101
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Mutz J, Edgcumbe DR, Brunoni AR, Fu CH. Efficacy and acceptability of non-invasive brain stimulation for the treatment of adult unipolar and bipolar depression: A systematic review and meta-analysis of randomised sham-controlled trials. Neurosci Biobehav Rev 2018; 92:291-303. [DOI: 10.1016/j.neubiorev.2018.05.015] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 04/30/2018] [Accepted: 05/09/2018] [Indexed: 12/15/2022]
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102
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Effects of prefrontal theta-burst stimulation on brain function in treatment-resistant depression: A randomized sham-controlled neuroimaging study. Brain Stimul 2018; 11:1054-1062. [DOI: 10.1016/j.brs.2018.04.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 03/08/2018] [Accepted: 04/19/2018] [Indexed: 11/19/2022] Open
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103
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Hsu JH, Daskalakis ZJ, Blumberger DM. An Update on Repetitive Transcranial Magnetic Stimulation for the Treatment of Co-morbid Pain and Depressive Symptoms. Curr Pain Headache Rep 2018; 22:51. [DOI: 10.1007/s11916-018-0703-7] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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104
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Duan X, Yao G, Liu Z, Cui R, Yang W. Mechanisms of Transcranial Magnetic Stimulation Treating on Post-stroke Depression. Front Hum Neurosci 2018; 12:215. [PMID: 29899693 PMCID: PMC5988869 DOI: 10.3389/fnhum.2018.00215] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 05/08/2018] [Indexed: 12/13/2022] Open
Abstract
Post-stroke depression (PSD) is a neuropsychiatric affective disorder that can develop after stroke. Patients with PSD show poorer functional and recovery outcomes than patients with stroke who do not suffer from depression. The risk of suicide is also higher in patients with PSD. PSD appears to be associated with complex pathophysiological mechanisms involving both psychological and psychiatric problems that are associated with functional deficits and neurochemical changes secondary to brain damage. Transcranial magnetic stimulation (TMS) is a non-invasive way to investigate cortical excitability via magnetic stimulation of the brain. TMS is currently a valuable tool that can help us understand the pathophysiology of PSD. Although repetitive TMS (rTMS) is an effective treatment for patients with PSD, its mechanism of action remains unknown. Here, we review the known mechanisms underlying rTMS as a tool for better understanding PSD pathophysiology. It should be helpful when considering using rTMS as a therapeutic strategy for PSD.
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Affiliation(s)
- Xiaoqin Duan
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetics, The Second Hospital of Jilin University, Changchun, China
| | - Gang Yao
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetics, The Second Hospital of Jilin University, Changchun, China
| | - Zhongliang Liu
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetics, The Second Hospital of Jilin University, Changchun, China
| | - Ranji Cui
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetics, The Second Hospital of Jilin University, Changchun, China
| | - Wei Yang
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetics, The Second Hospital of Jilin University, Changchun, China
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105
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Dollfus S, Jaafari N, Guillin O, Trojak B, Plaze M, Saba G, Nauczyciel C, Montagne Larmurier A, Chastan N, Meille V, Krebs MO, Ayache SS, Lefaucheur JP, Razafimandimby A, Leroux E, Morello R, Marie Batail J, Brazo P, Lafay N, Wassouf I, Harika-Germaneau G, Guillevin R, Guillevin C, Gerardin E, Rotharmel M, Crépon B, Gaillard R, Delmas C, Fouldrin G, Laurent G, Nathou C, Etard O. High-Frequency Neuronavigated rTMS in Auditory Verbal Hallucinations: A Pilot Double-Blind Controlled Study in Patients With Schizophrenia. Schizophr Bull 2018; 44:505-514. [PMID: 29897597 PMCID: PMC5890503 DOI: 10.1093/schbul/sbx127] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Despite extensive testing, the efficacy of low-frequency (1 Hz) repetitive transcranial magnetic stimulation (rTMS) of temporo-parietal targets for the treatment of auditory verbal hallucinations (AVH) in patients with schizophrenia is still controversial, but promising results have been reported with both high-frequency and neuronavigated rTMS. Here, we report a double-blind sham-controlled study to assess the efficacy of high-frequency (20 Hz) rTMS applied over a precise anatomical site in the left temporal region using neuronavigation. METHODS Fifty-nine of 74 randomized patients with schizophrenia or schizoaffective disorders (DSM-IV R) were treated with rTMS or sham treatment and fully evaluated over 4 weeks. The rTMS target was determined by morphological MRI at the crossing between the projection of the ascending branch of the left lateral sulcus and the superior temporal sulcus (STS). RESULTS The primary outcome was response to treatment, defined as a 30% decrease of the Auditory Hallucinations Rating Scale (AHRS) frequency item, observed at 2 successive evaluations. While there was no difference in primary outcome between the treatment groups, the percentages of patients showing a decrease of more than 30% of AHRS score (secondary outcome) did differ between the active (34.6%) and sham groups (9.1%) (P = .016) at day 14. DISCUSSION This controlled study reports negative results on the primary outcome but demonstrates a transient effect of 20 Hz rTMS guided by neuronavigation and targeted on an accurate anatomical site for the treatment of AVHs in schizophrenia patients.
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Affiliation(s)
- Sonia Dollfus
- CHU de Caen, Service de Psychiatrie, Centre Esquirol, Caen, France,Normandie Univ, UNICAEN, Imagerie et Strategies Therapeutiques de la schizophrenie (ISTS), EA4766, Caen, France,To whom correspondence should be addressed; CHU de Caen, Service de Psychiatrie, Centre Esquirol, Caen F-14000, France, tel: +332 3106 5018; Fax: +332 3106 4789; e-mail: , http://www.ists.cyceron.fr/
| | - Nemat Jaafari
- Centre Hospitalier Henri Laborit, Poitiers, France,Laboratoire expérimental et clinique en Neurosciences, Univ Poitiers, Poitiers, France
| | - Olivier Guillin
- Department of Psychiatry, CH Le Rouvray, Sotteville les Rouen, France,INSERM U 1079, University of Medicine, Rouen, France,CHU Charles Nicolle, Rouen, France
| | - Benoit Trojak
- CHU de Dijon, Service de psychiatrie et d’addictologie, Dijon, France
| | - Marion Plaze
- Centre Hospitalier Sainte-Anne, Service Hospitalo-Universitaire, Paris, France
| | - Ghassen Saba
- Henri Mondor Hospital, Paris-Est Créteil University, Créteil, France
| | | | | | | | - Vincent Meille
- CHU de Dijon, Service de psychiatrie et d’addictologie, Dijon, France
| | - Marie-Odile Krebs
- Centre Hospitalier Sainte-Anne, Service Hospitalo-Universitaire, Paris, France
| | - Samar S Ayache
- Clinical Neurophysiology Unit, Department of Physiology, Henri Mondor Hospital, Paris-Est Créteil University, Créteil, France
| | - Jean Pascal Lefaucheur
- Clinical Neurophysiology Unit, Department of Physiology, Henri Mondor Hospital, Paris-Est Créteil University, Créteil, France
| | - Annick Razafimandimby
- Normandie Univ, UNICAEN, Imagerie et Strategies Therapeutiques de la schizophrenie (ISTS), EA4766, Caen, France
| | - Elise Leroux
- Normandie Univ, UNICAEN, Imagerie et Strategies Therapeutiques de la schizophrenie (ISTS), EA4766, Caen, France
| | - Rémy Morello
- CHU de Caen, Unité de biostatistiques et recherche clinique, Caen, France
| | | | - Perrine Brazo
- CHU de Caen, Service de Psychiatrie, Centre Esquirol, Caen, France,Normandie Univ, UNICAEN, Imagerie et Strategies Therapeutiques de la schizophrenie (ISTS), EA4766, Caen, France
| | | | - Issa Wassouf
- Centre Hospitalier Henri Laborit, Poitiers, France
| | | | | | | | | | - Maud Rotharmel
- Department of Psychiatry, CH Le Rouvray, Sotteville les Rouen, France
| | - Benoit Crépon
- Centre Hospitalier Sainte-Anne, Service de neurophysiologie clinique, Paris, France
| | - Raphael Gaillard
- Centre Hospitalier Sainte-Anne, Service Hospitalo-Universitaire, Paris, France
| | - Christophe Delmas
- Department of Psychiatry, CH Le Rouvray, Sotteville les Rouen, France
| | | | - Guillaume Laurent
- Department of Psychiatry, CH Le Rouvray, Sotteville les Rouen, France
| | - Clément Nathou
- CHU de Caen, Service de Psychiatrie, Centre Esquirol, Caen, France,Normandie Univ, UNICAEN, Imagerie et Strategies Therapeutiques de la schizophrenie (ISTS), EA4766, Caen, France,Department of Psychiatry, CH Le Rouvray, Sotteville les Rouen, France
| | - Olivier Etard
- Normandie Univ, UNICAEN, Imagerie et Strategies Therapeutiques de la schizophrenie (ISTS), EA4766, Caen, France,CHU de Caen, Service des explorations fonctionnelles du système nerveux, Caen, France
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106
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Pinto N, Duarte M, Gonçalves H, Silva R, Gama J, Pato MV. Bilateral theta-burst magnetic stimulation influence on event-related brain potentials. PLoS One 2018; 13:e0190693. [PMID: 29304065 PMCID: PMC5755903 DOI: 10.1371/journal.pone.0190693] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Accepted: 12/19/2017] [Indexed: 11/19/2022] Open
Abstract
Theta-burst stimulation (TBS) can be a non-invasive technique to modulate cognitive functions, with promising therapeutic potential, but with some contradictory results. Event related potentials are used as a marker of brain deterioration and can be used to evaluate TBS-related cognitive performance, but its use remains scant. This study aimed to study bilateral inhibitory and excitatory TBS effects upon neurocognitive performance of young healthy volunteers, using the auditory P300' results. Using a double-blind sham-controlled study, 51 healthy volunteers were randomly assigned to five different groups, two submitted to either excitatory (iTBS) or inhibitory (cTBS) stimulation over the left dorsolateral pre-frontal cortex (DLPFC), two other actively stimulated the right DLPFC and finally a sham stimulation group. An oddball based auditory P300 was performed just before a single session of iTBS, cTBS or sham stimulation and repeated immediately after. P300 mean latency comparison between the pre- and post-TBS stimulation stages revealed significantly faster post stimulation latencies only when iTBS was performed on the left hemisphere (p = 0.003). Right and left hemisphere cTBS significantly delayed P300 latency (right p = 0.026; left p = 0.000). Multiple comparisons for N200 showed slower latencies after iTBS over the right hemisphere. No significant difference was found in amplitude variation. TBS appears to effectively influence neural networking involved in P300 formation, but effects seem distinct for iTBS vs cTBS and for the right or the left hemisphere. P300 evoked potentials can be an effective and practical tool to evaluate transcranial magnetic stimulation related outcomes.
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Affiliation(s)
- Nuno Pinto
- CICS-Health Sciences Research Centre, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
- Dr. Lopes Dias School of Health - Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal
- * E-mail:
| | - Marta Duarte
- CICS-Health Sciences Research Centre, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
| | - Helena Gonçalves
- CICS-Health Sciences Research Centre, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
| | - Ricardo Silva
- CICS-Health Sciences Research Centre, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
| | - Jorge Gama
- CICS-Health Sciences Research Centre, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
- Department of Mathematics - University of Beira Interior, Covilhã, Portugal
| | - Maria Vaz Pato
- CICS-Health Sciences Research Centre, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
- Sousa Martins Hospital, Guarda Local Health Unit, Guarda, Portugal
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107
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Fernandez L, Major BP, Teo WP, Byrne LK, Enticott PG. Assessing cerebellar brain inhibition (CBI) via transcranial magnetic stimulation (TMS): A systematic review. Neurosci Biobehav Rev 2017; 86:176-206. [PMID: 29208533 DOI: 10.1016/j.neubiorev.2017.11.018] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 11/10/2017] [Accepted: 11/25/2017] [Indexed: 12/24/2022]
Abstract
The inhibitory tone that the cerebellum exerts on the primary motor cortex (M1) is known as cerebellar brain inhibition (CBI). Studies show CBI to be relevant to several motor functions, including adaptive motor learning and muscle control. CBI can be assessed noninvasively via transcranial magnetic stimulation (TMS) using a double-coil protocol. Variability in parameter choice and controversy surrounding the protocol's ability to isolate the cerebellothalamocortical pathway casts doubt over its validity in neuroscience research. This justifies a systematic review of both the protocol, and its application. The following review examines studies using the double-coil protocol to assess CBI in healthy adults. Parameters and CBI in relation to task-based studies, other non-invasive protocols, over different muscles, and in clinical samples are reviewed. Of the 1398 studies identified, 24 met selection criteria. It was found that methodological design and selection of parameters in several studies may have reduced the validity of outcomes. Further systematic testing of CBI protocols is warranted, both from a parameter and task-based perspective.
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Affiliation(s)
- Lara Fernandez
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Victoria, 3220, Australia.
| | - Brendan P Major
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Victoria, 3220, Australia
| | - Wei-Peng Teo
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, 3220, Australia
| | - Linda K Byrne
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Victoria, 3220, Australia
| | - Peter G Enticott
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Victoria, 3220, Australia; Deakin Child Study Centre, School of Psychology, Deakin University, Geelong, Victoria, 3220, Australia
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108
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Valero-Cabré A, Amengual JL, Stengel C, Pascual-Leone A, Coubard OA. Transcranial magnetic stimulation in basic and clinical neuroscience: A comprehensive review of fundamental principles and novel insights. Neurosci Biobehav Rev 2017; 83:381-404. [DOI: 10.1016/j.neubiorev.2017.10.006] [Citation(s) in RCA: 190] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 09/29/2017] [Accepted: 10/06/2017] [Indexed: 01/13/2023]
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109
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Chung SW, Rogasch NC, Hoy KE, Sullivan CM, Cash RFH, Fitzgerald PB. Impact of different intensities of intermittent theta burst stimulation on the cortical properties during TMS-EEG and working memory performance. Hum Brain Mapp 2017; 39:783-802. [PMID: 29124791 DOI: 10.1002/hbm.23882] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/09/2017] [Accepted: 11/02/2017] [Indexed: 02/06/2023] Open
Abstract
Intermittent theta burst stimulation (iTBS) is a noninvasive brain stimulation technique capable of increasing cortical excitability beyond the stimulation period. Due to the rapid induction of modulatory effects, prefrontal application of iTBS is gaining popularity as a therapeutic tool for psychiatric disorders such as depression. In an attempt to increase efficacy, higher than conventional intensities are currently being applied. The assumption that this increases neuromodulatory may be mechanistically false for iTBS. This study examined the influence of intensity on the neurophysiological and behavioural effects of iTBS in the prefrontal cortex. Sixteen healthy participants received iTBS over prefrontal cortex at either 50, 75 or 100% resting motor threshold in separate sessions. Single-pulse TMS and concurrent electroencephalography (EEG) was used to assess changes in cortical reactivity measured as TMS-evoked potentials and oscillations. The n-back task was used to assess changes in working memory performance. The data can be summarised as an inverse U-shape relationship between intensity and iTBS plastic effects, where 75% iTBS yielded the largest neurophysiological changes. Improvement in reaction time in the 3-back task was supported by the change in alpha power, however, comparison between conditions revealed no significant differences. The assumption that higher intensity results in greater neuromodulatory effects may be false, at least in healthy individuals, and should be carefully considered for clinical populations. Neurophysiological changes associated with working memory following iTBS suggest functional relevance. However, the effects of different intensities on behavioural performance remain elusive in the present healthy sample.
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Affiliation(s)
- Sung Wook Chung
- Monash Alfred Psychiatry Research Centre, Monash University, Central Clinical School and The Alfred, Melbourne, Australia
| | - Nigel C Rogasch
- Brain and Mental Health Laboratory, School of Psychological Sciences and Monash Biomedical Imaging, Monash Institute of Cognitive and Clinical Neuroscience, Monash University, Melbourne, Australia
| | - Kate E Hoy
- Monash Alfred Psychiatry Research Centre, Monash University, Central Clinical School and The Alfred, Melbourne, Australia
| | - Caley M Sullivan
- Monash Alfred Psychiatry Research Centre, Monash University, Central Clinical School and The Alfred, Melbourne, Australia
| | - Robin F H Cash
- Monash Alfred Psychiatry Research Centre, Monash University, Central Clinical School and The Alfred, Melbourne, Australia
| | - Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Monash University, Central Clinical School and The Alfred, Melbourne, Australia.,Epworth Clinic, Epworth Healthcare, Camberwell, VIC, Australia
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110
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Baeken C, Duprat R, Wu GR, De Raedt R, van Heeringen K. Subgenual Anterior Cingulate-Medial Orbitofrontal Functional Connectivity in Medication-Resistant Major Depression: A Neurobiological Marker for Accelerated Intermittent Theta Burst Stimulation Treatment? BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017; 2:556-565. [PMID: 29560909 DOI: 10.1016/j.bpsc.2017.01.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 01/06/2017] [Accepted: 01/06/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND Accelerated repetitive transcranial magnetic stimulation paradigms have been shown to result in fast decreases in depressive symptoms and suicidal ideation. Although the subgenual anterior cingulate cortex (sgACC) region has been put forward as a possible biological marker, so far, no studies evaluated the clinical effects of accelerated intermittent theta burst stimulation (aiTBS) on sgACC functional connectivity (FC). METHODS Fifty patients with treatment-resistant depression were enrolled in this registered randomized double-blind sham-controlled crossover aiTBS treatment study. All received 20 iTBS sessions applied to the left dorsolateral prefrontal cortex (5 daily sessions spread over 4 days). Forty-four complete resting-state functional magnetic resonance imaging scans were collected. Baseline resting-state functional magnetic resonance imaging scans were compared with a matched healthy control group. Besides depression severity, all patients were also assessed with the Scale for Suicide Ideation and the Beck Hopelessness Scale. RESULTS Our main resting-state functional magnetic resonance imaging findings indicate that a positive sgACC FC correlation with the medial orbitofrontal cortex could distinguish aiTBS responders from nonresponders at baseline. Beneficial aiTBS treatment strengthened sgACC-medial orbitofrontal cortex FC patterns. Moreover, this increased FC pattern was associated with a decrease in feelings of hopelessness. CONCLUSIONS Clinical response to aiTBS treatment is not only characterized by stronger FC patterns between the sgACC and the medial orbitofrontal cortex, but it is also associated with decreases in hopelessness. Our observations provide a possible neurobiological explanation why accelerated repetitive transcranial magnetic stimulation paradigms may result in prompt attenuation of negative thinking in depressed patients.
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Affiliation(s)
- Chris Baeken
- Department of Psychiatry and Medical Psychology, Ghent University, Ghent; Ghent Experimental Psychiatry Lab, Ghent University, Ghent; Department of Psychiatry, University Hospital, Brussels, Belgium.
| | - Romain Duprat
- Department of Psychiatry and Medical Psychology, Ghent University, Ghent; Ghent Experimental Psychiatry Lab, Ghent University, Ghent
| | - Guo-Rong Wu
- Department of Psychiatry and Medical Psychology, Ghent University, Ghent; Ghent Experimental Psychiatry Lab, Ghent University, Ghent; Key Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing, China
| | - Rudi De Raedt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent
| | - Kees van Heeringen
- Department of Psychiatry and Medical Psychology, Ghent University, Ghent
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111
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Aleman A, Lincoln TM, Bruggeman R, Melle I, Arends J, Arango C, Knegtering H. Treatment of negative symptoms: Where do we stand, and where do we go? Schizophr Res 2017; 186:55-62. [PMID: 27293137 DOI: 10.1016/j.schres.2016.05.015] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 05/16/2016] [Accepted: 05/17/2016] [Indexed: 12/16/2022]
Abstract
Negative symptoms, e.g. social withdrawal, reduced initiative, anhedonia and affective flattening, are notoriously difficult to treat. In this review, we take stock of recent research into treatment of negative symptoms by summarizing psychosocial as well as pharmacological and other biological treatment strategies. Major psychosocial approaches concern social skills training, cognitive behavior therapy for psychosis, cognitive remediation and family intervention. Some positive findings have been reported, with the most robust improvements observed for social skills training. Although cognitive behavior therapy shows significant effects for negative symptoms as a secondary outcome measure, there is a lack of data to allow for definite conclusions of its effectiveness for patients with predominant negative symptoms. With regard to pharmacological interventions, antipsychotics have been shown to improve negative symptoms, but this seems to be limited to secondary negative symptoms in acute patients. It has also been suggested that antipsychotics may aggravate negative symptoms. Recent studies have investigated glutamatergic compounds, e.g. glycine receptor inhibitors and drugs that target the NMDA receptor or metabotropic glutamate 2/3 (mGlu2/3) receptor, but no consistent evidence of improvement of negative symptoms was found. Finally, some small studies have suggested improvement of negative symptoms after non-invasive electromagnetic neurostimulation, but this has only been partly replicated and it is still unclear whether these are robust improvements. We address methodological issues, in particular the heterogeneity of negative symptoms and treatment response, and suggest avenues for future research. There is a need for more detailed studies that focus on different dimensions of negative symptoms.
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Affiliation(s)
- André Aleman
- University of Groningen, University Medical Center Groningen, Department of Neuroscience, Groningen, The Netherlands.
| | - Tania M Lincoln
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Hamburg, Germany
| | - Richard Bruggeman
- University of Groningen, University Medical Center Groningen and Rob Giel Research Center, Department of Psychiatry, Groningen, The Netherlands
| | - Ingrid Melle
- NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway
| | - Johan Arends
- GGZ Drenthe Mental Health Center, Department of Psychotic Disorders, Assen, The Netherlands
| | - Celso Arango
- Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Madrid, Spain
| | - Henderikus Knegtering
- University of Groningen, University Medical Center Groningen, Department of Neuroscience, Groningen, The Netherlands; GGZ Lentis Mental Health Center, Department of Psychotic Disorders, Groningen, The Netherlands
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112
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Berlim MT, McGirr A, Rodrigues Dos Santos N, Tremblay S, Martins R. Efficacy of theta burst stimulation (TBS) for major depression: An exploratory meta-analysis of randomized and sham-controlled trials. J Psychiatr Res 2017; 90:102-109. [PMID: 28254709 DOI: 10.1016/j.jpsychires.2017.02.015] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 02/14/2017] [Accepted: 02/17/2017] [Indexed: 01/08/2023]
Abstract
Theta burst stimulation (TBS) has been proposed as a novel treatment for major depression (MD). However, randomized and sham-controlled trials (RCTs) published to date have yielded heterogeneous clinical results and we have thus carried out the present systematic review and exploratory meta-analysis of RCTs to evaluate this issue. We searched the literature for RCTs on TBS for MD from January 2001 through September 2016 using MEDLINE, EMBASE, PsycINFO, and CENTRAL. We then performed a random-effects meta-analysis with the main outcome measures including pre-post score changes in the Hamilton Depression Rating Scale (HAM-D) as well as rates of response, remission and dropout. Data were obtained from 5 RCTs, totalling 221 subjects with MD. The pooled Hedges' g for pre-post change in HAM-D scores was 1.0 (p = 0.003), indicating a significant and large-sized difference in outcome favouring active TBS. Furthermore, active TBS was associated with significantly higher response rates when compared to sham TBS (35.6% vs. 17.5%, respectively; p = 0.005), although the groups did not differ in terms of rates of remission (18.6% vs. 10.7%, respectively; p = 0.1) and dropout (4.2% vs. 7.8%, respectively; p = 0.5). Finally, subgroup analyses indicated that bilateral TBS and unilateral intermittent TBS seem to be the most promising protocols. In conclusion, although TBS is a promising novel therapeutic intervention for MD, future studies should identify more clinically-relevant stimulation parameters as well as neurobiological predictors of treatment outcome, and include larger sample sizes, active comparators and longer follow-up periods.
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Affiliation(s)
- Marcelo T Berlim
- Neuromodulation Research Clinic, Douglas Institute and McGill University, Montréal, Québec, Canada; Depressive Disorders Program, Douglas Institute and McGill University, Montréal, Québec, Canada.
| | - Alexander McGirr
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Sara Tremblay
- Neuromodulation Research Clinic, Douglas Institute and McGill University, Montréal, Québec, Canada; Institute of Neurology, University College London, London, United Kingdom
| | - Ruben Martins
- Neuromodulation Research Clinic, Douglas Institute and McGill University, Montréal, Québec, Canada
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113
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Chung SW, Lewis BP, Rogasch NC, Saeki T, Thomson RH, Hoy KE, Bailey NW, Fitzgerald PB. Demonstration of short-term plasticity in the dorsolateral prefrontal cortex with theta burst stimulation: A TMS-EEG study. Clin Neurophysiol 2017; 128:1117-1126. [DOI: 10.1016/j.clinph.2017.04.005] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 03/28/2017] [Accepted: 04/04/2017] [Indexed: 12/13/2022]
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114
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New Treatment Strategies of Depression: Based on Mechanisms Related to Neuroplasticity. Neural Plast 2017; 2017:4605971. [PMID: 28491480 PMCID: PMC5405587 DOI: 10.1155/2017/4605971] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 03/10/2017] [Accepted: 03/23/2017] [Indexed: 12/22/2022] Open
Abstract
Major depressive disorder is a severe and complex mental disorder. Impaired neurotransmission and disrupted signalling pathways may influence neuroplasticity, which is involved in the brain dysfunction in depression. Traditional neurobiological theories of depression, such as monoamine hypothesis, cannot fully explain the whole picture of depressive disorders. In this review, we discussed new treatment directions of depression, including modulation of glutamatergic system and noninvasive brain stimulation. Dysfunction of glutamatergic neurotransmission plays an important role in the pathophysiology of depression. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has rapid and lasting antidepressive effects in previous studies. In addition to ketamine, other glutamatergic modulators, such as sarcosine, also show potential antidepressant effect in animal models or clinical trials. Noninvasive brain stimulation is another new treatment strategy beyond pharmacotherapy. Growing evidence has demonstrated that superficial brain stimulations, such as transcranial magnetic stimulation, transcranial direct current stimulation, cranial electrotherapy stimulation, and magnetic seizure therapy, can improve depressive symptoms. The antidepressive effect of these brain stimulations may be through modulating neuroplasticity. In conclusion, drugs that modulate neurotransmission via NMDA receptor and noninvasive brain stimulation may provide new directions of treatment for depression. Furthermore, exploring the underlying mechanisms will help in developing novel therapies for depression in the future.
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Luo J, Zheng H, Zhang L, Zhang Q, Li L, Pei Z, Hu X. High-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) Improves Functional Recovery by Enhancing Neurogenesis and Activating BDNF/TrkB Signaling in Ischemic Rats. Int J Mol Sci 2017; 18:ijms18020455. [PMID: 28230741 PMCID: PMC5343989 DOI: 10.3390/ijms18020455] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 02/05/2017] [Accepted: 02/10/2017] [Indexed: 01/05/2023] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) has rapidly become an attractive therapeutic approach for stroke. However, the mechanisms underlying this remain elusive. This study aimed to investigate whether high-frequency rTMS improves functional recovery mediated by enhanced neurogenesis and activation of brain-derived neurotrophic factor (BDNF)/tropomyosin-related kinase B (TrkB) pathway and to compare the effect of conventional 20 Hz rTMS and intermittent theta burst stimulation (iTBS) on ischemic rats. Rats after rTMS were sacrificed seven and 14 days after middle cerebral artery occlusion (MCAO), following evaluation of neurological function. Neurogenesis was measured using specific markers: Ki67, Nestin, doublecortin (DCX), NeuN and glial fibrillary acidic protein (GFAP), and the expression levels of BDNF were visualized by Western blotting and RT-PCR analysis. Both high-frequency rTMS methods significantly improved neurological function and reduced infarct volume. Moreover, 20 Hz rTMS and iTBS significantly promoted neurogenesis, shown by an increase of Ki67/DCX, Ki67/Nestin, and Ki67/NeuN-positive cells in the peri-infarct striatum. These beneficial effects were accompanied by elevated protein levels of BDNF and phosphorylated-TrkB. In conclusion, high-frequency rTMS improves functional recovery possibly by enhancing neurogenesis and activating BDNF/TrkB signaling pathway and conventional 20 Hz rTMS is better than iTBS at enhancing neurogenesis in ischemic rats.
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Affiliation(s)
- Jing Luo
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China.
| | - Haiqing Zheng
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China.
| | - Liying Zhang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China.
| | - Qingjie Zhang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China.
| | - Lili Li
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China.
| | - Zhong Pei
- Department of Neurology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China.
| | - Xiquan Hu
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China.
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Brem AK, Lehto SM. Stuck between Bench and Bedside: Why Non-invasive Brain Stimulation Is Not Accessible to Depressed Patients in Europe. Front Hum Neurosci 2017; 11:39. [PMID: 28217090 PMCID: PMC5289969 DOI: 10.3389/fnhum.2017.00039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 01/18/2017] [Indexed: 11/21/2022] Open
Affiliation(s)
- Anna-Katharine Brem
- Max Planck Institute of PsychiatryMunich, Germany
- Department of Experimental Psychology, University of OxfordOxford, UK
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Interventional Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical SchoolBoston, MA, USA
- *Correspondence: Anna-Katharine Brem
| | - Soili M. Lehto
- Department of Psychology, Institute of Behavioral Sciences, University of HelsinkiHelsinki, Finland
- Department of Psychiatry, Institute of Clinical Medicine, University of Eastern FinlandKuopio, Finland
- Department of Psychiatry, Kuopio University HospitalKuopio, Finland
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Hussain S. Neuromodulation: the attitudes, the evidence and the trends. Australas Psychiatry 2017; 25:5-6. [PMID: 28145144 DOI: 10.1177/1039856216686223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Salam Hussain
- Clinical Senior Lecturer, University of Western Australia, Perth, WA, and; Consultant Psychiatrist, Sir Charles Gairdner Hospital, Perth, WA, Australia
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Iwabuchi SJ, Raschke F, Auer DP, Liddle PF, Lankappa ST, Palaniyappan L. Targeted transcranial theta-burst stimulation alters fronto-insular network and prefrontal GABA. Neuroimage 2017; 146:395-403. [DOI: 10.1016/j.neuroimage.2016.09.043] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 09/12/2016] [Accepted: 09/17/2016] [Indexed: 10/21/2022] Open
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Becker JE, Maley C, Shultz E, Taylor WD. Update on Transcranial Magnetic Stimulation for Depression and Other Neuropsychiatric Illnesses. Psychiatr Ann 2016. [DOI: 10.3928/00485713-20160930-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Repetitive Transcranial Magnetic Stimulation for Depression Due to Cerebrovascular Disease: A Systematic Review. J Stroke Cerebrovasc Dis 2016; 25:2792-2800. [PMID: 27743927 DOI: 10.1016/j.jstrokecerebrovasdis.2016.08.043] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 08/28/2016] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE This study aims to perform a systematic review evaluating the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in improving depression resulting from cerebrovascular disease including vascular depression (VD) and poststroke depression (PSD). METHODS A literature search of multiple scientific databases was conducted for English studies published from January 1980 to June 2016. Studies were included if the sample consisted of 50% or more adult humans with VD or PSD and had 3 or more subjects, the intervention applied was rTMS, and depression was assessed pre- and post intervention using a formal outcome measure. Randomized controlled trials (RCTs) were assessed for methodological quality using the Physiotherapy Evidence Database (PEDro) tool. A level of evidence was assigned to each study according to the modified Sackett Scale. RESULTS Five studies met the inclusion criteria including 3 RCTs (level 1b; PEDro range: 6-8) and 2 uncontrolled pre-post studies (level 4). There were 186 participants with either PSD (n = 40) or VD (n = 146); the majority of the participants were female (52.7%) and had a mean age ranging from 51.9 to 67.9 years. There were no adverse effects reported by any of the studies. Using clinically accepted criteria for the response rate, all studies reported a benefit from rTMS for the treatment of depression. Three studies also demonstrated a benefit on remission rates as well. CONCLUSIONS rTMS was reported to be beneficial in treating depression among individuals with cerebrovascular disease over the short term. However, heterogeneous populations and variability in study design and protocol, as well as a limited number of studies to review, challenge the ability to form conclusions as to the effectiveness of rTMS.
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Desmyter S, Duprat R, Baeken C, Van Autreve S, Audenaert K, van Heeringen K. Accelerated Intermittent Theta Burst Stimulation for Suicide Risk in Therapy-Resistant Depressed Patients: A Randomized, Sham-Controlled Trial. Front Hum Neurosci 2016; 10:480. [PMID: 27729854 PMCID: PMC5037167 DOI: 10.3389/fnhum.2016.00480] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 09/09/2016] [Indexed: 01/23/2023] Open
Abstract
Objectives: We aimed to examine the effects and safety of accelerated intermittent Theta Burst Stimulation (iTBS) on suicide risk in a group of treatment-resistant unipolar depressed patients, using an extensive suicide assessment scale. Methods: In 50 therapy-resistant, antidepressant-free depressed patients, an intensive protocol of accelerated iTBS was applied over the left dorsolateral prefrontal cortex (DLPFC) in a randomized, sham-controlled crossover design. Patients received 20 iTBS sessions over 4 days. Suicide risk was assessed using the Beck Scale of Suicide ideation (BSI). Results: The iTBS protocol was safe and well tolerated. We observed a significant decrease of the BSI score over time, unrelated to active or sham stimulation and unrelated to depression-response. No worsening of suicidal ideation was observed. The effects of accelerated iTBS on mood and depression severity are reported in Duprat et al. (2016). The decrease in suicide risk lasted up to 1 month after baseline, even in depression non-responders. Conclusions: This accelerated iTBS protocol was safe. The observed significant decrease in suicide risk was unrelated to active or sham stimulation and unrelated to depression response. Further sham-controlled research in suicidal depressed patients is necessary. (Clinicaltrials.gov identifier: NCT01832805).
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Affiliation(s)
- Stefanie Desmyter
- Department of Psychiatry and Institute for Neuroscience, University Hospital Ghent Ghent, Belgium
| | - Romain Duprat
- Department of Psychiatry and Medical Psychology, Ghent University Ghent, Belgium
| | - Chris Baeken
- Department of Psychiatry and Medical Psychology, Ghent University Ghent, Belgium
| | - Sara Van Autreve
- Department of Psychiatry and Medical Psychology, Ghent University Ghent, Belgium
| | - Kurt Audenaert
- Department of Psychiatry and Medical Psychology, Ghent University Ghent, Belgium
| | - Kees van Heeringen
- Unit for Suicide Research, Department of Psychiatry and Medical Psychology, Ghent University Ghent, Belgium
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Abstract
This special issue surveys recent work and underscores the challenges of psychiatric brain stimulation research with child and adolescent populations. The field of child and adolescent psychopharmacology is replete with examples of potential pitfalls in the assumption that "children are little adults." Arguably, younger age portends more neurobiological and descriptive heterogeneity in research pursuits and clinical practice. For existing brain stimulation modalities, there are a paucity of translational models to design studies for youth and no well-studied dosing schemes. The long-term positive and negative effects of neuromodulation interventions in youth are unknown. Inherent pragmatic and ethical limitations often present barriers for participant recruitment and will necessitate innovative approaches to study design and team efforts. These challenges are not insurmountable, and sustained efforts will advance the growing field of pediatric neuromodulation.
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Affiliation(s)
- Paul E. Croarkin
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Alexander Rotenberg
- Pediatric Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
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Duprat R, Desmyter S, Rudi DR, van Heeringen K, Van den Abbeele D, Tandt H, Bakic J, Pourtois G, Dedoncker J, Vervaet M, Van Autreve S, Lemmens GMD, Baeken C. Accelerated intermittent theta burst stimulation treatment in medication-resistant major depression: A fast road to remission? J Affect Disord 2016; 200:6-14. [PMID: 27107779 DOI: 10.1016/j.jad.2016.04.015] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 04/11/2016] [Indexed: 10/21/2022]
Abstract
Although accelerated repetitive Transcranial Magnetic Stimulation (rTMS) paradigms and intermittent Theta-burst Stimulation (iTBS) may have the potency to result in superior clinical outcomes in Treatment Resistant Depression (TRD), accelerated iTBS treatment has not yet been studied. In this registered randomized double-blind sham-controlled crossover study, spread over four successive days, 50 TRD patients received 20 iTBS sessions applied to the left dorsolateral prefrontal cortex (DLPFC). The accelerated iTBS treatment procedure was found to be safe and resulted in immediate statistically significant decreases in depressive symptoms regardless of order/type of stimulation (real/sham). While only 28% of the patients showed a 50% reduction of their initial Hamilton Depression Rating Scale score at the end of the two-week procedure, this response rate increased to 38% when assessed two weeks after the end of the sham-controlled iTBS protocol, indicating delayed clinical effects. Importantly, 30% of the responders were considered in clinical remission. We found no demographic predictors for response. Our findings indicate that only four days of accelerated iTBS treatment applied to the left DLPFC in TRD may lead to meaningful clinical responses within two weeks post stimulation.
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Affiliation(s)
- Romain Duprat
- Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium
| | - Stefanie Desmyter
- Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
| | - De Raedt Rudi
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Kees van Heeringen
- Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
| | - Dirk Van den Abbeele
- Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
| | - Hannelore Tandt
- Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
| | - Jasmina Bakic
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Gilles Pourtois
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Josefien Dedoncker
- Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium
| | - Myriam Vervaet
- Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
| | - Sara Van Autreve
- Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
| | - Gilbert M D Lemmens
- Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
| | - Chris Baeken
- Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium; Department of Psychiatry, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium.
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Effect of high-frequency repetitive transcranial magnetic stimulation on major depressive disorder in patients with Parkinson’s disease. J Neurol 2016; 263:1442-8. [DOI: 10.1007/s00415-016-8160-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 05/03/2016] [Accepted: 05/03/2016] [Indexed: 10/21/2022]
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125
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Fitzgibbon BM, Hoy KE, Guymer EK, Littlejohn GO, Fitzgerald PB. Repetitive transcranial magnetic stimulation for pain. Pain 2016; 157:1174-1175. [DOI: 10.1097/j.pain.0000000000000503] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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126
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Chung SW, Hill AT, Rogasch NC, Hoy KE, Fitzgerald PB. Use of theta-burst stimulation in changing excitability of motor cortex: A systematic review and meta-analysis. Neurosci Biobehav Rev 2016; 63:43-64. [PMID: 26850210 DOI: 10.1016/j.neubiorev.2016.01.008] [Citation(s) in RCA: 165] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 12/30/2015] [Accepted: 01/26/2016] [Indexed: 12/13/2022]
Abstract
Noninvasive brain stimulation has been demonstrated to modulate cortical activity in humans. In particular, theta burst stimulation (TBS) has gained notable attention due to its ability to induce lasting physiological changes after short stimulation durations. The present study aimed to provide a comprehensive meta-analytic review of the efficacy of two TBS paradigms; intermittent (iTBS) and continuous (cTBS), on corticospinal excitability in healthy individuals. Literature searches yielded a total of 87 studies adhering to the inclusion criteria. iTBS yielded moderately large MEP increases lasting up to 30 min with a pooled SMD of 0.71 (p<0.00001). cTBS produced a reduction in MEP amplitudes lasting up to 60 min, with the largest effect size seen at 5 min post stimulation (SMD=-0.9, P<0.00001). The collected studies were of heterogeneous nature, and a series of tests conducted indicated a degree of publication bias. No significant change in SICI and ICF was observed, with exception to decrease in SICI with cTBS at the early time point (SMD=0.42, P=0.00036). The results also highlight several factors contributing to TBS efficacy, including the number of pulses, frequency of stimulation and BDNF polymorphisms. Further research investigating optimal TBS stimulation parameters, particularly for iTBS, is needed in order for these paradigms to be successfully translated into clinical settings.
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Affiliation(s)
- Sung Wook Chung
- Monash Alfred Psychiatry Research Centre, Central Clinical School, The Alfred and Monash University, Melbourne, Australia.
| | - Aron T Hill
- Monash Alfred Psychiatry Research Centre, Central Clinical School, The Alfred and Monash University, Melbourne, Australia
| | - Nigel C Rogasch
- Brain and Mental Health Laboratory, School of Psychological Sciences and Monash Biomedical Imaging, Monash University, Melbourne, Australia
| | - Kate E Hoy
- Monash Alfred Psychiatry Research Centre, Central Clinical School, The Alfred and Monash University, Melbourne, Australia
| | - Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Central Clinical School, The Alfred and Monash University, Melbourne, Australia
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Measuring Brain Stimulation Induced Changes in Cortical Properties Using TMS-EEG. Brain Stimul 2015; 8:1010-20. [DOI: 10.1016/j.brs.2015.07.029] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/10/2015] [Accepted: 07/13/2015] [Indexed: 11/19/2022] Open
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