Solutions for managing variability in non-invasive brain stimulation studies

In the last three decades, a number of non-invasive brain stimulation (NIBS) protocols, capable of assessing and modulating plasticity in the human motor cortex (M1), have been described. For almost as long, NIBS has delivered the tantalising prospect of non-invasive neuromodulation as a therapeutic...

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Bibliographic Details
Published in:Neuroscience letters 2020-02, Vol.719, p.133332-133332, Article 133332
Main Authors: Guerra, Andrea, López-Alonso, Virginia, Cheeran, Binith, Suppa, Antonio
Format: Article
Language:English
Subjects:
Evoked Potentials, Motor - physiology
Humans
Motor Cortex - physiology
Neuronal Plasticity - physiology
Non-invasive brain stimulation
Paired associative stimulation
Stereotaxic Techniques - rehabilitation
Theta burst stimulation
Transcranial direct current stimulation
Transcranial Direct Current Stimulation - methods
Transcranial magnetic stimulation
Transcranial Magnetic Stimulation - methods
Variability
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Summary:In the last three decades, a number of non-invasive brain stimulation (NIBS) protocols, capable of assessing and modulating plasticity in the human motor cortex (M1), have been described. For almost as long, NIBS has delivered the tantalising prospect of non-invasive neuromodulation as a therapeutic intervention for neurorehabilitation, psychiatry, chronic pain and other disease states. Apart from modest effects in depression, this early promise has not been realised since the symptomatic improvements produced by NIBS are generally weak. One key factor explaining this lack of clinical translation concerns variability in response to NIBS. Several studies have demonstrated a number of physiological, technical and statistical factors accounting for intra- and inter-subject variability. However, solutions to overcome this problem are still under debate. In the present review, we have provided a detailed description of methodological and technical solutions to control known factors influencing variability. We have also suggested potential strategies to strengthen and stabilize NIBS-induced after-effects. Finally, we propose new possible outcome variables which better reflect intrinsic cortical activity, allowing a more sensitive measurement and valid interpretation of responses to NIBS.
ISSN:0304-3940
1872-7972
DOI:10.1016/j.neulet.2017.12.060