title: Neuroimaging effects of 1 Hz right temporoparietal rTMS on normal auditory processing: implications for clinical hallucination treatment paradigms.
abstract: OBJECTIVE
  Repetitive transcranial magnetic stimulation (rTMS) has attracted attention as a putative clinical neuromodulatory tool, including for ameliorating hallucinations, although existing clinical data are inconsistent. There is a notable paucity of research on its physiological effects on normal neuronal functioning.
  
  
  METHODS
  We neuroimaged 24 healthy adult volunteers undertaking a variable loading passive auditory task, randomized into 2 matched and double-masked groups: half received a 17-minute 1 Hz right temporoparietal rTMS paradigm and half sham rTMS.
  
  
  RESULTS
  One hertz rTMS led to attenuation of the underlying auditory cortex response to the stimulus and a contralateral increase in cortical activity. Subanalysis of the auditory tasks demonstrated that rTMS effects varied with stimulus frequency and differences between the active and sham conditions were lost at the highest frequency.
  
  
  CONCLUSIONS
  This work is, to the best of our knowledge, the first to neuroimage the effects of a "hallucinatory rTMS protocol" on basic auditory processing in healthy controls. Our data demonstrated that a so-called "inhibitory paradigm" can also produce distal neuronal activation and that effects can vary with neural loading. These results highlight the insufficient knowledge of the effects of rTMS on normal physiology, and this, combined with a lack of consensus on clinical trial parameters, may be contributing to the ambivalent data in therapeutic trials.
authors.affiliation: *Green Parks House, Oxleas NHS Foundation Trust, Princess Royal University Hospital, Kent, United Kingdom; †Cognition, Schizophrenia and Imaging Laboratory, Department of Psychosis Studies, the Institute of Psychiatry, King's College, London, United Kingdom.
authors.forename: Derek K
authors.initials: DK
authors.lastname: Tracy
authors.forename: Maria
authors.initials: M
authors.lastname: de Sousa de Abreu
authors.forename: Natasza
authors.initials: N
authors.lastname: Nalesnik
authors.forename: Lan
authors.initials: L
authors.lastname: Mao
authors.forename: Claudia
authors.initials: C
authors.lastname: Lage
authors.forename: Sukhwinder S
authors.initials: SS
authors.lastname: Shergill
mesh_terms: D000161:Acoustic Stimulation; D000328:Adult; D001303:Auditory Cortex / Q000502:physiology*; D001931:Brain Mapping / Q000379:methods*; D006212:Hallucinations / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D064368:Healthy Volunteers; D006801:Humans; D008131:London; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D055815:Young Adult