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Hebel T, Grözinger M, Landgrebe M, Padberg F, Schecklmann M, Schlaepfer T, Schönfeldt-Lecuona C, Ullrich H, Zwanzger P, Langguth B, Bajbouj M, Bewernick B, Brinkmann K, Cordes J, Di Pauli J, Eichhammer P, Freundlieb N, Hajak G, Höppner-Buchmann J, Hurlemann R, Kamp D, Kayser S, Kis B, Kreuzer PM, Kuhn J, Lammers M, Lugmayer B, Mielacher C, Nickl-Jockschat T, Nunhofer C, Palm U, Poeppl TB, Polak T, Sakreida K, Sartorius A, Silberbauer C, Zilles-Wegner D. Evidence and expert consensus based German guidelines for the use of repetitive transcranial magnetic stimulation in depression. World J Biol Psychiatry 2022; 23:327-348. [PMID: 34668449 DOI: 10.1080/15622975.2021.1995810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Non-invasive brain stimulation techniques such as repetitive transcranial magnetic stimulation (rTMS) offer a promising alternative to psychotherapeutic and pharmacological treatments for depression. This paper aims to present a practical guide for its clinical implementation based on evidence from the literature as well as on the experience of a group of leading German experts in the field. METHODS The current evidence base for the use of rTMS in depression was examined via review of the literature. From the evidence and from clinical experience, recommendations for the use of rTMS in clinical practice were derived. All members of the of the German Society for Brain Stimulation in Psychiatry and all members of the sections Clinical Brain Stimulation and Experimental Brain Stimulation of the German Society for Psychiatry, Psychotherapy, Psychosomatics and Mental Health were invited to participate in a poll on whether they consent with the recommendations. FINDINGS Among rTMS experts, a high consensus rate could be identified for clinical practice concerning the setting and the technical parameters of rTMS treatment in depression, indications and contra-indications, the relation of rTMS to other antidepressive treatment modalities and the frequency and management of side effects.
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Affiliation(s)
- Tobias Hebel
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
| | - Michael Grözinger
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH University, Aachen, Germany
| | - Michael Landgrebe
- Department of Psychiatry, Kbo-Lech-Mangfall Clinic, Agatharied, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, LMU University Munich, Munich, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
| | - Thomas Schlaepfer
- Department of Psychiatry and Psychotherapy, Interventional Biological Psychiatry, University Freiburg, Freiburg, Germany
| | | | - Heiko Ullrich
- Department of Psychiatry, Psychotherapy and Psychosomatics, Siegen Hospital, Siegen, Germany
| | - Peter Zwanzger
- Department of Psychiatry and Psychotherapy, LMU University Munich, Munich, Germany.,Clinical Center for Psychiatry, Psychotherapy, Psychosomatic Medicine, Geriatrics and Neurology, Kbo-Inn-Salzach-Klinikum, Wasserburg/Inn, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
| | | | | | - Bettina Bewernick
- Departments of Geriatric Psychiatry, Psychiatry, and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Klaus Brinkmann
- Center for Psychosocial Medicine, Agaplesion Diakonieklinikum Hospital Rotenburg, Rotenburg, Germany
| | - Joachim Cordes
- Department of Psychiatry and Psychotherapy, Kaiserswerther Diakonie, Düsseldorf, Germany
| | - Jan Di Pauli
- Department of Adult Psychiatry, Rankweil Hospital, Vocklabruck, Austria
| | - Peter Eichhammer
- Clinic for Mental Health, Goldener Steig Hospital, Freyung, Germany
| | - Nils Freundlieb
- Department of Psychiatry and Psychotherapy, Center for Psychosocial Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Göran Hajak
- Department of Psychiatry and Psychotherapy, Sozialstiftung, Bamberg, Germany
| | - Jacqueline Höppner-Buchmann
- Department of Geriatric Psychiatry and Psychotherapy, Helios Hospital Schwerin, Carl-Friedrich-Flemming Hospital, Schwerin, Germany
| | - Rene Hurlemann
- Department of Psychiatry and Psychotherapy, Karl-Jaspers Hospital, University Oldenburg, Bad Zwischenahn, Germany
| | - Daniel Kamp
- Department of Psychiatry and Psychotherapy, LVR Hospital, Heinrich-Heine University, Düsseldorf, Germany
| | - Sarah Kayser
- Department of General Psychiatry, Psychotherapy and Psychosomatics 3/Geriatric Psychiatry, Rheinhessen Hospital Alzey, Alzey, Germany
| | - Bernhard Kis
- Department of Psychiatry, Psychotherapy and Psychosomatics, Catholic Hospitals Ruhrhalbinsel, Hattingen, Germany
| | - Peter M Kreuzer
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
| | - Jens Kuhn
- Department of Psychiatry, Psychotherapy and Psychosomatics, Johanniter Hospital Oberhausen, Oberhausen, Germany
| | - Melisande Lammers
- Hospital for Psychosomatics and Psychotherapy, MediClin Reichshof Hospital, Reichshof-Eckenhagen, Germany
| | - Beatrix Lugmayer
- Department of Psychiatry, Salzkammergut Hospital Vöcklabruck, Vocklabruck, Austria
| | - Clemens Mielacher
- Department of Psychiatry and Psychotherapy, Section Clinical Psychology, University Hospital Bonn, Bonn, Germany
| | - Thomas Nickl-Jockschat
- Departments of Psychiatry, Neuroscience and Pharmacology, Iowa Neuroscience Institute Carver College of Medicine University of Iowa, Iowa City, IA, USA
| | - Christian Nunhofer
- Private Practice in Neurology, Psychiatry and Psychotherapy, Neumarkt, Germany
| | - Ulrich Palm
- Medical Park Chiemseeblick, Bernau-Felden, Germany
| | - Timm B Poeppl
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH University, Aachen, Germany
| | - Thomas Polak
- Department and Clinic of Psychiatry, Psychosomatics and Psychotherapy, Neurovascular Functional Diagnostics, Center for Mental Health, Würzburg University Hospital, Wuerzburg, Germany
| | - Katrin Sakreida
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH University, Aachen, Germany
| | - Alexander Sartorius
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany
| | | | - David Zilles-Wegner
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Georg-August University, Göttingen, Germany
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Pinto N, Oliveira I, Ferreira J, Gama J, Vaz Pato M. Can theta burst stimulation safely influence auditory hearing thresholds in healthy young adults? Clin Neurophysiol 2019; 130:1900-1907. [PMID: 31408791 DOI: 10.1016/j.clinph.2019.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 06/27/2019] [Accepted: 07/13/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This TBS sham-controlled study aimed to evaluate the effects of intermittent TBS (iTBS) and continuous TBS (cTBS) upon ipsilateral hearing thresholds after stimulation on the left auditory cortex. METHODS Sixty healthy adults, aged between 19 and 32 years (median of 23 years), were randomly distributed into three groups and underwent iTBS, cTBS or sham stimulation. Each double-blind experimental session comprised two pure tone audiometric evaluations per subject, before and after stimulation. To assess volunteer safety, a follow-up of at least 48 hours was implemented. RESULTS The iTBS group mean thresholds displayed a tendency to decrease after stimulation, predominantly in the 500 Hz-6000 Hz interval and group comparisons revealed significant differences between the iTBS and sham groups for 500 Hz (p = 0.041) and between the iTBS and cTBS groups for 4000 Hz (p = 0.038). Neither relevant side effects nor any significant hearing threshold impairment after active or sham stimulation were found. CONCLUSIONS A single stimulation session led to an effective neuromodulation of the auditory cortex, reflected in lower thresholds when using iTBS. SIGNIFICANCE These encouraging results with this safe noninvasive tool suggest that iTBS may have the potential to positively influence hearing thresholds.
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Affiliation(s)
- Nuno Pinto
- CICS-Health Sciences Research Centre, University of Beira Interior, Covilhã 6200-506, Portugal; Dr. Lopes Dias School of Health - Polytechnic Institute of Castelo Branco, 6000-767, Portugal.
| | - Iris Oliveira
- CICS-Health Sciences Research Centre, University of Beira Interior, Covilhã 6200-506, Portugal.
| | - Joana Ferreira
- CICS-Health Sciences Research Centre, University of Beira Interior, Covilhã 6200-506, Portugal.
| | - Jorge Gama
- CICS-Health Sciences Research Centre, University of Beira Interior, Covilhã 6200-506, Portugal; University of Beira Interior - Department of Mathematics, Covilhã 6200-506, Portugal.
| | - Maria Vaz Pato
- CICS-Health Sciences Research Centre, University of Beira Interior, Covilhã 6200-506, Portugal; Sousa Martins Hospital, Guarda Local Health Unit, Guarda 6300-858, Portugal.
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Mai S, Braun J, Probst V, Kammer T, Pollatos O. Changes in emotional processing following interoceptive network stimulation with rTMS. Neuroscience 2019; 406:405-419. [DOI: 10.1016/j.neuroscience.2019.03.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 02/01/2019] [Accepted: 03/06/2019] [Indexed: 12/16/2022]
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Landgrebe M, Hajak G, Wolf S, Padberg F, Klupp P, Fallgatter AJ, Polak T, Höppner J, Haker R, Cordes J, Klenzner T, Schönfeldt-Lecuona C, Kammer T, Graf E, Koller M, Kleinjung T, Lehner A, Schecklmann M, Pöppl TB, Kreuzer P, Frank E, Langguth B. 1-Hz rTMS in the treatment of tinnitus: A sham-controlled, randomized multicenter trial. Brain Stimul 2017; 10:1112-1120. [DOI: 10.1016/j.brs.2017.08.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/20/2017] [Accepted: 08/02/2017] [Indexed: 01/01/2023] Open
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Husain FT. Neural networks of tinnitus in humans: Elucidating severity and habituation. Hear Res 2016; 334:37-48. [DOI: 10.1016/j.heares.2015.09.010] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 09/19/2015] [Accepted: 09/22/2015] [Indexed: 02/06/2023]
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Zhang D, Ma Y. Repetitive transcranial magnetic stimulation improves both hearing function and tinnitus perception in sudden sensorineural hearing loss patients. Sci Rep 2015; 5:14796. [PMID: 26463446 PMCID: PMC4604476 DOI: 10.1038/srep14796] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 09/09/2015] [Indexed: 11/17/2022] Open
Abstract
The occurrence of sudden sensorineural hearing loss (SSHL) affects not only cochlear activity but also neural activity in the central auditory system. Repetitive transcranial magnetic stimulation (rTMS) above the auditory cortex has been reported to improve auditory processing and to reduce the perception of tinnitus, which results from network dysfunction involving both auditory and non-auditory brain regions. SSHL patients who were refractory to standard corticosteroid therapy (SCT) and hyperbaric oxygen (HBO) therapy received 20 sessions of 1 Hz rTMS to the temporoparietal junction ipsilateral to the symptomatic ear (rTMS group). RTMS therapy administered in addition to SCT and HBO therapy resulted in significantly greater recovery of hearing function and improvement of tinnitus perception compared SCT and HBO therapy without rTMS therapy. Additionally, the single photon emission computed tomography (SPECT) measurements obtained in a subgroup of patients suggested that the rTMS therapy could have alleviated the decrease in regional cerebral brain flow (rCBF) in SSHL patients. RTMS appears to be an effective, practical, and safe treatment strategy for SSHL.
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Affiliation(s)
- Dai Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Yuewen Ma
- Department of Rehabilitation Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China
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Sahakian BJ, Bruhl AB, Cook J, Killikelly C, Savulich G, Piercy T, Hafizi S, Perez J, Fernandez-Egea E, Suckling J, Jones PB. The impact of neuroscience on society: cognitive enhancement in neuropsychiatric disorders and in healthy people. Philos Trans R Soc Lond B Biol Sci 2015; 370:20140214. [PMID: 26240429 PMCID: PMC4528826 DOI: 10.1098/rstb.2014.0214] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2015] [Indexed: 01/23/2023] Open
Abstract
In addition to causing distress and disability to the individual, neuropsychiatric disorders are also extremely expensive to society and governments. These disorders are both common and debilitating and impact on cognition, functionality and wellbeing. Cognitive enhancing drugs, such as cholinesterase inhibitors and methylphenidate, are used to treat cognitive dysfunction in Alzheimer's disease and attention deficit hyperactivity disorder, respectively. Other cognitive enhancers include specific computerized cognitive training and devices. An example of a novel form of cognitive enhancement using the technological advancement of a game on an iPad that also acts to increase motivation is presented. Cognitive enhancing drugs, such as methylphenidate and modafinil, which were developed as treatments, are increasingly being used by healthy people. Modafinil not only affects 'cold' cognition, but also improves 'hot' cognition, such as emotion recognition and task-related motivation. The lifestyle use of 'smart drugs' raises both safety concerns as well as ethical issues, including coercion and increasing disparity in society. As a society, we need to consider which forms of cognitive enhancement (e.g. pharmacological, exercise, lifelong learning) are acceptable and for which groups (e.g. military, doctors) under what conditions (e.g. war, shift work) and by what methods we would wish to improve and flourish.
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Affiliation(s)
- Barbara J Sahakian
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 3EB, UK
| | - Annette B Bruhl
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 3EB, UK Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland
| | - Jennifer Cook
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK
| | - Clare Killikelly
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK
| | - George Savulich
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK
| | - Thomas Piercy
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK
| | - Sepehr Hafizi
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK CAMEO North Team, 3 Thorpe Road, Peterborough PE3 6AN, UK
| | - Jesus Perez
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK CAMEO South Team, Block 7, Ida Darwin Site, Fulbourn, Cambridge CB21 5EE, UK
| | - Emilio Fernandez-Egea
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 3EB, UK
| | - John Suckling
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 3EB, UK
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 3EB, UK
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Lefaucheur JP, André-Obadia N, Antal A, Ayache SS, Baeken C, Benninger DH, Cantello RM, Cincotta M, de Carvalho M, De Ridder D, Devanne H, Di Lazzaro V, Filipović SR, Hummel FC, Jääskeläinen SK, Kimiskidis VK, Koch G, Langguth B, Nyffeler T, Oliviero A, Padberg F, Poulet E, Rossi S, Rossini PM, Rothwell JC, Schönfeldt-Lecuona C, Siebner HR, Slotema CW, Stagg CJ, Valls-Sole J, Ziemann U, Paulus W, Garcia-Larrea L. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS). Clin Neurophysiol 2014; 125:2150-2206. [PMID: 25034472 DOI: 10.1016/j.clinph.2014.05.021] [Citation(s) in RCA: 1276] [Impact Index Per Article: 127.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 05/09/2014] [Accepted: 05/13/2014] [Indexed: 12/11/2022]
Abstract
A group of European experts was commissioned to establish guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS) from evidence published up until March 2014, regarding pain, movement disorders, stroke, amyotrophic lateral sclerosis, multiple sclerosis, epilepsy, consciousness disorders, tinnitus, depression, anxiety disorders, obsessive-compulsive disorder, schizophrenia, craving/addiction, and conversion. Despite unavoidable inhomogeneities, there is a sufficient body of evidence to accept with level A (definite efficacy) the analgesic effect of high-frequency (HF) rTMS of the primary motor cortex (M1) contralateral to the pain and the antidepressant effect of HF-rTMS of the left dorsolateral prefrontal cortex (DLPFC). A Level B recommendation (probable efficacy) is proposed for the antidepressant effect of low-frequency (LF) rTMS of the right DLPFC, HF-rTMS of the left DLPFC for the negative symptoms of schizophrenia, and LF-rTMS of contralesional M1 in chronic motor stroke. The effects of rTMS in a number of indications reach level C (possible efficacy), including LF-rTMS of the left temporoparietal cortex in tinnitus and auditory hallucinations. It remains to determine how to optimize rTMS protocols and techniques to give them relevance in routine clinical practice. In addition, professionals carrying out rTMS protocols should undergo rigorous training to ensure the quality of the technical realization, guarantee the proper care of patients, and maximize the chances of success. Under these conditions, the therapeutic use of rTMS should be able to develop in the coming years.
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Affiliation(s)
- Jean-Pascal Lefaucheur
- Department of Physiology, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris, Créteil, France; EA 4391, Nerve Excitability and Therapeutic Team, Faculty of Medicine, Paris Est Créteil University, Créteil, France.
| | - Nathalie André-Obadia
- Neurophysiology and Epilepsy Unit, Pierre Wertheimer Neurological Hospital, Hospices Civils de Lyon, Bron, France; Inserm U 1028, NeuroPain Team, Neuroscience Research Center of Lyon (CRNL), Lyon-1 University, Bron, France
| | - Andrea Antal
- Department of Clinical Neurophysiology, Georg-August University, Göttingen, Germany
| | - Samar S Ayache
- Department of Physiology, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris, Créteil, France; EA 4391, Nerve Excitability and Therapeutic Team, Faculty of Medicine, Paris Est Créteil University, Créteil, France
| | - Chris Baeken
- Department of Psychiatry and Medical Psychology, Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium; Department of Psychiatry, University Hospital (UZBrussel), Brussels, Belgium
| | - David H Benninger
- Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Roberto M Cantello
- Department of Translational Medicine, Section of Neurology, University of Piemonte Orientale "A. Avogadro", Novara, Italy
| | | | - Mamede de Carvalho
- Institute of Physiology, Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Portugal
| | - Dirk De Ridder
- Brai(2)n, Tinnitus Research Initiative Clinic Antwerp, Belgium; Department of Neurosurgery, University Hospital Antwerp, Belgium
| | - Hervé Devanne
- Department of Clinical Neurophysiology, Lille University Hospital, Lille, France; ULCO, Lille-Nord de France University, Lille, France
| | - Vincenzo Di Lazzaro
- Department of Neurosciences, Institute of Neurology, Campus Bio-Medico University, Rome, Italy
| | - Saša R Filipović
- Department of Neurophysiology, Institute for Medical Research, University of Belgrade, Beograd, Serbia
| | - Friedhelm C Hummel
- Brain Imaging and Neurostimulation (BINS) Laboratory, Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Satu K Jääskeläinen
- Department of Clinical Neurophysiology, Turku University Hospital, University of Turku, Turku, Finland
| | - Vasilios K Kimiskidis
- Laboratory of Clinical Neurophysiology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Giacomo Koch
- Non-Invasive Brain Stimulation Unit, Neurologia Clinica e Comportamentale, Fondazione Santa Lucia IRCCS, Rome, Italy
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Thomas Nyffeler
- Perception and Eye Movement Laboratory, Department of Neurology, University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Antonio Oliviero
- FENNSI Group, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Emmanuel Poulet
- Department of Emergency Psychiatry, CHU Lyon, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France; EAM 4615, Lyon-1 University, Bron, France
| | - Simone Rossi
- Brain Investigation & Neuromodulation Lab, Unit of Neurology and Clinical Neurophysiology, Department of Neuroscience, University of Siena, Siena, Italy
| | - Paolo Maria Rossini
- Brain Connectivity Laboratory, IRCCS San Raffaele Pisana, Rome, Italy; Institute of Neurology, Catholic University, Rome, Italy
| | - John C Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London, United Kingdom
| | | | - Hartwig R Siebner
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | | | - Charlotte J Stagg
- Oxford Centre for Functional MRI of the Brain (FMRIB), Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - Josep Valls-Sole
- EMG Unit, Neurology Service, Hospital Clinic, Department of Medicine, University of Barcelona, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Ulf Ziemann
- Department of Neurology & Stroke, and Hertie Institute for Clinical Brain Research, Eberhard Karls University, Tübingen, Germany
| | - Walter Paulus
- Department of Clinical Neurophysiology, Georg-August University, Göttingen, Germany
| | - Luis Garcia-Larrea
- Inserm U 1028, NeuroPain Team, Neuroscience Research Center of Lyon (CRNL), Lyon-1 University, Bron, France; Pain Unit, Pierre Wertheimer Neurological Hospital, Hospices Civils de Lyon, Bron, France
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Moseley P, Fernyhough C, Ellison A. Auditory verbal hallucinations as atypical inner speech monitoring, and the potential of neurostimulation as a treatment option. Neurosci Biobehav Rev 2013; 37:2794-805. [PMID: 24125858 PMCID: PMC3870271 DOI: 10.1016/j.neubiorev.2013.10.001] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 09/05/2013] [Accepted: 10/02/2013] [Indexed: 02/09/2023]
Abstract
We discuss ‘inner speech’ theories of auditory verbal hallucinations. Atypical self-monitoring may lead to the experience of inner speech as external. We summarize research into the use of neurostimulation to treat hallucinations. Effects of neurostimulation may be due to modulation of self-monitoring networks.
Auditory verbal hallucinations (AVHs) are the experience of hearing voices in the absence of any speaker, often associated with a schizophrenia diagnosis. Prominent cognitive models of AVHs suggest they may be the result of inner speech being misattributed to an external or non-self source, due to atypical self- or reality monitoring. These arguments are supported by studies showing that people experiencing AVHs often show an externalising bias during monitoring tasks, and neuroimaging evidence which implicates superior temporal brain regions, both during AVHs and during tasks that measure verbal self-monitoring performance. Recently, efficacy of noninvasive neurostimulation techniques as a treatment option for AVHs has been tested. Meta-analyses show a moderate effect size in reduction of AVH frequency, but there has been little attempt to explain the therapeutic effect of neurostimulation in relation to existing cognitive models. This article reviews inner speech models of AVHs, and argues that a possible explanation for reduction in frequency following treatment may be modulation of activity in the brain regions involving the monitoring of inner speech.
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Affiliation(s)
- Peter Moseley
- Psychology Department, Durham University, South Road, Durham DH1 3LE, UK.
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Schraven SP, Plontke SK, Rahne T, Wasserka B, Plewnia C. Hearing Safety of Long-Term Treatment with Theta Burst Stimulation. Brain Stimul 2013; 6:563-8. [DOI: 10.1016/j.brs.2012.10.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 08/03/2012] [Accepted: 10/10/2012] [Indexed: 12/23/2022] Open
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Langguth B, De Ridder D. Tinnitus: therapeutic use of superficial brain stimulation. HANDBOOK OF CLINICAL NEUROLOGY 2013; 116:441-467. [PMID: 24112915 DOI: 10.1016/b978-0-444-53497-2.00036-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Tinnitus is a common disorder and traditional treatment approaches such as medication, active or passive sound enhancement, and cognitive behavioral therapy have limited efficacy. Thus, there is an urgent need for more effective treatment approaches. Functional imaging studies in patients with tinnitus have revealed alterations in neuronal activity of central auditory pathways, probably resulting as a consequence of sensory deafferentation. However, nonauditory brain areas are also involved. These nonauditory brain areas might represent both an "awareness" network involved in the conscious perception of the tinnitus signal as well as areas related to a nontinnitus-specific distress network consisting of the anterior cingulate cortex, anterior insula, and amygdala. Moreover, memory mechanisms involving the hippocampus and the parahippocampal region may play a role in the persistence of the awareness of the phantom percept, as well as in the reinforcement of the associated distress. All of these networks represent potential targets for treatment via pharmacological treatment or noninvasive and invasive brain stimulation. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive method of applying electromagnetic fields to the brain that can induce alterations of neuronal activity that outlast the stimulation period. Single sessions of rTMS over the temporal or temporoparietal cortex have been successful in transiently reducing tinnitus perception. Repeated sessions of rTMS have resulted in tinnitus relief in a subgroup of patients, lasting from several days to several months. However, effect sizes of rTMS in the treatment of tinnitus are only moderate, and interindividual variability is high. Larger and longer lasting effects have been observed with direct electrical stimulation of the auditory cortex via implanted epidural electrodes. Transcranial direct current stimulation (tDCS) has also shown potential for the treatment of tinnitus. Both auditory and frontal tDCS have shown tinnitus reduction in a subgroup of patients. In spite of the promising results of the different brain stimulation approaches, further research is needed before these techniques can be recommended for routine clinical use.
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Affiliation(s)
- Berthold Langguth
- Interdisciplinary Tinnitus Clinic, Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
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Tringali S, Perrot X, Collet L, Moulin A. Exposition sonore et répercussions auditives au cours de la stimulation magnétique transcrânienne répétitive : données récentes et revue de la littérature. Neurophysiol Clin 2013; 43:19-33. [DOI: 10.1016/j.neucli.2012.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Revised: 04/16/2012] [Accepted: 07/07/2012] [Indexed: 12/12/2022] Open
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