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Lányi O, Koleszár B, Schulze Wenning A, Balogh D, Engh MA, Horváth AA, Fehérvari P, Hegyi P, Molnár Z, Unoka Z, Csukly G. Excitation/inhibition imbalance in schizophrenia: a meta-analysis of inhibitory and excitatory TMS-EMG paradigms. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2024; 10:56. [PMID: 38879590 PMCID: PMC11180212 DOI: 10.1038/s41537-024-00476-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/16/2024] [Indexed: 06/19/2024]
Abstract
Cortical excitation-inhibition (E/I) imbalance is a potential model for the pathophysiology of schizophrenia. Previous research using transcranial magnetic stimulation (TMS) and electromyography (EMG) has suggested inhibitory deficits in schizophrenia. In this meta-analysis we assessed the reliability and clinical potential of TMS-EMG paradigms in schizophrenia following the methodological recommendations of the PRISMA guideline and the Cochrane Handbook. The search was conducted in three databases in November 2022. Included articles reported Short-Interval Intracortical Inhibition (SICI), Intracortical Facilitation (ICF), Long-Interval Intracortical Inhibition (LICI) and Cortical Silent Period (CSP) in patients with schizophrenia and healthy controls. Meta-analyses were conducted using a random-effects model. Subgroup analysis and meta-regressions were used to assess heterogeneity. Results of 36 studies revealed a robust inhibitory deficit in schizophrenia with a significant decrease in SICI (Cohen's d: 0.62). A trend-level association was found between SICI and antipsychotic medication. Our findings support the E/I imbalance hypothesis in schizophrenia and suggest that SICI may be a potential pathophysiological characteristic of the disorder.
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Affiliation(s)
- Orsolya Lányi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Boróka Koleszár
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | | | - David Balogh
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Marie Anne Engh
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - András Attila Horváth
- Neurocognitive Research Center, Nyírő Gyula National Institute of Psychiatry and Addictology, Budapest, Hungary
| | - Péter Fehérvari
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Biostatistics, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Zsolt Molnár
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
- Department of Anesthesiology and Intensive Therapy, Poznan University of Medical Sciences, Poznan, Poland
| | - Zsolt Unoka
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Gábor Csukly
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
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Taylor SF, Gu P, Simmonite M, Lasagna C, Tso IF, Lee TG, Vesia M, Hernandez-Garcia L. Lateral Prefrontal Stimulation of Active Cortex With Theta Burst Transcranial Magnetic Stimulation Affects Subsequent Engagement of the Frontoparietal Network. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:235-244. [PMID: 37918508 PMCID: PMC10922157 DOI: 10.1016/j.bpsc.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 10/11/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND A critical unanswered question about therapeutic transcranial magnetic stimulation is what patients should do during treatment to optimize its effectiveness. Here, we address this lack of knowledge in healthy participants, testing the hypotheses that stimulating the left dorsolateral prefrontal cortex (dlPFC) while participants perform a working memory task will provide stronger effects on subsequent activation, perfusion, connectivity, and performance than stimulating resting dlPFC. METHODS After a baseline functional magnetic resonance imaging session to localize dlPFC activation and the associated frontoparietal network (FPN) engaged by an n-back task, healthy participants (N = 40, 67.5% female) underwent 3 counterbalanced sessions, separated by several weeks, during which they received intermittent theta burst stimulation (iTBS) followed by magnetic resonance imaging scans as follows: 1) iTBS to the dlPFC while resting passively (passive), 2) iTBS to the dlPFC while performing the n-back task (active), and 3) iTBS to a vertex site, while not engaged in the n-back task and resting passively (control). RESULTS We found no difference in n-back performance between the 3 conditions. However, FPN activation was reduced while performing the n-back task in the active condition relative to the passive and control conditions. There was no differential activity in the FPN on comparing passive with control conditions, i.e., there was no effect of the site of stimulation. We found no effects of state or site of stimulation on perfusion or connectivity with the dlPFC. CONCLUSIONS In this study, the state of the brain while receiving iTBS affected FPN activation, possibly reflecting greater efficiency of FPN network activation when participants were stimulated while engaging the FPN.
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Affiliation(s)
- Stephan F Taylor
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan; Department of Psychology, University of Michigan, Ann Arbor, Michigan.
| | - Pan Gu
- Department of Neuroscience, University of Texas at Dallas, Richardson, Texas
| | - Molly Simmonite
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan; Department of Psychology, University of Michigan, Ann Arbor, Michigan
| | - Carly Lasagna
- Department of Psychology, University of Michigan, Ann Arbor, Michigan
| | - Ivy F Tso
- Department of Psychiatry & Behavioral Health, The Ohio State University, Columbus, Ohio
| | - Taraz G Lee
- Department of Psychology, University of Michigan, Ann Arbor, Michigan
| | - Michael Vesia
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan
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3
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Quoilin C, Chaise F, Duque J, de Timary P. Relationship between transcranial magnetic stimulation markers of motor control and clinical recovery in obsessive compulsive disorder/Gilles de la Tourette syndrome: a proof of concept case study. Front Psychiatry 2024; 15:1307344. [PMID: 38304284 PMCID: PMC10832049 DOI: 10.3389/fpsyt.2024.1307344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/04/2024] [Indexed: 02/03/2024] Open
Abstract
Background Obsessive compulsive disorder (OCD) and Gilles de la Tourette syndrome (GTS) are neurodevelopmental disorders characterized by difficulties in controlling intrusive thoughts (obsessions) and undesired actions (tics), respectively. Both conditions have been associated with abnormal inhibition but a tangible deficit of inhibitory control abilities is controversial in GTS. Methods Here, we examined a 25 years-old male patient with severe OCD symptoms and a mild form of GTS, where impairments in motor control were central. Transcranial magnetic stimulation (TMS) was applied over the primary motor cortex (M1) to elicit motor-evoked potentials (MEPs) during four experimental sessions, allowing us to assess the excitability of motor intracortical circuitry at rest as well as the degree of MEP suppression during action preparation, a phenomenon thought to regulate movement initiation. Results When tested for the first time, the patient presented a decent level of MEP suppression during action preparation, but he exhibited a lack of intracortical inhibition at rest, as evidenced by reduced short-interval intracortical inhibition (SICI) and long-interval intracortical inhibition (LICI). Interestingly, the patient's symptomatology drastically improved over the course of the sessions (reduced obsessions and tics), coinciding with feedback given on his good motor control abilities. These changes were reflected in the TMS measurements, with a significant strengthening of intracortical inhibition (SICI and LICI more pronounced than previously) and a more selective tuning of MEPs during action preparation; MEPs became even more suppressed, or selectively facilitated depending on the behavioral condition in which they we probed. Conclusion This study highlights the importance of better understanding motor inhibitory mechanisms in neurodevelopmental disorders and suggests a biofeedback approach as a potential novel treatment.
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Affiliation(s)
- Caroline Quoilin
- CoActions Lab, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Fostine Chaise
- CoActions Lab, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Julie Duque
- CoActions Lab, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Philippe de Timary
- CoActions Lab, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
- Department of Adult Psychiatry, Cliniques universitaires Saint-Luc, Brussels, Belgium
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Batschelett MA, Huddleston DA, Crocetti D, Horn PS, Mostofsky SH, Gilbert DL. Biomarkers of tic severity in children with Tourette syndrome: Motor cortex inhibition measured with transcranial magnetic stimulation. Dev Med Child Neurol 2023; 65:1321-1331. [PMID: 36938698 PMCID: PMC10509315 DOI: 10.1111/dmcn.15578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/21/2023]
Abstract
AIM To compare transcranial magnetic stimulation (TMS)-derived measures of primary motor cortex (M1) physiology between children with and without Tourette syndrome, and to dimensionally analyze TMS measures with Tourette syndrome-related symptom severity. METHOD We used a cross-sectional experimental design. Sixty 8- to 12-year-old children participated (30 with Tourette syndrome: three females, mean age 10 years 10 months, standard deviation [SD] 1 year 3 months; 30 typically developing children: seven females, mean age 10 years 7 months, SD 1 year 3 months). In the group with Tourette syndrome, 15 (one female, mean age 10 years 11 months, SD 1 year 3 months) had comorbid attention-deficit/hyperactivity disorder (ADHD), rated with the Conners, Third Edition and the parent-reported ADHD rating scales. Tic severity was rated with the Yale Global Tic Severity Scale and urge severity with the Individualized Premonitory Urge for Tics Scale. M1 short-interval cortical inhibition (SICI) and intracortical facilitation were compared between diagnostic groups and, within the group with Tourette syndrome, correlated with symptom severity using linear mixed-effects models for repeated measures. RESULTS Accounting for ADHD, we found no difference in SICI or intracortical facilitation in those with Tourette syndrome versus typically developing children (p > 0.1). In the group with Tourette syndrome, reduced M1 SICI predicted greater total (p = 0.012) and global (p = 0.002) tic severity. There were no associations with urge severity (p > 0.5). INTERPRETATION Reduced M1 SICI is robustly associated with increased tic, but not urge, severity. WHAT THIS PAPER ADDS Increased tic severity is associated with reduced motor cortex short-interval cortical inhibition (SICI). Children with Tourette syndrome with increased urge severity also show increased tic severity. However, reduced motor cortex SICI is associated with tic, but not urge, severity.
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Affiliation(s)
- Mitchell A Batschelett
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, USA
| | - David A Huddleston
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
| | - Deana Crocetti
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Paul S Horn
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
| | - Stewart H Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Donald L Gilbert
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
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Le Boterff Q, Rabah A, Carment L, Bendjemaa N, Térémetz M, Alouit A, Levy A, Tanguy G, Morin V, Amado I, Cuenca M, Turc G, Maier MA, Krebs MO, Lindberg PG. A tablet-based quantitative assessment of manual dexterity for detection of early psychosis. Front Psychiatry 2023; 14:1200864. [PMID: 37435404 PMCID: PMC10330763 DOI: 10.3389/fpsyt.2023.1200864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/06/2023] [Indexed: 07/13/2023] Open
Abstract
Background We performed a pilot study on whether tablet-based measures of manual dexterity can provide behavioral markers for detection of first-episode psychosis (FEP), and whether cortical excitability/inhibition was altered in FEP. Methods Behavioral and neurophysiological testing was undertaken in persons diagnosed with FEP (N = 20), schizophrenia (SCZ, N = 20), autism spectrum disorder (ASD, N = 20), and in healthy control subjects (N = 20). Five tablet tasks assessed different motor and cognitive functions: Finger Recognition for effector (finger) selection and mental rotation, Rhythm Tapping for temporal control, Sequence Tapping for control/memorization of motor sequences, Multi Finger Tapping for finger individuation, and Line Tracking for visuomotor control. Discrimination of FEP (from other groups) based on tablet-based measures was compared to discrimination through clinical neurological soft signs (NSS). Cortical excitability/inhibition, and cerebellar brain inhibition were assessed with transcranial magnetic stimulation. Results Compared to controls, FEP patients showed slower reaction times and higher errors in Finger Recognition, and more variability in Rhythm Tapping. Variability in Rhythm Tapping showed highest specificity for the identification of FEP patients compared to all other groups (FEP vs. ASD/SCZ/Controls; 75% sensitivity, 90% specificity, AUC = 0.83) compared to clinical NSS (95% sensitivity, 22% specificity, AUC = 0.49). Random Forest analysis confirmed FEP discrimination vs. other groups based on dexterity variables (100% sensitivity, 85% specificity, balanced accuracy = 92%). The FEP group had reduced short-latency intra-cortical inhibition (but similar excitability) compared to controls, SCZ, and ASD. Cerebellar inhibition showed a non-significant tendency to be weaker in FEP. Conclusion FEP patients show a distinctive pattern of dexterity impairments and weaker cortical inhibition. Easy-to-use tablet-based measures of manual dexterity capture neurological deficits in FEP and are promising markers for detection of FEP in clinical practice.
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Affiliation(s)
- Quentin Le Boterff
- INSERM U1266 Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Ayah Rabah
- INSERM U1266 Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Loïc Carment
- INSERM U1266 Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Narjes Bendjemaa
- INSERM U1266 Institut de Psychiatrie et Neurosciences de Paris, Paris, France
- GHU Paris Psychiatrie & Neurosciences, Paris, France
| | - Maxime Térémetz
- INSERM U1266 Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Anaëlle Alouit
- INSERM U1266 Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Agnes Levy
- GHU Paris Psychiatrie & Neurosciences, Paris, France
| | | | | | | | | | - Guillaume Turc
- INSERM U1266 Institut de Psychiatrie et Neurosciences de Paris, Paris, France
- GHU Paris Psychiatrie & Neurosciences, Paris, France
| | - Marc A. Maier
- CNRS, Integrative Neuroscience and Cognition Center, Université Paris Cité, Paris, France
| | - Marie-Odile Krebs
- INSERM U1266 Institut de Psychiatrie et Neurosciences de Paris, Paris, France
- GHU Paris Psychiatrie & Neurosciences, Paris, France
| | - Påvel G. Lindberg
- INSERM U1266 Institut de Psychiatrie et Neurosciences de Paris, Paris, France
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Gao B, Qu YC, Cai MY, Zhang YY, Lu HT, Li HX, Tang YX, Shen H. Phytochemical interventions for post-traumatic stress disorder: A cluster co-occurrence network analysis using CiteSpace. JOURNAL OF INTEGRATIVE MEDICINE 2023:S2095-4964(23)00048-1. [PMID: 37380564 DOI: 10.1016/j.joim.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 03/16/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVE This study investigated trends in the study of phytochemical treatment of post-traumatic stress disorder (PTSD). METHODS The Web of Science database (2007-2022) was searched using the search terms "phytochemicals" and "PTSD," and relevant literature was compiled. Network clustering co-occurrence analysis and qualitative narrative review were conducted. RESULTS Three hundred and one articles were included in the analysis of published research, which has surged since 2015 with nearly half of all relevant articles coming from North America. The category is dominated by neuroscience and neurology, with two journals, Addictive Behaviors and Drug and Alcohol Dependence, publishing the greatest number of papers on these topics. Most studies focused on psychedelic intervention for PTSD. Three timelines show an "ebb and flow" phenomenon between "substance use/marijuana abuse" and "psychedelic medicine/medicinal cannabis." Other phytochemicals account for a small proportion of the research and focus on topics like neurosteroid turnover, serotonin levels, and brain-derived neurotrophic factor expression. CONCLUSION Research on phytochemicals and PTSD is unevenly distributed across countries/regions, disciplines, and journals. Since 2015, the research paradigm shifted to constitute the mainstream of psychedelic research thus far, leading to the exploration of botanical active ingredients and molecular mechanisms. Other studies focus on anti-oxidative stress and anti-inflammation. Please cite this article as: Gao B, Qu YC, Cai MY, Zhang YY, Lu HT, Li HX, Tang YX, Shen H. Phytochemical interventions for post-traumatic stress disorder: A cluster co-occurrence network analysis using CiteSpace. J Integr Med. 2023; Epub ahead of print.
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Affiliation(s)
- Biao Gao
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai 200433, China; Teaching and Research Support Center, Naval Medical University, Shanghai 200433, China
| | - Yi-Cui Qu
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai 200433, China
| | - Meng-Yu Cai
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai 200433, China
| | - Yin-Yin Zhang
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai 200433, China
| | - Hong-Tao Lu
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai 200433, China
| | - Hong-Xia Li
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai 200433, China
| | - Yu-Xiao Tang
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai 200433, China
| | - Hui Shen
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai 200433, China.
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Pross B, Münz S, Nitsche MA, Padberg F, Strube W, Papazova I, Falkai P, Hasan A. Smoking status ameliorates cholinergic impairments in cortical inhibition in patients with schizophrenia. Brain Res 2023; 1812:148380. [PMID: 37121425 DOI: 10.1016/j.brainres.2023.148380] [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: 02/23/2023] [Revised: 04/20/2023] [Accepted: 04/26/2023] [Indexed: 05/02/2023]
Abstract
Rationale Modulation of cortical excitability, in particular inhibition, is impaired in patients with schizophrenia. Chronic nicotine consumption, which is prevalent in this group, has been shown to alter cortical excitability in healthy individuals and to increase inhibitory activity. Thus, beneficial effects of smoking on impaired cortical excitability in patients with schizophrenia have been proposed, though direct experimental evidence is still lacking. OBJECTIVES We aimed to explore the effect of chronic smoking on cortical excitability by comparing smoking and non-smoking patients with schizophrenia. METHOD Twenty-six smoking and 19 non-smoking patients diagnosed with schizophrenia were included. Transcranial magnetic stimulation (TMS) applied to the primary motor cortex served as experimental paradigm for measuring corticospinal and intracortical excitability as follows: Resting motor threshold (RMT) and the input/output curve (I/O curve) were obtained to assess corticospinal excitability. Intracortical excitability was explored using paired-pulse TMS techniques (intracortical facilitation (ICF), short-latency intracortical inhibition (SICI) and short-latency afferent inhibition (SAI)). RESULTS A significantly stronger inhibition in the cholinergically driven SAI protocol was observed in smokers compared to non-smokers. All other measures did not show significant differences between groups. CONCLUSION Our results suggest an increased inhibition within cholinergic circuits due to chronic nicotine consumption in schizophrenia. This increase may compensate impaired cholinergic neurotransmission and could explain the high rate of smokers in schizophrenia.
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Affiliation(s)
- Benjamin Pross
- Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Faculty of Medicine, University of Augsburg, Bezirkskrankenhaus Augsburg, Geschwister-Schönert-Str. 1, 86156 Augsburg, Germany.
| | - Susanne Münz
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Michael A Nitsche
- Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund, Dept. Psychology and Neurosciences, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Wolfgang Strube
- Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Faculty of Medicine, University of Augsburg, Bezirkskrankenhaus Augsburg, Geschwister-Schönert-Str. 1, 86156 Augsburg, Germany
| | - Irina Papazova
- Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Faculty of Medicine, University of Augsburg, Bezirkskrankenhaus Augsburg, Geschwister-Schönert-Str. 1, 86156 Augsburg, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Faculty of Medicine, University of Augsburg, Bezirkskrankenhaus Augsburg, Geschwister-Schönert-Str. 1, 86156 Augsburg, Germany
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Miyazawa A, Kanahara N, Shiko Y, Ozawa Y, Kawasaki Y, Komatsu H, Masumo Y, Nakata Y, Iyo M. The cortical silent period in schizophrenia: A systematic review and meta-analysis focusing on disease stage and antipsychotic medication. J Psychopharmacol 2022; 36:479-488. [PMID: 35475374 DOI: 10.1177/02698811221078751] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Although numerous studies reported some changes of cortical silent period (CSP), an indicator of gamma-aminobutyric acid (GABA) function in central nervous system, in schizophrenia patients, it has been unknown how the disease stage and antipsychotic medication affect CSP values. METHODS The present study conducted a systematic review of previous literature comparing CSP between schizophrenia patients and healthy subjects, and then performed meta-analysis on the effects of (1) the disease stage and (2) antipsychotics on CSP. RESULTS (1) In the comparison of the disease stage comprising a total of 17 reports, there was no significant difference in CSP between patients under drug-naïve first-episode psychoses and healthy controls, or between patients with antipsychotic medication and healthy controls. (2) In the comparison of the antipsychotic class, patients treated with clozapine were longer in CSP compared to healthy controls. Patients treated with olanzapine/quetiapine or with other type of antipsychotics were not different from healthy controls. Regarding other type of antipsychotics, the iteration analysis after leaving out one literature showed that patients were shorter in CSP than healthy controls. CONCLUSION The results showed that clozapine seems to surely prolong CSP, indicating the enhancement of GABA transmission via GABAB receptors, suggesting the possible relationship between the CSP prolongation by clozapine and its high efficacy in psychopathology. The finding of shorter CSP in patients with other type of antipsychotics was distinct from clozapine/olanzapine/quetiapine, but was difficult to interpret since this group included a variety of transcranial magnetic stimulation (TMS) methodologies and patients' background.
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Affiliation(s)
- Atsuhiro Miyazawa
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Nobuhisa Kanahara
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan.,Division of Medical Treatment and Rehabilitation, Center for Forensic Mental Health, Chiba University, Chiba, Japan
| | - Yuki Shiko
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yoshihito Ozawa
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yohei Kawasaki
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Hiroshi Komatsu
- Department of Psychiatry, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Yuto Masumo
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yusuke Nakata
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Masaomi Iyo
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
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Eldaief MC, Dickerson BC, Camprodon JA. Transcranial Magnetic Stimulation for the Neurological Patient: Scientific Principles and Applications. Semin Neurol 2022; 42:149-157. [PMID: 35213900 PMCID: PMC9838190 DOI: 10.1055/s-0041-1742265] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Non-invasive brain stimulation has been increasingly recognized for its potential as an investigational, diagnostic and therapeutic tool across the clinical neurosciences. Transcranial magnetic stimulation (TMS) is a non-invasive method of focal neuromodulation. Diagnostically, TMS can be used to probe cortical excitability and plasticity, as well as for functional mapping. Therapeutically, depending on the pattern employed, TMS can either facilitate or inhibit stimulated cortex potentially modulating maladaptive physiology through its effects on neuroplasticity. Despite this potential, applications of TMS in neurology have only been approved for diagnostic clinical neurophysiology, pre-surgical mapping of motor and language cortex, and the treatment of migraines. In this article, we discuss the principles of TMS and its clinical applications in neurology, including experimental applications in stroke rehabilitation, seizures, autism spectrum disorder, neurodegenerative disorders, movement disorders, tinnitus, chronic pain and functional neurological disorder. To promote increased cross-talk across neurology and psychiatry, we also succinctly review the TMS literature for the treatment of major depression and obsessive compulsive disorder. Overall, we argue that larger clinical trials that are better informed by circuit-level biomarkers and pathophysiological models will lead to an expansion of the application of TMS for patients cared for by neurologists.
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Affiliation(s)
- Mark C. Eldaief
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts,Department of Psychology, Center for Brain Science, Neuroimaging Facility, Harvard University, Cambridge, Massachusetts
| | - Bradford C. Dickerson
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
| | - Joan A. Camprodon
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
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10
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Cui L, Li H, Li JB, Zeng H, Zhang Y, Deng W, Zhou W, Cao L. Altered cerebellar gray matter and cerebellar-cortex resting-state functional connectivity in patients with bipolar disorder Ⅰ. J Affect Disord 2022; 302:50-57. [PMID: 35074460 DOI: 10.1016/j.jad.2022.01.073] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/16/2022] [Accepted: 01/18/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Bipolar disorder (BP) is a common psychiatric disorder characterized by extreme fluctuations in mood. Recent studies have indicated the involvement of cerebellum in the pathogenesis of BP. However, no study has focused on the precise role of cerebellum exclusively in patients with bipolar I disorder (BP-I). METHODS Forty-five patients with BP-I and 40 healthy controls were recruited. All subjects underwent clinical evaluation and Magnetic Resonance diffusion Tension Imaging scans. For structural images, we used a spatially unbiased infratentorial template toolbox to isolate the cerebellum and then preformed voxel-based morphometry (VBM) analyses to assess the difference in cerebellar gray matter volume (GMV) between the two groups. For the functional images, we chose the clusters that survived from VBM analysis as seeds and performed functional connectivity (FC) analysis. Between-group differences were assessed using the independent Students t test or the nonparametric Mann-Whitney U Test. For multiple comparisons, the results were further corrected with Gaussian random field (GRF) approach (voxel-level P < 0.001, cluster-level P < 0.05). RESULTS Compared with healthy controls, BP-I patients showed significantly decreased GMV in left lobule V and left lobule VI (P < 0.05, GRF corrected). The FC of cerebellum with bilateral superior temporal gyrus, bilateral insula, bilateral rolandic operculum, right putamen, and left precentral gyrus was disrupted in BP-I patients (P < 0.05, GRF corrected). CONCLUSIONS BP-I patients showed decreased cerebellar GMV and disrupted cerebellar-cortex resting-state FC. This suggests that cerebellar abnormalities may play an important role in the pathogenesis of BP-I.
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Affiliation(s)
- Liqian Cui
- Department of Neurology, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, China.
| | - Hao Li
- Department of Neurology, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, China
| | - Jin Biao Li
- Department of Neurology, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, China
| | - Huixing Zeng
- Department of Neurology, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, China
| | - Yizhi Zhang
- Guangzhou Huiai, Hospital, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510370, China
| | - Wenhao Deng
- Guangzhou Huiai, Hospital, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510370, China
| | - Wenjin Zhou
- Guangzhou Huiai, Hospital, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510370, China
| | - Liping Cao
- Guangzhou Huiai, Hospital, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510370, China.
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Godoy LD, Prizon T, Rossignoli MT, Leite JP, Liberato JL. Parvalbumin Role in Epilepsy and Psychiatric Comorbidities: From Mechanism to Intervention. Front Integr Neurosci 2022; 16:765324. [PMID: 35250498 PMCID: PMC8891758 DOI: 10.3389/fnint.2022.765324] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/24/2022] [Indexed: 12/22/2022] Open
Abstract
Parvalbumin is a calcium-binding protein present in inhibitory interneurons that play an essential role in regulating many physiological processes, such as intracellular signaling and synaptic transmission. Changes in parvalbumin expression are deeply related to epilepsy, which is considered one of the most disabling neuropathologies. Epilepsy is a complex multi-factor group of disorders characterized by periods of hypersynchronous activity and hyperexcitability within brain networks. In this scenario, inhibitory neurotransmission dysfunction in modulating excitatory transmission related to the loss of subsets of parvalbumin-expressing inhibitory interneuron may have a prominent role in disrupted excitability. Some studies also reported that parvalbumin-positive interneurons altered function might contribute to psychiatric comorbidities associated with epilepsy, such as depression, anxiety, and psychosis. Understanding the epileptogenic process and comorbidities associated with epilepsy have significantly advanced through preclinical and clinical investigation. In this review, evidence from parvalbumin altered function in epilepsy and associated psychiatric comorbidities were explored with a translational perspective. Some advances in potential therapeutic interventions are highlighted, from current antiepileptic and neuroprotective drugs to cutting edge modulation of parvalbumin subpopulations using optogenetics, designer receptors exclusively activated by designer drugs (DREADD) techniques, transcranial magnetic stimulation, genome engineering, and cell grafting. Creating new perspectives on mechanisms and therapeutic strategies is valuable for understanding the pathophysiology of epilepsy and its psychiatric comorbidities and improving efficiency in clinical intervention.
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Affiliation(s)
- Lívea Dornela Godoy
- Department of Psychology, Faculty of Philosophy, Sciences and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Tamiris Prizon
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Matheus Teixeira Rossignoli
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - João Pereira Leite
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- João Pereira Leite,
| | - José Luiz Liberato
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- *Correspondence: José Luiz Liberato,
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12
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di Hou M, Santoro V, Biondi A, Shergill SS, Premoli I. A systematic review of TMS and neurophysiological biometrics in patients with schizophrenia. J Psychiatry Neurosci 2021; 46:E675-E701. [PMID: 34933940 PMCID: PMC8695525 DOI: 10.1503/jpn.210006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 08/06/2021] [Accepted: 09/06/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Transcranial magnetic stimulation can be combined with electromyography (TMS-EMG) and electroencephalography (TMS-EEG) to evaluate the excitatory and inhibitory functions of the cerebral cortex in a standardized manner. It has been postulated that schizophrenia is a disorder of functional neural connectivity underpinned by a relative imbalance of excitation and inhibition. The aim of this review was to provide a comprehensive overview of TMS-EMG and TMS-EEG research in schizophrenia, focused on excitation or inhibition, connectivity, motor cortical plasticity and the effect of antipsychotic medications, symptom severity and illness duration on TMS-EMG and TMS-EEG indices. METHODS We searched PsycINFO, Embase and Medline, from database inception to April 2020, for studies that included TMS outcomes in patients with schizophrenia. We used the following combination of search terms: transcranial magnetic stimulation OR tms AND interneurons OR glutamic acid OR gamma aminobutyric acid OR neural inhibition OR pyramidal neurons OR excita* OR inhibit* OR GABA* OR glutam* OR E-I balance OR excitation-inhibition balance AND schizoaffective disorder* OR Schizophrenia OR schizophreni*. RESULTS TMS-EMG and TMS-EEG measurements revealed deficits in excitation or inhibition, functional connectivity and motor cortical plasticity in patients with schizophrenia. Increased duration of the cortical silent period (a TMS-EMG marker of γ-aminobutyric acid B receptor activity) with clozapine was a relatively consistent finding. LIMITATIONS Most of the studies used patients with chronic schizophrenia and medicated patients, employed cross-sectional group comparisons and had small sample sizes. CONCLUSION TMS-EMG and TMS-EEG offer an opportunity to develop a novel and improved understanding of the physiologic processes that underlie schizophrenia and to assess the therapeutic effect of antipsychotic medications. In the future, these techniques may also help predict disease progression and further our understanding of the excitatory/inhibitory balance and its implications for mechanisms that underlie treatment-resistant schizophrenia.
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Affiliation(s)
- Meng di Hou
- From the Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK (Hou, Shergill); the Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK (Santoro, Biondi, Premoli); and the Kent and Medway Medical School, Canterbury, UK (Shergill)
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13
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Mehta UM, Ektare A, Jakhar J, Basavaraju R, Sanjay TN, Naik SS, Syed FA, Bhargav PH, Reddy PV, Kelkar RS, Arumugham SS, Kesavan M, Thirthalli J, Gangadhar BN. A transdiagnostic evaluation of cortical inhibition in severe mental disorders using Transcranial Magnetic Stimulation. J Psychiatr Res 2021; 143:364-369. [PMID: 34571321 DOI: 10.1016/j.jpsychires.2021.09.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/16/2021] [Accepted: 09/23/2021] [Indexed: 10/20/2022]
Abstract
Multiple lines of investigations suggest the presence of cortical inhibition aberrations as central to the phenotypic manifestations of severe mental disorders. Transcranial Magnetic Stimulation (TMS) combined with electromyography can characterize these inhibitory processes in the motor cortex with satisfactory temporal precision. We examined TMS-evoked short- (SICI) and long-interval intracortical inhibition (LICI) and cortical silent period (CSP) as markers of GABAA- (SICI) and GABAB-mediated (LICI and CSP) cortical neurotransmission in symptomatic individuals with mania (n = 40), schizophrenia (n = 76), unipolar depression (n = 86), and OCD (n = 43), and compared them against similar recordings in healthy subjects (n = 125). We hypothesized transdiagnostic GABAA deficits across all the clinical groups and diagnosis-specific GABAB alterations in mania (increased) and OCD (decreased). After controlling for potential confounder variables (gender, education, benzodiazepine prescription, and motor threshold) using the ANCOVA, we observed no significant group difference in SICI (F = 1.04, P = 0.38), but a significant group effect in LICI (F = 16.29, P < 0.001) and CSP (F = 3.02, P = 0.018). Post-hoc analyses revealed that LICI was significantly reduced in OCD but increased in mania and schizophrenia with reference to the healthy group. Similarly, CSP was significantly reduced in OCD and depression groups as compared to the reference group. We observed that LICI and CSP, both followed similar descending gradients from mania through schizophrenia and depression to OCD; with significant elevation in mania, and reduction in depression and OCD, as compared to the healthy group. This pattern of GABAB-mediated cortical inhibition aberrations needs independent validation as potential state-markers of distinct clinical categories.
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Affiliation(s)
- Urvakhsh Meherwan Mehta
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India.
| | - Aboli Ektare
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Jitender Jakhar
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Rakshathi Basavaraju
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Tarasingh N Sanjay
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Shalini S Naik
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Farooq Ali Syed
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Praerna Hemant Bhargav
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Preethi V Reddy
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Radhika Suneel Kelkar
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Shyam Sundar Arumugham
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Muralidharan Kesavan
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Bangalore N Gangadhar
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
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14
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Di Lazzaro V, Bella R, Benussi A, Bologna M, Borroni B, Capone F, Chen KHS, Chen R, Chistyakov AV, Classen J, Kiernan MC, Koch G, Lanza G, Lefaucheur JP, Matsumoto H, Nguyen JP, Orth M, Pascual-Leone A, Rektorova I, Simko P, Taylor JP, Tremblay S, Ugawa Y, Dubbioso R, Ranieri F. Diagnostic contribution and therapeutic perspectives of transcranial magnetic stimulation in dementia. Clin Neurophysiol 2021; 132:2568-2607. [PMID: 34482205 DOI: 10.1016/j.clinph.2021.05.035] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 04/22/2021] [Accepted: 05/28/2021] [Indexed: 02/07/2023]
Abstract
Transcranial magnetic stimulation (TMS) is a powerful tool to probe in vivo brain circuits, as it allows to assess several cortical properties such asexcitability, plasticity and connectivity in humans. In the last 20 years, TMS has been applied to patients with dementia, enabling the identification of potential markers of thepathophysiology and predictors of cognitive decline; moreover, applied repetitively, TMS holds promise as a potential therapeutic intervention. The objective of this paper is to present a comprehensive review of studies that have employed TMS in dementia and to discuss potential clinical applications, from the diagnosis to the treatment. To provide a technical and theoretical framework, we first present an overview of the basic physiological mechanisms of the application of TMS to assess cortical excitability, excitation and inhibition balance, mechanisms of plasticity and cortico-cortical connectivity in the human brain. We then review the insights gained by TMS techniques into the pathophysiology and predictors of progression and response to treatment in dementias, including Alzheimer's disease (AD)-related dementias and secondary dementias. We show that while a single TMS measure offers low specificity, the use of a panel of measures and/or neurophysiological index can support the clinical diagnosis and predict progression. In the last part of the article, we discuss the therapeutic uses of TMS. So far, only repetitive TMS (rTMS) over the left dorsolateral prefrontal cortex and multisite rTMS associated with cognitive training have been shown to be, respectively, possibly (Level C of evidence) and probably (Level B of evidence) effective to improve cognition, apathy, memory, and language in AD patients, especially at a mild/early stage of the disease. The clinical use of this type of treatment warrants the combination of brain imaging techniques and/or electrophysiological tools to elucidate neurobiological effects of neurostimulation and to optimally tailor rTMS treatment protocols in individual patients or specific patient subgroups with dementia or mild cognitive impairment.
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Affiliation(s)
- Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.
| | - Rita Bella
- Department of Medical and Surgical Sciences and Advanced Technologies, Section of Neurosciences, University of Catania, Catania, Italy
| | - Alberto Benussi
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Matteo Bologna
- Department of Human Neurosciences, Sapienza University of Rome, Italy; IRCCS Neuromed, Pozzilli, IS, Italy
| | - Barbara Borroni
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Fioravante Capone
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Kai-Hsiang S Chen
- Department of Neurology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Robert Chen
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Canada; Division of Brain, Imaging& Behaviour, Krembil Brain Institute, Toronto, Canada
| | | | - Joseph Classen
- Department of Neurology, University Hospital Leipzig, Leipzig University Medical Center, Germany
| | - Matthew C Kiernan
- Department of Neurology, Royal Prince Alfred Hospital, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Giacomo Koch
- Non Invasive Brain Stimulation Unit/Department of Behavioral and Clinical Neurology, Santa Lucia Foundation IRCCS, Rome, Italy; Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Giuseppe Lanza
- Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy; Department of Neurology IC, Oasi Research Institute-IRCCS, Troina, Italy
| | - Jean-Pascal Lefaucheur
- ENT Team, EA4391, Faculty of Medicine, Paris Est Créteil University, Créteil, France; Clinical Neurophysiology Unit, Department of Physiology, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris, Créteil, France
| | | | - Jean-Paul Nguyen
- Pain Center, clinique Bretéché, groupe ELSAN, Multidisciplinary Pain, Palliative and Supportive care Center, UIC 22/CAT2 and Laboratoire de Thérapeutique (EA3826), University Hospital, Nantes, France
| | - Michael Orth
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Swiss Huntington's Disease Centre, Siloah, Bern, Switzerland
| | - Alvaro Pascual-Leone
- Hinda and Arthur Marcus Institute for Aging Research, Center for Memory Health, Hebrew SeniorLife, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA; Guttmann Brain Health Institute, Universitat Autonoma Barcelona, Spain
| | - Irena Rektorova
- Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University (CEITEC MU), Brno, Czech Republic; Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Patrik Simko
- Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University (CEITEC MU), Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Sara Tremblay
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, ON, Canada; Royal Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Raffaele Dubbioso
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Federico Ranieri
- Unit of Neurology, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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15
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Effects of single-dose L-theanine on motor cortex excitability. Clin Neurophysiol 2021; 132:2062-2064. [PMID: 34293527 DOI: 10.1016/j.clinph.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 06/30/2021] [Accepted: 07/02/2021] [Indexed: 11/21/2022]
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16
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Vuralli D, Karatas H, Yemisci M, Bolay H. Updated review on the link between cortical spreading depression and headache disorders. Expert Rev Neurother 2021; 21:1069-1084. [PMID: 34162288 DOI: 10.1080/14737175.2021.1947797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Experimental animal studies have revealed mechanisms that link cortical spreading depression (CSD) to the trigeminal activation mediating lateralized headache. However, conventional CSD as seen in lissencephalic brain is insufficient to explain some clinical features of aura and migraine headache. AREAS COVERED The importance of CSD in headache development including dysfunction of the thalamocortical network, neuroinflammation, calcitonin gene-related peptide, transgenic models, and the role of CSD in migraine triggers, treatment options, neuromodulation and future directions are reviewed. EXPERT OPINION The conventional understanding of CSD marching across the hemisphere is invalid in gyrencephalic brains. Thalamocortical dysfunction and interruption of functional cortical network systems by CSD, may provide alternative explanations for clinical manifestations of migraine phases including aura. Not all drugs showing CSD blocking properties in lissencephalic brains, have efficacy in migraine headache and monoclonal antibodies against CGRP ligand/receptors which are effective in migraine treatment, have no impact on aura in humans or CSD properties in rodents. Functional networks and molecular mechanisms mediating and amplifying the effects of limited CSD in migraine brain remain to be investigated to define new targets.
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Affiliation(s)
- Doga Vuralli
- Department of Neurology and Algology, Gazi University Faculty of Medicine, Besevler, Ankara, Turkey.,Neuropsychiatry Center, Gazi University, Besevler, Ankara, Turkey.,Neuroscience and Neurotechnology Center of Excellence (NÖROM), Ankara, Turkey
| | - Hulya Karatas
- Neuroscience and Neurotechnology Center of Excellence (NÖROM), Ankara, Turkey.,Institute of Neurological Sciences and Psychiatry, Hacettepe University, Ankara, Turkey
| | - Muge Yemisci
- Neuroscience and Neurotechnology Center of Excellence (NÖROM), Ankara, Turkey.,Institute of Neurological Sciences and Psychiatry, Hacettepe University, Ankara, Turkey.,Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Hayrunnisa Bolay
- Department of Neurology and Algology, Gazi University Faculty of Medicine, Besevler, Ankara, Turkey.,Neuropsychiatry Center, Gazi University, Besevler, Ankara, Turkey.,Neuroscience and Neurotechnology Center of Excellence (NÖROM), Ankara, Turkey
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17
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Taylor JJ, Newberger NG, Stern AP, Phillips A, Feifel D, Betensky RA, Press DZ. Seizure risk with repetitive TMS: Survey results from over a half-million treatment sessions. Brain Stimul 2021; 14:965-973. [PMID: 34133991 DOI: 10.1016/j.brs.2021.05.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/24/2021] [Accepted: 05/29/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Seizures are rare during repetitive transcranial magnetic stimulation (rTMS) treatment, but estimating risk is difficult because of study heterogeneity and sampling limitations. Moreover, there are few studies comparing rates between device manufacturers. OBJECTIVE The objective of this study was to calculate rTMS seizure rates across various FDA-cleared devices in naturalistic clinical settings. METHODS In July and August 2018, approximately 500 members of the Clinical TMS Society (CTMSS) were electronically surveyed about seizures in their practices. Seizures were distinguished from non-seizures by a remote semi-structured interview with a Board-certified neurologist and Co-Chair of the CTMSS Standards Committee. Exact Poisson calculations were used to estimate seizure rates and confidence intervals across the four most widely used manufacturers. RESULTS The survey was completed by 134 members, with 9 responses excluded because of data inconsistencies. In total, 18 seizures were reported in 586,656 sessions and 25,526 patients across all device manufacturers. The overall seizure rate was 0.31 (95% CI: 0.18, 0.48) per 10,000 sessions, and 0.71 (95% CI: 0.42, 1.11) per 1000 patients. The Brainsway H-coil seizure rate of 5.56 per 1000 patients (95% CI: 2.77,9.95) was significantly higher (p < 0.001) than the three most widely used figure- 8 coil devices' combined seizure rate of 0.14 per 1000 patients (95% CI: 0.01, 0.51). CONCLUSION The absolute risk of a seizure with rTMS is low, but generic Brainsway H-coil treatment appears to be associated with a higher relative risk than generic figure- 8 coil treatment. Well-designed prospective studies are warranted to further investigate this risk.
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Affiliation(s)
- Joseph J Taylor
- Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | | | - Adam P Stern
- Berenson Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Angela Phillips
- Department of Veterans Affairs, Palo Alto, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
| | - David Feifel
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Kadima Neuropsychiatry Institute, La Jolla, CA, USA
| | - Rebecca A Betensky
- Department of Biostatistics, School of Global Public Health, New York University, New York, NY, USA
| | - Daniel Z Press
- Berenson Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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18
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Moulier V, Gaudeau-Bosma C, Thomas F, Isaac C, Thomas M, Durand F, Schenin-King Andrianisaina P, Valabregue R, Laidi C, Benadhira R, Bouaziz N, Januel D. Effect of Intermittent Theta Burst Stimulation on the Neural Processing of Emotional Stimuli in Healthy Volunteers. J Clin Med 2021; 10:jcm10112449. [PMID: 34205840 PMCID: PMC8198492 DOI: 10.3390/jcm10112449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Intermittent theta burst stimulation (iTBS) is a form of repetitive transcranial magnetic stimulation that has shown to be effective in treatment-resistant depression. Through studying the effect of iTBS on healthy subjects, we wished to attain a greater understanding of its impact on the brain. Our objective was to assess whether 10 iTBS sessions altered the neural processing of emotional stimuli, mood and brain anatomy in healthy subjects. METHODS In this double-blind randomized sham-controlled study, 30 subjects received either active iTBS treatment (10 sessions, two sessions a day) or sham treatment over the left dorsolateral prefrontal cortex. Assessments of mood, structural magnetic resonance imaging (MRI) and functional MRI (fMRI) were performed before and after iTBS sessions. During the fMRI, three different categories of stimuli were presented: positive, negative and neutral photographs. RESULTS This study showed that, during the presentation of negative stimuli (compared with neutral stimuli), 10 sessions of iTBS increased activity in the left anterior insula. However, iTBS did not induce any change in mood, regional gray matter volume or cortical thickness. CONCLUSIONS iTBS modifies healthy subjects' brain activity in a key region that processes emotional stimuli. (AFSSAPS: ID-RCB 2010A01032-37).
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Affiliation(s)
- Virginie Moulier
- Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France; (F.T.); (C.I.); (M.T.); (F.D.); (P.S.-K.A.); (R.B.); (N.B.); (D.J.)
- Centre Hospitalier du Rouvray, University Department of Psychiatry, 76301 Sotteville-lès-Rouen, France
- Correspondence: ; Tel.: +33-014-309-3232
| | - Christian Gaudeau-Bosma
- Espace Territoriale d’Accompagnement Psychosociale, CH Les Murets, GHT94, 94120 Fontenay sous Bois, France;
| | - Fanny Thomas
- Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France; (F.T.); (C.I.); (M.T.); (F.D.); (P.S.-K.A.); (R.B.); (N.B.); (D.J.)
| | - Clémence Isaac
- Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France; (F.T.); (C.I.); (M.T.); (F.D.); (P.S.-K.A.); (R.B.); (N.B.); (D.J.)
| | - Maxence Thomas
- Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France; (F.T.); (C.I.); (M.T.); (F.D.); (P.S.-K.A.); (R.B.); (N.B.); (D.J.)
| | - Florence Durand
- Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France; (F.T.); (C.I.); (M.T.); (F.D.); (P.S.-K.A.); (R.B.); (N.B.); (D.J.)
| | - Palmyre Schenin-King Andrianisaina
- Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France; (F.T.); (C.I.); (M.T.); (F.D.); (P.S.-K.A.); (R.B.); (N.B.); (D.J.)
| | - Romain Valabregue
- Institut du Cerveau et de la Moelle Épinière—ICM, Sorbonne Universités, UPMC Univ Paris 06, Inserm U1127, CNRS UMR 7225, 75013 Paris, France;
| | - Charles Laidi
- Pôle de Psychiatrie, Assistance Publique-Hôpitaux de Paris (AP-HP), Faculté de Médecine de Créteil, DMU IMPACT, Hôpitaux Universitaires Mondor, 94028 Créteil, France;
- Institut National de la Santé et de la Recherche Médicale (INSERM), U955, Institut Mondor de Recherche Biomédicale, Psychiatrie Translationnelle, 94028 Créteil, France
- UNIACT, Psychiatry Team, Neurospin Neuroimaging Platform, CEA Saclay, 91191 Gif-sur-Yvette, France
- Fondation Fondamental, 94028 Créteil, France
| | - René Benadhira
- Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France; (F.T.); (C.I.); (M.T.); (F.D.); (P.S.-K.A.); (R.B.); (N.B.); (D.J.)
| | - Noomane Bouaziz
- Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France; (F.T.); (C.I.); (M.T.); (F.D.); (P.S.-K.A.); (R.B.); (N.B.); (D.J.)
| | - Dominique Januel
- Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France; (F.T.); (C.I.); (M.T.); (F.D.); (P.S.-K.A.); (R.B.); (N.B.); (D.J.)
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19
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Clinical and Neurophysiological Effects of Botulinum Neurotoxin Type A in Chronic Migraine. Toxins (Basel) 2021; 13:toxins13060392. [PMID: 34072379 PMCID: PMC8229748 DOI: 10.3390/toxins13060392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/20/2021] [Accepted: 05/24/2021] [Indexed: 12/13/2022] Open
Abstract
Chronic pain syndromes present a subversion of both functional and structural nociceptive networks. We used transcranial magnetic stimulation (TMS) to evaluate changes in cortical excitability and plasticity in patients with chronic migraine (CM) treated with botulinum neurotoxin type A (BoNT/A). We enrolled 11 patients with episodic migraine (EM) and 11 affected by CM. Baseline characteristics for both groups were recorded using single- and paired-pulse TMS protocols. The same TMS protocol was repeated in CM patients after four cycles of BoNT/A completed in one year. At baseline, compared with EM patients, patients with CM had a lower threshold in both hemispheres (right hemisphere: 46% ± 7.8 vs. 52% ± 4.28, p = 0.03; left hemisphere: 52% ± 4.28 vs. 53.54% ± 6.58, p = 0.02). In EM, paired-pulse stimulation elicited a physiologically shaped response, whereas in CM, physiological intracortical inhibition (ICI) between 1 and 3 ms intervals was absent at baseline. On the contrary, increasing intracortical facilitation (ICF) was observed for all interstimulus intervals (ISIs). In CM, cortical excitability was partially reduced after BoNT/A treatment, along with a significant decrease observed in MIDAS score (from 20.7 to 9.8; p = 0.008). The lower motor threshold in CM reflects a higher cortical hyperexcitability. The lack of physiological ICI in CM could indicate sensitisation of the trigeminovascular system. Although reduced, this type of response is still observable after treatment, despite a marked clinical improvement. Our study suggests a long-term alteration of cortical plasticity due to chronic pain.
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20
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Hare SM, Du X, Adhikari BM, Chen S, Mo C, Summerfelt A, Kvarta MD, Garcia L, Kochunov P, Elliot Hong L. Mapping local and long-distance resting connectivity markers of TMS-related inhibition reduction in schizophrenia. NEUROIMAGE-CLINICAL 2021; 31:102688. [PMID: 33991855 PMCID: PMC8135038 DOI: 10.1016/j.nicl.2021.102688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 03/07/2021] [Accepted: 04/26/2021] [Indexed: 11/17/2022]
Abstract
Short interval intracortical inhibition (SICI) is a biomarker for altered motor inhibition in schizophrenia, but the manner in which distant sites influence the inhibitory cortical-effector response remains elusive. Our study investigated local and long-distance resting state functional connectivity (rsFC) markers of SICI in a sample of N = 23 patients with schizophrenia and N = 29 controls. Local functional connectivity was quantified using regional homogeneity (ReHo) analysis and long-range connectivity was estimated using seed-based rsFC analysis. Direct and indirect effects of connectivity measures on SICI were modeled using mediation analysis. Higher SICI ratios (indicating reduced inhibition) in patients were associated with lower ReHo in the right insula. Follow-up rsFC analyses showed that higher SICI scores (indicating reduced inhibition) were associated with reduced connectivity between right insula and hubs of the corticospinal pathway: sensorimotor cortex and basal ganglia. Mediation analysis supported a model in which the direct effect of local insular connectivity strength on SICI is mediated by the interhemispheric connectivity between insula and left sensorimotor cortex. The broader clinical implications of these findings are discussed with emphasis on how these preliminary findings might inform novel interventions designed to restore or improve SICI in schizophrenia and deepen our understanding of motor inhibitory control and impact of abnormal signaling in motor-inhibitory pathways in schizophrenia.
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Affiliation(s)
- Stephanie M Hare
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States.
| | - Xiaoming Du
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Bhim M Adhikari
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Shuo Chen
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Chen Mo
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Ann Summerfelt
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Mark D Kvarta
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Laura Garcia
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
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21
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Cao KX, Ma ML, Wang CZ, Iqbal J, Si JJ, Xue YX, Yang JL. TMS-EEG: An emerging tool to study the neurophysiologic biomarkers of psychiatric disorders. Neuropharmacology 2021; 197:108574. [PMID: 33894219 DOI: 10.1016/j.neuropharm.2021.108574] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 03/08/2021] [Accepted: 04/15/2021] [Indexed: 01/02/2023]
Abstract
The etiology of psychiatric disorders remains largely unknown. The exploration of the neurobiological mechanisms of mental illness helps improve diagnostic efficacy and develop new therapies. This review focuses on the application of concurrent transcranial magnetic stimulation and electroencephalography (TMS-EEG) in various mental diseases, including major depressive disorder, bipolar disorder, schizophrenia, autism spectrum disorder, attention-deficit/hyperactivity disorder, substance use disorder, and insomnia. First, we summarize the commonly used protocols and output measures of TMS-EEG; then, we review the literature exploring the alterations in neural patterns, particularly cortical excitability, plasticity, and connectivity alterations, and studies that predict treatment responses and clinical states in mental disorders using TMS-EEG. Finally, we discuss the potential mechanisms underlying TMS-EEG in establishing biomarkers for psychiatric disorders and future research directions.
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Affiliation(s)
- Ke-Xin Cao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Mao-Liang Ma
- Department of Clinical Psychology, Tianjin Medical University General Hospital Airport Site, Tianjin, China
| | - Cheng-Zhan Wang
- Department of Clinical Psychology, Tianjin Medical University General Hospital, Tianjin, China
| | - Javed Iqbal
- School of Psychology, Shaanxi Normal University and Key Laboratory for Behavior and Cognitive Neuroscience of Shaanxi Province, Xi'an, China
| | - Ji-Jian Si
- Department of Clinical Psychology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yan-Xue Xue
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China; Key Laboratory for Neuroscience of Ministry of Education and Neuroscience, National Health and Family Planning Commission, Peking University, Beijing, China.
| | - Jian-Li Yang
- Department of Clinical Psychology, Tianjin Medical University General Hospital, Tianjin, China.
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22
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Zelek-Molik A, Bobula B, Gądek-Michalska A, Chorązka K, Bielawski A, Kuśmierczyk J, Siwiec M, Wilczkowski M, Hess G, Nalepa I. Psychosocial Crowding Stress-Induced Changes in Synaptic Transmission and Glutamate Receptor Expression in the Rat Frontal Cortex. Biomolecules 2021; 11:biom11020294. [PMID: 33669305 PMCID: PMC7920072 DOI: 10.3390/biom11020294] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/11/2021] [Accepted: 02/12/2021] [Indexed: 11/16/2022] Open
Abstract
This study demonstrates how exposure to psychosocial crowding stress (CS) for 3, 7, and 14 days affects glutamate synapse functioning and signal transduction in the frontal cortex (FC) of rats. CS effects on synaptic activity were evaluated in FC slices of the primary motor cortex (M1) by measuring field potential (FP) amplitude, paired-pulse ratio (PPR), and long-term potentiation (LTP). Protein expression of GluA1, GluN2B mGluR1a/5, VGLUT1, and VGLUT2 was assessed in FC by western blot. The body’s response to CS was evaluated by measuring body weight and the plasma level of plasma corticosterone (CORT), adrenocorticotropic hormone (ACTH), and interleukin 1 beta (IL1B). CS 3 14d increased FP and attenuated LTP in M1, while PPR was augmented in CS 14d. The expression of GluA1, GluN2B, and mGluR1a/5 was up-regulated in CS 3d and downregulated in CS 14d. VGLUTs expression tended to increase in CS 7d. The failure to blunt the effects of chronic CS on FP and LTP in M1 suggests the impairment of habituation mechanisms by psychosocial stressors. PPR augmented by chronic CS with increased VGLUTs level in the CS 7d indicates that prolonged CS exposure changed presynaptic signaling within the FC. The CS bidirectional profile of changes in glutamate receptors’ expression seems to be a common mechanism evoked by stress in the FC.
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Affiliation(s)
- Agnieszka Zelek-Molik
- Department of Brain Biochemistry, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Krakow, Poland; (K.C.); (A.B.); (J.K.); (M.W.); (I.N.)
- Correspondence: ; Tel.: +48-12-6623335
| | - Bartosz Bobula
- Department of Physiology, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Krakow, Poland; (B.B.); (A.G.-M.); (M.S.); (G.H.)
| | - Anna Gądek-Michalska
- Department of Physiology, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Krakow, Poland; (B.B.); (A.G.-M.); (M.S.); (G.H.)
| | - Katarzyna Chorązka
- Department of Brain Biochemistry, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Krakow, Poland; (K.C.); (A.B.); (J.K.); (M.W.); (I.N.)
| | - Adam Bielawski
- Department of Brain Biochemistry, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Krakow, Poland; (K.C.); (A.B.); (J.K.); (M.W.); (I.N.)
| | - Justyna Kuśmierczyk
- Department of Brain Biochemistry, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Krakow, Poland; (K.C.); (A.B.); (J.K.); (M.W.); (I.N.)
| | - Marcin Siwiec
- Department of Physiology, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Krakow, Poland; (B.B.); (A.G.-M.); (M.S.); (G.H.)
| | - Michał Wilczkowski
- Department of Brain Biochemistry, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Krakow, Poland; (K.C.); (A.B.); (J.K.); (M.W.); (I.N.)
| | - Grzegorz Hess
- Department of Physiology, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Krakow, Poland; (B.B.); (A.G.-M.); (M.S.); (G.H.)
| | - Irena Nalepa
- Department of Brain Biochemistry, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Krakow, Poland; (K.C.); (A.B.); (J.K.); (M.W.); (I.N.)
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23
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Sleepwalking Associated With Clozapine Treatment: 2 Cases. J Clin Psychopharmacol 2021; 40:305-306. [PMID: 32332468 DOI: 10.1097/jcp.0000000000001208] [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: 11/25/2022]
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24
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Bouaziz N, Laidi C, Thomas F, Schenin-King Andrianisaina P, Moulier V, Januel D. Intermittent Theta-Burst Stimulation Over the DorsoLateral PreFrontal Cortex (DLPFC) in Healthy Subjects Produces No Cumulative Effect on Cortical Excitability. Front Psychiatry 2021; 12:626479. [PMID: 33679482 PMCID: PMC7930830 DOI: 10.3389/fpsyt.2021.626479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Intermittent Theta Burst Stimulation (iTBS) is a design of repetitive Transcranial Magnetic Stimulation (rTMS) and could be a candidate to replace rTMS in the treatment of depression, thanks to its efficacy, shorter duration, and ease of use. The antidepressant mechanism of iTBS, and whether this mechanism is mediated by a modulation of cortical excitability, remains unknown. Methods: Using a randomized double-blind, sham-controlled trial, 30 healthy volunteers received either iTBS or a sham treatment targeting the left DorsoLateral PreFrontal Cortex (L-DLPFC), twice a day over 5 consecutive days. Cortical excitability was measured before and after the 5 days of stimulation. Results: No difference in cortical excitability was observed between active or sham iTBS. Conclusion: Our study does not support any effect on cortical excitability of repetitive iTBS targeting the L-DLPFC.
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Affiliation(s)
- Noomane Bouaziz
- Unité de recherche clinique, Pôle 93G03, EPS de Ville Evrard, Neuilly sur Marne, France
| | - Charles Laidi
- Pôle de Psychiatrie, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine de Créteil, DMU IMPACT, Hôpitaux Universitaires Mondor, Créteil, France
| | - Fanny Thomas
- Unité de recherche clinique, Pôle 93G03, EPS de Ville Evrard, Neuilly sur Marne, France
| | | | - Virginie Moulier
- Unité de recherche clinique, Pôle 93G03, EPS de Ville Evrard, Neuilly sur Marne, France.,Service hospitalo-universitaire de psychiatrie adulte, CH du Rouvray, Sotteville-lès-Rouen, France
| | - Dominique Januel
- Unité de recherche clinique, Pôle 93G03, EPS de Ville Evrard, Neuilly sur Marne, France
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25
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Cardullo S, Gómez Pérez LJ, Cuppone D, Sarlo M, Cellini N, Terraneo A, Gallimberti L, Madeo G. A Retrospective Comparative Study in Patients With Cocaine Use Disorder Comorbid With Attention Deficit Hyperactivity Disorder Undergoing an rTMS Protocol Treatment. Front Psychiatry 2021; 12:659527. [PMID: 33841218 PMCID: PMC8026860 DOI: 10.3389/fpsyt.2021.659527] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 02/22/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Adult attention-deficit/hyperactivity disorder (ADHD) is associated with high comorbidity with other psychiatric diseases, including cocaine use disorder (CocUD). Given the common fronto-striatal dysfunction, ADHD patients often use cocaine as self-medication for ameliorating symptoms by increasing striatal dopamine release. Yet, comorbidity with ADHD is related to poor treatment outcomes. CocUD has been treated with transcranial magnetic stimulation (TMS), but no studies investigated the outcomes in patients comorbid with ADHD. Methods: Twenty-two ADHD/CocUD and 208 CocUD-only participants received a high-frequency (15 Hz) rTMS treatment stimulating the left-DLPFC. We investigated whether both groups of patients shared similar demographic and clinical characteristics at baseline. Then, we monitored the effect of treatment testing for potential differences between groups. Results: At baseline demographic, toxicology and clinical features were not different between the two groups except for global severity index (GSI from SCL-90): patients of ADHD/CocUD group reported higher general symptomatology compared to the CocUD-only group. Concerning the effect of treatment, both groups significantly improved over time regarding cocaine use, craving, and other negative affect symptoms. No differences were observed between groups. Conclusions: To our knowledge, this is the first study comparing the demographic characterization and rTMS clinical improvements of patients with a dual diagnosis of ADHD and CocUD against CocUD-only patients. Cocaine use and common self-reported withdrawal/abstinence symptoms appear to benefit from rTMS treatment with no differences between groups. Future studies are needed to further investigate these preliminary results.
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Affiliation(s)
| | | | - Diego Cuppone
- Fondazione Novella Fronda, Piazza Castello, Padova, Italy
| | - Michela Sarlo
- Department of Communication Sciences, Humanities and International Studies, University of Urbino Carlo Bo, Urbino, Italy
| | - Nicola Cellini
- Department of General Psychology, University of Padova, Padova, Italy.,Padova Neuroscience Center, University of Padova, Padova, Italy
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26
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Tu PC, Chen MH, Chang WC, Kao ZK, Hsu JW, Lin WC, Li CT, Su TP, Bai YM. Identification of common neural substrates with connectomic abnormalities in four major psychiatric disorders: A connectome-wide association study. Eur Psychiatry 2020; 64:e8. [PMID: 33267917 PMCID: PMC8057470 DOI: 10.1192/j.eurpsy.2020.106] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Recent imaging studies of large datasets suggested that psychiatric disorders have common biological substrates. This study aimed to identify all the common neural substrates with connectomic abnormalities across four major psychiatric disorders by using the data-driven connectome-wide association method of multivariate distance matrix regression (MDMR). Methods This study analyzed a resting functional magnetic resonance imaging dataset of 100 patients with schizophrenia, 100 patients with bipolar I disorder, 100 patients with bipolar II disorder, 100 patients with major depressive disorder, and 100 healthy controls (HCs). We calculated a voxel-wise 4,330 × 4,330 matrix of whole-brain functional connectivity (FC) with 8-mm isotropic resolution for each participant and then performed MDMR to identify structures where the overall multivariate pattern of FC was significantly different between each patient group and the HC group. A conjunction analysis was performed to identify common neural regions with FC abnormalities across these four psychiatric disorders. Results The conjunction of the MDMR maps revealed that the four groups of patients shared connectomic abnormalities in distributed cortical and subcortical structures, which included bilateral thalamus, cerebellum, frontal pole, supramarginal gyrus, postcentral gyrus, lingual gyrus, lateral occipital cortex, and parahippocampus. The follow-up analysis based on pair-wise FC of these regions demonstrated that these psychiatric disorders also shared similar patterns of FC abnormalities characterized by sensory/subcortical hyperconnectivity, association/subcortical hypoconnectivity, and sensory/association hyperconnectivity. Conclusions These findings suggest that major psychiatric disorders share common connectomic abnormalities in distributed cortical and subcortical regions and provide crucial support for the common network hypothesis of major psychiatric disorders.
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Affiliation(s)
- Pei-Chi Tu
- Department of Medical Research, Taipei Veterans General Hospital, Taipei112, Taiwan.,Department of Psychiatry, Taipei Veterans General Hospital, Taipei112, Taiwan.,Institute of Philosophy of Mind and Cognition, National Yang-Ming University, Taipei, Taiwan.,Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei112, Taiwan.,Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Wan-Chen Chang
- Department of Medical Research, Taipei Veterans General Hospital, Taipei112, Taiwan.,Department of Psychiatry, Taipei Veterans General Hospital, Taipei112, Taiwan.,Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan
| | - Zih-Kai Kao
- Department of Medical Research, Taipei Veterans General Hospital, Taipei112, Taiwan.,Department of Psychiatry, Taipei Veterans General Hospital, Taipei112, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei112, Taiwan.,Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei112, Taiwan.,Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei112, Taiwan.,Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei112, Taiwan.,Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei112, Taiwan.,Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
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27
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Sundman MH, Lim K, Ton That V, Mizell JM, Ugonna C, Rodriguez R, Chen NK, Fuglevand AJ, Liu Y, Wilson RC, Fellous JM, Rapcsak S, Chou YH. Transcranial magnetic stimulation reveals diminished homoeostatic metaplasticity in cognitively impaired adults. Brain Commun 2020; 2:fcaa203. [PMID: 33376989 PMCID: PMC7750948 DOI: 10.1093/braincomms/fcaa203] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 09/22/2020] [Accepted: 10/13/2020] [Indexed: 12/13/2022] Open
Abstract
Homoeostatic metaplasticity is a neuroprotective physiological feature that counterbalances Hebbian forms of plasticity to prevent network destabilization and hyperexcitability. Recent animal models highlight dysfunctional homoeostatic metaplasticity in the pathogenesis of Alzheimer's disease. However, the association between homoeostatic metaplasticity and cognitive status has not been systematically characterized in either demented or non-demented human populations, and the potential value of homoeostatic metaplasticity as an early biomarker of cognitive impairment has not been explored in humans. Here, we report that, through pre-conditioning the synaptic activity prior to non-invasive brain stimulation, the association between homoeostatic metaplasticity and cognitive status could be established in a population of non-demented human subjects (older adults across cognitive spectrums; all within the non-demented range). All participants (n = 40; age range, 65-74, 47.5% female) underwent a standardized neuropsychological battery, magnetic resonance imaging and a transcranial magnetic stimulation protocol. Specifically, we sampled motor-evoked potentials with an input/output curve immediately before and after repetitive transcranial magnetic stimulation to assess neural plasticity with two experimental paradigms: one with voluntary muscle contraction (i.e. modulated synaptic activity history) to deliberately introduce homoeostatic interference, and one without to serve as a control condition. From comparing neuroplastic responses across these experimental paradigms and across cohorts grouped by cognitive status, we found that (i) homoeostatic metaplasticity is diminished in our cohort of cognitively impaired older adults and (ii) this neuroprotective feature remains intact in cognitively normal participants. This novel finding suggests that (i) future studies should expand their scope beyond just Hebbian forms of plasticity that are traditionally assessed when using non-invasive brain stimulation to investigate cognitive ageing and (ii) the potential value of homoeostatic metaplasticity in serving as a biomarker for cognitive impairment should be further explored.
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Affiliation(s)
- Mark H Sundman
- Department of Psychology, University of Arizona, Tucson, AZ 85721, USA
| | - Koeun Lim
- Department of Psychology, University of Arizona, Tucson, AZ 85721, USA
| | - Viet Ton That
- Department of Psychology, University of Arizona, Tucson, AZ 85721, USA
| | | | - Chidi Ugonna
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ 85721, USA
- Department of Medical Imaging, University of Arizona, Tucson, AZ 85721, USA
| | - Rudolph Rodriguez
- Department of Psychology, University of Arizona, Tucson, AZ 85721, USA
| | - Nan-Kuei Chen
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ 85721, USA
- Department of Medical Imaging, University of Arizona, Tucson, AZ 85721, USA
| | - Andrew J Fuglevand
- Department of Physiology, College of Medicine, University of Arizona, Tucson, AZ 85721, USA
- Department of Neuroscience, College of Medicine, University of Arizona, Tucson, AZ 85721, USA
| | - Yilin Liu
- Department of Psychology, University of Arizona, Tucson, AZ 85721, USA
| | - Robert C Wilson
- Department of Psychology, University of Arizona, Tucson, AZ 85721, USA
| | - Jean-Marc Fellous
- Department of Psychology, University of Arizona, Tucson, AZ 85721, USA
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ 85721, USA
| | - Steven Rapcsak
- Department of Psychology, University of Arizona, Tucson, AZ 85721, USA
- Department of Neurology, University of Arizona, Tucson, AZ 85721, USA
| | - Ying-Hui Chou
- Department of Psychology, University of Arizona, Tucson, AZ 85721, USA
- Evelyn F. McKnight Brain Institute, Arizona Center on Aging, and BIO5 Institute, University of Arizona, Tucson, AZ 85721, USA
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Scott E, Kidgell DJ, Frazer AK, Pearce AJ. The Neurophysiological Responses of Concussive Impacts: A Systematic Review and Meta-Analysis of Transcranial Magnetic Stimulation Studies. Front Hum Neurosci 2020; 14:306. [PMID: 33192374 PMCID: PMC7481389 DOI: 10.3389/fnhum.2020.00306] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 07/08/2020] [Indexed: 01/20/2023] Open
Abstract
Aim: This systematic review and meta-analysis investigated neurophysiological responses using transcranial magnetic stimulation (TMS) following a concussion or sub-concussion. Methods: A systematic searching of relevant databases for peer-reviewed literature quantifying motor evoked potentials from TMS between 1999 and 2019 was performed. A meta-analysis quantified pooled data for measures including motor threshold, motor latency, and motor evoked potential amplitude and for inhibitory measures such as cortical silent period duration, short-interval intracortical inhibition (SICI), and long-interval intracortical inhibition (LICI) ratios. Results: Fifteen articles met the inclusion criteria. The studies were arbitrarily classified into the groups, based on time post-concussion, “acute” (subjects 0–3 months post-injury, n = 8) and “post-acute” (3 months−2 years post-concussion, n = 7). A TMS quality of study checklist rated studies from moderate to high in methodological quality; however, the risk of bias analysis found that the included studies were categorised as high risk of bias, particularly for a lack of allocation concealment and blinding of participants in the methodologies. A meta-analysis showed no differences in excitability measures, apart from a decreased motor threshold that was observed in the concussed group (SMD −0.28, 95% CI −0.51 to −0.04; P = 0.02) for the post-acute time frame. Conversely, all inhibitory measures showed differences between groups. Cortical silent period duration was found to be significantly increased in the acute (SMD 1.19, 95% CI 0.58–1.81; P < 0.001) and post-acute (SMD 0.55, 95% CI 0.12–0.98; P = 0.01) time frames. The SICI (SMD −1.15, 95% CI −1.95 to −0.34; P = 0.005) and LICI (SMD −1.95, 95% CI −3.04 to −0.85; P = 0.005) ratios were reduced, inferring increased inhibition, for the post-acute time frame. Conclusion: This systematic review and meta-analysis demonstrates that inhibitory pathways are affected in the acute period post-concussion. However, persistent alterations in cortical excitability remain, with increased intracortical inhibition. While TMS should be considered as a reliable technique to measure the functional integrity of the central nervous system, the high risk of bias and heterogeneity in data suggest that future studies should aim to incorporate standardised methodological techniques, particularly with threshold determination and stimulus intervals for paired-pulse measures.
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Affiliation(s)
- Emily Scott
- College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia
| | - Dawson J Kidgell
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Science, School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia
| | - Ashlyn K Frazer
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Science, School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia
| | - Alan J Pearce
- College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia
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29
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Kinfe T, Stadlbauer A, Winder K, Hurlemann R, Buchfelder M. Incisionless MR-guided focused ultrasound: technical considerations and current therapeutic approaches in psychiatric disorders. Expert Rev Neurother 2020; 20:687-696. [PMID: 32511043 DOI: 10.1080/14737175.2020.1779590] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION MR-guided focused ultrasound operating at higher intensities have been reported to effectively and precisely ablate deeper brain structures like the basal ganglia or the thalamic nuclei for the treatment of refractory movement disorders, neuropathic pain and most recently neuropsychiatric disorders, while low-intensity focused ultrasound represents an approach promoting mechanical blood-brain-barrier opening and neuromodulation. This narrative review summarizes the technical development and the therapeutic potential of incisionless MRgFUS in order to treat neuropsychiatric disorders. AREAS COVERED A narrative review of clinical trials assessing the safety and efficacy of MRgFUS. A literature review was performed using the following search terms: MR-guided focused ultrasound, psychiatric disorders, noninvasive and invasive brain modulation/stimulation techniques. EXPERT OPINION MRgFUS ablation is under clinical investigation (unblinded study design) for obsessive-compulsive disorders (OCDs) [capsulotomy; ALIC] and depression/anxiety disorders [capsulotomy] and has demonstrated an improvement in OCD and depression, although of preliminary character. Low-intensity ultrasound applications have been explored in Alzheimer´s disease (phase 1 study) and healthy subjects. Currently, limited evidence hinders comparison and selection between MRgFUS and noninvasive/invasive brain modulation therapies. However, comparative, sham-controlled trials are needed to reexamine the preliminary findings for the treatment of psychiatric disorders.
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Affiliation(s)
- Thomas Kinfe
- Department of Neurosurgery, Friedrich-Alexander University (FAU) of Erlangen-Nürnberg , Germany.,Division of Functional Neurosurgery and Stereotaxy, Friedrich-Alexander University (FAU) of Erlangen-Nürnberg , Germany.,Friedrich-Alexander University (FAU) of Erlangen-Nürnberg, Erlangen, Germany
| | - Andreas Stadlbauer
- Department of Neurosurgery, Friedrich-Alexander University (FAU) of Erlangen-Nürnberg , Germany.,Friedrich-Alexander University (FAU) of Erlangen-Nürnberg, Erlangen, Germany
| | - Klemens Winder
- Friedrich-Alexander University (FAU) of Erlangen-Nürnberg, Erlangen, Germany.,Department of Neurology, Erlangen, Germany
| | - Rene Hurlemann
- Department of Psychiatry, University Oldenburg , Oldenburg, Germany
| | - Michael Buchfelder
- Department of Neurosurgery, Friedrich-Alexander University (FAU) of Erlangen-Nürnberg , Germany.,Friedrich-Alexander University (FAU) of Erlangen-Nürnberg, Erlangen, Germany
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30
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Vittala A, Murphy N, Maheshwari A, Krishnan V. Understanding Cortical Dysfunction in Schizophrenia With TMS/EEG. Front Neurosci 2020; 14:554. [PMID: 32547362 PMCID: PMC7270174 DOI: 10.3389/fnins.2020.00554] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 05/05/2020] [Indexed: 12/16/2022] Open
Abstract
In schizophrenia and related disorders, a deeper mechanistic understanding of neocortical dysfunction will be essential to developing new diagnostic and therapeutic techniques. To this end, combined transcranial magnetic stimulation and electroencephalography (TMS/EEG) provides a non-invasive tool to simultaneously perturb and measure neurophysiological correlates of cortical function, including oscillatory activity, cortical inhibition, connectivity, and synchronization. In this review, we summarize the findings from a variety of studies that apply TMS/EEG to understand the fundamental features of cortical dysfunction in schizophrenia. These results lend to future applications of TMS/EEG in understanding the pathophysiological mechanisms underlying cognitive deficits in schizophrenia.
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Affiliation(s)
- Aadith Vittala
- Department of Biosciences, Rice University, Houston, TX, United States
| | - Nicholas Murphy
- Department of Psychiatry and Behavioral Science, Baylor College of Medicine, Houston, TX, United States
| | - Atul Maheshwari
- Department of Neurology, Baylor College of Medicine, Houston, TX, United States.,Department of Neuroscience, Baylor College of Medicine, Houston, TX, United States
| | - Vaishnav Krishnan
- Department of Psychiatry and Behavioral Science, Baylor College of Medicine, Houston, TX, United States.,Department of Neurology, Baylor College of Medicine, Houston, TX, United States.,Department of Neuroscience, Baylor College of Medicine, Houston, TX, United States
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31
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de Goede AA, Cumplido-Mayoral I, van Putten MJAM. Spatiotemporal Dynamics of Single and Paired Pulse TMS-EEG Responses. Brain Topogr 2020; 33:425-437. [PMID: 32367427 PMCID: PMC7293671 DOI: 10.1007/s10548-020-00773-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 04/21/2020] [Indexed: 12/28/2022]
Abstract
For physiological brain function a particular balance between excitation and inhibition is essential. Paired pulse transcranial magnetic stimulation (TMS) can estimate cortical excitability and the relative contribution of inhibitory and excitatory networks. Combining TMS with electroencephalography (EEG) enables additional assessment of the spatiotemporal dynamics of neuronal responses in the stimulated brain. This study aims to evaluate the spatiotemporal dynamics and stability of single and paired pulse TMS-EEG responses, and assess long intracortical inhibition (LICI) at the cortical level. Twenty-five healthy subjects were studied twice, approximately one week apart. Manual coil positioning was applied in sixteen subjects and robot-guided positioning in nine. Both motor cortices were stimulated with 50 single pulses and 50 paired pulses at each of the five interstimulus intervals (ISIs): 100, 150, 200, 250 and 300 ms. To assess stability and LICI, the intraclass correlation coefficient and cluster-based permutation analysis were used. We found great resemblance in the topographical distribution of the characteristic TMS-EEG components for single and paired pulse TMS. Stimulation of the dominant and non-dominant hemisphere resulted in a mirrored spatiotemporal dynamics. No significant effect on the TMS-EEG responses was found for either stimulated hemisphere, time or coil positioning method, indicating the stability of both single and paired pulse TMS-EEG responses. For all ISIs, LICI was characterized by significant suppression of the late N100 and P180 components in the central areas, without affecting the early P30, N45 and P60 components. These observations in healthy subjects can serve as reference values for future neuropsychiatric and pharmacological studies.
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Affiliation(s)
- Annika A de Goede
- Department of Clinical Neurophysiology, Technical Medical Centre, University of Twente, P.O. Box 217, Technohal 3385, 7500 AE, Enschede, The Netherlands.
| | - Irene Cumplido-Mayoral
- Department of Clinical Neurophysiology, Technical Medical Centre, University of Twente, P.O. Box 217, Technohal 3385, 7500 AE, Enschede, The Netherlands.,Biomedical Engineering, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Michel J A M van Putten
- Department of Clinical Neurophysiology, Technical Medical Centre, University of Twente, P.O. Box 217, Technohal 3385, 7500 AE, Enschede, The Netherlands.,Department of Neurology and Clinical Neurophysiology, Medisch Spectrum Twente, Enschede, The Netherlands
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32
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Kassahun BT, Bier M, Ding J. Perturbing Circadian Oscillations in an In Vitro Suprachiasmatic Nucleus With Magnetic Stimulation. Bioelectromagnetics 2020; 41:63-72. [PMID: 31856348 DOI: 10.1002/bem.22235] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 11/21/2019] [Indexed: 11/08/2022]
Abstract
Many neurological disorders are associated with abnormal oscillatory dynamics. The suprachiasmatic nucleus (SCN) is responsible for the timing and synchronization of physiological processes. We performed experiments on PERIOD2::LUCIFERASE transgenic "knock-in" mice. In these mice, a gene that is expressed in a circadian pattern is fused to an inserted gene that codes for luciferase, which is a bioluminescent enzyme. A one-time 3 min magnetic stimulation (MS) was applied to excised slices of the SCN. The MS consisted of a 50-mT field that was turned on and off 4,500 times. The rise time and fall time of the field were 75 μs. A photon count that extended over the full 5 days that the slice remained viable, subsequently revealed how the MS affected the circadian cycle. The MS was applied at points in the circadian cycle that correspond to either maximal or minimal bioluminescence. It was found that both the amplitude and period of the endogenous circadian oscillation are affected by MS and that the effects strongly depend on where in the circadian cycle the stimulation was applied. Our MS dose is in the same range as clinically applied doses, and our findings imply that transcranial MS may be instrumental in remedying disorders that originate in circadian rhythm abnormalities. Bioelectromagnetics. 2020;41:63-72 © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Binyam T Kassahun
- Department of Physics, East Carolina University, Greenville, North Carolina
| | - Martin Bier
- Department of Physics, East Carolina University, Greenville, North Carolina
| | - Jian Ding
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina
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33
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Baran E, Del Regno P, Sinha AA. Pemphigus vulgaris, steroid management with ongoing psychosis. Int J Dermatol 2020; 59:120-122. [PMID: 30968389 DOI: 10.1111/ijd.14467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 02/13/2019] [Accepted: 03/25/2019] [Indexed: 01/24/2023]
Affiliation(s)
- Emilia Baran
- Department of Dermatology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Paula Del Regno
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Animesh A Sinha
- Department of Dermatology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
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34
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Stanković M, Nešić M. No Evidence of Improved Emotion Perception Through Unilateral Hand Contraction. Percept Mot Skills 2019; 127:126-141. [PMID: 31771447 DOI: 10.1177/0031512519888080] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Previous studies have identified improved cognitive performance from unilateral hand contraction to effect contralateral hemisphere activation. As little is known of whether this activation can improve emotion perception, this study examined any differences in perception accuracy and reaction times of matching photographs of human facial expressions presented to the left or right visual fields after left versus right hemisphere activation triggered by unilateral hand contractions. We used photographs of happy, sad, and neutral facial expressions presented briefly and simultaneously (two photographs in each presentation) either unilaterally (intrahemisphere condition) or bilaterally (interhemisphere condition). We recruited 68 university student participants (aged 19–23 years) and randomly assigned half of them to squeeze a dynamometer with the right hand, while the other half squeezed with the left hand, prior to performing the Dimond face-matching task. Matching of happy faces was faster than matching of sad faces. In females (but not males), perception accuracy was higher when stimuli were presented in the right (vs. left) visual field. We found no difference in emotion perception of photographs in either unilateral (intrahemispheric) or bilateral (interhemispheric) stimuli presentations as a function of hand contractions.
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Affiliation(s)
- Miloš Stanković
- General and Experimental Psychology, Department of Psychology, Ludwig-Maximilians-Universität München, Germany
| | - Milkica Nešić
- Department of Physiology, Faculty of Medicine, University of Niš, Serbia
- Department of Psychology, Faculty of Philosophy, University of Niš, Serbia
- Center for Cognitive Science, University of Niš, Serbia
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35
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van Nuland AJM, den Ouden HEM, Zach H, Dirkx MFM, van Asten JJA, Scheenen TWJ, Toni I, Cools R, Helmich RC. GABAergic changes in the thalamocortical circuit in Parkinson's disease. Hum Brain Mapp 2019; 41:1017-1029. [PMID: 31721369 PMCID: PMC7267977 DOI: 10.1002/hbm.24857] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 08/31/2019] [Accepted: 10/22/2019] [Indexed: 12/29/2022] Open
Abstract
Parkinson's disease is characterized by bradykinesia, rigidity, and tremor. These symptoms have been related to an increased gamma‐aminobutyric acid (GABA)ergic inhibitory drive from globus pallidus onto the thalamus. However, in vivo empirical evidence for the role of GABA in Parkinson's disease is limited. Some discrepancies in the literature may be explained by the presence or absence of tremor. Specifically, recent functional magnetic resonance imaging (fMRI) findings suggest that Parkinson's tremor is associated with reduced, dopamine‐dependent thalamic inhibition. Here, we tested the hypothesis that GABA in the thalamocortical motor circuit is increased in Parkinson's disease, and we explored differences between clinical phenotypes. We included 60 Parkinson patients with dopamine‐resistant tremor (n = 17), dopamine‐responsive tremor (n = 23), or no tremor (n = 20), and healthy controls (n = 22). Using magnetic resonance spectroscopy, we measured GABA‐to‐total‐creatine ratio in motor cortex, thalamus, and a control region (visual cortex) on two separate days (ON and OFF dopaminergic medication). GABA levels were unaltered by Parkinson's disease, clinical phenotype, or medication. However, motor cortex GABA levels were inversely correlated with disease severity, particularly rigidity and tremor, both ON and OFF medication. We conclude that cortical GABA plays a beneficial rather than a detrimental role in Parkinson's disease, and that GABA depletion may contribute to increased motor symptom expression.
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Affiliation(s)
- Annelies J M van Nuland
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands
| | - Hanneke E M den Ouden
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands
| | - Heidemarie Zach
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, The Netherlands.,Medical University of Vienna, Department of Neurology, Vienna, Austria
| | - Michiel F M Dirkx
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, The Netherlands
| | - Jack J A van Asten
- Radboud University Medical Centre, Department of Radiology and Nuclear Medicine, Nijmegen, The Netherlands
| | - Tom W J Scheenen
- Radboud University Medical Centre, Department of Radiology and Nuclear Medicine, Nijmegen, The Netherlands
| | - Ivan Toni
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands
| | - Roshan Cools
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands
| | - Rick C Helmich
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands.,Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, The Netherlands
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36
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Tu PC, Bai YM, Li CT, Chen MH, Lin WC, Chang WC, Su TP. Identification of Common Thalamocortical Dysconnectivity in Four Major Psychiatric Disorders. Schizophr Bull 2019; 45:1143-1151. [PMID: 30500946 PMCID: PMC6737486 DOI: 10.1093/schbul/sby166] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Recent genetic and imaging analyses of large datasets suggested that common biological substrates exist across psychiatric diagnoses. Functional connectivity (FC) abnormalities of thalamocortical circuits were consistently found in patients with schizophrenia but have been less studied in other major psychiatric disorders. This study aimed to examine thalamocortical FC in 4 major psychiatric disorders to identify the common connectivity abnormalities across major psychiatric disorders. METHODS This study recruited 100 patients with schizophrenia, 100 patients with bipolar I disorder, 88 patients with bipolar II disorder, 100 patients with major depressive disorder, and 160 healthy controls (HCs). Each participant underwent resting functional magnetic resonance imaging. The thalamus was used to derive FC maps, and group comparisons were made between each patient group and HCs using an independent-sample t test. Conjunction analysis was used to identify the common thalamocortical abnormalities among these 4 psychiatric disorders. RESULTS The 4 groups of patients shared a similar pattern of thalamocortical dysconnectivity characterized by a decrease in thalamocortical FC with the dorsal anterior cingulate, anterior prefrontal cortex and inferior parietal cortex. The groups also showed an increase in FC with the postcentral gyrus, precentral gyrus, superior temporal cortex, and lateral occipital areas. Further network analysis demonstrated that the frontoparietal regions showing hypoconnectivity belonged to the salience network. CONCLUSION Our findings provide FC evidence that supports the common network hypothesis by identifying common thalamocortical dysconnectivities across 4 major psychiatric disorders. The network analysis also supports the cardinal role of salience network abnormalities in major psychiatric disorders.
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Affiliation(s)
- Pei-Chi Tu
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Institute of Philosophy of Mind and Cognition, School of Humanities and Social Sciences, National Yang-Ming University, Taipei, Taiwan,Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ya Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wan-Chen Chang
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan,Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan,To whom correspondence should be addressed; Tung-Ping Su, Department of Psychiatry, Cheng-Hsin General Hospital, No.45, Cheng Hsin St., Taipei 112, Taiwan; tel: +886-2-28264400 ext. 3502, fax: +886-2-28742421, e-mail:
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37
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Hui J, Tremblay S, Daskalakis ZJ. The Current and Future Potential of Transcranial Magnetic Stimulation With Electroencephalography in Psychiatry. Clin Pharmacol Ther 2019; 106:734-746. [DOI: 10.1002/cpt.1541] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 05/07/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Jeanette Hui
- Temerty Centre for Therapeutic Brain Intervention Centre for Addiction and Mental Health Toronto Ontario Canada
- Institute of Medical Science University of Toronto Toronto Ontario Canada
| | - Sara Tremblay
- Royal's Institute of Mental Health Research Ottawa Ontario Canada
- School of Psychology University of Ottawa Ottawa Ontario Canada
| | - Zafiris J. Daskalakis
- Temerty Centre for Therapeutic Brain Intervention Centre for Addiction and Mental Health Toronto Ontario Canada
- Institute of Medical Science University of Toronto Toronto Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
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38
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Minzenberg MJ, Leuchter AF. The effect of psychotropic drugs on cortical excitability and plasticity measured with transcranial magnetic stimulation: Implications for psychiatric treatment. J Affect Disord 2019; 253:126-140. [PMID: 31035213 DOI: 10.1016/j.jad.2019.04.067] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 03/03/2019] [Accepted: 04/08/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Repetitive transcranial magnetic stimulation (rTMS) is an emerging treatment for neuropsychiatric disorders. Patients in rTMS treatment typically receive concomitant psychotropic medications, which affect neuronal excitability and plasticity and may interact to affect rTMS treatment outcomes. A greater understanding of these drug effects may have considerable implications for optimizing multi-modal treatment of psychiatric patients, and elucidating the mechanism(s) of action (MOA) of rTMS. METHOD We summarized the empirical literature that tests how psychotropic drugs affect cortical excitability and plasticity, using varied experimental TMS paradigms. RESULTS Glutamate antagonists robustly attenuate plasticity, largely without changes in excitability per se; antiepileptic drugs show the opposite pattern of effects, while calcium channel blockers attenuate plasticity. Benzodiazepines have moderate and variable effects on plasticity, and negligible effects on excitability. Antidepressants with potent 5HT transporter inhibition reduce both excitability and alter plasticity, while antidepressants with other MOAs generally lack either effect. Catecholaminergic drugs, cholinergic agents and lithium have minimal effects on excitability but exhibit robust and complex, non-linear effects in TMS plasticity paradigms. LIMITATIONS These effects remain largely untested in sustained treatment protocols, nor in clinical populations. In addition, how these medications impact clinical response to rTMS remains largely unknown. CONCLUSIONS Psychotropic medications exert robust and varied effects on cortical excitability and plasticity. We encourage the field to more directly and fully investigate clinical pharmaco-TMS studies to improve outcomes.
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Affiliation(s)
- M J Minzenberg
- Neuromodulation Division, Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, 760 Westwood Plaza, Los Angeles, CA 90024, United States.
| | - A F Leuchter
- Neuromodulation Division, Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, 760 Westwood Plaza, Los Angeles, CA 90024, United States
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39
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Martinotti G, Montemitro C, Pettorruso M, Viceconte D, Alessi MC, Di Carlo F, Lucidi L, Picutti E, Santacroce R, Di Giannantonio M. Augmenting pharmacotherapy with neuromodulation techniques for the treatment of bipolar disorder: a focus on the effects of mood stabilizers on cortical excitability. Expert Opin Pharmacother 2019; 20:1575-1588. [PMID: 31150304 DOI: 10.1080/14656566.2019.1622092] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction: Mood stabilizers and antipsychotics have been demonstrated to be effective in Bipolar Disorder, with lithium as the gold standard. However, the presence of adverse events and treatment-resistance is still a relevant issue. To this respect, the use of brain stimulation techniques may be considered as an augmentation strategy, with both Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS) having shown some level of efficacy in bipolar patients although clinical trials are still not sufficient to draw any conclusion. Areas covered: The authors have conducted a systematic review of the literature, in order to evaluate the role of mood stabilizers on neural activity and cortical excitability. Furthermore, the article reviews neuromodulation techniques and highlights the potential of integrating pharmacological first-line therapies with these techniques to treat BD patients. Expert opinion: The combination of neuromodulation techniques and available pharmacotherapies is a valuable opportunity which is not undermined by specific effects on cortical excitability and could improve BD patient outcome. Neurostimulation techniques may be considered safer than antidepressant treatments in BD, with a lower level of manic switches and may represent a new treatment strategy in BD depressive episodes.
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Affiliation(s)
- G Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti , Chieti , Italy.,Department of Pharmacy, Pharmacology, Clinical Science, University of Hertfordshire , Herts , UK
| | - C Montemitro
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti , Chieti , Italy
| | - M Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti , Chieti , Italy
| | - D Viceconte
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti , Chieti , Italy
| | - M C Alessi
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti , Chieti , Italy
| | - F Di Carlo
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti , Chieti , Italy
| | - L Lucidi
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti , Chieti , Italy
| | - E Picutti
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti , Chieti , Italy
| | - R Santacroce
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti , Chieti , Italy
| | - M Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti , Chieti , Italy
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Hanzlíková Z, Kofler M, Slovák M, Věchetová G, Fečíková A, Kemlink D, Sieger T, Růžička E, Valls‐Solé J, Edwards MJ, Serranová T. Prepulse inhibition of the blink reflex is abnormal in functional movement disorders. Mov Disord 2019; 34:1022-1030. [DOI: 10.1002/mds.27706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 04/03/2019] [Accepted: 04/07/2019] [Indexed: 01/28/2023] Open
Affiliation(s)
- Zuzana Hanzlíková
- Department of Neurology and Center of Clinical NeuroscienceCharles University in Prague, 1st Faculty of Medicine and General University Hospital Prague Czech Republic
| | - Markus Kofler
- Department of NeurologyHochzirl Hospital Hochzirl Austria
| | - Matěj Slovák
- Department of Neurology and Center of Clinical NeuroscienceCharles University in Prague, 1st Faculty of Medicine and General University Hospital Prague Czech Republic
| | - Gabriela Věchetová
- Department of Neurology and Center of Clinical NeuroscienceCharles University in Prague, 1st Faculty of Medicine and General University Hospital Prague Czech Republic
| | - Anna Fečíková
- Department of Neurology and Center of Clinical NeuroscienceCharles University in Prague, 1st Faculty of Medicine and General University Hospital Prague Czech Republic
| | - David Kemlink
- Department of Neurology and Center of Clinical NeuroscienceCharles University in Prague, 1st Faculty of Medicine and General University Hospital Prague Czech Republic
| | - Tomáš Sieger
- Department of Neurology and Center of Clinical NeuroscienceCharles University in Prague, 1st Faculty of Medicine and General University Hospital Prague Czech Republic
- Department of Cybernetics, Faculty of Electrical EngineeringCzech Technical University in Prague Prague Czech Republic
| | - Evžen Růžička
- Department of Neurology and Center of Clinical NeuroscienceCharles University in Prague, 1st Faculty of Medicine and General University Hospital Prague Czech Republic
| | - Josep Valls‐Solé
- Neurology Service, Hospital Clíınic, Facultad de MedicinaUniversitat de Barcelona Barcelona Spain
| | - Mark J. Edwards
- Neuroscience Research Centre, Institute of Molecular and Clinical SciencesSt George's University of London London United Kingdom
| | - Tereza Serranová
- Department of Neurology and Center of Clinical NeuroscienceCharles University in Prague, 1st Faculty of Medicine and General University Hospital Prague Czech Republic
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Tremblay S, Rogasch NC, Premoli I, Blumberger DM, Casarotto S, Chen R, Di Lazzaro V, Farzan F, Ferrarelli F, Fitzgerald PB, Hui J, Ilmoniemi RJ, Kimiskidis VK, Kugiumtzis D, Lioumis P, Pascual-Leone A, Pellicciari MC, Rajji T, Thut G, Zomorrodi R, Ziemann U, Daskalakis ZJ. Clinical utility and prospective of TMS–EEG. Clin Neurophysiol 2019; 130:802-844. [DOI: 10.1016/j.clinph.2019.01.001] [Citation(s) in RCA: 117] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 12/15/2022]
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Pujol J, Blanco-Hinojo L, Maciá D, Alonso P, Harrison BJ, Martínez-Vilavella G, Deus J, Menchón JM, Cardoner N, Soriano-Mas C. Mapping Alterations of the Functional Structure of the Cerebral Cortex in Obsessive–Compulsive Disorder. Cereb Cortex 2019; 29:4753-4762. [DOI: 10.1093/cercor/bhz008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 01/09/2019] [Accepted: 01/11/2019] [Indexed: 12/18/2022] Open
Abstract
AbstractWe mapped alterations of the functional structure of the cerebral cortex using a novel imaging approach in a sample of 160 obsessive–compulsive disorder (OCD) patients. Whole-brain functional connectivity maps were generated using multidistance measures of intracortical neural activity coupling defined within isodistant local areas. OCD patients demonstrated neural activity desynchronization within the orbitofrontal cortex and in primary somatosensory, auditory, visual, gustatory, and olfactory areas. Symptom severity was significantly associated with the degree of functional structure alteration in OCD-relevant brain regions. By means of a novel imaging perspective, we once again identified brain alterations in the orbitofrontal cortex, involving areas purportedly implicated in the pathophysiology of OCD. However, our results also indicated that weaker intracortical activity coupling is also present in each primary sensory area. On the basis of previous neurophysiological studies, such cortical activity desynchronization may best be interpreted as reflecting deficient inhibitory neuron activity and altered sensory filtering.
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Affiliation(s)
- Jesus Pujol
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain
| | - Laura Blanco-Hinojo
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain
| | - Dídac Maciá
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain
| | - Pino Alonso
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Clinical Sciences, University of Barcelona, Spain
| | - Ben J Harrison
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia
| | | | - Joan Deus
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain
- Department of Clinical and Health Psychology, Autonomous University of Barcelona, Spain
| | - José M Menchón
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Clinical Sciences, University of Barcelona, Spain
| | - Narcís Cardoner
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain
- Mental Health Department, Parc Taulí Sabadell University Hospital, Institut d’Investigació i Innovació Sanitària Parc Taulí (I3PT), Barelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Spain
| | - Carles Soriano-Mas
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona, Spain
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Du X, Choa FS, Chiappelli J, Wisner KM, Wittenberg G, Adhikari B, Bruce H, Rowland LM, Kochunov P, Hong LE. Aberrant Middle Prefrontal-Motor Cortex Connectivity Mediates Motor Inhibitory Biomarker in Schizophrenia. Biol Psychiatry 2019; 85:49-59. [PMID: 30126607 PMCID: PMC6289820 DOI: 10.1016/j.biopsych.2018.06.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/29/2018] [Accepted: 06/09/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Inhibitory deficits in motor cortex in schizophrenia have been well demonstrated using short-interval intracortical inhibition (SICI) by transcranial magnetic stimulation. However, it remains unknown whether these deficits originate from dysfunction of motor cortex itself or reflect abnormal modulations of motor cortex by other schizophrenia-related brain areas. METHODS The study was completed by 24 patients with schizophrenia spectrum disorders and 30 healthy control subjects. SICI was obtained by delivering transcranial magnetic stimulation over the left motor cortex. Resting-state functional magnetic resonance imaging and diffusion tensor imaging fractional anisotropy were used to measure functional connectivity (FC) and white matter microstructures, respectively. Stimulation sites for SICI at motor cortex were used as the seeds to obtain whole-brain FC maps. Clinical symptoms were assessed with the Brief Psychiatric Rating Scale. RESULTS In schizophrenia, left prefrontal cortex-motor cortex FC was inversely associated with SICI but positively associated with the underlying white matter microstructure at the left corona radiata and also associated with overall symptoms (all corrected p < .05). Mediation analysis showed that the prefrontal-motor cortex FC significantly mediated the corona radiata white matter effects on SICI (p = .007). CONCLUSIONS Higher resting-state left prefrontal-motor cortex FC, accompanied by a higher fractional anisotropy of left corona radiata, predicted fewer inhibitory deficits, suggesting that the inhibitory deficits in motor cortex in schizophrenia may in part be mediated by a top-down prefrontal influence. SICI may serve as a robust biomarker indexing inhibitory dysfunction at anatomic as well as circuitry levels in schizophrenia.
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Affiliation(s)
- Xiaoming Du
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland.
| | - Fow-Sen Choa
- Department of Electrical Engineering and Computer Science,
University of Maryland Baltimore County, Baltimore, MD, USA
| | - Joshua Chiappelli
- Maryland Psychiatric Research Center, Department of
Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Krista M. Wisner
- Maryland Psychiatric Research Center, Department of
Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - George Wittenberg
- Departments of Neurology, Physical Therapy and
Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD,
USA
| | - Bhim Adhikari
- Maryland Psychiatric Research Center, Department of
Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Heather Bruce
- Maryland Psychiatric Research Center, Department of
Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Laura M. Rowland
- Maryland Psychiatric Research Center, Department of
Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of
Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - L. Elliot Hong
- Maryland Psychiatric Research Center, Department of
Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
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Cortical excitability affects mood state in patients with idiopathic generalized epilepsies (IGEs). Epilepsy Behav 2019; 90:84-89. [PMID: 30517908 DOI: 10.1016/j.yebeh.2018.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 11/01/2018] [Accepted: 11/02/2018] [Indexed: 11/20/2022]
Abstract
Previously, we demonstrated an association between cortical hyperexcitability and mood disturbance in healthy adults. Studies have documented hyperexcitability in patients with idiopathic generalized epilepsies (IGEs; long-interval intracortical inhibition [LICI]) and high prevalence of mood comorbidities. This study aimed to investigate the influences of cortical excitability and seizure control on mood state in patients with IGEs. Single and paired-pulse transcranial magnetic stimulation (TMS) was applied to 30 patients with IGEs (16 controlled IGEs [cIGEs], 14 with treatment-resistant IGEs [trIGEs]), and 22 healthy controls (HCs) to assess cortical excitability with LICI. The Profile of Mood Sates (POMS) questionnaire was used to assess total mood disturbance (TMD), as well as, six mood domains: Depression, Confusion, Anger, Anxiety, Fatigue, and Vigor. To assess the effects of seizure control (HC vs. cIGEs vs. trIGEs) and LICI response (inhibitory vs. excitatory) on TMD, a two-way multivariate analysis of variance (MANOVA) was performed. Analyses revealed a significant main effect of long-interval intracortical inhibition (LICI) response on TMD (F(1, 46) = 4.69, p = 0.04), but not seizure control (F(2, 46) = 0.288, p = 0.75). Excitatory responders endorsed significantly higher TMD scores, indicating greater mood disturbance, than inhibitory responders (MD = -2.12; T (50) = -2.47, p = 0.04). Also, excitatory responders endorsed more items than inhibitory responders on the Depression (MD = -2.12; T (50) = -2.47, p = 0.04) and Fatigue (MD = -3.42; T (50) = -2.96, p = 0.03) subscales of the POMS. These findings provide further evidence of a relationship between hyperexcitability and mood disturbance, and indicate that cortical excitability may have greater influence on mood state than seizure control in patients with IGEs. Results also support theories for the underlying role of gamma-aminobutyric acid (GABA) network dysfunction in the etiology of depression. To better understand the clinical relevance and causal nature of these relationships, further investigation is warranted.
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Hsu CW, Wang LJ, Lin PY. Efficacy of repetitive transcranial magnetic stimulation for Tourette syndrome: A systematic review and meta-analysis. Brain Stimul 2018; 11:1110-1118. [DOI: 10.1016/j.brs.2018.06.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 05/28/2018] [Accepted: 06/01/2018] [Indexed: 12/27/2022] Open
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46
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Test-retest reliability of short-interval intracortical inhibition and intracortical facilitation in patients with schizophrenia. Psychiatry Res 2018; 267:575-581. [PMID: 30032068 PMCID: PMC6131061 DOI: 10.1016/j.psychres.2018.06.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 05/29/2018] [Accepted: 06/07/2018] [Indexed: 12/31/2022]
Abstract
Impaired short-interval intracortical inhibition (SICI) elicited by paired-pulse TMS (ppTMS) has emerged as one of the most consistent TMS findings in patients with schizophrenia. Reduction of SICI has been reproducibly found, suggesting that SICI may be a new biomarker indexing the inhibitory dysfunction in schizophrenia. This study evaluated whether SICI has the test-retest reliability suitable for clinical trial and research applications. SICIs, intracortical facilitation (ICF), and other ppTMS effects were obtained using inter-stimulus intervals (ISIs) from 1 to 500 ms, on 2 occasions about 3-4 weeks apart in patients with schizophrenia and healthy individuals. Acceptable test-retest reliabilities were found for SICI (at 1 and 3 ms ISIs) in both patients and controls (all intraclass correlation coefficients r > 0.6). However, test-retest reliability in longer ISIs and in ICF were modest or poor. To our knowledge, this is the first study demonstrated the acceptable reliability of SICI measure in patients with schizophrenia. The data support SICI as a reliable biomarker for schizophrenia.
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47
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Chalah MA, Palm U, Lefaucheur JP, Créange A, Ayache SS. Interhermispheric inhibition predicts anxiety levels in multiple sclerosis: A corticospinal excitability study. Brain Res 2018; 1699:186-194. [PMID: 30172702 DOI: 10.1016/j.brainres.2018.08.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/18/2018] [Accepted: 08/28/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Depression and anxiety stand among the most frequent and debilitating complaints in multiple sclerosis (MS) patients. Understanding their neurophysiological correlates might improve their management. To date, no single study has addressed this issue. METHOD Patients completed the Hospital Anxiety and Depression Scale (HADS). Transcranial magnetic stimulation (TMS) was performed to obtain the following corticospinal excitability measures: resting motor threshold, short-interval intracortical inhibition and facilitation, cortical silent period and interhemispheric inhibition (IHI). Anxiety and depression scores were the primary outcomes in the univariate analysis. When obtaining significant associations between anxiety/depression and TMS measures, a multivariate analysis was performed using stepwise linear regression with anxiety and depression scores employed separately as dependent variables and TMS measures, clinical and sociodemographic data as independent variables. Due to the small sample size and the large number of studied variables, only variables with p values <0.05 in the univariate analysis were included in the multivariate analysis. RESULTS Fifty patients completed the study (n = 24 women). Their mean age was 51.82 ± 12.72 years. Mean depression score was 6.08 ± 3.66. Mean anxiety score was 5.82 ± 3.42. A significant association was found between anxiety and IHI (p < 0.05), fatigue (p < 0.05), depression (p < 0.05), and female gender (p < 0.05). Stepwise linear regression analysis was performed and IHI values explained 9.10% of variance in anxiety levels (standardized β: 0.31; p < 0.01) when controlling for remaining variables. As for depression, it did not significantly correlate with any TMS measures. CONCLUSION The results highlight the relationship between anxiety and callosal transfer as reflected by IHI values. The current findings are consistent with previous works assessing healthy participants and patients with social anxiety disorders. Compared to MS patients with aberrant callosal transfer (suggested by low IHI values), those exhibiting a relatively more efficient one (reflected by high IHI values) seem to have higher anxiety scores, a finding that merits further assessment.
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Affiliation(s)
- Moussa A Chalah
- EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, 94010 Créteil, France; Service de Physiologie - Explorations Fonctionnelles, Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris, 94010 Créteil, France
| | - Ulrich Palm
- Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Ludwig-Maximilian University, 80336 Munich, Germany
| | - Jean-Pascal Lefaucheur
- EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, 94010 Créteil, France; Service de Physiologie - Explorations Fonctionnelles, Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris, 94010 Créteil, France
| | - Alain Créange
- EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, 94010 Créteil, France; Service de Neurologie, Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris, 94010 Créteil, France
| | - Samar S Ayache
- EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, 94010 Créteil, France; Service de Physiologie - Explorations Fonctionnelles, Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris, 94010 Créteil, France; Neurology Division, Lebanese American University Medical Center Rizk Hospital, Beirut, Lebanon.
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48
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Lanza G, Bella R, Cantone M, Pennisi G, Ferri R, Pennisi M. Cognitive Impairment and Celiac Disease: Is Transcranial Magnetic Stimulation a Trait d'Union between Gut and Brain? Int J Mol Sci 2018; 19:ijms19082243. [PMID: 30065211 PMCID: PMC6121508 DOI: 10.3390/ijms19082243] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 07/23/2018] [Accepted: 07/27/2018] [Indexed: 02/07/2023] Open
Abstract
Celiac disease is a systemic disorder with multifactorial pathogenesis and multifaceted symptomatology. In response to gluten exposure, a significant part of the general population produces antibodies that have been hypothesized to be deleterious to the brain. Among the well-known neurological manifestations, adult celiac patients often complain cognitive symptoms, ranging from the so-called "brain fog" till an overt dementia. Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation technique that can contribute to the assessment and monitoring of celiac patients, even in those without a clear neurological involvement. The studies here reviewed seem to converge on an impaired central motor conductivity and a "hyperexcitable celiac brain" to TMS, which partially reverts back after a long-term gluten restriction. Notably, a clear hyperexcitability is a stably reported feature of both degenerative and vascular dementia. Therefore, given its potential neuroprotective effect, the gluten-free diet should be introduced as early as possible, although the overall response of neurological symptoms (and cognition in particular) is still controversial. Identifying new and possibly modifiable risk factors may be of crucial importance for patients, clinicians, and researchers.
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Affiliation(s)
- Giuseppe Lanza
- Oasi Research Institute-IRCCS, Via Conte Ruggero, 73-94018 Troina, Italy.
| | - Rita Bella
- Department of Medical and Surgical Sciences and Advanced Technologies, Section of Neurosciences, University of Catania, Via S. Sofia, 78-95123 Catania, Italy.
| | - Mariagiovanna Cantone
- IRCCS Centro Neurolesi Bonino Pulejo, Via Provinciale Palermo, Contrada Casazza, 98124 Messina, Italy.
| | - Giovanni Pennisi
- Department of Surgery and Medical-Surgery Specialties, University of Catania, Via S. Sofia, 78-95123 Catania, Italy.
| | - Raffaele Ferri
- Oasi Research Institute-IRCCS, Via Conte Ruggero, 73-94018 Troina, Italy.
| | - Manuela Pennisi
- Spinal Unit, Emergency Hospital Cannizzaro, Via Messina, 829-95126 Catania, Italy.
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49
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Cognitive Impairment and Celiac Disease: Is Transcranial Magnetic Stimulation a Trait d'Union between Gut and Brain? Int J Mol Sci 2018. [PMID: 30065211 DOI: 10.3390/ijms19082243.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Celiac disease is a systemic disorder with multifactorial pathogenesis and multifaceted symptomatology. In response to gluten exposure, a significant part of the general population produces antibodies that have been hypothesized to be deleterious to the brain. Among the well-known neurological manifestations, adult celiac patients often complain cognitive symptoms, ranging from the so-called "brain fog" till an overt dementia. Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation technique that can contribute to the assessment and monitoring of celiac patients, even in those without a clear neurological involvement. The studies here reviewed seem to converge on an impaired central motor conductivity and a "hyperexcitable celiac brain" to TMS, which partially reverts back after a long-term gluten restriction. Notably, a clear hyperexcitability is a stably reported feature of both degenerative and vascular dementia. Therefore, given its potential neuroprotective effect, the gluten-free diet should be introduced as early as possible, although the overall response of neurological symptoms (and cognition in particular) is still controversial. Identifying new and possibly modifiable risk factors may be of crucial importance for patients, clinicians, and researchers.
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50
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Grados M, Huselid R, Duque-Serrano L. Transcranial Magnetic Stimulation in Tourette Syndrome: A Historical Perspective, Its Current Use and the Influence of Comorbidities in Treatment Response. Brain Sci 2018; 8:brainsci8070129. [PMID: 29986411 PMCID: PMC6071080 DOI: 10.3390/brainsci8070129] [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: 04/06/2018] [Revised: 06/25/2018] [Accepted: 06/28/2018] [Indexed: 11/25/2022] Open
Abstract
Background. Tourette syndrome (TS) is a childhood-onset neuropsychiatric disorder consisting of impairing motor and vocal tics which often persists adolescent and adult years. In this older refractory group, standard treatments such as pharmacotherapy and psychotherapeutic interventions may only have limited effects. Based on electrical cortical dysregulation in individuals with TS, a novel approach has employed brain stimulation strategies to modulate the putative aberrant neural electrical activity in pathways that may underlie tics, such as insula-supplementary motor area (SMA) connectivity. Methods. This review will examine all published clinical trials employing transcranial magnetic stimulation (TMS) to ameliorate tics, and discuss a framework for the pathophysiology of TS in relation to electrical brain activity. A framework for future research in tic disorders using TMS and imaging targeting neuroplasticity will be discussed. Results. Therapeutic electrical brain activity modulation with TMS has been carried out in stroke neuro-rehabilitation and neuropsychiatry, including trials in TS. Eleven trials document the use of TMS in TS targeting several brain areas, a positive effect is seen for those trials targeting the SMA. In particular, it appears that younger individuals with concurrent attention-deficit hyperactivity disorder (ADHD) benefit the most. Conclusions. TMS can be used as an effective tool to explore the psychophysiology of TS and potentially provide a therapeutic option. Ultimately, translational research using TMS in TS needs to explore connectivity differences pre- and post-treatment in individuals with TS that are linked to improvement in tic symptoms, with an emphasis on approaches using functional neuroimaging as well as other probes of neuroplasticity.
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Affiliation(s)
- Marco Grados
- Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
| | - Rachel Huselid
- Johns Hopkins University Krieger School of Arts & Sciences, Baltimore, MD 21205, USA.
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