Theta burst transcranial magnetic stimulation of fronto-parietal networks: Modulation by mental state

额顶叶网络的 Theta 爆发经颅磁刺激：精神状态的调节

基本信息

批准号：
9813336
负责人：
Stephan F Taylor
金额：
$ 23.4万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-08-01 至 2021-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9813336
关键词：
Address Affect Area Back Behavior Brain Cerebrum Dementia Devices Functional Magnetic Resonance Imaging Future Growth Impairment Intervention Knowledge Learning Magnetic Resonance Imaging Magnetism Measures Memory Mental Depression Motor Cortex Nerve Tissue Neuronal Plasticity Neurons Neurophysiology - biologic function Parietal Performance Perfusion Prefrontal Cortex Proliferating Rest Short-Term Memory Site Spin Labels Testing Therapeutic Therapeutic Effect Therapeutic Uses Tissues Transcranial magnetic stimulation Ultrasonography Work blood oxygen level dependent cognitive control cognitive function cognitive task depressed patient design flexibility follow-up imaging modality improved insight knowledge base mental state multimodality neuronal excitability neuropsychiatry new technology psychologic relating to nervous system tool treatment effect

项目摘要

Abstract The recent growth of non-invasive brain stimulation has provided new technologies to probe neural function and treat diverse neuropsychiatric conditions, but much remains to be learned about how stimulation interacts with brain networks. We will address this question for transcranial magnetic stimulation (TMS), a powerful and flexible type of non-invasive brain stimulation that directly stimulates neurons and can induce persisting effects and neuroplastic changes which outlast the period of stimulation. We will examine a particular type of TMS, known as theta burst stimulation (TBS), which induces longer lasting effects than other forms of TMS, making TBS an important tool for therapeutic applications. While TBS provides relatively focal stimulation, effects on the brain occur through interconnected networks in ways that are poorly understood. Moreover, stimulation is highly state-dependent, and the use of TMS in most therapeutic settings, such as the treatment of depression, leaves mental state uncontrolled. Augmenting TMS by pairing it with psychological interventions is an attractive idea for improving therapeutic TMS, but the relevant knowledge base is sparse. To address this critical gap, this exploratory R21 proposal will examine the effects of TBS on specific brain networks and the interaction between TBS and mental state. We will test the broad hypothesis that when TBS is applied during a controlled mental state, network changes will be facilitated, compared to stimulation when mental state is uncontrolled. We will focus on the dorsolateral prefrontal cortex (dlPFC) and the associated fronto- parietal network (FPN), which subserves cognitive control -- the ability to flexibly adapt and regulate behavior, an ability known to be impaired in neuropsychiatric conditions such as depression and dementia. We will use an ‘n-back’ task tapping cognitive control and the FPN. We will comprehensively assess brain activity with three functional magnetic resonance imaging (fMRI) modalities: blood oxygenation level-dependent (BOLD) activation will measure FPN activity with the n-back task, resting state BOLD fMRI will measure connectivity and resting state arterial spin labeling (ASL) MRI will measure cerebral perfusion. TBS will be applied to 40 healthy subjects in 3 conditions, each followed by an fMRI session. Analysis will utilize powerful within-subject comparisons. In Aim 1, we will show that persisting neural changes induced by TBS to the dlPFC, compared to TBS to the vertex, will affect the FPN. In Aim 2, we will demonstrate modulation of the effect of dlPFC TBS administered when subjects are performing the n-back task, compared to when their mental state is unconstrained. In Aim 3, we will test predictions that n-back performance will improve following TBS to dlPFC, but not to the cortical vertex, and will improve even more following TBS during n-back performance. Impact: Results will provide insights into the effect of TMS on the brain, identifying a network target manipulated by TBS and interacting with mental state. Demonstrated this interaction will lay critical groundwork for future studies to show how controlling mental state during TMS can improve therapeutic effects.

抽象的近年来非侵入性脑刺激的发展为探测神经功能提供了新技术并治疗不同的神经精神疾病，但关于刺激如何相互作用还有很多东西有待了解我们将通过经颅磁刺激 (TMS) 来解决这个问题，这是一种强大且有效的方法。灵活类型的非侵入性脑刺激，直接刺激神经元并可产生持续效应以及在刺激期间持续的神经塑性变化我们将检查一种特殊类型的 TMS，称为 theta 爆发刺激 (TBS)，它比其他形式的 TMS 产生更持久的效果，使得 TBS 是治疗应用的重要工具，虽然 TBS 提供相对集中的刺激，但对患者的影响却很大。大脑通过相互连接的网络以人们知之甚少的方式发生作用。高度状态依赖性，并且 TMS 在大多数治疗环境中的使用，例如抑郁症的治疗，通过将 TMS 与心理干预相结合来增强 TMS 是一种很有吸引力的方法。改善 TMS 治疗的想法，但相关知识库很少。这项探索性的 R21 提案将研究 TBS 对特定大脑网络的影响以及我们将检验何时应用 TBS 的广泛假设。与精神状态下的刺激相比，在受控的精神状态下，网络变化将更加容易我们将重点关注背外侧前额皮质（dlPFC）和相关的额叶皮质。顶叶网络（FPN），有助于认知控制——灵活适应和调节行为的能力，我们将使用一种已知在神经精神疾病（例如抑郁症和痴呆症）中受损的能力。一项利用认知控制和 FPN 的“n-back”任务，我们将全面评估大脑活动。三种功能磁共振成像 (fMRI) 模式：血氧水平依赖性 (BOLD) 激活将通过 n-back 任务测量 FPN 活动，静息状态 BOLD fMRI 将测量连接性静息态动脉自旋标记 (ASL) MRI 将测量 40 名患者的脑灌注。健康受试者处于 3 种情况下，每种情况下都会进行功能磁共振成像分析。在目标 1 中，我们将展示与 dlPFC 相比，TBS 引起的持续神经变化。 TBS 到顶点，会影响 FPN 在目标 2 中，我们将演示 dlPFC TBS 的调制效果。当受试者执行 n-back 任务时与他们的精神状态相同时进行比较在目标 3 中，我们将测试从 TBS 到 dlPFC 后 n-back 性能将得到改善的预测，但不会到达皮质顶点，并且会在 n-back 影响期间进一步提高以下 TBS：结果将深入了解 TMS 对大脑的影响，识别由 TMS 操纵的网络目标 TBS 和与心理状态的互动已证明这种互动将为以下奠定重要基础。未来的研究将表明如何在 TMS 期间控制精神状态可以提高治疗效果。