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Site-specific effects of online rTMS during a working memory task in healthy older adults

Site-specific effects of online rTMS during a working memory task in healthy older adults

Lysianne Beynel, Simon W. Davis, Courtney A. Crowell, Moritz Dannhauer, Wesley Lim, Hannah Palmer, Susan A. Hilbig, Alexandra Brito, Connor Hile, Bruce Luber, Sarah H. Lisanby, Angel V. Peterchev, Roberto Cabeza, Lawrence G. Appelbaum
Journal of neural engineering

The process of manipulating information within working memory (WM) is
central to many cognitive functions, but also declines rapidly in old
age. Given the importance of WM manipulation for maintaining healthy
cognition, improving this process could markedly enhance health-span in
older adults. The current pre-registered study tested the potential of
online repetitive transcranial magnetic stimulation (rTMS) to enhance WM
manipulation in healthy elderly adults. Online 5Hz rTMS was applied over
the left lateral parietal cortex of 15 subjects to test the hypothesis
that active rTMS would significantly improve performance compared to
sham stimulation, and that these effects would be most pronounced in
conditions with the highest cognitive demand. rTMS was applied while
participants performed a delayed-response alphabetization task with two
individually-titrated levels of difficulty. Sham stimulation was applied
using an electrical sham coil that produced similar clicking sounds and
somatosensory sensation as active stimulation but induced negligible
effects on the brain. A stimulation site in left lateral parietal cortex
was identified from fMRI activation maps and was targeted using
individualized electric field modeling, stereotactic neuronavigation,
and real-time robotic positioning, allowing optimal coil placement
during the stimulation. Contrary to the a priori hypothesis, active rTMS
significantly decreased accuracy relative to sham, and only in the
hardest difficulty level. These results, therefore, demonstrate
engagement of cortical WM processing, but not the anticipated
facilitation, and provide a prescription for future studies that may
attempt to enhance memory through application of different stimulation

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