The influence of endogenous estrogen on high-frequency prefrontal transcranial magnetic stimulation

Sung Wook Chung, Cassandra J. Thomson, Susan Lee, Roisin N. Worsley, Nigel C. Rogasch, Jayashri Kulkarni, Richard H. Thomson, Paul B. Fitzgerald, Rebecca A. Segrave

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: The use of repetitive transcranial magnetic stimulation (rTMS) as both therapeutic and experimental tools has grown enormously over the past decade. However, variability in response to rTMS is one challenge that remains to be solved. Estrogen can impact neural plasticity and may also affect plastic changes following rTMS. The present study investigated whether estrogen levels influence the neurophysiological effects of high-frequency (HF) rTMS in the left dorsolateral prefrontal cortex (DLPFC). Hypothesis: It was hypothesised that individuals with higher endogenous estrogen would demonstrate greater rTMS-induced changes in cortical reactivity. Methods: 29 healthy adults (15M/14F) received HF-rTMS over left DLPFC. Females attended two sessions, one during a high-estrogen (HE) phase of the menstrual cycle, another during a low-estrogen (LE) phase. Males attended one session. Estrogen level was verified via blood assay. TMS-EEG was used to probe changes in cortical plasticity and comparisons were made using cluster-based permutation statistics and Bayesian analysis. Results: In females, a significant increase in TMS-evoked P60 amplitude, and decrease in N45, N100 and P180 amplitudes was observed during HE. A less pervasive pattern of change was observed during LE. No significant changes in TEPs were seen in males. Between-condition comparisons revealed higher likelihood of the change in N100 and/or P180 being larger in females during HE compared to both females during LE and males. Conclusions: These preliminary findings indicate that a greater neuroplastic response to prefrontal HF-rTMS is seen in women when estrogen is at its highest compared to men, suggesting that endogenous estrogen levels contribute to variability in response to HF-rTMS.

Original languageEnglish
Number of pages9
JournalBrain Stimulation
DOIs
Publication statusAccepted/In press - 13 May 2019

Keywords

  • Estrogen
  • Hormones
  • Prefrontal cortex
  • Repetitive transcranial magnetic stimulation (rTMS)
  • TMS-EEG

Cite this

@article{a037f32214aa4ec2bb5b769c1cce3b14,
title = "The influence of endogenous estrogen on high-frequency prefrontal transcranial magnetic stimulation",
abstract = "Background: The use of repetitive transcranial magnetic stimulation (rTMS) as both therapeutic and experimental tools has grown enormously over the past decade. However, variability in response to rTMS is one challenge that remains to be solved. Estrogen can impact neural plasticity and may also affect plastic changes following rTMS. The present study investigated whether estrogen levels influence the neurophysiological effects of high-frequency (HF) rTMS in the left dorsolateral prefrontal cortex (DLPFC). Hypothesis: It was hypothesised that individuals with higher endogenous estrogen would demonstrate greater rTMS-induced changes in cortical reactivity. Methods: 29 healthy adults (15M/14F) received HF-rTMS over left DLPFC. Females attended two sessions, one during a high-estrogen (HE) phase of the menstrual cycle, another during a low-estrogen (LE) phase. Males attended one session. Estrogen level was verified via blood assay. TMS-EEG was used to probe changes in cortical plasticity and comparisons were made using cluster-based permutation statistics and Bayesian analysis. Results: In females, a significant increase in TMS-evoked P60 amplitude, and decrease in N45, N100 and P180 amplitudes was observed during HE. A less pervasive pattern of change was observed during LE. No significant changes in TEPs were seen in males. Between-condition comparisons revealed higher likelihood of the change in N100 and/or P180 being larger in females during HE compared to both females during LE and males. Conclusions: These preliminary findings indicate that a greater neuroplastic response to prefrontal HF-rTMS is seen in women when estrogen is at its highest compared to men, suggesting that endogenous estrogen levels contribute to variability in response to HF-rTMS.",
keywords = "Estrogen, Hormones, Prefrontal cortex, Repetitive transcranial magnetic stimulation (rTMS), TMS-EEG",
author = "Chung, {Sung Wook} and Thomson, {Cassandra J.} and Susan Lee and Worsley, {Roisin N.} and Rogasch, {Nigel C.} and Jayashri Kulkarni and Thomson, {Richard H.} and Fitzgerald, {Paul B.} and Segrave, {Rebecca A.}",
year = "2019",
month = "5",
day = "13",
doi = "10.1016/j.brs.2019.05.007",
language = "English",
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The influence of endogenous estrogen on high-frequency prefrontal transcranial magnetic stimulation. / Chung, Sung Wook; Thomson, Cassandra J.; Lee, Susan; Worsley, Roisin N.; Rogasch, Nigel C.; Kulkarni, Jayashri; Thomson, Richard H.; Fitzgerald, Paul B.; Segrave, Rebecca A.

In: Brain Stimulation, 13.05.2019.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - The influence of endogenous estrogen on high-frequency prefrontal transcranial magnetic stimulation

AU - Chung, Sung Wook

AU - Thomson, Cassandra J.

AU - Lee, Susan

AU - Worsley, Roisin N.

AU - Rogasch, Nigel C.

AU - Kulkarni, Jayashri

AU - Thomson, Richard H.

AU - Fitzgerald, Paul B.

AU - Segrave, Rebecca A.

PY - 2019/5/13

Y1 - 2019/5/13

N2 - Background: The use of repetitive transcranial magnetic stimulation (rTMS) as both therapeutic and experimental tools has grown enormously over the past decade. However, variability in response to rTMS is one challenge that remains to be solved. Estrogen can impact neural plasticity and may also affect plastic changes following rTMS. The present study investigated whether estrogen levels influence the neurophysiological effects of high-frequency (HF) rTMS in the left dorsolateral prefrontal cortex (DLPFC). Hypothesis: It was hypothesised that individuals with higher endogenous estrogen would demonstrate greater rTMS-induced changes in cortical reactivity. Methods: 29 healthy adults (15M/14F) received HF-rTMS over left DLPFC. Females attended two sessions, one during a high-estrogen (HE) phase of the menstrual cycle, another during a low-estrogen (LE) phase. Males attended one session. Estrogen level was verified via blood assay. TMS-EEG was used to probe changes in cortical plasticity and comparisons were made using cluster-based permutation statistics and Bayesian analysis. Results: In females, a significant increase in TMS-evoked P60 amplitude, and decrease in N45, N100 and P180 amplitudes was observed during HE. A less pervasive pattern of change was observed during LE. No significant changes in TEPs were seen in males. Between-condition comparisons revealed higher likelihood of the change in N100 and/or P180 being larger in females during HE compared to both females during LE and males. Conclusions: These preliminary findings indicate that a greater neuroplastic response to prefrontal HF-rTMS is seen in women when estrogen is at its highest compared to men, suggesting that endogenous estrogen levels contribute to variability in response to HF-rTMS.

AB - Background: The use of repetitive transcranial magnetic stimulation (rTMS) as both therapeutic and experimental tools has grown enormously over the past decade. However, variability in response to rTMS is one challenge that remains to be solved. Estrogen can impact neural plasticity and may also affect plastic changes following rTMS. The present study investigated whether estrogen levels influence the neurophysiological effects of high-frequency (HF) rTMS in the left dorsolateral prefrontal cortex (DLPFC). Hypothesis: It was hypothesised that individuals with higher endogenous estrogen would demonstrate greater rTMS-induced changes in cortical reactivity. Methods: 29 healthy adults (15M/14F) received HF-rTMS over left DLPFC. Females attended two sessions, one during a high-estrogen (HE) phase of the menstrual cycle, another during a low-estrogen (LE) phase. Males attended one session. Estrogen level was verified via blood assay. TMS-EEG was used to probe changes in cortical plasticity and comparisons were made using cluster-based permutation statistics and Bayesian analysis. Results: In females, a significant increase in TMS-evoked P60 amplitude, and decrease in N45, N100 and P180 amplitudes was observed during HE. A less pervasive pattern of change was observed during LE. No significant changes in TEPs were seen in males. Between-condition comparisons revealed higher likelihood of the change in N100 and/or P180 being larger in females during HE compared to both females during LE and males. Conclusions: These preliminary findings indicate that a greater neuroplastic response to prefrontal HF-rTMS is seen in women when estrogen is at its highest compared to men, suggesting that endogenous estrogen levels contribute to variability in response to HF-rTMS.

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