# Cognitive and Neural Correlates of TMS Motor Intracortical Inhibition in Schizophrenia

> **NIH NIH K01** · UNIVERSITY OF MARYLAND BALTIMORE · 2024 · $177,866

## Abstract

Project Summary: This K01 application is designed to prepare the applicant to become a successful,
independent investigator combining state of the art neuroimaging methods and transcranial magnetic
stimulation (TMS) to elucidate the neural circuits that underlie specific signs and symptoms of schizophrenia
(Sz), and using repetitive TMS as an intervention to attempt to normalize circuit function. To achieve this
career objective, I have worked with my mentoring/advisory committee to develop a plan to receive training in:
(1) TMS application, data analysis and how to design TMS studies, (2) clinical trial study design and
implementation, and (3) cognitive neuroscience including circuitry of specific cognitive domains and cognitive
impairment(s) in Sz. The short interval intracortical inhibition (SICI) is a biomarker of cortical excitability that
can be easily obtained with non-invasive paired-pulse TMS. Intracortical inhibition is consistently reduced in
prior studies of Sz (indicated by higher SICI scores in Sz). The overall goal of the proposed K01 research is to
evaluate the broader significance and clinical impact of reduced SICI in Sz, and evaluate whether repetitive
TMS can enhance SICI in Sz. The proposed research is important because it will help determine whether SICI
may serve as a meaningful target for future intervention studies and clinical trials. The specific aims are to: (1)
determine the specificity of relationships between SICI and different cognitive domains in Sz; (2) determine the
relationship between SICI and brain functional communication in Sz; and (3) perform a pilot mechanistic
repetitive TMS clinical trial targeting motor cortex of Sz patients to evaluate whether repetitive TMS can
enhance SICI in Sz. Aim 1 will combine use of paired-pulse TMS (to measure SICI) and in-depth cognitive
assessment to test the hypothesis that reduced inhibition (indexed by higher SICI score) in Sz will be
associated with poorer motor inhibition (Stop-Signal) task performance, and will generalize to spatial working
memory performance, which is thought to be sensitive to the same type of excitatory/inhibitory signaling
imbalance that is assayed by SICI. Aim 2 will combine use of paired-pulse TMS (to measure SICI) and resting
functional magnetic resonance imaging (fMRI) to test the hypothesis that reduced inhibition (indexed by higher
SICI score) in Sz is associated with lower resting connectivity between the anterior insula and both the motor
cortex and the dorsolateral-prefrontal cortex. Aim 3 will use inhibitory 1Hz repetitive TMS applied to motor
cortex of a sample of participants with Sz (N=17 active TMS, N=17 sham TMS) to evaluate whether five
sessions of active repetitive TMS can enhance SICI in Sz relative to sham stimulation. The proposed research
combines several quantitative approaches/assessments (cognitive assessment, fMRI, paired-pulse TMS, and
repetitive TMS) to better understand the underlying neurophysiology of Sz and its relat...

## Key facts

- **NIH application ID:** 10806699
- **Project number:** 1K01MH133116-01A1
- **Recipient organization:** UNIVERSITY OF MARYLAND BALTIMORE
- **Principal Investigator:** Stephanie Hare
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $177,866
- **Award type:** 1
- **Project period:** 2024-05-01 → 2029-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10806699

## Citation

> US National Institutes of Health, RePORTER application 10806699, Cognitive and Neural Correlates of TMS Motor Intracortical Inhibition in Schizophrenia (1K01MH133116-01A1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10806699. Licensed CC0.

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