***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In open trials , 1-Hz repetitive transcranial magnetic stimulation ( rTMS ) to the supplementary motor area ( SMA ) improved symptoms and normalized cortical hyper-excitability of patients with obsessive-compulsive disorder ( OCD ) . Here we present the results of a r and omized sham-controlled double-blind study . Medication-resistant OCD patients ( n=21 ) were assigned 4 wk either active or sham rTMS to the SMA bilaterally . rTMS parameters consisted of 1200 pulses/d , at 1 Hz and 100 % of motor threshold ( MT ) . Eighteen patients completed the study . Response to treatment was defined as a > or = 25 % decrease on the Yale-Brown Obsessive Compulsive Scale ( YBOCS ) . Non-responders to sham and responders to active or sham rTMS were offered four additional weeks of open active rTMS . After 4 wk , the response rate in the completer sample was 67 % ( 6/9 ) with active and 22 % ( 2/9 ) with sham rTMS . At 4 wk , patients receiving active rTMS showed on average a 25 % reduction in the YBOCS compared to a 12 % reduction in those receiving sham . In those who received 8-wk active rTMS , OCD symptoms improved from 28.2+/-5.8 to 14.5+/-3.6 . In patients r and omized to active rTMS , MT measures on the right hemisphere increased significantly over time . At the end of 4-wk rTMS the abnormal hemispheric laterality found in the group r and omized to active rTMS normalized . The results of the first r and omized sham-controlled trial of SMA stimulation in the treatment of resistant OCD support further investigation into the potential therapeutic applications of rTMS in this disabling condition HighlightsThe rIFG have been suggested its crucial role in impulsivity by inhibitory rTMS.No excitatory rTMS studies have been conducted at rIFG to examine impulsivity . Negative findings from excitatory rTMS at rIFG across motor/cognitive impulsivity . The role of rIFG in impulsivity may require further examinations . Background : Impulsivity is a multi‐faceted concept . It is a crucial feature of many neuropsychiatric disorders . Three subtypes of impulsivity have been identified : motor , temporal , and cognitive impulsivity . Existing evidence suggests that the right inferior frontal gyrus ( rIFG ) plays a crucial role in impulsivity , and such a role has been eluci date d using inhibitory repetitive transcranial magnetic stimulation ( rTMS ) . There is a dearth of studies using excitatory rTMS at the rIFG , an important gap in the literature this study aim ed to address . Methods : Twenty healthy male adults completed a single‐blind sham‐controlled r and omised crossover study aim ed at assessing the efficacy of rTMS in the neuromodulation of impulsivity . This involved delivering 10‐Hz excitatory rTMS to the rIFG at the intensity of 100 % motor threshold with 900 pulses per session . Trait impulsivity was measured at baseline using the Barrett Impulsiveness Scale and UPPS‐P Impulsiveness Scale . The Stop Signal Task ( SST ) and Information Sampling Task ( IST ) , administered before and after rTMS sessions , were used as behavioural measures of impulsivity . Results : No significant changes on any measures from either SST or IST after active rTMS at the rIFG compared to the sham‐controlled condition were found . Conclusions : Excitatory rTMS applied to the rIFG did not have a statistically significant effect on response inhibition and reflective/cognitive impulsivity . Further research is required before drawing firm conclusions . This may involve a larger sample of highly impulsive individuals , a different stimulation site or a different TMS modality such as theta burst stimulation Objective . To investigate the safety and efficacy of 50-Hz repetitive transcranial magnetic stimulation ( rTMS ) in the treatment of motor symptoms in  Parkinson disease ( PD ) . Background . Progression of PD is characterized by the emergence of motor deficits that gradually respond less to dopaminergic therapy . rTMS has shown promising results in improving gait , a major cause of disability , and may provide a therapeutic alternative . Prior controlled studies suggest that an increase in stimulation frequency might enhance therapeutic efficacy . Methods . In this r and omized , double blind , sham-controlled study , the authors investigated the safety and efficacy of 50-Hz rTMS of the motor cortices in 8 sessions over 2 weeks . Assessment of safety and clinical efficacy over a 1-month period included timed tests of gait and bradykinesia , Unified Parkinson ’s Disease Rating Scale ( UPDRS ) , and additional clinical , neurophysiological , and neuropsychological parameters . In addition , the safety of 50-Hz rTMS was tested with electromyography-electroencephalogram ( EMG-EEG ) monitoring during and after stimulation . Results . The authors investigated 26 patients with mild to moderate PD : 13 received 50-Hz rTMS and 13 sham stimulation . The 50-Hz rTMS did not improve gait , bradykinesia , and global and motor UPDRS , but there appeared a short-lived “ on”-state improvement in activities of daily living ( UPDRS II ) . The 50-Hz rTMS lengthened the cortical silent period , but other neurophysiological and neuropsychological measures remained unchanged . EMG/EEG recorded no pathological increase of cortical excitability or epileptic activity . There were no adverse effects . Conclusion . It appears that 50-Hz rTMS of the motor cortices is safe , but it fails to improve motor performance and functional status in PD . Prolonged stimulation or other techniques with rTMS might be more efficacious but need to be established in future research Previous evidence suggests that high-frequency repetitive transcranial magnetic stimulation ( HF-rTMS ) improves inhibitory control in healthy young adults . Little is known as to whether HF-rTMS would show similar facilitation effects in older adults undergoing normal aging . We recruited 16 healthy elderly adults and r and omly assigned them to either a 10 Hz HF-rTMS or sham stimulation group . Five daily stimulation sessions over the left dorsolateral prefrontal cortex were given to each participant . Changes in inhibitory control were assessed using a modified Stroop task . Participants performed the Stroop task twice , 1 day before and after the five daily stimulations . We found that participants in the active HF-rTMS stimulation group showed improved performance in reaction time during incongruent trials ( i.e. those with distracting information ) after HF-rTMS treatment compared with pre-treatment trials . To the best of our knowledge , this study is one of the first studies demonstrating that daily HF-rTMS can improve attentional control in normally aging individuals It has been 30 years since the discovery that repeated electrical stimulation of neural pathways can lead to long-term potentiation in hippocampal slices . With its relevance to processes such as learning and memory , the technique has produced a vast literature on mechanisms of synaptic plasticity in animal models . To date , the most promising method for transferring these methods to humans is repetitive transcranial magnetic stimulation ( rTMS ) , a noninvasive method of stimulating neural pathways in the brain of conscious subjects through the intact scalp . However , effects on synaptic plasticity reported are often weak , highly variable between individuals , and rarely last longer than 30 min . Here we describe a very rapid method of conditioning the human motor cortex using rTMS that produces a controllable , consistent , long-lasting , and powerful effect on motor cortex physiology and behavior after an application period of only 20 - 190 In a double-blind , controlled study , we examined the therapeutic effects of high-frequency left prefrontal repetitive transcranial magnetic stimulation ( rTMS ) on schizophrenia symptoms . A total of 22 chronic hospitalized schizophrenia patients were r and omly assigned to 2 weeks ( 10 sessions ) of real or sham rTMS . rTMS was given with the following parameters : 20 trains of 5-second 10-Hz stimulation at 100 percent motor threshold , 30 seconds apart . Effects on positive and negative symptoms , self-reported symptoms , rough neuropsychological functioning , and hormones were assessed . Although there was a significant improvement in both groups in most of the symptom measures , no real differences were found between the groups . A decrease of more than 20 percent in the total PANSS score was found in 7 control subjects but only 1 subject from the real rTMS group . There was no change in hormone levels or neuropsychological functioning , measured by the MMSE , in either group . Left prefrontal rTMS ( with the used parameters ) seems to produce a significant nonspecific effect of the treatment procedure but no therapeutic effect in the most chronic and severely ill schizophrenia patients Repetitive transcranial magnetic stimulation ( rTMS ) has been developed as a novel tool for modulating cognition by delivering stimulation in the brain . However , the effects of rTMS on cognition are still controversial . This r and omized , sham-controlled , crossover study was design ed to determine whether rTMS of the left dorsolateral prefrontal cortex ( DLPFC ) interferes with the Go/NoGo task and whether personal parameters such as age affect rTMS . A total of 24 healthy subjects ( 12 male and 12 female , aged 20 - 37 years ) underwent one session of active rTMS followed by sham rTMS ( total of 1600 pulses , 100 % of motor threshold , 5 Hz , 8 s ) , or vice versa . The results did not show any differences between active and sham rTMS stimulation in terms of performance accuracy , response speed , or choice reaction time ( cRT ) implicating that short-term rTMS will not enhance or deteriorate cognition . However , percentage cRT shortening induced by active rTMS was negatively correlated with age ( r = -0.57 , P = 0.005 ) , whereas that induced by sham rTMS was not ( r = -0.23 , P > 0.05 ) , suggesting that cognition of younger subjects might have greater modulation by active stimulation than older ones . This finding may help explain some of the controversies or paradoxical results observed in studies of the effect of left DLPFC rTMS on cognition A 14-min continuous performance test ( CPT ) requiring a high rate of responding was administered to a probability-weighted r and om sample of 816 9–17-year-old children drawn from a population of 17,117 children in an ongoing epidemiological and longitudinal study in Western North Carolina . Systematic main effects of improved performance with older age were found in this age range for all variables , including reaction time ( RT ) , RT st and ard error , errors of omission , errors of commission , and signal detection parameters ( d ' and β ) . Significant gender main effects included more impulsive errors , less variability , and faster RT by males , with no interactions between age and gender . There were no main effects of ethnicity or interactions of ethnicity with age and /or gender . Large main effects of interstimulus interval ( ISI ; 1 , 2 , or 4-s intervals ) and time block were present for most CPT performance measures . The normative data from the CPT should provide a useful framework for interpreting similar data in future studies of child and adolescent psychopathology BACKGROUND Because st and ard repetitive transcranial magnetic stimulation ( rTMS ) protocol s exhibit post-stimulus effects of short duration , novel protocol s such as theta burst stimulation ( TBS ) , are promising approaches to enhance the effectiveness of rTMS .  However , little is known about the side effect profile of such protocol s. Thus , the present study explores whether TBS is safe particularly in terms of effects on cognition , mood , and electroencephalogram ( EEG ) measures in healthy subjects . METHODS Twenty-four healthy volunteers participated in 2 r and omized , placebo-controlled , cross-over experiments and underwent continuous TBS ( cTBS ) , intermittent TBS ( iTBS ) , and shamTBS either over the left dorsolateral prefrontal cortex ( DLPFC , n = 12 ) or the medial prefrontal cortices ( mPFC , n = 12 ) . Clinical side effects , performance in a neuropsychological battery , mood changes , and resting EEG were recorded . RESULTS Neither a seizure nor epileptiform EEG activity was observed . The most prominent side effect was the occurrence of vagal reactions during TBS ; otherwise no serious side effects were found . St and ardized low-resolution brain electromagnetic tomography showed current density changes in the alpha2 b and after iTBS of the DLPFC , which remained detectable up to 50 min after stimulation . The few changes in neuropsychological performance were concordant with stimulation site . No impact on mood was detected . CONCLUSIONS Although TBS protocol s of the human prefrontal cortex seem to be safe in healthy subjects , future studies need to address the occurrence of vagal reactions . Excitatory and inhibitory properties of motor cortex TBS might not be transferable to prefrontal sites , and the action of specific TBS protocol s needs to be further investigated prior to clinical application Objectives Prior research has demonstrated that executive function ( EF ) strength is positively associated with dietary self-control . As such , the differential operation of the brain centers underlying EFs ( i.e. , dorsolateral prefrontal cortex [ DLPFC ] ) may explain controlled aspects of dietary self-control . The present study was design ed to examine the causal relationship between DLPFC function and two aspects of dietary self 
    Output:
    
Subgroup analyses ( e.g. , excitatory vs. inhibitory rTMS , conventional rTMS vs. theta burst stimulation , analyses by stimulation sites , and type of outcome measure used ) identified key parameters associated with the effects of rTMS on motor and temporal impulsivity .
Age , sex , stimulation intensity and the number of pulses were not significant moderators for effects of rTMS on motor impulsivity .
Due to lack of sufficient data to inform a meta- analysis , it has not been possible to assess the effects of rTMS on reflection impulsivity .
The present findings provide preliminary evidence that rTMS can be used to modulate motor and temporal impulsivity in healthy individuals .