Functional lesions and human action monitoring: Combining repetitive transcranial magnetic stimulation and event-related brain potentials

Objective: Electrophysiological recordings of the error-related negativity (ERN) and functional imaging data point to an involvement of medial frontal cortex (including the anterior cingulate cortex, ACC) and dorsolateral prefrontal cortex (DLPFC) in the detection and correction of performance errors. Here, we studied this network by applying trains of rapid transcranial magnetic stimulation (rTMS) prior to the recording of the ERN. Methods: Low-frequency (0.9 Hz) rTMS was applied to medial frontal or lateral frontal regions (different sessions) for 60 s immediately before each 3 min ERN recording in 11 healthy young subjects. The ERN was obtained by multichannel recordings in a typical Eriksen flanker task with instructions calling for immediate error correction in case a performance error was detected by the subject. Event-related potentials were quantified and statistically evaluated using standard methodology. Results: Compared to a no-stimulation control condition, medial frontal stimulation led to a small but reliable decrease in the number of corrected errors as well as to an attenuation of the ERN and an increase of the subsequent error-positivity (Pe). No effect on these components was seen after lateral frontal stimulation. No reliable effects on the lateralized readiness potential were observed. Conclusions: Functional lesions by rTMS appear to interfere with the functions of the medial frontal cortex in error detection and correction.