Remediation of sleep-deprivation-induced working memory impairment with fMRI-guided transcranial magnetic stimulation.
Repetitive transcranial magnetic stimulation (rTMS) was applied to test the role of selected cortical regions in remediating sleep-deprivation-induced deficits in visual working memory (WM) performance. Three rTMS targets were chosen using a functional magnetic resonance imaging (fMRI)-identified network associated with sleep-deprivation-induced WM performance impairment: 2 regions from the network (upper left middle occipital gyrus and midline parietal cortex) and 1 nonnetwork region (lower left middle occipital gyrus). Fifteen participants underwent total sleep deprivation for 48 h. rTMS was applied at 5 Hz during a WM task in a within-subject sham-controlled design. The rTMS to the upper-middle occipital site resulted in a reduction of the sleep-induced reaction time deficit without a corresponding decrease in accuracy, whereas stimulation at the other sites did not. Each subject had undergone fMRI scanning while performing the task both pre- and postsleep deprivation, and the degree to which each individual activated the fMRI network was measured. The degree of performance enhancement with upper-middle occipital rTMS correlated with the degree to which each individual failed to sustain network activation. No effects were found in a subset of participants who performed the same rTMS procedure after recovering from sleep deprivation, suggesting that the performance enhancements seen following sleep deprivation were state dependent.
Luber
B
B
Division of Brain Stimulation and Therapeutic Modulation, New York State Psychiatric Institute, NY 10032, USA. luberbr@pi.cpmc.columbia.edu
Stanford
A D
AD
Bulow
P
P
Nguyen
T
T
Rakitin
B C
BC
Habeck
C
C
Basner
R
R
Stern
Y
Y
Lisanby
S H
SH
D000328:Adult; D001931:Brain Mapping; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology*; D009778:Occipital Lobe / Q000502:physiology; D010296:Parietal Lobe / Q000502:physiology; D010775:Photic Stimulation; D012892:Sleep Deprivation / Q000503:physiopathology*; D050781:Transcranial Magnetic Stimulation