The effects of repetitive transcranial magnetic stimulation on the whole-brain functional network of postherpetic neuralgia patients

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Abstract

The effects of repetitive transcranial magnetic stimulation (rTMS), the clinical treatment for postherpetic neuralgia (PHN), on whole-brain functional network of PHN patients is not fully understood.

To explore the effects of rTMS on the whole-brain functional network of PHN patients.

10 PHN patients (male/female: 5/5 Age: 63–79 years old) who received rTMS treatment were recruited in this study. High-resolution T1-weighted and functional Magnetic Resonance Imaging (fMRI) were acquired before and after 10 consecutive rTMS sessions. The whole-brain functional connectivity networks were constructed by Pearson correlation. Global and node-level network parameters, which can reflect the topological organization of the brain network, were calculated to investigate the characteristics of whole-brain functional networks. Non-parametric paired signed rank tests were performed for the above network parameters with sex and age as covariates. P < .05 (with FDR correction for multi-comparison analysis) indicated a statistically significant difference. Correlation analysis was performed between the network parameters and clinical variables.

The rTMS showed significant increase in characteristic path length and decrease of clustering coefficient, global, and local efficiency derived from the networks at some specific network sparsity, but it showed no significant difference for small-worldness. rTMS treatment showed significant differences in the brain regions related to sensory-motor, emotion, cognition, affection, and memory, as observed by changes in node degree, node betweenness, and node efficiency. Besides, node-level network parameters in some brain areas showed significant correlations with clinical variables including visual analog scales (VAS) and pain duration.

rTMS has significant effects on the whole-brain functional network of PHN patients with a potential for suppression of sensory-motor function and improvement of emotion, cognition, affection, and memory functions.

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Most cited references 27

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Weight-conserving characterization of complex functional brain networks.

Mikail Rubinov, Olaf Sporns (2011)

Complex functional brain networks are large networks of brain regions and functional brain connections. Statistical characterizations of these networks aim to quantify global and local properties of brain activity with a small number of network measures. Important functional network measures include measures of modularity (measures of the goodness with which a network is optimally partitioned into functional subgroups) and measures of centrality (measures of the functional influence of individual brain regions). Characterizations of functional networks are increasing in popularity, but are associated with several important methodological problems. These problems include the inability to characterize densely connected and weighted functional networks, the neglect of degenerate topologically distinct high-modularity partitions of these networks, and the absence of a network null model for testing hypotheses of association between observed nontrivial network properties and simple weighted connectivity properties. In this study we describe a set of methods to overcome these problems. Specifically, we generalize measures of modularity and centrality to fully connected and weighted complex networks, describe the detection of degenerate high-modularity partitions of these networks, and introduce a weighted-connectivity null model of these networks. We illustrate our methods by demonstrating degenerate high-modularity partitions and strong correlations between two complementary measures of centrality in resting-state functional magnetic resonance imaging (MRI) networks from the 1000 Functional Connectomes Project, an open-access repository of resting-state functional MRI datasets. Our methods may allow more sound and reliable characterizations and comparisons of functional brain networks across conditions and subjects. Copyright © 2011 Elsevier Inc. All rights reserved.

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Modulation of cortical excitability induced by repetitive transcranial magnetic stimulation: influence of timing and geometrical parameters and underlying mechanisms.

Gaby Pell, Yiftach Roth, Abraham Zangen (2010)

Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation technique that activates neurons via generation of brief pulses of high-intensity magnetic field. If these pulses are applied in a repetitive fashion (rTMS), persistent modulation of neural excitability can be achieved. The technique has proved beneficial in the treatment of a number of neurological and psychiatric conditions. However, the effect of rTMS on excitability and the other performance indicators shows a considerable degree of variability across different sessions and subjects. The frequency of stimulation has always been considered as the main determinant of the direction of excitability modulation. However, interactions exist between frequency and several other stimulation parameters that also influence the degree of modulation. In addition, the spatial interaction of the transient electric field induced by the TMS pulse with the cortical neurons is another contributor to variability. Consideration of all of these factors is necessary in order to improve the consistency of the conditioning effect and to better understand the outcomes of investigations with rTMS. These user-controlled sources of variability are discussed against the background of the mechanisms that are believed to drive the excitability changes. The mechanism behind synaptic plasticity is commonly accepted as the driver of sustained excitability modulation for rTMS and indeed, plasticity and rTMS share many characteristics, but definitive evidence is lacking for this. It is more likely that there is a multiplicity of mechanisms behind the action of rTMS. The different mechanisms interact with each other and this will contribute to the variability of rTMS-induced excitability changes. This review investigates the links between rTMS and synaptic plasticity, describes their similarities and differences, and highlights a neglected contribution of the membrane potential. In summary, the principal aims of this review are (i) to discuss the different experimental and subject-related factors that contribute to the variability of excitability modulation induced by rTMS, and (ii) to discuss a generalized underlying mechanism for the excitability modulation. Copyright © 2010 Elsevier Ltd. All rights reserved.

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Small worlds inside big brains.

Olaf Sporns, Christopher Honey (2006)

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Author and article information

Journal

Journal ID (nlm-ta): Medicine (Baltimore)

Journal ID (iso-abbrev): Medicine (Baltimore)

Journal ID (publisher-id): MEDI

Title: Medicine

Publisher: Wolters Kluwer Health

ISSN (Print): 0025-7974

ISSN (Electronic): 1536-5964

Publication date Collection: June 2019

Publication date (Electronic): 21 June 2019

Volume: 98

Issue: 25

Electronic Location Identifier: e16105

Affiliations

[a ]Beijing Jishuitan Hospital

[b ]Department of Pain Management, Xuanwu Hospital Capital Medical University

[c ]School of Biomedical Engineering, Capital Medical University, Beijing, China.

Author notes

[∗ ]Correspondence: Jiaxiang Ni, Xicheng District, Beijing, China (e-mail: nijiaxiang2018@ 123456163.com ) and Haiyun Li, School of Biomedical Engineering, Capital Medical University, Beijing, China (e-mail: haiyunli@ 123456ccmu.edu.cn ).

Article

Publisher ID: MD-D-18-07922 Accession ID: 16105

DOI: 10.1097/MD.0000000000016105

PMC ID: 6636965

PubMed ID: 31232955

SO-VID: 9874ba57-a268-4c4d-9444-9934dcba181e

License:

This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

History

Date received : 30 October 2018

Date revision received : 17 April 2019

Date accepted : 25 May 2019

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Keywords: functional magnetic resonance imaging,functional network,postherpetic neuralgia,repetitive transcranial magnetic stimulation

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Keywords: functional magnetic resonance imaging, functional network, postherpetic neuralgia, repetitive transcranial magnetic stimulation

The effects of repetitive transcranial magnetic stimulation on the whole-brain functional network of postherpetic neuralgia patients

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Most cited references 27

Weight-conserving characterization of complex functional brain networks.

Modulation of cortical excitability induced by repetitive transcranial magnetic stimulation: influence of timing and geometrical parameters and underlying mechanisms.

Small worlds inside big brains.

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