Interleaved TMS/CASL: Comparison of different rTMS protocols

Continuous Arterial Spin Labeling (CASL) offers the possibility to quantitatively measure the regional cerebral blood flow (rCBF). We demonstrate, for the first time, the feasibility of interleaving Transcranial Magnetic Stimulation (TMS) with CASL at 3 T. Two different repetitive TMS (rTMS) protoco...

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Bibliographic Details
Published in:NeuroImage (Orlando, Fla.) Vol. 49; no. 1; pp. 612 - 620
Main Authors: Moisa, Marius, Pohmann, Rolf, Uludağ, Kamil, Thielscher, Axel
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.01.2010
Elsevier Limited
Subjects:
Adult
Algorithms
Blood Circulation Time
Cerebral Arteries - anatomy & histology
Cerebral Arteries - physiology
Cerebrovascular Circulation - physiology
Data Interpretation, Statistical
Electromyography
Evoked Potentials, Motor - physiology
Experiments
Female
Humans
Image Processing, Computer-Assisted
Male
Medical imaging
Motor Cortex - blood supply
Motor Cortex - physiology
Muscle, Skeletal - innervation
Muscle, Skeletal - physiology
Oxygen - blood
Perfusion
Scanners
Spin Labels
Studies
Transcranial Magnetic Stimulation - methods
Young Adult
ISSN:1053-8119, 1095-9572, 1095-9572
Online Access:Get full text
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Summary:Continuous Arterial Spin Labeling (CASL) offers the possibility to quantitatively measure the regional cerebral blood flow (rCBF). We demonstrate, for the first time, the feasibility of interleaving Transcranial Magnetic Stimulation (TMS) with CASL at 3 T. Two different repetitive TMS (rTMS) protocols were applied to the motor cortex in 10 subjects and the effect on rCBF was measured using a CASL sequence with separate RF coils for labeling the inflowing blood. Each subject was investigated, using a block design, under 7 different conditions: continuous 2 Hz rTMS (3 intensities: 100%, 110% and 120% resting motor threshold [MT]), short 10 Hz rTMS trains at 110% MT (8 pulses per train; 3 different numbers of trains per block with 2, 4 and 12 s intervals between trains) and volitional movement (acoustically triggered by 50% MT stimuli). We show robust rCBF increases in motor and premotor areas due to rTMS, even at the lowest stimulation intensity of 100% MT. RCBF exhibited a linear positive dependency on stimulation intensity (for continuous 2 Hz rTMS) and the number of 10 Hz trains in the stimulated M1/S1 as well as in premotor and supplementary motor areas. Interestingly, the 2 different rTMS protocols yielded markedly different rCBF activation time courses, which did not correlate with the electromyographic recordings of the muscle responses. In future, this novel combination of TMS with ASL will offer the possibility to investigate the immediate and after-effects of rTMS stimulation on rCBF, which previously was only possible using PET.
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ISSN:1053-8119
1095-9572
1095-9572
DOI:10.1016/j.neuroimage.2009.07.010