Combining Transcranial Magnetic Stimulation and Deep Brain Stimulation: Current Knowledge, Relevance and Future...

Area of Science:

• Neuroscience
• Neuromodulation
• Clinical Neurophysiology

Background:

• Deep brain stimulation (DBS) is an invasive technique for neurological disorders, but its mechanisms are not fully understood.
• Investigating cortico-basal networks using Transcranial Magnetic Stimulation (TMS) in DBS patients offers insights into DBS mechanisms.
• DBS may modulate cortical excitability and plasticity, potentially contributing to therapeutic effects.

Purpose of the Study:

• To review studies combining TMS and DBS in neurological disorders.
• To present evidence and recommendations on the safety of combined TMS-DBS.
• To outline future research perspectives and novel applications of this approach.

Main Methods:

• Review of experimental studies combining TMS and DBS.
• Analysis of existing evidence on the neurophysiological effects of combined TMS-DBS.
• Evaluation of safety concerns and recommendations for combined TMS-DBS application.

Main Results:

• Studies combining TMS and DBS primarily aim to understand DBS effects on the cerebral cortex.
• The combination of TMS and DBS may induce cortical synaptic plasticity, with unexplored therapeutic potential.
• New DBS technologies and targets offer future research opportunities for brain network investigation.

Conclusions:

• The combined TMS-DBS approach is a valuable tool for investigating cortico-basal networks and DBS mechanisms.
• Safety concerns currently limit the application of combined TMS-DBS, necessitating careful consideration.
• Future research should focus on exploring the therapeutic potential of TMS-DBS-induced plasticity and addressing safety issues.