Instantaneous effects of prefrontal transcranial magnetic stimulation on brain oxygenation: A systematic review

•Provides a thorough understanding of brain activation during/immediately after prefrontal TMS.•The prefrontal cortex, insula, striatum, anterior cingulate and thalamus are engaged.•The target engagement (local and remote regions) is inconsistent among studies. This systematic review investigates ho...

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Bibliographic Details
Published in:	NeuroImage (Orlando, Fla.) Vol. 293; p. 120618
Main Authors:	Xia, Adam W.L., Jin, Minxia, Qin, Penny P.I., Kan, Rebecca L.D., Zhang, Bella B.B., Giron, Cristian G., Lin, Tim T.Z., Li, Ami S.M., Kranz, Georg S.
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-06-2024 Elsevier Limited Elsevier
Subjects:	Brain Brain - physiology Brain mapping Brain Mapping - methods Cortex (cingulate) Cortex (insular) Excitability Functional magnetic resonance imaging Functional near-infrared spectroscopy Hemodynamics Hemoglobin Humans Infrared spectroscopy Magnetic fields Magnetic Resonance Imaging Medical imaging Mental disorders Neostriatum Neuroimaging Oxygen - blood Oxygenation Prefrontal cortex Prefrontal Cortex - diagnostic imaging Prefrontal Cortex - physiology Psychotherapy Putamen Spectroscopy, Near-Infrared - methods Systematic review Transcranial magnetic stimulation Transcranial Magnetic Stimulation - methods Functional magnetic resonance imaging Transcranial magnetic stimulation Prefrontal cortex Functional near-infrared spectroscopy
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Summary:	•Provides a thorough understanding of brain activation during/immediately after prefrontal TMS.•The prefrontal cortex, insula, striatum, anterior cingulate and thalamus are engaged.•The target engagement (local and remote regions) is inconsistent among studies. This systematic review investigates how prefrontal transcranial magnetic stimulation (TMS) immediately influences neuronal excitability based on oxygenation changes measured by functional magnetic resonance imaging (fMRI) or functional near-infrared spectroscopy (fNIRS). A thorough understanding of TMS-induced excitability changes may enable clinicians to adjust TMS parameters and optimize treatment plans proactively. Five databases were searched for human studies evaluating brain excitability using concurrent TMS/fMRI or TMS/fNIRS. Thirty-seven studies (13 concurrent TMS/fNIRS studies, 24 concurrent TMS/fMRI studies) were included in a qualitative synthesis. Despite methodological inconsistencies, a distinct pattern of activated nodes in the frontoparietal central executive network, the cingulo-opercular salience network, and the default-mode network emerged. The activated nodes included the prefrontal cortex (particularly dorsolateral prefrontal cortex), insula cortex, striatal regions (especially caudate, putamen), anterior cingulate cortex, and thalamus. High-frequency repetitive TMS most consistently induced expected facilitatory effects in these brain regions. However, varied stimulation parameters (e.g., intensity, coil orientation, target sites) and the inter- and intra-individual variability of brain state contribute to the observed heterogeneity of target excitability and co-activated regions. Given the considerable methodological and individual variability across the limited evidence, conclusions should be drawn with caution.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1 ObjectType-Undefined-4
ISSN:	1053-8119 1095-9572
DOI:	10.1016/j.neuroimage.2024.120618