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Title: Lack of Target Engagement Following Low-Frequency Deep Transcranial Magnetic Stimulation of the Anterior Insula
Authors: Primavera A. Spagnolo
Han Wang
Prachaya Srivanitchapoom
Melanie Schwandt
Markus Heilig
Mark Hallett
National Institute on Alcohol Abuse and Alcoholism
National Institute of Neurological Disorders and Stroke
Faculty of Medicine, Siriraj Hospital, Mahidol University
Linköpings universitet
Peking Union Medical College
Keywords: Medicine;Neuroscience
Issue Date: 1-Jan-2018
Citation: Neuromodulation. (2018)
Abstract: © 2018 International Neuromodulation Society Objective: To evaluate the safety and efficacy of low-frequency, inhibitory, deep rTMS with a novel H-coil specifically designed to stimulate the insula. Methods: In a randomized, crossover order, 16 healthy volunteers underwent two sessions (sham; active) of 1 Hz repetitive TMS at an intensity of 120% of individual motor threshold, over the right anterior insular cortex localized using a neuronavigation system. Before, immediately after, and one hour after rTMS, subjects performed two tasks that have previously been shown in fMRI experiments to activate insular cortex: A blink suppression task and a forced-choice risk-taking task. Results: No drop-outs or adverse events occurred. Active deep rTMS did not result in decreased urge to blink compared to sham. Similarly, no significant time × condition interaction on risk-taking behavior was found. Conclusions: Low-frequency deep rTMS using a novel H8 coil was shown to be safe but did not affect any of the behavioral markers, also used to investigate modulation of insula activity. Our findings highlight the challenges of modulating the activity of deep brain regions with TMS. Further studies are necessary to identify effective stimulation parameters for deep targets, and to characterize the effects of deep TMS on overlying cortical regions.
ISSN: 15251403
Appears in Collections:Scopus 2018

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