Enhancing Visuospatial Working Memory Performance Using Intermittent Theta-Burst Stimulation Over the Right Dorsolateral Prefrontal Cortex

Ronald Ngetich, Donggang Jin, Wenjuan Li, Bian Song, Junjun Zhang, Zhenlan Jin, Ling Li, Ronald Ngetich, Donggang Jin, Wenjuan Li, Bian Song, Junjun Zhang, Zhenlan Jin, Ling Li

Abstract

Noninvasive brain stimulation provides a promising approach for the treatment of neuropsychiatric conditions. Despite the increasing research on the facilitatory effects of this kind of stimulation on the cognitive processes, the majority of the studies have used the standard stimulation approaches such as the transcranial direct current stimulation and the conventional repetitive transcranial magnetic stimulation (rTMS) which seem to be limited in robustness and the duration of the transient effects. However, a recent specialized type of rTMS, theta-burst stimulation (TBS), patterned to mimic the natural cross-frequency coupling of the human brain, may induce robust and longer-lasting effects on cortical activity. Here, we aimed to investigate the effects of the intermittent TBS (iTBS), a facilitatory form of TBS, over the right DLPFC (rDLPFC), a brain area implicated in higher-order cognitive processes, on visuospatial working memory (VSWM) performance. Therefore, iTBS was applied over either the rDLPFC or the vertex of 24 healthy participants, in two separate sessions. We assessed VSWM performance using 2-back and 4-back visuospatial tasks before iTBS (at the baseline (BL), and after the iTBS. Our results indicate that the iTBS over the rDLPFC significantly enhanced VSWM performance in the 2-back task, as measured by the discriminability index and the reaction time. However, the 4-back task performance was not significantly modulated by iTBS. These findings demonstrate that the rDLPFC plays a critical role in VSWM and that iTBS is a safe and effective approach for investigating the causal role of the specific brain areas.

Keywords: intermittent theta-burst stimulation (iTBS); n-back task; neuroplasticity; right dorsolateral prefrontal cortex (rDLPFC); working memory.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Ngetich, Jin, Li, Song, Zhang, Jin and Li.

Figures

FIGURE 1
FIGURE 1
(A) Overview of the experimental paradigm. Our experiment consisted of three separate sessions. During the first session, the participants were screened on eligibility, had their T1-weighted images acquired, and AMT estimated. In the second session, participants performed the baseline n-back task followed by iTBS and then the post-stimulation n-back task. In the third session, the participants received iTBS and performed the post-stimulation n-back task. (B) The iTBS target brain areas, the vertex and the Rdlpfc, respectively.
FIGURE 2
FIGURE 2
Description of the visuospatial n-back task. The behavioral n-back task consisted of 2-back and 4-back tasks.
FIGURE 3
FIGURE 3
(A) Discriminability index for both 2-back and 4-back tasks under different stimulation conditions, namely: Baseline (BL), iTBS over the vertex, and iTBS over the rDLPFC. (B) The stimulation effect (δd’ scores). The stimulation effect was obtained by subtracting the BL scores from the post-stimulation scores. The yellow and the blue colors refer to the 2-back and 4-back tasks, respectively. The asterisks indicate the level of significance, with ** indicating p ≤ 0.01, and **** indicating p ≤ 0.0001. The errors bars indicate the standard mean error (SME).
FIGURE 4
FIGURE 4
The reaction time (RT) performance for both 2-back and 4-back tasks. The yellow and blue colors indicate 2-back and 4-back tasks, respectively. The asterisks indicate the level of significance, with *** indicating p ≤ 0.001. The errors bars indicate the standard mean error (SME).

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