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Augmentation of cognitive control with theta burst stimulation of the right ventrolateral prefrontal cortex : first steps towards a novel therapeutic approach to improve bipolar disorder outcome Robin Luciani , Karling

Abstract

Background: Bipolar disorder (BD) affects more than 1% of the population and causes deficits in response inhibition. Response inhibition involves three sub-components (interference inhibition, action withholding, and action cancellation), that can be assessed together in the Hybrid Response Inhibition (HRI) task. The right Inferior Frontal Gyrus (rIFG) is a potential target for augmentation of response inhibition. Current investigations of repetitive transcranial magnetic stimulation (rTMS) in BD remain limited. This proof-of-concept study will explore rTMS of the rIFG and its effect on response inhibition using the HRI task in BD and controls. Methods: Within individuals with BD (n = 12) and a sex / age-matched control group (n = 12), we investigated the HRI performance scores associated with the three sub-components of response inhibition immediately before and after intermittent TMS (iTMS) and continuous TMS (cTMS) to either increase or decrease cortical excitability of the rIFG, respectively. Results: The response inhibition sub-component ‘action withholding’ was significantly improved in the HRI task following iTMS for the BD group. While there were no other significant effects observed in the results, noticeable trends may imply that there may be other effects of TMS on response inhibition in BD that differs from controls. Conclusions: Overall, this exploratory study successfully provided an initial evaluation of the effects of TMS on response inhibition in BD, showing trends and patterns that demonstrate the potential effectiveness of this novel intervention. Our study provides insights for further development and research of TMS over the rIFG in BD.

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Attribution-NonCommercial-NoDerivatives 4.0 International