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Prefrontal TMS produces smaller EEG responses than motor-cortex TMS: implications for rTMS treatment in depression

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Abstract

Rationale

The stimulus intensity of prefrontal repetitive transcranial magnetic stimulation (rTMS) during depression treatment is usually determined by adjusting it with respect to the motor threshold (MT). There is some evidence that reactivity of the prefrontal cortex to transcranial magnetic stimulation (TMS) is lower than that of the motor cortex at MT stimulation. However, it is unknown whether this is true when other stimulus intensities are used. We investigated whether the magnitude and shape of the overall TMS-evoked electroencephalographic (EEG) responses differ between prefrontal and motor cortices.

Methods

Magnetic pulses to the left motor and prefrontal cortices (the middle frontal gyrus identified from magnetic resonance images) were delivered at four intensities (60, 80, 100, and 120% of MT of the right abductor digiti minimi muscle) for six subjects. Simultaneously, EEG was recorded with 60 scalp electrodes.

Results

Global mean-field amplitudes (GMFAs) reflecting overall cortical activity were significantly smaller after prefrontal- than after motor-cortex TMS. A significant positive correlation (r s=0.84, p<0.01) was found between GMFAs of motor- and prefrontal-cortex TMS across the experiments. However, when correlation between the responses of motor and prefrontal cortices was examined, significant positive correlations were found at 80 and 100% intensities only.

Conclusions

This study provides further evidence that the prefrontal and motor cortices have different reactivity to TMS, but the MT may be used for determining the stimulus intensity of prefrontal rTMS treatment in depression, at least at motor threshold intensities or near to it.

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Acknowledgements

The study was supported by the Academy of Finland and the research funds of the Helsinki University Central Hospital and the Instrumentarium Foundation.

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Authors and Affiliations

  1. BioMag Laboratory, Helsinki University Central Hospital, P.O. Box 340, FIN-00029 HUS, Helsinki, Finland

    Seppo Kähkönen, Juha Wilenius & Risto J. Ilmoniemi

  2. Cognitive Brain Research Unit, University of Helsinki, Helsinki, Finland

    Seppo Kähkönen

  3. Department of Physical Sciences, University of Helsinki, Helsinki, Finland

    Soile Komssi

  4. Department of Radiology, Helsinki University Central Hospital, Helsinki, Finland

    Soile Komssi

  5. Nexstim Ltd., Helsinki, Finland

    Risto J. Ilmoniemi

Authors
  1. Seppo Kähkönen
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  2. Soile Komssi
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  3. Juha Wilenius
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  4. Risto J. Ilmoniemi
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Correspondence to Seppo Kähkönen.

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Kähkönen, S., Komssi, S., Wilenius, J. et al. Prefrontal TMS produces smaller EEG responses than motor-cortex TMS: implications for rTMS treatment in depression. Psychopharmacology 181, 16–20 (2005). https://doi.org/10.1007/s00213-005-2197-3

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  • DOI: https://doi.org/10.1007/s00213-005-2197-3

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