# Can learning be facilitated by transcranial magnetic stimulation?

I read a book a while ago called The Brain that Changes Itself by Norman Doidge (2007), and it brought to my attention a machine known as a transcranial magnetic stimulator (TMS) which can noninvasively excite neurons in someone's brain. Doidge mentioned an experiment that used TMS to excite the neurons in patients' pleasure centers, which caused them so much enjoyment that some actually begged the researchers to do it again.

I have also learned about PTSD (posttraumatic stress disorder) and how it happens when overly excited neurons are firing, creating a strong memory.

What if the TMS was made to excite the part of the brain that stores memory (the amygdala I believe) in a fashion similar to PTSD's inadvertently created states, and during the hyper-excited state, the subject was given accurate information to memorize? I specify "accurate" because whatever would be learned or observed in this state would be powerfully etched into memory.

I am not a neuroscientist, so please give answers in layman's terms.

I would like to know if it is possible, what the mechanism would be that would allow us to experience improved learning and what the possible side effects would be.

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All I happen to know on the topic is that the hippocampus plays a big role in memory encoding, but memories are stored in more complex ways throughout the cerebrum. The amygdala is very important for emotional processes, and seems to accentuate encoding of memories and info from particularly emotional episodes...but I don't know that it does the storing itself. I have a feeling that stimulating it would cause an emotionally haywire state, and maybe affect encoding indirectly. Also, TMS may have trouble reaching such deep parts of the brain as the limbic system; maybe it's achievable though! –  Nick Stauner Feb 5 at 19:52
@NickStauner I believe the limbic brain can be stimulated with TMS because in the book they had an experiments where the TMS was directed at the pleasure center of participants--this is in the limbic brain, no? If it could somehow be controlled to simulate a powerful positive experience while a participant is being feed knowledge, I would think that the participant would have a powerfully engrained memory of the knowledge that was feed to them and more over if it was a pleasurable experience, the patient may be inadvertently conditioned to enjoy that memory. Perhaps... –  Klik Feb 5 at 20:12
I happened to attend a psychopharmacology lecture two days ago that pointed to the nucleus accumbens as a neuroanatomical "pleasure center." The ventral tegmental area seems to be almost as important to the reinforcement system too. Both are components of the mesolimbic pathway, so yes, that does seem to suggest the accessibility of deeper structures to TMS. Cool! I like your hypothesis too, and would be happy (pun intended) to sign up for such an experiment :D –  Nick Stauner Feb 5 at 20:28
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## 1 Answer

Sadly (or should I be happy that Google is this awesome? Not to mention the rate of scientific progress!), all I really had to do to come up with an answer was perform a Google search for "learning transcranial magnetic stimulation". The first hit, a ScienceDaily page (Ruhr-University Bochum, 2011) page, lists some journal references (Mix, Benali, Eysel, & Funke, 2010; Benali et al., 2011) that effectively say (in laymen's terms), "Yes!" Here's ScienceDaily's summary (I'll let you read the rest at the source):

What sounds like science fiction is actually possible: thanks to magnetic stimulation, the activity of certain brain nerve cells can be deliberately influenced. What happens in the brain in this context has been unclear up to now. Medical experts have now shown that various stimulus patterns changed the activity of distinct neuronal cell types. In addition, certain stimulus patterns led to rats learning more easily. [Emphasis added.]

To show how hard I'm working to really earn that bounty of yours, here's the summary from the second Google hit, a review article on this very topic (Reis et al., 2008; again, plenty more info at the source):

In summary, the scarce studies performed so far point to the encouraging conclusion that noninvasive brain stimulation can contribute to the understanding of mechanisms underlying motor learning and motor memory formation and raise the exciting hypothesis that this increased understanding could in the future result in the development of new strategies to enhance specific stages of learning and memory processing in healthy humans and in patients with brain lesions (see chapter by Gerloff et al.). [Gerloff et al. doesn't appear in the references; emphasis added.]

Edit: I see from your comment that you want me to explain the mechanism. Since you offer a bounty, I'll play along and dance for it a bit. Here's another excerpt from Reis and colleagues (2008, page 6 of 16):

It would be theoretically possible to facilitate motor learning processes in which [the primary motor cortex] is involved by enhancing excitability in the “learning” [primary motor cortex (Pascual–Leone, Valls–Solé, Wassermann, & Hallett, 1994)] or by decreasing excitability in the “resting” [primary motor cortex (Schambra, Sawaki, & Cohen, 2003; Plewnia, Lotze, & Gerloff, 2003)], but see also Wassermann[, Wedegaertner, Ziemann, George, & Chen (1998)]. The intrinsic intracortical mechanisms by which these oversimplified models may operate remain to be identified ([Perez & Cohen, 2008; Daskalakis, Paradiso, Christensen, Fitzgerald, Gunraj, & Chen, 2004; Koch, Franca, Mochizuki, Marconi, Caltagirone, & Rothwell, 2007;] see for discussion chapters by Walsh et al., Di Lazzaro et al., Berardelli et al.). [References unavailable for these three discussion chapters; emphasis added.]

You may want to read the review further for yourself or ask follow-up questions if this is an unsatisfactory explanation of the mechanism.

Since that review was a little hesitant to conclude conclusively, and it's five years old now, I'll also throw in a brand-new bit of original research (Wall et al., 2013) that demonstrates the supportive trend continues:

Conclusion: These preliminary findings suggest rTMS does not adversely impact neurocognitive functioning in adolescents and may provide subtle enhancement of verbal memory as measured by the CAVLT. Further controlled investigations with larger sample sizes and rigorous trial designs are warranted to confirm and extend these findings. [Emphasis added.]

$\uparrow$ That $\uparrow$ was the fifth Google hit! Also, the seventh (Jelić et al., 2013) says it's not a placebo effect!

Going a little wide, transcranial direct current stimulation (which is somewhat different from magnetic stimulation, though maybe not in ways that concern you) works too (Fields, 2011; Kincses, Antal, Nitsche, Bártfai, & Paulus, 2004; Fregni et al., 2005; Nitsche et al., 2003; Ohn et al., 2008; Flöel, Rösser, Michka, Knecht, & Breitenstein, 2008; Chi & Snyder, 2012)—you can even try it yourself for \$249 or £179! I just had to follow a few links from the 14th Google hit (Mims, 2012) to find all that. I'm a little shocked (pardon the pun) at how legit this actually seems...

Also (16th Google hit), it looks like the U.S. National Institutes of Health Clinical Center is currently recruiting participants for their study, "The Effect of Transcranial Magnetic Stimulation on Learning With Reward in Healthy Humans", so maybe you could even get Uncle Sam to pay you (for testing magnetic, not electrical stimulation)! However, if I'm reading that right, it's a study of learning disruption, which is another potential (and maybe not-so-desirable) application of TMS, according to the 18th hit (De Weerd et al., 2012).

Edit: Reis and colleagues (2008) also review this disruptive process somewhat; I get the impression that disruption is much easier than enhancement to achieve with magnetic stimulation (not sure whether this applies to direct electrical current as well). It seems TMS has been used mostly to knock out brain function temporarily in localized areas to simulate the effects of brain lesions. Use of TMS to enhance excitability rather than inhibit it seems to be the more recent innovation, and maybe a separable effect (i.e., it may be possible to excite the brain using TMS without causing inhibition).

In anticipation of the next question, "Is it safe?" I feel I should add that this is definitely not my area of expertise – I got a B- in biopsych as an undergrad – so again, I'll let the experts speak for themselves (Poreisz, Boros, Antal, & Paulus, 2007), but as a fan of dystopian sci-fi, I will at least say that the short-term dangers seem like they could've been much worse! Same for the ethical ramifications, more or less (Hamilton, Messing, & Chatterjee, 2011). It's reassuring to see so much thought going into this already; I might otherwise be worried about how far behind the times we seem to be here! BTW, these last revelations come thanks in part to the 33rd Google hit (Oremus, 2013). I'm afraid no amount of tDCS will allow us to keep up with Google...

P.S. From what I've seen in skimming some of these, it doesn't have anything in particular to do with the limbic system (which includes the amygdala). I saw a brief explanation suggesting it affects myelination, which is basically the process by which the brain speeds up electrical signal transmission. Myelin is a sort of segmented coating for the axons of neurons, which can be quite long individually. Myelin allows electrical signals (action potentials) to jump across myelinated segments quickly, rather than propagating relatively slowly across every millimeter in the normal fashion. I also saw some indication that transcranial electromagnetic (didn't note which) stimulation might speed up other aspects of neural construction, such as the rate at which connections form (not just the rate at which they upgrade from the neural equivalents of a dial-up modem to fiber-optic).

References

Benali, A., Trippe, J., Weiler, E., Mix, A., Petrasch–Parwez, E., Girzalsky, W., ... & Funke, K. (2011). Theta-burst transcranial magnetic stimulation alters cortical inhibition. The Journal of Neuroscience, 31(4), 1193–1203.
Boggio, P. S., Ferrucci, R., Rigonatti, S. P., Covre, P., Nitsche, M., Pascual–Leone, A., & Fregni, F. (2006). Effects of transcranial direct current stimulation on working memory in patients with Parkinson's disease. Journal of the Neurological Sciences, 249(1), 31–38. Retrieved from http://www.tmslab.org/publications/154.pdf.
Chi, R. P., & Snyder, A. W. (2012). Brain stimulation enables the solution of an inherently difficult problem. Neuroscience Letters, 515(2), 121–124. Retrieved from http://ingienous.com/wp-content/uploads/2012/05/snyder-9-dots-paper.pdf.
Daskalakis, Z. J., Paradiso, G. O., Christensen, B. K., Fitzgerald, Gunraj, & Chen. (2004). Exploring the connectivity between the cerebellum and motor cortex in humans. Journal of Physiology, 557, 689–700. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1665103/.
De Weerd, P., Reithler, J., van de Ven, V., Been, M., Jacobs, C., & Sack, A. T. (2012). Posttraining transcranial magnetic stimulation of striate cortex disrupts consolidation early in visual skill learning. The Journal of Neuroscience, 32(6), 1981–1988. Retrieved from http://www.jneurosci.org/content/32/6/1981.long.
Fields, R. D. (2011, November 25). Amping up brain function: Transcranial stimulation shows promise in speeding up learning. Scientific American: Mind & Brain. Retrieved from http://www.scientificamerican.com/article/amping-up-brain-function/.
Flöel, A., Rösser, N., Michka, O., Knecht, S., & Breitenstein, C. (2008). Noninvasive brain stimulation improves language learning. Journal of Cognitive Neuroscience, 20(8), 1415–1422. Retrieved from http://www.researchgate.net/publication/5548486_Noninvasive_brain_stimulation_improves_language_learning/file/5046351db1c615613a.pdf.
Fregni, F., Boggio, P. S., Nitsche, M., Bermpohl, F., Antal, A., Feredoes, E., ... & Pascual–Leone, A. (2005). Anodal transcranial direct current stimulation of prefrontal cortex enhances working memory. Experimental Brain Research, 166(1), 23–30. Retrieved from http://www.researchgate.net/publication/7745540_Anodal_transcranial_direct_current_stimulation_of_prefrontal_cortex_enhances_working_memory/file/9fcfd50a3483033595.pdf.
Hamilton, R., Messing, S., & Chatterjee, A. (2011). Rethinking the thinking cap Ethics of neural enhancement using noninvasive brain stimulation. Neurology, 76(2), 187–193. Retrieved from http://wernicke.ccn.upenn.edu/~chatterjee/anjan_pdfs/Neurology_2011_HamiltonMessing_Chatterjee.pdf.
Jelić, M. B., Stevanović, V. B., Milanović, S. D., Ljubisavljević, M. R., & Filipović, S. R. (2013). Transcranial magnetic stimulation has no placebo effect on motor learning. Clinical Neurophysiology, 124(8). 1646–1651.
Kincses, T. Z., Antal, A., Nitsche, M. A., Bártfai, O., & Paulus, W. (2004). Facilitation of probabilistic classification learning by transcranial direct current stimulation of the prefrontal cortex in the human. Neuropsychologia, 42(1), 113–117. Retrieved from http://www.researchgate.net/publication/9011312_Facilitation_of_probabilistic_classification_learning_by_transcranial_direct_current_stimulation_of_the_prefrontal_cortex_in_the_human/file/d912f50597d44df446.pdf.
Koch, G., Franca, M., Mochizuki, H., Marconi, Caltagirone, & Rothwell. (2007). Interactions between pairs of transcranial magnetic stimuli over the human left dorsal premotor cortex differ from those seen in primary motor cortex. Journal of Physiology, 578, 551–562. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2075160/.
Mims, C. (2012, March 8). DIY kit overclocks your brain with direct current. Technology Review: View. Retrieved from http://www.technologyreview.com/view/427177/diy-kit-overclocks-your-brain-with-direct-current/.
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Nitsche, M. A., Schauenburg, A., Lang, N., Liebetanz, D., Exner, C., Paulus, W., & Tergau, F. (2003). Facilitation of implicit motor learning by weak transcranial direct current stimulation of the primary motor cortex in the human. Journal of Cognitive Neuroscience, 15(4), 619–626. Retrieved from http://www.researchgate.net/publication/10710628_Facilitation_of_implicit_motor_learning_by_weak_transcranial_direct_current_stimulation_of_the_primary_motor_cortex_in_the_human/file/79e4150ae2024da0f0.pdf.
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Reis, J., Robertson, E. M., Krakauer, J. W., Rothwell, J., Marshall, L., Gerloff, C., ... & Cohen, L. G. (2008). Consensus: Can transcranial direct current stimulation and transcranial magnetic stimulation enhance motor learning and memory formation?. Brain Stimulation, 1(4), 363–369. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2621080/.
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Please note that TMS and tDCS are completely different methods that should not be mixed up like you did in your answer. –  H.Muster Feb 11 at 16:41
@NickStauner I enjoyed reading your answer very much. You included sources and put a good amount of effort into the answer. Since it is relevant to the question, could you please elaborate on the possible negative consequence of TMS that you mentioned (learning disruption) and could you include a detailed description of how the mechanism of one method (it appears there are many) of how learning can be facilitated by TMS. Thank you for bringing the tDCS to my attention--the device leaves me skeptical, but perhaps it works. If you do these things, I will mark as the answer. –  Klik Feb 11 at 19:33
Glad you liked it! I'm hesitant to elaborate where I've included hyperlinks to the original, freely available, full text itself, but mostly because I don't see the details as directly relevant to the OP as you've worded it. I'll do it anyway, since it's easy enough, but you might also want to edit your interest in negative consequences into the OP too. Also, TBH, I've answered your title question directly, but not so much the question about stimulating the amygdala. FWIW, that route seems unnecessary given the evident efficacy of cortical electromagnetic stimulation, but it might work too... –  Nick Stauner Feb 11 at 19:56
@NickStauner: With mixing up, I referred to the following. In the paragraph starting with "Going a little wide..." you wrote about tDCS, in the next paragraph ("Also (16th Google hit)...") about TMS, in the next ("In anticipation of the next") about both tDCS and TMS again. Apart from the fact that both TMS and tDCS are methods of non-invasive brain stimulation, they have not much in common since the underlying principles are very different and so are the risks of the methods. Judging from what I have read so far, review papers that refer to both methods make this distinction quite clear. –  H.Muster Feb 11 at 20:03
@NickStauner You did a good job I'll give you the answer. As for the amygdala that was commented on before. I am not sure exactly how the mechanism of the brain works to create PTSD, but I know the amygdala and limbic brain is involved. My thought was to mimic the mechanism that creates PTSD, but in a positive manner and for learning. Since I don't fully understand how the TMS works, I wouldn't know what would need to be stimulated, but I still believe it is possible to simulate the PTSD mechanism for learning. This answer has given me hope that we are in the right direction. –  Klik Feb 12 at 2:18
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