TY - JOUR
T1 - Changes in cerebrovascular reactivity following low-frequency repetitive transcranial magnetic stimulation
AU - Sallustio, Fabrizio
AU - Di Legge, Silvia
AU - Rizzato, Barbara
AU - Stanzione, Paolo
AU - Koch, Giacomo
PY - 2010/8/15
Y1 - 2010/8/15
N2 - 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.
AB - 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.
KW - Cerebrovascular reactivity
KW - rTMS
KW - Transcranial Doppler
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U2 - 10.1016/j.jns.2010.05.011
DO - 10.1016/j.jns.2010.05.011
M3 - Article
C2 - 20542298
AN - SCOPUS:77953872554
SN - 0022-510X
VL - 295
SP - 58
EP - 61
JO - Journal of the Neurological Sciences
JF - Journal of the Neurological Sciences
IS - 1-2
ER -