Neurophysiological Basis of TMS Workshop

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1 Neurophysiological Basis of TMS Workshop Programme 31st March - 3rd April 2017 Sobell Department Institute of Neurology University College London 33 Queen Square London WC1N 3BG Brought to you by

2 31 March Day 1. Holiday Inn Bloomsbury, Coram Street, WC1N 1HT 1.00 pm Welcome and opening address from Professor John Rothwell 1.15pm Introductory Lecture: Application of TMS in research Overview of how TMS is applied, looking at and discussing studies that have used TMS as a tool to investigate causal brain-behaviour relations. 2.30pm 3.15pm 4.30pm Introductory lecture continued TMS Safety - contraindications, ethics Day 1 wrap up

3 1 April Day 2. UCL Sobell Department, 33 Queen Square, WC1N 3BG 9.30am Lecture 1 Physiology of transcranial motor cortex stimulation Basic principles of magnetic and electrical stimulation Physiology of transcranial magnetic and electrical motor cortex stimulation Common measurements and applications of single pulse TMS Practical session 1 Single pulse TMS 1.00pm 3.00pm 5.30pm Brief familiarization with hardware and set-up, followed by demonstration of TMS. Delegates will then be asked to: Locate the motor hotspot for a hand muscle Find resting motor threshold Find active motor threshold Recognize relevant features of the motor evoked potential (MEP) (e.g size, latency and silent period) and how they are affected by intrinsic (e.g. muscle activity) and extrinsic factors (e.g. coil position and orientation, stimulus intensity) Stimulus-response curve Lunch break (off-site) Lecture 2 Twin-coil TMS Insights into cortico-cortical connectivity Basic principles of twin-coil TMS Intra- and inter-hemispheric circuits activated by twin-coil TMS Research and clinical applications Practical session 2 Twin-coil TMS Cortico-cortical connectivity. Initial demonstration of twin-coil TMS to cortico-cortical connectivity. Delegates will be asked to: Find the hotspot, resting and active motor thresholds Use and interpret some intracortical inhibitory and facilitatory paradigms: o Inter-hemispheric inhibition (IHI) and o facilitation (IHF) Day 2 wrap up

4 2 April Day 3. UCL Sobell Department, 33 Queen Square, WC1N 3BG 9.30am 1.00pm 3.00pm 5.30pm Lecture 3 Paired pulse TMS Insights into intracortical circuitry Basic principles of paired-pulse TMS Physiology of cortical circuits investigated with paired-pulse TMS Research and clinical applications Practical session 3 Paired pulse TMS Initial demonstration of paired-pulse TMS paradigms. Delegates will be asked to: Find the hotspot, resting and active motor thresholds Use and interpret some intracortical inhibitory and facilitatory paradigms: o Short-interval intracortical inhibition (SICI) o Intracortical facilitation (ICF) o Short-interval intracortical facilitation (SICF) o Long-interval intracortical inhibition (LICI) Lunch break (off-site) Lecture 4 Combining neuronavigation with TMS Principles of neuronavigation and uses of neuronavigation: Reliable and accurate targeting of cortical areas Mapping the motor cortex Stimulating non-motor areas of the cortex Practical session 4 Neuronavigation and TMS Initial demonstration Brainsight neuronavigation system. Delegates will then have the opportunity to practice: Locating and record the hotspot using Brainsight (MEP guided approach) Attempt to map a hand representation of the motor cortex Locate the hotspot using MRI image of brain (anatomy guide approach) Day 3 wrap up

5 3 April Day 4. Holiday Inn Bloomsbury, Coram Street, WC1N 1HT 9.30am 12.30pm Lecture 5 Influences on the excitability of the brain / rtms for the induction of plasticity Induction of plasticity-like processes via rtms (intrinsic and extrinsic plasticity) rtms protocols Safety Effects on intracortical excitability and cortico-cortical connectivity Effects on behavior (online/offline lesions) Note of caution: inter- and intra-individual variability Introduction to multi-modal applications Demonstration/discussions of: TMS and tdcs TMS and NIRS TMS and EEG TMS with NIRS / EEG TMS and EMG Group Question and Answer Session: Discuss and review delegates research concepts and ideas Discuss the potential and relevance of TMS in future research projects Future training / workshop requirements 1.30pm Workshop summary and wrap up

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