Treatment emergent affective switch with intermittent theta burst stimulation over right temporo-parietal junction: A case report

Wired to Punish? Electroencephalographic Study of the Resting-state Neuronal Oscillations Underlying Third-party Punishment

For over a decade, neuroimaging and brain stimulation studies have investigated neural mechanisms of third-party punishment, a key instrument for social norms enforcement. However, the neural dynamics underlying these mechanisms are still unclear. Previous electroencephalographic studies on third-party punishment have shown that inter-brain connectivity is linked to punishment behavior. However, no clear evidence was provided regarding whether the effect of inter-brain connectivity on third-party punishment is mediated by local neuronal states. In this study, we further investigate whether resting-state neuronal activity in the alpha frequency range can predict individual differences in third-party punishment. More specifically, we show that the global resting-state connectivity between the right dorsolateral prefrontal and right temporo-parietal regions is negatively correlated with the level of third-party punishment. Additionally, individuals with stronger local resting-state long-range temporal correlations in the right temporo-parietal cortices demonstrated a lower level of third-party punishment. Thus, our results further support the idea that global and local neuronal dynamics can contribute to individual differences in third-party punishment.

Efficacy of intensive orbitofrontal continuous Theta Burst Stimulation (iOFcTBS) in Obsessive Compulsive Disorder: A Randomized Placebo Controlled Study

Transcranial magnetic stimulation (TMS) can non-invasively modulate specific brain regions in Obsessive-compulsive disorder (OCD). Citing orbito-frontal cortex (OFC) hyper-connectivity with striatum as the most consistent finding implicated in patho-physiologically of OCD, we aimed to study the effect of novel continuous Theta Burst Stimulation (cTBS) targeting OFC in OCD subjects on a randomized placebo control design. Thirty-three patients were randomly allocated to active cTBS (n= 18) and sham (n= 15) groups. They received 10 TBS sessions, 2 per day (total of 1200 pulses; intensive protocol) for 5 days in a week. The Yale Brown Obsessive Compulsive Scale (Y-BOCS), Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), and Clinical Global Impression-Severity (CGI-S) scores were assessed at baseline, after last session and at 2 weeks post-rTMS. On repeated measures-ANOVA, a significant group*time effect (from pretreatment to 2 weeks post TBS) for obsessions, compulsions, HAM-A, HAM-D, and CGI scores was found. But when controlled for confounding variables, only HAM-A scores and CGI effect retained statistical significance. We conclude that intensive OFC cTBS (iOFcTBS) in OCD is well tolerated with clinically significant improvements in anxiety symptoms and global severity. This improvement in anxiety symptoms could be due to modulations of state dependent dysregulation in OCD.