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Publication Detail
Introduction to Basic Mechanisms of Transcranial Magnetic Stimulation
Transcranial magnetic stimulation (TMS) is a noninvasive means of electrically stimulating the human brain. Although we have an accurate understanding of the biophysics of TMS, its action on neural tissue is still incompletely understood. The consensus is that TMS to the motor cortex activates cortical circuits, recruiting inhibitory neurons at the lowest threshold and excitatory neurons at a slightly higher intensity. The latter is directionally dependent, suggesting axons within these circuits have a specific orientation. Activation produces excitatory synaptic input onto corticospinal neurons, causing high-frequency repetitive discharge. This can be recorded with epidural electrodes as discharge of large-diameter corticospinal neurons in the spinal cord. Repeated activation of inputs with repetitive TMS creates an after-effect on cortical excitability similar to the early stages of long-term potentiation and depression, respectively. Increasingly sophisticated computer models of the action of TMS are being developed, which can test hypotheses derived from experimental data.
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