Transcranial magnetic stimulation (TMS) is a neuropsychiatric tool that can serve
as a useful method to better understand the neurobiology of cognitive function, behavior,
and emotional processing. The purpose of this article is to examine the utility of
TMS as a means to measure neocortical function in neuropsychiatric disorders in general,
and schizophrenia in particular, for the Cognitive Neuroscience Treatment Research
to Improve Cognition in Schizophrenia initiative. When incorporating TMS paradigms
in research studies, methodologic considerations include technical aspects of TMS,
cohort selection and confounding factors, and subject safety. Available evidence suggests
benefits of TMS alone or in combination with neurophysiologic and neuroimaging methods,
including positron emission tomography, single photon emission computed tomography,
magnetic resonance imaging, functional magnetic resonance imaging, functional near
infrared spectroscopy, magnetoencephalography, and electroencephalography, to explore
neocortical function. With the multiple TMS techniques including single-pulse, paired-pulse,
paired associative stimulation, and repetitive TMS and theta burst stimulation, combined
with neurophysiologic and neuroimaging methods, there exists a plethora of TMS experimental
paradigms to modulate neocortical physiologic processes. Specifically, TMS can measure
cortical excitability, intracortical inhibitory and excitatory mechanisms, and local
and network cortical plasticity. Coupled with functional and electrophysiologic modalities,
TMS can provide insight into the mechanisms underlying healthy neurodevelopment and
aging, as well as neuropsychiatric pathology. Thus, TMS could be a useful tool in
the Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia
armamentarium of biomarker methods. Future investigations are warranted to optimize
TMS methodologies for this purpose.
Key Words
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Article info
Publication history
Published online: May 16, 2011
Accepted:
February 25,
2011
Received in revised form:
February 21,
2011
Received:
December 14,
2010
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© 2011 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
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- Standardization, Integration, and Sharing—Leveraging Research InvestmentsBiological PsychiatryVol. 70Issue 1
- PreviewCognitive impairment has been recognized as a significant cause of disability in schizophrenia for more than 20 years (1,2), but the development of effective treatments for cognitive impairment in schizophrenia has been slow to advance. The National Institute of Mental Health (NIMH) Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative (3) brought together members of academia, the pharmaceutical industry, and the US Food and Drug Administration to increase the viability of drug development by establishing consensus guidelines for study methodology, identifying promising targets for further investigation, and developing a standardized cognitive battery for use as end points in clinical trials.
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