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CC-BY-NC-ND 4.0 · International Journal of Epilepsy 2016; 03(01): 002-006
DOI: 10.1016/j.ijep.2016.02.003
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Comparison of low frequency repetitive transcranial magnetic stimulation parameters on motor cortex excitability in normal subjects

Lara M. Schrader
a   David Geffen School of Medicine at UCLA, Department of Neurology, Los Angeles, CA 90095, USA
,
Sima Sadeghinejad
a   David Geffen School of Medicine at UCLA, Department of Neurology, Los Angeles, CA 90095, USA
c   Ahmanson-Lovelace Brain Mapping Center, Brain Research Center, David Geffen School of Medicine at UCLA, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA
,
Jalleh Sadeghinejad
a   David Geffen School of Medicine at UCLA, Department of Neurology, Los Angeles, CA 90095, USA
c   Ahmanson-Lovelace Brain Mapping Center, Brain Research Center, David Geffen School of Medicine at UCLA, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA
,
Movses Kazanchyan
a   David Geffen School of Medicine at UCLA, Department of Neurology, Los Angeles, CA 90095, USA
c   Ahmanson-Lovelace Brain Mapping Center, Brain Research Center, David Geffen School of Medicine at UCLA, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA
,
Lisa Koski
b   McGill University, Department of Medicine, Montreal, Quebec, Canada
,
John M. Stern
a   David Geffen School of Medicine at UCLA, Department of Neurology, Los Angeles, CA 90095, USA
,
Allan D. Wu
a   David Geffen School of Medicine at UCLA, Department of Neurology, Los Angeles, CA 90095, USA
,
Marco Iacoboni
c   Ahmanson-Lovelace Brain Mapping Center, Brain Research Center, David Geffen School of Medicine at UCLA, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA
,
Marc R. Nuwer
a   David Geffen School of Medicine at UCLA, Department of Neurology, Los Angeles, CA 90095, USA
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Publikationsverlauf

Received: 02. Januar 2015

Accepted: 22. Oktober 2015

Publikationsdatum:
06. Mai 2018 (online)

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Abstract

Background/objectives Optimal low frequency repetitive transcranial magnetic stimulation (LF-rTMS) parameters for treating epilepsy and other brain disorders are unknown. To address this question, a systematic study of the effects of LF-rTMS frequency and intensity on cortical excitability was performed.

Methods Using a four-period crossover design, subjects were scheduled for four LF-rTMS sessions that were at least four weeks apart. LF-rTMS was delivered as 900 pulses directed at primary motor cortex using four protocols: 0.5 Hz at 90% resting motor threshold (RMT), 0.5 Hz at 110% RMT, 1 Hz at 90% RMT, and 1 Hz at 110% RMT. Motor evoked potential (MEP) amplitude, resting motor threshold (RMT), and cortical silent period (CSP) were measured before, immediately after, and 60 min after LF-rTMS. Each of the four protocols was analyzed separately to compare baseline measurements to those after LF-rTMS.

Results None of the four LF-rTMS protocols produced a trend or significant change in MEP amplitude, RMT, or CSP.

Conclusion The lack of significant effect from the four LF-rTMS protocols indicates that none produced evidence for alteration of cortical excitability. The direct comparison of four LF-rTMS protocols is distinct to this investigation, as most similar studies were exploratory and studied only one or two protocols. The negative result relates only to the methods used in this investigation and does not indicate that LF-rTMS does not alter cortical excitability with other parameters. These results may be useful when designing additional investigations into the effect of LF-rTMS on epilepsy, other disorders, and cortical excitability.

Keywords

Low frequency repetitive transcranial magnetic stimulation - Stimulation parameters - Cortical excitability - Brain stimulation