Divergent effects of high-frequency rTMS on cognitive performance in sleep-deprived nurses: An EEG brain network study

IF 3.7 3区医学 Q2 NEUROSCIENCES

Brain Research Bulletin Pub Date : 2026-03-01 Epub Date: 2026-02-09 DOI:10.1016/j.brainresbull.2026.111772

Sujie Wang , Mengru Xu , Linze Qian , Lingyun Gao , Yu Sun

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引用次数: 0

Abstract

Background:

Sleep deprivation (SD) is a common occupational hazard, particularly for shift workers like nurses, leading to significant impairments in cognitive functions such as sustained attention and working memory. High-frequency repetitive transcranial magnetic stimulation (rTMS) is a promising neuromodulation technique for cognitive enhancement, but its effects in sleep-deprived individuals and the underlying neural mechanisms remain poorly understood. This study aimed to investigate the efficacy of high-frequency rTMS over the left dorsolateral prefrontal cortex (DLPFC) in modulating sustained attention and working memory after a night shift and to explore the associated changes in brain network topology.

Methods:

In a within-subject design, 28 healthy female night-shift nurses participated in two experimental sessions after a night of work: one with real 5 Hz rTMS and one with sham rTMS applied to the left DLPFC. Following stimulation, participants performed a psychomotor vigilance task (PVT) and a 2-back task while their electroencephalography (EEG) data were recorded. Behavioral performance (reaction time and accuracy) and subjective fatigue were assessed. Graph theory analysis was applied to the EEG data to evaluate changes in functional brain network topology at both global and nodal levels.

Results:

Real rTMS significantly reduced subjective mental fatigue compared to sham stimulation. However, the behavioral effects were task-dependent. For the 2-back task, real rTMS led to a significant impairment in performance, characterized by slower reaction times and lower accuracy. For the PVT, there was a non-significant trend towards improved performance. These behavioral outcomes were mirrored by distinct patterns of network reorganization. During the PVT, real rTMS induced decreased functional segregation (lower clustering coefficient and local efficiency) in the alpha band. Conversely, during the 2-back task, it resulted in increased functional segregation and small-worldness in the theta band.

Conclusion:

High-frequency rTMS over the left DLPFC exerts differential, task-specific effects on cognitive function in a sleep-deprived state. The impairment in working memory, despite a network configuration theoretically supportive of local processing, likely results from an inverted-U effect, where the rTMS pushed an already strained and compensating brain system past its optimal level of cortical excitability. The findings highlight the critical role of both baseline brain state and specific cognitive demands in determining the outcomes of neuromodulation, providing crucial insights for the targeted application of rTMS to mitigate cognitive deficits from sleep deprivation.

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高频rTMS对睡眠剥夺护士认知表现的发散效应：脑电图脑网络研究。

背景：睡眠剥夺（SD）是一种常见的职业危害，特别是对于轮班工作者，如护士，会导致认知功能的严重损害，如持续注意力和工作记忆。高频重复经颅磁刺激（rTMS）是一种很有前途的认知增强神经调节技术，但其在睡眠剥夺个体中的作用及其潜在的神经机制尚不清楚。本研究旨在探讨高频rTMS对夜班后左背外侧前额叶皮层（DLPFC）持续注意和工作记忆的调节作用，并探讨脑网络拓扑结构的相关变化。方法：采用受试者内设计，28名健康女性夜班护士在夜间工作后参加了两个实验：一个是真实的5 Hz rTMS，另一个是假rTMS，应用于左侧DLPFC。刺激后，参与者执行精神运动警觉性任务（PVT）和双背任务，同时记录他们的脑电图（EEG）数据。评估行为表现（反应时间和准确性）和主观疲劳。图论分析应用于脑电数据，在全局和节点水平上评估脑功能网络拓扑结构的变化。结果：与假刺激相比，真实rTMS显著减轻了主观精神疲劳。然而，行为影响是任务依赖的。对于双背任务，真实的rTMS导致了表现的显著损害，其特征是反应时间较慢，准确性较低。对于PVT，有一个不显著的趋势，以提高性能。这些行为结果反映在不同的网络重组模式上。在PVT过程中，真实rTMS诱导α波段功能分离降低（聚类系数和局部效率降低）。相反，在双背任务中，它导致theta波段的功能分离和小世界性增加。结论：在睡眠剥夺状态下，高频rTMS对左侧DLPFC的认知功能有不同的、任务特异性的影响。尽管网络结构理论上支持局部处理，但工作记忆的损害可能是由倒u效应造成的，即rTMS将已经紧张的大脑系统推向了皮质兴奋性的最佳水平。研究结果强调了基线脑状态和特定认知需求在决定神经调节结果中的关键作用，为有针对性地应用rTMS减轻睡眠剥夺引起的认知缺陷提供了重要见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brain Research Bulletin 医学-神经科学

CiteScore

6.90

自引率

2.60%

发文量

253

审稿时长

67 days

期刊介绍： The Brain Research Bulletin (BRB) aims to publish novel work that advances our knowledge of molecular and cellular mechanisms that underlie neural network properties associated with behavior, cognition and other brain functions during neurodevelopment and in the adult. Although clinical research is out of the Journal''s scope, the BRB also aims to publish translation research that provides insight into biological mechanisms and processes associated with neurodegeneration mechanisms, neurological diseases and neuropsychiatric disorders. The Journal is especially interested in research using novel methodologies, such as optogenetics, multielectrode array recordings and life imaging in wild-type and genetically-modified animal models, with the goal to advance our understanding of how neurons, glia and networks function in vivo.