Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
Department of Neurology, Peking Union Medical College Hospital, Beijing, China.
Neuromodulation. 2019 Dec;22(8):877-883. doi: 10.1111/ner.12875. Epub 2018 Oct 29.
To evaluate the safety and efficacy of low-frequency, inhibitory, deep rTMS with a novel H-coil specifically designed to stimulate the insula.
In a randomized, crossover order, 16 healthy volunteers underwent two sessions (sham; active) of 1 Hz repetitive TMS at an intensity of 120% of individual motor threshold, over the right anterior insular cortex localized using a neuronavigation system. Before, immediately after, and one hour after rTMS, subjects performed two tasks that have previously been shown in fMRI experiments to activate insular cortex: A blink suppression task and a forced-choice risk-taking task.
No drop-outs or adverse events occurred. Active deep rTMS did not result in decreased urge to blink compared to sham. Similarly, no significant time × condition interaction on risk-taking behavior was found.
Low-frequency deep rTMS using a novel H8 coil was shown to be safe but did not affect any of the behavioral markers, also used to investigate modulation of insula activity. Our findings highlight the challenges of modulating the activity of deep brain regions with TMS. Further studies are necessary to identify effective stimulation parameters for deep targets, and to characterize the effects of deep TMS on overlying cortical regions.
评估新型 H 线圈低频抑制性深部 rTMS 刺激岛叶的安全性和有效性，该线圈专门设计用于刺激岛叶。
16 名健康志愿者以随机交叉顺序进行两次治疗（假刺激；真刺激），在使用神经导航系统定位的右侧前岛叶上，以个体运动阈值的 120%强度给予 1Hz 重复 TMS。在 rTMS 之前、之后即刻和之后 1 小时，受试者进行了两项先前在 fMRI 实验中已被证明可激活岛叶的任务：眨眼抑制任务和强制选择冒险任务。
无脱落或不良事件发生。与假刺激相比，真刺激深部 rTMS 并未导致眨眼冲动减少。同样，在冒险行为上也未发现时间×条件的显著交互作用。
使用新型 H8 线圈的低频深部 rTMS 被证明是安全的，但并未影响任何行为标志物，这些标志物也被用于研究岛叶活动的调节。我们的研究结果强调了使用 TMS 调节深部脑区活动的挑战。有必要进行进一步的研究，以确定深部靶标的有效刺激参数，并描述深部 TMS 对覆盖其上的皮质区域的影响。
