Background
Rapid-rate repetitive transcranial magnetic stimulation (rTMS) can produce a lasting
increase in cortical excitability in healthy subjects or induce beneficial effects
in patients with neuropsychiatric disorders; however, the conditioning effects of
rTMS are often subtle and variable, limiting therapeutic applications. Here we show
that magnitude and direction of after-effects induced by rapid-rate rTMS depend on
the state of cortical excitability before stimulation and can be tuned by preconditioning
with transcranial direct current stimulation (tDCS).
Methods
Ten healthy volunteers received a 20-sec train of 5-Hz rTMS given at an intensity
of individual active motor threshold to the left primary motor hand area. This interventional
protocol was preconditioned by 10 min of anodal, cathodal, or sham tDCS. We used single-pulse
TMS to assess corticospinal excitability at rest before, between, and after the two
interventions.
Results
The 5-Hz rTMS given after sham tDCS failed to produce any after-effect, whereas 5-Hz
rTMS led to a marked shift in corticospinal excitability when given after effective
tDCS. The direction of rTMS-induced plasticity critically depended on the polarity
of tDCS conditioning.
Conclusions
Preconditioning with tDCS enhances cortical plasticity induced by rapid-rate rTMS
and can shape the direction of rTMS-induced after-effects.
Keywords
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Article info
Publication history
Published online: September 20, 2004
Accepted:
July 26,
2004
Received in revised form:
July 6,
2004
Received:
March 28,
2004
Identification
Copyright
© 2004 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
