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TMS-EEG in the Investigation of Excitation-Inhibition Imbalance in Psychosis and Cognition

Published online by Cambridge University Press:  07 July 2023

Panayiota G Michalopoulou ,
Rachel TS Chow ,
Nimra Farooq ,
Timea Szentgyorgyi ,
Maryam Mohammed-Akram ,
Lorenzo Rocchi  and
Sukhi S Shergill
Panayiota G Michalopoulou*
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
Rachel TS Chow
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
Nimra Farooq
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
Timea Szentgyorgyi
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
Maryam Mohammed-Akram
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
Lorenzo Rocchi
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom University of Cagliari, Cagliari, Italy
Sukhi S Shergill
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom Kent and Medway Medical School, Kent, United Kingdom
*
*Corresponding author.
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Abstract

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Aims

Transcranial Magnetic Stimulation (TMS) is an in-vivo, non-invasive, and safe method that probes neurophysiological properties associated with cortical glutamatergic (excitatory) and GABAergic (inhibitory) neurotransmission. The combination of TMS with Electroencephalography (EEG) allows us to measure TMS-evoked cortical responses directly from brain activity and it is uniquely placed to elucidate in-vivo cortical Excitatory/Inhibitory processes. Schizophrenia has been associated with Excitation/Inhibition (E/I) imbalance. Cognitive impairment, which is almost ubiquitous in schizophrenia, has been linked with the E/I abnormalities observed in schizophrenia. Among the TMS-EEG evoked potentials (TEPs), the N100 is thought to reflect activation of inhibitory GABA-B cortical circuits and has been associated with attentional processes in healthy individuals, attention deficit hyperactivity disorder (ADHD) and depression. Our aim was to investigate the cortical processes related to the generation of N100 after motor cortex stimulation and its association with attention measures in patients with schizophrenia and healthy controls.

Methods

TEPs were recorded following application of 150 TMS pulses at 90% of resting motor threshold on two brain sites, i.e., left primary motor cortex (M1) and dorsolateral prefrontal cortex (DLPFC) in stable patients with schizophrenia (n = 9) and healthy controls (n = 9). Region of Interest (ROI) analysis was performed to calculate the regional average of the N100 peak amplitude in M1 and DLPFC based on previous literature. Attention was assessed with a Continuous Performance Task (CPT).

Results

We found a significant negative correlation between the amplitude of N100 from M1 and CPT score in the patient group (rho = -0.73, p = 0.026). The N100 component from DLPFC in patients did not correlate with the CPT score (rho = -0.034, p = 0.93), which may suggest regional specificity of M1 inhibitory processes in attention in patients with schizophrenia.

Conclusion

N100 is considered to be related to cortical inhibitory processes influenced by cortico–striato–thalamo–cortical loops, with greater cortical inhibitory activity producing a larger N100 amplitude. Our preliminary results suggest association of the GABA-B-ergic TEP N100 with attentional processes in M1 and may represent cortical inhibition beyond motor inhibition in patients with schizophrenia. Overall, TMS-EEG offers the potential to investigate the state and dynamics of E/I imbalance in schizophrenia and cognition.

Type
Research
Information
BJPsych Open , Volume 9 , Supplement S1: Abstracts from the RCPsych International Congress 2023, 10–13 July , July 2023 , pp. S62 - S63
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NC
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. This does not need to be placed under each abstract, just each page is fine.
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists

Footnotes

Abstracts were reviewed by the RCPsych Academic Faculty rather than by the standard BJPsych Open peer review process and should not be quoted as peer-reviewed by BJPsych Open in any subsequent publication.

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