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Cacace AT, Berri B. Blast Overpressures as a Military and Occupational Health Concern. Am J Audiol 2023; 32:779-792. [PMID: 37713532 DOI: 10.1044/2023_aja-23-00125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2023] Open
Abstract
PURPOSE This tutorial reviews effects of environmental stressors like blast overpressures and other well-known acoustic contaminants (continuous, intermittent, and impulsive noise) on hearing, tinnitus, vestibular, and balance-related functions. Based on the overall outcome of these effects, detailed consideration is given to the health and well-being of individuals. METHOD Because hearing loss and tinnitus are consequential in affecting quality of life, novel neuromodulation paradigms are reviewed for their positive abatement and treatment-related effects. Examples of clinical data, research strategies, and methodological approaches focus on repetitive transcranial magnetic stimulation (rTMS) and electrical stimulation of the vagus nerve paired with tones (VNSt) for their unique contributions to this area. RESULTS Acoustic toxicants transmitted through the atmosphere are noteworthy for their propensity to induce hearing loss and tinnitus. Mounting evidence also indicates that high-level rapid onset changes in atmospheric sound pressure can significantly impact vestibular and balance function. Indeed, the risk of falling secondary to loss of, or damage to, sensory receptor cells in otolith organs (utricle and saccule) is a primary reason for this concern. As part of the complexities involved in VNSt treatment strategies, vocal dysfunction may also manifest. In addition, evaluation of temporospatial gait parameters is worthy of consideration based on their ability to detect and monitor incipient neurological disease, cognitive decline, and mortality. CONCLUSION Highlighting these respective areas underscores the need to enhance information exchange among scientists, clinicians, and caregivers on the benefits and complications of these outcomes.
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Affiliation(s)
- Anthony T Cacace
- Department of Communication Sciences & Disorders, Wayne State University, Detroit, MI
| | - Batoul Berri
- Department of Communication Sciences & Disorders, Wayne State University, Detroit, MI
- Department of Otolaryngology, University of Michigan, Ann Arbor
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Zhu C, Wang XY, Zhao J, Long B, Xiao X, Pan LY, Yuan TF, Chen JH. Effect of transdermal drug delivery therapy on anxiety symptoms in schizophrenic patients. Front Neurosci 2023; 17:1177214. [PMID: 37360162 PMCID: PMC10289061 DOI: 10.3389/fnins.2023.1177214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/25/2023] [Indexed: 06/28/2023] Open
Abstract
Objective To evaluate the efficacy and safety of transdermal drug delivery therapy for schizophrenia with anxiety symptoms. Methods A total of 80 schizophrenic patients (34 males and 56 females) with comorbid anxiety disorders were randomly assigned to the treatment group (n = 40) and the control group (n = 40) with 6 weeks of follow-up. The patients in the treatment group received the standard antipsychotic drug treatment along with transdermal drug delivery therapy. The evaluation of the patients included the Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD-17), and treatment emergent symptom scale (TESS) at baseline, 3 weeks, and 6 weeks after transdermal drug delivery therapy. The Positive and Negative Symptom Scale (PANSS) was assessed at baseline and after 6 weeks of treatment. Results After 3 and 6 weeks of treatment, the HAMA scale scores in the treatment group were lower than those in the control group (p < 0.001). However, there were no significant differences in the HAMD-17 scale scores, PANSS total scores, and subscale scores between the two groups (p > 0.05). Additionally, no significant differences in adverse effects were observed between the two groups during the intervention period (p > 0.05). After 6 weeks of penetration therapy, there was a low negative correlation between total disease duration and the change in HAMA scale score (pretreatment-posttreatment) in the treatment group. Conclusion Combined traditional Chinese medicine directed penetration therapy can improve the anxiety symptoms of patients with schizophrenia and has a safe profile.
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Affiliation(s)
- Cuifang Zhu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute of Traditional Chinese Medicine for Mental Health, Shanghai, China
| | - Xin-Yue Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute of Traditional Chinese Medicine for Mental Health, Shanghai, China
| | - Bin Long
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute of Traditional Chinese Medicine for Mental Health, Shanghai, China
| | - Xudong Xiao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute of Traditional Chinese Medicine for Mental Health, Shanghai, China
| | - Ling-Yi Pan
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ti-Fei Yuan
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian-Hua Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute of Traditional Chinese Medicine for Mental Health, Shanghai, China
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TAVAKOLI H, HEIDARPANAH A. Literature Review of the Efficacy of Repetitive Transcranial Magnetic Stimulation on Epilepsy. IRANIAN JOURNAL OF CHILD NEUROLOGY 2023; 17:9-28. [PMID: 36721826 PMCID: PMC9881833 DOI: 10.22037/ijcn.v17i2.38752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 12/03/2022] [Indexed: 02/02/2023]
Abstract
Repetitive transcranial magnetic stimulation (rTMS), often recognized as a safe and tolerable method with promising therapeutic potential for the treatment of a variety of neurological disorders, has been extensively studied by medical engineering scientists in recent decades. Epilepsy has always been one of the vital foci in the therapeutic role of rTMS, especially its low-frequency type. However, various reports, clinical trials, and review articles published in recent years have yielded conflicting results regarding the efficacy and side effects of rTMS in patients. In this review article, reviewing studies published from January 2000 to October 2021, we examined the efficacy and side effects of rTMS with a specific look at its therapeutic applications in epilepsy. Our study indicates promising results in the clinical application of this technique for patients with epilepsy. Among other things, it has the ability to reduce interictal epileptic abnormalities, does not interfere with neuropsychological function in normal people, does not worsen cognitive function and even improves Stroop function, rarely has serious side effects such as seizures and psychotic symptoms, has low risk in children as adults, and has potential for improving suicidal ideation. Despite some limitations in this study, including the small number of studies performed and the heterogeneity among studies, this review article suggests significant rtMS potentials in improving the complications of epilepsy. Our review also showed that the reported side effects of using this technique are not very common. Therefore, we can recommend further use of this technique as a promising tool in clinical research.
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Affiliation(s)
- Hassan TAVAKOLI
- Radiation Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran,Department of Physiology and Medical physics, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Arsalan HEIDARPANAH
- Department of Biomedical Engineering, Faculty of Electrical Engineering, South Tehran Branch, Islamic Azad University, Tehran, Iran
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Rossi S, Antal A, Bestmann S, Bikson M, Brewer C, Brockmöller J, Carpenter LL, Cincotta M, Chen R, Daskalakis JD, Di Lazzaro V, Fox MD, George MS, Gilbert D, Kimiskidis VK, Koch G, Ilmoniemi RJ, Lefaucheur JP, Leocani L, Lisanby SH, Miniussi C, Padberg F, Pascual-Leone A, Paulus W, Peterchev AV, Quartarone A, Rotenberg A, Rothwell J, Rossini PM, Santarnecchi E, Shafi MM, Siebner HR, Ugawa Y, Wassermann EM, Zangen A, Ziemann U, Hallett M. Safety and recommendations for TMS use in healthy subjects and patient populations, with updates on training, ethical and regulatory issues: Expert Guidelines. Clin Neurophysiol 2021; 132:269-306. [PMID: 33243615 PMCID: PMC9094636 DOI: 10.1016/j.clinph.2020.10.003] [Citation(s) in RCA: 545] [Impact Index Per Article: 181.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 12/11/2022]
Abstract
This article is based on a consensus conference, promoted and supported by the International Federation of Clinical Neurophysiology (IFCN), which took place in Siena (Italy) in October 2018. The meeting intended to update the ten-year-old safety guidelines for the application of transcranial magnetic stimulation (TMS) in research and clinical settings (Rossi et al., 2009). Therefore, only emerging and new issues are covered in detail, leaving still valid the 2009 recommendations regarding the description of conventional or patterned TMS protocols, the screening of subjects/patients, the need of neurophysiological monitoring for new protocols, the utilization of reference thresholds of stimulation, the managing of seizures and the list of minor side effects. New issues discussed in detail from the meeting up to April 2020 are safety issues of recently developed stimulation devices and pulse configurations; duties and responsibility of device makers; novel scenarios of TMS applications such as in the neuroimaging context or imaging-guided and robot-guided TMS; TMS interleaved with transcranial electrical stimulation; safety during paired associative stimulation interventions; and risks of using TMS to induce therapeutic seizures (magnetic seizure therapy). An update on the possible induction of seizures, theoretically the most serious risk of TMS, is provided. It has become apparent that such a risk is low, even in patients taking drugs acting on the central nervous system, at least with the use of traditional stimulation parameters and focal coils for which large data sets are available. Finally, new operational guidelines are provided for safety in planning future trials based on traditional and patterned TMS protocols, as well as a summary of the minimal training requirements for operators, and a note on ethics of neuroenhancement.
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Affiliation(s)
- Simone Rossi
- Department of Scienze Mediche, Chirurgiche e Neuroscienze, Unit of Neurology and Clinical Neurophysiology, Brain Investigation and Neuromodulation Lab (SI-BIN Lab), University of Siena, Italy.
| | - Andrea Antal
- Department of Clinical Neurophysiology, University Medical Center, Georg-August University of Goettingen, Germany; Institue of Medical Psychology, Otto-Guericke University Magdeburg, Germany
| | - Sven Bestmann
- Department of Movement and Clinical Neurosciences, UCL Queen Square Institute of Neurology, London, UK and Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of New York, New York, NY, USA
| | - Carmen Brewer
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health (NIH), Bethesda, MD, USA
| | - Jürgen Brockmöller
- Department of Clinical Pharmacology, University Medical Center, Georg-August University of Goettingen, Germany
| | - Linda L Carpenter
- Butler Hospital, Brown University Department of Psychiatry and Human Behavior, Providence, RI, USA
| | - Massimo Cincotta
- Unit of Neurology of Florence - Central Tuscany Local Health Authority, Florence, Italy
| | - Robert Chen
- Krembil Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Canada
| | - Jeff D Daskalakis
- Center for Addiction and Mental Health (CAMH), University of Toronto, Canada
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico, Roma, Italy
| | - Michael D Fox
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Mark S George
- Medical University of South Carolina, Charleston, SC, USA
| | - Donald Gilbert
- Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Vasilios K Kimiskidis
- Laboratory of Clinical Neurophysiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Greece
| | | | - Risto J Ilmoniemi
- Department of Neuroscience and Biomedical Engineering (NBE), Aalto University School of Science, Aalto, Finland
| | - Jean Pascal Lefaucheur
- EA 4391, ENT Team, Faculty of Medicine, Paris Est Creteil University (UPEC), Créteil, France; Clinical Neurophysiology Unit, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, (APHP), Créteil, France
| | - Letizia Leocani
- Department of Neurology, Institute of Experimental Neurology (INSPE), IRCCS-San Raffaele Hospital, Vita-Salute San Raffaele University, Milano, Italy
| | - Sarah H Lisanby
- National Institute of Mental Health (NIMH), National Institutes of Health (NIH), Bethesda, MD, USA; Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Carlo Miniussi
- Center for Mind/Brain Sciences - CIMeC, University of Trento, Rovereto, Italy
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Alvaro Pascual-Leone
- Hinda and Arthur Marcus Institute for Aging Research and Center for Memory Health, Hebrew SeniorLife, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA; Guttmann Brain Health Institut, Institut Guttmann, Universitat Autonoma Barcelona, Spain
| | - Walter Paulus
- Department of Clinical Neurophysiology, University Medical Center, Georg-August University of Goettingen, Germany
| | - Angel V Peterchev
- Departments of Psychiatry & Behavioral Sciences, Biomedical Engineering, Electrical & Computer Engineering, and Neurosurgery, Duke University, Durham, NC, USA
| | - Angelo Quartarone
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Alexander Rotenberg
- Department of Neurology, Division of Epilepsy and Clinical Neurophysiology, Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - John Rothwell
- Department of Movement and Clinical Neurosciences, UCL Queen Square Institute of Neurology, London, UK and Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | - Paolo M Rossini
- Department of Neuroscience and Rehabilitation, IRCCS San Raffaele-Pisana, Roma, Italy
| | - Emiliano Santarnecchi
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Mouhsin M Shafi
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Hartwig R Siebner
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark; Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark; Institute for Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Yoshikatzu Ugawa
- Department of Human Neurophysiology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Eric M Wassermann
- National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Abraham Zangen
- Zlotowski Center of Neuroscience, Ben Gurion University, Beer Sheva, Israel
| | - Ulf Ziemann
- Department of Neurology & Stroke, and Hertie-Institute for Clinical Brain Research, University of Tübingen, Germany
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD, USA.
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Tsuboyama M, Kaye HL, Rotenberg A. Review of Transcranial Magnetic Stimulation in Epilepsy. Clin Ther 2020; 42:1155-1168. [PMID: 32624320 DOI: 10.1016/j.clinthera.2020.05.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 05/18/2020] [Accepted: 05/27/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE Despite the availability of numerous pharmacologic and nonpharmacologic antiseizure therapies, a fraction of patients with epilepsy remain refractory to current treatment options, underscoring the need for novel drugs and neuromodulatory therapies. Transcranial magnetic stimulation (TMS), coupled with either electromyography or electroencephalography, enables rapid measurement of the cortical excitation/inhibition ratio, which is pathologically shifted toward excess excitability in patients with epilepsy. In this review, we summarize: (1) TMS protocols that have been deployed to identify promising compounds in the antiepilepsy drug (AED)-development pipeline, and (2) the therapeutic potential of TMS in the treatment of drug-resistant seizures. METHODS A focused literature review of the use of TMS in epilepsy, using a PubMed search, was performed. Over 70 articles were included that pertained to: (1) the use of TMS-EMG and TMS-EEG in elucidating the mechanisms of action of AEDs and in discovering potential new AEDs; and (2) the use of repetitive TMS in the treatment of seizures. FINDINGS Studies from the literature have reported that AEDs alter TMS-derived metrics, typically by leading to a net increase in cortical inhibition with successful therapy. Preclinical TMS work in rodent models of epilepsy has led to the development of novel antiseizure drug compounds. Clinical translational studies of TMS have been used to determine guidelines on the dosages of other agents in the AED pipeline in preparation for clinical trials. Several studies have described the use of therapeutic repetitive TMS in both the ictal and interictal states of epilepsy, with inconsistent results. IMPLICATIONS TMS has diagnostic and therapeutic potential in epilepsy. TMS-derived markers can enable early-stage measures of AED target engagement, and can facilitate studies of the pharmacokinetic and pharmacodynamic properties of AEDs. TMS may also be used in the early prediction of the efficacy of different AEDs in treating patients, and in direct neuromodulation of epileptic networks. From the therapeutics perspective, despite favorable results in some trials, the optimization of treatment paradigms and the determination of ideal candidates for TMS are still needed. Finally, preclinical experiments of TMS have provided mechanistic insight into its effects on the excitation/inhibition ratio, and may facilitate rational drug-device coupling paradigms. Overall, the capacity of TMS in both the modulation and measurement of changes in cortical excitability highlights its unique role in advancing antiepilepsy therapeutics.
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Affiliation(s)
- Melissa Tsuboyama
- Neuromodulation Program, Department of Neurology, Division of Epilepsy and Clinical Neurophysiology, Boston Children's Hospital, Boston, MA, USA; FM Kirby Neurobiology Center, Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Harper L Kaye
- Behavioral Neuroscience Program, Boston University School of Medicine, Boston, MA, USA
| | - Alexander Rotenberg
- Neuromodulation Program, Department of Neurology, Division of Epilepsy and Clinical Neurophysiology, Boston Children's Hospital, Boston, MA, USA; FM Kirby Neurobiology Center, Department of Neurology, Boston Children's Hospital, Boston, MA, USA; Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Boston, MA, USA.
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Sabel BA, Thut G, Haueisen J, Henrich-Noack P, Herrmann CS, Hunold A, Kammer T, Matteo B, Sergeeva EG, Waleszczyk W, Antal A. Vision modulation, plasticity and restoration using non-invasive brain stimulation – An IFCN-sponsored review. Clin Neurophysiol 2020; 131:887-911. [DOI: 10.1016/j.clinph.2020.01.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 12/18/2019] [Accepted: 01/02/2020] [Indexed: 12/11/2022]
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Lawson McLean A. Publication trends in transcranial magnetic stimulation: a 30-year panorama. Brain Stimul 2019; 12:619-627. [DOI: 10.1016/j.brs.2019.01.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 01/02/2019] [Accepted: 01/07/2019] [Indexed: 01/11/2023] Open
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Cacace AT, Hu J, Romero S, Xuan Y, Burkard RF, Tyler RS. Glutamate is down-regulated and tinnitus loudness-levels decreased following rTMS over auditory cortex of the left hemisphere: A prospective randomized single-blinded sham-controlled cross-over study. Hear Res 2018; 358:59-73. [DOI: 10.1016/j.heares.2017.10.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 10/25/2017] [Accepted: 10/31/2017] [Indexed: 12/14/2022]
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Nardone R, Brigo F, Höller Y, Sebastianelli L, Versace V, Saltuari L, Lochner P, Trinka E. Transcranial magnetic stimulation studies in complex regional pain syndrome type I: A review. Acta Neurol Scand 2018; 137:158-164. [PMID: 28971481 DOI: 10.1111/ane.12852] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2017] [Indexed: 01/23/2023]
Abstract
The sensory and motor cortical representation corresponding to the affected limb is altered in patients with complex regional pain syndrome (CRPS). Transcranial magnetic stimulation (TMS) represents a useful non-invasive approach for studying cortical physiology. If delivered repetitively, TMS can also modulate cortical excitability and induce long-lasting neuroplastic changes. In this review, we performed a systematic search of all studies using TMS to explore cortical excitability/plasticity and repetitive TMS (rTMS) for the treatment of CRPS. Literature searches were conducted using PubMed and EMBASE. We identified 8 articles matching the inclusion criteria. One hundred fourteen patients (76 females and 38 males) were included in these studies. Most of them have applied TMS in order to physiologically characterize CRPS type I. Changes in motor cortex excitability and brain mapping have been reported in CRPS-I patients. Sensory and motor hyperexcitability are in the most studies bilateral and likely involve corresponding regions within the central nervous system rather than the entire hemisphere. Conversely, sensorimotor integration and plasticity were found to be normal in CRPS-I. TMS examinations also revealed that the nature of motor dysfunction in CRPS-I patients differs from that observed in patients with functional movement disorders, limb immobilization, or idiopathic dystonia. TMS studies may thus lead to the implementation of correct rehabilitation strategies in CRPS-I patients. Two studies have begun to therapeutically use rTMS. This non-invasive brain stimulation technique could have therapeutic utility in CRPS, but further well-designed studies are needed to corroborate initial findings.
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Affiliation(s)
- R. Nardone
- Department of Neurology Franz Tappeiner Hospital Merano Italy
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience Paracelsus Medical University Salzburg Austria
- Spinal Cord Injury and Tissue Regeneration Center Salzburg Austria
| | - F. Brigo
- Department of Neurology Franz Tappeiner Hospital Merano Italy
- Department of Neuroscience, Biomedicine and Movement Science University of Verona Verona Italy
| | - Y. Höller
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience Paracelsus Medical University Salzburg Austria
| | - L. Sebastianelli
- Department of Neurorehabilitation Hospital of Vipiteno, and Research Department for Neurorehabilitation South Tyrol Bolzano Italy
| | - V. Versace
- Department of Neurorehabilitation Hospital of Vipiteno, and Research Department for Neurorehabilitation South Tyrol Bolzano Italy
| | - L. Saltuari
- Department of Neurorehabilitation Hospital of Vipiteno, and Research Department for Neurorehabilitation South Tyrol Bolzano Italy
- Department of Neurology Hochzirl Hospital Zirl Austria
| | - P. Lochner
- Department of Neurology Saarland University Medical Center Homburg Germany
| | - E. Trinka
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience Paracelsus Medical University Salzburg Austria
- Spinal Cord Injury and Tissue Regeneration Center Salzburg Austria
- University for Medical Informatics and Health Technology, UMIT Hall in Tirol Austria
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Hardy S, Bastick L, O'Neill-Kerr A, Sabesan P, Lankappa S, Palaniyappan L. Transcranial magnetic stimulation in clinical practice. BJPSYCH ADVANCES 2018. [DOI: 10.1192/apt.bp.115.015206] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
SummaryUp to 40% of people with depression do not recover following standard treatments such as medication and psychotherapy. Transcranial magnetic stimulation (TMS) is a treatment used worldwide for adult patients with severe clinical depression when antidepressants have repeatedly failed to control their symptoms. This article explains the use of TMS in clinical practice.
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Yuan Y, Pang N, Chen YD, Wang Y, Li XL. Theoretical analysis of the effects of transcranial magneto-acoustical stimulation on neuronal firing rhythm and Ca
2+
concentration with Chay neuron model. Biomed Phys Eng Express 2017. [DOI: 10.1088/2057-1976/aa84c8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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12
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Hameed MQ, Dhamne SC, Gersner R, Kaye HL, Oberman LM, Pascual-Leone A, Rotenberg A. Transcranial Magnetic and Direct Current Stimulation in Children. Curr Neurol Neurosci Rep 2017; 17:11. [PMID: 28229395 PMCID: PMC5962296 DOI: 10.1007/s11910-017-0719-0] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Promising results in adult neurologic and psychiatric disorders are driving active research into transcranial brain stimulation techniques, particularly transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), in childhood and adolescent syndromes. TMS has realistic utility as an experimental tool tested in a range of pediatric neuropathologies such as perinatal stroke, depression, Tourette syndrome, and autism spectrum disorder (ASD). tDCS has also been tested as a treatment for a number of pediatric neurologic conditions, including ASD, attention-deficit/hyperactivity disorder, epilepsy, and cerebral palsy. Here, we complement recent reviews with an update of published TMS and tDCS results in children, and discuss developmental neuroscience considerations that should inform pediatric transcranial stimulation.
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Affiliation(s)
- Mustafa Q Hameed
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA
- F.M. Kirby Neurobiology Center, Department of Neurology, Boston Children's Hospital Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA
- Department of Neurosurgery, Boston Children's Hospital Harvard Medical School, Boston, MA, 02115, USA
| | - Sameer C Dhamne
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA
- F.M. Kirby Neurobiology Center, Department of Neurology, Boston Children's Hospital Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Roman Gersner
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA
- F.M. Kirby Neurobiology Center, Department of Neurology, Boston Children's Hospital Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Harper L Kaye
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA
- F.M. Kirby Neurobiology Center, Department of Neurology, Boston Children's Hospital Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Lindsay M Oberman
- Neuroplasticity and Autism Spectrum Disorder Program and Department of Psychiatry and Human Behavior, E.P. Bradley Hospital and Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division for Cognitive Neurology, Beth Israel Deaconness Medical Center Harvard Medical School, Boston, MA, USA
- Institut Guttmann, Universitat Autonoma, Barcelona, Spain
| | - Alexander Rotenberg
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA.
- F.M. Kirby Neurobiology Center, Department of Neurology, Boston Children's Hospital Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA.
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Yuan Y, Pang N, Chen Y, Wang Y, Li X. A Phase-Locking Analysis of Neuronal Firing Rhythms with Transcranial Magneto-Acoustical Stimulation Based on the Hodgkin-Huxley Neuron Model. Front Comput Neurosci 2017; 11:1. [PMID: 28163679 PMCID: PMC5247465 DOI: 10.3389/fncom.2017.00001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 01/04/2017] [Indexed: 11/18/2022] Open
Abstract
Transcranial magneto-acoustical stimulation (TMAS) uses ultrasonic waves and a static magnetic field to generate electric current in nerve tissues for the purpose of modulating neuronal activities. It has the advantage of high spatial resolution and penetration depth. Neuronal firing rhythms carry and transmit nerve information in neural systems. In this study, we investigated the phase-locking characteristics of neuronal firing rhythms with TMAS based on the Hodgkin-Huxley neuron model. The simulation results indicate that the modulation frequency of ultrasound can affect the phase-locking behaviors. The results of this study may help us to explain the potential firing mechanism of TMAS.
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Affiliation(s)
- Yi Yuan
- Institute of Electrical Engineering, Yanshan UniversityQinhuangdao, China
| | - Na Pang
- Institute of Electrical Engineering, Yanshan UniversityQinhuangdao, China
| | - Yudong Chen
- Institute of Electrical Engineering, Yanshan UniversityQinhuangdao, China
| | - Yi Wang
- School of Control Engineering, Northeastern University at QinhuangdaoQinhuangdao, China
| | - Xiaoli Li
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal UniversityBeijing, China
- Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal UniversityBeijing, China
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14
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Hesse G. Evidence and evidence gaps in tinnitus therapy. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2016; 15:Doc04. [PMID: 28025604 PMCID: PMC5169077 DOI: 10.3205/cto000131] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
A nearly endless number of procedures has been tried and in particular sold for the treatment of tinnitus, unfortunately they have not been evaluated appropriately in an evidence-based way. A causal therapy, omitting the tinnitus still does not exist, actually it cannot exist because of the various mechanisms of its origin. However or perhaps because of that, medical interventions appear and reappear like fashion trends that can never be proven by stable and reliable treatment success. This contribution will discuss and acknowledge all current therapeutic procedures and the existing or non-existing evidence will be assessed. Beside external evidence, the term of evidence also encompasses the internal evidence, i.e. the experience of the treating physician and the patient's needs shall be included. While there is no evidence for nearly all direct procedures that intend modulating or stimulating either the cochlea or specific cervical regions such as the auditory cortex, there are therapeutic procedures that are acknowledged in clinical practice and have achieved at least a certain degree of evidence and generate measurable effect sizes. Those are in particular habituation therapy and psychotherapeutic measures, especially if they are combined with concrete measures for improved audio perception (hearing aids, CI, hearing therapies).
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Affiliation(s)
- Gerhard Hesse
- Tinnitus-Klinik, Bad Arolsen, Germany; University of Witten-Herdecke, Germany
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15
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Analgesic effects of navigated motor cortex rTMS in patients with chronic neuropathic pain. Eur J Pain 2016; 20:1413-22. [DOI: 10.1002/ejp.864] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2016] [Indexed: 12/12/2022]
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16
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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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17
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Soleimani R, Jalali MM, Hasandokht T. Therapeutic impact of repetitive transcranial magnetic stimulation (rTMS) on tinnitus: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2015; 273:1663-75. [DOI: 10.1007/s00405-015-3642-5] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 04/28/2015] [Indexed: 10/23/2022]
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18
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Deer TR, Mekhail N, Petersen E, Krames E, Staats P, Pope J, Saweris Y, Lad SP, Diwan S, Falowski S, Feler C, Slavin K, Narouze S, Merabet L, Buvanendran A, Fregni F, Wellington J, Levy RM. The appropriate use of neurostimulation: stimulation of the intracranial and extracranial space and head for chronic pain. Neuromodulation Appropriateness Consensus Committee. Neuromodulation 2015; 17:551-70; discussion 570. [PMID: 25112890 DOI: 10.1111/ner.12215] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 04/17/2014] [Accepted: 05/13/2014] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The International Neuromodulation Society (INS) has identified a need for evaluation and analysis of the practice of neurostimulation of the brain and extracranial nerves of the head to treat chronic pain. METHODS The INS board of directors chose an expert panel, the Neuromodulation Appropriateness Consensus Committee (NACC), to evaluate the peer-reviewed literature, current research, and clinical experience and to give guidance for the appropriate use of these methods. The literature searches involved key word searches in PubMed, EMBASE, and Google Scholar dated 1970-2013, which were graded and evaluated by the authors. RESULTS The NACC found that evidence supports extracranial stimulation for facial pain, migraine, and scalp pain but is limited for intracranial neuromodulation. High cervical spinal cord stimulation is an evolving option for facial pain. Intracranial neurostimulation may be an excellent option to treat diseases of the nervous system, such as tremor and Parkinson's disease, and in the future, potentially Alzheimer's disease and traumatic brain injury, but current use of intracranial stimulation for pain should be seen as investigational. CONCLUSIONS The NACC concludes that extracranial nerve stimulation should be considered in the algorithmic treatment of migraine and other disorders of the head. We should strive to perfect targets outside the cranium when treating pain, if at all possible.
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Brunoni AR, Shiozawa P, Truong D, Javitt DC, Elkis H, Fregni F, Bikson M. Understanding tDCS effects in schizophrenia: a systematic review of clinical data and an integrated computation modeling analysis. Expert Rev Med Devices 2014; 11:383-94. [PMID: 24754366 DOI: 10.1586/17434440.2014.911082] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Although recent clinical studies using transcranial direct current stimulation (tDCS) for schizophrenia showed encouraging results, several tDCS montages were employed and their current flow pattern has not been investigated. We performed a systematic review to identify clinical tDCS studies in schizophrenia. We then applied computer head modeling analysis for prediction of current flow. Out of 41 references, we identified 12 relevant studies. The most employed montage was anode and cathode over the left dorsolateral prefrontal and temporoparietal cortex, respectively. Computational model analysis predicted activation and under-activation under the anode and the cathode, respectively, occurring in areas respectively associated with negative and positive symptoms. We also identified tDCS-induced electrical currents in cortical areas between the electrodes (frontoparietal network) and, to a lesser extent, in deeper structures involved in schizophrenia pathophysiology. Mechanisms of tDCS effects in schizophrenia and the usefulness of computer modeling techniques for planning tDCS trials in schizophrenia are discussed.
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Affiliation(s)
- Andre R Brunoni
- Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
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20
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Muller PA, Dhamne SC, Vahabzadeh-Hagh AM, Pascual-Leone A, Jensen FE, Rotenberg A. Suppression of motor cortical excitability in anesthetized rats by low frequency repetitive transcranial magnetic stimulation. PLoS One 2014; 9:e91065. [PMID: 24646791 PMCID: PMC3960125 DOI: 10.1371/journal.pone.0091065] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 02/07/2014] [Indexed: 12/24/2022] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a widely-used method for modulating cortical excitability in humans, by mechanisms thought to involve use-dependent synaptic plasticity. For example, when low frequency rTMS (LF rTMS) is applied over the motor cortex, in humans, it predictably leads to a suppression of the motor evoked potential (MEP), presumably reflecting long-term depression (LTD) -like mechanisms. Yet how closely such rTMS effects actually match LTD is unknown. We therefore sought to (1) reproduce cortico-spinal depression by LF rTMS in rats, (2) establish a reliable animal model for rTMS effects that may enable mechanistic studies, and (3) test whether LTD-like properties are evident in the rat LF rTMS setup. Lateralized MEPs were obtained from anesthetized Long-Evans rats. To test frequency-dependence of LF rTMS, rats underwent rTMS at one of three frequencies, 0.25, 0.5, or 1 Hz. We next tested the dependence of rTMS effects on N-methyl-D-aspartate glutamate receptor (NMDAR), by application of two NMDAR antagonists. We find that 1 Hz rTMS preferentially depresses unilateral MEP in rats, and that this LTD-like effect is blocked by NMDAR antagonists. These are the first electrophysiological data showing depression of cortical excitability following LF rTMS in rats, and the first to demonstrate dependence of this form of cortical plasticity on the NMDAR. We also note that our report is the first to show that the capacity for LTD-type cortical suppression by rTMS is present under barbiturate anesthesia, suggesting that future neuromodulatory rTMS applications under anesthesia may be considered.
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Affiliation(s)
- Paul A. Muller
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Sameer C. Dhamne
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Andrew M. Vahabzadeh-Hagh
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
- Institut Universitari de Neurorehabilitació Guttmann, Universidad Autónoma de Barcelona, Badalona, Spain
| | - Frances E. Jensen
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania, United States of America
| | - Alexander Rotenberg
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
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Shiozawa P, da Silva ME, Cordeiro Q, Fregni F, Brunoni AR. Transcranial Direct Current Stimulation (tDCS) for the Treatment of Persistent Visual and Auditory Hallucinations in Schizophrenia: A Case Study. Brain Stimul 2013; 6:831-3. [DOI: 10.1016/j.brs.2013.03.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 03/05/2013] [Accepted: 03/07/2013] [Indexed: 11/16/2022] Open
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22
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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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23
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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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Repetitive transcranial magnetic stimulation (rTMS) noise: A relevance for tinnitus treatment? Brain Stimul 2012; 5:655-6. [DOI: 10.1016/j.brs.2011.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Accepted: 10/05/2011] [Indexed: 11/19/2022] Open
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25
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Vahabzadeh-Hagh AM, Muller PA, Gersner R, Zangen A, Rotenberg A. Translational neuromodulation: approximating human transcranial magnetic stimulation protocols in rats. Neuromodulation 2012; 15:296-305. [PMID: 22780329 PMCID: PMC5764706 DOI: 10.1111/j.1525-1403.2012.00482.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Transcranial magnetic stimulation (TMS) is a well-established clinical protocol with numerous potential therapeutic and diagnostic applications. Yet, much work remains in the elucidation of TMS mechanisms, optimization of protocols, and in development of novel therapeutic applications. As with many technologies, the key to these issues lies in the proper experimentation and translation of TMS methods to animal models, among which rat models have proven popular. A significant increase in the number of rat TMS publications has necessitated analysis of their relevance to human work. We therefore review the essential principles for the approximation of human TMS protocols in rats as well as specific methods that addressed these issues in published studies. MATERIALS AND METHODS We performed an English language literature search combined with our own experience and data. We address issues that we see as important in the translation of human TMS methods to rat models and provide a summary of key accomplishments in these areas. RESULTS An extensive literature review illustrated the growth of rodent TMS studies in recent years. Current advances in the translation of single, paired-pulse, and repetitive stimulation paradigms to rodent models are presented. The importance of TMS in the generation of data for preclinical trials is also highlighted. CONCLUSIONS Rat TMS has several limitations when considering parallels between animal and human stimulation. However, it has proven to be a useful tool in the field of translational brain stimulation and will likely continue to aid in the design and implementation of stimulation protocols for therapeutic and diagnostic applications.
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Affiliation(s)
- Andrew M. Vahabzadeh-Hagh
- Department of Neurology, Children's Hospital, Harvard Medical School, Boston, MA 02215, USA
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Paul A. Muller
- Department of Neurology, Children's Hospital, Harvard Medical School, Boston, MA 02215, USA
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Roman Gersner
- Department of Neurobiology, The Weizmann Institute of Science, Rehovot 76100, Israel
| | - Abraham Zangen
- Department of Neurobiology, The Weizmann Institute of Science, Rehovot 76100, Israel
| | - Alexander Rotenberg
- Department of Neurology, Children's Hospital, Harvard Medical School, Boston, MA 02215, USA
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
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