The Magstim Conference and Workshop was held in the Examination Schools of Oxford University, on a sunny weekend in early summer. This is a good venue for the meeting, except for people who had been undergraduates at Oxford whose anxiety levels were rising as they stepped into the building where they sat their exams.
The meeting was sponsored by Magstim, a company that makes devices for non-invasive brain stimulation (www.magstim.com). However as in previous years the sponsors left the scientific organisation to an independent committee of researchers: Prof. Vince Walsh (UCL), Dr Charlotte Stagg (Oxford) and Dr Sven Bestmann (UCL). These researchers are at the forefront of the development of brain stimulation as a tool for clinical and research applications, using both of the main methods of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS).
The constituency of the meeting is a wide array of clinical practitioners, physiologists and cognitive neuroscientists, who are positioned on a spectrum of engagement with brain stimulation from people who are developing the use of new forms of stimulation through to people who wish to use brain stimulation as a tool for aiding people with brain injuries. With such a wide field, the organisers of the meeting faced a difficult problem in providing a series of presentations that would appeal to the masses, while being detailed enough to engage the experts. As in previous years, they did so by dividing the presentations into themed sessions split across the two days of the meeting.
The first day opened with the usual housekeeping announcements, including the promise that the audience would be kept informed of any developments in the weekend’s decisive Premiership football matches. This freed the audience to concentrate on the talks.
The first session was entitled “Cognition” and the four speakers introduced topics where brain stimulation can help in understanding the processes that underlie functions such as perceiving faces (David Pitcher, NIMH) or suppressing ongoing actions (Michal Lavidor, Bar Ilan University; Adam Aron, UCSD). Paul Sauseng (University of Surrey) demonstrated the value of alternating current stimulation in modulating performance in a memory task.
In the second session, “Connectivity”, the speakers showed the range of scales at which brain stimulation can be useful. The first speaker (Robert Chen, University of Toronto) highlighted the complex interactions that occur between excitatory and inhibitory circuits within the human motor cortex. The next presentation (Matthew Rushworth, Oxford University) widened the scale to interactions between brain areas, with the possibility that frontal brain areas may tune the activity of early visual areas to enhance detection of specific stimuli. Joseph Galea (UCL) demonstrated the effect of stimulating the cerebellum on other brain areas. The cerebellum is somewhat neglected by brain stimulation researchers due to its relative inaccessibility, however novel methods such as tDCS or patterned TMS may help to establish causal involvement of the cerebellum in functions beyond its traditional motor role. The final speaker of the session (Jenny Crinion, UCL) widened the scope of the session to the use of tDCS to restore functional networks that have been damaged by brain injury. Her research demonstrated that anodal tDCS over Broca’s area can help in restoring speech in people rendered aphasic due to stroke.
The second day opened with the meeting’s keynote lecture from Mark George, Distinguished Professor of Psychiatry, Radiology and Neurosciences at the Medical University of South Carolina. Prof. George’s lecture focused on the use of daily application of TMS for treating depression. This is an area where brain stimulation has shown very promising results, with a projected figure of 12 people per day in the US showing remission from depression following TMS treatment. Prof. George used his own clinical experience to argue for more aggressive application of TMS in each patient, since higher daily doses are associated with a higher chance of remission.
Following the keynote lecture, Charlotte Stagg (Oxford University) introduced a session on “Plasticity and Change”. Yoshkazu Ugawa (Fukushima Medical University) showed how multi-pulse TMS can be used to change the excitability of the motor cortex, with the direction and extent of change depending on the temporal pattern of pulses, the experiments for which required chaining together up to eight Magstim TMS stimulators. By contrast Antonio Oliviero (SESCAM, Spain) followed this talk with a much simper idea: holding a static magnet against the head. He showed that a static magnetic field can reduce motor cortex excitability, which is true whether the North or the South pole is held against the head. Finally Gabrielle Todd (University of South Australia) suggested ways to optimise the effect of TMS in inducing plasticity, with the important message that TMS effects are highly sensitive to parameters of the stimulation, such as stimulation intensity and temporal patterning, and to the state of the brain at the time of the stimulation.
The final session of the meeting was introduced by Vince Walsh in a state of rising tension among the football fans; kick-off was due in the deciding match between Manchester United and Manchester City, with City needing the win to take the Premiership title from United. Fortunately the session on “Clinical Applications” lived up to its promise to engage the audience, with talks on the use of TMS in movement disorders (Mark Edwards, UCL) and emotional and cognitive disorders (Yuping Wang, Beijing; Ysbrand van der Werf, VU University Amsterdam). A final talk by Shirley Fecteau (Laval University) showed the potential of brain stimulation in treating addictive behaviour.
This was the sixth annual meeting on brain stimulation hosted by Magstim. In this time the meeting has become known for the high quality of its research presentations and for the relaxed feel of the poster sessions. Brain stimulation is a field where basic and applied research interacts fruitfully; this meeting has the feel of a place where things happen. We all left with notebooks full of new ideas. And City won with a last-minute goal.