Annual Survey of Electroconvulsive Therapy Practice in Serbia

s / Brain Stimulation 8 (2015) 395e411 409 Method: We studied 8 healthy subjects while they performed a spatial attention task in the scanner with an MRI-compatible TMS coil placed over the right parietal cortex. The task involved 5 different conditions during which subjects covertly attended to the left or right, attended to the left or right while receiving TMS, or received TMS at rest. We studied intrinsic compensatory strategies by comparing the “pathological condition” (attending under the influence of TMS) to the “healthy condition” (attending without TMS) and controlling for the effects of TMS at rest. Results: Wedescribe a bilateral pattern of activatory and inhibitory changes within the attentional network, revealing a circuit-wide adaptive strategy to maintain functional competence despite the “virtual” TMS lesion. The analysis of the areas of maximum significance identifies a contralesional focus of parietal inhibition, which suggests a possible therapeutic target for neglect rehabilitation in line with current neurorehabilitation protocols. Conclusions: These data reveal the potential of the simultaneous combination of TMS-fMRI to study connectivity and plasticity in a translational framework. We suggest pathophysiological mechanisms of functional recovery and a therapeutic roadmap for functional rehabilitation of structural lesions. This approach could be used to study other neuropsychiatric disorders, due to structural or functional lesions.