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. 2012 Apr;5(2):116-23.
doi: 10.1016/j.brs.2012.03.007. Epub 2012 Mar 30.

Effect of continuous theta burst stimulation of the right dorsolateral prefrontal cortex on cerebral blood flow changes during decision making

Sang Soo Cho  1 , Giovanna Pellecchia, Ji Hyun Ko, Nicola Ray, Ignacio Obeso, Sylvain Houle, Antonio P Strafella
Affiliations

Effect of continuous theta burst stimulation of the right dorsolateral prefrontal cortex on cerebral blood flow changes during decision making

Sang Soo Cho et al. Brain Stimul. 2012 Apr.

Abstract

Decision making is a cognitive function relaying on a complex neural network. In particular, the right dorsolateral prefrontal cortex (DLPFC) plays a key role within this network. We used positron emission tomography (PET) combined with continuous theta burst transcranial magnetic stimulation (cTBS) to investigate neuronal and behavioral changes in normal volunteers while performing a delay discounting (DD) task. We aimed to test whether stimulation of right DLPFC would modify the activation pattern of the neural circuit underlying decision making during the DD task and influence discounting behavior. We found that cTBS of the right DLPFC influenced decision making by reducing impulsivity and inducing participants to favor large but delayed rewards instead of immediate but small rewards. Stimulation also affected activation in several prefrontal areas associated with DD. In particular, we observed a reduced regional cerebral blood flow (rCBF) in the ipsilateral DLPFC (BA 46) extending into the rostral part of the prefrontal cortex (BA 10) as well as a disrupted relationship between impulsivity (k-value) and rCBF in these and other prefrontal areas. These findings suggest that transcranial magnetic stimulation of the DLPFC influences the neural network underlying impulsive decision making behavior.

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Conflict of interest statement

The authors report no financial or other conflict of interest relevant to the subject of this article.

Figures

Figure 1
Figure 1
Examples of each behavioral task. (A) Delay discounting task, (B) Magnitude discrimination task, (C) Physical discrimination task.
Figure 2
Figure 2
Experimental design: timelines of the experiment. A total 12 scans were acquired for each subject. To exclude carry-over effects of cTBS, cTBS scans were followed by sham stimulation scans.
Figure 3
Figure 3
Brain regions showing increased rCBF during S-DD task compared to control tasks (S-MD/S-PD) (P < 0.05 FDR corrected for multiple comparisons with 50 voxels of spatial extended threshold).
Figure 4
Figure 4
(A) Brain regions showing decreased activation following right DLPFC-cTBS while performing DD task. (B) Specific cTBS-induced rCBF response from right rPFC during S-DD and T-DD. Values were extracted from a cluster mean from the area shown in the left.
Figure 5
Figure 5
The mean of natural-log transformed k-value (ln(k)) for the S-DD and T-DD conditions. Error bars represent the standard errors of the mean. *P < 0.05, paired-sample t-test (two-tailed).
Figure 6
Figure 6
(A) Neurobehavioral correlation between ln(k) of DD tasks and rCBF: brain regions that showed steeper regression slope in S-DD than T-DD (B) Regression plots between normalized rCBF of the right rPFC and impulsive scale ln(k) during cTBS (red circle) and sham stimulation (blue circle) condition. *P < 0.05, Spearman’s correlation (two-tailed).
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