Brain responses evoked by high-frequency repetitive TMS : An ERP study

Background: Many recent studies have employed repetitive transcranial magnetic stimulation (rTMS) to study brain-behavior relationships. However, the pulse-to-pulse neural effects of rapid delivery of multiple TMS pulses are unknown largely because of TMS-evoked electrical artifacts limiting recording of brain activity. Objective: In this study, TMS-related artifacts were removed with independent component analysis (ICA), which allowed for the investigation of the neurophysiological effects of rTMS with simultaneous electroencephalographic (EEG) recordings. Methods: 10-Hz, 3-sec rTMS trains (110% of motor threshold) were delivered to the postcentral gyrus and superior parietal lobule in 16 young adults. Simultaneous EEG recordings were made with a TMS-compatible system. The stereotypical pattern of TMS-related electrical artifacts was identified by ICA. Results: Removal of artifacts allowed for identification of a series of five evoked brain potentials occurring within 100 ms of each TMS pulse. With the exception of the first potential, for both areas targeted, there was a quadratic relationship between potential peak amplitude and pulse number within the TMS train. This was characterized by a decrease followed by a rise in amplitude. Conclusions: ICA is an effective method for removal of TMS-evoked electrical artifacts in EEG data. With the use of this procedure we found that the physiological responses to rTMS-evoked potentials, 3 TMS pulses delivered in a high-frequency train of pulses are not independent. The sensitivity of the magnitude of these responses to recent stimulation history suggests a complex recruitment of multiple neuronal events with different temporal dynamics. rTMS-evoked potentials, 4

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