Single High-Frequency Repetitive Transcranial Magnetic Stimulation and Intermittent Theta Pulse Stimulation Promote Working Memory Behavior in Participants: An Event-Related Potential Study

Longting Hu; Jinyan He; Menglin Han; Zhiqiang Wang; Yulan Gao; Boyu Zhang; Shuyan Zhou; Kangling Wang

doi:10.1016/j.brainresbull.2024.111147

Single High-Frequency Repetitive Transcranial Magnetic Stimulation and Intermittent Theta Pulse Stimulation Promote Working Memory Behavior in Participants: An Event-Related Potential Study

Brain Res Bull. 2024 Nov 26:111147. doi: 10.1016/j.brainresbull.2024.111147. Online ahead of print.

Authors

Longting Hu¹, Jinyan He², Menglin Han¹, Zhiqiang Wang¹, Yulan Gao¹, Boyu Zhang¹, Shuyan Zhou¹, Kangling Wang³

Affiliations

¹ Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou 510220, China.
² Department of Rehabilitation, Foshan Fourth People's Hospital, Foshan 528200, China.
³ Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou 510220, China. Electronic address: wkangling@126.com.

PMID: 39608615
DOI: 10.1016/j.brainresbull.2024.111147

Abstract

Objective: Repetitive transcranial magnetic stimulation (rTMS) to the left dorsolateral prefrontal cortex (L-DLPFC) has an improving effect in cognitive function, but it is still not clear in what specific cognitive domains. We here combined a single session of TMS (HF-rTMS/iTBS) with electroencephalography (EEG) to clarify the effects of magnetic stimulation techniques on executive function, working memory, and visuospatial attention in healthy participants, and to investigate the underlying neurophysiological mechanisms.

Methods: Fifty-one healthy participants were randomly assigned to three stimulation groups (HF-rTMS, iTBS, and sham groups). Classical psychological paradigms (task-switching, 2-back with visual Oddball) and event-related potentials (ERPs) were performed to compare the behavioral indices of each paradigm before and after the two stimulations, as well as the changes in the ERP components.

Results: Analysis of behavioral indicators showed that reaction times in the 2-back paradigm were faster after HF-rTMS and iTBS than after sham stimulation. However, no statistically significant differences were observed in the behavioral changes in the task-switching and visual Oddball paradigms. ERP analysis showed that N2 amplitude in the frontal and central regions of the participants increased during the 2-back paradigm following HF-rTMS and iTBS; however, no statistically significant differences were observed between the ERP components of the task-switching and visual Oddball paradigms.

Conclusion: Single sessions of HF-rTMS and iTBS on the L-DLPFC specifically enhanced working memory performance, with no significant effects on executive function and visuospatial attention. Both true stimulations elicited more negative N2 in the frontal and central channels during the 2-back paradigm, suggesting increased recruitment of cognitive resources from these brain areas. Although iTBS and HF-rTMS improved working memory behavior, iTBS's shorter stimulation time suggests it may have greater potential for clinical applications in terms of time-benefit costs.

Keywords: cognitive functions; event-related potentials; executive functions; transcranial magnetic stimulation; visuospatial attention; working memory.