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Forman, L.

Publications and source records attributed to Forman, L..

5 recordsLinked to original sources

Noninvasive profiling of input-output excitability curves in human prefrontal cortex

Abstract.O_ST_ABSBackgroundC_ST_ABSThe prefrontal cortex plays a critical role in cognitive control and behavior, and its dysfunction has been linked to numerous psychiatric and neurological disorders. However, noninvasive measurement of prefrontal activity remains challenging, limiting our understanding of how to optimize prefrontal treatments. Input-output relationships reveal how neural circuits respond to different inputs and are essential for determining optimal treatment parameters and understanding individual variability in treatment response, yet systematic investigation of prefrontal input-output relationships has been lacking. ObjectiveTo characterize human prefrontal excitability with input-output (I/O) curves. MethodsWe employed transcranial magnetic stimulation (TMS) with electroencephalography in a randomized mixed-block design with 28 healthy participants receiving single-pulse TMS to left dorsolateral prefrontal cortex (dlPFC) across 12 stimulation intensities (60-140% of resting motor threshold). We quantified prefrontal excitability using early local TMS-evoked potentials (EL-TEPs), cortical responses measured locally 20-60 ms post-stimulus. ResultsWe observed a strong effect of TMS intensity on prefrontal EL-TEP amplitudes. Sigmoidal EL-TEP I/O curves were observed in 57% of participants, with the sigmoidality partially explained by EL-TEP signal quality. Correlations were observed between EL-TEP and motor-evoked potential curve parameters, but intensity parameterization approaches did not significantly differ in explaining inter-individual EL-TEP response variability. Reliable EL-TEPs could be obtained using fewer TMS pulses at high intensities, and test- retest assessments revealed robust I/O curve profiles. ConclusionsThese findings provide a systematic noninvasive characterization of prefrontal input-output physiology, establishing a framework for estimating prefrontal excitability. The comparison of various intensity parameterizations motivates the need for enhanced models and individualized measurement of stimulation responses. HighlightsO_LIWe present noninvasive input-output curves for prefrontal TMS. C_LIO_LIEL-TEPs exhibit robust dose-dependent responses to TMS intensity. C_LIO_LISigmoidal I/O curves observed in 57% of participants, with a strong dependence on signal quality. C_LIO_LICorrelations observed between MEP and prefrontal EL-TEP curve parameters. C_LIO_LIHigh test-retest reliability and rapid protocols at [≥]110% rMT C_LI

neuroscience↗

Sensory Entrained TMS (seTMS) enhances motor cortex plasticity

Neural excitability fluctuates with sensory events, creating windows of opportunity to enhance brain stimulation. Repetitive transcranial magnetic stimulation (TMS), including intermittent theta burst stimulation (iTBS), is a promising treatment for neurological and psychiatric disorders, but does not account for fluctuations in neural excitability, likely contributing to variable outcomes. Sensory Entrained TMS (seTMS) leverages sensorimotor oscillations to enhance corticospinal responses, but the sustained effects as a repetitive protocol are unknown. We extended seTMS to iTBS measuring motor-evoked potentials (MEPs) as a physiological readout in a randomized crossover study comparing standard iTBS with sensory entrained iTBS (se-iTBS, n=20). se-iTBS more than doubled the MEP effect (55% vs. 26% MEP enhancement) and persisted for at least 30 minutes. Notably, more than 80% of participants showed larger responses with se-iTBS at all time points. se-iTBS may provide a robust and practical framework for optimizing TMS that bridges electrophysiological mechanisms and clinical applications.

neuroscience↗

NaviNIBS: a comprehensive and open-source software toolbox for neuronavigated noninvasive brain stimulation.

Image-guided positioning, or neuronavigation, is critical for precise targeting of transcranial magnetic stimulation (TMS) and other noninvasive brain stimulation. However, existing commercial systems have limitations in flexibility and extensibility for research applications. We present new open-source software for neuronavigated non-invasive brain stimulation (NaviNIBS) that provides comprehensive functionality for TMS experiments. NaviNIBS supports imaging data import, target planning, head registration, real-time tool tracking, and integration with robotic positioning and electrophysiology systems. Key features include flexible target specification, support for multiple tracking hardware options, refined head registration techniques, and an extensible addon system. We describe the software architecture, core functionality, characterization of tracking performance, and example applications of NaviNIBS. This software aims to facilitate methodological improvements and novel experimental paradigms in noninvasive brain stimulation research.

neuroscience↗

Sensory Entrained TMS (seTMS) enhances motor cortex excitability

Transcranial magnetic stimulation (TMS) applied to the motor cortex has revolutionized the study of motor physiology in humans. Despite this, TMS-evoked electrophysiological responses show significant variability, due in part to inconsistencies between TMS pulse timing and ongoing brain oscillations. Variable responses to TMS limit mechanistic insights and clinical efficacy, necessitating the development of methods to precisely coordinate the timing of TMS pulses to the phase of relevant oscillatory activity. We introduce Sensory Entrained TMS (seTMS), a novel approach that uses musical rhythms to synchronize brain oscillations and time TMS pulses to enhance cortical excitability. Focusing on the sensorimotor alpha rhythm, a neural oscillation associated with motor cortical inhibition, we examine whether rhythm-evoked sensorimotor alpha phase alignment affects primary motor cortical (M1) excitability in healthy young adults (n=33). We first confirmed using electroencephalography (EEG) that passive listening to musical rhythms desynchronizes inhibitory sensorimotor brain rhythms (mu oscillations) around 200 ms before auditory rhythmic events (27 participants). We then targeted this optimal time window by delivering single TMS pulses over M1 200 ms before rhythmic auditory events while recording motor-evoked potentials (MEPs; 19 participants), which resulted in significantly larger MEPs compared to standard single pulse TMS and an auditory control condition. Neither EEG measures during passive listening nor seTMS-induced MEP enhancement showed dependence on musical experience or training. These findings demonstrate that seTMS effectively enhances corticomotor excitability and establishes a practical, cost-effective method for optimizing non-invasive brain stimulation outcomes.

neuroscience↗

Real-time optimization to enhance noninvasive cortical excitability assessment in the human dorsolateral prefrontal cortex

ObjectiveWe currently lack a robust noninvasive method to measure prefrontal excitability in humans. Concurrent TMS and EEG in the prefrontal cortex is usually confounded by artifacts. Here we asked if real-time optimization could reduce artifacts and enhance a TMS-EEG measure of left prefrontal excitability. MethodsThis closed-loop optimization procedure adjusts left dlPFC TMS coil location, angle, and intensity in real-time based on the EEG response to TMS. Our outcome measure was the left prefrontal early (20-60 ms) and local TMS-evoked potential (EL-TEP). ResultsIn 18 healthy participants, this optimization of coil angle and brain target significantly reduced artifacts by 63% and, when combined with an increase in intensity, increased EL-TEP magnitude by 75% compared to a non-optimized approach. ConclusionsReal-time optimization of TMS parameters during dlPFC stimulation can enhance the EL-TEP. SignificanceEnhancing our ability to measure prefrontal excitability is important for monitoring pathological states and treatment response. HighlightsO_LIWe developed a real-time closed-loop optimization procedure to obtain high amplitude early local TEPs (EL-TEPs) from dlPFC TMS. C_LIO_LISequential optimization of coil angle and brain target reduced artifacts by 63%. C_LIO_LISequential optimization of coil angle, brain target, and intensity increased EL-TEP amplitude by 75%. C_LI

neuroscience↗