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Aceves-Serrano L, Neva JL, Doudet DJ. Insight Into the Effects of Clinical Repetitive Transcranial Magnetic Stimulation on the Brain From Positron Emission Tomography and Magnetic Resonance Imaging Studies: A Narrative Review. Front Neurosci 2022; 16:787403. [PMID: 35264923 PMCID: PMC8899094 DOI: 10.3389/fnins.2022.787403] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 02/01/2022] [Indexed: 12/14/2022] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) has been proposed as a therapeutic tool to alleviate symptoms for neurological and psychiatric diseases such as chronic pain, stroke, Parkinson’s disease, major depressive disorder, and others. Although the therapeutic potential of rTMS has been widely explored, the neurological basis of its effects is still not fully understood. Fortunately, the continuous development of imaging techniques has advanced our understanding of rTMS neurobiological underpinnings on the healthy and diseased brain. The objective of the current work is to summarize relevant findings from positron emission tomography (PET) and magnetic resonance imaging (MRI) techniques evaluating rTMS effects. We included studies that investigated the modulation of neurotransmission (evaluated with PET and magnetic resonance spectroscopy), brain activity (evaluated with PET), resting-state connectivity (evaluated with resting-state functional MRI), and microstructure (diffusion tensor imaging). Overall, results from imaging studies suggest that the effects of rTMS are complex and involve multiple neurotransmission systems, regions, and networks. The effects of stimulation seem to not only be dependent in the frequency used, but also in the participants characteristics such as disease progression. In patient populations, pre-stimulation evaluation was reported to predict responsiveness to stimulation, while post-stimulation neuroimaging measurements showed to be correlated with symptomatic improvement. These studies demonstrate the complexity of rTMS effects and highlight the relevance of imaging techniques.
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Affiliation(s)
- Lucero Aceves-Serrano
- Department of Medicine/Neurology, University of British Columbia, Vancouver, BC, Canada
- *Correspondence: Lucero Aceves-Serrano,
| | - Jason L. Neva
- École de Kinésiologie et des Sciences de l’Activité Physique, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
| | - Doris J. Doudet
- Department of Medicine/Neurology, University of British Columbia, Vancouver, BC, Canada
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Sonmez AI, Camsari DD, Nandakumar AL, Voort JLV, Kung S, Lewis CP, Croarkin PE. Accelerated TMS for Depression: A systematic review and meta-analysis. Psychiatry Res 2019; 273:770-781. [PMID: 31207865 PMCID: PMC6582998 DOI: 10.1016/j.psychres.2018.12.041] [Citation(s) in RCA: 113] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/17/2018] [Accepted: 12/06/2018] [Indexed: 12/23/2022]
Abstract
Repetitive transcranial magnetic stimulation (TMS) is now widely available for the clinical treatment of depression, but the associated financial and time burdens are problematic for patients. Accelerated TMS (aTMS) protocols address these burdens and attempt to increase the efficiency of standard TMS. This systematic review and meta-analysis aimed to examine accelerated TMS studies for depressive disorders in accordance with PRISMA guidelines. Inclusion criteria consisted of studies with full text publications available in English describing more than one session of TMS (repetitive or theta burst stimulation) per day. Studies describing accelerated TMS protocols for conditions other than depression or alternative neuromodulation methods, preclinical studies, and neurophysiology studies regarding transcranial stimulation were excluded. Eighteen articles describing eleven distinct studies (seven publications described overlapping samples) met eligibility criteria. A Hedges' g effect size and confidence intervals were calculated. The summary analysis of three suitable randomized control trials revealed a cumulative effect size of 0.39 (95% CI 0.005-0.779). A separate analysis including open-label trials and active arms of suitable RCTs revealed a g of 1.27 (95% CI 0.902-1.637). Overall, the meta-analysis suggested that aTMS improves depressive symptom severity. In general, study methodologies were acceptable, but future efforts could enhance sham techniques and blinding.
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Affiliation(s)
| | | | | | | | | | | | - Paul E. Croarkin
- Reprints: Paul E. Croarkin, DO, MSCS, Department of Psychiatry and Psychology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, , Telephone: (507) 293-2557, Fax: (507) 293-3933
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3
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Niida R, Yamagata B, Matsuda H, Niida A, Uechi A, Kito S, Mimura M. Regional brain volume reductions in major depressive disorder and bipolar disorder: An analysis by voxel-based morphometry. Int J Geriatr Psychiatry 2019; 34:186-192. [PMID: 30328161 DOI: 10.1002/gps.5009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 10/05/2018] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The present study investigated the usefulness of evaluating the existence of volume reduction in brain regions using voxel-based morphometry (VBM) to dissociate major depressive disorder (MDD) from bipolar disorder (BD). METHODS/DESIGN This study enrolled 92 individuals with MDD, 32 individuals with BD, and 43 healthy controls (HCs). We focused on gray matter volume (GMV) of the subgenual anterior cingulate cortex (sgACC), subcallosal area (SCA), and hippocampus. The degree of volume reduction in these brain regions was calculated as the z score, and the differences of z scores in these regions were investigated among the MDD, BD, and HC groups. We then performed a receiver operating characteristic curve analysis to dissociate the individuals with MDD and BD from the HCs based on the z scores in the GMV of these brain regions. RESULTS While there were no significant differences in the z scores of the hippocampus among the three groups, the z score of the sgACC was significantly higher in the MDD group than in the BD and HC groups, and the SCA z score was significantly higher in the MDD and BD groups than in the HC group. CONCLUSIONS Our findings suggest that VBM evaluation of GMV reduction in the sgACC may be useful as an objective adjunctive tool to distinguish between MDD and BD.
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Affiliation(s)
- Richi Niida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Department of Radiology, Nanbu Hospital, Itoman, Okinawa, Japan
| | - Bun Yamagata
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Hiroshi Matsuda
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Akira Niida
- Department of Radiology, Nanbu Hospital, Itoman, Okinawa, Japan
| | - Akihiko Uechi
- Cognitive Neuroscience Research Project, Kansai Gaidai University, Hirakata, Osaka, Japan
| | - Shinsuke Kito
- Department of Psychiatry, Jikei University School of Medicine, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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Monteiro DC, Cantilino A. Use of a Double-Cone Coil in Transcranial Magnetic Stimulation for Depression Treatment. Neuromodulation 2018; 22:867-870. [PMID: 30506758 DOI: 10.1111/ner.12896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/18/2018] [Accepted: 09/26/2018] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Approximately 15% of all people will experience a depressive episode throughout their lives, and by 2020, depression will be the second largest cause of disability around the world. Transcranial magnetic stimulation (TMS) has been shown to be an effective option for treating this condition. Devices such as the double-cone coil may bring new insights regarding depression treatment. METHODS A literature search was performed on PubMed, ScienceDirect, Cochrane, LILACS, and Google Scholar by applying the descriptors "depression" AND "transcranial magnetic stimulation" AND "double cone-coil." RESULTS Six studies were considered eligible (three clinical trials, two case series, and one isolated case report). All of them described treatments with transcranial magnetic stimulation by double-cone coil (DC-TMS) at 10 Hz over the dorsomedial prefrontal cortex, achieving response and remission rates of 40-52.4% and 34.7-47.6%, respectively. Two clinical trials investigated both intermittent theta-burst stimulation and 10 Hz TMS, suggesting a slight advantage of the latter. They also found no additional gains by combining both techniques. CONCLUSION Despite the small number of controlled clinical trials and the small sample sizes, which limit the generalization of the obtained results, the collected data provide an optimistic perspective on the effectiveness of using DC-TMS for depression treatment.
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Affiliation(s)
- Dennison Carreiro Monteiro
- Neuropsychiatry, Behavioral Science Postgraduate Program at the Universidade Federal de Pernambuco, Recife, Brazil
| | - Amaury Cantilino
- Neuropsychiatry, Behavioral Science Postgraduate Program at the Universidade Federal de Pernambuco, Recife, Brazil
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Li J, Yang Y, Zhu Y, Zhou L, Han Y, Yin T, Cheng Z, Zhang G, Shen Y, Chen J. Towards characterizing the regional cerebral perfusion in evaluating the severity of major depression disorder with SPECT/CT. BMC Psychiatry 2018; 18:70. [PMID: 29562903 PMCID: PMC5863480 DOI: 10.1186/s12888-018-1654-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 03/08/2018] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a common mental disorder worldwide, but now there is a lack of clinically effective assessment and management of MDD. In this study, we used technetium-99 m ethylcysteinate dimer ([99mTc]ECD) SPECT/CT to characterize the regional cerebral blood flow (rCBF) status of MDD patients, and to explore an objective image assessment model of MDD which is non- or minimally-invasive, convenient and accurate in a clinical setting. METHODS The severity of MDD was assessed by three trained psychiatrists, based on scores obtained from HAMD and HAMA. [99mTc]ECD rCBF SPECT/CT was performed in 20 healthy controls and 74 unipolar MDD patients before receiving the treatment. The CT attenuation-corrected SPECT images data were automatically registered, analyzed simultaneously by 3D-SSP and eZIS. RESULTS The mean score of HAMD and HAMA in the MDD patients was 25.49 ± 6.00, and 23.12 ± 5.83, respectively. There was a positive correlation between two scores. The MDD women had higher HAMD scores than MDD men. The decreased rCBF of MDD patients in frontal lobes (bilateral B11, B47 and right B4, B6, B10, B46), temporal lobe (right B21, B41, B42) and cingulated cortex (bilateral B24, B33), while their increased rCBF in occipital lobe (bilateral B17, B19 and left B18). Additionally, the depression severity was negatively correlated with decreased rCBF in left ventral anterior cingulate cortex B24, and was positively correlated with decreased rCBF in left inferior prefrontal gyrus B47 and increased rCBF in right associative visual cortex B19. The anxiety severity was negatively correlated with decreased rCBF in left subgenual cortex B25. CONCLUSIONS Although the mechanism underlying the correlation is not yet fully understood, our findings indicated that the rCBF SPECT/CT may provide an objective assessment for MDD severity. It might be used monitoring therapeutic efficacy in the management of MDD.
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Affiliation(s)
- Jinming Li
- 0000 0004 0368 7223grid.33199.31Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province 430030 China ,0000 0004 1758 2270grid.412632.0Department of Nuclear Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei Province 430060 China
| | - Yuan Yang
- 0000 0004 0368 7223grid.33199.31Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province 430030 China
| | - Yuankai Zhu
- 0000 0004 0368 7223grid.33199.31Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province 430030 China
| | - Liqiang Zhou
- 0000 0004 0368 7223grid.33199.31Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province 430030 China
| | - Yunfeng Han
- 0000 0004 0368 7223grid.33199.31Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province 430030 China
| | - Tao Yin
- 0000 0004 0368 7223grid.33199.31Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province 430030 China
| | - Zhaoting Cheng
- 0000 0004 0368 7223grid.33199.31Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province 430030 China
| | - Guopeng Zhang
- 0000 0004 0368 7223grid.33199.31Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province 430030 China
| | - Yanxia Shen
- 0000 0004 0368 7223grid.33199.31Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province 430030 China
| | - Jing Chen
- Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, China.
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Silverstein WK, Noda Y, Barr MS, Vila-Rodriguez F, Rajji TK, Fitzgerald PB, Downar J, Mulsant BH, Vigod S, Daskalakis ZJ, Blumberger DM. NEUROBIOLOGICAL PREDICTORS OF RESPONSE TO DORSOLATERAL PREFRONTAL CORTEX REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION IN DEPRESSION: A SYSTEMATIC REVIEW. Depress Anxiety 2015; 32:871-91. [PMID: 26382227 DOI: 10.1002/da.22424] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 08/19/2015] [Accepted: 08/24/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND A significant proportion of patients with depression fail to respond to psychotherapy and standard pharmacotherapy, leading to treatment-resistant depression (TRD). Due to the significant prevalence of TRD, alternative therapies for depression have emerged as viable treatments in the armamentarium for this disorder. Repetitive transcranial magnetic stimulation (rTMS) is now being offered in clinical practice in broader numbers. Many studies have investigated various different neurobiological predictors of response of rTMS. However, a synthesis of this literature and an understanding of what biological targets predict response is lacking. This review aims to systematically synthesize the literature on the neurobiological predictors of rTMS in patients with depression. METHODS Medline (1996-2014), Embase (1980-2014), and PsycINFO (1806-2014) were searched under set terms. Two authors reviewed each article and came to consensus on the inclusion and exclusion criteria. All eligible studies were reviewed, duplicates were removed, and data were extracted individually. RESULTS The search identified 1,673 articles, 41 of which met both inclusion and exclusion criteria. Various biological factors at baseline appear to predict response to rTMS, including levels of certain molecular factors, blood flow in brain regions implicated in depression, electrophysiological findings, and specific genetic polymorphisms. CONCLUSIONS Significant methodological variability in rTMS treatment protocols limits the ability to generalize conclusions. However, response to treatment may be predicted by baseline frontal lobe blood flow, and presence of polymorphisms of the 5-hydroxytryptamine (5-HT) -1a gene, the LL genotype of the serotonin transporter linked polymorphic region (5-HTTLPR) gene, and Val/Val homozygotes of the brain-derived neurotrophic factor (BDNF) gene.
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Affiliation(s)
- William K Silverstein
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Yoshihiro Noda
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Mera S Barr
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Fidel Vila-Rodriguez
- Non-Invasive Neurostimulation Therapies Laboratory, Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tarek K Rajji
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne, Victoria, Australia
| | - Jonathan Downar
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,MRI-Guided rTMS Clinic, Department of Psychiatry, University Health Network, Toronto, Ontario, Canada
| | - Benoit H Mulsant
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Simone Vigod
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Reproductive Life Stages Program, Women's Mental Health Program, Women's College Hospital, Toronto, Ontario, Canada
| | - Zafiris J Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Daniel M Blumberger
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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7
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Noda Y, Silverstein WK, Barr MS, Vila-Rodriguez F, Downar J, Rajji TK, Fitzgerald PB, Mulsant BH, Vigod SN, Daskalakis ZJ, Blumberger DM. Neurobiological mechanisms of repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex in depression: a systematic review. Psychol Med 2015; 45:3411-3432. [PMID: 26349810 DOI: 10.1017/s0033291715001609] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Depression is one of the most prevalent mental illnesses worldwide and a leading cause of disability, especially in the setting of treatment resistance. In recent years, repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising alternative strategy for treatment-resistant depression and its clinical efficacy has been investigated intensively across the world. However, the underlying neurobiological mechanisms of the antidepressant effect of rTMS are still not fully understood. This review aims to systematically synthesize the literature on the neurobiological mechanisms of treatment response to rTMS in patients with depression. Medline (1996-2014), Embase (1980-2014) and PsycINFO (1806-2014) were searched under set terms. Three authors reviewed each article and came to consensus on the inclusion and exclusion criteria. All eligible studies were reviewed, duplicates were removed, and data were extracted individually. Of 1647 articles identified, 66 studies met both inclusion and exclusion criteria. rTMS affects various biological factors that can be measured by current biological techniques. Although a number of studies have explored the neurobiological mechanisms of rTMS, a large variety of rTMS protocols and parameters limits the ability to synthesize these findings into a coherent understanding. However, a convergence of findings suggest that rTMS exerts its therapeutic effects by altering levels of various neurochemicals, electrophysiology as well as blood flow and activity in the brain in a frequency-dependent manner. More research is needed to delineate the neurobiological mechanisms of the antidepressant effect of rTMS. The incorporation of biological assessments into future rTMS clinical trials will help in this regard.
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Affiliation(s)
- Y Noda
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health,Toronto,Ontario,Canada
| | - W K Silverstein
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health,Toronto,Ontario,Canada
| | - M S Barr
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health,Toronto,Ontario,Canada
| | - F Vila-Rodriguez
- Non-Invasive Neurostimulation Therapies Laboratory,Department of Psychiatry,Faculty of Medicine,University of British Columbia,Vancouver,British Columbia,Canada
| | - J Downar
- Department of Psychiatry,University of Toronto,Toronto,Ontario,Canada
| | - T K Rajji
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health,Toronto,Ontario,Canada
| | - P B Fitzgerald
- Monash Alfred Psychiatry Research Centre,The Alfred and Monash University Central Clinical School,Melbourne,Victoria,Australia
| | - B H Mulsant
- Department of Psychiatry,University of Toronto,Toronto,Ontario,Canada
| | - S N Vigod
- Department of Psychiatry,University of Toronto,Toronto,Ontario,Canada
| | - Z J Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health,Toronto,Ontario,Canada
| | - D M Blumberger
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health,Toronto,Ontario,Canada
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Tang Q, Li G, Wang A, Liu T, Feng S, Guo Z, Chen H, He B, McClure MA, Ou J, Xing G, Mu Q. A systematic review for the antidepressant effects of sleep deprivation with repetitive transcranial magnetic stimulation. BMC Psychiatry 2015; 15:282. [PMID: 26573324 PMCID: PMC4647580 DOI: 10.1186/s12888-015-0674-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Accepted: 11/04/2015] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Sleep deprivation (SD) and repetitive transcranial magnetic stimulation (rTMS) have been commonly used to treat depression. Recent studies suggest that co-therapy with rTMS and SD may produce better therapeutic effects than either therapy alone. Therefore, this study was to review the current findings to determine if rTMS can augment the therapeutic effects of SD on depression. METHODS Embase, JSTOR, Medline, PubMed, ScienceDirect, and the Cochrane Central Register of Controlled Trials were searched for clinical studies published between January 1985 and March 2015 using the search term "rTMS/repetitive transcranial magnetic stimulation AND sleep deprivation AND depress*". Only randomized and sham-controlled trials (RCTs) involving the combined use of rTMS and SD in depression patients were included in this systematic review. The scores of the Hamilton Rating Scale for Depression were extracted as primary outcome measures. RESULTS Three RCTs with 72 patients that met the inclusion criteria were included for the systematic review. One of the trials reported skewed data and was described alone. The other two studies, which involved 30 patients in the experimental group (SD + active rTMS) and 22 patients in the control group (SD + sham rTMS), reported normally distributed data. The primary outcome measures showed different results among the three publications: two of which showed great difference between the experimental and the control subjects, and the other one showed non-significant antidepressant effect of rTMS on SD. In addition, two of the included studies reported secondary outcome measures with Clinical Global Impression Rating Scale and a self-reported well-being scale which presented good improvement for the depressive patients in the experiment group when compared with the control. The follow-up assessments in two studies indicated maintained results with the immediate measurements. CONCLUSIONS From this study, an overview of the publications concerning the combined use of rTMS and SD is presented, which provides a direction for future research of therapies for depression. More studies are needed to confirm whether there is an augmentative antidepressant effect of rTMS on SD.
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Affiliation(s)
- Qing Tang
- Department of Radiology & Imaging Institute of Rehabilitation and Development of Brain Function, North Sichuan Medical University Nanchong Central Hospital, 97 South Renmin Road, Shunqing District, Nanchong, 637000, Sichuan, China.
| | - Guangming Li
- Department of Oncology, North Sichuan Medical University Nanchong Central Hospital, 97 South Renmin Road, Shunqing District, Nanchong, 637000, Sichuan, China.
| | - Anguo Wang
- Department of Urology Surgery, North Sichuan Medical University Nanchong Central Hospital, 97 South Renmin Road, Shunqing District, Nanchong, 637000, Sichuan, China.
| | - Tao Liu
- Department of Cardiology, North Sichuan Medical University Nanchong Central Hospital, 97 South Renmin Road, Shunqing District, Nanchong, 637000, Sichuan, China.
| | - Shenggang Feng
- Department of Nephrology, North Sichuan Medical University Nanchong Central Hospital, 97 South Renmin Road, Shunqing District, Nanchong, 637000, Sichuan, China.
| | - Zhiwei Guo
- Department of Radiology & Imaging Institute of Rehabilitation and Development of Brain Function, North Sichuan Medical University Nanchong Central Hospital, 97 South Renmin Road, Shunqing District, Nanchong, 637000, Sichuan, China.
| | - Huaping Chen
- Department of Radiology & Imaging Institute of Rehabilitation and Development of Brain Function, North Sichuan Medical University Nanchong Central Hospital, 97 South Renmin Road, Shunqing District, Nanchong, 637000, Sichuan, China.
| | - Bin He
- Department of Radiology & Imaging Institute of Rehabilitation and Development of Brain Function, North Sichuan Medical University Nanchong Central Hospital, 97 South Renmin Road, Shunqing District, Nanchong, 637000, Sichuan, China.
| | - Morgan A. McClure
- Department of Radiology & Imaging Institute of Rehabilitation and Development of Brain Function, North Sichuan Medical University Nanchong Central Hospital, 97 South Renmin Road, Shunqing District, Nanchong, 637000 Sichuan China
| | - Jun Ou
- Department of Radiology & Imaging Institute of Rehabilitation and Development of Brain Function, North Sichuan Medical University Nanchong Central Hospital, 97 South Renmin Road, Shunqing District, Nanchong, 637000, Sichuan, China.
| | - Guoqiang Xing
- Lotus Biotech.com LLC., John Hopkins University-MCC, 9601 Medical Center Drive, Rockville, MD, 20850, USA.
| | - Qiwen Mu
- Department of Radiology & Imaging Institute of Rehabilitation and Development of Brain Function, North Sichuan Medical University Nanchong Central Hospital, 97 South Renmin Road, Shunqing District, Nanchong, 637000, Sichuan, China. .,Peking University Third Hospital, 49 Garden North Road, Haidian District, Beijing, 100080, China.
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9
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Baeken C, Marinazzo D, Everaert H, Wu GR, Van Hove C, Audenaert K, Goethals I, De Vos F, Peremans K, De Raedt R. The Impact of Accelerated HF-rTMS on the Subgenual Anterior Cingulate Cortex in Refractory Unipolar Major Depression: Insights From 18FDG PET Brain Imaging. Brain Stimul 2015; 8:808-15. [DOI: 10.1016/j.brs.2015.01.415] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Revised: 01/17/2015] [Accepted: 01/31/2015] [Indexed: 01/16/2023] Open
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10
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Bares M, Brunovsky M, Novak T, Kopecek M, Stopkova P, Sos P, Höschl C. QEEG Theta Cordance in the Prediction of Treatment Outcome to Prefrontal Repetitive Transcranial Magnetic Stimulation or Venlafaxine ER in Patients With Major Depressive Disorder. Clin EEG Neurosci 2015; 46:73-80. [PMID: 24711613 DOI: 10.1177/1550059413520442] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 12/22/2013] [Indexed: 11/15/2022]
Abstract
The aims of this double-blind study were to assess and compare the efficacy of quantitative electroencephalographic (QEEG) prefrontal theta band cordance in the prediction of response to 4-week, right, prefrontal, 1-Hz repetitive transcranial magnetic stimulation (rTMS) or venlafaxine ER in patients with major depressive disorder (MDD). Prefrontal QEEG cordance values of 50 inpatients (25 subjects in each group) completing 4 weeks of the study were obtained at baseline and after 1 week of treatment. Depressive symptoms were assessed using Montgomery-Åsberg Depression Rating Scale (MADRS) at baseline and at week 1 and 4. Treatment response was defined as a ≥50% reduction in baseline MADRS total score. All responders (n = 9) and 6 of 16 nonresponders in the rTMS group had reduced cordance at week 1 (P < .01). Reduction of theta cordance value at week 1 was detected in all responders (n = 10) to venlafaxine ER, but only in 4 of 15 nonresponders (P = .005). The comparison of the areas under the curve of cordance change for prediction of response between rTMS (0.75) and venlafaxine ER (0.89) treated groups yielded no significant difference (P = .27). Our study indicates that prefrontal QEEG cordance is a promising tool not only for predicting the response to certain antidepressants but also to rTMS treatment, with comparable predictive efficacy for both therapeutic interventions.
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Affiliation(s)
- Martin Bares
- Prague Psychiatric Center and National Institute of Mental Health, Prague, Czech Republic The Department of Psychiatry and Medical Psychology of Third Medical Faculty, Charles University, Prague, Czech Republic
| | - Martin Brunovsky
- Prague Psychiatric Center and National Institute of Mental Health, Prague, Czech Republic The Department of Psychiatry and Medical Psychology of Third Medical Faculty, Charles University, Prague, Czech Republic
| | - Tomas Novak
- Prague Psychiatric Center and National Institute of Mental Health, Prague, Czech Republic The Department of Psychiatry and Medical Psychology of Third Medical Faculty, Charles University, Prague, Czech Republic
| | - Miloslav Kopecek
- Prague Psychiatric Center and National Institute of Mental Health, Prague, Czech Republic The Department of Psychiatry and Medical Psychology of Third Medical Faculty, Charles University, Prague, Czech Republic
| | - Pavla Stopkova
- Prague Psychiatric Center and National Institute of Mental Health, Prague, Czech Republic The Department of Psychiatry and Medical Psychology of Third Medical Faculty, Charles University, Prague, Czech Republic
| | - Peter Sos
- Prague Psychiatric Center and National Institute of Mental Health, Prague, Czech Republic The Department of Psychiatry and Medical Psychology of Third Medical Faculty, Charles University, Prague, Czech Republic
| | - Cyril Höschl
- Prague Psychiatric Center and National Institute of Mental Health, Prague, Czech Republic The Department of Psychiatry and Medical Psychology of Third Medical Faculty, Charles University, Prague, Czech Republic
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Takahashi S, Ukai S, Tsuji T, Ueyama T, Kono M, Yamanaka N, Shinosaki K. Reduction of cortical excitability and increase of thalamic activity in a low-frequency rTMS treatment for chronic tinnitus. Neurocase 2015; 21:339-44. [PMID: 24606019 DOI: 10.1080/13554794.2014.893000] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Low-frequency repetitive transcranial magnetic stimulation (rTMS) has received increasing attention for the treatment of tinnitus, but its therapeutic mechanisms are unclear. We performed low-frequency rTMS treatment for a patient with chronic tinnitus and examined changes of cortical excitability and cerebral blood flow using paired-pulse TMS and single-photon emission computed tomography. After the rTMS treatment, tinnitus loudness was decreased, cortical excitability was reduced, and blood flow in the thalamus was increased. Our results suggest that low-frequency rTMS treatment reduces tinnitus loudness by an inhibitory effect on the cortical excitability and a remote activation effect on the thalamus through the corticothalamic networks.
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Affiliation(s)
- Shun Takahashi
- a Department of Neuropsychiatry , Wakayama Medical University , Wakayama , Japan
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