Modulating motor cortical oscillation with coordinated reset multifocal transcranial magnetic stimulation

According to the theory of coordinated reset (CR) stimulation, multifocal bursts of stimuli delivered in a random order with a spe-cific interval may reduce the resonance power of the oscillatory generator in the epicenter. We develop a noninvasive coordi-nated multifocal burst stimulation (COMBS) with three repetitive transcranial stimulation machines based on CR theory to modulate the target frequency in the primary motor cortex and to assess its effect on motor cortical excitability in separate experiments. Electroencephalography and electromyography were recorded in 16 healthy participants during a finger-tapping task, both before and after the intervention. The resting oscillatory power at the targeted frequency was not changed by COMBS. a-Band power was increased in both preparation and movement stages and the low I3-band power was increased in the movement stage of the finger tapping task. The extent of low I3-band event-related desynchronization was reduced by COMBS. There were no changes in reaction time, but there was a trend for a reduced error rate after COMBS. In another 14 healthy participants, there were no significant changes in cortical excitability before and after COMBS measured by rest motor threshold, short interval intracortical inhibition, short interval intracortical facilitation, and cortical silent period. The result indi-cates that COMBS may modify the cortical oscillatory power and its perturbation within specific movement stage.NEW & NOTEWORTHY This is the first study, to our knowledge, to apply coordinated reset (CR) neuromodulation to the motor cortex with three repetitive transcranial magnetic stimulation (rTMS) stimulators to assess its effect on cortical oscillation. The results revealed enhancement of a-band power specifically in preparation and movement stages and low I3-band power in the movement stage of a motor task. It postulated that CR stimulation may modify the motor cortical oscillation in the specific move-ment stages.