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Abstracts / Brain Stimulation 8 (2015) 360e377

pulse TMS over the right superior cerebellum (lobule 6) [3] and
veried the necessity of the left superior (with visual and motor
control) and inferior cerebellum during visual working memory
with a double-pulse (1s interval) stimulation using fMRI-guided
TMS [4]. In the current follow-up study, involvement of the right
inferior cerebellum during visual working memory is further
investigated.
Methods: 9 healthy, right-handed young-adults performed 2
tasks: (1) Visual Memory TMS (VM-TMS) and (2) Verbal Memory
TMS (VERM-TMS) while a double-pulse (1s interval) stimulation
sequence was applied over the right inferior cerebellum (lobule 8A/
7B) specic to VM activation during fMRI-guided (BrainSight Ver2)
TMS (Magstim Rapid2 system with a 110mm double cone coil). Each
task comprised of two runs of 18 stimulation (Stim) and 18 nonstimulation (non-Stim) trials per run (Fig. 1). Task order was
counterbalanced across all subjects.

7B and not 8, hence disrupting the visual processes essential for

VM but not VERM. Further investigations using VERM fMRIguided targets in the right inferior cerebellum are needed to
ascertain this.
References
1. Stoodley CJ , Schmahmann JD . Functional topography in the human cerebellum: a meta- analysis of neuroimaging studies. NeuroImage 2009;44(2):
489e501.
2. E, K.H , et al. A meta-analysis of cerebellar contributions to higher cognition from
PET and fMRI studies. Human brain mapping 2014;35(2):593e615.
3. Desmond JE , Chen SH , Shieh PB . Cerebellar transcranial magnetic stimulation impairs verbal working memory. Annals of Neurology 2005;58(4):
553e60.
4. Chen SHA , et al. Cerebellar transcranial magnetic simulation (TMS) impairs visual
working memory in 20th Annual Human Brain Mapping. Hamburg: Germany;
2014.
5. Kirschen PK , Chen SHA , Desmond JE . Modality specic cerebro-cerebellar activations in verbal working memory: an fMRI study. Behav Neurol 2010;23(1-2):
51e63.

216
Effects of deep brain stimulation of the nucleus basalis of
Meynert in EEG resting-state oscillatory power and phase
synchronization
H.L. Lee a,*, J. Kuhn b, K. Hardenacke b, T.O.J. Gruendler b,c,d,
T. Schueller b, V. Sturm e, J. Fell f, N. Axmacher a,g
a
German Center for Neurodegenerative Diseases, Bonn, Germany
b
University of Cologne, Germany
c
Otto-von-Guericke University Magdeburg, Germany
c
Center for Behavioral Brain Sciences, Magdeburg, Germany
e
University of Wuerzburg, Germany
f
University of Bonn, Germany
g
Ruhr University Bochum, Germany
*E-mail: hwee-ling.lee@dzne.de.

Results: Paired t-tests showed, TMS administered to the right

inferior cerebellum, decreased accuracy only in the VM-TMS task (t
[8]4.64;p0.0017), but had no effects on RT or the VERM-TMS
conditions (Fig. 2).

Discussion: Our ndings veried the contributions of the right

inferior cerebellum during VM-TMS and possible topographic
specicity for visual and verbal WM within this lobule. Kirschen
et al. [5] showed the right lobule 8 to be activated specically
for auditory input and lobule 7B for visual processes during
VERM. It is plausible that our lack of signicant effect during
VERM-TMS is explained by the TMS target to be within lobule

Introduction: Deep brain stimulation (DBS) has been proposed to

ameliorate memory dysfunction in patients with Alzheimers disease (AD). In this study, we investigated the changes in electroencephalography (EEG) resting-state oscillatory power and phase
synchronization after one year of DBS of the nucleus basalis of
Meynert (NBM) in AD patients.
Methods: EEG resting-state data were recorded before and after
one year of DBS of NBM in 7 AD patients. The data were
segmented into epochs of 2s, and EEG epochs with ocular,
muscular and other types of artifacts were discarded from subsequent analyses. Oscillatory power across trials of each electrode, and averaged pairwise phase consistency (PPC) across trials
of each electrode paired with all other electrodes were compared
before and after DBS in each frequency band of interests (delta: 24 Hz, theta: 4-8 Hz, alpha1: 8-10.5 Hz, alpha2: 10.5-13 Hz, beta1:
13-20 Hz, beta2: 20-30 Hz, gamma1: 30-40 Hz, and gamma2:
40-80 Hz).
Results: As compared to before DBS, patients after DBS demonstrate increased oscillatory power in the delta (strongest), theta,
beta2, and gamma1 frequency bands. Further, patients after DBS
also demonstrate increased averaged PPC in the delta frequency
band, and decreased averaged PPC in the alpha2, beta1, beta2,
gamma1 and gamma2 frequency bands.
Discussion: Our results demonstrate changes in EEG restingstate oscillatory power and phase synchronization for AD patients after one year of DBS of NBM. Changes in the beta and
gamma frequency bands are often associated with memory
functions, whereas changes in the delta and theta frequency
bands are most likely related to progression of the disease.
Further examination of the relationship between cognitive

Abstracts / Brain Stimulation 8 (2015) 360e377

neuropsychological testing and resting-state oscillatory power

and phase synchronization will determine whether these EEG
resting-state changes are associated with cognitive functioning
in AD patients.
217
Benecial effect of transcranic magnetic stimulation combined
with mirror therapy in stroke patients: a pilot study in
neurorehabilitative setting
D. Dalla Libera , S. Regazzi , C. Fasoletti , D. Dinacci Ruggieri , P. Rossi
Hildebrand, Neurorehabilitation, Brissago, Switzerland
Introduction: Both mirror therapy (MT) and repetitive transcranial magnetic stimulation (TMS) have been proved to promote
cortical reorganization and functional recovery of post- stroke
patients.
Methods: Ten patients affected by subacute rst-ever stroke documented by a brain CT- with severe disability (NIHSS 10-14) and
hand paresis were recruited at 3 months from the event and
received a complete neurological examination including MRC,
NIHSS, Brunnstrom Recovery Stages, Fugl-Meyer grading. Moreover, FAB, BECK, 10-item Spielberger Trait Anger Scale, Montreal
Cognitive Assessment (MoCa) and FIM were recorded.
They underwent 12 session (3 time/week) of 15 minutes of 10 Hz
TMS through a 8-coil applied on the ipsilesional somatosensory
cortex of the affected emisphere, followed by 15 minutes of MT for
the upper limb. A control group of ten patients underwent TMS
stimulation withouth MT.
Double-pulse TMS through a gure-eight focal coil was used to
study intracortical inhibition (ICI) in primary motor cortex of both
side at rest and during the preparation of movement.
Results: The rst group (TMS + MT) shows better results than the
second group (TMS only) both from a clinical and neurophysiological point of view.
A motor evoked potentials - previously absent - was elicited after
1 month treatment for the affected upper limb; a normalization of
the silent period and reduction of and intracortical inhibition in the
affected emisphere was evident, together with a signicant modication of ICI over the unaffected hemisphere. Such results were
reproducible in 3 evaluations done on different time.
Conclusion: TMS treatment combined with MT may be added to
the conventional therapy of severely impaired stroke patients even
in an early phase after the insult, with positive results on both
neurophysiological and clinical parameters. We may suppose that
TMS, when combined with MT enhances synaptic plasticity and
induce nerugenesis.
218
Evaluation of tDCS-induced Cortical Excitability Changes by
Motor Evoked Potentials Amplitude
A.V. Masliukova , N.A. Smirnov
Ivanovo State Medical Academy, Ivanovo, Russia
Background: The present study investigated the possibility of
assessment of excitatory anodal transcranial direct current
stimulation (tDCS) and inhibitory cathodal tDCA to the motor
cortex measured by the amplitude of the motor evoked potential (MEP) using navigated transcranial magnetic stimulation
(TMS).
Methods: Ten healthy right-handed adults received anodal and
cathodal tDCS separated by at least 24 hours. The order of tDCS
polarity conditions (anodal vs. cathodal) was counterbalanced
among participants. TDCS was delivered through a couple of
saline-soaked, sponge electrodes (30 cm2) using a constantcurrent stimulator built in Neuron-Spectrum-5 (Neurosoft) with
an intensity of 2 mA for 20 min. The active electrode was placed

377

over the motor cortical representational eld of the right

abductor pollicis brevis (APB), dened by means of navigated
TMS. Neuro-MS/D (Neurosoft) stimulator with Neural Navigator (NeNa, Brain Science Tools) guided by individual MRI
data were used for navigated TMS. The reference electrode was
placed over the right frontopolar cortex (above the eyebrow).
However, in the present study, stimulation may have extended
beyond eld of the right APB due to the large electrode size used.
Recording of MEPs from the APB was performed with NeuronSpectrum-5 (Neurosoft) before the tDCS (baseline) and immediately after.
Results: The analyses showed that the MEP amplitudes increased
+29.2  7.6% following the anodal stimulation (P < 0.01) and
decreased -20.7  5.8% following the cathodal stimulation (P
<0.05), compared with the baseline. Moreover, after tDCS, we
found a signicant difference in the mean MEP amplitudes between
the two tDCS conditions (after anodal 381.5 mV and after cathodal
267.8 mV; p<0.001).
Conclusions: The study revealed that anodal and cathodal tDCS are
both techniques to induce cortical excitability changes. And it is
possible to directly evaluate tDCS-induced changes at the cortical
level by recording the MEPs using navigated TMS.

219
A TMS-EEG study for attentional gating by oscillatory alpha
activity
Yuka Okazaki a,*, Yuji Mizuno a,b,c, Keiichi Kitajo a,b
a
RIKEN Brain Science Institute, Japan
b
Tokyo University of Agriculture and Technology, Japan
c
Japan Society for the Promotion of Science, Japan
*E-mail: y.okazaki@brain.riken.jp.
Introduction: It is well accepted that alpha activity is hemispherically lateralized during orienting of attention associated with
sensory gating. The underlying mechanism, however, has not been
fully understood. We hypothesized that ongoing oscillations are
more robust to phase perturbation under the higher alpha power
state than the lower alpha power state reecting the dynamics of
neural oscillations, which is less sensitive to external inputs. To test
this hypothesis, we assessed the extent to which phase of ongoing
oscillations is modulated by the transcranial magnetic stimulation
(TMS) under varying alpha power states in a covert attention-orienting task.
Methods: A target Gabor stimulus was presented at a cued location in either the left or right visual hemield, together with a
distractor Gabor stimulus. The participants were asked to covertly
attend to the cued hemield and discriminate the orientation of
the target stimulus. In half of the trials TMS was applied on the left
or right visual hemisphere instead of a presentation of Gabor
stimulus. We analysed brain responses to TMS-perturbation on the
ipsilateral or contralateral hemispheres with respect to the
attentional cueing.
Results: Our key nding was that the lower alpha power
related to the target led to strong phase resetting, while the
higher alpha power related to the distracter resulted in weaker
phase resetting. Moreover, the phase resetting propagated from
the TMS-targeted visual area to the rest of the brain but the
propagation was less efcient when pre-TMS alpha power was
high.
Discussion: Our results provide a new mechanistic account that
oscillatory alpha dynamics plays an important role in sensory
gating by modulating the alpha power together with the efciency
of global propagation of phase resetting. This alpha dynamics is
presumably associated with information ow between task-relevant regions.