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Research Article| Volume 54, ISSUE 8, P826-832, October 15, 2003

Intensity-dependent regional cerebral blood flow during 1-Hz repetitive transcranial magnetic stimulation (rTMS) in healthy volunteers studied with h215o positron emission tomography: II. effects of prefrontal cortex rTMS

DOI:https://doi.org/10.1016/S0006-3223(03)00324-X
Intensity-dependent regional cerebral blood flow during 1-Hz repetitive transcranial magnetic stimulation (rTMS) in healthy volunteers studied with h215o positron emission tomography: II. effects of prefrontal cortex rTMS
Previous ArticleIntensity-dependent regional cerebral blood flow during 1-Hz repetitive transcranial magnetic stimulation (rTMS) in healthy volunteers studied with H215O positron emission tomography: i. effects of primary motor cortex rTMS
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      Abstract

      Background

      The changes in brain activity produced by repetitive transcranial magnetic stimulation (rTMS) of the prefrontal cortex (PFC) remain unclear. We examined intensity-related changes in brain activity with positron emission tomography (PET) in normal volunteers during rTMS delivered to the left PFC.

      Methods

      In 10 healthy volunteers, we delivered 1-Hz rTMS at randomized intensities over left PFC with a figure-eight coil. Intensities were 80, 90, 100, 110, and 120% of the right-hand muscle twitch threshold. Regional cerebral blood flow (rCBF) scans were acquired with H215O PET during rTMS at each intensity.

      Results

      Repetitive transcranial magnetic stimulation intensity was inversely correlated with rCBF in the stimulated and contralateral PFC, ipsilateral medial temporal lobe, both parahippocampi, and posterior middle temporal gyri. Positive correlations of rCBF with intensity occurred in ipsilateral anterior cingulate, cerebellum, contralateral insula, primary auditory cortex, and somatosensory face area.

      Conclusions

      The intensity-related inverse relationship between 1-Hz rTMS and prefrontal activity appears opposite to that seen with rTMS over the motor cortex in a companion study. Intensity-dependent increases in rCBF were seen in a number of distant cortical and subcortical areas with PFC rTMS, suggesting activation of left anterior cingulate, claustrum, and cerebellum. The regional differences in direction of rTMS effects and the greater activation of distant structures at higher intensities sug-gest the potential importance of higher-intensity prefrontal rTMS for therapeutic applications in neuropsychiatric patients.

      Keywords

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      Article info

      Publication history

      Accepted: March 17, 2003
      Received in revised form: February 27, 2003
      Received: March 21, 2002

      Identification

      DOI: https://doi.org/10.1016/S0006-3223(03)00324-X

      Copyright

      © 2003 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

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