Open Access Highly Accessed Research article

Continuous theta-burst stimulation modulates tactile synchronization

Kevin GH Lee1, Mark F Jacobs1, Michael J Asmussen1, Christopher M Zapallow1, Mark Tommerdahl3 and Aimee J Nelson12*

Author affiliations

1 Department of Kinesiology, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada

2 Department of Kinesiology, McMaster University, Hamilton, Ontario L8S 4K1, Canada

3 Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27559, USA

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Citation and License

BMC Neuroscience 2013, 14:89  doi:10.1186/1471-2202-14-89

Published: 23 August 2013



Temporal order judgement (TOJ) is the ability to detect the order of occurrence of two sequentially delivered stimuli. Previous research has shown that TOJ in the presence of synchronized periodic conditioning stimuli impairs TOJ performance, and this phenomenon is suggested to be mediated by GABAergic interneurons that cause perceptual binding across the two skin sites. Application of continuous theta-burst repetitive TMS (cTBS) over primary somatosensory cortex (SI) alters temporal and spatial tactile perception. The purpose of this study was to examine TOJ perception in the presence and absence of synchronized periodic conditioning stimuli before and after cTBS applied over left-hemisphere SI. A TOJ task was administered on the right index and middle finger (D2 and D3) in two separate sessions in the presence and absence of conditioning stimuli (a background low amplitude sinusoidal vibration).


CTBS reduced the impact of the conditioning stimuli on TOJ performance for up to 18 minutes following stimulation while sham cTBS did not affect TOJ performance. In contrast, the TOJ task performed in the absence of synchronized conditioning stimulation was unaltered following cTBS.


We conclude that cTBS suppresses inhibitory networks in SI that mediate perceptual binding during TOJ synchronization. CTBS offers one method to suppress cortical excitability in the cortex and potentially benefit clinical populations with altered inhibitory cortical circuits. Additionally, TOJ measures with conditioning stimuli may provide an avenue to assess sensory processing in neurologically impaired patient populations.

Temporal order judgment; Continuous theta-burst TMS; Synchronization effect; Cortical Metrics device; Primary somatosensory cortex; Tactile perception