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J Physiol Volume 586, Number 18, 4481-4487, September 15, 2008 DOI: 10.1113/jphysiol.2008.159558
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NEUROSCIENCE

Low-frequency repetitive transcranial magnetic stimulation suppresses specific excitatory circuits in the human motor cortex

 V. Di Lazzaro1,2, F. Pilato1, M. Dileone1, P. Profice1, A. Oliviero1,3, P. Mazzone4, A. Insola5, F. Ranieri1, P. A. Tonali1,2 and J. C. Rothwell6

1 Institute of Neurology, Università Cattolica, L.go A. Gemelli 8, 00168 Rome, Italy
2 Fondazione Don C Gnocchi, Roma. Italy
3 FENNSI Group, Hospital Nacional de Paraplejicos, SESCAM, Finca la Peraleda,45071 Toledo, Spain
4 Neurochirurgia CTO, Via S. Nemesio 21, 00145 Rome, Italy
5 Neurofisiologia CTO, Via S. Nemesio 21, 00145 Rome, Italy
6 Sobell Department of Neurophysiology, Institute of Neurology and The National Hospital for Neurology & Neurosurgery, Queen Square, London WC1N 3BG, UK

Previous studies have shown that low-frequency repetitive transcranial magnetic stimulation (rTMS) suppresses motor-evoked potentials (MEPs) evoked by single pulse TMS. The aim of the present paper was to investigate the central nervous system level at which rTMS produces a suppression of MEP amplitude. We recorded corticospinal volleys evoked by single pulse TMS of the motor cortex before and after 1 Hz rTMS in five conscious subjects who had an electrode implanted in the cervical epidural space for the control of pain. One of the patients had Parkinson's disease and was studied on medication. Repetitive TMS significantly suppressed the amplitude of later I-waves, and reduced the amplitude of concomitantly recorded MEPs. The earliest I-wave was not significantly modified by rTMS. The present results show that 1 Hz rTMS may decrease the amplitude of later descending waves, consistent with a cortical origin of the effect of 1 Hz rTMS on MEPs.

(Received 10 July 2008; accepted after revision 22 July 2008; first published online 23 July 2008)
Corresponding author V. Di Lazzaro: Istituto di Neurologia, Università Cattolica, L.go A. Gemelli 8, 00168 Rome, Italy.  Email: vdilazzaro{at}rm.unicatt.it






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