Transcranial brain stimulation: Past and future

Rothwell, John C.

doi:10.1177/2398212818818070

Cited by 23 publications

(13 citation statements)

References 29 publications

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“…From the pioneering application of TMS to assess the primary motor cortex (M1) and the cortical-spinal conductivity [35], scientists boost the potentialities of this technique, which is employed today to study cortical excitability, to map connectivity, and to probe the propensity to undergo plastic phenomena [36]. This gives novel insights into the pathophysiology underlying several neurological and neuropsychiatric diseases [37,38].…”

Section: Transcranial Magnetic Stimulationmentioning

confidence: 99%

Evaluation and Treatment of Vascular Cognitive Impairment by Transcranial Magnetic Stimulation

Cantone¹,

Lanza

Fisicaro

et al. 2020

Neural Plasticity

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The exact relationship between cognitive functioning, cortical excitability, and synaptic plasticity in dementia is not completely understood. Vascular cognitive impairment (VCI) is deemed to be the most common cognitive disorder in the elderly since it encompasses any degree of vascular-based cognitive decline. In different cognitive disorders, including VCI, transcranial magnetic stimulation (TMS) can be exploited as a noninvasive tool able to evaluate in vivo the cortical excitability, the propension to undergo neural plastic phenomena, and the underlying transmission pathways. Overall, TMS in VCI revealed enhanced cortical excitability and synaptic plasticity that seem to correlate with the disease process and progression. In some patients, such plasticity may be considered as an adaptive response to disease progression, thus allowing the preservation of motor programming and execution. Recent findings also point out the possibility to employ TMS to predict cognitive deterioration in the so-called “brains at risk” for dementia, which may be those patients who benefit more of disease-modifying drugs and rehabilitative or neuromodulatory approaches, such as those based on repetitive TMS (rTMS). Finally, TMS can be exploited to select the responders to specific drugs in the attempt to maximize the response and to restore maladaptive plasticity. While no single TMS index owns enough specificity, a panel of TMS-derived measures can support VCI diagnosis and identify early markers of progression into dementia. This work reviews all TMS and rTMS studies on VCI. The aim is to evaluate how cortical excitability, plasticity, and connectivity interact in the pathophysiology of the impairment and to provide a translational perspective towards novel treatments of these patients. Current pitfalls and limitations of both studies and techniques are also discussed, together with possible solutions and future research agenda.

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Section: Transcranial Magnetic Stimulationmentioning

confidence: 99%

Evaluation and Treatment of Vascular Cognitive Impairment by Transcranial Magnetic Stimulation

Cantone¹,

Lanza

Fisicaro

et al. 2020

Neural Plasticity

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“…From pioneering applications of TMS to assess the primary motor cortex (M1) functioning and the cortical-spinal tract ( Barker et al, 1985 ; Cantone et al, 2019b ; Lanza et al, 2019a , 2020b ), researchers have boosted the potentialities of this technique, which is today employed to study cortical excitability, to map connectivity ( Dubbioso et al, 2021 ), and to probe distinctive plastic phenomena ( Rothwell, 2018 ). Overall, this has provided insights into the pathophysiology, treatment, and monitoring of different neurological and neuropsychiatric disorders ( Di Pino et al, 2014a ; Gomes-Osman et al, 2018 ; Cantone et al, 2019a ).…”

Section: Introductionmentioning

confidence: 99%

A comprehensive review of transcranial magnetic stimulation in secondary dementia

Lanza

Fisicaro

Dubbioso

et al. 2022

Front. Aging Neurosci.

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Although primary degenerative diseases are the main cause of dementia, a non-negligible proportion of patients is affected by a secondary and potentially treatable cognitive disorder. Therefore, diagnostic tools able to early identify and monitor them and to predict the response to treatment are needed. Transcranial magnetic stimulation (TMS) is a non-invasive neurophysiological technique capable of evaluating in vivo and in “real time” the motor areas, the cortico-spinal tract, and the neurotransmission pathways in several neurological and neuropsychiatric disorders, including cognitive impairment and dementia. While consistent evidence has been accumulated for Alzheimer’s disease, other degenerative cognitive disorders, and vascular dementia, to date a comprehensive review of TMS studies available in other secondary dementias is lacking. These conditions include, among others, normal-pressure hydrocephalus, multiple sclerosis, celiac disease and other immunologically mediated diseases, as well as a number of inflammatory, infective, metabolic, toxic, nutritional, endocrine, sleep-related, and rare genetic disorders. Overall, we observed that, while in degenerative dementia neurophysiological alterations might mirror specific, and possibly primary, neuropathological changes (and hence be used as early biomarkers), this pathogenic link appears to be weaker for most secondary forms of dementia, in which neurotransmitter dysfunction is more likely related to a systemic or diffuse neural damage. In these cases, therefore, an effort toward the understanding of pathological mechanisms of cognitive impairment should be made, also by investigating the relationship between functional alterations of brain circuits and the specific mechanisms of neuronal damage triggered by the causative disease. Neurophysiologically, although no distinctive TMS pattern can be identified that might be used to predict the occurrence or progression of cognitive decline in a specific condition, some TMS-associated measures of cortical function and plasticity (such as the short-latency afferent inhibition, the short-interval intracortical inhibition, and the cortical silent period) might add useful information in most of secondary dementia, especially in combination with suggestive clinical features and other diagnostic tests. The possibility to detect dysfunctional cortical circuits, to monitor the disease course, to probe the response to treatment, and to design novel neuromodulatory interventions in secondary dementia still represents a gap in the literature that needs to be explored.

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“…Transcranial magnetic stimulation (TMS), a non-invasive brain imaging technique, can be used to assess traininginduced neuroplasticity in corticomotor pathways following motor skill training (Rothwell, 2018). There is some evidence that both acute and chronic pain can affect the plasticity of the motor cortex-as assessed by TMS-following motor skill training, although reported findings are not conclusive.…”

Section: Introductionmentioning

confidence: 99%

Pain’s Adverse Impact on Training-Induced Performance and Neuroplasticity: A Systematic Review

Stanisic

Häggman‐Henrikson

Kothari

et al. 2022

Brain Imaging and Behavior

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Motor training is a widely used therapy in many pain conditions. The brain’s capacity to undergo functional and structural changes i.e., neuroplasticity is fundamental to training-induced motor improvement and can be assessed by transcranial magnetic stimulation (TMS). The aim was to investigate the impact of pain on training-induced motor performance and neuroplasticity assessed by TMS. The review was carried out in accordance with the PRISMA-guidelines and a Prospero protocol (CRD42020168487). An electronic search in PubMed, Web of Science and Cochrane until December 13, 2019, identified studies focused on training-induced neuroplasticity in the presence of experimentally-induced pain, 'acute pain' or in a chronic pain condition, 'chronic pain'. Included studies were assessed by two authors for methodological quality using the TMS Quality checklist, and for risk of bias using the Newcastle–Ottawa Scale. The literature search identified 231 studies. After removal of 71 duplicates, 160 abstracts were screened, and 24 articles were reviewed in full text. Of these, 17 studies on acute pain (n = 7) or chronic pain (n = 10), including a total of 258 patients with different pain conditions and 248 healthy participants met the inclusion criteria. The most common types of motor training were different finger tasks (n = 6). Motor training was associated with motor cortex functional neuroplasticity and six of seven acute pain studies and five of ten chronic pain studies showed that, compared to controls, pain can impede such trainings-induced neuroplasticity. These findings may have implications for motor learning and performance and with putative impact on rehabilitative procedures such as physiotherapy.

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Transcranial brain stimulation: Past and future

Cited by 23 publications

References 29 publications

Evaluation and Treatment of Vascular Cognitive Impairment by Transcranial Magnetic Stimulation

Evaluation and Treatment of Vascular Cognitive Impairment by Transcranial Magnetic Stimulation

A comprehensive review of transcranial magnetic stimulation in secondary dementia

Pain’s Adverse Impact on Training-Induced Performance and Neuroplasticity: A Systematic Review

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