Investigating high- and low-frequency neuro-cardiac-guided TMS for probing the frontal vagal pathway

作者：Manreena Kaur, Jessica Michael, Kate E. Hoy, Bernadette M. Fitzgibbon, Megan S. Ross, Tabitha A. Iseger, Martijn Arns, Abdul‐Rahman Hudaib, Paul B. Fitzgerald · 发表于：Brain stimulation · 年份：2020 · DOI：10.1016/j.brs.2020.03.002 · 被引用次数：49 · 研究领域：Transcranial Magnetic Stimulation Studies、Pain Management and Treatment、Virtual Reality Applications and Impacts

BACKGROUND: Investigating approaches for determining a functionally meaningful dorsolateral prefrontal cortex (DLPFC) stimulation site is imperative for optimising repetitive transcranial magnetic stimulation (rTMS) response rates for treatment-resistant depression. One proposed approach is neuro-cardiac-guided rTMS (NCG-TMS) in which high frequency rTMS is applied to the DLPFC to determine the site of greatest heart rate deceleration. This site is thought to index a frontal-vagal autonomic pathway that intersects a key pathway believed to underlie rTMS response. OBJECTIVE: We aimed to independently replicate previous findings of high-frequency NCG-TMS and extend it to evaluate the use of low-frequency rTMS for NCG-TMS. METHODS: Twenty healthy participants (13 female; aged 38.6 ± 13.9) underwent NCG-TMS on frontal, fronto-central (active) and central (control) sites. For high-frequency NCG-TMS, three 5 s trains of 10 Hz were provided at each left hemisphere site. For low-frequency NCG-TMS, 60 s trains of 1 Hz were applied to left and right hemispheres and heart rate and heart rate variability outcome measures were analysed. RESULTS: For high-frequency NCG-TMS, heart rate deceleration was observed at the left frontal compared with the central site. For low-frequency NCG-TMS, accelerated heart rate was found at the right frontal compared with central sites. No other site differences were observed. CONCLUSION: Opposite patterns of heart rate activity were found for high- and low...