Effects of transcranial magnetic stimulation on visual evoked potentials in a visual suppression task

Transcranial magnetic stimulation (TMS) can non-invasively modify cortical neural activity by means of a time-varying magnetic field. For example, in cognitive neuroscience, it is applied to create reversible "virtual lesions" in healthy humans (usually assessed as diminished performance in a behavioral task), thereby helping to establish causal structure-function relationships. Despite its widespread use, it is still rather unclear how TMS acts on existing, task-related neural activity, potentially resulting in a measurable effect on the behavioral level. Here, we deliver TMS to early visual areas while recording EEG in order to directly characterize the interaction between TMS-evoked (TEPs) and visual-evoked potentials (VEPs). Simultaneously, the subjects' performance is assessed in a visual forced-choice task. This allows us to compare the TMS effects on the VEPs across different levels of behavioral impairment. By systematically varying the stimulation intensity, we demonstrate that TMS strongly enhances the overall visual stimulus-related activity (rather than disrupting it). This enhancement effect saturates when behavior is impaired. This might indicate that the neural coding of the visual stimulus is robust to noise within a certain dynamic range (as indexed by the enhancement). Strong disturbances might saturate this range, causing behavioral impairment. Variation of the timing between the visual stimulus and the magnetic pulse reveals a "constructive interference" between the TEPs and VEPs: The better the overlap between both evoked potentials, the stronger the interaction effect when TMS and visual stimulation are combined. Importantly, however, this effect is uncorrelated with the strength of behavioral impairment.