Effects of repetitive transcranial magnetic stimulation on resting-state connectivity: A systematic review.
Journal Article (Journal Article;Systematic Review)
The brain is organized into networks that reorganize dynamically in response to cognitive demands and exogenous stimuli. In recent years, repetitive transcranial magnetic stimulation (rTMS) has gained increasing use as a noninvasive means to modulate cortical physiology, with effects both proximal to the stimulation site and in distal areas that are intrinsically connected to the proximal target. In light of these network-level neuromodulatory effects, there has been a rapid growth in studies attempting to leverage information about network connectivity to improve neuromodulatory control and intervention outcomes. However, the mechanisms-of-action of rTMS on network-level effects remain poorly understood and is based primarily on heuristics from proximal stimulation findings. To help bridge this gap, the current paper presents a systematic review of 33 rTMS studies with baseline and post-rTMS measures of fMRI resting-state functional connectivity (RSFC). Literature synthesis revealed variability across studies in stimulation parameters, studied populations, and connectivity analysis methodology. Despite this variability, it is observed that active rTMS induces significant changes on RSFC, but the prevalent low-frequency-inhibition/high-frequency-facilitation heuristic endorsed for proximal rTMS effects does not fully describe distal connectivity findings. This review also points towards other important considerations, including that the majority of rTMS-induced changes were found outside the stimulated functional network, suggesting that rTMS effects tend to spread across networks. Future studies may therefore wish to adopt conventions and systematic frameworks, such as the Yeo functional connectivity parcellation atlas adopted here, to better characterize network-level effect that contribute to the efficacy of these rapidly developing noninvasive interventions.
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Duke Authors
Cited Authors
- Beynel, L; Powers, JP; Appelbaum, LG
Published Date
- May 1, 2020
Published In
Volume / Issue
- 211 /
Start / End Page
- 116596 -
PubMed ID
- 32014552
Pubmed Central ID
- PMC7571509
Electronic International Standard Serial Number (EISSN)
- 1095-9572
Digital Object Identifier (DOI)
- 10.1016/j.neuroimage.2020.116596
Language
- eng
Conference Location
- United States