title: Depressed intracortical inhibition after long trains of subthreshold repetitive magnetic stimuli at low frequency.
abstract: OBJECTIVE
  Repetitive transcranial magnetic stimulation (rTMS) modulates cortical excitability. These effects outlast the rTMS train, and range from inhibition to facilitation according to the variables used for rTMS. Several studies have demonstrated short and long-term effects on motor evoked potential (MEP) size, whereas the effects on intracortical inhibition (ICI) and facilitation (ICF) are still unclear. We investigated short- (1-15 min), intermediate- (16-30 min), and long-term (6 h) effects on intracortical excitability.
  
  
  METHODS
  Fourteen healthy subjects were stimulated with rTMS trains of 900 pulses (1 Hz, 90% resting motor threshold (rMTh)), delivered over the primary motor cortex and the occipital area. MTh, MEP size, silent period, intracortical inhibition at short (ICI) and long inter-stimulus intervals, and ICF were tested before and after rTMS.
  
  
  RESULTS
  ICI was reduced 16-30 min after 1 Hz rTMS trains over the primary motor area, whereas the other response variables remained unchanged. The ICI reduction at 16-30 min was reproducible on different days in the same subjects; it was absent at 6 h and after stimulation of the occipital area.
  
  
  CONCLUSIONS
  Subthreshold 1 Hz rTMS decreases ICI by reducing the excitability of intracortical inhibitory interneurones or by altering the electrical properties of the facilitatory chain of neurons responsible for the I waves.
authors.affiliation: Istituto Neurologico Mediterraneo Neuromed IRCCS, Via Atinense 18, 86077 Pozzilli (IS), Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Modugno
authors.forename: Antonio
authors.initials: A
authors.lastname: Currà
authors.forename: Antonella
authors.initials: A
authors.lastname: Conte
authors.forename: Maurizio
authors.initials: M
authors.lastname: Inghilleri
authors.forename: Luisa
authors.initials: L
authors.lastname: Fofi
authors.forename: Rocco
authors.initials: R
authors.lastname: Agostino
authors.forename: Mario
authors.initials: M
authors.lastname: Manfredi
authors.forename: Alfredo
authors.initials: A
authors.lastname: Berardelli
mesh_terms: D000328:Adult; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D008280:Magnetics; D008297:Male; D009044:Motor Cortex / Q000502:physiology*; D009433:Neural Inhibition / Q000502:physiology*; D009778:Occipital Lobe / Q000502:physiology