TY - JOUR
T1 - 1-Hz repetitive transcranial magnetic stimulation increases cerebral vasomotor reactivity
T2 - A possible autonomic nervous system modulation
AU - Vernieri, Fabrizio
AU - Altamura, Claudia
AU - Palazzo, Paola
AU - Altavilla, Riccardo
AU - Fabrizio, Emma
AU - Fini, Rita
AU - Melgari, Jean Marc
AU - Paolucci, Matteo
AU - Pasqualetti, Patrizio
AU - Maggio, Paola
PY - 2014
Y1 - 2014
N2 - 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.
AB - 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.
KW - Cerebral hemodynamics
KW - Cerebral vasomotor reactivity
KW - Repetitive transcranial magnetic stimulation
KW - Transcranial Doppler
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U2 - 10.1016/j.brs.2013.12.014
DO - 10.1016/j.brs.2013.12.014
M3 - Article
C2 - 24485467
AN - SCOPUS:84896389340
VL - 7
SP - 281
EP - 286
JO - Brain Stimulation
JF - Brain Stimulation
SN - 1935-861X
IS - 2
ER -