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Sham-derived effects and the minimal reliability of theta burst stimulation

Theta-burst stimulation (TBS) is a patterned form of repetitive transcranial magnetic stimulation (rTMS) that has been used to induce long-term modulation (plasticity) of corticospinal excitability in a drastically shorter duration protocol than conventional rTMS protocols. In this study we tested t...

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Autores principales: Boucher, P. O., Ozdemir, R. A., Momi, D., Burke, M. J., Jannati, A., Fried, P. J., Pascual-Leone, A., Shafi, M. M., Santarnecchi, Emiliano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8551312/
https://www.ncbi.nlm.nih.gov/pubmed/34707206
http://dx.doi.org/10.1038/s41598-021-98751-w
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author Boucher, P. O.
Ozdemir, R. A.
Momi, D.
Burke, M. J.
Jannati, A.
Fried, P. J.
Pascual-Leone, A.
Shafi, M. M.
Santarnecchi, Emiliano
author_facet Boucher, P. O.
Ozdemir, R. A.
Momi, D.
Burke, M. J.
Jannati, A.
Fried, P. J.
Pascual-Leone, A.
Shafi, M. M.
Santarnecchi, Emiliano
author_sort Boucher, P. O.
collection PubMed
description Theta-burst stimulation (TBS) is a patterned form of repetitive transcranial magnetic stimulation (rTMS) that has been used to induce long-term modulation (plasticity) of corticospinal excitability in a drastically shorter duration protocol than conventional rTMS protocols. In this study we tested the reliability of the effects of two well defined TBS protocols, continuous TBS (cTBS) and intermittent TBS (iTBS), especially in relation to sham TBS, within and across the same 24 participants. All TBS protocols were repeated after approximately 1 month to assess the magnitude and reliability of the modulatory effects of each TBS protocol. Baseline and post-TBS changes in motor evoked potentials (MEP—measure of corticospinal excitability) amplitudes were compared across the cTBS, iTBS and sham TBS protocols and between the initial and retest visits. Overall, across participants, at the initial visit, iTBS facilitated MEPs as compared to baseline excitability, with sham eliciting the same effect. cTBS did not show a significant suppression of excitability compared to baseline MEPs at either visit, and even facilitated MEPs above baseline excitability at a single time point during the repeat visit. Otherwise, effects of TBS were generally diminished in the repeat visit, with iTBS and sham TBS replicating facilitation of MEPs above baseline excitability at similar time points. However, no protocol demonstrated consistent intra-individual modulation of corticospinal excitability upon retest. As the first study to test both iTBS and cTBS against sham TBS across repeat visits, our findings challenge the efficacy and reliability of TBS protocols and emphasize the importance of accounting for sham effects of TBS. Furthermore, given that therapeutic effects of TBS are hypothetically derived from consistent and repeated modulation of brain activity, the non-replicability of plasticity and sham effects call into question these basic mechanisms.
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spelling pubmed-85513122021-11-01 Sham-derived effects and the minimal reliability of theta burst stimulation Boucher, P. O. Ozdemir, R. A. Momi, D. Burke, M. J. Jannati, A. Fried, P. J. Pascual-Leone, A. Shafi, M. M. Santarnecchi, Emiliano Sci Rep Article Theta-burst stimulation (TBS) is a patterned form of repetitive transcranial magnetic stimulation (rTMS) that has been used to induce long-term modulation (plasticity) of corticospinal excitability in a drastically shorter duration protocol than conventional rTMS protocols. In this study we tested the reliability of the effects of two well defined TBS protocols, continuous TBS (cTBS) and intermittent TBS (iTBS), especially in relation to sham TBS, within and across the same 24 participants. All TBS protocols were repeated after approximately 1 month to assess the magnitude and reliability of the modulatory effects of each TBS protocol. Baseline and post-TBS changes in motor evoked potentials (MEP—measure of corticospinal excitability) amplitudes were compared across the cTBS, iTBS and sham TBS protocols and between the initial and retest visits. Overall, across participants, at the initial visit, iTBS facilitated MEPs as compared to baseline excitability, with sham eliciting the same effect. cTBS did not show a significant suppression of excitability compared to baseline MEPs at either visit, and even facilitated MEPs above baseline excitability at a single time point during the repeat visit. Otherwise, effects of TBS were generally diminished in the repeat visit, with iTBS and sham TBS replicating facilitation of MEPs above baseline excitability at similar time points. However, no protocol demonstrated consistent intra-individual modulation of corticospinal excitability upon retest. As the first study to test both iTBS and cTBS against sham TBS across repeat visits, our findings challenge the efficacy and reliability of TBS protocols and emphasize the importance of accounting for sham effects of TBS. Furthermore, given that therapeutic effects of TBS are hypothetically derived from consistent and repeated modulation of brain activity, the non-replicability of plasticity and sham effects call into question these basic mechanisms. Nature Publishing Group UK 2021-10-27 /pmc/articles/PMC8551312/ /pubmed/34707206 http://dx.doi.org/10.1038/s41598-021-98751-w Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Boucher, P. O.
Ozdemir, R. A.
Momi, D.
Burke, M. J.
Jannati, A.
Fried, P. J.
Pascual-Leone, A.
Shafi, M. M.
Santarnecchi, Emiliano
Sham-derived effects and the minimal reliability of theta burst stimulation
title Sham-derived effects and the minimal reliability of theta burst stimulation
title_full Sham-derived effects and the minimal reliability of theta burst stimulation
title_fullStr Sham-derived effects and the minimal reliability of theta burst stimulation
title_full_unstemmed Sham-derived effects and the minimal reliability of theta burst stimulation
title_short Sham-derived effects and the minimal reliability of theta burst stimulation
title_sort sham-derived effects and the minimal reliability of theta burst stimulation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8551312/
https://www.ncbi.nlm.nih.gov/pubmed/34707206
http://dx.doi.org/10.1038/s41598-021-98751-w
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