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Paired Associative Stimulation of the Temporal Cortex: Effects on the Auditory Steady-State Response.

ABSTRACT: Background:Paired associative stimulation (PAS) is the repeated combination of a sensory stimulus with transcranial magnetic stimulation (TMS) in close temporal association. Recently, a study demonstrated that PAS of an auditory stimulus together with TMS of the temporal cortex is capable of changing the amplitude of auditory evoked potentials (AEP). Objective:This study examined the influence of tone duration and habituation in temporal cortex PAS as elicited by 40 and 20?Hz amplitude modulated auditory steady-state responses (aSSR). Methods:Eighteen subjects participated in two experiments, including two PAS protocols each, which consisted of 200 auditory stimuli (4?kHz) paired with temporal cortex TMS with an interstimulus interval (ISI) of 45?ms between tone onset and TMS pulse, delivered at 0.1?Hz. Experiment 1 compared auditory stimuli with different lengths [PAS (23?ms) vs. PAS (400?ms)]. Experiment 2 investigated verum vs. sham PAS. aSSR for the paired tone (4?kHz) and a control tone (1?kHz) were measured pre- and post-interventional-using 40?Hz aSSR in experiment 1 and both 20 and 40?Hz aSSR in experiment 2. Results:A statistically significant, sham-controlled decrease in amplitude was observed for the 20?Hz aSSR using the 4?kHz PAS carrier frequency in experiment 2. Conclusion:Frequency-specific effects for the 20?Hz aSSR confirm the feasibility of auditory PAS and highlight the secondary auditory cortex as its target site, introducing new possible treatment protocols for patients suffering from tinnitus. The amplitude decrease can be explained by principles of spike timing-dependent plasticity and the superposition model of aSSR.

SUBMITTER: Engel S

PROVIDER: S-EPMC5682298 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Paired Associative Stimulation of the Temporal Cortex: Effects on the Auditory Steady-State Response.

Engel Sarah S Markewitz Robert Daniel Heinrich RDH Langguth Berthold B Schecklmann Martin M

Frontiers in psychiatry 20171108

<h4>Background</h4>Paired associative stimulation (PAS) is the repeated combination of a sensory stimulus with transcranial magnetic stimulation (TMS) in close temporal association. Recently, a study demonstrated that PAS of an auditory stimulus together with TMS of the temporal cortex is capable of changing the amplitude of auditory evoked potentials (AEP).<h4>Objective</h4>This study examined the influence of tone duration and habituation in temporal cortex PAS as elicited by 40 and 20 Hz ampl ...[more]

PMID: 29167648

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Project description:ObjectiveTo determine whether neurophysiological mechanisms indicating cortical excitability, long-term potentiation (LTP)-like plasticity, GABAergic and glutamatergic function are altered in patients with anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis and whether they can be helpful as markers of diagnostic assessment, disease progression, and potentially therapy response.MethodsNeurophysiological characterizations of patients with NMDAR encephalitis (n = 34, mean age: 28 ± 11 years; 30 females) and age/gender-matched healthy controls (n = 27, 28.5 ± 10 years; 25 females) were performed using transcranial magnetic stimulation-derived protocols including resting motor threshold, recruitment curve, intracortical facilitation, short intracortical inhibition, and cortical silent period. Paired associative stimulation (PAS) was applied to assess LTP-like mechanisms which are mediated through NMDAR. Moreover, resting state functional connectivity was determined using functional magnetic resonance imaging.ResultsPAS-induced plasticity differed significantly between groups (P = 0.0056). Cortical excitability, as assessed via motor-evoked potentials after PAS, decreased in patients, whereas it increased in controls indicating malfunctioning of NMDAR in encephalitis patients. Lower PAS-induced plasticity significantly correlated with the modified Rankin Scale (mRS) (r = -0.41; P = 0.0031) and was correlated with lower functional connectivity within the motor network in NMDAR encephalitis patients (P < 0.001, uncorrected). Other neurophysiological parameters were not significantly different between groups. Follow-up assessments were available in six patients and demonstrated parallel improvement of PAS-induced plasticity and mRS.InterpretationAssessment of PAS-induced plasticity may help to determine NMDAR dysfunction and disease severity in NMDAR encephalitis, and might even aid as a sensitive, noninvasive, and well-tolerated "electrophysiological biomarker" to monitor therapy response in the future.Clinical trial registrationClinicalTrials.gov: Identifier: NCT01865578.

Dataset Information

Paired Associative Stimulation of the Temporal Cortex: Effects on the Auditory Steady-State Response.

Publications

Paired Associative Stimulation of the Temporal Cortex: Effects on the Auditory Steady-State Response.

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