Neuro-Cardiac-Guided TMS (NCG TMS): A replication and extension study

Tabitha A. Iseger; Frank Padberg; J. Leon Kenemans; Hanneke van Dijk; Martijn Arns

doi:10.1016/j.biopsycho.2021.108097

Neuro-Cardiac-Guided TMS (NCG TMS): A replication and extension study

Tabitha A. Iseger, Frank Padberg, J. Leon Kenemans, Hanneke van Dijk, Martijn Arns^*

^*Corresponding author for this work

Research output: Contribution to journal › (Systematic) Review article › peer-review

Abstract

Neuro-Cardiac-Guided Transcranial Magnetic Stimulation (NCG-TMS) was studied for its potential to specifically target the frontal-vagal network. Previous research demonstrated that prefrontal stimulation led to significant heartrate slowing. We aimed to replicate these results in a larger sample and extend the findings to investigate dose-response relationships, reproducibility and stimulation frequency (10 Hz and intermittent theta burst (iTBS)). Data of forty-five healthy controls were analyzed, of which 28 received 10 Hz TMS (NCG-TMS) and 27 iTBS (NCG-iTBS; 10 received both protocols) at different stimulation sites according to the 10 20-EEG system. NCG-TMS yielded a relative heartrate deceleration at the F3/4 coil position replicating earlier studies. Both internal consistency and dose-response relationships were found. For NCG-iTBS adverse events were reported and topography for frontal-vagal activation was more lateralised relative to NCG-TMS. These results indicate that we were able to transsynaptically stimulate the frontal-vagal network and that excitability thresholds for the prefrontal cortex may differ relative to motor cortex.

Original language	English
Article number	108097
Number of pages	11
Journal	Biological Psychology
Volume	162
DOIs	https://doi.org/10.1016/j.biopsycho.2021.108097
Publication status	Published - May 2021

Keywords

TMS
Heart rate
Frontal-vagal
Dorsolateral prefrontal cortex
Target engagement
Personalized medicine
TRANSCRANIAL MAGNETIC STIMULATION
CORTICAL EXCITABILITY
PHOSPHENE THRESHOLDS
NERVE-STIMULATION
DEPRESSION
MOTOR
TARGETS
CONNECTIVITY
ASSOCIATION
DISORDER

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Cite this

@article{8cb5a558a03d49b99c0bbfe6d857c208,

title = "Neuro-Cardiac-Guided TMS (NCG TMS): A replication and extension study",

abstract = "Neuro-Cardiac-Guided Transcranial Magnetic Stimulation (NCG-TMS) was studied for its potential to specifically target the frontal-vagal network. Previous research demonstrated that prefrontal stimulation led to significant heartrate slowing. We aimed to replicate these results in a larger sample and extend the findings to investigate dose-response relationships, reproducibility and stimulation frequency (10 Hz and intermittent theta burst (iTBS)). Data of forty-five healthy controls were analyzed, of which 28 received 10 Hz TMS (NCG-TMS) and 27 iTBS (NCG-iTBS; 10 received both protocols) at different stimulation sites according to the 10 20-EEG system. NCG-TMS yielded a relative heartrate deceleration at the F3/4 coil position replicating earlier studies. Both internal consistency and dose-response relationships were found. For NCG-iTBS adverse events were reported and topography for frontal-vagal activation was more lateralised relative to NCG-TMS. These results indicate that we were able to transsynaptically stimulate the frontal-vagal network and that excitability thresholds for the prefrontal cortex may differ relative to motor cortex.",

keywords = "TMS, Heart rate, Frontal-vagal, Dorsolateral prefrontal cortex, Target engagement, Personalized medicine, TRANSCRANIAL MAGNETIC STIMULATION, CORTICAL EXCITABILITY, PHOSPHENE THRESHOLDS, NERVE-STIMULATION, DEPRESSION, MOTOR, TARGETS, CONNECTIVITY, ASSOCIATION, DISORDER",

author = "Iseger, {Tabitha A.} and Frank Padberg and Kenemans, {J. Leon} and {van Dijk}, Hanneke and Martijn Arns",

note = "Funding Information: MA is unpaid research director of the non-profit Brainclinics Foundation, a minority shareholder in neuroCare Group (Munich, Germany), and a co-inventor on 4 patent applications (A61B5/0402; US2007/0299323, A1; WO2010/139361 A1) related to EEG, neuromodulation and psychophysiology, but does not own these nor receives any proceeds related to these patents; Research Institute Brainclinics received funding from Brain Resource (Sydney, Australia) and neuroCare Group (Munich, Germany), and equipment support from Brainsway, Deymed, neuroConn and MagVenture. TI and MA are coinventors on a patent covering the Neuro-Cardiac-Guided TMS method (owned by neuroCare Group), but receive no proceeds or royalties. FP is a member of the European Scientific Advisory Board of Brainsway Inc., Jerusalem, Israel, and has received speaker's honoraria from Mag&More GmbH (Munich, Germany). His lab has received support with equipment from neuroConn (Ilmenau, Germany), Mag&More GmbH and Brainsway Inc., Jerusalem, Israel. Publisher Copyright: {\textcopyright} 2021 The Authors",

year = "2021",

month = may,

doi = "10.1016/j.biopsycho.2021.108097",

language = "English",

volume = "162",

journal = "Biological Psychology",

issn = "0301-0511",

publisher = "Elsevier Science",

}

TY - JOUR

T1 - Neuro-Cardiac-Guided TMS (NCG TMS)

T2 - A replication and extension study

AU - Iseger, Tabitha A.

AU - Padberg, Frank

AU - Kenemans, J. Leon

AU - van Dijk, Hanneke

AU - Arns, Martijn

N1 - Funding Information: MA is unpaid research director of the non-profit Brainclinics Foundation, a minority shareholder in neuroCare Group (Munich, Germany), and a co-inventor on 4 patent applications (A61B5/0402; US2007/0299323, A1; WO2010/139361 A1) related to EEG, neuromodulation and psychophysiology, but does not own these nor receives any proceeds related to these patents; Research Institute Brainclinics received funding from Brain Resource (Sydney, Australia) and neuroCare Group (Munich, Germany), and equipment support from Brainsway, Deymed, neuroConn and MagVenture. TI and MA are coinventors on a patent covering the Neuro-Cardiac-Guided TMS method (owned by neuroCare Group), but receive no proceeds or royalties. FP is a member of the European Scientific Advisory Board of Brainsway Inc., Jerusalem, Israel, and has received speaker's honoraria from Mag&More GmbH (Munich, Germany). His lab has received support with equipment from neuroConn (Ilmenau, Germany), Mag&More GmbH and Brainsway Inc., Jerusalem, Israel. Publisher Copyright: © 2021 The Authors

PY - 2021/5

Y1 - 2021/5

N2 - Neuro-Cardiac-Guided Transcranial Magnetic Stimulation (NCG-TMS) was studied for its potential to specifically target the frontal-vagal network. Previous research demonstrated that prefrontal stimulation led to significant heartrate slowing. We aimed to replicate these results in a larger sample and extend the findings to investigate dose-response relationships, reproducibility and stimulation frequency (10 Hz and intermittent theta burst (iTBS)). Data of forty-five healthy controls were analyzed, of which 28 received 10 Hz TMS (NCG-TMS) and 27 iTBS (NCG-iTBS; 10 received both protocols) at different stimulation sites according to the 10 20-EEG system. NCG-TMS yielded a relative heartrate deceleration at the F3/4 coil position replicating earlier studies. Both internal consistency and dose-response relationships were found. For NCG-iTBS adverse events were reported and topography for frontal-vagal activation was more lateralised relative to NCG-TMS. These results indicate that we were able to transsynaptically stimulate the frontal-vagal network and that excitability thresholds for the prefrontal cortex may differ relative to motor cortex.

AB - Neuro-Cardiac-Guided Transcranial Magnetic Stimulation (NCG-TMS) was studied for its potential to specifically target the frontal-vagal network. Previous research demonstrated that prefrontal stimulation led to significant heartrate slowing. We aimed to replicate these results in a larger sample and extend the findings to investigate dose-response relationships, reproducibility and stimulation frequency (10 Hz and intermittent theta burst (iTBS)). Data of forty-five healthy controls were analyzed, of which 28 received 10 Hz TMS (NCG-TMS) and 27 iTBS (NCG-iTBS; 10 received both protocols) at different stimulation sites according to the 10 20-EEG system. NCG-TMS yielded a relative heartrate deceleration at the F3/4 coil position replicating earlier studies. Both internal consistency and dose-response relationships were found. For NCG-iTBS adverse events were reported and topography for frontal-vagal activation was more lateralised relative to NCG-TMS. These results indicate that we were able to transsynaptically stimulate the frontal-vagal network and that excitability thresholds for the prefrontal cortex may differ relative to motor cortex.

KW - TMS

KW - Heart rate

KW - Frontal-vagal

KW - Dorsolateral prefrontal cortex

KW - Target engagement

KW - Personalized medicine

KW - TRANSCRANIAL MAGNETIC STIMULATION

KW - CORTICAL EXCITABILITY

KW - PHOSPHENE THRESHOLDS

KW - NERVE-STIMULATION

KW - DEPRESSION

KW - MOTOR

KW - TARGETS

KW - CONNECTIVITY

KW - ASSOCIATION

KW - DISORDER

U2 - 10.1016/j.biopsycho.2021.108097

DO - 10.1016/j.biopsycho.2021.108097

M3 - (Systematic) Review article

C2 - 33895224

SN - 0301-0511

VL - 162

JO - Biological Psychology

JF - Biological Psychology

M1 - 108097

ER -