Preconditioning of Low-Frequency Repetitive Transcranial Magnetic Stimulation with Transcranial Direct Current Stimulation: Evidence for Homeostatic Plasticity in the Human Motor Cortex

By Hartwig Roman Siebner, N. Lang, V. Rizzo, Michael A. Nitsche, Walter Paulus, Roger N. Lemon, John C. Rothwell. Journal of Neuroscience, 2004

702 citations recorded by the source corpus.

Recent experimental work in animals has emphasized the importance of homeostatic plasticity as a means of stabilizing the properties of neuronal circuits. Here, we report a phenomenon that indicates a homeostatic pattern of cortical plasticity in healthy human subjects. The experiments combined two techniques that can produce long-term effects on the excitability of corticospinal output neurons: transcranial direct current stimulation (TDCS) and repetitive transcranial magnetic stimulation (rTMS) of the left primary motor cortex. “Facilitatory preconditioning” with anodal TDCS caused a subsequent period of 1 Hz rTMS to reduce corticospinal excitability to below baseline levels for >20 min. Conversely, “inhibitory preconditioning” with cathodal TDCS resulted in 1 Hz rTMS increasing corticospinal excitability for at least 20 min. No changes in excitability occurred when 1 Hz rTMS was preceded by sham TDCS. Thus, changing the initial state of the motor cortex by a period of DC polarization reversed the conditioning effects of 1 Hz rTMS. These preconditioning effects of TDCS suggest the existence of a homeostatic mechanism in the human motor cortex that stabilizes corticospinal excitability within a physiologically useful range.

Subfields: Biomedical Engineering, Cellular and Molecular Neuroscience, Neurology

View Paper: https://www.semanticscholar.org/paper/812a93afb20900b97d386ffb13772293854b8a27

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In Biomedical Engineering

In Cellular and Molecular Neuroscience

In Neurology

Citations in the corpus

Safety and recommendations for TMS use in healthy subjects and patient populations, with updates on training, ethical and regulatory issues: Expert Guidelines (2020, positive): “5 mA intensity for 10-15 min combined with 1 or 5 Hz rTMS 100-600 pulses 85-130% of RMT or 100% AMT or 90 % phosphene threshold) is limited (Moliadze et al., 2003, 2010; Siebner et al., 2004; Lang et al., 2004, 2007; Cosentino et al., 2012; Bocci et al., 2014).”
Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS). (2014, neutral): “…a previous session of transcranial direct current stimulation (tDCS), the ‘‘classically inhibitory’’ LF rTMS may have surprising facilitatory actions (Siebner et al., 2004), while the mirror effect (i.e., reversal of the facilitatory effect of HF rTMS) can be obtained if cortical excitability is…”
Determinants of the induction of cortical plasticity by non‐invasive brain stimulation in healthy subjects (2010, methodology): “Several studies have employed tDCS to prime the motor cortex prior to stimulation with rTMS. Siebner et al. (2004) demonstrated that the response to a 15 min period of 1 Hz rTMS was modulated bi-directionally by tDCS. Anodal tDCS increased the depressant response to 1 Hz rTMS while when primed with…”
A common polymorphism in the brain‐derived neurotrophic factor gene (BDNF) modulates human cortical plasticity and the response to rTMS (2008, background): “…Hz rTMS alone is insufficient to induce any after-effects, but when pre-conditioned by cathodal TDCS it generates facilitation of the motor cortex, producing a homeostatic-like effect (Siebner et al. 2004) that has been shown to be impaired in patients with focal dystonia (Quartarone et al. 2005).”
How does transcranial DC stimulation of the primary motor cortex alter regional neuronal activity in the human brain? (2005, methodology): “Using an identical protocol, our previous work on tDCS-induced changes in corticospinal excitability has shown that 10 min of tDCS to the left M1 (1 mA) never induced muscle twitches or changed the muscle tone (Nitsche & Paulus, 2001; Nitsche et al., 2003a; Lang et al., 2004a; Lang et al., 2004b; Si”
Anodal transcranial direct current stimulation of prefrontal cortex enhances working memory (2005, methodology): “For sham stimulation, the electrodes were placed in the same position; however, the stimulator was turned off after 5 s as previously described (Siebner et al. 2004).”
Neuroscience and Biobehavioral Reviews Auditory Verbal Hallucinations as Atypical Inner Speech Monitoring, and the Potential of Neurostimulation as a Treatment Option (positive): “For example, Siebner et al. (2004) showed that if excitability was increased at baseline, then 1 Hz rTMS reduced excitability; however, if excitability was decreased at baseline, the same stimulation had the effect of increasing excitability .”
Enhancement of human cognitive performance using transcranial magnetic stimulation (TMS) (2013, background): “Prior brain stimulation can change whether cortex is up or down regulated in excitability by a train of rTMS (Silvanto et al., 2008b) and whether enhancement or disruption effects are found (Siebner, 2004).”