Comparing GABA-dependent physiological measures of inhibition with proton magnetic resonance spectroscopy measurement of GABA using ultra-high-field MRI

ABSTRACT Imbalances in glutamatergic (excitatory) and GABA (inhibitory) signalling within key brain networks are thought to underlie many brain and mental health disorders, and for this reason there is considerable interest in investigating how individual variability in localised concentrations of these molecules relate to brain disorders. Magnetic resonance spectroscopy (MRS) provides a reliable means of measuring, in vivo, concentrations of neurometabolites such as GABA, glutamate and glutamine that can be correlated with brain function and dysfunction. However, an issue of much debate is whether the GABA observed and measured using MRS represents the entire pool of GABA available for measurement (i.e., metabolic, intracellular, and extracellular) or is instead limited to only some portion of it. GABA function can also be investigated indirectly in humans through the use of non‐invasive transcranial magnetic stimulation (TMS) techniques that can be used to measure cortical excitability and GABA‐mediated physiological inhibition. To investigate this issue further we collected in a single session both types of measurement, i.e., TMS measures of cortical excitability and physiological inhibition and ultra‐high‐field (7 T) MRS measures of GABA, glutamate and glutamine, from the left sensorimotor cortex of the same group of right‐handed individuals. We found that TMS and MRS measures were largely uncorrelated with one another, save for the plateau of the TMS IO curve that was negatively correlated with MRS‐Glutamate (Glu) and intra‐cortical facilitation (10ms ISI) that was positively associated with MRS‐Glutamate concentration. These findings are consistent with the view that the GABA concentrations measured using the MRS largely represent pools of GABA that are linked to tonic rather than phasic inhibition and thus contribute to the inhibitory tone of a brain area rather than GABAergic synaptic transmission. Highlightsultra‐high‐field (7 Tesla) MRS used to measure of GABA concentration.TMS used to measure cortical excitability and GABA‐mediated physiological inhibition.Both TMS and MRS measures obtained from primary motor cortex in the same individuals.TMS measures of physiological inhibition uncorrelated with MRS measures of GABA.MRS may represent pools of GABA linked to tonic rather than phasic inhibition.

[1]  Richard E Carson,et al.  Widespread abnormality of the γ-aminobutyric acid-ergic system in Tourette syndrome. , 2012, Brain : a journal of neurology.

[2]  E. Maher,et al.  Improvement of resolution for brain coupled metabolites by optimized 1H MRS at 7 T , 2010, NMR in biomedicine.

[3]  M Hallett,et al.  Neural correlates of tic generation in Tourette syndrome: an event-related functional MRI study. , 2006, Brain : a journal of neurology.

[4]  Peter B Barker,et al.  J‐difference editing of gamma‐aminobutyric acid (GABA): Simulated and experimental multiplet patterns , 2013, Magnetic resonance in medicine.

[5]  J. Rothwell,et al.  Interaction between intracortical inhibition and facilitation in human motor cortex. , 1996, The Journal of physiology.

[6]  Peter B Barker,et al.  Reproducibility of brain spectroscopy at 7T using conventional localization and spectral editing techniques , 2013, Journal of magnetic resonance imaging : JMRI.

[7]  Peter G. Morris,et al.  Increased GABA Contributes to Enhanced Control over Motor Excitability in Tourette Syndrome , 2014, Current Biology.

[8]  Charlotte J. Stagg,et al.  Magnetic Resonance Spectroscopy: Tools for Neuroscience Research and Emerging Clinical Applications , 2013 .

[9]  Robert Chen,et al.  Two phases of short-interval intracortical inhibition , 2003, Experimental Brain Research.

[10]  Michael Orth,et al.  Transcranial magnetic stimulation in Gilles de la Tourette syndrome. , 2009, Journal of psychosomatic research.

[11]  A Münchau,et al.  Altered modulation of intracortical excitability during movement preparation in Gilles de la Tourette syndrome. , 2010, Brain : a journal of neurology.

[12]  Eric M. Wassermann,et al.  Transcranial Magnetic Stimulation-Evoked Cortical Inhibition: A Consistent Marker of Attention-Deficit/Hyperactivity Disorder Scores in Tourette Syndrome , 2005, Biological Psychiatry.

[13]  Mark Hallett,et al.  Role of the sensorimotor cortex in tourette syndrome using multimodal imaging , 2014, Human brain mapping.

[14]  K Ugurbil,et al.  In vivo 1H NMR spectroscopy of the human brain at 7 T , 2001, Magnetic resonance in medicine.

[15]  Brian D. Ross,et al.  Magnetic Resonance Spectroscopy Diagnosis of Neurological Diseases , 1999 .

[16]  H. Bostock,et al.  Two phases of intracortical inhibition revealed by transcranial magnetic threshold tracking , 2002, Experimental Brain Research.

[17]  A Rothenberger,et al.  Decreased motor inhibition in Tourette's disorder: evidence from transcranial magnetic stimulation. , 1997, The American journal of psychiatry.

[18]  Julien Doyon,et al.  Relationship between transcranial magnetic stimulation measures of intracortical inhibition and spectroscopy measures of GABA and glutamate+glutamine. , 2013, Journal of neurophysiology.

[19]  M. Hasselmo Neuromodulation and cortical function: modeling the physiological basis of behavior , 1995, Behavioural Brain Research.

[20]  S. Provencher Estimation of metabolite concentrations from localized in vivo proton NMR spectra , 1993, Magnetic resonance in medicine.

[21]  P. Derambure,et al.  The effects of low- and high-frequency repetitive TMS on the input/output properties of the human corticospinal pathway , 2008, Experimental Brain Research.

[22]  Tobias Schmidt-Wilcke,et al.  Interrelation of resting state functional connectivity, striatal GABA levels, and cognitive control processes , 2015, Human brain mapping.

[23]  Walter Paulus,et al.  Enhancement of human motor cortex inhibition by the dopamine receptor agonist pergolide: evidence from transcranial magnetic stimulation , 1996, Neuroscience Letters.

[24]  A. Strafella,et al.  TMS and drugs revisited 2014 , 2015, Clinical Neurophysiology.

[25]  Jie Zhang,et al.  Association of cortical disinhibition with tic, ADHD, and OCD severity in Tourette syndrome , 2004, Movement disorders : official journal of the Movement Disorder Society.

[26]  M. DiFiglia,et al.  Altered parvalbumin-positive neuron distribution in basal ganglia of individuals with Tourette syndrome. , 2005, Proceedings of the National Academy of Sciences of the United States of America.

[27]  Robert Chen Studies of human motor physiology with transcranial magnetic stimulation , 2000, Muscle & nerve. Supplement.

[28]  Christian Beste,et al.  Striatal and thalamic GABA level concentrations play differential roles for the modulation of response selection processes by proprioceptive information , 2015, NeuroImage.

[29]  M. Garwood,et al.  Simultaneous in vivo spectral editing and water suppression , 1998, NMR in biomedicine.

[30]  B. Steinhoff,et al.  Effects of antiepileptic drugs on motor cortex excitability in humans: A transcranial magnetic stimulation study , 1996, Annals of neurology.

[31]  L. M. M.-T. Theory of Probability , 1929, Nature.

[32]  Ulf Ziemann,et al.  Pharmaco-transcranial magnetic stimulation studies of motor excitability. , 2013, Handbook of clinical neurology.

[33]  Wolfgang Bogner,et al.  3D GABA imaging with real-time motion correction, shim update and reacquisition of adiabatic spiral MRSI , 2014, NeuroImage.

[34]  P K Bhattacharyya,et al.  Spectral quality control in motion‐corrupted single‐voxel J‐difference editing scans: An interleaved navigator approach , 2007, Magnetic resonance in medicine.

[35]  Amelia Draper,et al.  Alterations in structural connectivity may contribute both to the occurrence of tics in Gilles de la Tourette syndrome and to their subsequent control. , 2015, Brain : a journal of neurology.

[36]  S. Francis,et al.  Applications of multi-nuclear magnetic resonance spectroscopy at 7T. , 2011, World journal of radiology.

[37]  U. Ziemann,et al.  TMS-assisted neurophysiological profiling of the dopamine receptor agonist cabergoline in human motor cortex , 2007, Journal of Neural Transmission.

[38]  Saadallah Ramadan,et al.  Glutamate and glutamine: a review of in vivo MRS in the human brain , 2013, NMR in biomedicine.

[39]  C. Rae A Guide to the Metabolic Pathways and Function of Metabolites Observed in Human Brain 1H Magnetic Resonance Spectra , 2013, Neurochemical Research.

[40]  R. Edden,et al.  In vivo magnetic resonance spectroscopy of GABA: a methodological review. , 2012, Progress in nuclear magnetic resonance spectroscopy.

[41]  Mark Tommerdahl,et al.  Title: Reduced Gabaergic Inhibition and Abnormal Sensory Symptoms in Children with Tourette Syndrome Running Head: Abnormal Gaba Levels and Sensory Processing in Ts Submitted for the Steven Hsiao Special Issue Nicolaas Puts, Phd Author Contributions Introduction , 2022 .

[42]  E. Wagenmakers,et al.  A default Bayesian hypothesis test for correlations and partial correlations , 2012, Psychonomic bulletin & review.

[43]  Alexander Münchau,et al.  Corticospinal System Excitability at Rest Is Associated with Tic Severity in Tourette Syndrome , 2008, Biological Psychiatry.

[44]  J C Rothwell,et al.  Relationship between physiological measures of excitability and levels of glutamate and GABA in the human motor cortex , 2011, The Journal of physiology.

[45]  John C. Rothwell,et al.  Opposite effects of weak transcranial direct current stimulation on different phases of short interval intracortical inhibition (SICI) , 2013, Experimental Brain Research.

[46]  K. Uğurbil,et al.  In vivo 1H NMR spectroscopy of the human brain at high magnetic fields: Metabolite quantification at 4T vs. 7T , 2009, Magnetic resonance in medicine.

[47]  Matthew C Kiernan,et al.  Assessment of cortical excitability using threshold tracking techniques , 2006, Muscle & nerve.

[48]  C. Marsden,et al.  Corticocortical inhibition in human motor cortex. , 1993, The Journal of physiology.

[49]  M. Hallett,et al.  Human motor evoked responses to paired transcranial magnetic stimuli. , 1992, Electroencephalography and clinical neurophysiology.

[50]  Yingxi Lin,et al.  The contribution of GABAergic dysfunction to neurodevelopmental disorders. , 2011, Trends in molecular medicine.

[51]  Charlotte J. Stagg,et al.  Magnetic Resonance Spectroscopy as a tool to study the role of GABA in motor-cortical plasticity , 2014, NeuroImage.

[52]  Charles Capaday,et al.  Task-dependent changes of motor cortical network excitability during precision grip compared to isolated finger contraction. , 2012, Journal of neurophysiology.

[53]  Mark Hallett,et al.  Role of the right dorsal anterior insula in the urge to tic in tourette syndrome , 2015, Movement disorders : official journal of the Movement Disorder Society.

[54]  J C Rothwell,et al.  Excitability of motor cortex inhibitory circuits in Tourette syndrome before and after single dose nicotine. , 2005, Brain : a journal of neurology.

[55]  R Gruetter,et al.  Automatic, localized in Vivo adjustment of all first‐and second‐order shim coils , 1993, Magnetic resonance in medicine.

[56]  J. Mink,et al.  Recent advances in Tourette syndrome research , 2006, Trends in Neurosciences.

[57]  V. Eapen,et al.  Pathogenetic model for Tourette syndrome delineates overlap with related neurodevelopmental disorders including Autism , 2012, Translational Psychiatry.

[58]  David Burke,et al.  The effects of alterations in conditioning stimulus intensity on short interval intracortical inhibition , 2009, Brain Research.

[59]  Jie Zhang,et al.  Comparison of the Inhibitory and Excitatory Effects of ADHD Medications Methylphenidate and Atomoxetine on Motor Cortex , 2006, Neuropsychopharmacology.

[60]  C. Capaday,et al.  Input-output properties and gain changes in the human corticospinal pathway , 1997, Experimental Brain Research.

[61]  Detlef Claus,et al.  Corticospinal conduction studied with magnetic double stimulation in the intact human , 1992, Journal of the Neurological Sciences.