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Wan X, Zhang Y, Li Y, Song W. Effects of parietal repetitive transcranial magnetic stimulation in prolonged disorders of consciousness: A pilot study. Heliyon 2024; 10:e30192. [PMID: 38707352 PMCID: PMC11066627 DOI: 10.1016/j.heliyon.2024.e30192] [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: 09/22/2023] [Revised: 04/21/2024] [Accepted: 04/22/2024] [Indexed: 05/07/2024] Open
Abstract
Objective Although the parietal cortex is related to consciousness, the dorsolateral prefrontal and primary motor cortices are the usual targets for repetitive transcranial magnetic stimulation (rTMS) for prolonged disorders of consciousness (pDoC). Herein, we applied parietal rTMS to patients with pDoC, to verify its neurobehavioral effects and explore a new potential rTMS target. Materials and methods Twenty-six patients with pDoC were assigned to a rTMS or sham group. The rTMS group received 10 sessions of parietal rTMS; the sham group received 10 sessions of sham stimulation. The Coma Recovery Scale-Revised (CRS-R) and event-related potential (ERP) were collected before and after the 10 sessions or sham sessions. Results After the 10 sessions, the rTMS group showed: a significant CRS-R score increase; ERP appearance of a P300 waveform and significantly increased Fz amplitudes; increased potentials on topographic mapping, especially in the left prefrontal cortex; and an increase in delta and theta band powers at Fz, Cz, and Pz. The sham group did not show such changes in CRS-R score or ERP results statistically. Conclusion Parietal rTMS shows promise as a novel intervention in the recovery of consciousness in pDoC. It showed neurobehavioral enhancement of residual brain function and may promote frontal activity by enhancing frontal-parietal connections. The parietal cortex may thus be an alternative for rTMS therapy protocols.
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Affiliation(s)
- Xiaoping Wan
- Department of Rehabilitation Medicine, Xuan Wu Hospital, Capital Medical University, No. 45 Chang Chun Street, Beijing, 100053, China
| | - Ye Zhang
- Department of Rehabilitation Medicine, Xuan Wu Hospital, Capital Medical University, No. 45 Chang Chun Street, Beijing, 100053, China
| | - Yanhua Li
- Department of Rehabilitation Medicine, Xuan Wu Hospital, Capital Medical University, No. 45 Chang Chun Street, Beijing, 100053, China
| | - Weiqun Song
- Department of Rehabilitation Medicine, Xuan Wu Hospital, Capital Medical University, No. 45 Chang Chun Street, Beijing, 100053, China
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Messina G, Monda A, Messina A, Di Maio G, Monda V, Limone P, Dipace A, Monda M, Polito R, Moscatelli F. Relationship between Non-Invasive Brain Stimulation and Autonomic Nervous System. Biomedicines 2024; 12:972. [PMID: 38790934 PMCID: PMC11117478 DOI: 10.3390/biomedicines12050972] [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: 03/15/2024] [Revised: 04/16/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024] Open
Abstract
Non-invasive brain stimulation (NIBS) approaches have seen a rise in utilization in both clinical and basic neuroscience in recent years. Here, we concentrate on the two methods that have received the greatest research: transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS). Both approaches have yielded pertinent data regarding the cortical excitability in subjects in good health as well as pertinent advancements in the management of various clinical disorders. NIBS is a helpful method for comprehending the cortical control of the ANS. Previous research has shown that there are notable changes in muscular sympathetic nerve activity when the motor cortex is modulated. Furthermore, in NIBS investigations, the ANS has been employed more frequently as an outcome measure to comprehend the overall impacts of these methods, including their safety profile. Though there is ample proof that brain stimulation has autonomic effects on animals, new research on the connection between NIBS and the ANS has produced contradictory findings. In order to better understand NIBS processes and ANS function, it is crucial to take into account the reciprocal relationship that exists between central modulation and ANS function.
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Affiliation(s)
- Giovanni Messina
- Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetics and Sports Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (A.M.); (G.D.M.); (M.M.)
| | - Antonietta Monda
- Department of Human Sciences and Quality of Life Promotion, San Raffaele Telematic University, 00166 Rome, Italy;
| | - Antonietta Messina
- Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetics and Sports Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (A.M.); (G.D.M.); (M.M.)
| | - Girolamo Di Maio
- Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetics and Sports Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (A.M.); (G.D.M.); (M.M.)
| | - Vincenzo Monda
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, 80133 Naples, Italy;
| | - Pierpaolo Limone
- Department of Psychology and Education, Pegaso Telematic University, 80143 Naples, Italy; (P.L.); (A.D.)
| | - Anna Dipace
- Department of Psychology and Education, Pegaso Telematic University, 80143 Naples, Italy; (P.L.); (A.D.)
| | - Marcellino Monda
- Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetics and Sports Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (A.M.); (G.D.M.); (M.M.)
| | - Rita Polito
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Fiorenzo Moscatelli
- Department of Wellbeing, Nutrition and Sport, Pegaso Telematic University, 80143 Naples, Italy;
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Badr MY, Ahmed GK, Amer RA, Aref HM, Salem RM, Elmokadem HA, Khedr EM. Impact of Repetitive Transcranial Magnetic Stimulation on Cognitive and Psychiatric Dysfunction in Patients with Fibromyalgia: A Double-Blinded, Randomized Clinical Trial. Brain Sci 2024; 14:416. [PMID: 38790395 PMCID: PMC11119225 DOI: 10.3390/brainsci14050416] [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: 03/20/2024] [Revised: 04/11/2024] [Accepted: 04/16/2024] [Indexed: 05/26/2024] Open
Abstract
Few randomized controlled trials have reported that repetitive transcranial magnetic stimulation (rTMS) has controversial results for managing multiple domains of fibromyalgia-related symptoms. This work aimed to evaluate the effect of low-frequency rTMS over the right dorsolateral prefrontal area (DLPFC) on the Fibromyalgia Impact Questionnaire (FIQ) concerning psychiatric and cognitive disorders. Forty-two eligible patients with fibromyalgia (FM) were randomized to have 20 sessions of active or sham rTMS (1 Hz, 120% of resting motor threshold with a total of 1200 pules/session) over the right DLPFC. All participants were evaluated at baseline, post sessions, and 3 months after sessions with the FIQ, Hamilton depression, and anxiety rating scales (HDRS and HARS), Montreal Cognitive Assessment (MoCA), Rey Auditory Verbal Learning Test (RAVLT), Tower of London test (TOL), the Trail Making, and Digit Span Tests. Both groups showed improvement in most rating scales at 1 and 3 months follow-up, with greater improvement in the active group, with significant correlation between FIQ cognitive rating scales, including RAVLT and TOL. Twenty sessions of low-frequency rTMS over the right DLPFC can improve FIQ scores regarding the psychiatric and cognitive symptoms of medicated patients with FM to a greater extent than sham. Changes in RAVLT and TOL correlated with changes in FIQ results.
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Affiliation(s)
- Marwa Y. Badr
- Department of Neuropsychiatry, Faculty of Medicine, Tanta University, Tanta 31511, Egypt; (M.Y.B.); (R.A.A.); (H.M.A.)
| | - Gellan K. Ahmed
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut 71526, Egypt;
| | - Reham A. Amer
- Department of Neuropsychiatry, Faculty of Medicine, Tanta University, Tanta 31511, Egypt; (M.Y.B.); (R.A.A.); (H.M.A.)
| | - Hend M. Aref
- Department of Neuropsychiatry, Faculty of Medicine, Tanta University, Tanta 31511, Egypt; (M.Y.B.); (R.A.A.); (H.M.A.)
| | - Rehab M. Salem
- Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Tanta University, Tanta 31511, Egypt; (R.M.S.); (H.A.E.)
| | - Heba A. Elmokadem
- Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Tanta University, Tanta 31511, Egypt; (R.M.S.); (H.A.E.)
| | - Eman M. Khedr
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut 71526, Egypt;
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Ankri YLE, Braw YC, Meiron O. Stress and Right Prefrontal Transcranial Direct Current Stimulation (tDCS) Interactive Effects on Visual Working Memory and Learning. Brain Sci 2023; 13:1642. [PMID: 38137090 PMCID: PMC10741696 DOI: 10.3390/brainsci13121642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/16/2023] [Accepted: 11/24/2023] [Indexed: 12/24/2023] Open
Abstract
Stress impacts prefrontal cortex (PFC) activity and modulates working memory performance. In a recent study, stimulating the dorsolateral PFC (dlPFC) using transcranial direct current stimulation (tDCS) interacted with social stress in modulating participants' working memory. More specifically, stress disrupted the enhancing effects of dlPFC tDCS on working memory performance. The current study aimed to further explore these initial findings by randomizing healthy females to four experimental conditions (N = 130); stimulation (right dlPFC tDCS vs. sham) and stress manipulation (social stress vs. control). Participants performed cognitive tasks (i.e., visual working memory task and a visual declarative memory task) at baseline and post-stimulation. They also completed self-report measures of stress and anxiety. A significant stimulation × stress interaction was evident in the declarative memory (One-Card Learning, OCL) task, while working memory performance was unaffected. Though tDCS stimulation and stress did not interact to affect working memory, further research is warranted as these initial findings suggest that immediate visual-memory learning may be affected by these factors. The limited number of earlier studies, as well as the variability in their designs, provides additional impetus for studying the interactive effects of stress and tDCS on human visual learning.
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Affiliation(s)
- Yael L. E. Ankri
- Department of Psychology, Ariel University, Ariel 4077625, Israel; (Y.L.E.A.); (Y.C.B.)
| | - Yoram C. Braw
- Department of Psychology, Ariel University, Ariel 4077625, Israel; (Y.L.E.A.); (Y.C.B.)
| | - Oded Meiron
- Faculty of Education, Bar-Ilan University, Ramat-Gan 5290002, Israel
- Clinical Research Center for Brain Sciences, Herzog Medical Center, P.O. Box 3900, Jerusalem 9103702, Israel
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Gorban C, Zhang Z, Mensen A, Khatami R. The Comparison of Early Hemodynamic Response to Single-Pulse Transcranial Magnetic Stimulation following Inhibitory or Excitatory Theta Burst Stimulation on Motor Cortex. Brain Sci 2023; 13:1609. [PMID: 38002568 PMCID: PMC10670137 DOI: 10.3390/brainsci13111609] [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: 10/12/2023] [Revised: 11/14/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023] Open
Abstract
We present a new study design aiming to enhance the understanding of the mechanism by which continuous theta burst stimulation (cTBS) or intermittent theta burst stimulation (iTBS) paradigms elicit cortical modulation. Using near-infrared spectroscopy (NIRS), we compared the cortical hemodynamics of the previously inhibited (after cTBS) or excited (after iTBS) left primary motor cortex (M1) as elicited by single-pulse TMS (spTMS) in a cross-over design. Mean relative changes in hemodynamics within 6 s of the stimulus were compared using a two-sample t-test (p < 0.05) and linear mixed model between real and sham stimuli and between stimuli after cTBS and iTBS. Only spTMS after cTBS resulted in a significant increase (p = 0.04) in blood volume (BV) compared to baseline. There were no significant changes in other hemodynamic parameters (oxygenated/deoxygenated hemoglobin). spTMS after cTBS induced a larger increase in BV than spTMS after iTBS (p = 0.021) and sham stimulus after cTBS (p = 0.009). BV showed no significant difference between real and sham stimuli after iTBS (p = 0.37). The greater hemodynamic changes suggest increased vasomotor reactivity after cTBS compared to iTBS. In addition, cTBS could decrease lateral inhibition, allowing activation of surrounding areas after cTBS.
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Affiliation(s)
- Corina Gorban
- Center for Sleep Medicine, Sleep Research and Epileptology, Clinic Barmelweid, 5017 Barmelweid, Switzerland; (C.G.); (A.M.); (R.K.)
- Department of Neurology, Bern University Hospital, University of Bern, 3012 Bern, Switzerland
| | - Zhongxing Zhang
- Center for Sleep Medicine, Sleep Research and Epileptology, Clinic Barmelweid, 5017 Barmelweid, Switzerland; (C.G.); (A.M.); (R.K.)
| | - Armand Mensen
- Center for Sleep Medicine, Sleep Research and Epileptology, Clinic Barmelweid, 5017 Barmelweid, Switzerland; (C.G.); (A.M.); (R.K.)
| | - Ramin Khatami
- Center for Sleep Medicine, Sleep Research and Epileptology, Clinic Barmelweid, 5017 Barmelweid, Switzerland; (C.G.); (A.M.); (R.K.)
- Department of Neurology, Bern University Hospital, University of Bern, 3012 Bern, Switzerland
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