Network-targeted cerebellar transcranial magnetic stimulation improves attentional control

Area of Science:

• Neuroscience
• Cognitive Science
• Neuromodulation

Background:

• Attentional control is crucial for neurological and psychiatric conditions, yet reliable non-invasive biomarkers for improvement are scarce.
• Functional connectivity within the dorsal attention network (DAN) is a potential biomarker for attention.
• Cerebellar transcranial magnetic stimulation (TMS) offers a novel approach to modulate brain networks non-invasively.

Purpose of the Study:

• To investigate if network-targeted cerebellar TMS can enhance attentional control by modulating the DAN.
• To assess the impact of stimulating the DAN versus the default mode network (DMN) on sustained and transient attention.
• To identify if baseline attentional performance influences the effectiveness of cerebellar TMS.

Main Methods:

• Healthy young adults received intermittent theta burst TMS (iTBS) targeting cerebellar nodes of the DAN and DMN, identified via fMRI.
• Participants completed sustained attention (gradual onset continuous performance task, gradCPT) and transient attention (attentional blink) tasks pre- and post-stimulation.
• Two stimulation sessions were conducted: one targeting the cerebellar DAN and another targeting the cerebellar DMN as a control.

Main Results:

• Cerebellar DAN stimulation significantly reduced attentional lapses on the gradCPT compared to DMN stimulation.
• Individuals with poorer baseline gradCPT performance showed the most significant improvements after DAN stimulation.
• TMS improved attentional blink performance irrespective of the cerebellar stimulation site (DAN or DMN).

Conclusions:

• Network-targeted cerebellar TMS can enhance sustained attention, particularly in individuals with lower baseline performance, by modulating DAN functional connectivity.
• Modulating functional connectivity in both DAN and DMN via cerebellar stimulation can improve transient attention.
• These findings support the potential of cerebellar TMS as an intervention for attentional deficits and advancing functional connectivity models.