{"doi":"10.1016/j.brs.2024.03.008","title":"High frequency transcranial magnetic stimulation increases slow-wave activity during subsequent sleep in older adults with cognitive complaints","abstract":"Slow-wave activity (SWA) during non-rapid eye movement (NREM) sleep is critical for restoring neuronal homeostasis and is associated with better cognitive function among older adults [[1]Wilckens K.A. et al.Slow-wave activity enhancement to improve cognition.Trends Neurosci. 2018; 41: 470-482Abstract Full Text Full Text PDF PubMed Scopus (73) Google Scholar]. SWA declines with aging, which may contribute to various forms of age-related pathology [[2]Mander B.A. et al.β-amyloid disrupts human NREM slow waves and related hippocampus-dependent memory consolidation.Nat Neurosci. 2015; 18: 1051-1057Crossref PubMed Scopus (0) Google Scholar] and functional decline [[3]Moe K.E. et al.Sleep/wake patterns in Alzheimer’s disease: relationships with cognition and function.J Sleep Res. 1995; 4: 15-20Crossref PubMed Google Scholar]. Enhancing SWA with methods that do not interfere with sleep or daytime function could potentially mitigate these age-related problems [[1]Wilckens K.A. et al.Slow-wave activity enhancement to improve cognition.Trends Neurosci. 2018; 41: 470-482Abstract Full Text Full Text PDF PubMed Scopus (73) Google Scholar]. However, SWA is highly stable within an individual from night to night [[4]Israel B. et al.Short-term stability of sleep and heart rate variability in good sleepers and patients with insomnia: for some measures, one night is enough.Sleep. 2012; 35: 1285-1291Crossref PubMed Scopus (78) Google Scholar], making SWA enhancement a challenge. Further, SWA enhancement approaches used in younger participants that involve low frequency neuromodulation during sleep have not replicated well in older populations [[5]Marshall L. et al.Boosting slow oscillations during sleep potentiates memory.Nature. 2006; 444: 610-613Crossref PubMed Scopus (1346) Google Scholar]. In contrast, high frequency (≥10 Hz) repetitive transcranial magnetic stimulation (rTMS) during wakefulness, before sleep, leads to a rebound increase in SWA during subsequent sleep [[6]Huber R. et al.TMS-induced cortical potentiation during wakefulness locally increases slow wave activity during sleep.PLoS One. 2007; 2: e276Crossref PubMed Scopus (0) Google Scholar]. High frequency rTMS taps into the use-dependent link between neural transmission and SWA: neuronal populations that are more active during wakefulness show greater SWA during subsequent sleep compared to less active neuronal populations [[7]Huber R. et al.Local sleep and learning.Nature. 2004; 430: 78-81Crossref PubMed Scopus (1404) Google Scholar]. Specifically, neuronal transmission during wakefulness releases presynaptic adenosine triphosphate (ATP), which triggers astrocyte signaling of sleep-regulating cytokines (i.e. tumor necrosis factor α and interleukin 1) [[8]Krueger J. et al.Sleep as a fundamental property of neuronal assemblies.Nat Rev Neurosci. 2008; 9: 910-919Crossref PubMed Scopus (308) Google Scholar]. These cytokines stimulate GABAergic (γ-amino-butyric-acid) neurotransmission, which broadly inhibits and controls neural activity, manifested as SWA [[8]Krueger J. et al.Sleep as a fundamental property of neuronal assemblies.Nat Rev Neurosci. 2008; 9: 910-919Crossref PubMed Scopus (308) Google Scholar,[9]Imeri L. Opp M.R. How (and why) the immune system makes us sleep.Nat Rev Neurosci. 2009; 10: 199-210Crossref PubMed Scopus (493) Google Scholar]. Thus, wake rTMS modulates cortical excitability [[10]Nardone R. et al.Transcranial magnetic stimulation (TMS)/repetitive TMS in mild cognitive impairment and Alzheimer’s disease.Acta Neurol Scand. 2014; 129: 351-366Crossref PubMed Scopus (92) Google Scholar], which is subsequently regulated by an increase in SWA during sleep. It is, however, unknown whether high frequency rTMS potentiates subsequent SWA among older populations. Older adults, particularly those with cognitive complaints, represent a population for which SWA enhancement has therapeutic implications, given the link between SWA and various aspects of cognition and cognitive","journal":"Brain stimulation","year":2024,"id":455497,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":6,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9581,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":279235,"name":"Ahmad Mayeli","orcid":"0000-0002-2084-5559","position":1,"is_corresponding":false},{"id":721776,"name":"Michelle E. Stepan","orcid":"0000-0001-9109-0491","position":2,"is_corresponding":false},{"id":1255221,"name":"Christine W. Peng","orcid":null,"position":3,"is_corresponding":false},{"id":1255218,"name":"Rima F. Habte","orcid":null,"position":4,"is_corresponding":false},{"id":1280076,"name":"Kamakashi Sharma","orcid":null,"position":5,"is_corresponding":false},{"id":1279630,"name":"Sabine A. Janssen","orcid":"0000-0003-1605-6984","position":6,"is_corresponding":false},{"id":1280077,"name":"Savannah L. Applegate","orcid":null,"position":7,"is_corresponding":false},{"id":312681,"name":"Meredith L. Wallace","orcid":"0000-0003-3951-890X","position":8,"is_corresponding":false},{"id":265804,"name":"Daniel J. Buysse","orcid":"0000-0002-3288-1864","position":9,"is_corresponding":false},{"id":476388,"name":"Fabio Ferrarelli","orcid":null,"position":10,"is_corresponding":false},{"id":271298,"name":"Kristine A. Wilckens","orcid":"0000-0002-8273-8476","position":0,"is_corresponding":true}],"reference_count":10,"raw_metadata":null,"created_at":"2026-07-19T02:03:22.974789Z","pmid":"38490473","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}