Continuous theta burst stimulation at 30 hz does not modulate cortical excitability in a sham-controlled study

Abstract Theta burst stimulation (TBS) can modulate cortical excitability but suffers from high inter-subject variability. Modified TBS frequency patterns (30 Hz) showed consistent inhibitory aftereffects, but further research into the time course of these effects is needed. This study aimed to inve...

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Main Authors: Joana Frieske, Sybren Van Hoornweder, Marten Nuyts, Stefanie Verstraelen, Stephan P. Swinnen, Raf L.J. Meesen
Format: Article
Language:English
Published: Nature Portfolio 2024-12-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-81399-7
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author Joana Frieske
Sybren Van Hoornweder
Marten Nuyts
Stefanie Verstraelen
Stephan P. Swinnen
Raf L.J. Meesen
author_facet Joana Frieske
Sybren Van Hoornweder
Marten Nuyts
Stefanie Verstraelen
Stephan P. Swinnen
Raf L.J. Meesen
author_sort Joana Frieske
collection DOAJ
description Abstract Theta burst stimulation (TBS) can modulate cortical excitability but suffers from high inter-subject variability. Modified TBS frequency patterns (30 Hz) showed consistent inhibitory aftereffects, but further research into the time course of these effects is needed. This study aimed to investigate the efficacy of a 30 Hz continuous TBS (cTBS) protocol. Participants (n = 20) underwent an experimental session (real cTBS) and a control session (sham cTBS). To assess cortical excitability, Transcranial Magnetic Stimulation was applied over the primary motor cortex before cTBS, and at five timepoints after cTBS. Percentage change (PC) to baseline was analysed using a Linear Mixed Model. No difference in PC was found between real and sham cTBS (p = 0.696). Our results demonstrate a significant increase in PC over time (p = 0.006) at 30, (p = 0.01), 45 (p = 0.027), and 55 min (p = 0.024) post cTBS, irrespective of condition. Secondary analysis dividing the sample into responders and paradox-responders showed no significant predictors for cTBS responsiveness. We could not replicate previously reported suppressive effects of 30 Hz cTBS. Increases in MEP amplitudes over a 60-minute time window were independent of stimulation condition and marked by high inter-subject variability. Validations of modified TBS protocols are further needed to replicate findings and understand mechanisms underlying individuals’ responsiveness.
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spelling doaj-art-8d5bcb63e7144d6b8c8b126de50dd1142025-08-20T02:20:38ZengNature PortfolioScientific Reports2045-23222024-12-011411910.1038/s41598-024-81399-7Continuous theta burst stimulation at 30 hz does not modulate cortical excitability in a sham-controlled studyJoana Frieske0Sybren Van Hoornweder1Marten Nuyts2Stefanie Verstraelen3Stephan P. Swinnen4Raf L.J. Meesen5REVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, University of Hasselt - Campus DiepenbeekREVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, University of Hasselt - Campus DiepenbeekREVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, University of Hasselt - Campus DiepenbeekREVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, University of Hasselt - Campus DiepenbeekMovement Control and Neuroplasticity Research Group, Department of Movement Sciences, Group Biomedical Sciences, KU LeuvenREVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, University of Hasselt - Campus DiepenbeekAbstract Theta burst stimulation (TBS) can modulate cortical excitability but suffers from high inter-subject variability. Modified TBS frequency patterns (30 Hz) showed consistent inhibitory aftereffects, but further research into the time course of these effects is needed. This study aimed to investigate the efficacy of a 30 Hz continuous TBS (cTBS) protocol. Participants (n = 20) underwent an experimental session (real cTBS) and a control session (sham cTBS). To assess cortical excitability, Transcranial Magnetic Stimulation was applied over the primary motor cortex before cTBS, and at five timepoints after cTBS. Percentage change (PC) to baseline was analysed using a Linear Mixed Model. No difference in PC was found between real and sham cTBS (p = 0.696). Our results demonstrate a significant increase in PC over time (p = 0.006) at 30, (p = 0.01), 45 (p = 0.027), and 55 min (p = 0.024) post cTBS, irrespective of condition. Secondary analysis dividing the sample into responders and paradox-responders showed no significant predictors for cTBS responsiveness. We could not replicate previously reported suppressive effects of 30 Hz cTBS. Increases in MEP amplitudes over a 60-minute time window were independent of stimulation condition and marked by high inter-subject variability. Validations of modified TBS protocols are further needed to replicate findings and understand mechanisms underlying individuals’ responsiveness.https://doi.org/10.1038/s41598-024-81399-7Transcranial magnetic stimulation (TMS)Continuous theta burst stimulation (cTBS)Variability30 hz cTBSResponsivenessCortical excitability
spellingShingle Joana Frieske
Sybren Van Hoornweder
Marten Nuyts
Stefanie Verstraelen
Stephan P. Swinnen
Raf L.J. Meesen
Continuous theta burst stimulation at 30 hz does not modulate cortical excitability in a sham-controlled study
Scientific Reports
Transcranial magnetic stimulation (TMS)
Continuous theta burst stimulation (cTBS)
Variability
30 hz cTBS
Responsiveness
Cortical excitability
title Continuous theta burst stimulation at 30 hz does not modulate cortical excitability in a sham-controlled study
title_full Continuous theta burst stimulation at 30 hz does not modulate cortical excitability in a sham-controlled study
title_fullStr Continuous theta burst stimulation at 30 hz does not modulate cortical excitability in a sham-controlled study
title_full_unstemmed Continuous theta burst stimulation at 30 hz does not modulate cortical excitability in a sham-controlled study
title_short Continuous theta burst stimulation at 30 hz does not modulate cortical excitability in a sham-controlled study
title_sort continuous theta burst stimulation at 30 hz does not modulate cortical excitability in a sham controlled study
topic Transcranial magnetic stimulation (TMS)
Continuous theta burst stimulation (cTBS)
Variability
30 hz cTBS
Responsiveness
Cortical excitability
url https://doi.org/10.1038/s41598-024-81399-7
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