Influences of current direction on 1 Hz motor cortex rTMS

Objective: Neuromodulatory changes induced by repetitive transcranial magnetic stimulation (rTMS) are highly variable and lack replicability. Amongst many influencing factors, the current direction of the stimulation is known to affect rTMS aftereffects. In this study, we investigated the influence...

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Main Authors: Carolina Kanig, Mirja Osnabruegge, Florian Schwitzgebel, Wolfgang Mack, Martin Schecklmann, Stefan Schoisswohl
Format: Article
Language:English
Published: Elsevier 2025-10-01
Series:Brain Research Bulletin
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Online Access:http://www.sciencedirect.com/science/article/pii/S0361923025002965
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author Carolina Kanig
Mirja Osnabruegge
Florian Schwitzgebel
Wolfgang Mack
Martin Schecklmann
Stefan Schoisswohl
author_facet Carolina Kanig
Mirja Osnabruegge
Florian Schwitzgebel
Wolfgang Mack
Martin Schecklmann
Stefan Schoisswohl
author_sort Carolina Kanig
collection DOAJ
description Objective: Neuromodulatory changes induced by repetitive transcranial magnetic stimulation (rTMS) are highly variable and lack replicability. Amongst many influencing factors, the current direction of the stimulation is known to affect rTMS aftereffects. In this study, we investigated the influence of current direction on cortical and peripheral markers of motor cortex plasticity as induced by 1 Hz rTMS as well as the correlation of cortical and peripheral markers. Additionally, we investigated possible confounding variables. Methods: Twenty-five healthy subjects received 2000 pulses of 1 Hz rTMS at 110 % resting motor threshold intensity over the left motor hotspot inducing anterior-posterior – posterior-anterior (AP-PA) and posterior-anterior – anterior-posterior (PA-AP) current directions in the brain. Motor evoked potentials (MEPs) and transcranial evoked potentials (TEPs) before and after rTMS were assessed with single pulses. Coil placement was ensured by a neuronavigated robot-assisted setup. Results: In sum, 1 Hz rTMS resulted in higher amplitudes of MEPs and TEP components N15, N45 and P60 and a reduced amplitude of N100, whereby the induced PA-AP current direction in the brain elicited higher effects. MEP and TEP N15 latency were prolonged and N100 shortened after rTMS. PA-AP current direction elicited stronger changes in latency for MEPs and N15. N45 and MEP correlated in the PA-AP pre rTMS condition with negligible effect size. Conclusions: Our findings of facilitatory pre-to-post rTMS changes are in contrast to preliminary assumptions that 1 Hz rTMS acts inhibitory. However, since high variability and low reliability of rTMS aftereffects are prominent in the current literature, these results shed light that potential influencing factors need to be better reported, controlled and investigated. We suggest to further investigate effects of stimulation intensity and tiredness of subjects on rTMS. We were able to replicate current direction effects which strengthens the hypothesis of activation of different sets of neurons.
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spelling doaj-art-8e953cdbb7ac4f678fcaa997f2e5f81e2025-08-20T03:33:04ZengElsevierBrain Research Bulletin1873-27472025-10-0123011148410.1016/j.brainresbull.2025.111484Influences of current direction on 1 Hz motor cortex rTMSCarolina Kanig0Mirja Osnabruegge1Florian Schwitzgebel2Wolfgang Mack3Martin Schecklmann4Stefan Schoisswohl5Department of Human Sciences, Institute of Psychology, University of the Bundeswehr Munich, Werner-Heisenberg-Weg 39, Neubiberg 85577, Germany; Department of Psychiatry and Psychotherapy, University of Regensburg, Universitätsstraße 31, Regensburg 93053, Germany; Corresponding author at: Department of Human Sciences, Institute of Psychology, University of the Bundeswehr Munich, Werner-Heisenberg-Weg 39, Neubiberg 85577, Germany.Department of Human Sciences, Institute of Psychology, University of the Bundeswehr Munich, Werner-Heisenberg-Weg 39, Neubiberg 85577, Germany; Department of Psychiatry and Psychotherapy, University of Regensburg, Universitätsstraße 31, Regensburg 93053, GermanyDepartment of Electrical Engineering, University of the Bundeswehr Munich, Werner-Heisenberg-Weg 39, Neubiberg 85577, GermanyDepartment of Human Sciences, Institute of Psychology, University of the Bundeswehr Munich, Werner-Heisenberg-Weg 39, Neubiberg 85577, GermanyDepartment of Psychiatry and Psychotherapy, University of Regensburg, Universitätsstraße 31, Regensburg 93053, GermanyDepartment of Human Sciences, Institute of Psychology, University of the Bundeswehr Munich, Werner-Heisenberg-Weg 39, Neubiberg 85577, Germany; Department of Psychiatry and Psychotherapy, University of Regensburg, Universitätsstraße 31, Regensburg 93053, GermanyObjective: Neuromodulatory changes induced by repetitive transcranial magnetic stimulation (rTMS) are highly variable and lack replicability. Amongst many influencing factors, the current direction of the stimulation is known to affect rTMS aftereffects. In this study, we investigated the influence of current direction on cortical and peripheral markers of motor cortex plasticity as induced by 1 Hz rTMS as well as the correlation of cortical and peripheral markers. Additionally, we investigated possible confounding variables. Methods: Twenty-five healthy subjects received 2000 pulses of 1 Hz rTMS at 110 % resting motor threshold intensity over the left motor hotspot inducing anterior-posterior – posterior-anterior (AP-PA) and posterior-anterior – anterior-posterior (PA-AP) current directions in the brain. Motor evoked potentials (MEPs) and transcranial evoked potentials (TEPs) before and after rTMS were assessed with single pulses. Coil placement was ensured by a neuronavigated robot-assisted setup. Results: In sum, 1 Hz rTMS resulted in higher amplitudes of MEPs and TEP components N15, N45 and P60 and a reduced amplitude of N100, whereby the induced PA-AP current direction in the brain elicited higher effects. MEP and TEP N15 latency were prolonged and N100 shortened after rTMS. PA-AP current direction elicited stronger changes in latency for MEPs and N15. N45 and MEP correlated in the PA-AP pre rTMS condition with negligible effect size. Conclusions: Our findings of facilitatory pre-to-post rTMS changes are in contrast to preliminary assumptions that 1 Hz rTMS acts inhibitory. However, since high variability and low reliability of rTMS aftereffects are prominent in the current literature, these results shed light that potential influencing factors need to be better reported, controlled and investigated. We suggest to further investigate effects of stimulation intensity and tiredness of subjects on rTMS. We were able to replicate current direction effects which strengthens the hypothesis of activation of different sets of neurons.http://www.sciencedirect.com/science/article/pii/S0361923025002965Repetitive transcranial magnetic stimulation (rTMS)Motor evoked potential (MEP)Transcranial evoked potential (TEP)Cortical excitabilityCurrent direction
spellingShingle Carolina Kanig
Mirja Osnabruegge
Florian Schwitzgebel
Wolfgang Mack
Martin Schecklmann
Stefan Schoisswohl
Influences of current direction on 1 Hz motor cortex rTMS
Brain Research Bulletin
Repetitive transcranial magnetic stimulation (rTMS)
Motor evoked potential (MEP)
Transcranial evoked potential (TEP)
Cortical excitability
Current direction
title Influences of current direction on 1 Hz motor cortex rTMS
title_full Influences of current direction on 1 Hz motor cortex rTMS
title_fullStr Influences of current direction on 1 Hz motor cortex rTMS
title_full_unstemmed Influences of current direction on 1 Hz motor cortex rTMS
title_short Influences of current direction on 1 Hz motor cortex rTMS
title_sort influences of current direction on 1 hz motor cortex rtms
topic Repetitive transcranial magnetic stimulation (rTMS)
Motor evoked potential (MEP)
Transcranial evoked potential (TEP)
Cortical excitability
Current direction
url http://www.sciencedirect.com/science/article/pii/S0361923025002965
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