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重复经颅磁刺激研究中的因果推断:挑战与展望

Causal Inferences in Repetitive Transcranial Magnetic Stimulation Research: Challenges and Perspectives.

作者信息

Hobot Justyna, Klincewicz Michał, Sandberg Kristian, Wierzchoń Michał

机构信息

Consciousness Lab, Psychology Institute, Jagiellonian University, Krakow, Poland.

Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark.

出版信息

Front Hum Neurosci. 2021 Jan 14;14:586448. doi: 10.3389/fnhum.2020.586448. eCollection 2020.

Abstract

Transcranial magnetic stimulation (TMS) is used to make inferences about relationships between brain areas and their functions because, in contrast to neuroimaging tools, it modulates neuronal activity. The central aim of this article is to critically evaluate to what extent it is possible to draw causal inferences from repetitive TMS (rTMS) data. To that end, we describe the logical limitations of inferences based on rTMS experiments. The presented analysis suggests that rTMS alone does not provide the sort of premises that are sufficient to warrant strong inferences about the direct causal properties of targeted brain structures. Overcoming these limitations demands a close look at the designs of rTMS studies, especially the methodological and theoretical conditions which are necessary for the functional decomposition of the relations between brain areas and cognitive functions. The main points of this article are that TMS-based inferences are limited in that stimulation-related causal effects are not equivalent to structure-related causal effects due to TMS side effects, the electric field distribution, and the sensitivity of neuroimaging and behavioral methods in detecting structure-related effects and disentangling them from confounds. Moreover, the postulated causal effects can be based on indirect (network) effects. A few suggestions on how to manage some of these limitations are presented. We discuss the benefits of combining rTMS with neuroimaging in experimental reasoning and we address the restrictions and requirements of rTMS control conditions. The use of neuroimaging and control conditions allows stronger inferences to be gained, but the strength of the inferences that can be drawn depends on the individual experiment's designs. Moreover, in some cases, TMS might not be an appropriate method of answering causality-related questions or the hypotheses have to account for the limitations of this technique. We hope this summary and formalization of the reasoning behind rTMS research can be of use not only for scientists and clinicians who intend to interpret rTMS results causally but also for philosophers interested in causal inferences based on brain stimulation research.

摘要

经颅磁刺激(TMS)用于推断脑区与其功能之间的关系,因为与神经成像工具不同,它能调节神经元活动。本文的核心目的是批判性地评估从重复经颅磁刺激(rTMS)数据中得出因果推断的可能性。为此,我们描述了基于rTMS实验的推断的逻辑局限性。所呈现的分析表明,仅rTMS本身并不能提供足以支持对目标脑结构的直接因果属性进行有力推断的前提。克服这些局限性需要仔细审视rTMS研究的设计,尤其是脑区与认知功能之间关系的功能分解所必需的方法学和理论条件。本文的要点是,基于TMS的推断存在局限性,因为由于TMS副作用、电场分布以及神经成像和行为方法在检测与结构相关的效应并将其与混淆因素区分开方面的敏感性,与刺激相关的因果效应并不等同于与结构相关的因果效应。此外,假定的因果效应可能基于间接(网络)效应。本文提出了一些关于如何处理其中一些局限性的建议。我们讨论了在实验推理中将rTMS与神经成像相结合的益处,并阐述了rTMS对照条件的限制和要求。使用神经成像和对照条件可以得出更强有力的推断,但能够得出的推断的强度取决于单个实验的设计。此外,在某些情况下,TMS可能不是回答因果关系相关问题的合适方法,或者假设必须考虑到该技术的局限性。我们希望对rTMS研究背后的推理进行的总结和形式化不仅对打算因果性地解释rTMS结果的科学家和临床医生有用,而且对基于脑刺激研究对因果推断感兴趣的哲学家也有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7698/7873895/19fb4295e31c/fnhum-14-586448-g0001.jpg

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