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Meybodian M, Mahmoodifar S, Mandegari M, Baradaranfar M, Dadgarnia M, Vaziribozorg S. The Effect of Electrical Stimulation Therapy on Brain Derived Neurotrophic Factor in Patients with Tinnitus. Indian J Otolaryngol Head Neck Surg 2023; 75:498-501. [PMID: 37206826 PMCID: PMC10188857 DOI: 10.1007/s12070-022-03417-2] [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: 11/12/2021] [Accepted: 12/12/2022] [Indexed: 03/06/2023] Open
Abstract
Introduction: The aim of this study was to determine the effect of electric stimulation therapy on brain-derived neurotrophic factor (BDNF) in patients with tinnitus. Materials and methods: In this before-after clinical trial study, 45 patients aged 30-80 years old with tinnitus were involved. The hearing threshold, loudness, and frequency of tinnitus were assessed. Tinnitus Handicap Inventory (THI) questionnaire was completed by the patients. Before holding electrical stimulation sessions, the patients were evaluated for serum brain-derived neurotrophic factor (BDNF) level. Patients underwent five electrical stimulation sessions of 20 min for 5 consecutive days. After completion of electrical stimulation session, THI questionnaire was re-completed by the patients and they were evaluated for serum BDNF level. Results: Mean BDNF level before and after the intervention was (1238 ± 494.2) and (1148.2 ± 496.7), respectively (P = 0.04). Mean loudness score before and after the intervention was (6.36 ± 1.47) and (5.27 ± 1.68), respectively (P = 0.01). Mean THI score before and after the intervention was (58.21 ± 11.8) and (53.17 ± 15.19), respectively (p = 0.01). In patients with severe THI1, there was a significant difference between serum BDNF level (p = 0.019) and loudness (p = 0.003) before and after the intervention. However, in patients with mild, moderate, and very severe THI1, no such effect was observed (p > 0.05). Conclusion: According to the results of the present study, electrical stimulation therapy significantly decreased the mean plasma BDNF level in patients with tinnitus, especially in patients with severe tinnitus so it can be used as a marker to define the response to treatment and determine the severity of tinnitus in primary evaluations.
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Affiliation(s)
- Mojtaba Meybodian
- Department of Otolaryngology- Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Samira Mahmoodifar
- Department of Otolaryngology- Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Mandegari
- Department of Otolaryngology- Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammadhossein Baradaranfar
- Department of Otolaryngology- Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammadhossein Dadgarnia
- Department of Otolaryngology- Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sedighe Vaziribozorg
- Department of Otolaryngology- Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Amat F, Zimdahl JW, Barry KM, Rodger J, Mulders WHAM. Long-Term Effects of Repetitive Transcranial Magnetic Stimulation on Tinnitus in a Guinea Pig Model. Brain Sci 2022; 12:brainsci12081096. [PMID: 36009159 PMCID: PMC9405768 DOI: 10.3390/brainsci12081096] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/05/2022] [Accepted: 08/15/2022] [Indexed: 11/16/2022] Open
Abstract
The auditory phantom sensation of tinnitus is associated with neural hyperactivity. Modulating this hyperactivity using repetitive transcranial magnetic stimulation (rTMS) has shown beneficial effects in human studies. Previously, we investigated rTMS in a tinnitus animal model and showed that rTMS over prefrontal cortex (PFC) attenuated tinnitus soon after treatment, likely via indirect effects on auditory pathways. Here, we explored the duration of these beneficial effects. Acoustic trauma was used to induce hearing loss and tinnitus in guinea pigs. Once tinnitus developed, high-frequency (20 Hz), high-intensity rTMS was applied over PFC for two weeks (weekdays only; 10 min/day). Behavioral signs of tinnitus were monitored for 6 weeks after treatment ended. Tinnitus developed in 77% of animals between 13 and 60 days post-trauma. rTMS treatment significantly reduced the signs of tinnitus at 1 week on a group level, but individual responses varied greatly at week 2 until week 6. Three (33%) of the animals showed the attenuation of tinnitus for the full 6 weeks, 45% for 1–4 weeks and 22% were non-responders. This study provides further support for the efficacy of high-frequency repetitive stimulation over the PFC as a therapeutic tool for tinnitus, but also highlights individual variation observed in human studies.
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Affiliation(s)
- Farah Amat
- The Auditory Laboratory, School of Human Sciences, University of Western Australia, Crawley, WA 6009, Australia
| | - Jack W. Zimdahl
- The Auditory Laboratory, School of Human Sciences, University of Western Australia, Crawley, WA 6009, Australia
| | - Kristin M. Barry
- The Auditory Laboratory, School of Human Sciences, University of Western Australia, Crawley, WA 6009, Australia
| | - Jennifer Rodger
- School of Biological Sciences, University of Western Australia, Crawley, WA 6009, Australia
- Perron Institute for Neurological and Translational Research, Crawley, WA 6009, Australia
| | - Wilhelmina H. A. M. Mulders
- The Auditory Laboratory, School of Human Sciences, University of Western Australia, Crawley, WA 6009, Australia
- Correspondence:
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De Vis C, Barry KM, Mulders WHAM. Hearing Loss Increases Inhibitory Effects of Prefrontal Cortex Stimulation on Sound Evoked Activity in Medial Geniculate Nucleus. Front Synaptic Neurosci 2022; 14:840368. [PMID: 35300310 PMCID: PMC8921694 DOI: 10.3389/fnsyn.2022.840368] [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: 12/21/2021] [Accepted: 02/08/2022] [Indexed: 11/21/2022] Open
Abstract
Sensory gating is the process whereby irrelevant sensory stimuli are inhibited on their way to higher cortical areas, allowing for focus on salient information. Sensory gating circuitry includes the thalamus as well as several cortical regions including the prefrontal cortex (PFC). Defective sensory gating has been implicated in a range of neurological disorders, including tinnitus, a phantom auditory perception strongly associated with cochlear trauma. Recently, we have shown in rats that functional connectivity between PFC and auditory thalamus, i.e., the medial geniculate nucleus (MGN), changes following cochlear trauma, showing an increased inhibitory effect from PFC activation on the spontaneous firing rate of MGN neurons. In this study, we further investigated this phenomenon using a guinea pig model, in order to demonstrate the validity of our finding beyond a single species and extend data to include data on sound evoked responses. Effects of PFC electrical stimulation on spontaneous and sound-evoked activity of single neurons in MGN were recorded in anaesthetised guinea pigs with normal hearing or hearing loss 2 weeks after acoustic trauma. No effect, inhibition and excitation were observed following PFC stimulation. The proportions of these effects were not different in animals with normal hearing and hearing loss but the magnitude of effect was. Indeed, hearing loss significantly increased the magnitude of inhibition for sound evoked responses, but not for spontaneous activity. The findings support previous observations that PFC can modulate MGN activity and that functional changes occur within this pathway after cochlear trauma. These data suggest hearing loss can alter sensory gating which may be a contributing factor toward tinnitus development.
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Moretti J, Rodger J. A little goes a long way: Neurobiological effects of low intensity rTMS and implications for mechanisms of rTMS. CURRENT RESEARCH IN NEUROBIOLOGY 2022; 3:100033. [PMID: 36685761 PMCID: PMC9846462 DOI: 10.1016/j.crneur.2022.100033] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/26/2022] [Accepted: 02/15/2022] [Indexed: 01/25/2023] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a widespread technique in neuroscience and medicine, however its mechanisms are not well known. In this review, we consider intensity as a key therapeutic parameter of rTMS, and review the studies that have examined the biological effects of rTMS using magnetic fields that are orders of magnitude lower that those currently used in the clinic. We discuss how extensive characterisation of "low intensity" rTMS has set the stage for translation of new rTMS parameters from a mechanistic evidence base, with potential for innovative and effective therapeutic applications. Low-intensity rTMS demonstrates neurobiological effects across healthy and disease models, which include depression, injury and regeneration, abnormal circuit organisation, tinnitus etc. Various short and long-term changes to metabolism, neurotransmitter release, functional connectivity, genetic changes, cell survival and behaviour have been investigated and we summarise these key changes and the possible mechanisms behind them. Mechanisms at genetic, molecular, cellular and system levels have been identified with evidence that low-intensity rTMS and potentially rTMS in general acts through several key pathways to induce changes in the brain with modulation of internal calcium signalling identified as a major mechanism. We discuss the role that preclinical models can play to inform current clinical research as well as uncover new pathways for investigation.
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Affiliation(s)
- Jessica Moretti
- School of Biological Sciences, The University of Western Australia, Perth, WA, Australia,Perron Institute for Neurological and Translational Science, Perth, WA, Australia
| | - Jennifer Rodger
- School of Biological Sciences, The University of Western Australia, Perth, WA, Australia,Perron Institute for Neurological and Translational Science, Perth, WA, Australia,Corresponding author. School of Biological Sciences M317, The University of Western Australia, 35 Stirling Highway, Crawley WA, 6009, Australia.
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5
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Zimdahl JW, Thomas H, Bolland SJ, Leggett K, Barry KM, Rodger J, Mulders WHAM. Excitatory Repetitive Transcranial Magnetic Stimulation Over Prefrontal Cortex in a Guinea Pig Model Ameliorates Tinnitus. Front Neurosci 2021; 15:693935. [PMID: 34366777 PMCID: PMC8339289 DOI: 10.3389/fnins.2021.693935] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/01/2021] [Indexed: 11/13/2022] Open
Abstract
Tinnitus, a phantom auditory perception that can seriously affect quality of life, is generally triggered by cochlear trauma and associated with aberrant activity throughout the auditory pathways, often referred to as hyperactivity. Studies suggest that non-auditory structures, such as prefrontal cortex (PFC), may be involved in tinnitus generation, by affecting sensory gating in auditory thalamus, allowing hyperactivity to reach the cortex and lead to perception. Indeed, human studies have shown that repetitive transcranial magnetic stimulation (rTMS) of PFC can alleviate tinnitus. The current study investigated whether this therapeutic effect is achieved through inhibition of thalamic hyperactivity, comparing effects of two common clinical rTMS protocols with sham treatment, in a guinea pig tinnitus model. Animals underwent acoustic trauma and once tinnitus developed were treated with either intermittent theta burst stimulation (iTBS), 20 Hz rTMS, or sham rTMS (10 days, 10 min/day; weekdays only). Tinnitus was reassessed and extracellular recordings of spontaneous tonic and burst firing rates in auditory thalamus made. To verify effects in PFC, densities of neurons positive for calcium-binding proteins, calbindin and parvalbumin, were investigated using immunohistochemistry. Both rTMS protocols significantly reduced tinnitus compared to sham. However, spontaneous tonic firing decreased following 20 Hz stimulation and increased following iTBS in auditory thalamus. Burst rate was significantly different between 20 Hz and iTBS stimulation, and burst duration was increased only after 20 Hz treatment. Density of calbindin, but not parvalbumin positive neurons, was significantly increased in the most dorsal region of PFC indicating that rTMS directly affected PFC. Our results support the involvement of PFC in tinnitus modulation, and the therapeutic benefit of rTMS on PFC in treating tinnitus, but indicate this is not achieved solely by suppression of thalamic hyperactivity.
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Affiliation(s)
- Jack W Zimdahl
- School of Human Sciences, University of Western Australia, Crawley, WA, Australia
| | - Harrison Thomas
- School of Human Sciences, University of Western Australia, Crawley, WA, Australia
| | - Samuel J Bolland
- School of Biological Sciences, University of Western Australia, Crawley, WA, Australia.,Perron Institute for Neurological and Translational Research, Crawley, WA, Australia
| | - Kerry Leggett
- School of Human Sciences, University of Western Australia, Crawley, WA, Australia
| | - Kristin M Barry
- School of Human Sciences, University of Western Australia, Crawley, WA, Australia
| | - Jennifer Rodger
- School of Biological Sciences, University of Western Australia, Crawley, WA, Australia.,Perron Institute for Neurological and Translational Research, Crawley, WA, Australia
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6
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Cook JA, Barry KM, Zimdahl JW, Leggett K, Mulders WHAM. Spontaneous firing patterns in the medial geniculate nucleus in a guinea pig model of tinnitus. Hear Res 2021; 403:108190. [PMID: 33556774 DOI: 10.1016/j.heares.2021.108190] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 01/21/2021] [Accepted: 01/27/2021] [Indexed: 12/14/2022]
Abstract
The mechanism of tinnitus, the perception of sound in the absence of acoustic stimulation, remains as yet unknown. It has been proposed that tinnitus is caused by altered spontaneous activity in the auditory pathway following cochlear damage in combination with inadequate gating at the level of the auditory thalamus, the medial geniculate nucleus (MGN). To investigate this further we made electrophysiological recordings in MGN of guinea pigs (n = 9) with and without tinnitus after acoustic trauma (continuous loud tone at 10 kHz, 124 dB SPL for 2 h). Parameters of interest were spontaneous tonic and burst firing. After acoustic trauma, 5 out of 9 guinea pigs developed signs of tinnitus as determined by the gap prepulse inhibition of acoustic startle. Spontaneous firing rates were significantly increased in the tinnitus animals as compared to the non-tinnitus animals and this change was specific to pure-tone responsive MGN neurons. However, burst firing parameters, including number of bursts per minute, burst duration, number of spikes in each burst, and percentage of spikes occurring in a burst, were not different between tinnitus and non-tinnitus animals. In addition, our data showed a strong dependence of spontaneous firing rates with heart rate, which implies that monitoring physiological status in animals is pertinent to obtaining reliable data when recording at higher levels of the auditory pathway. Our results suggest that increases in the tonic spontaneous fining rate of pure-tone responsive MGN neurons but not changes in burst firing parameters, are a robust neural signature of tinnitus in anaesthetised animals.
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Affiliation(s)
- J A Cook
- The Auditory laboratory, School of Human Sciences, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - K M Barry
- The Auditory laboratory, School of Human Sciences, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - J W Zimdahl
- The Auditory laboratory, School of Human Sciences, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - K Leggett
- The Auditory laboratory, School of Human Sciences, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - W H A M Mulders
- The Auditory laboratory, School of Human Sciences, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia.
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7
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Zhang J, Firestone E, Elattma A. Animal Models of Tinnitus Treatment: Cochlear and Brain Stimulation. Curr Top Behav Neurosci 2021; 51:83-129. [PMID: 34282563 DOI: 10.1007/7854_2021_227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Neuromodulation, via stimulation of a variety of peripheral and central structures, is used to suppress tinnitus. However, investigative limitations in humans due to ethical reasons have made it difficult to decipher the mechanisms underlying treatment-induced tinnitus relief, so a number of animal models have arisen to address these unknowns. This chapter reviews animal models of cochlear and brain stimulation and assesses their modulatory effects on behavioral evidence of tinnitus and its related neural correlates. When a structure is stimulated, localized modulation, often presenting as downregulation of spontaneous neuronal spike firing rate, bursting and neurosynchrony, occurs within the brain area. Through anatomical projections and transmitter pathways, the interventions activate both auditory- and non-auditory structures by taking bottom-up ascending and top-down descending modes to influence their target brain structures. Furthermore, it is the brain oscillations that cochlear or brain stimulation evoke and connect the prefrontal cortex, striatal systems, and other limbic structures to refresh neural networks and relieve auditory, attentive, conscious, as well as emotional reactive aspects of tinnitus. This oscillatory neural network connectivity is achieved via the thalamocorticothalamic circuitry including the lemniscal and non-lemniscal auditory brain structures. Beyond existing technologies, the review also reveals opportunities for developing advanced animal models using new modalities to achieve precision neuromodulation and tinnitus abatement, such as optogenetic cochlear and/or brain stimulation.
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Affiliation(s)
- Jinsheng Zhang
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA. .,Department of Communication Sciences and Disorders, Wayne State University College of Liberal Arts and Sciences, Detroit, MI, USA.
| | - Ethan Firestone
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ahmed Elattma
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA
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8
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Rossi S, Antal A, Bestmann S, Bikson M, Brewer C, Brockmöller J, Carpenter LL, Cincotta M, Chen R, Daskalakis JD, Di Lazzaro V, Fox MD, George MS, Gilbert D, Kimiskidis VK, Koch G, Ilmoniemi RJ, Lefaucheur JP, Leocani L, Lisanby SH, Miniussi C, Padberg F, Pascual-Leone A, Paulus W, Peterchev AV, Quartarone A, Rotenberg A, Rothwell J, Rossini PM, Santarnecchi E, Shafi MM, Siebner HR, Ugawa Y, Wassermann EM, Zangen A, Ziemann U, Hallett M. Safety and recommendations for TMS use in healthy subjects and patient populations, with updates on training, ethical and regulatory issues: Expert Guidelines. Clin Neurophysiol 2021; 132:269-306. [PMID: 33243615 PMCID: PMC9094636 DOI: 10.1016/j.clinph.2020.10.003] [Citation(s) in RCA: 532] [Impact Index Per Article: 177.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 12/11/2022]
Abstract
This article is based on a consensus conference, promoted and supported by the International Federation of Clinical Neurophysiology (IFCN), which took place in Siena (Italy) in October 2018. The meeting intended to update the ten-year-old safety guidelines for the application of transcranial magnetic stimulation (TMS) in research and clinical settings (Rossi et al., 2009). Therefore, only emerging and new issues are covered in detail, leaving still valid the 2009 recommendations regarding the description of conventional or patterned TMS protocols, the screening of subjects/patients, the need of neurophysiological monitoring for new protocols, the utilization of reference thresholds of stimulation, the managing of seizures and the list of minor side effects. New issues discussed in detail from the meeting up to April 2020 are safety issues of recently developed stimulation devices and pulse configurations; duties and responsibility of device makers; novel scenarios of TMS applications such as in the neuroimaging context or imaging-guided and robot-guided TMS; TMS interleaved with transcranial electrical stimulation; safety during paired associative stimulation interventions; and risks of using TMS to induce therapeutic seizures (magnetic seizure therapy). An update on the possible induction of seizures, theoretically the most serious risk of TMS, is provided. It has become apparent that such a risk is low, even in patients taking drugs acting on the central nervous system, at least with the use of traditional stimulation parameters and focal coils for which large data sets are available. Finally, new operational guidelines are provided for safety in planning future trials based on traditional and patterned TMS protocols, as well as a summary of the minimal training requirements for operators, and a note on ethics of neuroenhancement.
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Affiliation(s)
- Simone Rossi
- Department of Scienze Mediche, Chirurgiche e Neuroscienze, Unit of Neurology and Clinical Neurophysiology, Brain Investigation and Neuromodulation Lab (SI-BIN Lab), University of Siena, Italy.
| | - Andrea Antal
- Department of Clinical Neurophysiology, University Medical Center, Georg-August University of Goettingen, Germany; Institue of Medical Psychology, Otto-Guericke University Magdeburg, Germany
| | - Sven Bestmann
- Department of Movement and Clinical Neurosciences, UCL Queen Square Institute of Neurology, London, UK and Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of New York, New York, NY, USA
| | - Carmen Brewer
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health (NIH), Bethesda, MD, USA
| | - Jürgen Brockmöller
- Department of Clinical Pharmacology, University Medical Center, Georg-August University of Goettingen, Germany
| | - Linda L Carpenter
- Butler Hospital, Brown University Department of Psychiatry and Human Behavior, Providence, RI, USA
| | - Massimo Cincotta
- Unit of Neurology of Florence - Central Tuscany Local Health Authority, Florence, Italy
| | - Robert Chen
- Krembil Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Canada
| | - Jeff D Daskalakis
- Center for Addiction and Mental Health (CAMH), University of Toronto, Canada
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico, Roma, Italy
| | - Michael D Fox
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Mark S George
- Medical University of South Carolina, Charleston, SC, USA
| | - Donald Gilbert
- Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Vasilios K Kimiskidis
- Laboratory of Clinical Neurophysiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Greece
| | | | - Risto J Ilmoniemi
- Department of Neuroscience and Biomedical Engineering (NBE), Aalto University School of Science, Aalto, Finland
| | - Jean Pascal Lefaucheur
- EA 4391, ENT Team, Faculty of Medicine, Paris Est Creteil University (UPEC), Créteil, France; Clinical Neurophysiology Unit, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, (APHP), Créteil, France
| | - Letizia Leocani
- Department of Neurology, Institute of Experimental Neurology (INSPE), IRCCS-San Raffaele Hospital, Vita-Salute San Raffaele University, Milano, Italy
| | - Sarah H Lisanby
- National Institute of Mental Health (NIMH), National Institutes of Health (NIH), Bethesda, MD, USA; Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Carlo Miniussi
- Center for Mind/Brain Sciences - CIMeC, University of Trento, Rovereto, Italy
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Alvaro Pascual-Leone
- Hinda and Arthur Marcus Institute for Aging Research and Center for Memory Health, Hebrew SeniorLife, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA; Guttmann Brain Health Institut, Institut Guttmann, Universitat Autonoma Barcelona, Spain
| | - Walter Paulus
- Department of Clinical Neurophysiology, University Medical Center, Georg-August University of Goettingen, Germany
| | - Angel V Peterchev
- Departments of Psychiatry & Behavioral Sciences, Biomedical Engineering, Electrical & Computer Engineering, and Neurosurgery, Duke University, Durham, NC, USA
| | - Angelo Quartarone
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Alexander Rotenberg
- Department of Neurology, Division of Epilepsy and Clinical Neurophysiology, Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - John Rothwell
- Department of Movement and Clinical Neurosciences, UCL Queen Square Institute of Neurology, London, UK and Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | - Paolo M Rossini
- Department of Neuroscience and Rehabilitation, IRCCS San Raffaele-Pisana, Roma, Italy
| | - Emiliano Santarnecchi
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Mouhsin M Shafi
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Hartwig R Siebner
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark; Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark; Institute for Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Yoshikatzu Ugawa
- Department of Human Neurophysiology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Eric M Wassermann
- National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Abraham Zangen
- Zlotowski Center of Neuroscience, Ben Gurion University, Beer Sheva, Israel
| | - Ulf Ziemann
- Department of Neurology & Stroke, and Hertie-Institute for Clinical Brain Research, University of Tübingen, Germany
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD, USA.
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9
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Chalfouh C, Guillou C, Hardouin J, Delarue Q, Li X, Duclos C, Schapman D, Marie JP, Cosette P, Guérout N. The Regenerative Effect of Trans-spinal Magnetic Stimulation After Spinal Cord Injury: Mechanisms and Pathways Underlying the Effect. Neurotherapeutics 2020; 17:2069-2088. [PMID: 32856173 PMCID: PMC7851265 DOI: 10.1007/s13311-020-00915-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Spinal cord injury (SCI) leads to a loss of sensitive and motor functions. Currently, there is no therapeutic intervention offering a complete recovery. Here, we report that repetitive trans-spinal magnetic stimulation (rTSMS) can be a noninvasive SCI treatment that enhances tissue repair and functional recovery. Several techniques including immunohistochemical, behavioral, cells cultures, and proteomics have been performed. Moreover, different lesion paradigms, such as acute and chronic phase following SCI in wild-type and transgenic animals at different ages (juvenile, adult, and aged), have been used. We demonstrate that rTSMS modulates the lesion scar by decreasing fibrosis and inflammation and increases proliferation of spinal cord stem cells. Our results demonstrate also that rTSMS decreases demyelination, which contributes to axonal regrowth, neuronal survival, and locomotor recovery after SCI. This research provides evidence that rTSMS induces therapeutic effects in a preclinical rodent model and suggests possible translation to clinical application in humans.
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Affiliation(s)
- C Chalfouh
- Normandie Univ, UNIROUEN, EA3830 GRHV, 76000, Rouen, France.
- Institute for Research and Innovation in Biomedicine (IRIB), 76000, Rouen, France.
| | - C Guillou
- PISSARO Proteomic Facility, Normandie Univ, UNIROUEN, 76821, Mont-Saint-Aignan, France
- Institute for Research and Innovation in Biomedicine (IRIB), Mont-Saint-Aignan, France
| | - J Hardouin
- PISSARO Proteomic Facility, Normandie Univ, UNIROUEN, 76821, Mont-Saint-Aignan, France
- Institute for Research and Innovation in Biomedicine (IRIB), Mont-Saint-Aignan, France
| | - Q Delarue
- Normandie Univ, UNIROUEN, EA3830 GRHV, 76000, Rouen, France
- Institute for Research and Innovation in Biomedicine (IRIB), 76000, Rouen, France
| | - X Li
- Department of Neurobiology, Care sciences and Society, BioClinicum, Karolinska Institutet, 17164, Stockholm, Sweden
| | - C Duclos
- Normandie Univ, UNIROUEN, EA3830 GRHV, 76000, Rouen, France
- Institute for Research and Innovation in Biomedicine (IRIB), 76000, Rouen, France
| | - D Schapman
- Institute for Research and Innovation in Biomedicine (IRIB), Mont-Saint-Aignan, France
- Normandie Univ, UNIROUEN, SFR IRIB, Plateau PRIMACEN, F-76821, Mont-Saint-Aignan, France
| | - J-P Marie
- Normandie Univ, UNIROUEN, EA3830 GRHV, 76000, Rouen, France
- Institute for Research and Innovation in Biomedicine (IRIB), 76000, Rouen, France
| | - P Cosette
- PISSARO Proteomic Facility, Normandie Univ, UNIROUEN, 76821, Mont-Saint-Aignan, France
- Institute for Research and Innovation in Biomedicine (IRIB), Mont-Saint-Aignan, France
| | - N Guérout
- Normandie Univ, UNIROUEN, EA3830 GRHV, 76000, Rouen, France.
- Institute for Research and Innovation in Biomedicine (IRIB), 76000, Rouen, France.
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10
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Pinto N, Oliveira I, Ferreira J, Gama J, Vaz Pato M. Can theta burst stimulation safely influence auditory hearing thresholds in healthy young adults? Clin Neurophysiol 2019; 130:1900-1907. [PMID: 31408791 DOI: 10.1016/j.clinph.2019.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 06/27/2019] [Accepted: 07/13/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This TBS sham-controlled study aimed to evaluate the effects of intermittent TBS (iTBS) and continuous TBS (cTBS) upon ipsilateral hearing thresholds after stimulation on the left auditory cortex. METHODS Sixty healthy adults, aged between 19 and 32 years (median of 23 years), were randomly distributed into three groups and underwent iTBS, cTBS or sham stimulation. Each double-blind experimental session comprised two pure tone audiometric evaluations per subject, before and after stimulation. To assess volunteer safety, a follow-up of at least 48 hours was implemented. RESULTS The iTBS group mean thresholds displayed a tendency to decrease after stimulation, predominantly in the 500 Hz-6000 Hz interval and group comparisons revealed significant differences between the iTBS and sham groups for 500 Hz (p = 0.041) and between the iTBS and cTBS groups for 4000 Hz (p = 0.038). Neither relevant side effects nor any significant hearing threshold impairment after active or sham stimulation were found. CONCLUSIONS A single stimulation session led to an effective neuromodulation of the auditory cortex, reflected in lower thresholds when using iTBS. SIGNIFICANCE These encouraging results with this safe noninvasive tool suggest that iTBS may have the potential to positively influence hearing thresholds.
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Affiliation(s)
- Nuno Pinto
- CICS-Health Sciences Research Centre, University of Beira Interior, Covilhã 6200-506, Portugal; Dr. Lopes Dias School of Health - Polytechnic Institute of Castelo Branco, 6000-767, Portugal.
| | - Iris Oliveira
- CICS-Health Sciences Research Centre, University of Beira Interior, Covilhã 6200-506, Portugal.
| | - Joana Ferreira
- CICS-Health Sciences Research Centre, University of Beira Interior, Covilhã 6200-506, Portugal.
| | - Jorge Gama
- CICS-Health Sciences Research Centre, University of Beira Interior, Covilhã 6200-506, Portugal; University of Beira Interior - Department of Mathematics, Covilhã 6200-506, Portugal.
| | - Maria Vaz Pato
- CICS-Health Sciences Research Centre, University of Beira Interior, Covilhã 6200-506, Portugal; Sousa Martins Hospital, Guarda Local Health Unit, Guarda 6300-858, Portugal.
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11
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Barry K, Robertson D, Mulders W. Changes in auditory thalamus neural firing patterns after acoustic trauma in rats. Hear Res 2019; 379:89-97. [DOI: 10.1016/j.heares.2019.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 04/24/2019] [Accepted: 05/02/2019] [Indexed: 12/28/2022]
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12
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Frequency-specific effects of low-intensity rTMS can persist for up to 2 weeks post-stimulation: A longitudinal rs-fMRI/MRS study in rats. Brain Stimul 2019; 12:1526-1536. [PMID: 31296402 DOI: 10.1016/j.brs.2019.06.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 06/23/2019] [Accepted: 06/26/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Evidence suggests that repetitive transcranial magnetic stimulation (rTMS), a non-invasive neuromodulation technique, alters resting brain activity. Despite anecdotal evidence that rTMS effects wear off, there are no reports of longitudinal studies, even in humans, mapping the therapeutic duration of rTMS effects. OBJECTIVE Here, we investigated the longitudinal effects of repeated low-intensity rTMS (LI-rTMS) on healthy rodent resting-state networks (RSNs) using resting-state functional MRI (rs-fMRI) and on sensorimotor cortical neurometabolite levels using proton magnetic resonance spectroscopy (MRS). METHODS Sprague-Dawley rats received 10 min LI-rTMS daily for 15 days (10 Hz or 1 Hz stimulation, n = 9 per group). MRI data were acquired at baseline, after seven days and after 14 days of daily stimulation and at two more timepoints up to three weeks post-cessation of daily stimulation. RESULTS 10 Hz stimulation increased RSN connectivity and GABA, glutamine, and glutamate levels. 1 Hz stimulation had opposite but subtler effects, resulting in decreased RSN connectivity and glutamine levels. The induced changes decreased to baseline levels within seven days following stimulation cessation in the 10 Hz group but were sustained for at least 14 days in the 1 Hz group. CONCLUSION Overall, our study provides evidence of long-term frequency-specific effects of LI-rTMS. Additionally, the transient connectivity changes following 10 Hz stimulation suggest that current treatment protocols involving this frequency may require ongoing "top-up" stimulation sessions to maintain therapeutic effects.
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13
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Orenay-Boyacioglu S, Caliskan M, Boyacioglu O, Coskunoglu A, Bozkurt G, Cam FS. Chronic tinnitus and BDNF/GDNF CpG promoter methylations: a case-control study. Mol Biol Rep 2019; 46:3929-3936. [PMID: 31041673 DOI: 10.1007/s11033-019-04837-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 04/25/2019] [Indexed: 01/12/2023]
Abstract
Brain-derived neurotrophic factor (BDNF) and Glial-derived neurotrophic factor (GDNF) are neurotrophic factors that play key roles in the auditory pathway. While the relationship between serum levels and polymorphisms of BDNF/GDNF and chronic tinnitus is emphasized in the literature, there is no study showing the link between the promoter methylations of these genes and tinnitus. For this purpose, the relationship between chronic tinnitus and peripheral blood derived BDNF/GDNF promoter methylations was investigated to identify their role in the pathophysiology of tinnitus. In this case-control study, we examined the possible effects of BDNF/GDNF methylations in the blood samples of patients with tinnitus complaints for more than 3 months. Sixty tinnitus subjects between the ages of 18-55 and 50 healthy control subjects in the same age group who were free of any otorhinolaryngology and systemic disease were selected for examination. Methylation of total 12 CpG sites in BDNF and GDNF promoter regions were determined by the bisulfite-pyrosequencing method. Statistically significant differences were detected between BDNF CpG6 and GDNF CpG3-5-6 methylation ratios in the comparison of control group and the chronic tinnitus patients (P = 0.002, 0.0005, 0.00003, and 0.0029, respectively). To our knowledge, this is the first study in the literature investigating the relationship between chronic tinnitus and peripheral blood derived BDNF/GDNF promoter methylations. It is believed that the current results might be supported by investigating the relationships between BDNF/GDNF methylations and genotypes in future research using higher sample sizes.
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Affiliation(s)
- Seda Orenay-Boyacioglu
- Department of Medical Genetics, Faculty of Medicine, Aydin Adnan Menderes University, Aydin, Turkey.
| | - Metin Caliskan
- Department of Medical Genetics, Faculty of Medicine, Aydin Adnan Menderes University, Aydin, Turkey
| | - Olcay Boyacioglu
- Faculty of Engineering, Aydin Adnan Menderes University, Aydin, Turkey
| | - Aysun Coskunoglu
- Department of Medical Genetics, State Hospital of Sivas, Sivas, Turkey
| | - Gokay Bozkurt
- Department of Medical Genetics, Faculty of Medicine, Aydin Adnan Menderes University, Aydin, Turkey
| | - F Sirri Cam
- Department of Medical Genetics, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
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14
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Low-intensity repetitive transcranial magnetic stimulation over prefrontal cortex in an animal model alters activity in the auditory thalamus but does not affect behavioural measures of tinnitus. Exp Brain Res 2019; 237:883-896. [DOI: 10.1007/s00221-018-05468-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 12/29/2018] [Indexed: 12/19/2022]
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15
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Seewoo BJ, Etherington SJ, Feindel KW, Rodger J. Combined rTMS/fMRI Studies: An Overlooked Resource in Animal Models. Front Neurosci 2018; 12:180. [PMID: 29628873 PMCID: PMC5876299 DOI: 10.3389/fnins.2018.00180] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 03/06/2018] [Indexed: 12/11/2022] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique, which has brain network-level effects in healthy individuals and is also used to treat many neurological and psychiatric conditions in which brain connectivity is believed to be abnormal. Despite the fact that rTMS is being used in a clinical setting and animal studies are increasingly identifying potential cellular and molecular mechanisms, little is known about how these mechanisms relate to clinical changes. This knowledge gap is amplified by non-overlapping approaches used in preclinical and clinical rTMS studies: preclinical studies are mostly invasive, using cellular and molecular approaches, while clinical studies are non-invasive, including functional magnetic resonance imaging (fMRI), TMS electroencephalography (EEG), positron emission tomography (PET), and behavioral measures. A non-invasive method is therefore needed in rodents to link our understanding of cellular and molecular changes to functional connectivity changes that are clinically relevant. fMRI is the technique of choice for examining both short and long term functional connectivity changes in large-scale networks and is becoming increasingly popular in animal research because of its high translatability, but, to date, there have been no reports of animal rTMS studies using this technique. This review summarizes the main studies combining different rTMS protocols with fMRI in humans, in both healthy and patient populations, providing a foundation for the design of equivalent studies in animals. We discuss the challenges of combining these two methods in animals and highlight considerations important for acquiring clinically-relevant information from combined rTMS/fMRI studies in animals. We believe that combining rTMS and fMRI in animal models will generate new knowledge in the following ways: functional connectivity changes can be explored in greater detail through complementary invasive procedures, clarifying mechanism and improving the therapeutic application of rTMS, as well as improving interpretation of fMRI data. And, in a more general context, a robust comparative approach will refine the use of animal models of specific neuropsychiatric conditions.
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Affiliation(s)
- Bhedita J Seewoo
- Experimental and Regenerative Neurosciences, School of Biological Sciences, The University of Western Australia, Perth, WA, Australia.,Centre for Microscopy, Characterization and Analysis, Research Infrastructure Centers, The University of Western Australia, Perth, WA, Australia
| | - Sarah J Etherington
- School of Veterinary and Life Sciences, Murdoch University, Perth, WA, Australia
| | - Kirk W Feindel
- Centre for Microscopy, Characterization and Analysis, Research Infrastructure Centers, The University of Western Australia, Perth, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Perth, WA, Australia
| | - Jennifer Rodger
- Experimental and Regenerative Neurosciences, School of Biological Sciences, The University of Western Australia, Perth, WA, Australia.,Brain Plasticity Group, Perron Institute for Neurological and Translational Research, Perth, WA, Australia
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