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Continuous theta burst stimulation over the dorsolateral prefrontal cortex improves force steadiness during submaximal contractions without visual feedback.

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Title: Continuous theta burst stimulation over the dorsolateral prefrontal cortex improves force steadiness during submaximal contractions without visual feedback.
Authors: Okegawa T; Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo., Kaneko N; Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo., Yamasaki D; Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo.; Japan Society for the Promotion of Science, Tokyo, Japan., Nakazawa K; Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo.
Source: Neuroreport [Neuroreport] 2026 Sep 02; Vol. 37 (13), pp. 515-523. Date of Electronic Publication: 2026 Jul 07.
Publication Type: Journal Article; Randomized Controlled Trial
Language: English
Journal Info: Publisher: Lippincott Williams & Wilkins Country of Publication: England NLM ID: 9100935 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1473-558X (Electronic) Linking ISSN: 09594965 NLM ISO Abbreviation: Neuroreport Subsets: MEDLINE
Imprint Name(s): Publication: London, England : Lippincott Williams & Wilkins
Original Publication: Oxford, UK : Rapid Communications of Oxford Ltd., [1990-
MeSH Terms: Dorsolateral Prefrontal Cortex*/physiology , Evoked Potentials, Motor*/physiology , Feedback, Sensory*/physiology , Isometric Contraction*/physiology , Muscle Contraction*/physiology , Transcranial Magnetic Stimulation*/methods, Muscle, Skeletal/physiology ; Prefrontal Cortex/physiology ; Pyramidal Tracts/physiology ; Adult ; Female ; Humans ; Male ; Young Adult ; Electromyography
Abstract: Background: Without visual feedback, the central nervous system must rely on the integration of internal models and proprioceptive information. While the dorsolateral prefrontal cortex (DLPFC) is involved in motor control and sensorimotor monitoring, whether it causally influences force steadiness and whether any such influence is dependent on corticospinal excitability remains unclear.
Objective: This study aimed to investigate whether modulating DLPFC activity using theta burst transcranial stimulation (TBS) influences force steadiness during submaximal contractions performed without visual feedback, and whether this depends on corticospinal excitability.
Methods: Twenty-eight healthy volunteers were randomly assigned to receive either inhibitory continuous TBS (cTBS) or facilitatory intermittent TBS over the left DLPFC. Participants performed a 35% submaximal isometric wrist flexion task without visual feedback. We assessed the submaximal force and its coefficient of variation. Motor evoked potentials (MEPs) and maximal voluntary contraction force were also measured at pre, 15 min, and 30 min poststimulation.
Results: Following cTBS, the coefficient of variation of submaximal force significantly decreased at 15 min poststimulation ( P  = 0.013), indicating improved force steadiness. This improvement occurred without any significant changes in MEP amplitudes, maximal voluntary contraction force, or the mean level of submaximal force production.
Conclusion: Transient inhibition of the left DLPFC may enhance force steadiness without visual feedback. This enhancement was not accompanied by detectable changes in resting corticospinal excitability. These results suggest that the DLPFC contributes to the qualitative stability of motor output, possibly by optimizing sensorimotor integration and mitigating maladaptive monitoring of internal feedback under limited-feedback situations.
(Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved.)
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Grant Information: JPMJSP2108 JST SPRING program; JPMJPR24I5 JST PRESTO program; JPMJMS2012 JST MOONSHOT program
Contributed Indexing: Keywords: dorsolateral prefrontal cortex; force steadiness; theta burst transcranial stimulation
Entry Date(s): Date Created: 20260720 Date Completed: 20260729 Latest Revision: 20260825
Update Code: 20260826
DOI: 10.1097/WNR.0000000000002290
PMID: 42474339
Database: MEDLINE
Description
ISSN:1473-558X
DOI:10.1097/WNR.0000000000002290