A. Pascual-leone et al., Study and modulation of human cortical excitability with transcranial magnetic stimulation, J CL NEURPH, 15(4), 1998, pp. 333-343
Transcranial magnetic stimulation (TMS) can be applied in different paradig
ms to obtain a measure of various aspects of cortical excitability. These d
ifferent TMS paradigms provide information about different neurotransmitter
systems, enhance our understanding about the pathophysiology of neuropsych
iatric conditions, and in the future may be helpful as a guide for pharmaco
logical interventions. In addition, repetitive TMS (rTMS) modulates cortica
l excitability beyond the duration of the rTMS trains themselves. Depending
on rTMS parameters, a lasting inhibition or facilitation of cortical excit
ability can be induced. These effects can be demonstrated neurophysiologica
lly or by combining rTMS with neuroimaging techniques. The effects do not r
emain limited to the cortical area directly targeted by rTMS, but affect a
wider neural network transynaptically. Modulation of cortical excitability
by rTMS may in the future be useful not only as a research tool but also as
a therapeutic intervention in neurology, psychiatry, and neurorehabilitati
on.