Short-interval and long-interval intracortical inhibition of TMS-evoked EEG potentials

Brain Stimul. 2018 Jul-Aug;11(4):818-827. doi: 10.1016/j.brs.2018.03.008. Epub 2018 Mar 15.

Abstract

Background: Inhibition in the human motor cortex can be probed by means of paired-pulse transcranial magnetic stimulation (ppTMS) at interstimulus intervals of 2-3 ms (short-interval intracortical inhibition, SICI) or ∼100 ms (long-interval intracortical inhibition, LICI). Conventionally, SICI and LICI are recorded as motor evoked potential (MEP) inhibition in the hand muscle. Pharmacological experiments indicate that they are mediated by GABAA and GABAB receptors, respectively.

Objective/hypothesis: SICI and LICI of TMS-evoked EEG potentials (TEPs) and their pharmacological properties have not been systematically studied. Here, we sought to examine SICI by ppTMS-evoked compared to single-pulse TMS-evoked TEPs, to investigate its pharmacological manipulation and to compare SICI with our previous results on LICI.

Methods: PpTMS-EEG was applied to the left motor cortex in 16 healthy subjects in a randomized, double-blind placebo-controlled crossover design, testing the effects of a single oral dose 20 mg of diazepam, a positive modulator at the GABAA receptor, vs. 50 mg of the GABAB receptor agonist baclofen on SICI of TEPs.

Results: We found significant SICI of the N100 and P180 TEPs prior to drug intake. Diazepam reduced SICI of the N100 TEP, while baclofen enhanced it. Compared to our previous ppTMS-EEG results on LICI, the SICI effects on TEPs, including their drug modulation, were largely analogous.

Conclusions: Findings suggest a similar interaction of paired-pulse effects on TEPs irrespective of the interstimulus interval. Therefore, SICI and LICI as measured with TEPs cannot be directly derived from SICI and LICI measured with MEPs, but may offer novel insight into paired-pulse responses recorded directly from the brain rather than muscle.

Keywords: Baclofen; Diazepam; GABA; Long-interval intracortical inhibition; Paired-pulse transcranial magnetic stimulation; Short-interval intracortical inhibition; TMS-Evoked EEG potential.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Baclofen / pharmacology
  • Cross-Over Studies
  • Diazepam / pharmacology
  • Double-Blind Method
  • Electroencephalography / methods*
  • Evoked Potentials, Motor / drug effects
  • Evoked Potentials, Motor / physiology
  • GABA Modulators / pharmacology
  • GABA-B Receptor Agonists / pharmacology
  • Humans
  • Male
  • Motor Cortex / drug effects
  • Motor Cortex / physiology*
  • Muscle, Skeletal / drug effects
  • Muscle, Skeletal / physiology
  • Neural Inhibition / drug effects
  • Neural Inhibition / physiology*
  • Transcranial Magnetic Stimulation / methods*
  • Young Adult

Substances

  • GABA Modulators
  • GABA-B Receptor Agonists
  • Baclofen
  • Diazepam