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Dose-response relationship between iTBS and prefrontal activation during executive functioning: A fNIRS study.

Bella B B Zhang1, Rebecca L D Kan1, Cristian G Giron1

  • 1Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China.

Frontiers in Psychiatry
|January 6, 2023
PubMed
Summary

Intermittent theta-burst stimulation (iTBS) at 70% resting motor threshold (RMT) improved executive function and maintained brain activity. Lower (50%) and higher (100%) intensities of iTBS decreased brain activity and did not improve performance.

Keywords:
dorsolateral prefrontal cortexexecutive functionfunctional near infrared spectroscopyintermittent theta burst stimulationstimulation intensity

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Area of Science:

  • Neuroscience
  • Cognitive Science
  • Neuromodulation

Background:

  • Intermittent theta-burst stimulation (iTBS) is a non-invasive brain stimulation technique gaining traction for neuropsychiatric disorders.
  • iTBS offers similar benefits to repetitive transcranial magnetic stimulation (rTMS) but in a shorter duration.
  • Optimal stimulation intensity for iTBS, especially for prefrontal regions, remains undetermined.

Purpose of the Study:

  • To investigate the effects of varying iTBS intensities on brain activity and executive function.
  • To determine the optimal stimulation intensity for iTBS applied to the left dorsolateral prefrontal cortex (DLPFC).

Main Methods:

  • Twenty healthy adults participated in a randomized crossover experiment.
  • Participants received iTBS over the left DLPFC at 50%, 70%, or 100% of their resting motor threshold (RMT).
  • Functional near-infrared spectroscopy (fNIRS) measured prefrontal hemoglobin changes during a verbal fluency task (VFT) pre- and post-stimulation.

Main Results:

  • iTBS at 70% RMT maintained oxyhemoglobin (HbO) levels during VFT, unlike 50% and 100% RMT which decreased HbO.
  • An inverse U-shaped relationship was observed between iTBS intensity and prefrontal hemodynamic response.
  • Only 70% RMT iTBS significantly improved VFT performance, correlating positively with HbO changes.

Conclusions:

  • The relationship between iTBS intensity and outcomes differs from conventional rTMS.
  • 70% RMT iTBS appears more effective than 100% RMT for enhancing executive function and brain activity.
  • These findings suggest an optimal intensity range for iTBS targeting the DLPFC.