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• W2493044146 abstract "Objective Mapping the cortical language representation and associated networks is not only of basic scientific interest but can also help to maximize the extent of tumour resection whilst preserving important brain functions as language. The use of navigated repetitive transcranial magnetic stimulation (rTMS) to depict cortical sites crucially involved in language processing non-invasively is a rather novel approach, which has shown promising results. However, specificity is rather low and the level of pain and discomfort during stimulation seems to be rather high when applying the commonly used 10 Hz stimulation protocol. Therefore, we here compared different rTMS protocols in order to test for discomfort/pain, test-retest reliability, rate and site of distinct evoked language errors. Methods 13 right-handed, healthy volunteers were investigated in 3 consecutive sessions (short-term: 2–5 days, long-term: 21–40 days). 10 Hz, 30 Hz and 50 Hz rTMS were applied over the left hemisphere, continuously covering facial (pre-)motor and language-related cortical areas. First, stimulation intensity was adjusted to the lowest intensity required to disrupt rhythmic tongue movements when stimulating over the hotspot of the primary motor representation (M1) of the tongue. This parameter was titled “motor inhibition threshold” (MIT) and was regarded suitable to mirror the efficacy of cortical inhibition. Thereafter, online-rTMS was applied during a picture-naming task in a randomized sequence. Bursts were triggered to picture presentation without delay (picture-to-trigger interval = 0). Errors were rated by two independent raters using post-hoc video analysis and were categorised as follows: arrest, delay, anomia, dysarthria, speech motor disturbance, semantic and phonemic paraphasia. At the end of each exam, the volunteers were asked to rate the mean and maximum level of discomfort on a 0–10 numeric rating scale (NRS). Results Better tolerability was observed for the higher-frequency rTMS protocols (i.e., 30 & 50 Hz) than for 10 Hz rTMS. Moreover, 30 and 50 Hz rTMS reliably evoked tongue movement disruption (ICC = 0.65) at lower stimulation intensities compared to 10 Hz rTMS (p  Conclusions Higher-frequency rTMS (i.e., 30 & 50 Hz) may allow for cortical inhibition at a more favourable pain-effect relationship as compared to 10 Hz.Despite good test-retest reliability of the event rates, the low repeatability of the cortical sites corresponding to distinct errors requires critical discussion." @default.
• W2493044146 created "2016-08-23" @default.
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• W2493044146 date "2016-09-01" @default.
• W2493044146 modified "2023-09-26" @default.
• W2493044146 title "EP 66. Better tolerability and lower mean intensities favour higher-frequent stimulation as compared to 10 Hz online-rTMS for language mapping: A test-retest reliability study in healthy volunteers." @default.
• W2493044146 doi "https://doi.org/10.1016/j.clinph.2016.05.117" @default.
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