Changes in cerebrovascular reactivity following low-frequency repetitive transcranial magnetic stimulation

Fabrizio Sallustio, Silvia Di Legge, Barbara Rizzato, Paolo Stanzione, Giacomo Koch

Research output: Contribution to journalArticlepeer-review


Objectives: Repetitive Transcranial Magnetic Stimulation (rTMS) potential therapeutic uses have been explored in many conditions including stroke. However, its potential effects on cerebral hemodynamics have not been deeply considered. Transcranial Doppler ultrasonography (TCD) is a promising tool in detecting focal changes of cerebral blood flow velocity (CBFV) and cerebrovascular reactivity (CRV) induced by rTMS. We evaluated possible changes in CBFV and CVR in healthy volunteers. Methods: Low-frequency (1 Hz) and Sham rTMS were applied over the motor cortex (M1) of the left hemisphere of healthy volunteers. CBFV and CVR were evaluated in the ipsilateral middle cerebral artery (MCA). CVR to hypercapnia was derived from the breath-holding index (BHI). Subjects were randomly assigned to real or sham stimulation. Results: Maximal CBFV of MCA tended to decrease after 1 Hz M1 rTMS. Low-frequency 1 Hz M1 rTMS increased BHI (measured in MCA) immediately after rTMS, and the observed effect vanished after 15 min when applied over M1. We did not observe any significant change in Pulsatility Index (PI) and Resistance Index (RI) measures in all conditions. No significant changes of above mentioned parameters were observed in the sham stimulation group. Conclusions: Low-frequency rTMS induces a significant modulation of CVR in healthy subjects. This effect should be relevant in acute stroke patients with impaired cerebral autoregulation.

Original languageEnglish
Pages (from-to)58-61
Number of pages4
JournalJournal of the Neurological Sciences
Issue number1-2
Publication statusPublished - Aug 15 2010


  • Cerebrovascular reactivity
  • rTMS
  • Transcranial Doppler

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology


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