Effects of repetitive transcranial magnetic stimulation and their underlying neural mechanisms evaluated with magnetic resonance imaging-based brain connectivity network analyses

Xiaowei Han; Zhengyang Zhu; Jixin Luan; Pin Lv; Xiaoyan Xin; Xin Zhang; Amir Shmuel; Zeshan Yao; Guolin Ma; Bing Zhang

doi:10.1016/j.ejro.2023.100495

Effects of repetitive transcranial magnetic stimulation and their underlying neural mechanisms evaluated with magnetic resonance imaging-based brain connectivity network analyses

Eur J Radiol Open. 2023 Jun 8:10:100495. doi: 10.1016/j.ejro.2023.100495. eCollection 2023.

Authors

Xiaowei Han^{1

2

3}, Zhengyang Zhu^{1

2

3}, Jixin Luan⁴, Pin Lv^{1

2

3}, Xiaoyan Xin^{1

2

3}, Xin Zhang^{1

2

3}, Amir Shmuel⁵, Zeshan Yao⁶, Guolin Ma⁷, Bing Zhang^{1

2

3}

Affiliations

¹ Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, China.
² Medical Imaging Center, Affiliated Drum Tower Hospital, Medical School of Nanjing University, China.
³ Nanjing University Institute of Medical Imaging and Artificial Intelligence, Nanjing University, China.
⁴ China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, China.
⁵ Montreal Neurological Institute, McGill University, Canada.
⁶ Biomedical Engineering Institute, Jingjinji National Center of Technology Innovation, China.
⁷ Department of Radiology, China-Japan Friendship Hospital, China.

Abstract

Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain modulation and rehabilitation technique used in patients with neuropsychiatric diseases. rTMS can structurally remodel or functionally induce activities of specific cortical regions and has developed to an important therapeutic method in such patients. Magnetic resonance imaging (MRI) provides brain data that can be used as an explanation tool for the neural mechanisms underlying rTMS effects; brain alterations related to different functions or structures may be reflected in changes in the interaction and influence of brain connections within intrinsic specific networks. In this review, we discuss the technical details of rTMS and the biological interpretation of brain networks identified with MRI analyses, comprehensively summarize the neurobiological effects in rTMS-modulated individuals, and elaborate on changes in the brain network in patients with various neuropsychiatric diseases receiving rehabilitation treatment with rTMS. We conclude that brain connectivity network analysis based on MRI can reflect alterations in functional and structural connectivity networks comprising adjacent and separated brain regions related to stimulation sites, thus reflecting the occurrence of intrinsic functional integration and neuroplasticity. Therefore, MRI is a valuable tool for understanding the neural mechanisms of rTMS and practically tailoring treatment plans for patients with neuropsychiatric diseases.

Keywords: Brain connectivity network; Magnetic resonance imaging; Neuropathological mechanisms; Neuropsychiatric diseases; Repetitive transcranial magnetic stimulation.

Publication types

Review