis, with neuroimaging-guided TMS in individuals with problematic cannabis use. The study examines the impact of the left dorsolateral prefrontal cortex (DLPFC) stimulation on cognitive outcomes impacted by THC intoxication, including the subjective response to THC and the impairing effects of THC on behavioral performance. A framework for integrating TMS with human behavioral pharmacology methods, along with key details of the study design, are presented. We also discuss challenges, alternatives, and future directions.

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“…It does so with high accuracy. For example, in the case of bipolar disorder, TMS is purposefully positioned to affect the left dorsolateral prefrontal cortex [ 4 ]. This region plays a role in the regulation of emotional control.…”

Section: Discussionmentioning

confidence: 99%

“…These electromagnetic bursts act upon neurons with curved axonal processes at a right angle to the primary coil [ 3 ]. The electrical field induced in the neural tissue depolarizes the axons, eventually resulting in an action potential if the threshold is reached [ 4 ]. The ability to reach 120% motor evoked potentials (MEP) from 80% MEP is dependent on the type of coil and intensity of electrical current used [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…rTMS utilized in the treatment of psychiatric disorders is most commonly directed at the left dorsolateral prefrontal cortex (DLPFC) [ 3 ]. TMS over the DLPFC may stimulate the cortico-striatal-thalamo-cortical loop, which plays a pivotal role in the regulation of emotions via dopamine [ 4 ]. A single pulse TMS can be used to determine the location of the DLPFC, and intensity needed to evoke an action potential by obtaining an MEP in the primary motor cortex [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Transcranial Magnetic Stimulation in Bipolar II Disorder Treatment: A Case Report

Tran,

Hutto,

Thompson

et al. 2023

Cureus

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The objective of this case report is to describe and document the use of transcranial magnetic stimulation (TMS) to aid in the treatment of bipolar II disorder. A 35-year-old male with a past medical history of attention-deficit/hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), severe depression, and bipolar II disorder was presented to an outpatient psychiatric clinic 1.5 years after his initial TMS treatment for TMS maintenance therapy. He reported feeling depressed, brain fogginess, loss of concentration, fatigue, and constant changes in moods. He had tried multiple antidepressants and antipsychotics, seen several therapists, and underwent electroconvulsive therapy in 2014 with no improvement. In August 2021, he underwent the standard TMS protocol with 36 treatments and noticed significant improvement in his symptoms. He followed up with his psychiatrist who placed him on quetiapine 400 mg, lurasidone 120 mg, topiramate 100 mg, Adderall 20 mg, Wellbutrin 150 mg, propranolol 20 mg, and Klonopin 0.5 mg for management. However, after starting these medications, he noticed a loss of concentration, not being able to think straight, fatigue, depression, and a change in moods. In January 2023, the patient underwent maintenance TMS treatment with theta bursts (TBS). The treatment protocol consisted of 10 sessions for 3 ½ minutes each, 20 trains, 10 bursts, and eight seconds between intervals. He completed his treatment and reported feeling great and like himself again. Two weeks following treatment, he reported that his brain fog had resolved, hypomanic episodes had lessened, and depressive moods had been occurring less often. Due to improvement, topiramate and lurasidone were discontinued and the patient will continue with monthly follow-ups to monitor his progress. TMS appears to be a promising treatment option for bipolar disorder.

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Low frequency repetitive transcranial magnetic stimulation to the right dorsolateral prefrontal cortex engages thalamus, striatum, and the default mode network

Cited by 8 publications

References 59 publications

Interleaved TMS/fMRI shows that threat decreases dlPFC-mediated top-down regulation of emotion processing

Interleaved TMS/fMRI shows that threat decreases dlPFC-mediated top-down regulation of emotion processing

Combining noninvasive brain stimulation with behavioral pharmacology methods to study mechanisms of substance use disorder

Transcranial Magnetic Stimulation in Bipolar II Disorder Treatment: A Case Report

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