Department of Neurosurgery, Stanford University, Palo Alto, CA, USA.
Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Nat Commun. 2024 Aug 14;15(1):6982. doi: 10.1038/s41467-024-51443-1.
Theta-burst stimulation (TBS), a patterned brain stimulation technique that mimics rhythmic bursts of 3-8 Hz endogenous brain rhythms, has emerged as a promising therapeutic approach for treating a wide range of brain disorders, though the neural mechanism of TBS action remains poorly understood. We investigated the neural effects of TBS using intracranial EEG (iEEG) in 10 pre-surgical epilepsy participants undergoing intracranial monitoring. Here we show that individual bursts of direct electrical TBS at 29 frontal and temporal sites evoked strong neural responses spanning broad cortical regions. These responses exhibited dynamic local field potential voltage changes over the course of stimulation presentations, including either increasing or decreasing responses, suggestive of short-term plasticity. Stronger stimulation augmented the mean TBS response amplitude and spread with more recording sites demonstrating short-term plasticity. TBS responses were stimulation site-specific with stronger TBS responses observed in regions with strong baseline stimulation effective (cortico-cortical evoked potentials) and functional (low frequency phase locking) connectivity. Further, we could use these measures to predict stable and varying (e.g. short-term plasticity) TBS response locations. Future work may integrate pre-treatment connectivity alongside other biophysical factors to personalize stimulation parameters, thereby optimizing induction of neuroplasticity within disease-relevant brain networks.
theta 爆发刺激(TBS)是一种模仿 3-8Hz 内源性脑节律的节律性爆发的模式化脑刺激技术,已成为治疗广泛的脑疾病的有前途的治疗方法,尽管 TBS 作用的神经机制仍知之甚少。我们使用 10 名接受颅内监测的术前癫痫参与者的颅内脑电图(iEEG)研究了 TBS 的神经效应。在这里,我们显示 29 个额颞部位的直接电 TBS 单个爆发引发了跨越广泛皮质区域的强烈神经反应。这些反应在刺激呈现过程中表现出动态的局部场电位电压变化,包括增加或减少反应,提示短期可塑性。更强的刺激增强了平均 TBS 反应幅度和传播,更多的记录部位表现出短期可塑性。TBS 反应具有刺激部位特异性,在基线刺激有效(皮质-皮质诱发电位)和功能(低频相位锁定)连通性强的区域观察到更强的 TBS 反应。此外,我们可以使用这些措施来预测稳定和变化(例如短期可塑性)的 TBS 反应位置。未来的工作可能会整合治疗前的连通性以及其他生物物理因素,以个性化刺激参数,从而在与疾病相关的大脑网络中优化诱导神经可塑性。
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