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Cerebral Cortex Advance Access originally published online on January 17, 2008
Cerebral Cortex 2008 18(9):2077-2085; doi:10.1093/cercor/bhm231
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© The Author 2008. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Remediation of Sleep-Deprivation–Induced Working Memory Impairment with fMRI-Guided Transcranial Magnetic Stimulation

B. Luber1,2, A. D. Stanford1,2, P. Bulow1,2, T. Nguyen1, B. C. Rakitin3,4, C. Habeck3,4, R. Basner5, Y. Stern2,3,4 and S. H. Lisanby1,2

1 Division of Brain Stimulation and Therapeutic Modulation, New York State Psychiatric Institute, NY 10032, USA, 2 Department of Psychiatry, 3 Department of Neurology, Columbia University College of Physicians and Surgeons, NY 10032, USA, 4 Cognitive Neuroscience Division of the Taub Institute for Research in Alzheimer's Disease and the Aging Brain, NY 10032, USA, 5 Department of Medicine, Columbia University College of Physicians and Surgeons, NY 10032, USA

Address correspondence to email: luberbr{at}pi.cpmc.columbia.edu.

Repetitive transcranial magnetic stimulation (rTMS) was applied to test the role of selected cortical regions in remediating sleep-deprivation–induced deficits in visual working memory (WM) performance. Three rTMS targets were chosen using a functional magnetic resonance imaging (fMRI)–identified network associated with sleep-deprivation–induced WM performance impairment: 2 regions from the network (upper left middle occipital gyrus and midline parietal cortex) and 1 nonnetwork region (lower left middle occipital gyrus). Fifteen participants underwent total sleep deprivation for 48 h. rTMS was applied at 5 Hz during a WM task in a within-subject sham-controlled design. The rTMS to the upper-middle occipital site resulted in a reduction of the sleep-induced reaction time deficit without a corresponding decrease in accuracy, whereas stimulation at the other sites did not. Each subject had undergone fMRI scanning while performing the task both pre- and postsleep deprivation, and the degree to which each individual activated the fMRI network was measured. The degree of performance enhancement with upper-middle occipital rTMS correlated with the degree to which each individual failed to sustain network activation. No effects were found in a subset of participants who performed the same rTMS procedure after recovering from sleep deprivation, suggesting that the performance enhancements seen following sleep deprivation were state dependent.

Key Words: facilitation • fMRI • sleep deprivation • TMS • working memory


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