Bergmann Til Ole, Varatheeswaran Rathiga, Hanlon Colleen A, Madsen Kristoffer H, Thielscher Axel, Siebner Hartwig Roman
Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Langenbeckstr. 1, 55131, Mainz, Germany; Leibniz Institute for Resilience Research, Wallstraße 7-9, 55122, Mainz, Germany.
Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Langenbeckstr. 1, 55131, Mainz, Germany; Leibniz Institute for Resilience Research, Wallstraße 7-9, 55122, Mainz, Germany.
Neuroimage. 2021 Aug 15;237:118093. doi: 10.1016/j.neuroimage.2021.118093. Epub 2021 Apr 30.
The experimental manipulation of neural activity by neurostimulation techniques overcomes the inherent limitations of correlative recordings, enabling the researcher to investigate causal brain-behavior relationships. But only when stimulation and recordings are combined, the direct impact of the stimulation on neural activity can be evaluated. In humans, this can be achieved non-invasively through the concurrent combination of transcranial magnetic stimulation (TMS) with functional magnetic resonance imaging (fMRI). Concurrent TMS-fMRI allows the assessment of the neurovascular responses evoked by TMS with excellent spatial resolution and full-brain coverage. This enables the functional mapping of both local and remote network effects of TMS in cortical as well as deep subcortical structures, offering unique opportunities for basic research and clinical applications. The purpose of this review is to introduce the reader to this powerful tool. We will introduce the technical challenges and state-of-the art solutions and provide a comprehensive overview of the existing literature and the available experimental approaches. We will highlight the unique insights that can be gained from concurrent TMS-fMRI, including the state-dependent assessment of neural responsiveness and inter-regional effective connectivity, the demonstration of functional target engagement, and the systematic evaluation of stimulation parameters. We will also discuss how concurrent TMS-fMRI during a behavioral task can help to link behavioral TMS effects to changes in neural network activity and to identify peripheral co-stimulation confounds. Finally, we will review the use of concurrent TMS-fMRI for developing TMS treatments of psychiatric and neurological disorders and suggest future improvements for further advancing the application of concurrent TMS-fMRI.
通过神经刺激技术对神经活动进行实验性操控，克服了相关性记录的固有局限性，使研究人员能够研究大脑与行为之间的因果关系。但只有将刺激与记录相结合，才能评估刺激对神经活动的直接影响。在人类中，可以通过将经颅磁刺激（TMS）与功能磁共振成像（fMRI）同时结合的方式，以非侵入性的方法实现这一点。同时进行TMS-fMRI能够以出色的空间分辨率和全脑覆盖范围，评估TMS诱发的神经血管反应。这使得在皮质以及深部皮质下结构中，对TMS的局部和远程网络效应进行功能映射成为可能，为基础研究和临床应用提供了独特的机会。本综述的目的是向读者介绍这一强大的工具。我们将介绍技术挑战和最新的解决方案，并对现有文献和可用的实验方法进行全面概述。我们将重点介绍从同时进行的TMS-fMRI中可以获得的独特见解，包括对神经反应性和区域间有效连接性的状态依赖性评估、功能靶点参与的证明以及刺激参数的系统评估。我们还将讨论在行为任务期间同时进行TMS-fMRI如何有助于将行为TMS效应与神经网络活动的变化联系起来，并识别外周共刺激混淆因素。最后，我们将回顾同时进行TMS-fMRI在开发精神疾病和神经疾病的TMS治疗方法中的应用，并提出未来的改进建议，以进一步推进同时进行TMS-fMRI的应用。
