Effects of a Modified 30 Hz Intermittent Theta-Burst Stimulation (iTBS) Protocol on Corticospinal Excitability In Healthy Adults

Abstract

Theta-burst stimulation (TBS) is a form of repetitive transcranial magnetic stimulation (TMS) developed to induce neuroplasticity. TBS usually consists of 50 Hz bursts at 5 Hz intervals. When applied intermittently, it can lead to facilitation of motor evoked potentials (MEPs), although these effects can be variable between individuals. Here, we aimed to determine whether a version of intermittent TBS (iTBS) consisting of 30 Hz bursts at 6 Hz intervals would produce less variable modulation. Nineteen healthy adults underwent single-pulse TMS to assess corticomotor excitability at baseline as reflected in MEP amplitude. 30 Hz iTBS was then administered and MEP amplitude was reassessed at 5-, 20- and 45-mins after the iTBS protocol. Compared to baseline, MEPs were significantly facilitated up to 45-min post-iTBS and most participants exhibited the expected facilitation. These observations suggest that 30 Hz/6 Hz iTBS may provide a sound alternative to induce consistent neuromodulatory effects over the commonly used 50 Hz/5 Hz protocol.