1
|
Blyth SH, Cruz Bosch C, Raffoul JJ, Chesley J, Johnson B, Borodge D, Sagarwala R, Masters R, Brady RO, Vandekar S, Ward HB. Safety of rTMS for Schizophrenia: A Systematic Review and Meta-analysis. Schizophr Bull 2024:sbae158. [PMID: 39278637 DOI: 10.1093/schbul/sbae158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/18/2024]
Abstract
BACKGROUND AND HYPOTHESIS Current treatments for schizophrenia are only partially effective, and there are no medications for negative symptoms or cognitive impairment. Neuromodulation, such as repetitive transcranial magnetic stimulation (rTMS), has potential as a novel intervention for schizophrenia. Prior to clinical use, rTMS should have demonstrated safety in a large schizophrenia population. However, the safety profile of rTMS in schizophrenia is not well characterized, and regulatory agencies have expressed concern about safety in this population. STUDY DESIGN We conducted a systematic review with meta-analysis of rTMS studies in schizophrenia. We searched PubMed, the Cochrane Library, PsycINFO, and Science Citation Index Expanded for rTMS studies in schizophrenia that reported adverse effects. We extracted the number of participants who experienced an adverse effect and calculated the prevalence of each adverse effect for active or sham rTMS. We tested the difference between the prevalence of events in the active and sham conditions. We assessed risk of bias using the Cochrane Handbook. STUDY RESULTS The initial search identified 1472 studies. After screening, 261 full-text studies were assessed, and 126 met inclusion criteria (N = 4122 total subjects). The prevalence of headache or scalp pain, dizziness or syncope, facial twitching, and nausea was higher for active rTMS compared to sham (P < .05). The prevalence of all other adverse effects, including seizure, was not different between active and sham rTMS. CONCLUSIONS rTMS is safe and well tolerated for people with schizophrenia. Individuals with schizophrenia are not at increased risk for adverse effects, including seizure, compared to the general population.
Collapse
Affiliation(s)
- Sophia H Blyth
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Claudia Cruz Bosch
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Julian J Raffoul
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jordyn Chesley
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Benjamin Johnson
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Darara Borodge
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Raza Sagarwala
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ross Masters
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Roscoe O Brady
- Department of Psychiatry, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Simon Vandekar
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Heather Burrell Ward
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| |
Collapse
|
2
|
Wei JN, Zhang MK, Wang Z, Liu Y, Zhang J. Table tennis experience enhances motor control in older adults: Insights into sensorimotor-related cortical connectivity. Int J Clin Health Psychol 2024; 24:100464. [PMID: 38660391 PMCID: PMC11039312 DOI: 10.1016/j.ijchp.2024.100464] [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: 01/08/2024] [Accepted: 04/15/2024] [Indexed: 04/26/2024] Open
Abstract
Background Motor control declines with age and requires effective connectivity between the sensorimotor cortex and the primary motor cortex (M1). Despite research indicating that physical exercise can improve motor control in older individuals the effect of physical exercise on neural connectivity in older adults remains to be elucidated. Methods Older adults with experience in table tennis and fit aerobics and individuals without such experience for comparison were recruited for the study. Differences in motor control were assessed using the stop-signal task. The impact of exercise experience on DLPFC-M1 and pre-SMA-M1 neural connectivity was assessed with transcranial magnetic stimulation. Varied time intervals (short and long term) and stimulus intensities (subthreshold and suprathreshold) were used to explore neural connectivity across pathways. Results The present study showed that behavioral iexpression of the table tennis group was significantly better than the other two groups;The facilitatory regulation of preSMA-M1 in all groups is negatively correlated with SSRT. Regulatory efficiency was highest in the table tennis group. Only the neural network regulatory ability of the Table Tennis group showed a negative correlation with SSRT; Inhibitory regulation of DLPFC-M1 was positively correlated with SSRT; this effect was most robust in the table tennis group. Conclusion The preliminary findings of this study suggest that table tennis exercise may enhance the motor system regulated by neural networks and stabilize inhibitory regulation of DLPFC-M1, thereby affecting motor control in older adults.
Collapse
Affiliation(s)
- Jia-Ning Wei
- Center for Exercise and Brain Science, School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Ming-Kai Zhang
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Zhen Wang
- School of Sport and Health Science, Xi'an Physical Education University, Xi'an, China
| | - Yu Liu
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Jian Zhang
- Center for Exercise and Brain Science, School of Psychology, Shanghai University of Sport, Shanghai, China
| |
Collapse
|
3
|
Stephens E, Dhanasekara CS, Montalvan V, Zhang B, Bassett A, Hall R, Rodaniche A, Robohm-Leavitt C, Shen CL, Kahatuduwa CN. Utility of Repetitive Transcranial Magnetic Stimulation for Chronic Daily Headache Prophylaxis: A Systematic Review and Meta-Analysis. Curr Pain Headache Rep 2024; 28:149-167. [PMID: 38277066 DOI: 10.1007/s11916-024-01210-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 01/27/2024]
Abstract
PURPOSE OF REVIEW Management of chronic daily headaches (CDH) remains challenging due to the limited efficacy of standard prophylactic pharmacological measures. Several studies have reported that repetitive transcranial magnetic stimulation (rTMS) can effectively treat chronic headaches. The objective was to determine the utility of rTMS for immediate post-treatment and sustained CDH prophylaxis. RECENT FINDINGS All procedures were conducted per PRISMA guidelines. PubMed, Scopus, Web of Science, and ProQuest databases were searched for controlled clinical trials that have tested the efficacy of rTMS on populations with CDH. DerSimonian-Laird random-effects meta-analyses were performed using the 'meta' package in R to examine the post- vs. pre-rTMS changes in standardized headache intensity and frequency compared to sham-control conditions. Thirteen trials were included with a combined study population of N = 538 patients with CDH (rTMS, N = 284; Sham, N = 254). Patients exposed to rTMS had significantly reduced standardized CDH intensity and frequency in the immediate post-treatment period (Hedges' g = -1.16 [-1.89, -0.43], p = 0.002 and Δ = -5.07 [-10.05, -0.11], p = 0.045 respectively). However, these effects were sustained marginally in the follow-up period (Hedges' g = -0.43 [-0.76, -0.09], p = 0.012 and Δ = -3.33 [-5.52, -1.14], p = 0.003). Significant between-study heterogeneity was observed, at least partially driven by variations in rTMS protocols. Despite the observed clinically meaningful and statistically significant benefits in the immediate post-treatment period, the prophylactic effects of rTMS on CDH do not seem to sustain with discontinuation. Thus, the cost-effectiveness of the routine use of rTMS for CDH prophylaxis remains questionable. REGISTRATION Protocol preregistered in PROSPERO International Prospective Register of Systematic Reviews (CRD42021250100).
Collapse
Affiliation(s)
- Emily Stephens
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Chathurika S Dhanasekara
- Department of Surgery, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Victor Montalvan
- Department of Neurology, School of Medicine, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX, 79430, USA
- Department of Neurology, Division of Vascular Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Bei Zhang
- Division of Physical Medicine and Rehabilitation, Department of Neurology, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Ashley Bassett
- Department of Laboratory Science and Primary Care, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Rebecca Hall
- Department of Laboratory Science and Primary Care, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Alyssa Rodaniche
- Department of Laboratory Science and Primary Care, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Christina Robohm-Leavitt
- Department of Laboratory Science and Primary Care, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Chwan-Li Shen
- Department of Pathology, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
- Center of Excellence for Integrative Health, Texas Tech University Health Sciences Center, Lubbock, TX, USA
- Center of Excellence for Translational Neuroscience and Therapeutics, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Chanaka N Kahatuduwa
- Department of Neurology, School of Medicine, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX, 79430, USA.
- Center of Excellence for Integrative Health, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
- Center of Excellence for Translational Neuroscience and Therapeutics, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
- Department of Psychiatry, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
| |
Collapse
|
4
|
Oberman LM, Francis SM, Lisanby SH. The use of noninvasive brain stimulation techniques in autism spectrum disorder. Autism Res 2024; 17:17-26. [PMID: 37873560 PMCID: PMC10841888 DOI: 10.1002/aur.3041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 09/15/2023] [Indexed: 10/25/2023]
Abstract
Noninvasive brain stimulation (NIBS) techniques, including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), have recently emerged as alternative, nonpharmacological interventions for a variety of psychiatric, neurological, and neurodevelopmental conditions. NIBS is beginning to be applied in both research and clinical settings for the treatment of core and associated symptoms of autism spectrum disorder (ASD) including social communication deficits, restricted and repetitive behaviors, irritability, hyperactivity, depression and impairments in executive functioning and sensorimotor integration. Though there is much promise for these targeted device-based interventions, in other disorders (including adult major depressive disorder (MDD) and obsessive compulsive disorder (OCD) where rTMS is FDA cleared), data on the safety and efficacy of these interventions in individuals with ASD is limited especially in younger children when neurodevelopmental interventions typically begin. Most studies are open-label, small scale, and/or focused on a restricted subgroup of individuals with ASD. There is a need for larger, randomized controlled trials that incorporate neuroimaging in order to develop predictive biomarkers of treatment response and optimize treatment parameters. We contend that until such studies are conducted, we do not have adequate estimates of the safety and efficacy of NIBS interventions in children across the spectrum. Thus, broad off-label use of these techniques in this population is not supported by currently available evidence. Here we discuss the existing data on the use of NIBS to treat symptoms related to ASD and discuss future directions for the field.
Collapse
Affiliation(s)
- Lindsay M Oberman
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Sunday M Francis
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Sarah H Lisanby
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| |
Collapse
|
5
|
Radiansyah RS, Hadi DW. Repetitive transcranial magnetic stimulation in central post-stroke pain: current status and future perspective. Korean J Pain 2023; 36:408-424. [PMID: 37752663 PMCID: PMC10551398 DOI: 10.3344/kjp.23220] [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: 07/25/2023] [Revised: 09/03/2023] [Accepted: 09/14/2023] [Indexed: 09/28/2023] Open
Abstract
Central post-stroke pain (CPSP) is an incapacitating disorder that impacts a substantial proportion of stroke survivors and can diminish their quality of life. Conventional therapies for CPSP, including tricyclic antidepressants, anticonvulsants, and opioids, are frequently ineffective, necessitating the investigation of alternative therapeutic strategies. Repetitive transcranial magnetic stimulation (rTMS) is now recognized as a promising noninvasive pain management method for CPSP. rTMS modulates neural activity through the administration of magnetic pulses to specific cortical regions. Trials analyzing the effects of rTMS on CPSP have generated various outcomes, but the evidence suggests possible analgesic benefits. In CPSP and other neuropathic pain conditions, high-frequency rTMS targeting the primary motor cortex (M1) with figure-eight coils has demonstrated significant pain alleviation. Due to its associaton with analgesic benefits, M1 is the most frequently targeted area. The duration and frequency of rTMS sessions, as well as the stimulation intensity, have been studied in an effort to optimize treatment outcomes. The short-term pain relief effects of rTMS have been observed, but the long-term effects (> 3 months) require further investigation. Aspects such as stimulation frequency, location, and treatment period can influence the efficacy of rTMS and ought to be considered while planning the procedure. Standardized guidelines for using rTMS in CPSP would optimize therapy protocols and improve patient outcomes. This review article provides an up-to-date overview of the incidence, clinical characteristics, outcome of rTMS in CPSP patients, and future perspective in the field.
Collapse
Affiliation(s)
- Riva Satya Radiansyah
- Faculty of Medicine and Health, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia
| | - Deby Wahyuning Hadi
- Department of Neurology, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| |
Collapse
|
6
|
Kurkin S, Gordleeva S, Savosenkov A, Grigorev N, Smirnov N, Grubov VV, Udoratina A, Maksimenko V, Kazantsev V, Hramov AE. Transcranial Magnetic Stimulation of the Dorsolateral Prefrontal Cortex Increases Posterior Theta Rhythm and Reduces Latency of Motor Imagery. SENSORS (BASEL, SWITZERLAND) 2023; 23:4661. [PMID: 37430576 DOI: 10.3390/s23104661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 05/09/2023] [Accepted: 05/09/2023] [Indexed: 07/12/2023]
Abstract
Experiments show activation of the left dorsolateral prefrontal cortex (DLPFC) in motor imagery (MI) tasks, but its functional role requires further investigation. Here, we address this issue by applying repetitive transcranial magnetic stimulation (rTMS) to the left DLPFC and evaluating its effect on brain activity and the latency of MI response. This is a randomized, sham-controlled EEG study. Participants were randomly assigned to receive sham (15 subjects) or real high-frequency rTMS (15 subjects). We performed EEG sensor-level, source-level, and connectivity analyses to evaluate the rTMS effects. We revealed that excitatory stimulation of the left DLPFC increases theta-band power in the right precuneus (PrecuneusR) via the functional connectivity between them. The precuneus theta-band power negatively correlates with the latency of the MI response, so the rTMS speeds up the responses in 50% of participants. We suppose that posterior theta-band power reflects attention modulation of sensory processing; therefore, high power may indicate attentive processing and cause faster responses.
Collapse
Affiliation(s)
- Semen Kurkin
- Baltic Center for Neurotechnology and Artificial Intelligence, Immanuel Kant Baltic Federal University, 236016 Kaliningrad, Russia
| | - Susanna Gordleeva
- Neurodynamics and Cognitive Technology Laboratory, Lobachevsky State University of Nizhny Novgorod, 603105 Nizhniy Novgorod, Russia
| | - Andrey Savosenkov
- Baltic Center for Neurotechnology and Artificial Intelligence, Immanuel Kant Baltic Federal University, 236016 Kaliningrad, Russia
- Neurodynamics and Cognitive Technology Laboratory, Lobachevsky State University of Nizhny Novgorod, 603105 Nizhniy Novgorod, Russia
| | - Nikita Grigorev
- Baltic Center for Neurotechnology and Artificial Intelligence, Immanuel Kant Baltic Federal University, 236016 Kaliningrad, Russia
- Neurodynamics and Cognitive Technology Laboratory, Lobachevsky State University of Nizhny Novgorod, 603105 Nizhniy Novgorod, Russia
| | - Nikita Smirnov
- Baltic Center for Neurotechnology and Artificial Intelligence, Immanuel Kant Baltic Federal University, 236016 Kaliningrad, Russia
| | - Vadim V Grubov
- Baltic Center for Neurotechnology and Artificial Intelligence, Immanuel Kant Baltic Federal University, 236016 Kaliningrad, Russia
| | - Anna Udoratina
- Neurodynamics and Cognitive Technology Laboratory, Lobachevsky State University of Nizhny Novgorod, 603105 Nizhniy Novgorod, Russia
| | - Vladimir Maksimenko
- Baltic Center for Neurotechnology and Artificial Intelligence, Immanuel Kant Baltic Federal University, 236016 Kaliningrad, Russia
- Neurodynamics and Cognitive Technology Laboratory, Lobachevsky State University of Nizhny Novgorod, 603105 Nizhniy Novgorod, Russia
| | - Victor Kazantsev
- Neurodynamics and Cognitive Technology Laboratory, Lobachevsky State University of Nizhny Novgorod, 603105 Nizhniy Novgorod, Russia
| | - Alexander E Hramov
- Baltic Center for Neurotechnology and Artificial Intelligence, Immanuel Kant Baltic Federal University, 236016 Kaliningrad, Russia
- Neurodynamics and Cognitive Technology Laboratory, Lobachevsky State University of Nizhny Novgorod, 603105 Nizhniy Novgorod, Russia
| |
Collapse
|
7
|
Beisteiner R, Hallett M, Lozano AM. Ultrasound Neuromodulation as a New Brain Therapy. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2205634. [PMID: 36961104 PMCID: PMC10190662 DOI: 10.1002/advs.202205634] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 02/03/2023] [Indexed: 05/18/2023]
Abstract
Within the last decade, ultrasound has been "rediscovered" as a technique for brain therapies. Modern technologies allow focusing ultrasound through the human skull for highly focal tissue ablation, clinical neuromodulatory brain stimulation, and targeted focal blood-brain-barrier opening. This article gives an overview on the state-of-the-art of the most recent application: ultrasound neuromodulation as a new brain therapy. Although research centers have existed for decades, the first treatment centers were not established until 2020, and clinical applications are spreading rapidly.
Collapse
Affiliation(s)
- Roland Beisteiner
- Department of NeurologyFunctional Brain Diagnostics and TherapyHigh Field MR CenterMedical University of ViennaSpitalgasse 23Vienna1090Austria
| | - Mark Hallett
- Human Motor Control SectionNational Institute of Neurological Disorders and StrokeNational Institutes of Health10 Center DriveBethesdaMD20892–1428USA
| | - Andres M. Lozano
- Division of NeurosurgeryDepartment of SurgeryUniversity of TorontoTorontoONM5T 2S8Canada
| |
Collapse
|
8
|
Lin SHN, Lien YR, Shibata K, Sasaki Y, Watanabe T, Lin CP, Chang LH. The phase of plasticity-induced neurochemical changes of high-frequency repetitive transcranial magnetic stimulation are different from visual perceptual learning. Sci Rep 2023; 13:5720. [PMID: 37029245 PMCID: PMC10082079 DOI: 10.1038/s41598-023-32985-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/05/2023] [Indexed: 04/09/2023] Open
Abstract
Numerous studies have found that repetitive transcranial magnetic stimulation (rTMS) modulates plasticity. rTMS has often been used to change neural networks underlying learning, often under the assumption that the mechanism of rTMS-induced plasticity should be highly similar to that associated with learning. The presence of visual perceptual learning (VPL) reveals the plasticity of early visual systems, which is formed through multiple phases. Hence, we tested how high-frequency (HF) rTMS and VPL modulate the effect of visual plasticity by investigating neurometabolic changes in early visual areas. We employed an excitatory-to-inhibitory (E/I) ratio, which refers to glutamate concentration divided by GABA+ concentration, as an index of the degree of plasticity. We compared neurotransmitter concentration changes after applying HF rTMS to the visual cortex with those after training in a visual task, in otherwise identical procedures. Both the time courses of the E/I ratios and neurotransmitter contributions to the E/I ratio significantly differed between HF rTMS and training conditions. The peak E/I ratio occurred 3.5 h after HF rTMS with decreased GABA+, whereas the peak E/I ratio occurred 0.5 h after visual training with increased glutamate. Furthermore, HF rTMS temporally decreased the thresholds for detecting phosphene and perceiving low-contrast stimuli, indicating increased visual plasticity. These results suggest that plasticity in early visual areas induced by HF rTMS is not as involved in the early phase of development of VPL that occurs during and immediately after training.
Collapse
Affiliation(s)
- Shang-Hua N Lin
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yun R Lien
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | | | - Yuka Sasaki
- Department of Cognitive, Linguistics, and Psychological Sciences, Brown University, Providence, USA
| | - Takeo Watanabe
- Department of Cognitive, Linguistics, and Psychological Sciences, Brown University, Providence, USA
| | - Ching-Po Lin
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Li-Hung Chang
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Institute of Philosophy of Mind and Cognition, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| |
Collapse
|
9
|
Revilla-Pacheco F, Watanabe S, Rodríguez-Reyes J, Sánchez-Torres C, Shkurovich-Bialik P, Herrada-Pineda T, Rodríguez-Salgado P, Franco-Granillo J, Calderón-Juárez M. Transcranial electric stimulation motor evoked potentials for cervical spine intraoperative monitoring complications: systematic review and illustrative case of cardiac arrest. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:2723-2732. [PMID: 35790650 DOI: 10.1007/s00586-022-07297-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE We show a systematic review of known complications during intraoperative neuromonitoring (IONM) using transcranial electric stimulation motor evoked potentials (TES-MEP) on cervical spine surgery, which provides a summary of the main findings. A rare complication during this procedure, cardiac arrest by cardioinhibitory reflex, is also described. METHODS Findings of 523 scientific papers published from 1995 onwards were reviewed in the following databases: CENTRAL, Cochrane Library, Embase, Google Scholar, Ovid, LILACS, PubMed, and Web of Science. This study evaluated only complications on cervical spine surgery undergoing TES-MEP IONM. RESULTS The review of the literature yielded 13 studies on the complications of TES-MEP IONM, from which three were excluded. Five studies are case series; the rest are case reports. Overall, 169 complications on 167 patients were reported in a total of 38,915 patients, a global prevalence of 0.43%. The most common complication was tongue-bite in 129 cases, (76.3% of all complication events). Tongue-bite had a prevalence of 0.33% (CI 95%, 0.28-0.39%) in all patients on TES-MEP IONM. A relatively low prevalence of severe complications was found: cardiac-arrhythmia, bradycardia and seizure, the prevalence of this complications represents only one case in all the sample. Alongside, we report the occurrence of cardiac arrest attributable to TES-MEP IONM. CONCLUSIONS This systematic review shows that TES-MEP is a safe procedure with a very low prevalence of complications. To our best knowledge, asystole is reported for the first time as a complication during TES-MEP IONM.
Collapse
Affiliation(s)
| | - Shoko Watanabe
- Department of Neurosurgery, ABC Medical Center, Mexico City, Mexico
| | | | | | | | | | | | | | - Martín Calderón-Juárez
- Plan de Estudios Combinados en Medicina, Faculty of Medicine, National Autonomous University of Mexico, Circuto Escolar 411A, Coyoacán, 04360, Mexico City, Mexico.
| |
Collapse
|
10
|
Valiengo L, Pinto BS, Marinho KAP, Santos LA, Tort LC, Benatti RG, Teixeira BB, Miranda CS, Cardeal HB, Suen PJC, Loureiro JC, Vaughan RAR, Dini Mattar RAMPF, Lessa M, Oliveira PS, Silva VA, Gattaz WF, Brunoni AR, Forlenza OV. Treatment of depression in the elderly with repetitive transcranial magnetic stimulation using theta-burst stimulation: Study protocol for a randomized, double-blind, controlled trial. Front Hum Neurosci 2022; 16:941981. [PMID: 36118977 PMCID: PMC9471379 DOI: 10.3389/fnhum.2022.941981] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 08/04/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Transcranial magnetic stimulation (TMS) is a consolidated procedure for the treatment of depression, with several meta-analyses demonstrating its efficacy. Theta-burst stimulation (TBS) is a modification of TMS with similar efficacy and shorter session duration. The geriatric population has many comorbidities and a high prevalence of depression, but few clinical trials are conducted specifically for this age group. TBS could be an option in this population, offering the advantages of few side effects and no pharmacological interactions. Therefore, our aim is to investigate the efficacy of TBS in geriatric depression. Clinical trial registration [https://clinicaltrials.gov/ct2/], identifier [NCT04842929].
Collapse
Affiliation(s)
- Leandro Valiengo
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
- Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Programa de Fisiopatologia Experimental, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- *Correspondence: Leandro Valiengo,
| | - Bianca S. Pinto
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Kalian A. P. Marinho
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Leonardo A. Santos
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Luara C. Tort
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Rafael G. Benatti
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Bruna B. Teixeira
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Cristiane S. Miranda
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Henriette B. Cardeal
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Paulo J. C. Suen
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Julia C. Loureiro
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Renata A. R. Vaughan
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Roberta A. M. P. F. Dini Mattar
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Maíra Lessa
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Pedro S. Oliveira
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Valquíria A. Silva
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Wagner Farid Gattaz
- Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - André R. Brunoni
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
- Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Orestes Vicente Forlenza
- Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| |
Collapse
|
11
|
Adu MK, Eboreime E, Sapara AO, Agyapong VIO. The Use of Repetitive Transcranial Magnetic Stimulations for the Treatment of Bipolar Disorder: A Scoping Review. Behav Sci (Basel) 2022; 12:263. [PMID: 36004834 PMCID: PMC9404915 DOI: 10.3390/bs12080263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/14/2022] [Accepted: 07/27/2022] [Indexed: 12/02/2022] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive neuromodulation technique that involves the application of magnetic pulses on hyperactive or hypoactive cortical brain areas. rTMS is considered a high therapeutic tool in many neuropsychiatric conditions. Despite its wide and continuous usage for the treatment of psychiatric disorders, information about the use of rTMS in bipolar disorders is limited and not well-established in the literature. Objectives: This scoping review aims to explore the literature available regarding the application of rTMS for the management of bipolar disorders, to garner evidence in support of it uses in the management of bipolar disorders, and for recommendations on future clinical and research work. Method: We electronically conducted a data search in five research databases (MEDLINE, CINAHL, Psych INFO, SCOPUS, and EMBASE) using all identified keywords across all the databases to identify evidence-based studies. Articles were included if they were published randomized control designs aimed at the use of rTMS in the management of bipolar disorders. Overall, nine studies were eligible for this review. The search results are up to date as of the final date of data search-20 December 2020. Only full-text published articles written in English were reviewed. Review articles on treatment with rTMS for conditions either than bipolar disorders were excluded. Conclusion: The application of rTMS intervention for bipolar disorders looks promising despite the diversity of its outcomes and its clinical significance. However, to be able to draw a definite conclusion on the clinical effectiveness of the technique, more randomized controlled studies with well-defined stimulation parameters need to be conducted with large sample sizes in the future.
Collapse
Affiliation(s)
- Medard Kofi Adu
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada; (E.E.); (A.O.S.); (V.I.O.A.)
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada; (E.E.); (A.O.S.); (V.I.O.A.)
| | - Adegboyega Oyekunbi Sapara
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada; (E.E.); (A.O.S.); (V.I.O.A.)
| | - Vincent Israel Opoku Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada; (E.E.); (A.O.S.); (V.I.O.A.)
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 2E2, Canada
| |
Collapse
|
12
|
Giustiniani A, Vallesi A, Oliveri M, Tarantino V, Ambrosini E, Bortoletto M, Masina F, Busan P, Siebner H, Fadiga L, Koch G, Leocani L, Lefaucheur J, Rotenberg A, Zangen A, Violante I, Moliadze V, Gamboa O, Ugawa Y, Pascual-Leone A, Ziemann U, Miniussi C, Burgio F. A questionnaire to collect unintended effects of Transcranial Magnetic Stimulation: A consensus based approach. Clin Neurophysiol 2022; 141:101-108. [DOI: 10.1016/j.clinph.2022.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 05/18/2022] [Accepted: 06/10/2022] [Indexed: 11/03/2022]
|
13
|
Chen Q, Huang H, Chen G, Chen J, Fang F, Lei H, Zhang Y, Lin J, Chen X, Liu N, Li J, Chen R, Du H. The Effect of Cerebellar Repetitive Transcranial Magnetic Stimulation on Dysphagia due to Posterior Circulation Stroke, a Randomized Controlled Trial Protocol. Cerebrovasc Dis 2022; 51:706-711. [PMID: 35533666 DOI: 10.1159/000524241] [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: 01/03/2022] [Accepted: 03/11/2022] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION Cerebellum might be active during the task of swallowing. Little is known whether cerebellar repetitive transcranial magnetic stimulation (rTMS) could improve post-stroke dysphagia (PSD) due to occlusion in the posterior circulation. This paper describes the rationale and design of a randomized controlled trial that aims to determine the effect of cerebellar rTMS on dysphagia due to posterior circulation stroke. METHODS AND ANALYSIS Thirty patients with PSD due to occlusion in the posterior circulation will be randomly divided to receive real (n = 20) or sham (n = 10) cerebellar rTMS. Patients in the real rTMS group will receive 250 pulses rTMS at a low intensity with 10 Hz frequency for 10 days (five consecutive days per week). The severity of dysphagia will be assessed with videofluoroscopic swallowing study (VFSS) using the Rosenbek penetration aspiration scale (PAS), the pharyngeal constriction ratio (PCR), and the dysphagia outcome and severity scale (DOSS) before and immediately after the last session and then again after 1 and 3 months. The functional magnetic resonance imaging (fMRI) will be assessed before and after the last session and then again after 1 month and 3 months. The primary outcome is the improvement of swallowing function determined by PAS, PCR, and DOSS. The secondary outcomes include changes in brain connectivity network detected using fMRI. DISCUSSION This study will determine whether cerebellar rTMS improves dysphagia due to posterior circulation stroke in Chinese patients. Our findings will contribute to a new approach for swallowing function recovery after posterior circulation stroke.
Collapse
Affiliation(s)
- Qingfa Chen
- From the Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China
| | - Huayao Huang
- From the Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China
| | - Guangliang Chen
- From the Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jianhua Chen
- From the Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Fangshuang Fang
- From the Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Hanhan Lei
- From the Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yixian Zhang
- From the Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jilan Lin
- From the Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xiuyun Chen
- From the Health College, Fujian Medical University, Fuzhou, China
| | - Nan Liu
- From the Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jing Li
- From the Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China
| | - Ronghua Chen
- From the Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China.,From the Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Houwei Du
- From the Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China.,From the Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| |
Collapse
|
14
|
Sarica C, Nankoo JF, Fomenko A, Grippe TC, Yamamoto K, Samuel N, Milano V, Vetkas A, Darmani G, Cizmeci MN, Lozano AM, Chen R. Human Studies of Transcranial Ultrasound neuromodulation: A systematic review of effectiveness and safety. Brain Stimul 2022; 15:737-746. [DOI: 10.1016/j.brs.2022.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/25/2022] [Accepted: 05/02/2022] [Indexed: 01/11/2023] Open
|
15
|
Current Status of Neuromodulation-Induced Cortical Prehabilitation and Considerations for Treatment Pathways in Lower-Grade Glioma Surgery. LIFE (BASEL, SWITZERLAND) 2022; 12:life12040466. [PMID: 35454957 PMCID: PMC9024440 DOI: 10.3390/life12040466] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/19/2022] [Accepted: 03/19/2022] [Indexed: 12/15/2022]
Abstract
The infiltrative character of supratentorial lower grade glioma makes it possible for eloquent neural pathways to remain within tumoural tissue, which renders complete surgical resection challenging. Neuromodulation-Induced Cortical Prehabilitation (NICP) is intended to reduce the likelihood of premeditated neurologic sequelae that otherwise would have resulted in extensive rehabilitation or permanent injury following surgery. This review aims to conceptualise current approaches involving Repetitive Transcranial Magnetic Stimulation (rTMS-NICP) and extraoperative Direct Cortical Stimulation (eDCS-NICP) for the purposes of inducing cortical reorganisation prior to surgery, with considerations derived from psychiatric, rehabilitative and electrophysiologic findings related to previous reports of prehabilitation. Despite the promise of reduced risk and incidence of neurologic injury in glioma surgery, the current data indicates a broad but compelling possibility of effective cortical prehabilitation relating to perisylvian cortex, though it remains an under-explored investigational tool. Preliminary findings may prove sufficient for the continued investigation of prehabilitation in small-volume lower-grade tumour or epilepsy patients. However, considering the very low number of peer-reviewed case reports, optimal stimulation parameters and duration of therapy necessary to catalyse functional reorganisation remain equivocal. The non-invasive nature and low risk profile of rTMS-NICP may permit larger sample sizes and control groups until such time that eDCS-NICP protocols can be further elucidated.
Collapse
|
16
|
Prosvetov A, Tsygankov B, Guekht A, Kuznetsov E, Less U, Tumurov D, Popov G, Tsygankov D, Rangus S. Transcranial magnetic stimulation in the treatment of depressive disorder in Parkinson’s disease. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:79-85. [DOI: 10.17116/jnevro202212209179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
17
|
Cotovio G, Boes AD, Press DZ, Oliveira-Maia AJ, Pascual-Leone A. In Older Adults the Antidepressant Effect of Repetitive Transcranial Magnetic Stimulation Is Similar but Occurs Later Than in Younger Adults. Front Aging Neurosci 2022; 14:919734. [PMID: 35928992 PMCID: PMC9343621 DOI: 10.3389/fnagi.2022.919734] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/15/2022] [Indexed: 11/23/2022] Open
Abstract
Background Treatment resistant depression is common in older adults and treatment is often complicated by medical comorbidities and polypharmacy. Repetitive transcranial magnetic stimulation (rTMS) is a treatment option for this group due to its favorable profile. However, early influential studies suggested that rTMS is less effective in older adults. This evidence remains controversial. Methods Here, we evaluated the rTMS treatment outcomes in a large international multicenter naturalistic cohort of >500 patients comparing older vs. younger adults. Results We show that older adults, while having similar antidepressant response to younger adults, respond more slowly, which may help to explain differences from earlier studies when the duration of a treatment course was shorter. Conclusions Such evidence helps to resolve a long-standing controversy in treating older depressed patients with rTMS. Moreover, these findings provide an important data point in the call to revise policy decisions from major insurance providers that have unfairly excluded older adults.
Collapse
Affiliation(s)
- Gonçalo Cotovio
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal.,NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisbon, Portugal.,Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Aaron D Boes
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, United States.,Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, IA, United States.,Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA, United States
| | - Daniel Z Press
- Division of Cognitive Neurology, Department of Neurology, Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Albino J Oliveira-Maia
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal.,NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Alvaro Pascual-Leone
- Hinda and Arthur Marcus Institute for Aging Research, Deanna and Sidney Wolk Center for Aging Research, Hebrew SeniorLife, Boston, MA, United States.,Department of Neurology, Harvard Medical School, Boston, MA, United States
| |
Collapse
|
18
|
Harika-Germaneau G, Wassouf I, Le Tutour T, Guillevin R, Doolub D, Rostami R, Delbreil A, Langbour N, Jaafari N. Baseline Clinical and Neuroimaging Biomarkers of Treatment Response to High-Frequency rTMS Over the Left DLPFC for Resistant Depression. Front Psychiatry 2022; 13:894473. [PMID: 35669263 PMCID: PMC9163359 DOI: 10.3389/fpsyt.2022.894473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/05/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) has proven to be an efficient treatment option for patients with treatment-resistant depression (TRD). However, the success rate of this method is still low, and the treatment outcome is unpredictable. The objective of this study was to explore clinical and structural neuroimaging factors as potential biomarkers of the efficacy of high-frequency (HF) rTMS (20 Hz) over the left dorso-lateral pre-frontal cortex (DLPFC). METHODS We analyzed the records of 131 patients with mood disorders who were treated with rTMS and were assessed at baseline at the end of the stimulation and at 1 month after the end of the treatment. The response is defined as a 50% decrease in the MADRS score between the first and the last assessment. Each of these patients underwent a T1 MRI scan of the brain, which was subsequently segmented with FreeSurfer. Whole-brain analyses [Query, Design, Estimate, Contrast (QDEC)] were conducted and corrected for multiple comparisons. Additionally, the responder status was also analyzed using binomial multivariate regression models. The explored variables were clinical and anatomical features of the rTMS target obtained from T1 MRI: target-scalp distance, DLPFC gray matter thickness, and various cortical measures of interest previously studied. RESULTS The results of a binomial multivariate regression model indicated that depression type (p = 0.025), gender (p = 0.010), and the severity of depression (p = 0.027) were found to be associated with response to rTMS. Additionally, the resistance stage showed a significant trend (p = 0.055). Whole-brain analyses on volume revealed that the average volume of the left part of the superior frontal and the caudal middle frontal regions is associated with the response status. Other MRI-based measures are not significantly associated with response to rTMS in our population. CONCLUSION In this study, we investigated the clinical and neuroimaging biomarkers associated with responsiveness to high-frequency rTMS over the left DLPFC in a large sample of patients with TRD. Women, patients with bipolar depressive disorder (BDD), and patients who are less resistant to HF rTMS respond better. Responders present a lower volume of the left part of the superior frontal gyrus and the caudal middle frontal gyrus. These findings support further investigation into the use of clinical variables and structural MRI as possible biomarkers of rTMS treatment response.
Collapse
Affiliation(s)
- Ghina Harika-Germaneau
- Centre Hospitalier Henri Laborit, Unité de Recherche Clinique Pierre Deniker, Poitiers, France.,Centre de Recherches sur la Cognition et l'Apprentissage, Centre National de la Recherche Scientifique (CNRS 7295), Université de Poitiers, Poitiers, France
| | - Issa Wassouf
- Centre Hospitalier Henri Laborit, Unité de Recherche Clinique Pierre Deniker, Poitiers, France.,Centre de Recherches sur la Cognition et l'Apprentissage, Centre National de la Recherche Scientifique (CNRS 7295), Université de Poitiers, Poitiers, France.,Centre Hospitalier Nord Deux-Sèvres, Service de Psychiatrie Adulte, Thouars, France
| | - Tom Le Tutour
- Centre Hospitalier Henri Laborit, Unité de Recherche Clinique Pierre Deniker, Poitiers, France
| | - Remy Guillevin
- CHU de Poitiers, Service de Radiologie, Poitiers, France.,Laboratoire Dactim Mis, LMA, UMR CNRS 7348, Poitiers, France
| | - Damien Doolub
- Centre Hospitalier Henri Laborit, Unité de Recherche Clinique Pierre Deniker, Poitiers, France.,Centre de Recherches sur la Cognition et l'Apprentissage, Centre National de la Recherche Scientifique (CNRS 7295), Université de Poitiers, Poitiers, France
| | - Reza Rostami
- Department of Psychology, University of Tehran, Tehran, Iran.,Atieh Clinical Neuroscience Centre, Tehran, Iran
| | - Alexia Delbreil
- Centre Hospitalier Henri Laborit, Unité de Recherche Clinique Pierre Deniker, Poitiers, France.,Centre de Recherches sur la Cognition et l'Apprentissage, Centre National de la Recherche Scientifique (CNRS 7295), Université de Poitiers, Poitiers, France.,CHU Poitiers, Service de Médecine Légale, Poitiers, France
| | - Nicolas Langbour
- Centre Hospitalier Henri Laborit, Unité de Recherche Clinique Pierre Deniker, Poitiers, France.,Centre de Recherches sur la Cognition et l'Apprentissage, Centre National de la Recherche Scientifique (CNRS 7295), Université de Poitiers, Poitiers, France
| | - Nematollah Jaafari
- Centre Hospitalier Henri Laborit, Unité de Recherche Clinique Pierre Deniker, Poitiers, France.,Centre de Recherches sur la Cognition et l'Apprentissage, Centre National de la Recherche Scientifique (CNRS 7295), Université de Poitiers, Poitiers, France
| |
Collapse
|
19
|
Adu MK, Eboreime E, Sapara AO, Greenshaw AJ, Chue P, Agyapong VIO. The use of repetitive transcranial magnetic stimulation for treatment of obsessive-compulsive disorder: a scoping review. Ment Illn 2021; 13:1-13. [PMID: 35432816 PMCID: PMC8936147 DOI: 10.1108/mij-05-2021-0002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/04/2021] [Accepted: 06/04/2021] [Indexed: 11/21/2022] Open
Abstract
Purpose This paper aims to explore the relevant literature available regarding the use of repetitive transcranial magnetic stimulation (rTMS) as a mode of treatment for obsessive-compulsive disorder (OCD); to evaluate the evidence to support the use of rTMS as a treatment option for OCD. Design/methodology/approach The authors electronically conducted data search in five research databases (MEDLINE, CINAHL, Psych INFO, SCOPUS and EMBASE) using all identified keywords and index terms across all the databases to identify empirical studies and randomized controlled trials. The authors included articles published with randomized control designs, which aimed at the treatment of OCD with rTMS. Only full-text published articles written in English were reviewed. Review articles on treatment for conditions other than OCD were excluded. The Covidence software was used to manage and streamline the review. Findings Despite the inconsistencies in the published literature, the application of rTMS over the supplementary motor area and the orbitofrontal cortex has proven to be promising in efficacy and tolerability compared with other target regions such as the prefrontal cortex for the treatment of OCD. Despite the diversity in terms of the outcomes and clinical variability of the studies under review, rTMS appears to be a promising treatment intervention for OCD. Research limitations/implications The authors of this scoping review acknowledge several limitations. First, the search strategy considered only studies published in English and the results are up to date as the last day of the electronic data search of December 10, 2020. Though every effort was made to identify all relevant studies for the purposes of this review per the eligibility criteria, the authors still may have missed some relevant studies, especially those published in other languages. Originality/value This review brought to bare the varying literature on the application of rTMS and what is considered gaps in the knowledge in this area in an attempt to evaluate and provide information on the potential therapeutic effects of rTMS for OCD.
Collapse
Affiliation(s)
- Medard Kofi Adu
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta Edmonton Canada
| | - Ejemai Eboreime
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta Edmonton Canada
| | | | - Andrew James Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta Edmonton Canada
| | - Pierre Chue
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta Edmonton Canada
| | | |
Collapse
|
20
|
Valiengo L, Maia A, Cotovio G, Gordon PC, Brunoni AR, Forlenza OV, Oliveira-Maia AJ. Repetitive Transcranial Magnetic Stimulation for Major Depressive Disorder in Older Adults: Systematic Review and Meta-Analysis. J Gerontol A Biol Sci Med Sci 2021; 77:851-860. [PMID: 34432865 DOI: 10.1093/gerona/glab235] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Major Depressive Disorder (MDD) in older adults is a serious public health concern. Repetitive transcranial magnetic stimulation (rTMS) is a non-pharmacological intervention approved for Major Depressive Disorder (MDD) treatment in adults, but its value in older adults remains unknown. The present study aims to systematically review and meta-analyze evidence of rTMS efficacy in MDD treatment among older adults. METHODS We systematically reviewed the literature for randomized controlled trials (RCTs) and open-label studies assessing rTMS for the treatment of MDD in patients older than 50 years-old, published until June 2020. Random-effects meta-analyses using standardized mean differences (SMD) were conducted to assess change in depression severity score (primary outcome), while odds-ratios (OR) were used to assess secondary categorical outcomes (response and remission). Additionally, univariate meta-regression analyses were performed to identify potential predictors of change in depression severity scores. RESULTS Fourteen RCTs were included in meta-analyses and 26 studies (10 RCTs and 16 open-label studies) in meta-regression. Active rTMS was significantly superior to sham-treatment for reduction of severity (SMD=0.36; 95%CI=0.13-0.60), as well as response (OR=3.26; 95%CI=2.11-5.04) and remission (OR=4.63; 95%CI=2.24-9.55). Studies were of moderate to high quality, with funnel plots and Egger's regression test not suggestive of publication bias. In meta-regressions, higher mean age and number of sessions were significantly associated to greater improvement. CONCLUSIONS Our results support that rTMS is an effective, safe and well-tolerated treatment for MDD in older adults, and that it should be considered in the treatment of this vulnerable population.
Collapse
Affiliation(s)
- Leandro Valiengo
- Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Brazil.,Serviço Interdisciplinar de Neuromodulação (SIN), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Brazil
| | - Ana Maia
- Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal.,NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisbon, Portugal.,Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Gonçalo Cotovio
- Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal.,NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisbon, Portugal.,Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Pedro C Gordon
- Serviço Interdisciplinar de Neuromodulação (SIN), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Brazil.,Department of Neurology & Stroke, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - André R Brunoni
- Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Brazil.,Serviço Interdisciplinar de Neuromodulação (SIN), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Brazil
| | - Orestes V Forlenza
- Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Brazil
| | - Albino J Oliveira-Maia
- Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal.,NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisbon, Portugal
| |
Collapse
|
21
|
Kearney-Ramos T, Haney M. Repetitive transcranial magnetic stimulation as a potential treatment approach for cannabis use disorder. Prog Neuropsychopharmacol Biol Psychiatry 2021; 109:110290. [PMID: 33677045 PMCID: PMC9165758 DOI: 10.1016/j.pnpbp.2021.110290] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/22/2021] [Accepted: 02/19/2021] [Indexed: 01/22/2023]
Abstract
The expanding legalization of cannabis across the United States is associated with increases in cannabis use, and accordingly, an increase in the number and severity of individuals with cannabis use disorder (CUD). The lack of FDA-approved pharmacotherapies and modest efficacy of psychotherapeutic interventions means that many of those who seek treatment for CUD relapse within the first few months. Consequently, there is a pressing need for innovative, evidence-based treatment development for CUD. Preliminary evidence suggests that repetitive transcranial magnetic stimulation (rTMS) may be a novel, non-invasive therapeutic neuromodulation tool for the treatment of a variety of substance use disorders (SUDs), including recently receiving FDA clearance (August 2020) for use as a smoking cessation aid in tobacco cigarette smokers. However, the potential of rTMS for CUD has not yet been reviewed. This paper provides a primer on therapeutic neuromodulation techniques for SUDs, with a particular focus on reviewing the current status of rTMS research in people who use cannabis. Lastly, future directions are proposed for rTMS treatment development in CUD, with suggestions for study design parameters and clinical endpoints based on current gold-standard practices for therapeutic neuromodulation research.
Collapse
Affiliation(s)
- Tonisha Kearney-Ramos
- New York State Psychiatric Institute, New York, NY, USA; Columbia University Irving Medical Center, New York, NY, USA.
| | - Margaret Haney
- New York State Psychiatric Institute, New York, New York, USA,Columbia University Irving Medical Center, New York, New York, USA
| |
Collapse
|
22
|
Ahnaou A, Drinkenburg WHIM. Sleep, neuronal hyperexcitability, inflammation and neurodegeneration: Does early chronic short sleep trigger and is it the key to overcoming Alzheimer's disease? Neurosci Biobehav Rev 2021; 129:157-179. [PMID: 34214513 DOI: 10.1016/j.neubiorev.2021.06.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 05/13/2021] [Accepted: 06/25/2021] [Indexed: 01/13/2023]
Abstract
Evidence links neuroinflammation to Alzheimer's disease (AD); however, its exact contribution to the onset and progression of the disease is poorly understood. Symptoms of AD can be seen as the tip of an iceberg, consisting of a neuropathological build-up in the brain of extracellular amyloid-β (Aβ) plaques and intraneuronal hyperphosphorylated aggregates of Tau (pTau), which are thought to stem from an imbalance between its production and clearance resulting in loss of synaptic health and dysfunctional cortical connectivity. The glymphatic drainage system, which is particularly active during sleep, plays a key role in the clearance of proteinopathies. Poor sleep can cause hyperexcitability and promote Aβ and tau pathology leading to systemic inflammation. The early neuronal hyperexcitability of γ-aminobutyric acid (GABA)-ergic inhibitory interneurons and impaired inhibitory control of cortical pyramidal neurons lie at the crossroads of excitatory/inhibitory imbalance and inflammation. We outline, with a prospective framework, a possible vicious spiral linking early chronic short sleep, neuronal hyperexcitability, inflammation and neurodegeneration. Understanding the early predictors of AD, through an integrative approach, may hold promise for reducing attrition in the late stages of neuroprotective drug development.
Collapse
Affiliation(s)
- A Ahnaou
- Dept. of Neuroscience Discovery, Janssen Research & Development, A Division of Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse, B-2340, Belgium.
| | - W H I M Drinkenburg
- Dept. of Neuroscience Discovery, Janssen Research & Development, A Division of Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse, B-2340, Belgium
| |
Collapse
|
23
|
Mohamad Safiai NI, Mohamad NA, Basri H, Inche Mat LN, Hoo FK, Abdul Rashid AM, Yusof Khan AHK, Loh WC, Baharin J, Fernandez A, Samsudin IN, Mohamed MH, Siew MC, Lee KW, Ramachandran V, Pozo-Rosich P, Wan Sulaiman WA. High-frequency repetitive transcranial magnetic stimulation at dorsolateral prefrontal cortex for migraine prevention: A protocol for a systematic review of controlled trials. PLoS One 2021; 16:e0251528. [PMID: 34138860 PMCID: PMC8211237 DOI: 10.1371/journal.pone.0251528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 04/27/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Migraine may lead to a negative impact on the patients' quality of life with a subsequent substantial burden to society. Therapy options for treatment and prevention of migraine have progressed over the years and repetitive transcranial magnetic stimulation (rTMS) is one of the promising non-pharmacological options. It induces and alters electric current in the brain via repetitive non-invasive brain stimulation in high frequency. In migraine patients, two common stimulation sites are the M1 cortex and dorsolateral prefrontal cortex (DLPFC). The mechanism on how rTMS exerts therapeutic effects on migraine is not fully established, but the main postulation is that the neuromodulation via high-frequency rTMS (hf-rTMS) might inhibit pain perception. However, evidence from studies has been conflicting, thus the usefulness of hf-rTMS as migraine preventive treatment is still uncertain at this moment. METHODS This is a systematic review protocol describing essential reporting items based on the PRISMA for systematic review protocols (PRISMA-P) (Registration number: CRD42020220636). We aim to review the effectiveness, tolerability, and safety of hf-rTMS at DLPFC in randomised controlled trials (RCTs) as migraine prophylactic treatment. We will search Scopus, Cumulative Index to Nursing and Allied Health Literature Plus, PubMed, Cochrane Central Register of Controlled Trials and Biomed Central for relevant articles from randomised controlled clinical trials that used hf-rTMS applied at DLPFC for the treatment of migraine. The risk of bias will be assessed using the version 2 "Risk of bias" tool from Cochrane Handbook for Systematic Reviews of Interventions Version 6.1. We will investigate the evidence on efficacy, tolerability and safety and we will compare the outcomes between the hf-rTMS intervention and sham groups. DISCUSSION This systematic review will further determine the efficacy, safety, and tolerability of hf-rTMS applied at DLPFC for migraine prophylaxis. It will provide additional data for health practitioners and policymakers about the usefulness of hf-rTMS for migraine preventive treatment.
Collapse
Affiliation(s)
- Nabil Izzaatie Mohamad Safiai
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Nur Afiqah Mohamad
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Hamidon Basri
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Liyana Najwa Inche Mat
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Fan Kee Hoo
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Anna Misyail Abdul Rashid
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Abdul Hanif Khan Yusof Khan
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Wei Chao Loh
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Janudin Baharin
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Aaron Fernandez
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Intan Nureslyna Samsudin
- Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Mohd Hazmi Mohamed
- Department of ORL-HNS, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Mooi Ching Siew
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Kai Wei Lee
- Department of Pre-Clinical Sciences, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, Selangor, Malaysia
| | - Vasudevan Ramachandran
- Bharath Institute of Higher Education and Research, Selaiyur, Chennai, Tamil Nadu, India
| | - Patricia Pozo-Rosich
- Headache and Craniofacial Pain Unit, Neurology Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Headache and Neurological Pain Research Group, Vall d’Hebron Research Institute, Barcelona, Spain
| | - Wan Aliaa Wan Sulaiman
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| |
Collapse
|
24
|
Zhong L, Rao J, Wang J, Li F, Peng Y, Liu H, Zhang Y, Wang P. Repetitive Transcranial Magnetic Stimulation at Different Sites for Dysphagia After Stroke: A Randomized, Observer-Blind Clinical Trial. Front Neurol 2021; 12:625683. [PMID: 34122294 PMCID: PMC8187758 DOI: 10.3389/fneur.2021.625683] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 05/04/2021] [Indexed: 11/22/2022] Open
Abstract
Background: The clinical efficacy of repetitive transcranial magnetic stimulation (rTMS) protocols on patients with poststroke dysphagia is still unclear. Objective: This trial aimed to explore and analyze the effectiveness of 5 Hz rTMS on the unaffected hemisphere, affected hemisphere, and cerebellum in stroke patients with dysphagia. Methods: This observer-blind and randomized controlled trial included a total of 147 patients with stroke. Patients were divided into four treatment groups: the unaffected hemispheric group, the affected hemispheric group, the cerebellum group and the control group. Each group received traditional dysphagia treatment 5 days a week for 2 weeks. All recruited patients except for those in the control group underwent 10 consecutive rTMS sessions for 2 weeks. For the affected hemispheric group and unaffected hemispheric group, 5 Hz rTMS was applied to the affected mylohyoid cortical region or to the unaffected mylohyoid cortical region. For the cerebellum group, 5 Hz rTMS was applied to the mylohyoid cortical representation of the cerebellum (4.3 cm lateral and 2.4 cm below the inion). The Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS), Penetration/Aspiration Scale (PAS), Gugging Swallowing Screen (GUSS), and Standardized Swallowing Assessment (SSA) were used to evaluate clinical swallowing function before the intervention (baseline), immediately after the intervention and 2 weeks after the intervention. Results: There were significant time and intervention interaction effects on the FEDSS, PAS, SSA, and GUSS scores (p < 0.05). In a direct comparison of the swallowing parameters of the four groups, the changes in FEDSS, PAS, SSA, and GUSS scores showed a significantly greater improvement in the unaffected hemispheric group, the affected hemispheric group and cerebellum group than in the control group (p < 0.05). Conclusions: Whether stimulating the unaffected hemisphere or the affected hemisphere, 5 Hz high-frequency rTMS on mylohyoid cortical tissue might have a positive effect on poststroke patients with dysphagia. In addition, cerebellar rTMS is a safe method that represents a potential treatment for poststroke dysphagia, and more clinical trials are needed to develop this technique further. Clinical Trial Registration:chictr.org.cn, identifier: ChiCTR2000032255.
Collapse
Affiliation(s)
- Lida Zhong
- Department of Rehabilitation Medicine, Yue Bei People's Hospital, Shaoguan, China
| | - Jinzhu Rao
- Department of Rehabilitation Medicine, Yue Bei People's Hospital, Shaoguan, China
| | - Jing Wang
- Department of Rehabilitation Medicine, Yue Bei People's Hospital, Shaoguan, China
| | - Fang Li
- Department of Rehabilitation Medicine, Yue Bei People's Hospital, Shaoguan, China
| | - Yang Peng
- Department of Rehabilitation Medicine, Yue Bei People's Hospital, Shaoguan, China
| | - Huiyu Liu
- Department of Rehabilitation Medicine, Yue Bei People's Hospital, Shaoguan, China
| | - Yan Zhang
- School of Educational Science, Huazhong University of Science and Technology, Wuhan, China
| | - Pu Wang
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital Sun Yat-sen University, Shenzhen, China
| |
Collapse
|
25
|
Oberman LM, Hynd M, Nielson DM, Towbin KE, Lisanby SH, Stringaris A. Repetitive Transcranial Magnetic Stimulation for Adolescent Major Depressive Disorder: A Focus on Neurodevelopment. Front Psychiatry 2021; 12:642847. [PMID: 33927653 PMCID: PMC8076574 DOI: 10.3389/fpsyt.2021.642847] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/18/2021] [Indexed: 12/31/2022] Open
Abstract
Adolescent depression is a potentially lethal condition and a leading cause of disability for this age group. There is an urgent need for novel efficacious treatments since half of adolescents with depression fail to respond to current therapies and up to 70% of those who respond will relapse within 5 years. Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising treatment for major depressive disorder (MDD) in adults who do not respond to pharmacological or behavioral interventions. In contrast, rTMS has not demonstrated the same degree of efficacy in adolescent MDD. We argue that this is due, in part, to conceptual and methodological shortcomings in the existing literature. In our review, we first provide a neurodevelopmentally focused overview of adolescent depression. We then summarize the rTMS literature in adult and adolescent MDD focusing on both the putative mechanisms of action and neurodevelopmental factors that may influence efficacy in adolescents. We then identify limitations in the existing adolescent MDD rTMS literature and propose specific parameters and approaches that may be used to optimize efficacy in this uniquely vulnerable age group. Specifically, we suggest ways in which future studies reduce clinical and neural heterogeneity, optimize neuronavigation by drawing from functional brain imaging, apply current knowledge of rTMS parameters and neurodevelopment, and employ an experimental therapeutics platform to identify neural targets and biomarkers for response. We conclude that rTMS is worthy of further investigation. Furthermore, we suggest that following these recommendations in future studies will offer a more rigorous test of rTMS as an effective treatment for adolescent depression.
Collapse
|
26
|
Comparison of Treatment Outcome between Repetitive Transcranial Magnetic Stimulation (rTMS) and Transcutaneous Direct Current Stimulation (tDCS) in Intractable Tinnitus. J Clin Med 2021; 10:jcm10040635. [PMID: 33562396 PMCID: PMC7916028 DOI: 10.3390/jcm10040635] [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: 01/06/2021] [Revised: 01/28/2021] [Accepted: 02/03/2021] [Indexed: 11/17/2022] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) and transcutaneous direct current stimulation (tDCS) are non-invasive treatments for chronic tinnitus based on neuromodulation of cortical activity. Both are considered effective, but with heterogeneous results due to lack of established protocols. Because the target groups for both modalities overlap, it is difficult to recommend one of them. We tried to unify the inclusion criteria and treatment schedules to compare the two modalities. The medical charts of 36 patients who underwent rTMS as part of clinical routine were reviewed and data for 34 patients who underwent tDCS about 7 years later were collected prospectively. Both groups had chronic unilateral tinnitus refractory to medication. Patients were treated for 5 consecutive days, and tinnitus symptoms were evaluated by survey both at the end of the treatment schedule and 1 month after the treatment. The ratio of responders who showed >20% reduction in tinnitus handicap inventory scores were compared. At the end of the treatment, the rTMS group showed a rapid response compared to the tDCS group (rTMS, 30.6%; tDCS, 12.1%; p = 0.054). However, both groups showed a significant and similar reduction in tinnitus symptoms 1 month after the treatment (rTMS, 47.2%; tDCS, 36.4%; p = 0.618). As both groups showed comparable results for tinnitus reduction, tDCS may be superior in terms of cost-effectiveness.
Collapse
|
27
|
Ferrulli A, Massarini S, Macrì C, Luzi L. Safety and tolerability of repeated sessions of deep transcranial magnetic stimulation in obesity. Endocrine 2021; 71:331-343. [PMID: 32964308 PMCID: PMC7881959 DOI: 10.1007/s12020-020-02496-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/07/2020] [Indexed: 01/24/2023]
Abstract
PURPOSE Repetitive Transcranial Magnetic Stimulation (rTMS) has been demonstrated to be effective in body weight control in individuals with obesity. Most clinical trials on rTMS provided a reassuring safety profile. In the present work, we present an extensive analysis on both severe and mild Adverse Events (AEs) in obese individuals treated with rTMS. METHODS We examined the intensity, duration, correlation with the treatment, up to 1 year after the end of rTMS treatment. RESULTS Descriptive analysis included a total of 63 subjects undergoing a 5-week deep rTMS experimental treatment for obesity (age 48.3 ± 10.4 years; BMI 36.3 ± 4.4 kg/m2): 31 patients were treated with high-frequency rTMS (HF), 13 with low-frequency rTMS (LF), and 19 were sham treated (Sham). Thirty-two subjects (50.8%) reported a total of 52 AEs, including mainly moderate (51.9%) events. The most frequently reported side effects were headaches of moderate intensity (40.4%) and local pain/discomfort (19.2%) and resulted significantly more frequent in HF group compared to other groups (p < 0.05). No significant differences among groups were found for the other reported AEs: drowsiness, insomnia, paresthesia, vasovagal reactions, hypertensive crisis. No AEs potentially related to the rTMS arised up to 1 year from the end of the treatment. CONCLUSIONS This is the first comprehensive safety analysis in obese patients treated with rTMS. The analysis did not reveal any unexpected safety concerns. Only headaches and local pain/discomfort have been significantly more frequent in the HF group, confirming the good tolerability of rTMS even in the obese population potentially more susceptible to side effects of brain stimulation.
Collapse
Affiliation(s)
- Anna Ferrulli
- Department of Biomedical Sciences for Health, University of Milan, Via Mangiagalli 31, 20133, Milan, Italy
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Via Milanese 300, 20099, Sesto San Giovanni (MI), Italy
| | - Stefano Massarini
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Via Milanese 300, 20099, Sesto San Giovanni (MI), Italy
| | - Concetta Macrì
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Via Milanese 300, 20099, Sesto San Giovanni (MI), Italy
| | - Livio Luzi
- Department of Biomedical Sciences for Health, University of Milan, Via Mangiagalli 31, 20133, Milan, Italy.
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Via Milanese 300, 20099, Sesto San Giovanni (MI), Italy.
| |
Collapse
|
28
|
Haddad AF, Young JS, Berger MS, Tarapore PE. Preoperative Applications of Navigated Transcranial Magnetic Stimulation. Front Neurol 2021; 11:628903. [PMID: 33551983 PMCID: PMC7862711 DOI: 10.3389/fneur.2020.628903] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/29/2020] [Indexed: 12/18/2022] Open
Abstract
Preoperative mapping of cortical structures prior to neurosurgical intervention can provide a roadmap of the brain with which neurosurgeons can navigate critical cortical structures. In patients undergoing surgery for brain tumors, preoperative mapping allows for improved operative planning, patient risk stratification, and personalized preoperative patient counseling. Navigated transcranial magnetic stimulation (nTMS) is one modality that allows for highly accurate, image-guided, non-invasive stimulation of the brain, thus allowing for differentiation between eloquent and non-eloquent cortical regions. Motor mapping is the best validated application of nTMS, yielding reliable maps with an accuracy similar to intraoperative cortical mapping. Language mapping is also commonly performed, although nTMS language maps are not as highly concordant with direct intraoperative cortical stimulation maps as nTMS motor maps. Additionally, nTMS has been used to localize cortical regions involved in other functions such as facial recognition, calculation, higher-order motor processing, and visuospatial orientation. In this review, we evaluate the growing literature on the applications of nTMS in the preoperative setting. First, we analyze the evidence in support of the most common clinical applications. Then we identify usages that show promise but require further validation. We also discuss developing nTMS techniques that are still in the experimental stage, such as the use of nTMS to enhance postoperative recovery. Finally, we highlight practical considerations when utilizing nTMS and, importantly, its safety profile in neurosurgical patients. In so doing, we aim to provide a comprehensive review of the role of nTMS in the neurosurgical management of a patient with a brain tumor.
Collapse
Affiliation(s)
- Alexander F Haddad
- School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Jacob S Young
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Mitchel S Berger
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Phiroz E Tarapore
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| |
Collapse
|
29
|
Santos FH, Mosbacher JA, Menghini D, Rubia K, Grabner RH, Cohen Kadosh R. Effects of transcranial stimulation in developmental neurocognitive disorders: A critical appraisal. PROGRESS IN BRAIN RESEARCH 2021; 264:1-40. [PMID: 34167652 DOI: 10.1016/bs.pbr.2021.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Non-invasive brain stimulation (NIBS) has been highlighted as a powerful tool to promote neuroplasticity, and an attractive approach to support cognitive remediation. Here we provide a systematic review of 26 papers using NIBS to ameliorate cognitive dysfunctions in three prevalent neurodevelopmental disorders: Attention-Deficit/Hyperactivity Disorder (ADHD), Developmental Dyslexia and Developmental Dyscalculia. An overview of the state of research shows a predominance of studies using repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) techniques, and an unequal distribution among clinical conditions. Regarding the utility of NIBS, the results are promising but also ambiguous. Twenty-three papers reported beneficial effects, but many of these effects were found only once or were only partially replicated and some studies even reported detrimental effects. Furthermore, most studies differed in at least one core aspect, the NIBS applied, the questionnaires and cognitive tests conducted, or the age group investigated, and sample sizes were mostly small. Hence, further studies are needed to rigorously examine the potential of NIBS in the remediation of cognitive functions. Finally, we discuss potential caveats and future directions. We reason that if adequately addressing these challenges NIBS can be feasible, with potential benefits in treating neurodevelopmental disorders.
Collapse
Affiliation(s)
- Flavia H Santos
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Jochen A Mosbacher
- Educational Neuroscience, Institute of Psychology, University of Graz, Graz, Austria.
| | - Deny Menghini
- Department of Neuroscience, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Katya Rubia
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Roland H Grabner
- Educational Neuroscience, Institute of Psychology, University of Graz, Graz, Austria; BioTechMed-Graz, Graz, Austria
| | - Roi Cohen Kadosh
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
30
|
Zhou L, Huang X, Li H, Guo R, Wang J, Zhang Y, Lu Z. Rehabilitation effect of rTMS combined with cognitive training on cognitive impairment after traumatic brain injury. Am J Transl Res 2021; 13:11711-11717. [PMID: 34786098 PMCID: PMC8581933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/15/2021] [Indexed: 12/08/2022]
Abstract
OBJECTIVE To innvestigate the rehabilitation effects of repetitive transcranial magnetic stimulation (rTMS) combined with cognitive training on cognitive impairment in patients with traumatic brain injury (TBI) by using multimodal magnetic resonance imaging. METHODS Clinical data of 166 patients with cognitive impairment after TBI were retrospectively analyzed. The patients were assigned into an observation group and a control group according to different treatment methods, with 83 cases in each group. The observation group was given rTMS + cognitive training, and the control group was given cognitive training only. The changes in GCS score, the Cho/Cr, Cho/NAA and NAA/Cr ratios examined by MRSI, the score of cognitive impairment, the grading of cognitive impairment, and the changes in modified Barthel index were observed and compared between the two groups. RESULTS The GCS score, and the ratios of Cho/Cr, Cho/NAA and NAA/Cr after treatment were better than those before treatment in both groups and were lower in the observation group compared with the control group (all P<0.05). The score and grading of cognitive impairment as well as modified Barthel index after treatment were all significantly better in the observation group than in the control group (all P<0.05). CONCLUSION rTMS can improve the rehabilitation effect on cognitive impairment in patients after TBI and is recommended for clinical use.
Collapse
Affiliation(s)
- Li Zhou
- Department of Rehabilitation, The First Affiliated Hospital of Guangdong Pharmaceutical UniversityGuangzhou, Guangdong Province, China
| | - Xuming Huang
- Department of Rehabilitation, The First Affiliated Hospital of Guangdong Pharmaceutical UniversityGuangzhou, Guangdong Province, China
| | - Haiyan Li
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou, Guangdong Province, China
| | - Ruomi Guo
- Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou, Guangdong Province, China
| | - Jihui Wang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou, Guangdong Province, China
| | - Yu Zhang
- Department of Pathology, Guangdong Provincial Hospital of Traditional Chinese MedicineGuangzhou, Guangdong Province, China
| | - Zhengqi Lu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou, Guangdong Province, China
| |
Collapse
|
31
|
O'Neal CM, Stephens TM, Briggs RG, Sughrue ME, Conner AK. Navigated transcranial magnetic stimulation following awake craniotomy for resection of glioma: Description of two cases. Surg Neurol Int 2020; 11:433. [PMID: 33365195 PMCID: PMC7749929 DOI: 10.25259/sni_628_2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/19/2020] [Indexed: 01/23/2023] Open
Abstract
Background Although transcranial magnetic stimulation (TMS) has been indicated as a potential therapy for several neurologic conditions, there is little known regarding its use during the postoperative rehabilitation period in patients with brain tumors. Furthermore, seizures, a common presentation in these patients, are regarded as a major contraindication for TMS therapy. Case Description We demonstrate that postoperative continuous theta burst stimulation (cTBS), a patterned form of repetitive TMS, was safely tolerated in addition to current neurorehabilitation techniques in two brain tumor patients, including one patient with a history of tumor-related epilepsy. We administered navigated 5 Hz cTBS to two patients within 48 h following awake craniotomy for tumor resection. Active motor thresholds were measured in both patients before TBS administration to determine stimulus intensity. We used resting-state fMRI to identify likely damaged networks based on postoperative deficits. This aided in TMS planning and allowed deficit targeted therapy contralateral to the lesioned network node. Both patients tolerated TBS therapy well and had no adverse effects, including posttreatment seizures, despite one patient having a history of tumor-related epilepsy. Conclusion TBS may be safe in the immediate postoperative period for patients following brain tumor resection. Additional studies are needed to quantify the efficacy of TMS in improving neurologic deficits following tumor resection.
Collapse
Affiliation(s)
- Christen M O'Neal
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma, United States
| | - Tressie M Stephens
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma, United States
| | - Robert G Briggs
- Department of Neurosurgery, University of Southern California, Los Angeles, California, United States
| | - Michael E Sughrue
- Center for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital, Randwick, New South Wales, Australia
| | - Andrew K Conner
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma, United States
| |
Collapse
|
32
|
Toniolo S, Sen A, Husain M. Modulation of Brain Hyperexcitability: Potential New Therapeutic Approaches in Alzheimer's Disease. Int J Mol Sci 2020; 21:E9318. [PMID: 33297460 PMCID: PMC7730926 DOI: 10.3390/ijms21239318] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/30/2020] [Accepted: 12/05/2020] [Indexed: 12/12/2022] Open
Abstract
People with Alzheimer's disease (AD) have significantly higher rates of subclinical and overt epileptiform activity. In animal models, oligomeric Aβ amyloid is able to induce neuronal hyperexcitability even in the early phases of the disease. Such aberrant activity subsequently leads to downstream accumulation of toxic proteins, and ultimately to further neurodegeneration and neuronal silencing mediated by concomitant tau accumulation. Several neurotransmitters participate in the initial hyperexcitable state, with increased synaptic glutamatergic tone and decreased GABAergic inhibition. These changes appear to activate excitotoxic pathways and, ultimately, cause reduced long-term potentiation, increased long-term depression, and increased GABAergic inhibitory remodelling at the network level. Brain hyperexcitability has therefore been identified as a potential target for therapeutic interventions aimed at enhancing cognition, and, possibly, disease modification in the longer term. Clinical trials are ongoing to evaluate the potential efficacy in targeting hyperexcitability in AD, with levetiracetam showing some encouraging effects. Newer compounds and techniques, such as gene editing via viral vectors or brain stimulation, also show promise. Diagnostic challenges include identifying best biomarkers for measuring sub-clinical epileptiform discharges. Determining the timing of any intervention is critical and future trials will need to carefully stratify participants with respect to the phase of disease pathology.
Collapse
Affiliation(s)
- Sofia Toniolo
- Cognitive Neurology Group, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK;
- Wellcome Trust Centre for Integrative Neuroimaging, Department of Experimental Psychology, University of Oxford, Oxford OX2 6AE, UK
| | - Arjune Sen
- Oxford Epilepsy Research Group, Nuffield Department Clinical Neurosciences, John Radcliffe Hospital, Oxford OX3 9DU, UK;
| | - Masud Husain
- Cognitive Neurology Group, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK;
- Wellcome Trust Centre for Integrative Neuroimaging, Department of Experimental Psychology, University of Oxford, Oxford OX2 6AE, UK
| |
Collapse
|
33
|
Fried PJ, Santarnecchi E, Antal A, Bartres-Faz D, Bestmann S, Carpenter LL, Celnik P, Edwards D, Farzan F, Fecteau S, George MS, He B, Kim YH, Leocani L, Lisanby SH, Loo C, Luber B, Nitsche MA, Paulus W, Rossi S, Rossini PM, Rothwell J, Sack AT, Thut G, Ugawa Y, Ziemann U, Hallett M, Pascual-Leone A. Training in the practice of noninvasive brain stimulation: Recommendations from an IFCN committee. Clin Neurophysiol 2020; 132:819-837. [PMID: 33549501 DOI: 10.1016/j.clinph.2020.11.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 11/19/2020] [Accepted: 11/23/2020] [Indexed: 01/07/2023]
Abstract
As the field of noninvasive brain stimulation (NIBS) expands, there is a growing need for comprehensive guidelines on training practitioners in the safe and effective administration of NIBS techniques in their various research and clinical applications. This article provides recommendations on the structure and content of this training. Three different types of practitioners are considered (Technicians, Clinicians, and Scientists), to attempt to cover the range of education and responsibilities of practitioners in NIBS from the laboratory to the clinic. Basic or core competencies and more advanced knowledge and skills are discussed, and recommendations offered regarding didactic and practical curricular components. We encourage individual licensing and governing bodies to implement these guidelines.
Collapse
Affiliation(s)
- Peter J Fried
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Emiliano Santarnecchi
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Andrea Antal
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany
| | - David Bartres-Faz
- Department of Medicine, Faculty of Medicine and Health Sciences & Institut de Neurociències, University of Barcelona, Institut d'Investigacions Biomèdiques (IDIBAPS), Barcelona, Spain
| | - Sven Bestmann
- Department for Movement and Clinical Neuroscience, Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, UK
| | - Linda L Carpenter
- Butler Hospital, Department of Psychiatry and Human Behavior, Alpert Medical School at Brown University, Providence, RI, USA
| | - Pablo Celnik
- Department of Physical Medicine and Rehabilitation, Johns Hopkins, School of Medicine, Baltimore, MD, USA
| | - Dylan Edwards
- Moss Rehabilitation Research Institute, Elkins Park, PA, USA; Edith Cowan University, Joondalup, Australia
| | - Faranak Farzan
- Simon Fraser University, British Columbia, Surrey, Mechatronic Systems Engineering, Canada
| | - Shirley Fecteau
- Faculty of Medicine, Université Laval, CERVO Brain Research Center, Quebec City, Quebec, Canada
| | - Mark S George
- Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charlestown, SC, USA
| | - Bin He
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Yun-Hee Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Letizia Leocani
- Institute of Experimental Neurology, Ospedale San Raffaele, and Department of Neurology, Vita-Salute San Raffaele University, Milano, Italy
| | - Sarah H Lisanby
- Division of Translational Research, National Institute of Mental Health, National Institutes of Health, Bethesda, MA, USA
| | - Colleen Loo
- School of Psychiatry and Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Bruce Luber
- Noninvasive Neuromodulation Unit, National Institute of Mental Health, Bethesda, MD, USA
| | - Michael A Nitsche
- Leibniz Research Centre for Working Environment and Human Factors, Dept. Psychology and Neurosciences, Dortmund, Germany
| | - Walter Paulus
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany
| | - Simone Rossi
- Department of Medicine, Surgery and Neuroscience, Unit of Neurology and Clinical Neurophysiology, Siena Brain Investigation and Neuromodulation Lab (Si-BIN Lab), University of Siena, Italy
| | - Paolo M Rossini
- Department of Neuroscience and Neurorehabilitation, IRCCS San Raffaele-Pisana, Rome, Italy
| | - John Rothwell
- UCL Institute of Neurology, University College, London, UK
| | - Alexander T Sack
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands
| | - Gregor Thut
- Centre for Cognitive Neuroimaging, Institute of Neuroscience and Psychology, University of Glasgow, UK
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Ulf Ziemann
- Department of Neurology & Stroke, and Hertie Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD, USA
| | - Alvaro Pascual-Leone
- Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife and Department of Neurology, Harvard Medical School, Boston, MA, USA; Guttmann Brain Health Institute, Institut Guttmann, Universitat Autonoma, Barcelona, Spain.
| |
Collapse
|
34
|
Altomare EC, Committeri G, Di Matteo R, Capotosto P, Tosoni A. Automatic coding of environmental distance for walking-related locomotion in the foot-related sensory-motor system: A TMS study on macro-affordances. Neuropsychologia 2020; 150:107696. [PMID: 33253691 DOI: 10.1016/j.neuropsychologia.2020.107696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 11/17/2020] [Accepted: 11/25/2020] [Indexed: 11/25/2022]
Abstract
We have recently described a facilitation effect for the execution of a walking-related action in response to distant objects/locations in the extrapersonal space. Based on the parallelism with the well-known effect of "micro-affordance", observed during the execution of functionally appropriate hand-related actions towards manipulable objects, we have referred to this effect in terms of "macro-affordance". Here we used transcranical magnetic stimulation (TMS) to investigate whether a foot-related region located in the human dorsal precuneate cortex plays a causal role in the generation and maintenance of such behavioral effect. This question was addressed by comparing the magnitude of the facilitation effect during an incidental go/no-go task, i.e. advantage for walking-related actions to pictures framing an environment from a far vs. near distance, during three different TMS conditions. The three TMS conditions were collected in all subjects in a randomized order and included stimulation of: i. a foot-related region in the anterior precuneus, ii. a control region in the middle intraparietal sulcus (mIPS), and iii. a sham condition. Enrollment in the TMS protocol was based on analysis of individual performance during a preliminary session conducted using a sham stimulation. TMS was administered at a low frequency range before the beginning of each condition. The results showed that stimulation of the foot-related region in the anterior precuneus produced a significant reduction of the walking-related facilitation effect as compared to both stimulation of the active-control region and the non-active sham stimulation. These findings suggest that the foot-related sensory-motor system directly participates in the process of extraction of the spatial features (i.e. distance) from an environmental scene that are useful for locomotion. More in general, these findings support an automatic coding of environmental affordance or "macro-affordances" in the walking-related sensory-motor system.
Collapse
Affiliation(s)
- Emanuele Cosimo Altomare
- Department of Neuroscience, Imaging and Clinical Sciences, Institute for Advanced Biomedical Technologies (ITAB), University G. D'Annunzio, Chieti-Pescara, Italy
| | - Giorgia Committeri
- Department of Neuroscience, Imaging and Clinical Sciences, Institute for Advanced Biomedical Technologies (ITAB), University G. D'Annunzio, Chieti-Pescara, Italy
| | - Rosalia Di Matteo
- Department of Neuroscience, Imaging and Clinical Sciences, Institute for Advanced Biomedical Technologies (ITAB), University G. D'Annunzio, Chieti-Pescara, Italy
| | - Paolo Capotosto
- Department of Neuroscience, Imaging and Clinical Sciences, Institute for Advanced Biomedical Technologies (ITAB), University G. D'Annunzio, Chieti-Pescara, Italy
| | - Annalisa Tosoni
- Department of Neuroscience, Imaging and Clinical Sciences, Institute for Advanced Biomedical Technologies (ITAB), University G. D'Annunzio, Chieti-Pescara, Italy.
| |
Collapse
|
35
|
Hordacre B, Comacchio K, Williams L, Hillier S. Repetitive transcranial magnetic stimulation for post-stroke depression: a randomised trial with neurophysiological insight. J Neurol 2020; 268:1474-1484. [PMID: 33219421 DOI: 10.1007/s00415-020-10315-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/05/2020] [Accepted: 11/08/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Despite high incidence of depression after stroke, few trials have investigated the therapeutic efficacy of repetitive transcranial magnetic stimulation (rTMS). Here, we aimed to evaluate clinical benefit of delivering a higher dose of rTMS compared to previous stroke trials. Secondary aims were to document adverse effects and investigate the role of functional connectivity as a potential mechanism of clinical response to rTMS treatment. METHODS Eleven chronic stroke survivors were recruited to a double-blind, Sham-controlled, randomised trial to investigate 10 sessions of high-frequency rTMS for depression. Clinical assessments were obtained at baseline, after treatment and a 1-month follow-up. Adverse events were documented at completion of the treatment. Resting electroencephalography recordings were performed at baseline and after treatment to estimate functional connectivity. RESULTS There were no differences in baseline characteristics between groups (all p ≥ 0.42). Beck Depression Inventory scores decreased for the Active rTMS group from baseline to 1-month follow-up (p = 0.04), but did not change for the Sham group at post-treatment or follow-up (p ≥ 0.17). Stronger theta frequency functional connectivity between the left frontal cortex and right parietal cortex was associated with lower baseline depression (r = - 0.71, p = 0.05). This network strength increased following Active rTMS, with change in connectivity associated with improvement in BDI scores (r = 0.98, p = 0.001). Adverse events were transient and minor and were not statistically different between groups (p ≥ 0.21). CONCLUSIONS Active rTMS significantly improved depression and was well tolerated. The mechanistic role of theta frequency functional connectivity appears worthy of further investigation. The trial was registered on the Australian and New Zealand Clinical Trials Registry (ACTRN12619001303134) on September 23, 2019.
Collapse
Affiliation(s)
- Brenton Hordacre
- Innovation, IMPlementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, City East Campus, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
| | - Kristina Comacchio
- Innovation, IMPlementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, City East Campus, GPO Box 2471, Adelaide, South Australia, 5001, Australia
| | - Lindy Williams
- Innovation, IMPlementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, City East Campus, GPO Box 2471, Adelaide, South Australia, 5001, Australia
| | - Susan Hillier
- Innovation, IMPlementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, City East Campus, GPO Box 2471, Adelaide, South Australia, 5001, Australia
| |
Collapse
|
36
|
Effectiveness and tolerability of repetitive transcranial magnetic stimulation for preventive treatment of episodic migraine: a single-centre, randomised, double-blind, sham-controlled phase 2 trial (Magnet-EM). Trials 2020; 21:923. [PMID: 33176870 PMCID: PMC7657359 DOI: 10.1186/s13063-020-04832-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 10/20/2020] [Indexed: 01/04/2023] Open
Abstract
Background This is a phase II randomised, double-blind, sham-controlled trial to evaluate the effectiveness and tolerability of repetitive transcranial magnetic stimulation for preventive treatment of episodic migraine amongst migraine subjects. Methods Subjects age 18 to 60 years will undergo a baseline evaluation to establish the diagnosis of migraine based on the International Classification of Headache Disorder 3rd Edition (ICHD-3). Those who fulfil the ICHD-3 criteria for episodic migraine and compliant to the headache diary during a month run-in period will be enrolled. A total of 76 subjects will be randomised to receive either transcranial magnetic stimulation or sham stimulation for 5 sessions within 2 weeks duration. Follow-up sessions will be conducted monthly for three consecutive months. Prior to treatment, subjects will be required to fill up questionnaires and undergo few procedures such as electroencephalography, transcranial Doppler ultrasound and biochemical analysis for serum serotonin, serum calcitonin gene-related peptide and serum beta-endorphin. These procedures will be repeated at month 3 after receiving the last treatment. The primary outcome measure of this study is the difference in mean monthly migraine days at baseline and at months 1, 2 and 3 after treatment sessions. Discussion Following evidence from previous studies showing restoration of dorsolateral prefrontal cortex (DLPFC) activation to almost normal level, the rTMS intervention will target left DLPFC in this study. An intermediate duration of treatment sessions is selected for this study. It is set to five treatment sessions given within 2 weeks duration. Trial registration ClinicalTrials.gov NCT03556722. Registered on 14 June 2018
Collapse
|
37
|
Conson M, Cecere R, Baiano C, De Bellis F, Forgione G, Zappullo I, Trojano L. Implicit Motor Imagery and the Lateral Occipitotemporal Cortex: Hints for Tailoring Non-Invasive Brain Stimulation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165851. [PMID: 32806702 PMCID: PMC7459529 DOI: 10.3390/ijerph17165851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 08/09/2020] [Accepted: 08/10/2020] [Indexed: 12/13/2022]
Abstract
Background: Recent evidence has converged in showing that the lateral occipitotemporal cortex is over-recruited during implicit motor imagery in elderly and in patients with neurodegenerative disorders, such as Parkinson’s disease. These data suggest that when automatically imaging movements, individuals exploit neural resources in the visual areas to compensate for the decline in activating motor representations. Thus, the occipitotemporal cortex could represent a cortical target of non-invasive brain stimulation combined with cognitive training to enhance motor imagery performance. Here, we aimed at shedding light on the role of the left and right lateral occipitotemporal cortex in implicit motor imagery. Methods: We applied online, high-frequency, repetitive transcranial magnetic stimulation (rTMS) over the left and right lateral occipitotemporal cortex while healthy right-handers judged the laterality of hand images. Results: With respect to the sham condition, left hemisphere stimulation specifically reduced accuracy in judging the laterality of right-hand images. Instead, the hallmark of motor simulation, i.e., the biomechanical effect, was never influenced by rTMS. Conclusions: The lateral occipitotemporal cortex seems to be involved in mental representation of the dominant hand, at least in right-handers, but not in reactivating sensorimotor information during simulation. These findings provide useful hints for developing combined brain stimulation and behavioural trainings to improve motor imagery.
Collapse
Affiliation(s)
- Massimiliano Conson
- Laboratory of Developmental Neuropsychology, Department of Psychology, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy; (R.C.); (C.B.); (G.F.); (I.Z.)
- Correspondence: ; Tel.: +39-08-2327-5327
| | - Roberta Cecere
- Laboratory of Developmental Neuropsychology, Department of Psychology, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy; (R.C.); (C.B.); (G.F.); (I.Z.)
| | - Chiara Baiano
- Laboratory of Developmental Neuropsychology, Department of Psychology, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy; (R.C.); (C.B.); (G.F.); (I.Z.)
| | - Francesco De Bellis
- Laboratory of Neuropsychology, Department of Psychology, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy; (F.D.B.); (L.T.)
| | - Gabriela Forgione
- Laboratory of Developmental Neuropsychology, Department of Psychology, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy; (R.C.); (C.B.); (G.F.); (I.Z.)
| | - Isa Zappullo
- Laboratory of Developmental Neuropsychology, Department of Psychology, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy; (R.C.); (C.B.); (G.F.); (I.Z.)
| | - Luigi Trojano
- Laboratory of Neuropsychology, Department of Psychology, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy; (F.D.B.); (L.T.)
| |
Collapse
|
38
|
Hwang JH, Hwang H, Kim HR, Hong JS, Han DH, Shin JH, Kim SH, Kim SM. Effects of Repetitive Transcranial Magnetic Stimulation on Improvement of Mental Health and Clinical Parameters in Depressed Hemodialysis Patients: a Pilot Study. J Korean Med Sci 2020; 35:e205. [PMID: 32627438 PMCID: PMC7338214 DOI: 10.3346/jkms.2020.35.e205] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 05/14/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the therapeutic effect of repetitive transcranial magnetic stimulation (rTMS) as a nonpharmacologic treatment in depressed hemodialysis patients. METHODS Patients who scored ≥ 5 on the Patient Health Questionnaire-9 were randomized to either the rTMS (n = 7) or sham group (n = 7). The rTMS group was stimulated with a 110% motor threshold and 10 Hz on the left dorsolateral prefrontal cortex for 20 minutes, three times a week, for 4 weeks. In the sham group, the "1-wing 90-degree method" was used. We analyzed clinical indices before and after the intervention, as well as data from quantitative electroencephalography (frontal alpha asymmetry [FAA]), and various psychiatric questionnaires (Beck Depression Inventory-II, Beck Anxiety Inventory [BAI], Symptom Checklist-90-Revised Somatization Subscale [SCL-90R-SOM]), and Perceived Stress Scale. RESULTS One month after rTMS, the changes in hemoglobin A1c levels in the rTMS group were significantly greater than those in the sham group (F = 6.687, P = 0.032). The changes in BAI scores in the rTMS group were significantly greater than those in the sham group (F = 6.700, P = 0.025), and the changes in SCL-90R-SOM scores in the rTMS group were greater than those in the sham group (F = 4.943, P = 0.048). In addition, the changes in the FAA value at the F7 and F8 electrodes in the rTMS group were greater than those in the sham group (F = 6.468, P = 0.027). CONCLUSION In depressed hemodialysis patients, rTMS may improve anxiety and somatization symptoms, which may lead to improvements in clinical measures. Trial Registration Clinical Research Information Service Identifier: KCT0004082.
Collapse
Affiliation(s)
- Jin Ho Hwang
- Division of Nephrology, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Hyunchan Hwang
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Korea
| | - Hye Ri Kim
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Korea
| | - Ji Sun Hong
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Korea
| | - Jung Ho Shin
- Division of Nephrology, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Su Hyun Kim
- Division of Nephrology, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Sun Mi Kim
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Korea.
| |
Collapse
|
39
|
Sun N, He Y, Wang Z, Zou W, Liu X. The effect of repetitive transcranial magnetic stimulation for insomnia: a systematic review and meta-analysis. Sleep Med 2020; 77:226-237. [PMID: 32830052 DOI: 10.1016/j.sleep.2020.05.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/03/2020] [Accepted: 05/12/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) might be a promising technique in treating insomnia. A comprehensive meta-analysis of the available literature is conducted to offer evidence. OBJECTIVE To evaluate the efficacy and safety of rTMS for insomnia, either as monotherapy or as a complementary strategy. METHODS CENTRAL, PubMed, EMBASE, PsycINFO, CINAHL, PEDro, CBM, CNKI, WANFANG, and VIP were searched from earliest record to August 2019. Randomized control trials (RCTs) published in English and Chinese examining effects of rTMS on patients with insomnia were included. Two authors independently completed the article selection, data extraction and rating. Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the included studies. The RevMan software was used for meta-analysis. The quality of the evidence was assessed by Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS A total of 36 trials from 28 eligible studies were included, involving a total of 2357 adult participants (mean age, 48.80 years; 45.33% males). Compared with sham rTMS, rTMS was associated with improved PSQI total score (SMD -2.31, 95% CI -2.95 to -1.66; Z = 7.01, P < 0.00001) and scores of seven subscales. Compared to other treatment, rTMS as an adjunct to other treatment was associated with improved PSQI total score (SMD -1.44, 95% CI -2.00 to -0.88; Z = 5.01, P < 0.00001), and may have effects on scores of seven subscales. Compared with other treatment, rTMS was associated with improved Pittsburgh sleep quality index (PSQI) total score (SMD -0.63, 95% CI -1.22 to -0.04; Z = 2.08, P = 0.04), and may have a better score in sleep latency, sleep disturbance and hypnotic using of seven subscales. In the three pair of comparisons, the results for polysomnography (PSG) outcomes were varied. In general, rTMS may improve sleep quality through increasing slow wave and rapid eye movement (REM) sleep. The rTMS group was more prone to headache than the sham or blank control group (RR 1.71, 95% CI 1.03 to 2.85; Z = 2.07, P = 0.04). No severe adverse events were reported. Reporting biases and low and very low grade of some evidences should be considered when interpreting the results of this meta-analysis. CONCLUSIONS Our findings indicate that rTMS may be a safe and effective option for insomnia. Further international, multicenter, high-quality RCTs with more objective, quality of life related and follow-up assessments are needed.
Collapse
Affiliation(s)
- Nianyi Sun
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China; Department of Physical Medicine and Rehabilitation, The Second Clinical College, China Medical University, Shenyang, People's Republic of China
| | - Yu He
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China; Department of Physical Medicine and Rehabilitation, The Second Clinical College, China Medical University, Shenyang, People's Republic of China
| | - Zhiqiang Wang
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China; Department of Physical Medicine and Rehabilitation, The Second Clinical College, China Medical University, Shenyang, People's Republic of China
| | - Wenchen Zou
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Xueyong Liu
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China; Department of Physical Medicine and Rehabilitation, The Second Clinical College, China Medical University, Shenyang, People's Republic of China.
| |
Collapse
|
40
|
Leung A, Shirvalkar P, Chen R, Kuluva J, Vaninetti M, Bermudes R, Poree L, Wassermann EM, Kopell B, Levy R. Transcranial Magnetic Stimulation for Pain, Headache, and Comorbid Depression: INS-NANS Expert Consensus Panel Review and Recommendation. Neuromodulation 2020; 23:267-290. [PMID: 32212288 DOI: 10.1111/ner.13094] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/27/2019] [Accepted: 11/25/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND While transcranial magnetic stimulation (TMS) has been studied for the treatment of psychiatric disorders, emerging evidence supports its use for pain and headache by stimulating either motor cortex (M1) or dorsolateral prefrontal cortex (DLPFC). However, its clinical implementation is hindered due to a lack of consensus in the quality of clinical evidence and treatment recommendation/guideline(s). Thus, working collaboratively, this multinational multidisciplinary expert panel aims to: 1) assess and rate the existing outcome evidence of TMS in various pain/headache conditions; 2) provide TMS treatment recommendation/guidelines for the evaluated conditions and comorbid depression; and 3) assess the cost-effectiveness and technical issues relevant to the long-term clinical implementation of TMS for pain and headache. METHODS Seven task groups were formed under the guidance of a 5-member steering committee with four task groups assessing the utilization of TMS in the treatment of Neuropathic Pain (NP), Acute Pain, Primary Headache Disorders, and Posttraumatic Brain Injury related Headaches (PTBI-HA), and remaining three assessing the treatment for both pain and comorbid depression, and the cost-effectiveness and technological issues relevant to the treatment. RESULTS The panel rated the overall level of evidence and recommendability for clinical implementation of TMS as: 1) high and extremely/strongly for both NP and PTBI-HA respectively; 2) moderate for postoperative pain and migraine prevention, and recommendable for migraine prevention. While the use of TMS for treating both pain and depression in one setting is clinically and financially sound, more studies are required to fully assess the long-term benefit of the treatment for the two highly comorbid conditions, especially with neuronavigation. CONCLUSIONS After extensive literature review, the panel provided recommendations and treatment guidelines for TMS in managing neuropathic pain and headaches. In addition, the panel also recommended more outcome and cost-effectiveness studies to assess the feasibility of the long-term clinical implementation of the treatment.
Collapse
Affiliation(s)
- Albert Leung
- Professor of Anesthesiology and Pain Medicine, Department of Anesthesiology, Center for Pain Medicine, University of California, San Diego, School of Medicine, La Jolla, CA, USA.,Director, Center for Pain and Headache Research, VA San Diego Healthcare System, La Jolla, CA, USA
| | - Prasad Shirvalkar
- Assistant Professor, Departments of Anesthesiology (Pain Management), Neurology, and Neurosurgery, UCSF School of Medicine, USA
| | - Robert Chen
- Catherine Manson Chair in Movement Disorders, Professor of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada
| | - Joshua Kuluva
- Neurologist and Psychiatrist, TMS Health Solution, San Francisco, CA, USA
| | - Michael Vaninetti
- Assistant Clinical Professor, Anesthesiology and Pain Medicine, UCSD School of Medicine, La Jolla, CA, USA
| | - Richard Bermudes
- Chief Medical Officer, TMS Health Solutions, Assistant Clinical Professor- Volunteer, Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Lawrence Poree
- Professor of Anesthesiology, Director, Neuromodulation Service, Division of Pain Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA, USA
| | - Eric M Wassermann
- Director, Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Brian Kopell
- Professor of Neurosurgery, Mount Sinai Center for Neuromodulation, New York, NY, USA
| | - Robert Levy
- President of International Neuromodulation Society, Editor-in-Chief, Neuromodulation, Boca Raton, FL, USA
| | -
- See Appendix for Complete List of Task Group Members
| |
Collapse
|
41
|
Zewdie E, Ciechanski P, Kuo HC, Giuffre A, Kahl C, King R, Cole L, Godfrey H, Seeger T, Swansburg R, Damji O, Rajapakse T, Hodge J, Nelson S, Selby B, Gan L, Jadavji Z, Larson JR, MacMaster F, Yang JF, Barlow K, Gorassini M, Brunton K, Kirton A. Safety and tolerability of transcranial magnetic and direct current stimulation in children: Prospective single center evidence from 3.5 million stimulations. Brain Stimul 2019; 13:565-575. [PMID: 32289678 DOI: 10.1016/j.brs.2019.12.025] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/20/2019] [Accepted: 12/23/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Non-invasive brain stimulation is being increasingly used to interrogate neurophysiology and modulate brain function. Despite the high scientific and therapeutic potential of non-invasive brain stimulation, experience in the developing brain has been limited. OBJECTIVE To determine the safety and tolerability of non-invasive neurostimulation in children across diverse modalities of stimulation and pediatric populations. METHODS A non-invasive brain stimulation program was established in 2008 at our pediatric, academic institution. Multi-disciplinary neurophysiological studies included single- and paired-pulse Transcranial Magnetic Stimulation (TMS) methods. Motor mapping employed robotic TMS. Interventional trials included repetitive TMS (rTMS) and transcranial direct current stimulation (tDCS). Standardized safety and tolerability measures were completed prospectively by all participants. RESULTS Over 10 years, 384 children underwent brain stimulation (median 13 years, range 0.8-18.0). Populations included typical development (n = 118), perinatal stroke/cerebral palsy (n = 101), mild traumatic brain injury (n = 121) neuropsychiatric disorders (n = 37), and other (n = 7). No serious adverse events occurred. Drop-outs were rare (<1%). No seizures were reported despite >100 participants having brain injuries and/or epilepsy. Tolerability between single and paired-pulse TMS (542340 stimulations) and rTMS (3.0 million stimulations) was comparable and favourable. TMS-related headache was more common in perinatal stroke (40%) than healthy participants (13%) but was mild and self-limiting. Tolerability improved over time with side-effect frequency decreasing by >50%. Robotic TMS motor mapping was well-tolerated though neck pain was more common than with manual TMS (33% vs 3%). Across 612 tDCS sessions including 92 children, tolerability was favourable with mild itching/tingling reported in 37%. CONCLUSIONS Standard non-invasive brain stimulation paradigms are safe and well-tolerated in children and should be considered minimal risk. Advancement of applications in the developing brain are warranted. A new and improved pediatric NIBS safety and tolerability form is included.
Collapse
Affiliation(s)
- E Zewdie
- Calgary Pediatric Stroke Program, University of Calgary, Calgary, Alberta, Canada; Departments of Pediatrics and Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
| | - P Ciechanski
- Calgary Pediatric Stroke Program, University of Calgary, Calgary, Alberta, Canada; Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - H C Kuo
- Calgary Pediatric Stroke Program, University of Calgary, Calgary, Alberta, Canada; Departments of Pediatrics and Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - A Giuffre
- Calgary Pediatric Stroke Program, University of Calgary, Calgary, Alberta, Canada; Departments of Pediatrics and Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - C Kahl
- Departments of Pediatrics and Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - R King
- Departments of Pediatrics and Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - L Cole
- Calgary Pediatric Stroke Program, University of Calgary, Calgary, Alberta, Canada; Departments of Pediatrics and Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - H Godfrey
- Departments of Pediatrics and Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - T Seeger
- Calgary Pediatric Stroke Program, University of Calgary, Calgary, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - R Swansburg
- Departments of Pediatrics and Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - O Damji
- Calgary Pediatric Stroke Program, University of Calgary, Calgary, Alberta, Canada; Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - T Rajapakse
- Departments of Pediatrics and Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - J Hodge
- Calgary Pediatric Stroke Program, University of Calgary, Calgary, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - S Nelson
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - B Selby
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - L Gan
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Z Jadavji
- Calgary Pediatric Stroke Program, University of Calgary, Calgary, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - J R Larson
- Calgary Pediatric Stroke Program, University of Calgary, Calgary, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - F MacMaster
- Departments of Pediatrics and Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - J F Yang
- Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
| | - K Barlow
- Departments of Pediatrics and Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - M Gorassini
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - K Brunton
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - A Kirton
- Calgary Pediatric Stroke Program, University of Calgary, Calgary, Alberta, Canada; Departments of Pediatrics and Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
42
|
Ahn HM, Ham BJ, Kim SH. A Combined Approach of High-Frequency rTMS and Food-Inhibition Association Training Reduces Chocolate Snack Consumption. Front Psychiatry 2019; 10:815. [PMID: 31803079 PMCID: PMC6872527 DOI: 10.3389/fpsyt.2019.00815] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 10/16/2019] [Indexed: 02/02/2023] Open
Abstract
The ability to control impulsive urges is important for maintaining healthy eating habits. Various training strategies have been developed to reduce impulsive urges for food and strengthen cognitive control over tempting food intake. One frequent strategy uses food-inhibition association to alter the associative process between food cues and impulsive urges. Another strategy, repetitive transcranial magnetic stimulation (rTMS) over the dorsolateral prefrontal cortex (DLPFC) to strengthen cognitive control, has received increased attention. Findings, so far, are mixed and limited due to small effect size, interpretational ambiguity, and lack of standardized brain stimulation parameters. We examined whether tempting chocolate snack intake is modulated by food-inhibition association training combined with high-frequency rTMS. In Experiment 1, healthy young adult female volunteers [body mass index (BMI) range, 17-27] performed a food go/no-go task in which chocolate images were consistently paired with either a no-go cue (no-go group, n = 14) or a go cue (go group, n = 14), or both go and no-go cues at equal frequencies (neutral group, n = 15). In Experiment 2, we examined the effect of combined treatment with high-frequency rTMS and food go/no-go training. Sixty healthy young adult female volunteers (BMI range, 15-31) were randomly assigned to one of four groups with equal numbers of participants: rTMS/no-go, rTMS/neutral, sham/no-go, or sham/neutral. rTMS or sham stimulation was applied over the left DLPFC prior to the food go/no-go training task. After training, in both experiments, a taste test was conducted, and the amount of snack intake was measured. In Experiment 1, the no-go training group consumed fewer chocolate snacks than the go training group. No difference was found between the no-go and neutral training groups. In Experiment 2, combined rTMS and no-go training effectively reduced chocolate snack intake compared with neutral training. Although limited by the small sample size, our results suggest the therapeutic potential of combined high-frequency rTMS and food-inhibition association training in enhancing control over the intake of tempting foods in individuals with overeating.
Collapse
Affiliation(s)
- Hyeon Min Ahn
- Department of Brain and Cognitive Engineering, College of Medicine, Korea University, Seoul, South Korea
| | - Byung-Joo Ham
- Department of Psychiatry, College of Medicine, Korea University, Seoul, South Korea
| | - Sang Hee Kim
- Department of Brain and Cognitive Engineering, College of Medicine, Korea University, Seoul, South Korea
| |
Collapse
|
43
|
Han S, Ogawa A, Osada T, Suda A, Tanaka M, Nanjo H, Shimo Y, Hattori N, Konishi S. More subjects are required for ventrolateral than dorsolateral prefrontal TMS because of intolerability and potential drop-out. PLoS One 2019; 14:e0217826. [PMID: 31158248 PMCID: PMC6546272 DOI: 10.1371/journal.pone.0217826] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 05/21/2019] [Indexed: 11/18/2022] Open
Abstract
Transcranial magnetic stimulation (TMS) of the human lateral prefrontal cortex, particularly the ventral region, often causes considerable discomfort to subjects. To date, in contrast to abundant literature on stimulations to the dorsolateral prefrontal cortex, the ventrolateral prefrontal cortex has been less frequently stimulated, partly because some subjects are intolerable of stimulation to the ventrolateral prefrontal cortex. To predict the additional number of subjects required for the stimulation of the dorsolateral and ventrolateral prefrontal cortices, 20 young healthy subjects reported two evaluation scores: the discomfort caused by TMS and the resulting intolerability to complete the TMS experiments. Single-pulse stimulation (SPS) or theta-burst stimulation (TBS) was administered to the lateral prefrontal cortex. The high-resolution extended 10–20 system was used to provide accurate estimation of the voxelwise scores. The discomfort ratings with the SPS and TBS were relatively higher in the ventrolateral prefrontal cortex than those in the dorsolateral prefrontal cortex. Both the SPS and TBS elicited maximal discomfort at the stimulation position F8. The SPS and TBS to F8 under the standard TMS protocols were intolerable for approximately one half (11 and 10, respectively) of the subjects. The intolerability was further calculated for all voxels in the lateral prefrontal cortex, which enabled us to estimate the additional number of subjects required for specific target areas. These results suggest that prior knowledge of subjects’ discomfort during stimulation of the lateral prefrontal cortex can be of practical use in the experimental planning of the appropriate number of recruited subjects and provide the database for the probability of intolerability that can be used to predict the additional number of subjects.
Collapse
Affiliation(s)
- Shuyan Han
- Department of Neurophysiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Akitoshi Ogawa
- Department of Neurophysiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Takahiro Osada
- Department of Neurophysiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Akimitsu Suda
- Department of Neurophysiology, Juntendo University School of Medicine, Tokyo, Japan
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Masaki Tanaka
- Department of Neurophysiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Hitoshi Nanjo
- Department of Neurophysiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Yasushi Shimo
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Seiki Konishi
- Department of Neurophysiology, Juntendo University School of Medicine, Tokyo, Japan
- Research Institute for Diseases of Old Age, Juntendo University School of Medicine, Tokyo, Japan
- Sportology Center, Juntendo University School of Medicine, Tokyo, Japan
- Advanced Research Institute for Health Science, Juntendo University School of Medicine, Tokyo, Japan
- * E-mail:
| |
Collapse
|
44
|
Park JW, Kim H, Park T, Yeo JS, Hong HJ, Oh JY. A pilot study of the effects of high-frequency repetitive transcranial magnetic stimulation on dysphagia in the elderly. Neurogastroenterol Motil 2019; 31:e13561. [PMID: 30688391 DOI: 10.1111/nmo.13561] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 12/21/2018] [Accepted: 01/07/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Swallowing difficulty is common in the geriatric population and is associated with brain activity alteration with advancing age. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive approach to stimulate cortical neurons and can produce changes in cortical excitability. The objective of this study is to determine whether rTMS induces positive changes in the cortical areas and facilitates swallowing function in the elderly diagnosed with dysphagia. METHODS Eight right-handed elderly dysphagia patients without any neurologic deficits received 5 Hz rTMS to a pharyngeal motor hot spot in the right hemisphere for 10 minutes every weekday for 2 weeks. The intensity of the stimulation was set at 90% of the thenar motor threshold of the same hemisphere. They were all subjected to 18F-labeled fluorodeoxyglucose-PET scans at swallowing before and after rTMS. Differences between each patient's active image and control images on a voxel-by-voxel basis were examined to find significant increases in metabolism using statistical parametric mapping software. Videofluoroscopic swallowing study was also conducted before and after magnetic stimulation intervention. Penetration-aspiration scale (PAS) and videofluoroscopic dysphagia scale (VDS) were compared to evaluate swallowing function. KEY RESULTS After 2 weeks of rTMS intervention, the VDS score was significantly reduced (from 43.6 ± 10.3 to 27.2 ± 14.5: P < 0.05), and especially pharyngeal motor function was improved. Activation was significantly increased in the bilateral primary motor cortex, premotor cortex, and right prefrontal cortex, which showed asymmetry. CONCLUSIONS AND INFERENCES High-frequency rTMS positively affected the activation in cortices and swallowing function in elderly patients with dysphagia.
Collapse
Affiliation(s)
- Jin-Woo Park
- Department of Physical Medicine and Rehabilitation, Dongguk University Ilsan Hospital, Gyeonggi-do, Korea
| | - Hyojun Kim
- Department of Physical Medicine and Rehabilitation, Dongguk University Ilsan Hospital, Gyeonggi-do, Korea
| | - Taejune Park
- Department of Physical Medicine and Rehabilitation, Dongguk University Ilsan Hospital, Gyeonggi-do, Korea
| | - Jeong-Seok Yeo
- Department of Nuclear Medicine, Dongguk University Ilsan Hospital, Gyeonggi-do, Korea
| | - Ho-Jin Hong
- Department of Physical Medicine and Rehabilitation, Dongguk University Ilsan Hospital, Gyeonggi-do, Korea
| | - Jin-Young Oh
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Gyeonggi-do, Korea
| |
Collapse
|
45
|
High-frequency repetitive transcranial magnetic stimulation (rTMS) improves neurocognitive function in bipolar disorder. J Affect Disord 2019; 246:851-856. [PMID: 30795490 DOI: 10.1016/j.jad.2018.12.102] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 12/09/2018] [Accepted: 12/24/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Patients with bipolar disorder (BD) present widespread and significant neurocognitive impairments during all stages of the disorder. Repetitive transcranial magnetic stimulation (rTMS) has been used to improve clinical outcomes in common psychiatric diseases, such as depression, anxiety disorders, schizophrenia, and BD. Whether rTMS can improve cognitive function in BD patients remains unclear. The present study explored the regulatory effects of rTMS on cognitive function in patients with BD. METHODS Fifty-two eligible subjects with BD were randomly assigned to receive active or sham rTMS via high-speed magnetic stimulator with a figure-of-eight coil for 10 consecutive days. In the active rTMS group, a total of 25,000 stimuli were applied over the left dorsolateral prefrontal cortex at 110% of the motor threshold. The sham group received corresponding sham stimulation. Clinical manifestations and cognitive functions were assessed using a modified 24-item Hamilton Depression Rating Scale (HDRS), the Young Mania Rating Scale (YMRS), and the MATRICS Consensus Cognitive Battery (MCCB). RESULTS Ten consecutive days of high-frequency active rTMS improved scores on the Wechsler Memory Scale-III Spatial Span, and the MCCB Category Fluency subtest, without intolerable adverse effects. No significant differences in HDRS or YMRS scores were found between groups. LIMITATIONS No follow-up after the intervention. The effect of the drug on cognitive function in subjects was not excluded. CONCLUSIONS Short-term rTMS can improve cognitive function in BD patients.
Collapse
|
46
|
Rachid F. Accelerated transcranial magnetic stimulation for the treatment of Patients with depression: A review. Asian J Psychiatr 2019; 40:71-75. [PMID: 30771754 DOI: 10.1016/j.ajp.2019.02.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 02/07/2019] [Accepted: 02/07/2019] [Indexed: 11/30/2022]
Abstract
Major depressive disorder is a highly prevalent and profoundly disabling psychiatric disorder with significant morbidity and mortality and it is very often resistant to antidepressants, electroconvulsive therapy and psychotherapy. Therapeutic alternatives include repetitive transcranial magnetic stimulation which may be an effective choice for treatment-resistant depression but requires prolonged treatments for at least four to six weeks. Shorter exposure to this technique might be more advantageous for certain cases. The purpose of this review is to describe and discuss studies that have evaluated the safety and efficacy of accelerated transcranial magnetic stimulation (aTMS) in the acute treatment of depression. Methods: The electronic literature (NCBI Pubmed; Science Direct) on aTMS for the treatment of depression was reviewed. In the last years, a limited number of controlled and open-label studies have been published on the subject. The majority of these studies have shown promising results with aTMS, this protocol probably being at least as safe and as efficacious as conventional rTMS (five sessions per week) in the treatment of treatment-resistant depression (TRD) with a trend for faster response rates when more intensive protocols are used (15 sessions over two days). Future well-designed sham-controlled studies with larger samples are needed to confirm the safety and efficacy of aTMS in the treatment of depression.
Collapse
Affiliation(s)
- Fady Rachid
- Private Practice, 7, place de la Fusterie, 1204, Geneva, Switzerland.
| |
Collapse
|
47
|
Weiss Lucas C, Kallioniemi E, Neuschmelting V, Nettekoven C, Pieczewski J, Jonas K, Goldbrunner R, Karhu J, Grefkes C, Julkunen P. Cortical Inhibition of Face and Jaw Muscle Activity and Discomfort Induced by Repetitive and Paired-Pulse TMS During an Overt Object Naming Task. Brain Topogr 2019; 32:418-434. [DOI: 10.1007/s10548-019-00698-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 01/16/2019] [Indexed: 01/27/2023]
|
48
|
Burke MJ, Fried PJ, Pascual-Leone A. Transcranial magnetic stimulation: Neurophysiological and clinical applications. THE FRONTAL LOBES 2019; 163:73-92. [DOI: 10.1016/b978-0-12-804281-6.00005-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
|
49
|
Agarwal S, Koch G, Hillis AE, Huynh W, Ward NS, Vucic S, Kiernan MC. Interrogating cortical function with transcranial magnetic stimulation: insights from neurodegenerative disease and stroke. J Neurol Neurosurg Psychiatry 2019; 90:47-57. [PMID: 29866706 DOI: 10.1136/jnnp-2017-317371] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 05/07/2018] [Accepted: 05/07/2018] [Indexed: 12/11/2022]
Abstract
Transcranial magnetic stimulation (TMS) is an accessible, non-invasive technique to study cortical function in vivo. TMS studies have provided important pathophysiological insights across a range of neurodegenerative disorders and enhanced our understanding of brain reorganisation after stroke. In neurodegenerative disease, TMS has provided novel insights into the function of cortical output cells and the related intracortical interneuronal networks. Characterisation of cortical hyperexcitability in amyotrophic lateral sclerosis and altered motor cortical function in frontotemporal dementia, demonstration of cholinergic deficits in Alzheimer's disease and Parkinson's disease are key examples where TMS has led to advances in understanding of disease pathophysiology and potential mechanisms of propagation, with the potential for diagnostic applications. In stroke, TMS methodology has facilitated the understanding of cortical reorganisation that underlie functional recovery. These insights are critical to the development of effective and targeted rehabilitation strategies in stroke. The present review will provide an overview of cortical function measures obtained using TMS and how such measures may provide insight into brain function. Through an improved understanding of cortical function across a range of neurodegenerative disorders, and identification of changes in neural structure and function associated with stroke that underlie clinical recovery, more targeted therapeutic approaches may now be developed in an evolving era of precision medicine.
Collapse
Affiliation(s)
- Smriti Agarwal
- Brain and Mind Centre, University of Sydney, and Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Giacomo Koch
- Non-Invasive Brain Stimulation Unit, Neurologia Clinica e Comportamentale, Fondazione Santa Lucia IRCCS, Rome, Italy.,Stroke Unit, Department of Neuroscience, Policlinico Tor Vergata, Rome, Italy
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Cognitive Science, Johns Hopkins University, Baltimore, Maryland, USA
| | - William Huynh
- Brain and Mind Centre, University of Sydney, and Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Nick S Ward
- Sobell Department of Motor Neuroscience, UCL Institute of Neurology, University College London, London, UK.,UCL Partners Centre for Neurorehabilitation, UCL Institute of Neurology, University College London, London, UK.,The National Hospital for Neurology and Neurosurgery, London, UK
| | - Steve Vucic
- Westmead Clinical School, University of Sydney, Sydney, Australia
| | - Matthew C Kiernan
- Brain and Mind Centre, University of Sydney, and Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| |
Collapse
|
50
|
Herrero Babiloni A, De Beaumont L, Lavigne GJ. Transcranial Magnetic Stimulation. Sleep Med Clin 2018; 13:571-582. [DOI: 10.1016/j.jsmc.2018.07.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|