1-Hz repetitive transcranial magnetic stimulation increases cerebral vasomotor reactivity: A possible autonomic nervous system modulation

Fabrizio Vernieri, Claudia Altamura, Paola Palazzo, Riccardo Altavilla, Emma Fabrizio, Rita Fini, Jean Marc Melgari, Matteo Paolucci, Patrizio Pasqualetti, Paola Maggio

Research output: Contribution to journalArticlepeer-review

Abstract

Background Neuromodulation techniques, i.e. repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), can modify cerebral hemodynamics. High frequency rTMS appeared to decrease cerebral vasomotor reactivity (VMR), while there is still poor evidence about the effect of low frequency (LF) rTMS on cerebral blood flow (CBF) and VMR. Hypothesis The present study aimed to test if LF rTMS decreases CBF and increases cerebral VMR. Monolateral or bilateral hemispheric involvement and duration of the effect were considered. A possible role of autonomic nervous system in CBF and VMR modulation was also investigated. Methods Twenty-four right-handed healthy subjects underwent randomly real (12) or sham (12) 20-min 1-Hz rTMS on left primary motor cortex. Mean flow velocity and VMR of middle cerebral arteries were evaluated by means of transcranial Doppler before (T0), after 10 min (T1) and after 2 (T2), 5 (T3) and 24 h (T4) from rTMS. Heart rate variability (HRV) was studied within the same timing interval, assessing low frequency/high frequency (LF/HF) ratio as index of autonomic balance. Results After real rTMS compared with sham stimulation, MFV decreased bilaterally at T1 (F = 3.240, P =.030) while VMR increased bilaterally (F = 5.116, P =.002) for at least 5 h (T3). LF/HF ratio decreased early after real rTMS (F = 2.881, P =.040). Conclusion 1-Hz rTMS may induce a bilateral long-lasting increase of VMR, while its effect on MFV is short-lasting. Moreover, HRV changes induced by rTMS suggest a possible autonomic nervous system modulation.

Original languageEnglish
Pages (from-to)281-286
Number of pages6
JournalBrain Stimulation
Volume7
Issue number2
DOIs
Publication statusPublished - 2014

Keywords

  • Cerebral hemodynamics
  • Cerebral vasomotor reactivity
  • Repetitive transcranial magnetic stimulation
  • Transcranial Doppler

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)
  • Biophysics
  • Medicine(all)

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