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      The Effects of Intermittent Theta Burst Stimulation on Functional Brain Network Following Stroke: An Electroencephalography Study

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          Abstract

          Objective: Intermittent theta burst stimulation (iTBS) is a special form of repetitive transcranial magnetic stimulation (rTMS), which effectively increases cortical excitability and has been widely used as a neural modulation approach in stroke rehabilitation. As effects of iTBS are typically investigated by motor evoked potentials, how iTBS influences functional brain network following stroke remains unclear. Resting-state electroencephalography (EEG) has been suggested to be a sensitive measure for evaluating effects of rTMS on brain functional activity and network. Here, we used resting-state EEG to investigate the effects of iTBS on functional brain network in stroke survivors.

          Methods: We studied thirty stroke survivors (age: 63.1 ± 12.1 years; chronicity: 4.0 ± 3.8 months; UE FMA: 26.6 ± 19.4/66) with upper limb motor dysfunction. Stroke survivors were randomly divided into two groups receiving either Active or Sham iTBS over the ipsilesional primary motor cortex. Resting-state EEG was recorded at baseline and immediately after iTBS to assess the effects of iTBS on functional brain network.

          Results: Delta and theta bands interhemispheric functional connectivity were significantly increased after Active iTBS ( P = 0.038 and 0.011, respectively), but were not significantly changed after Sham iTBS ( P = 0.327 and 0.342, respectively). Delta and beta bands global efficiency were also significantly increased after Active iTBS ( P = 0.013 and 0.0003, respectively), but not after Sham iTBS ( P = 0.586 and 0.954, respectively).

          Conclusion: This is the first study that used EEG to investigate the acute neuroplastic changes after iTBS following stroke. Our findings for the first time provide evidence that iTBS modulates brain network functioning in stroke survivors. Acute increase in interhemispheric functional connectivity and global efficiency after iTBS suggest that iTBS has the potential to normalize brain network functioning following stroke, which can be utilized in stroke rehabilitation.

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          EEGLAB: an open source toolbox for analysis of single-trial EEG dynamics including independent component analysis

          Arnaud Delorme, Scott Makeig (2005)
          We have developed a toolbox and graphic user interface, EEGLAB, running under the crossplatform MATLAB environment (The Mathworks, Inc.) for processing collections of single-trial and/or averaged EEG data of any number of channels. Available functions include EEG data, channel and event information importing, data visualization (scrolling, scalp map and dipole model plotting, plus multi-trial ERP-image plots), preprocessing (including artifact rejection, filtering, epoch selection, and averaging), independent component analysis (ICA) and time/frequency decompositions including channel and component cross-coherence supported by bootstrap statistical methods based on data resampling. EEGLAB functions are organized into three layers. Top-layer functions allow users to interact with the data through the graphic interface without needing to use MATLAB syntax. Menu options allow users to tune the behavior of EEGLAB to available memory. Middle-layer functions allow users to customize data processing using command history and interactive 'pop' functions. Experienced MATLAB users can use EEGLAB data structures and stand-alone signal processing functions to write custom and/or batch analysis scripts. Extensive function help and tutorial information are included. A 'plug-in' facility allows easy incorporation of new EEG modules into the main menu. EEGLAB is freely available (http://www.sccn.ucsd.edu/eeglab/) under the GNU public license for noncommercial use and open source development, together with sample data, user tutorial and extensive documentation.
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            The use of fast Fourier transform for the estimation of power spectra: A method based on time averaging over short, modified periodograms

            P. Welch (1967)
            Article 0 comments Cited 706 times – based on 0 reviews     Review now
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              Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research.

              Simone Rossi, Mark Hallett, Paolo M Rossini … (2010)
              This article is based on a consensus conference, which took place in Certosa di Pontignano, Siena (Italy) on March 7-9, 2008, intended to update the previous safety guidelines for the application of transcranial magnetic stimulation (TMS) in research and clinical settings. Over the past decade the scientific and medical community has had the opportunity to evaluate the safety record of research studies and clinical applications of TMS and repetitive TMS (rTMS). In these years the number of applications of conventional TMS has grown impressively, new paradigms of stimulation have been developed (e.g., patterned repetitive TMS) and technical advances have led to new device designs and to the real-time integration of TMS with electroencephalography (EEG), positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). Thousands of healthy subjects and patients with various neurological and psychiatric diseases have undergone TMS allowing a better assessment of relative risks. The occurrence of seizures (i.e., the most serious TMS-related acute adverse effect) has been extremely rare, with most of the few new cases receiving rTMS exceeding previous guidelines, often in patients under treatment with drugs which potentially lower the seizure threshold. The present updated guidelines review issues of risk and safety of conventional TMS protocols, address the undesired effects and risks of emerging TMS interventions, the applications of TMS in patients with implanted electrodes in the central nervous system, and safety aspects of TMS in neuroimaging environments. We cover recommended limits of stimulation parameters and other important precautions, monitoring of subjects, expertise of the rTMS team, and ethical issues. While all the recommendations here are expert based, they utilize published data to the extent possible.
              Article 0 comments Cited 705 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Neurosci
                Journal ID (iso-abbrev): Front Neurosci
                Journal ID (publisher-id): Front. Neurosci.
                Title: Frontiers in Neuroscience
                Publisher: Frontiers Media S.A.
                ISSN (Print): 1662-4548
                ISSN (Electronic): 1662-453X
                Publication date (Electronic): 22 October 2021
                Publication date Collection: 2021
                Volume: 15
                Electronic Location Identifier: 755709
                Affiliations
                [1] 1Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology , Guangzhou, China
                [2] 2Department of Rehabilitation Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences , Guangzhou, China
                Author notes

                Edited by: Jing Wang, Xi’an Jiaotong University, China

                Reviewed by: Pratik Yashvant Chhatbar, Duke University, United States; Fabricio Lima Brasil, Santos Dumont Institute (ISD), Brazil

                *Correspondence: Guangqing Xu, guangchingx@ 123456163.com

                †These authors have contributed equally to this work

                This article was submitted to Neuroprosthetics, a section of the journal Frontiers in Neuroscience

                Article
                DOI: 10.3389/fnins.2021.755709
                PMC ID: 8569250
                PubMed ID: 34744616
                SO-VID: 3a062de2-31f7-4c1d-a7e4-3183ec456199
                Copyright © Copyright © 2021 Ding, Zhang, Chen, Chen, Li, Chen, Peng, Chen, Chen, Cai, Xu and Lan.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 09 August 2021
                Date accepted : 05 October 2021
                Page count
                Figures: 4, Tables: 2, Equations: 1, References: 52, Pages: 11, Words: 9115
                Categories
                Subject: Neuroscience
                Subject: Original Research

                ScienceOpen disciplines: Neurosciences
                Keywords: intermittent theta burst stimulation (itbs),electroencephalography (eeg),stroke,functional connectivity,graph theory
                Data availability:
                ScienceOpen disciplines: Neurosciences
                Keywords: intermittent theta burst stimulation (itbs), electroencephalography (eeg), stroke, functional connectivity, graph theory

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