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基于网络的 rTMS 调节工作记忆:在线干预有效参数的艰难选择。

Network-based rTMS to modulate working memory: The difficult choice of effective parameters for online interventions.

机构信息

Department of Psychiatry and Behavioral Science, Duke University School of Medicine, Durham, North Carolina, USA.

Duke Institute for Brain Sciences, Duke University School of Medicine, Durham, North Carolina, USA.

出版信息

Brain Behav. 2021 Nov;11(11):e2361. doi: 10.1002/brb3.2361. Epub 2021 Oct 15.

Abstract

BACKGROUND

Online repetitive transcranialmagnetic stimulation (rTMS) has been shown to modulate working memory (WM) performance in a site-specific manner, with behavioral improvements due to stimulation of the dorsolateral prefrontal cortex (DLPFC), and impairment from stimulation to the lateral parietal cortex (LPC). Neurobehavioral studies have demonstrated that subprocesses of WM allowing for the maintenance and manipulation of information in the mind involve unique cortical networks. Despite promising evidence of modulatory effects of rTMS on WM, no studies have yet demonstrated distinct modulatory control of these two subprocesses. The current study therefore sought to explore this possibility through site-specific stimulation during an online task invoking both skills.

METHODS

Twenty-nine subjects completed a 4-day protocol, in which active or sham 5Hz rTMS was applied over the DLPFC and LPC in separate blocks of trials while participants performed tasks that required either maintenance alone, or both maintenance and manipulation (alphabetization) of information. Stimulation targets were defined individually based on fMRI activation and structural network properties. Stimulation amplitude was adjusted using electric field modeling to equate induced current in the target region across participants.

RESULTS

Despite the use of advanced techniques, no significant differences or interactions between active and sham stimulation were found. Exploratory analyses testing stimulation amplitude, fMRI activation, and modal controllability showed nonsignificant but interesting trends with rTMS effects.

CONCLUSION

While this study did not reveal any significant behavioral changes in WM, the results may point to parameters that contribute to positive effects, such as stimulation amplitude and functional activation.

摘要

背景

在线重复经颅磁刺激(rTMS)已被证明可以以特定的方式调节工作记忆(WM)的性能,通过刺激背外侧前额叶皮层(DLPFC)可以提高行为表现,而通过刺激外侧顶叶皮层(LPC)则会导致损害。神经行为学研究表明,WM 的子过程允许在大脑中维持和操作信息,涉及独特的皮质网络。尽管 rTMS 对 WM 具有调节作用的证据很有前景,但尚无研究证明这两个子过程具有独特的调节控制作用。因此,当前的研究试图通过在调用这两种技能的在线任务中进行特定部位的刺激来探索这种可能性。

方法

29 名受试者完成了 4 天的方案,在单独的试验块中,在 DLPFC 和 LPC 上分别施加 5Hz 的真刺激或假刺激,而参与者执行仅需要维持或同时需要维持和操作(字母化)信息的任务。刺激靶点是根据 fMRI 激活和结构网络特性单独定义的。使用电场建模调整刺激幅度,以使目标区域中的诱导电流在参与者之间相等。

结果

尽管使用了先进的技术,但在真刺激和假刺激之间未发现显著差异或相互作用。对刺激幅度、fMRI 激活和模态可控性进行的探索性分析显示,rTMS 效应具有非显著但有趣的趋势。

结论

尽管这项研究没有发现 WM 中的任何行为变化,但结果可能指向有助于产生积极效果的参数,例如刺激幅度和功能激活。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2e6/8613413/58997fecfd44/BRB3-11-e2361-g006.jpg

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