Neuro-Cardiac-Guided TMS (NCG-TMS): Probing DLPFC-sgACC-vagus nerve connectivity using heart rate – First results

• Main Authors: Tabitha A. Iseger, Frank Padberg, J. Leon Kenemans, Richard Gevirtz, Martijn Arns
• Format: Article
• Language: English
• Published: Elsevier 2017-09-01
• Series: Brain Stimulation
• Subjects: Vagus nerve; DLPFC; Heart rate; rTMS; Neuronavigation; Depression
• Online Access: http://www.sciencedirect.com/science/article/pii/S1935861X17307933

Background: Given that many studies suggest a role of DLPFC-sgACC connectivity in depression and prior research demonstrating that neuromodulation of either of these nodes modulates parasympathetic activity and results in a heart rate deceleration, a new method is proposed to individualize localization of the DLPFC. This can, among others, be useful for rTMS treatment of depression. Methods: Ten healthy subjects received three trains of 10Hz rTMS randomly over 7 target regions (10–20 system). Results: Overall, F3 and F4 expressed the largest heart rate deceleration, in line with studies suggesting these are the best 10–20 sites to target the DLPFC. On the individual level, 20–40% subjects expressed the largest heart rate deceleration at FC3 or FC4, indicating individual differences as to the ‘optimal site for stimulation’. Conclusions: These results show that the NCG-TMS method is valid to localize the entry into the DLPFC-sgACC network.