• Gilbert / Wu Lab Research


    Transcranial Magnetic Stimulation Unit 

    The Transcranial Magnetic Stimulation (TMS) Lab at Cincinnati Children’s is one of the first labs in the country to use TMS technology to study child and adolescent brain function. Our research explores a range of topics related to learning, brain development and coordination of movement.  

    TMS research involves using a hand-sized magnet to temporarily activate or inhibit areas on the surface of the brain. This allows us to measure and study the “excitability” of the brain’s circuits for controlling movements and behaviors.  

    The brain’s control of movement, speech and behavior involves a balance of both excitatory “GO” and inhibitory “STOP” signaling. We have been studying these signals in children and adults with Tourette syndrome and ADHD to learn more about brain development, control and coordination of movement, and disruptive symptoms and behaviors. 

    In addition, TMS allows us to study how the brain learns new skills. Learning new skills and behaviors involves strengthening some brain connections and weakening others, creating new brain signaling patterns. Called “neuroplasticity,”  this adaptation may be important for understanding diseases and recovery. 

    We are also exploring the use of TMS to treat brain diseases. TMS can be used to externally apply energy to the brain and may mimic, or enhance, effects of therapy or practice. TMS pulses may also be able to modify abnormal brain activity linked to some diseases. We are exploring the use of TMS to precisely target areas of abnormal brain activity. 

    Contact Us

    For more information about the TMS unit, contact our research assistant, David Huddleston, BA, at: david.huddleston@cchmc.org.

  • Lab Publications

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    Wu SW, Shahana N, Huddleston DA, Gilbert DL. Effects of 30 Hz Theta Burst Transcranial Magnetic Stimulation on the primary motor cortex. Journal of Neuroscience Methods. 208: 161-164. 2012.

    Wu SW, Gilbert DL, Shahan N, Huddleston DA, Mostofsky SH. Transcranial Magnetic Stimulation Measures in Attention Deficit/Hyperactivity Disorder. Pediatric Neurology. 47: 177-185. Doi: 10.1016/j.pediatricneurol.2012.06.0003. 2012.

    Wu SW, Shahana N, Huddleston DA, Lewis AN, Gilbert DL. Safety and Tolerability of Theta Burst Stimulation in Children. Developmental Medicine and Child Neurology. 54 (7): 636-639. Doi: 10.111/j.1469-8749.2012.04300.x. 2012. 

    Edden RAE, Crocetti D, Zhu H, Gilbert DL, Mostofsky SH. Reduced GABA concentration in Attention Deficit/Hyperactivity Disorder. Archives of General Psychiatry. 69(7): 750-753. 2012. 

    Wu SW, Gilbert DL. Altered neurophysiological response to intermittent theta burst stimulation in Tourette Syndrome. Brain Stimulation. 5(3):315-9. 2012.

    MacNeil LK, Xavier P, Garvey MA, Gilbert DL, Ranta ME, Denckla MB, Mostofsky SH. Quantifying Excessive Mirror Overflow in Children with ADHD. Neurology. 76:622-628. 2011.

    Szaflarski JP, Vannest J, Wu SW, Difrancesco MW, Banks C, Gilbert DL. Excitatory repetitive transcranial magnetic stimulation induces improvements in chronic post-stroke aphasia. Medical Science Monitor. 17(3):CR132-139. 2011.

    Gilbert DL, Isaacs KM, Augusta M, MacNeil LK, Mostofsky SH. Motor Cortex Inhibition: a marker of ADHD Behavior and Motor Development in Children. Neurology. 76:615-621. 2011.

    Klotz JM, Johnson MD, Wu SW, Isaacs KM, Gilbert DL. Relationship between Reaction Time Variability and Motor Skill Development in ADHD. Child Neuropsychology. DOI:10.1080/09297049.2011.625356. 2012; 18(6), 576-585. 2011.

    Gilbert DL, Zhang J, Lipps TD, Natarajan N, Brandyberry J, Wang Z, Sallee FR, Wassermann EM. Atomoxetine Treatment of ADHD in Tourette Syndrome: Reduction in Motor Cortex Inhibition Correlates with Clinical Improvement. Clinical Neurophysiology. 118:1835-1841. 2007.

    Gilbert DL, Wang Z, Sallee FR, Ridel KR, Merhar S, Zhang J, Lipps TD, White C, Badreldin N,Wassermann EM. Dopamine transporter genotype influences the physiological response to medication in ADHD. Brain. 129:2038-2046. 2006.

    Gilbert DL, Ridel KR, Sallee FR, Zhang J, Lipps T, Wassermann EM. Comparison of the inhibitory and excitatory effects of ADHD medications methylphenidate and atomoxetine on motor cortex. Neuropsychopharmacology. 31:442-449. 2006.

    Gilbert DL, Sallee FR, Zhang J, Lipps T, Wassermann EM. Transcranial magnetic stimulation-evoked cortical inhibition: a consistent marker of attention-deficit/hyperactivity disorder scores in tourette syndrome. Biological Psychiatry. 57:1597-1600. 2005.

    Gilbert DL, Bansal AS, Sethuraman G, Huff T, Zhang J, Sallee FR, Wassermann EM. Association of Cortical Disinhibition with tic, ADHD, and OCD Severity in Tourette Syndrome. Movement Disorders. 19:416-425. 2004.

    Gilbert DL, Garvey M, Bansal AS, Huff T, Zhang J, Wassermann EM. Should transcranial magnetic stimulation research in children be considered minimal risk? Clinical Neurophysiology. 18:1730-1739. 2004.

  • Lab Presentations

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    Chen TH, Wu SW, Dixon S, Shahana N, Huddleston DA, Sarvis AM, Sallee FR, Gilbert DL. Motor Cortex Physiology and Stop Signal Reaction Times as Predictors and Correlates of Atomoxetine Responses in Children with ADHD. Presented at the 65th Annual Meeting of the American Academy of Neurology, San Diego, CA, March 21 and 22, 2013.

    Gilbert DL: “Tourette Syndrome: Pathophysiology, Immunology, Neurophysiology, and Pharmacological Treatments.” Tourette Syndrome Association USA Physician Training Retreat. University of Florida, Gainesville, FL, August 17, 2012.

    Sallee FR, Wu SW, Shahana N, Huddleston D, Gilbert DL. Baseline Stop Signal Reaction Times and Motor Cortex Physiology by Atomoxetine Responses in Children with ADHD. Presented at the 59th Annual Meeting of the American Academy of Child and Adolescent Psychiatry, San Diego, CA, October 26, 2012.

    Sallee FR, Wu SW, Shahana N, Huddleston DA, Gilbert DL. Baseline Stop Signal Reaction Times and Motor Cortex Physiology by Atomoxetine Response in Children With ADHD. Presented at the 67th Annual Meeting of the Society of Biological Psychiatry, Philadelphia, PA, May 4, 2012.

    Gilbert DL, Wu S, Shahana N, Huddleston DA, Shiels K, Mostofsky SH. Childhood ADHD Diagnosis, Behaviors, and Motor Overflow Correlate with Slower Inter-Hemispheric Inhibitory Signaling, as Measured with Transcranial Magnetic Stimulation. Presented at the 64th Annual Meeting of the American Academy of Neurology, New Orleans, LA, April 26, 2012.

    Gilbert DL, Shahana N, Huddleston DA, Wu S. The Effects of 30 Hz Theta Burst Stimulation. Presented at the 64th Annual Meeting of the American Academy of Neurology, New Orleans, LA, April 23, 2012.

    Mostofsky SH, Shiels K, Dirlikov B, Gilbert DL. Children with ADHD Show Increased Variability in Sequential Finger Movements. Presented at the 64th Annual Meeting of the American Academy of Neurology, New Orleans, LA, April 26, 2012.

    O’Malley JA, Wu SW, Huddleston DA, Mostofsky S, Gilbert DL. Quantification of Dysrhythmia in Children with ADHD using a Novel Automated Goniometer Method. Presented at the 64th Annual Meeting of the American Academy of Neurology, New Orleans, LA, April 26, 2012.

    Gilbert DL: “Non-Invasive Brain Stimulation in Children: Neurophysiology and Therapeutics of Transcranial Magnetic Stimulation.” Research Symposium Speaker at the 40th Annual Meeting of the Child Neurology Society, Savannah, GA, 27 October 2011.

    Gilbert DL: “What can Motor Cortex teach us about ADHD?” Grand Rounds, New York University Child Study Center, New York, NY, 18 February, 2011.

    Gilbert DL: “TMS evoked Motor Cortex Inhibition as a Biomarker of ADHD Severity and Effects of Methylphenidate and Atomoxetine.” Hot Topics Symposium Speaker, 3rd International Congress on ADHD, Berlin, Germany, 28 May 2011.

    Wu SW, O’Malley JA, Klotz JM, Gilbert DL. Novel automated goniometer quantification of motor speed and dysrhythmia in children with Attention Deficit Hyperactivity Disorder. Presented at the Third International Symposium on Paediatric Movement Disorders, Barcelona, Spain, February 24-25, 2011.

    Szaflarski, JP, Vannest J, Wu SW, DiFrancesco M, Banks C, Gilbert DL. Neuronavigated Excitatory rTMS Induces Improvements in Chronic Post-Stroke Aphasia. Presented at the 63rd Annual Meeting of the American Academy of Neurology; Honolulu, HA, April 14, 2011.

    Crocetti D, MacNeil LK, Gilbert DL, Edden RA, Mostofsky SH. Decreased Motor Cortex GABA in Children with ADHD Using Magnetic Resonance Spectroscopy. Presented at the 17th Annual Meeting of the Organization for Human Brain Mapping, Quebec City, Canada, June 2011

    Wu SW, Shahana N, Huddleston DA, Lewis AN, Gilbert DL. Safety and Tolerability of Theta Burst Stimulation in Children. Presented at the 40th Annual Meeting of the Child Neurology Society, Savannah, GA, 27 October 2011.

    Gilbert DL, Wu S, Michaud LJ, Lewis A, Huddleston D, Mehlman CT. Motor cortex activation requires greater stimulation intensity after neonatal brachial plexus injury. Presented at the XVII International Symposium on Brachial Plexus Surgery, Lisbon, Portugal, 19 May 2011.

    Vannest J, Banks C, Wu S, Gilbert DL, DiFrancesco M, Szaflarski JP. Post-stroke aphasia recovery and excitatory rTMS intervention. Presented at the 16th Annual Meeting of the Organization for Human Brain Mapping, Barcelona, Spain, June 2010.

    Gilbert DL, Isaacs KM, Xavier P, MacNeil L, Lewis AN, Denckla M, Mostofsky SM. In ADHD Children, Motor Subtle Signs Correlate with Reduced Motor Cortex Inhibition.62nd Annual Meeting of the American Academy of Neurology, April 13, 2010; Toronto, Canada.

    Wu SW, Isaacs KM, Gilbert DL. Is Motor System Long-Term Potentiation Normal in Tourette Syndrome? 62nd Annual Meeting of the American Academy of Neurology, April 13, 2010; Toronto, Canada.

    Mostofsky S, Xavier P, MacNeil L, Isaacs K, Lewis A, Denckla M, Gilbert DL. Quantification of Increased Mirror Overflow in ADHD: Laterality and Gender Effects. 62nd Annual Meeting of the American Academy of Neurology, April 14, 2010; Toronto, Canada.

    Klotz J, Johnson MD, Carvalho N, Kao E, Gilbert DL. Motor Signs and Reaction Times Mature More Slowly in ADHD Children. Presented at the 51st Annual National Student Research Forum, Galveston, TX, April 22-23, 2010.

    Gilbert DL.  Physiology of Motor Control in Tourette Syndrome. Symposium at 2009 Child Neurology Society Annual Meeting, October 15, 2009; Louisville, KY.

    Gilbert, DL. Transcranial Magnetic Stimulation Research. Visiting Professor; Pediatric Neurology Symposium, University of Alberta, January 15-16, 2009; Alberta, Canada.

    Wu SW, Isaacs KM, Gilbert DL. Is Motor System Long-Term Potentiation Normal in Tourette Syndrome? Presented at the 5th International Scientific Symposium on Tourette Syndrome, New York, NY, June 11-13, 2009.