Affiliations: Department of Neurology, Chang Gung Memorial Hospital
and Chang Gung University College of Medicine, Taipei, Taiwan
Note: [] Address for correspondence: Ying-Zu Huang, MD, PhD, Department
of Neurology, Chang Gung Memorial Hospital, 199, Dunhwa North Road, Taipei
10507, Taiwan. Tel.: +886 3 3281200, ext 3775; Fax: +886 3 3287226; E-mail:
yzhuang@adm.cgmh.org.tw
Abstract: Repetitive electrical stimulation has been applied to induce
long-term changes in synaptic strength in animal preparations. It is generally
believed that such changes in synapses form the basis of neural plasticity.
Recently, several techniques, including repetitive transcranial magnetic
stimulation (rTMS), have been developed to attempt to replicate similar
plasticity effects in the brains of conscious humans. However, traditional
paradigms of rTMS usually require lengthy stimulation and relatively high
stimulus intensity. In light of these problems, a novel rTMS paradigm- theta
burst stimulation (TBS) – was developed. TBS is able to produce
plasticity-like effects more efficiently and powerfully than traditional
protocols. The excitability of circuits within the motor cortex can be modified
not only by TBS over the primary motor cortex but also when it is delivered to
the premotor area. Moreover, TBS over the premotor cortex modifies aspects of
spinal reflexes. Studies using TBS over the motor and premotor cortices provide
further understanding of dystonia, and the results also distinguish the
different mechanisms of the effects of TBS given to the primary motor and
premotor cortices. In addition, some data also support the hypothesis that TBS
is a potential candidate technique to help restore damaged motor functions
through brain stimulation.
