Intermittent theta-burst stimulation to the right dorsolateral prefrontal cortex may increase potentiated startle in healthy individuals.

Autor: Teferi M; Center for Neuromodulation in Depression and Stress Department of Psychiatry University of Pennsylvania, Philadelphia, PA, USA., Gura H; Center for Neuromodulation in Depression and Stress Department of Psychiatry University of Pennsylvania, Philadelphia, PA, USA.; Neuroscience Graduate Group Perelman School of Medicine University of Pennsylvania, Philadelphia, PA, USA., Patel M; Center for Neuromodulation in Depression and Stress Department of Psychiatry University of Pennsylvania, Philadelphia, PA, USA., Casalvera A; Center for Neuromodulation in Depression and Stress Department of Psychiatry University of Pennsylvania, Philadelphia, PA, USA., Lynch KG; Department of Psychiatry University of Pennsylvania, Philadelphia, PA, USA., Makhoul W; Center for Neuromodulation in Depression and Stress Department of Psychiatry University of Pennsylvania, Philadelphia, PA, USA., Deng ZD; Noninvasive Neuromodulation Unit Experimental Therapeutics and Pathophysiology Branch National Institute of Mental Health National Institutes of Health Bethesda, Bethesda, MD, USA., Oathes DJ; Center for Neuromodulation in Depression and Stress Department of Psychiatry University of Pennsylvania, Philadelphia, PA, USA.; Center for Brain Imaging and Stimulation Department of Psychiatry University of Pennsylvania, Philadelphia, PA, USA.; Penn Brain Science, Translation, Innovation, and Modulation Center University of Pennsylvania, Philadelphia, PA, USA., Sheline YI; Center for Neuromodulation in Depression and Stress Department of Psychiatry University of Pennsylvania, Philadelphia, PA, USA., Balderston NL; Center for Neuromodulation in Depression and Stress Department of Psychiatry University of Pennsylvania, Philadelphia, PA, USA. nicholas.balderston@pennmedicine.upenn.edu.; Center for Brain Imaging and Stimulation Department of Psychiatry University of Pennsylvania, Philadelphia, PA, USA. nicholas.balderston@pennmedicine.upenn.edu.; Penn Brain Science, Translation, Innovation, and Modulation Center University of Pennsylvania, Philadelphia, PA, USA. nicholas.balderston@pennmedicine.upenn.edu.
Jazyk: angličtina
Zdroj: Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology [Neuropsychopharmacology] 2024 Sep; Vol. 49 (10), pp. 1619-1629. Date of Electronic Publication: 2024 May 13.
DOI: 10.1038/s41386-024-01871-w
Abstrakt: Repetitive transcranial magnetic stimulation (rTMS) treatment protocols targeting the right dlPFC have been effective in reducing anxiety symptoms comorbid with depression. However, the mechanism behind these effects is unclear. Further, it is unclear whether these results generalize to non-depressed individuals. We conducted a series of studies aimed at understanding the link between anxiety potentiated startle and the right dlPFC, following a previous study suggesting that continuous theta burst stimulation (cTBS) to the right dlPFC can make people more anxious. Based on these results we hypothesized that intermittent TBS (iTBS), which is thought to have opposing effects on plasticity, may reduce anxiety when targeted at the same right dlPFC region. In this double-blinded, cross-over design, 28 healthy subjects underwent 12 study visits over a 4-week period. During each of their 2 stimulation weeks, they received four 600 pulse iTBS sessions (2/day), with a post-stimulation testing session occurring 24 h following the final iTBS session. One week they received active stimulation, one week they received sham. Stimulation weeks were separated by a 1-week washout period and the order of active/sham delivery was counterbalanced across subjects. During the testing session, we induced anxiety using the threat of unpredictable shock and measured anxiety potentiated startle. Contrary to our initial hypothesis, subjects showed increased startle reactivity following active compared to sham stimulation. These results replicate work from our two previous trials suggesting that TMS to the right dlPFC increases anxiety potentiated startle, independent of both the pattern of stimulation and the timing of the post stimulation measure. Although these results confirm a mechanistic link between right dlPFC excitability and startle, capitalizing upon this link for the benefit of patients will require future exploration.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: