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Jin MX, Qin PP, Xia AWL, Kan RLD, Zhang BBB, Tang AHP, Li ASM, Lin TTZ, Giron CG, Pei JJ, Kranz GS. Neurophysiological and neuroimaging markers of repetitive transcranial magnetic stimulation treatment response in major depressive disorder: A systematic review and meta-analysis of predictive modeling studies. Neurosci Biobehav Rev 2024; 162:105695. [PMID: 38710424 DOI: 10.1016/j.neubiorev.2024.105695] [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] [Received: 10/26/2023] [Revised: 04/10/2024] [Accepted: 04/26/2024] [Indexed: 05/08/2024]
Abstract
Predicting repetitive transcranial magnetic stimulation (rTMS) treatment outcomes in major depressive disorder (MDD) could reduce the financial and psychological risks of treatment failure. We systematically reviewed and meta-analyzed studies that leveraged neurophysiological and neuroimaging markers to predict rTMS response in MDD. Five databases were searched from inception to May 25, 2023. The primary meta-analytic outcome was predictive accuracy pooled from classification models. Regression models were summarized qualitatively. A promising marker was identified if it showed a sensitivity and specificity of 80% or higher in at least two independent studies. Searching yielded 36 studies. Twenty-two classification modeling studies produced an estimated area under the summary receiver operating characteristic curve of 0.87 (95% CI = 0.83-0.92), with 86.8% sensitivity (95% CI = 80.6-91.2%) and 81.9% specificity (95% CI = 76.1-86.4%). Frontal theta cordance measured by electroencephalography is closest to proof of concept. Predicting rTMS response using neurophysiological and neuroimaging markers is promising for clinical decision-making. However, replications by different research groups are needed to establish rigorous markers.
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Affiliation(s)
- Min Xia Jin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Special Administrative Region of China; Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Penny Ping Qin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Special Administrative Region of China
| | - Adam Wei Li Xia
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Special Administrative Region of China
| | - Rebecca Lai Di Kan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Special Administrative Region of China
| | - Bella Bing Bing Zhang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Special Administrative Region of China
| | - Alvin Hong Pui Tang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Special Administrative Region of China
| | - Ami Sin Man Li
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Special Administrative Region of China
| | - Tim Tian Ze Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Special Administrative Region of China
| | - Cristian G Giron
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Special Administrative Region of China
| | - Jun Jie Pei
- Department of Rehabilitation Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Zhejiang, China
| | - Georg S Kranz
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Special Administrative Region of China; Mental Health Research Center, The Hong Kong Polytechnic University, Hong Kong, Special Administrative Region of China; Department of Psychiatry and Psychotherapy, Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Austria.
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Herrero Babiloni A, Provost C, Charlebois-Plante C, De Koninck BP, Apinis-Deshaies A, Lavigne GJ, Martel MO, De Beaumont L. One session of repetitive transcranial magnetic stimulation induces mild and transient analgesic effects among female individuals with painful temporomandibular disorders. J Oral Rehabil 2024; 51:827-839. [PMID: 38225806 DOI: 10.1111/joor.13655] [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: 06/29/2023] [Revised: 11/11/2023] [Accepted: 01/05/2024] [Indexed: 01/17/2024]
Abstract
OBJECTIVE Temporomandibular disorders (TMD) are characterised by chronic pain and dysfunction in the jaw joint and masticatory muscles. Repetitive transcranial magnetic stimulation (rTMS) has emerged as a potential non-invasive treatment for chronic pain; however, its effectiveness in individuals with TMD has not been thoroughly investigated. This study aimed to evaluate the immediate and sustained (over seven consecutive days) effects of a single session of active rTMS compared to sham stimulation on pain intensity and pain unpleasantness in individuals with TMD. METHODS A randomised, double-blind, sham-controlled trial enrolled 41 female participants with chronic TMD. Pain intensity and pain unpleasantness were assessed immediately pre- and post-intervention, as well as twice daily for 21 days using electronic diaries. Secondary outcomes included pain interference, sleep quality, positive and negative affect and pain catastrophizing. Adverse effects were monitored. Repeated measures ANOVA and multilevel modelling regression analyses were employed for data analysis. RESULT Active rTMS demonstrated a significant immediate mild reduction in pain intensity and pain unpleasantness compared to sham stimulation. However, these effects were not sustained over the 7-day post-intervention period. No significant differences were observed between interventions for pain interference, sleep quality and negative affect. A minority of participants reported minor and transient side effects, including headaches and fatigue. CONCLUSION A single session of active rTMS was safe and led to immediate mild analgesic effects in individuals with TMD compared to sham stimulation. However, no significant differences were observed between interventions over the 7-day post-intervention period. Based on this study, rTMS stimulation appears to be a promising safe approach to be tested in TMD patients with longer stimulation protocols.
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Affiliation(s)
- Alberto Herrero Babiloni
- Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
- Sacre-Coeur Hospital, University of Montreal, Montreal, Quebec, Canada
| | - Catherine Provost
- Sacre-Coeur Hospital, University of Montreal, Montreal, Quebec, Canada
| | - Camille Charlebois-Plante
- Sacre-Coeur Hospital, University of Montreal, Montreal, Quebec, Canada
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
| | - Beatrice P De Koninck
- Sacre-Coeur Hospital, University of Montreal, Montreal, Quebec, Canada
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
| | - Amelie Apinis-Deshaies
- Sacre-Coeur Hospital, University of Montreal, Montreal, Quebec, Canada
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
| | - Gilles J Lavigne
- Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
- Sacre-Coeur Hospital, University of Montreal, Montreal, Quebec, Canada
- Faculty of Dental Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Marc O Martel
- Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
- Department of Anesthesia, McGill University, Montreal, Quebec, Canada
| | - Louis De Beaumont
- Sacre-Coeur Hospital, University of Montreal, Montreal, Quebec, Canada
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
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Citrenbaum C, Corlier J, Ngo D, Vince-Cruz N, Wilson A, Wilke SA, Krantz D, Tadayonnejad R, Ginder N, Levitt J, Lee JH, Leuchter MK, Strouse TB, Corse A, Vyas P, Leuchter AF. Pretreatment pupillary reactivity is associated with differential early response to 10 Hz and intermittent theta-burst repetitive transcranial magnetic stimulation (rTMS) treatment of major depressive disorder (MDD). Brain Stimul 2023; 16:1566-1571. [PMID: 37863389 DOI: 10.1016/j.brs.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/04/2023] [Accepted: 10/08/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Repetitive Transcranial Magnetic Stimulation (rTMS) is an effective treatment for Major Depressive Disorder (MDD). Two common rTMS protocols, 10 Hz and intermittent theta burst stimulation (iTBS), have comparable rates of efficacy in groups of patients. Recent evidence suggests that some individuals may be more likely to benefit from one form of stimulation than the other. The pretreatment pupillary light reflex (PLR) is significantly associated with response to a full course of rTMS using heterogeneous stimulation protocols. OBJECTIVE To test whether the relationship between pretreatment PLR and early symptom improvement differed between subjects treated with iTBS or 10 Hz stimulation. METHODS PLR was measured in 52 subjects who received solely 10 Hz (n = 35) or iTBS (n = 17) to left dorsolateral prefrontal cortex (DLPFC) for the first ten sessions of their treatment course. Primary outcome measure was the percent change of Inventory of Depressive Symptomatology - Self Report (IDS-SR) from session 1 to session 10. RESULTS There was a positive association between normalized maximum constriction velocity (nMCV) and early improvement in subjects receiving 10 Hz stimulation (R = 0.48, p = 0.004) and a negative association in subjects receiving iTBS (R = -0.52, p = 0.03). ANOVA revealed a significant interaction between nMCV and the type of initial stimulation (p = 0.001). Among subjects with low nMCV, those initially treated with iTBS showed 2.6 times greater improvement after 10 sessions (p = 0.01) than subjects initially receiving 10 Hz stimulation. CONCLUSION nMCV may detect physiologic differences between those likely to benefit from 10 Hz or iTBS treatment. Future studies should examine whether PLR could guide prospective treatment selection.
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Affiliation(s)
- Cole Citrenbaum
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Juliana Corlier
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Doan Ngo
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Nikita Vince-Cruz
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Andrew Wilson
- Cooperative Institute for Research in Environmental Sciences (CIRES), University of Colorado Boulder, Boulder, CO, USA; NOAA National Centers for Environmental Information (NCEI), Boulder, CO, USA
| | - Scott A Wilke
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - David Krantz
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Reza Tadayonnejad
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA; Division of the Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, USA
| | - Nathaniel Ginder
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Jennifer Levitt
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - John H Lee
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Michael K Leuchter
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Thomas B Strouse
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Andrew Corse
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Pooja Vyas
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Andrew F Leuchter
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA.
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Seybert C, Cotovio G, Rodrigues da Silva D, Faro Viana F, Pereira P, Oliveira-Maia AJ. Replicability of motor cortex-excitability modulation by intermittent theta burst stimulation. Clin Neurophysiol 2023; 152:22-33. [PMID: 37269770 DOI: 10.1016/j.clinph.2023.04.014] [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: 08/31/2022] [Revised: 02/07/2023] [Accepted: 04/18/2023] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Transcranial Magnetic Stimulation (TMS) allows for cortical-excitability (CE) assessment and its modulation has been associated with neuroplasticity-like phenomena, thought to be impaired in neuropsychiatric disorders. However, the stability of these measures has been challenged, defying their potential as biomarkers. This study aimed to test the temporal stability of cortical-excitability modulation and study the impact of individual and methodological factors in determining within- and between-subject variability. METHODS We recruited healthy-subjects to assess motor cortex (MC) excitability modulation, collecting motor evoked potentials (MEP) from both hemispheres, before and after left-sided intermittent theta burst stimulation (iTBS), to obtain a measure of MEPs change (delta-MEPs). To assess stability across-time, the protocol was repeated after 6 weeks. Socio-demographic and psychological variables were collected to test association with delta-MEPs. RESULTS We found modulatory effects on left MC and not on right hemisphere following iTBS of left MC. Left delta-MEP was stable across-time when performed immediately after iTBS (ICC = 0.69), only when obtained first in left hemisphere. We discovered similar results in a replication cohort testing only left MC (ICC = 0.68). No meaningful associations were found between demographic and psychological factors and delta-MEPs. CONCLUSIONS Delta-MEP is stable immediately after modulation and not impacted by different individual factors, including expectation about TMS-effect. SIGNIFICANCE Motor cortex excitability modulation immediately after iTBS should be further explored as a potential biomarker for neuropsychiatric diseases.
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Affiliation(s)
- Carolina Seybert
- Champalimaud Research & Clinical Centre, Champalimaud Foundation, Lisbon, Portugal
| | - Gonçalo Cotovio
- Champalimaud Research & Clinical Centre, Champalimaud Foundation, Lisbon, Portugal; NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisbon, Portugal; Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | | | - Francisco Faro Viana
- Champalimaud Research & Clinical Centre, Champalimaud Foundation, Lisbon, Portugal; Department of Physics, Faculdade de Ciências da Universidade de Lisboa, Lisbon, Portugal
| | - Patrícia Pereira
- Champalimaud Research & Clinical Centre, Champalimaud Foundation, Lisbon, Portugal; Portuguese Red Cross Health School, Lisbon, Portugal
| | - Albino J Oliveira-Maia
- Champalimaud Research & Clinical Centre, Champalimaud Foundation, Lisbon, Portugal; NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisbon, Portugal.
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5
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Nicoletti VG, Fisicaro F, Aguglia E, Bella R, Calcagno D, Cantone M, Concerto C, Ferri R, Mineo L, Pennisi G, Ricceri R, Rodolico A, Saitta G, Torrisi G, Lanza G, Pennisi M. Challenging the Pleiotropic Effects of Repetitive Transcranial Magnetic Stimulation in Geriatric Depression: A Multimodal Case Series Study. Biomedicines 2023; 11:biomedicines11030958. [PMID: 36979937 PMCID: PMC10046045 DOI: 10.3390/biomedicines11030958] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Although the antidepressant potential of repetitive transcranial magnetic stimulation (rTMS), the pleiotropic effects in geriatric depression (GD) are poorly investigated. We tested rTMS on depression, cognitive performance, growth/neurotrophic factors, cerebral blood flow (CBF) to transcranial Doppler sonography (TCD), and motor-evoked potentials (MEPs) to TMS in GD. METHODS In this case series study, six drug-resistant subjects (median age 68.0 years) underwent MEPs at baseline and after 3 weeks of 10 Hz rTMS on the left dorsolateral prefrontal cortex. The percentage change of serum nerve growth factor, vascular endothelial growth factor, brain-derived growth factor, insulin-like growth factor-1, and angiogenin was obtained. Assessments were performed at baseline, and at the end of rTMS; psychocognitive tests were also repeated after 1, 3, and 6 months. RESULTS Chronic cerebrovascular disease was evident in five patients. No adverse/undesirable effect was reported. An improvement in mood was observed after rTMS but not at follow-up. Electrophysiological data to TMS remained unchanged, except for an increase in the right median MEP amplitude. TCD and neurotrophic/growth factors did not change. CONCLUSIONS We were unable to detect a relevant impact of high-frequency rTMS on mood, cognition, cortical microcircuits, neurotrophic/growth factors, and CBF. Cerebrovascular disease and exposure to multiple pharmacological treatments might have contributed.
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Affiliation(s)
- Vincenzo G Nicoletti
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Francesco Fisicaro
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Eugenio Aguglia
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Rita Bella
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, 95123 Catania, Italy
| | - Damiano Calcagno
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Mariagiovanna Cantone
- Neurology Unit, Policlinico University Hospital "G. Rodolico-San Marco", 95123 Catania, Italy
| | - Carmen Concerto
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Raffaele Ferri
- Clinical Neurophysiology Research Unit, Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Ludovico Mineo
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Giovanni Pennisi
- Clinical Neurophysiology Research Unit, Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Riccardo Ricceri
- Stroke Unit, Neurology Unit, Department of Neuroscience, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria di Modena, 41126 Modena, Italy
| | - Alessandro Rodolico
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Giulia Saitta
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Giulia Torrisi
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Giuseppe Lanza
- Clinical Neurophysiology Research Unit, Oasi Research Institute-IRCCS, 94018 Troina, Italy
- Department of Surgery and Medical-Surgical Specialties, University of Catania, 95123 Catania, Italy
| | - Manuela Pennisi
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
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Vigne M, Kweon J, Sharma P, Greenberg BD, Carpenter LL, Brown JC. Chronic caffeine consumption curbs rTMS-induced plasticity. Front Psychiatry 2023; 14:1137681. [PMID: 36911138 PMCID: PMC9993245 DOI: 10.3389/fpsyt.2023.1137681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 02/07/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Caffeine is a widely used psychostimulant. In the brain, caffeine acts as a competitive, non-selective adenosine receptor antagonist of A1 and A2A, both known to modulate long-term potentiation (LTP), the cellular basis of learning and memory. Repetitive transcranial magnetic stimulation (rTMS) is theorized to work through LTP induction and can modulate cortical excitability as measured by motor evoked potentials (MEPs). The acute effects of single caffeine doses diminish rTMS-induced corticomotor plasticity. However, plasticity in chronic daily caffeine users has not been examined. METHOD We conducted a post hoc secondary covariate analysis from two previously published plasticity-inducing pharmaco-rTMS studies combining 10 Hz rTMS and D-cycloserine (DCS) in twenty healthy subjects. RESULTS In this hypothesis-generating pilot study, we observed enhanced MEP facilitation in non-caffeine users compared to caffeine users and placebo. CONCLUSION These preliminary data highlight a need to directly test the effects of caffeine in prospective well-powered studies, because in theory, they suggest that chronic caffeine use could limit learning or plasticity, including rTMS effectiveness.
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Affiliation(s)
- Megan Vigne
- Neuromodulation Research Facility, TMS Clinic, Butler Hospital, Providence, RI, United States
| | - Jamie Kweon
- Neuromodulation Research Facility, TMS Clinic, Butler Hospital, Providence, RI, United States
| | - Prayushi Sharma
- Neuromodulation Research Facility, TMS Clinic, Butler Hospital, Providence, RI, United States
| | - Benjamin D Greenberg
- Neuromodulation Research Facility, TMS Clinic, Butler Hospital, Providence, RI, United States.,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Linda L Carpenter
- Neuromodulation Research Facility, TMS Clinic, Butler Hospital, Providence, RI, United States.,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Joshua C Brown
- Neuromodulation Research Facility, TMS Clinic, Butler Hospital, Providence, RI, United States.,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, United States.,Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, United States
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7
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Jannati A, Oberman LM, Rotenberg A, Pascual-Leone A. Assessing the mechanisms of brain plasticity by transcranial magnetic stimulation. Neuropsychopharmacology 2023; 48:191-208. [PMID: 36198876 PMCID: PMC9700722 DOI: 10.1038/s41386-022-01453-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 11/10/2022]
Abstract
Transcranial magnetic stimulation (TMS) is a non-invasive technique for focal brain stimulation based on electromagnetic induction where a fluctuating magnetic field induces a small intracranial electric current in the brain. For more than 35 years, TMS has shown promise in the diagnosis and treatment of neurological and psychiatric disorders in adults. In this review, we provide a brief introduction to the TMS technique with a focus on repetitive TMS (rTMS) protocols, particularly theta-burst stimulation (TBS), and relevant rTMS-derived metrics of brain plasticity. We then discuss the TMS-EEG technique, the use of neuronavigation in TMS, the neural substrate of TBS measures of plasticity, the inter- and intraindividual variability of those measures, effects of age and genetic factors on TBS aftereffects, and then summarize alterations of TMS-TBS measures of plasticity in major neurological and psychiatric disorders including autism spectrum disorder, schizophrenia, depression, traumatic brain injury, Alzheimer's disease, and diabetes. Finally, we discuss the translational studies of TMS-TBS measures of plasticity and their therapeutic implications.
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Affiliation(s)
- Ali Jannati
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
- F. M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Lindsay M Oberman
- Center for Neuroscience and Regenerative Medicine, Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Alexander Rotenberg
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- F. M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Department of Neurology, Harvard Medical School, Boston, MA, USA.
- Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, USA.
- Guttmann Brain Health Institute, Institut Guttmann, Barcelona, Spain.
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8
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Gonterman F. A Systematic Review Assessing Patient-Related Predictors of Response to Transcranial Magnetic Stimulation in Major Depressive Disorder. Neuropsychiatr Dis Treat 2023; 19:565-577. [PMID: 36919097 PMCID: PMC10008378 DOI: 10.2147/ndt.s388164] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 02/17/2023] [Indexed: 03/16/2023] Open
Abstract
Objective The safety and efficacy of transcranial magnetic stimulation (TMS) in the acute treatment of major depressive disorder (MDD) is well established. However, it is not well understood which patient-related factors are associated with a more robust antidepressant response. Identifying predictive factors for therapeutic response to TMS treatment in depression will guide clinicians in patient selection. Methods By systematic review of clinical trial data, the current study aims to identify and analyze reported patient-specific predictors of response to an acute course of TMS treatment for MDD. PubMed was searched for randomized controlled trials of TMS for patients with depression. Studies were appraised for risk of bias using components recommended by the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Results TMS data were available from 375 studies, 18 of which were included in this review. Treatment response is inversely associated with treatment refractoriness and age. Conclusion Inadequate sample size and large heterogeneity in study parameters among clinical trials limit any strong conclusions from being drawn; nonetheless, despite these limitations, there is mounting evidence, which points to age and treatment refractoriness as candidate variables for predicting clinical outcome. Implications of these findings for treatment of MDD are discussed.
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Affiliation(s)
- Fernando Gonterman
- Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Counseling & Clinical Psychology, Teachers College Columbia University, New York, NY, USA
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