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Kinjo M, Honda S, Wada M, Nakajima S, Koike S, Noda Y. A comparative study of the dorsolateral prefrontal cortex targeting approaches for transcranial magnetic stimulation treatment: Insights from the healthy control data. Brain Res 2024; 1838:148989. [PMID: 38723740 DOI: 10.1016/j.brainres.2024.148989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 05/05/2024] [Accepted: 05/06/2024] [Indexed: 05/13/2024]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) to the left dorsolateral prefrontal cortex (DLPFC) is an established treatment for medication-resistant depression. Several targeting methods for the left DLPFC have been proposed including identification with resting-state functional magnetic resonance imaging (rs-fMRI) neuronavigation, stimulus coordinates based on structural MRI, or electroencephalography (EEG) F3 site by Beam F3 method. To date, neuroanatomical and neurofunctional differences among those approaches have not been investigated on healthy subjects, which are structurally and functionally unaffected by psychiatric disorders. This study aimed to compare the mean location, its dispersion, and its functional connectivity with the subgenual cingulate cortex (SGC), which is known to be associated with the therapeutic outcome in depression, of various approaches to target the DLPFC in healthy subjects. Fifty-seven healthy subjects underwent MRI scans to identify the stimulation site based on their resting-state functional connectivity and were measured their head size for targeting with Beam F3 method. In addition, we included two fixed stimulus coordinates over the DLPFC in the analysis, as recommended in previous studies. From the results, the rs-fMRI method had, as expected, more dispersed target sites across subjects and the greatest anticorrelation with the SGC, reflecting the known fact that personalized neuronavigation yields the greatest antidepressant effect. In contrast, the targets located by the other methods were relatively close together with less dispersion, and did not differ in anticorrelation with the SGC, implying their limitation of the therapeutic efficacy and possible interchangeability of them.
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Affiliation(s)
- Megumi Kinjo
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Shiori Honda
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Masataka Wada
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Shinichiro Nakajima
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Shinsuke Koike
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan
| | - Yoshihiro Noda
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
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2
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Di Passa AM, Prokop-Millar S, Yaya H, Dabir M, McIntyre-Wood C, Fein A, MacKillop E, MacKillop J, Duarte D. Clinical efficacy of deep transcranial magnetic stimulation (dTMS) in psychiatric and cognitive disorders: A systematic review. J Psychiatr Res 2024; 175:287-315. [PMID: 38759496 DOI: 10.1016/j.jpsychires.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 04/23/2024] [Accepted: 05/02/2024] [Indexed: 05/19/2024]
Abstract
Deep transcranial magnetic stimulation (dTMS) has gained attention as an enhanced form of traditional TMS, targeting broader and deeper regions of the brain. However, a fulsome synthesis of dTMS efficacy across psychiatric and cognitive disorders using sham-controlled trials is lacking. We systematically reviewed 28 clinical trials comparing active dTMS to a sham/controlled condition to characterize dTMS efficacy across diverse psychiatric and cognitive disorders. A comprehensive search of APA PsycINFO, Cochrane, Embase, Medline, and PubMed databases was conducted. Predominant evidence supports dTMS efficacy in patients with obsessive-compulsive disorder (OCD; n = 2), substance use disorders (SUDs; n = 8), and in those experiencing depressive episodes with major depressive disorder (MDD) or bipolar disorder (BD; n = 6). However, the clinical efficacy of dTMS in psychiatric disorders characterized by hyperactivity or hyperarousal (i.e., attention-deficit/hyperactivity disorder, posttraumatic stress disorder, and schizophrenia) was heterogeneous. Common side effects included headaches and pain/discomfort, with rare but serious adverse events such as seizures and suicidal ideation/attempts. Risk of bias ratings indicated a collectively low risk according to the Grading of Recommendations, Assessment, Development, and Evaluations checklist (Meader et al., 2014). Literature suggests promise for dTMS as a beneficial alternative or add-on treatment for patients who do not respond well to traditional treatment, particularly for depressive episodes, OCD, and SUDs. Mixed evidence and limited clinical trials for other psychiatric and cognitive disorders suggest more extensive research is warranted. Future research should examine the durability of dTMS interventions and identify moderators of clinical efficacy.
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Affiliation(s)
- Anne-Marie Di Passa
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Shelby Prokop-Millar
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Horodjei Yaya
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Melissa Dabir
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Carly McIntyre-Wood
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada; Michael G DeGroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, ON, Canada
| | - Allan Fein
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada; Michael G DeGroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, ON, Canada
| | - Emily MacKillop
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - James MacKillop
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada; Michael G DeGroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, ON, Canada
| | - Dante Duarte
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada; Seniors Mental Health Program, Department of Psychiatry and Neurosciences, McMaster University, Hamilton, ON, Canada.
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3
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Salazar BH, Hoffman KA, Lincoln JA, Karmonik C, Rajab H, Helekar SA, Khavari R. Evaluating noninvasive brain stimulation to treat overactive bladder in individuals with multiple sclerosis: a randomized controlled trial protocol. BMC Urol 2024; 24:20. [PMID: 38273296 PMCID: PMC10809615 DOI: 10.1186/s12894-023-01358-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/06/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Multiple Sclerosis (MS) is an often debilitating disease affecting the myelin sheath that encompasses neurons. It can be accompanied by a myriad of pathologies and adverse effects such as neurogenic lower urinary tract dysfunction (NLUTD). Current treatment modalities for resolving NLUTD focus mainly on alleviating symptoms while the source of the discomfort emanates from a disruption in brain to bladder neural circuitry. Here, we leverage functional magnetic resonance imaging (fMRI), repetitive transcranial magnetic stimulation (rTMS) protocols and the brains innate neural plasticity to aid in resolving overactive bladder (OAB) symptoms associated with NLUTD. METHODS By employing an advanced neuro-navigation technique along with processed fMRI and diffusion tensor imaging data to help locate specific targets in each participant brain, we are able to deliver tailored neuromodulation protocols and affect either an excitatory (20 min @ 10 Hz, applied to the lateral and medial pre-frontal cortex) or inhibitory (20 min @ 1 Hz, applied to the pelvic supplemental motor area) signal on neural circuitry fundamental to the micturition cycle in humans to restore or reroute autonomic and sensorimotor activity between the brain and bladder. Through a regimen of questionnaires, bladder diaries, stimulation sessions and analysis, we aim to gauge rTMS effectiveness in women with clinically stable MS. DISCUSSION Some limitations do exist with this study. In targeting the MS population, the stochastic nature of MS in general highlights difficulties in recruiting enough participants with similar symptomology to make meaningful comparisons. As well, for this neuromodulatory approach to achieve some rate of success, there must be enough intact white matter in specific brain regions to receive effective stimulation. While we understand that our results will represent only a subset of the MS community, we are confident that we will accomplish our goal of increasing the quality of life for those burdened with MS and NLUTD. TRIAL REGISTRATION This trial is registered at ClinicalTrials.gov (NCT06072703), posted on Oct 10, 2023.
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Affiliation(s)
- Betsy H Salazar
- Department of Urology, Houston Methodist Hospital, 6560 Fannin St. Suite 2100, Houston, TX, 77030, USA
| | - Kristopher A Hoffman
- Department of Urology, Houston Methodist Hospital, 6560 Fannin St. Suite 2100, Houston, TX, 77030, USA
- Translational Imaging Center, Houston Methodist Research Institute, Houston, TX, USA
| | - John A Lincoln
- Department of Neurology, The University of Texas Health Science Center, Houston, TX, USA
| | - Christof Karmonik
- Translational Imaging Center, Houston Methodist Research Institute, Houston, TX, USA
| | - Hamida Rajab
- Department of Urology, Houston Methodist Hospital, 6560 Fannin St. Suite 2100, Houston, TX, 77030, USA
| | - Santosh A Helekar
- Center for Translational Biomagnetics and Neurometry, Houston Methodist Research Institute, Houston, TX, USA
| | - Rose Khavari
- Department of Urology, Houston Methodist Hospital, 6560 Fannin St. Suite 2100, Houston, TX, 77030, USA.
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Shaikh UJ, Pellicano A, Schüppen A, Heinzel A, Winz OH, Herzog H, Mottaghy FM, Binkofski F. Increasing striatal dopamine release through repeated bouts of theta burst transcranial magnetic stimulation of the left dorsolateral prefrontal cortex. A 18F-desmethoxyfallypride positron emission tomography study. Front Neurosci 2024; 17:1295151. [PMID: 38304075 PMCID: PMC10833002 DOI: 10.3389/fnins.2023.1295151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/20/2023] [Indexed: 02/03/2024] Open
Abstract
Introduction Transcranial Magnetic Stimulation (TMS) can modulate fronto-striatal connectivity in the human brain. Here Positron Emission Tomography (PET) and neuro-navigated TMS were combined to investigate the dynamics of the fronto-striatal connectivity in the human brain. Employing 18F-DesmethoxyFallypride (DMFP) - a Dopamine receptor-antagonist - the release of endogenous dopamine in the striatum in response to time-spaced repeated bouts of excitatory, intermittent theta burst stimulation (iTBS) of the Left-Dorsolateral Prefrontal Cortex (L-DLPFC) was measured. Methods 23 healthy participants underwent two PET sessions, each one with four blocks of iTBS separated by 30 minutes: sham (control) and verum (90% of individual resting motor threshold). Receptor Binding Ratios were collected for sham and verum sessions across 37 time frames (about 130 minutes) in striatal sub-regions (Caudate nucleus and Putamen). Results Verum iTBS increased the dopamine release in striatal sub-regions, relative to sham iTBS. Dopamine levels in the verum session increased progressively across the time frames until frame number 28 (approximately 85 minutes after the start of the session and after three iTBS bouts) and then essentially remained unchanged until the end of the session. Conclusion Results suggest that the short-timed iTBS protocol performed in time-spaced blocks can effectively induce a dynamic dose dependent increase in dopaminergic fronto-striatal connectivity. This scheme could provide an alternative to unpleasant and distressing, long stimulation protocols in experimental and therapeutic settings. Specifically, it was demonstrated that three repeated bouts of iTBS, spaced by short intervals, achieve larger effects than one single stimulation. This finding has implications for the planning of therapeutic interventions, for example, treatment of major depression.
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Affiliation(s)
- Usman Jawed Shaikh
- Section Clinical Cognitive Sciences, Department of Neurology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | | | - Andre Schüppen
- Section Clinical Cognitive Sciences, Department of Neurology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Interdisciplinary Center for Clinical Research – Brain Imaging Facility, University Hospital Aachen, Aachen, Germany
| | - Alexander Heinzel
- Department of Nuclear Medicine, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Research Centre Juelich, Institute of Neuroscience and Medicine (INM-4), Juelich, Germany
| | - Oliver H. Winz
- Department of Nuclear Medicine, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Hans Herzog
- Research Centre Juelich, Institute of Neuroscience and Medicine (INM-4), Juelich, Germany
| | - Felix M. Mottaghy
- Department of Nuclear Medicine, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), Maastricht, Netherlands
- Juelich Aachen Research Alliance (JARA)—BRAIN, Juelich, Germany
| | - Ferdinand Binkofski
- Section Clinical Cognitive Sciences, Department of Neurology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Research Centre Juelich, Institute of Neuroscience and Medicine (INM-4), Juelich, Germany
- Juelich Aachen Research Alliance (JARA)—BRAIN, Juelich, Germany
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Prentice A, Kolken Y, Tuttle C, van Neijenhof J, Pitch R, van Oostrom I, Kruiver V, Downar J, Sack AT, Arns M, van der Vinne N. 1Hz right orbitofrontal TMS benefits depressed patients unresponsive to dorsolateral prefrontal cortex TMS. Brain Stimul 2023; 16:1572-1575. [PMID: 37839775 DOI: 10.1016/j.brs.2023.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/06/2023] [Accepted: 10/08/2023] [Indexed: 10/17/2023] Open
Affiliation(s)
- Amourie Prentice
- Research Institute Brainclinics, Brainclinics Foundation, Bijleveldsingel 32, 6524 AD, Nijmegen, Netherlands; Synaeda Research, Synaeda Psycho Medisch Centrum, De Opgang 2-1, 9203 GD, Drachten, Netherlands; Dept. of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, Netherlands
| | - Ylka Kolken
- Research Institute Brainclinics, Brainclinics Foundation, Bijleveldsingel 32, 6524 AD, Nijmegen, Netherlands; Dept. of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, Netherlands
| | - Christina Tuttle
- Long Island Neurocare Therapy, 1739 N. Ocean Ave. Suite A, Medford, NY, 11763, Long Island, USA
| | | | - Richard Pitch
- Long Island Neurocare Therapy, 1739 N. Ocean Ave. Suite A, Medford, NY, 11763, Long Island, USA
| | - Iris van Oostrom
- Neurocare Clinics, Bijleveldsingel 34, 6524 AD, Nijmegen, Netherlands
| | - Vera Kruiver
- Neurocare Clinics, Bijleveldsingel 34, 6524 AD, Nijmegen, Netherlands
| | - Jonathan Downar
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, 1 King's College Cir, Toronto, Ontario, M5S 1A8, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, 250 College Street 8th Floor. Toronto, Ontario, M5T 1R8, Canada
| | - Alexander T Sack
- Dept. of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, Netherlands
| | - Martijn Arns
- Research Institute Brainclinics, Brainclinics Foundation, Bijleveldsingel 32, 6524 AD, Nijmegen, Netherlands; Synaeda Research, Synaeda Psycho Medisch Centrum, De Opgang 2-1, 9203 GD, Drachten, Netherlands; Dept. of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, Netherlands
| | - Nikita van der Vinne
- Research Institute Brainclinics, Brainclinics Foundation, Bijleveldsingel 32, 6524 AD, Nijmegen, Netherlands; Synaeda Research, Synaeda Psycho Medisch Centrum, De Opgang 2-1, 9203 GD, Drachten, Netherlands; Dept. of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, Netherlands.
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6
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Herrmann T, Koeppel C, Linn J, Croy I, Hummel T. Olfactory brain activations in patients with Major Depressive Disorder. Sci Rep 2023; 13:10072. [PMID: 37344484 DOI: 10.1038/s41598-023-36783-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 06/09/2023] [Indexed: 06/23/2023] Open
Abstract
Depression is associated with reduced olfactory function. This relationship is assumed to be based on either a reduced olfactory bulb volume or diminished functioning of higher cortical areas. As previous results are controversial, we aimed to re-evaluate central olfactory processing in depression. We recorded the BOLD signal of 21 patients with Major Depressive Disorder and 21 age and gender matched healthy controls during odor presentation. In addition, we measured the individual olfactory bulb volume, tested odor identification and odor threshold, and asked for hedonic odor perception. In both groups, odor presentation led to a pronounced activation of primary olfactory areas. However, secondary olfactory areas were significantly less activated in depressed individuals. The two groups did not differ in olfactory bulb volume. Our results point towards altered olfactory processing in patients in those regions that relate to sensory integration and attention allocation. Difficulties in cognitive processing could impact olfactory function in depression. We are therefore in favor of a top-down mechanism originating in higher cortical areas explaining parts of the relation between depression and olfaction.
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Affiliation(s)
- Theresa Herrmann
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Dresden, Germany.
| | - Carina Koeppel
- Department of Clinical Psychology, Friedrich Schiller University, Jena, Germany
| | - Jennifer Linn
- Department of Neuroradiology, TU Dresden, Dresden, Germany
| | - Ilona Croy
- Department of Clinical Psychology, Friedrich Schiller University, Jena, Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Dresden, Germany
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7
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Karatum O, Han M, Erdogan ET, Karamursel S, Nizamoglu S. Physical mechanisms of emerging neuromodulation modalities. J Neural Eng 2023; 20:031001. [PMID: 37224804 DOI: 10.1088/1741-2552/acd870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/24/2023] [Indexed: 05/26/2023]
Abstract
One of the ultimate goals of neurostimulation field is to design materials, devices and systems that can simultaneously achieve safe, effective and tether-free operation. For that, understanding the working mechanisms and potential applicability of neurostimulation techniques is important to develop noninvasive, enhanced, and multi-modal control of neural activity. Here, we review direct and transduction-based neurostimulation techniques by discussing their interaction mechanisms with neurons via electrical, mechanical, and thermal means. We show how each technique targets modulation of specific ion channels (e.g. voltage-gated, mechanosensitive, heat-sensitive) by exploiting fundamental wave properties (e.g. interference) or engineering nanomaterial-based systems for efficient energy transduction. Overall, our review provides a detailed mechanistic understanding of neurostimulation techniques together with their applications toin vitro, in vivo, and translational studies to guide the researchers toward developing more advanced systems in terms of noninvasiveness, spatiotemporal resolution, and clinical applicability.
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Affiliation(s)
- Onuralp Karatum
- Department of Electrical and Electronics Engineering, Koc University, Istanbul 34450, Turkey
| | - Mertcan Han
- Department of Electrical and Electronics Engineering, Koc University, Istanbul 34450, Turkey
| | - Ezgi Tuna Erdogan
- Department of Physiology, Koc University School of Medicine, Istanbul 34450, Turkey
| | - Sacit Karamursel
- Department of Physiology, Koc University School of Medicine, Istanbul 34450, Turkey
| | - Sedat Nizamoglu
- Department of Electrical and Electronics Engineering, Koc University, Istanbul 34450, Turkey
- Department of Biomedical Science and Engineering, Koc University, Istanbul 34450, Turkey
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8
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Conde-Antón Á, Heranando-Garijo I, Jiménez-Del-Barrio S, Mingo-Gómez MT, Medrano-de-la-Fuente R, Ceballos-Laita L. Effects of transcranial direct current stimulation and transcranial magnetic stimulation in patients with fibromyalgia. A systematic review. Neurologia 2023:S2173-5808(23)00009-3. [PMID: 37031798 DOI: 10.1016/j.nrleng.2020.07.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 07/19/2020] [Indexed: 04/11/2023] Open
Abstract
BACKGROUND Fibromyalgia syndrome (FM) is a chronic pathology characterized by widespread pain commonly associated with psychological distress affecting quality of life. In recent years, transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) have been investigated to treat chronic pain. The aim of the current review is to determine the effects of tDCS and TMS on the main symptoms of patients with FM. DEVELOPMENT A systematic review based on PRISMA guidelines was carried out. The search strategy was performed in MEDLINE, SCOPUS, PEDro and Cochrane Library. Randomized controlled trials based on the effects of tDCS and TMS on pain, pressure pain threshold (PPT), fatigue, anxiety and depression, catastrophizing and quality of life in patients with FM were analysed. Fourteen studies were included. CONCLUSIONS The application of tDCS to the motor cortex is the only intervention shown to decrease pain in the short and medium-term in patients with FM. The application of both interventions showed improvements in PPT, catastrophizing and quality of life when applied to the motor cortex, and in fatigue when applied to the dorsolateral prefrontal cortex. The effects of these interventions on anxiety and depression are unclear.
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Affiliation(s)
- Ángela Conde-Antón
- Facultad de Fisioterapia, Universidad de Valladolid, c/Universidad s/n Soria, Spain.
| | | | | | | | | | - Luis Ceballos-Laita
- Facultad de Fisioterapia, Universidad de Valladolid, c/Universidad s/n Soria, Spain.
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9
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Alawi M, Lee PF, Deng ZD, Goh YK, Croarkin PE. Modelling the differential effects of age on transcranial magnetic stimulation induced electric fields. J Neural Eng 2023; 20. [PMID: 36240726 DOI: 10.1088/1741-2552/ac9a76] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 10/14/2022] [Indexed: 11/11/2022]
Abstract
Objective. The therapeutic application of noninvasive brain stimulation modalities such as transcranial magnetic stimulation (TMS) has expanded in terms of indications and patient populations. Often neurodevelopmental and neurodegenerative changes are not considered in research studies and clinical applications. This study sought to examine TMS dosing across time points in the life cycle.Approach. TMS induced electric fields with a figure-of-eight coil was simulated at left dorsolateral prefrontal cortex regions and taken in vertex as a control region. Realistic magnetic resonance imaging-based head models (N= 48) were concurrently examined in a cross-sectional study of three different age groups (children, adults, and elderlies).Main results. Age had a negative correlation with electric field peaks in white matter, grey matter and cerebrospinal fluid (P< 0.001). Notably, the electric field map in children displayed the widest cortical surface spread of TMS induced electric fields.Significance. Age-related anatomical geometry beneath the coil stimulation site had a significant impact on the TMS induced electric fields for different age groups. Safety considerations for TMS applications and protocols in children are warranted based on the present electric field findings.
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Affiliation(s)
- Mansour Alawi
- Lee Kong Chian Faculty of Engineering & Science, University Tunku Abdul Rahman, Kajang, Malaysia
| | - Poh Foong Lee
- Lee Kong Chian Faculty of Engineering & Science, University Tunku Abdul Rahman, Kajang, Malaysia
| | - Zhi-De Deng
- Noninvasive Neuromodulation Unit, National Institute of Mental Health, NIH, Bethesda, MD, United States of America
| | - Yong Kheng Goh
- Lee Kong Chian Faculty of Engineering & Science, University Tunku Abdul Rahman, Kajang, Malaysia
| | - Paul E Croarkin
- Department of Psychiatry and Psychology, Mayo Clinic, Minnesota, MN, United States of America
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10
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Bateni H, Soltani E, Ali K, Zhou H, Shad MU. Effect of transcranial magnetic stimulation on postural control of individuals with major depressive disorder: A case report. SAGE Open Med Case Rep 2023; 11:2050313X231153757. [PMID: 36816824 PMCID: PMC9932753 DOI: 10.1177/2050313x231153757] [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: 08/10/2022] [Accepted: 01/09/2023] [Indexed: 02/16/2023] Open
Abstract
Accidental falls and major depressive disorder (MDD) are two common conditions associated with aging. Initial treatment of MDD often starts with administering antidepressants, followed by transcranial magnetic stimulation (TMS) for treatment-resistant individuals. The purpose of this case study was to determine the effect of repetitive TMS (rTMS) on postural control of an individual with MDD. A 44-year-old male with recurrent severe MDD was assessed for postural balance during eyes closed and eyes open conditions, pre and post three consecutive sessions receiving high-frequency rTMS (NeuroStar). Total excursion and velocity of sway significantly decreased following rTMS treatment when eyes were closed (p < 0.05). Power of the sway changed, but the changes were not statistically significant. The fractal dimension confidence circle area decreased significantly in eyes closed trials (p < 0.05). It appears that rTMS application can potentially impact postural steadiness in individuals with MDD. Our results warrant further studies with larger study samples.
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Affiliation(s)
- Hamid Bateni
- Physical Therapy Program, Northern
Illinois University, DeKalb, IL, USA,Hamid Bateni, Physical Therapy Program,
Northern Illinois University, 1425 W. Lincoln Hwy, DeKalb, IL 60115-2828, USA.
| | - Elham Soltani
- Psychiatry Program, The Valley Health
System, Las Vegas, NV, USA
| | - Kishwar Ali
- General Psychiatry Services, Aurora,
IL, USA
| | - Haiming Zhou
- Department of Statistics and Actuarial
Science, Northern Illinois University, DeKalb, IL, USA
| | - Mujeeb U Shad
- The Valley Health System, Las Vegas,
NV, USA,University of Nevada Las Vegas, Las
Vegas, NV, USA,Touro University Nevada College of
Osteopathic Medicine, Las Vegas, NV, USA
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11
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Hadden LM, Penny H, Jones AL, Partridge AM, Lancaster TM, Allen C. Pre-frontal stimulation does not reliably increase reward responsiveness. Cortex 2023; 159:268-285. [PMID: 36669446 PMCID: PMC10823575 DOI: 10.1016/j.cortex.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/17/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022]
Abstract
Depression is the leading cause of disability worldwide and its effects can be fatal, with over 800,000 people dying by suicide each year. Neuromodulatory treatments such as transcranial magnetic stimulation (TMS) are being used to treat depression. Despite its endorsement by two regulatory bodies: NICE (2016) and the FDA (2008), there are major questions about the treatment efficacy and biological mechanisms of TMS. Ahn et al.'s (2013) justified the use of TMS in a clinical context in an important study indicating that excitatory TMS increases reward responsiveness. A pseudo-replication of this study by Duprat et al., (2016) also found a similar effect of active TMS, but only with the addition of an exploratory covariate to the analyses-trait reward responsiveness. Here we replicate Ahn et al.'s (2013) key study, and to test the reliability of the effects, and their dependency on trait reward responsiveness as described by Duprat et al., (2016). Using excitatory and sham TMS, we tested volunteers using the probabilistic learning task to measure their reward responsiveness both before and after stimulation. We also examined affect (positive, negative) following stimulation. Irrespective of TMS, the task was shown to be sensitive to reward responsiveness. However, we did not show TMS to be effective in increasing reward responsiveness and we did not replicate Ahn et al., (2013) or Duprat et al., (2016)'s key findings for TMS efficacy, where we provide evidence favouring the null. Moreover, exploratory analyses suggested following active stimulation, positive affect was reduced. Given our findings, we question the basic effects, which support the use of TMS for depression, particularly considering potential deleterious effects of reduced positive affect in patients with depression.
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Affiliation(s)
- L M Hadden
- Cardiff University, School of Psychology, Tower Building, Park Place, Cardiff, CF10 3AT, UK
| | - H Penny
- Cardiff University, School of Psychology, Tower Building, Park Place, Cardiff, CF10 3AT, UK; Aneurin Bevan University Health Board, St Cadoc's Hospital, Lodge Road, Caerleon, NP18 3XQ, UK
| | - A L Jones
- School of Psychology, Faculty of Medicine, Health, and Life Sciences, Singleton Park, Swansea University, SA2 8PP, UK
| | - A M Partridge
- University of Sheffield, Research Services, New Spring House, 231 Glossop Road, Sheffield, S10 2GW, UK
| | - T M Lancaster
- Cardiff University, School of Psychology, Tower Building, Park Place, Cardiff, CF10 3AT, UK; University of Bath, Department of Psychology, Claverton Down, BA2 7AY, UK
| | - C Allen
- Cardiff University, School of Psychology, Tower Building, Park Place, Cardiff, CF10 3AT, UK; Department of Psychology, Durham University, Durham, DH1 3LE, UK.
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12
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Zaitsev OS, Poddubskaya AA, Tomskiy AA, Gamaleya AA, Maksakova OA, Potapov IV, Tsukarzi EE, Mosolov SN. Patients selection for psychiatric neurosurgery: pitfalls and considerations. PROGRESS IN BRAIN RESEARCH 2022; 272:173-183. [PMID: 35667801 DOI: 10.1016/bs.pbr.2022.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Neurosurgical interventions (destructive or neuromodulation) are considered as a therapeutic option for patients with treatment resistant mental disorders. However, the issues of indications and contraindications for psychiatric surgery, method and patient selection remain unresolved. This article discusses possible problems and contradictions in the selection of patients, the need for an interdisciplinary team to work to solve the question of the feasibility of using neurosurgical methods. The authors have identified the main problems that increase the risks of selection and lead to a lack of results or low efficiency of neurosurgical intervention, namely: (1) diagnostic errors or inaccuracies; (2) inconclusive data on therapeutic resistance; (3) lack of a common understanding of the goals and desired results among participants in the selection of patients for neurosurgery. Possible predictors of surgical outcome and ethical issues are also discussed. Neurosurgical interventions as a treatment option for psychiatric disorders are not officially approved in most countries. So an appropriate algorithm for patient selection and clear criteria for outcome measures are needed.
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Affiliation(s)
- Oleg S Zaitsev
- Burdenko National Medical Research Center of Neurosurgery, Moscow, Russian Federation.
| | - Anna A Poddubskaya
- Department of Functional Neurosurgery, Burdenko National Medical Research Center of Neurosurgery, Moscow, Russian Federation
| | - Alexey A Tomskiy
- Department of Functional Neurosurgery, Burdenko National Medical Research Center of Neurosurgery, Moscow, Russian Federation
| | - Anna A Gamaleya
- Department of Functional Neurosurgery, Burdenko National Medical Research Center of Neurosurgery, Moscow, Russian Federation
| | - Olga A Maksakova
- Department of Functional Neurosurgery, Burdenko National Medical Research Center of Neurosurgery, Moscow, Russian Federation
| | - Igor V Potapov
- Department of Functional Neurosurgery, Burdenko National Medical Research Center of Neurosurgery, Moscow, Russian Federation
| | - Eduard E Tsukarzi
- Moscow Research Institute of Psychiatry, Serbsky National Medical Research Center of Psychiatry and Narcology, Moscow, Russian Federation
| | - Sergey N Mosolov
- Moscow Research Institute of Psychiatry, Serbsky National Medical Research Center of Psychiatry and Narcology, Moscow, Russian Federation
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13
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Mallon S, Walker K, Bayley Z, Griffiths C. Practitioner perspectives on best practice in non-treatment factors that support the delivery of repetitive transcranial magnetic stimulation (rTMS) for depression. J Psychiatr Ment Health Nurs 2022; 29:463-471. [PMID: 34958704 PMCID: PMC9303925 DOI: 10.1111/jpm.12815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 10/01/2021] [Accepted: 12/17/2021] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN ABOUT THE SUBJECT?: The practices of mental health nurses in the administration of repetitive transcranial magnetic stimulation (rTMS) treatments for depression in outpatient clinic are crucial for patient outcomes To date, most research has focused directly on procedural aspects of treatment delivery with limited focus on the delivery of holistic care and treatment. There is a lack of best practice guidance based on the experiences of those involved in clinical delivery to inform and improve rTMS practices WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This study provides unique insights into service and personalized non-treatment factors associated with rTMS delivery that may reduce stress and improve the experiences of rTMS patients It reviews and updates understanding of the factors that contribute to the delivery of effective rTMS. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The need to apply findings for the development of best practice guidance Factors to improve practice include (a) rTMS machine demonstrations; (b) constructive, individualized, friendly, and therapeutic conversations; (c) a relaxing, comfortable, 'homely' physical environment; (d) long term supportive management; and (e) careful engagement of nursing and support staff.
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Affiliation(s)
| | - Kate Walker
- Northamptonshire Healthcare NHS Foundation Trust, Northampton, UK
| | | | - Chris Griffiths
- Northamptonshire Healthcare NHS Foundation Trust, Northampton, UK
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14
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Griffiths DC, da Silva DKM, Leathlean C, Jiang H, Ang DCS, Searle R. Investigation of physical activity, sleep, and mental health recovery in treatment resistant depression (TRD) patients receiving repetitive transcranial magnetic stimulation (rTMS) treatment. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022; 8:100337. [PMID: 35619990 PMCID: PMC9025392 DOI: 10.1016/j.jadr.2022.100337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 02/12/2022] [Accepted: 03/15/2022] [Indexed: 11/25/2022] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is effective in treating depression; however, the effect on physical activity, sleep and recovery is unclear. PHQ-9, GAD-7 and ReQol scores significantly improved with large effect sizes. Fitbit activity and sleep results werenon-significant. Improvements on the ReQoL and aspects of sleep and activity indicate the positive impact of rTMS on functioning and quality of life.
Background Methods Results Limitations Conclusions
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15
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Jannati A, Ryan MA, Kaye HL, Tsuboyama M, Rotenberg A. Biomarkers Obtained by Transcranial Magnetic Stimulation in Neurodevelopmental Disorders. J Clin Neurophysiol 2022; 39:135-148. [PMID: 34366399 PMCID: PMC8810902 DOI: 10.1097/wnp.0000000000000784] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
SUMMARY Transcranial magnetic stimulation (TMS) is a method for focal brain stimulation that is based on the principle of electromagnetic induction where small intracranial electric currents are generated by a powerful fluctuating magnetic field. Over the past three decades, TMS has shown promise in the diagnosis, monitoring, and treatment of neurological and psychiatric disorders in adults. However, the use of TMS in children has been more limited. We provide a brief introduction to the TMS technique; common TMS protocols including single-pulse TMS, paired-pulse TMS, paired associative stimulation, and repetitive TMS; and relevant TMS-derived neurophysiological measurements including resting and active motor threshold, cortical silent period, paired-pulse TMS measures of intracortical inhibition and facilitation, and plasticity metrics after repetitive TMS. We then discuss the biomarker applications of TMS in a few representative neurodevelopmental disorders including autism spectrum disorder, fragile X syndrome, attention-deficit hyperactivity disorder, Tourette syndrome, and developmental stuttering.
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Affiliation(s)
- Ali Jannati
- Neuromodulation Program and Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- F.M. Kirby Neurobiology Center, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Mary A. Ryan
- Neuromodulation Program and Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Harper Lee Kaye
- Behavioral Neuroscience Program, Division of Medical Sciences, Boston University School of Medicine, Boston, USA
| | - Melissa Tsuboyama
- Neuromodulation Program and Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Alexander Rotenberg
- Neuromodulation Program and Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- F.M. Kirby Neurobiology Center, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
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16
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Carvalho E, Morais M, Ferreira H, Silva M, Guimarães S, Pêgo A. A paradigm shift: Bioengineering meets mechanobiology towards overcoming remyelination failure. Biomaterials 2022; 283:121427. [DOI: 10.1016/j.biomaterials.2022.121427] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 01/31/2022] [Accepted: 02/17/2022] [Indexed: 12/14/2022]
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17
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Pateraki G, Anargyros K, Aloizou AM, Siokas V, Bakirtzis C, Liampas I, Tsouris Z, Ziogka P, Sgantzos M, Folia V, Peristeri E, Dardiotis E. Therapeutic application of rTMS in neurodegenerative and movement disorders: A review. J Electromyogr Kinesiol 2021; 62:102622. [PMID: 34890834 DOI: 10.1016/j.jelekin.2021.102622] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 11/08/2021] [Accepted: 11/22/2021] [Indexed: 12/11/2022] Open
Abstract
Transcranial magnetic stimulation (TMS) is a non-invasive form of brain stimulation that makes use of the magnetic field generated when an electric current passes through a magnetic coil placed over the scalp. It can be applied as a single stimulus at a time, in pairs of stimuli, or repetitively in trains of stimuli (repetitive TMS, rTMS). RTMS can induce changes in brain activity, whose after-effects reflect the processes of long-term potentiation and long-term depression, as certain protocols, namely those using low frequencies (≤1 Hz) seem to suppress cortical excitability, while those using high frequencies (>1 Hz) seem to enhance it. It is a technique with very few and mostly mild side-effects, whose effects can persist for long time periods, and as such, it has been studied as a potential treatment option in a multitude of neurodegenerative diseases, including those affecting movement. Although rTMS has received approval as a treatment strategy of only a few aspects in movement disorders in the latest guidelines, its further use seems to also be promising in their context. In this review, we gathered the available literature on the therapeutic application of rTMS in movement disorders, namely Parkinson's disease, Amyotrophic Lateral Sclerosis, Huntington's disease, Dystonia, Tic disorders and Essential Tremor.
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Affiliation(s)
- Georgia Pateraki
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Konstantinos Anargyros
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Athina-Maria Aloizou
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Vasileios Siokas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Christos Bakirtzis
- B' Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Liampas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Zisis Tsouris
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Pinelopi Ziogka
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Markos Sgantzos
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Vasiliki Folia
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Eleni Peristeri
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece.
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18
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Muratore AF, Bershad M, Steinglass JE, Foerde KE, Gianini L, Broft A, Attia E. Use of high-frequency repetitive transcranial magnetic stimulation to probe the neural circuitry of food choice in anorexia nervosa: A proof-of-concept study. Int J Eat Disord 2021; 54:2031-2036. [PMID: 34415081 PMCID: PMC9126092 DOI: 10.1002/eat.23597] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 11/07/2022]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is used to modulate neural systems and provides the opportunity for experimental tests of hypotheses regarding mechanisms underlying anorexia nervosa (AN). The present pilot study has investigated whether high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) to a region of the right dorsolateral prefrontal cortex (DLPFC) might be associated with change in food selection among adult inpatients with AN. Ten women received one session of sham and one session of HF-rTMS targeting the right DLPFC while completing a computerized Food Choice Task. Compared to sham, HF-rTMS was associated with changes in food ratings and food choice: inpatients reported higher healthiness ratings of low- and high-fat foods and selected a significantly greater proportion of high-fat foods over a neutrally rated reference item while receiving HF-rTMS. Findings suggest that HF-rTMS to the right DLPFC was associated with a reduction of fat avoidance on a food choice task among inpatients with AN and provide additional support for the possibility that this region, and related neural circuits, may underlie restrictive food choice. Research using rTMS to experimentally test neural mechanisms is needed to elucidate the underpinnings of AN and supports the development of novel treatment targets.
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Affiliation(s)
- Alexandra F. Muratore
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Mariya Bershad
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Joanna E. Steinglass
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Karin E. Foerde
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Loren Gianini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Allegra Broft
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Evelyn Attia
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
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19
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Pallanti S, Marras A, Dickson SL, Adan RA, Vieta E, Dell Osso B, Arango C, Fusar-Poli P, Soriano-Mas C, Carmi L, Meyer Lindenberg A, Zohar J. Manifesto for an ECNP Neuromodulation Thematic Working Group (TWG): Non-invasive brain stimulation as a new Super-subspecialty. Eur Neuropsychopharmacol 2021; 52:72-83. [PMID: 34348181 DOI: 10.1016/j.euroneuro.2021.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 07/03/2021] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
Non-Invasive Brain Stimulation (NIBS) techniques and in particular, repetitive Transcranial Magnetic Stimulation (rTMS), are developing beyond mere clinical application. Although originally purposed for the treatment of resistant neuropsychiatric disorders, NIBS is also contributing to a deeper understanding of psychiatric disorders. rTMS is also changing the model of the disorder itself, from "mental" to one of neural connectivity. TMS allows the assessment of brain circuit excitability and eventually, of plastic changes affecting these circuits. While a clinical translational approach is, at the present time, the most adequate to meet the dimensional-circuit base model of the disorder, it refines the standard categorical classification of psychiatric disorders. The discovery of the fundamental importance of the balance between neuroplasticity and inflammation is also now explored through neuro-modulation findings consistently with the evidence of anti-inflammatory actions of the magnetic pulses. rTMS may activate, inhibit, or otherwise interfere with the activity of neuronal cortical networks, depending on stimulus frequency and intensity of brain-induced electric field. Of particular interest, yet still unclear, is how the relatively unspecific nature of TMS stimulation may lead to specific neuronal reorganization, as well as a definition of the TMS-triggered reorganization of functional brain modules, raising attention on the importance of the active participation of the patient to the treatment.. Configuration and state of consciousness of the subject have made subjective experience under treatment regain importance in the neuro-scientific Psychiatry based on the requirement of United States National Institute of Health (NIH) and the substantial importance of the consciousness state in the efficacy of the TMS treatment. By focusing on the subjective experience, a renaissance of the phenomenology offers Psychiatry an opportunity to become proficient and to distinguish itself from other disciplines. For all these reasons, TMS should be included in the cluster of the sub-specialties as a new "Super-Specialty" and an appropriate training course has to be inaugurated. Psychiatrists are nowadays multi-specialists, moving from a specialty to another, vs super-specialist. The cultivation of a properly trained cohort of TMS psychiatrists will better meet the challenges of treatment-resistant psychiatric conditions (disorders of connectivity), through appropriate and ethical practice, meanwhile facilitating an informed development and integration of additional emerging neuro-modulation techniques. The aim of this consensus paper is to underline the interdisciplinary nature of NIBS, that also encompasses the subjective experience and to point out the necessity of a neuroscience-applied approach to NIBS in the context of the European College of Neuro-psychopharmacology (ECNP).
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Affiliation(s)
- Stefano Pallanti
- Istituto di Neuroscienze, Florence, IT; Albert Einstein College of Medicine and Montefiore Medical Center, NY, USA.
| | - Anna Marras
- Istituto di Neuroscienze, Florence, IT; Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, IT
| | - Suzanne L Dickson
- Department of Physiology/Endocrine, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - Roger Ah Adan
- Department of Translational Neuroscience, UMCU Brain Center, University Medical Center Utrecht, Utrecht University, The Netherlands; Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - Eduard Vieta
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Bernardo Dell Osso
- Ospedale Sacco-Polo Universitario, Psychiatric Clinic, Milano; University of Milano, IT
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid 28009, Spain
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) lab, Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan. Aldo Ravelli' Research Center for Neurotechnology and Experimental Brain Therapeutics, Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Health Sciences, University of Milan, Milan, Italy; Department of Psychiatry and Brain and Behavioral Sciences, Stanford University, California, USA. of Pavia, Pavia, Italy
| | - Carles Soriano-Mas
- Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Service, Bellvitge University Hospital and CIBERSAM,Barcelona, Spain. Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona, Spain
| | - Lior Carmi
- Academic Laboratory Manager, The National Institute of PTSD, Chaim Sheba Medical Center, School Of Psychological sciences, Tel Aviv University, Israel
| | - Andreas Meyer Lindenberg
- Central Institute of Mental Health, Mannheim; Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Chair of Psychiatry and Psychotherapy, University of Heidelberg, Germany
| | - Joseph Zohar
- Sheba Medical Center at Tel Hashomer, Israel, Sackler Faculty of Medicine, Tel Aviv
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20
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Cheng P, Zhou Y, Xu LZ, Chen YF, Hu RL, Zou YL, Li ZX, Zhang L, Shun Q, Yu X, Li LJ, Li WH. Clinical application of repetitive transcranial magnetic stimulation for post-traumatic stress disorder: A literature review. World J Clin Cases 2021; 9:8658-8665. [PMID: 34734044 PMCID: PMC8546820 DOI: 10.12998/wjcc.v9.i29.8658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/30/2021] [Accepted: 08/20/2021] [Indexed: 02/06/2023] Open
Abstract
The efficacy of traditional treatment for post-traumatic stress disorder (PTSD) is still unsatisfactory. Repetitive transcranial magnetic stimulation (rTMS) has been widely used in the treatment of various types of mental disorders, including PTSD. Although rTMS has been demonstrated to be effective in many cases, there are still arguments regarding its mechanism and protocol. This review aims to summarize the origin, development, principle, and future direction of rTMS and introduce this neuro-stimulation therapy to relevant clinicians.
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Affiliation(s)
- Peng Cheng
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Ying Zhou
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Li-Zhi Xu
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Ya-Fei Chen
- Xiangya Medical School, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
| | - Ruo-Lin Hu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Yi-Ling Zou
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Ze-Xuan Li
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Li Zhang
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Qi Shun
- Research Center for Brain Science and Human-like Intelligence, Xi’an Jiaotong University, Xi’an 710049, Shannxi Province, China
| | - Xun Yu
- Product Department, Solide Brain Medical Technology, Ltd., Xi’an 710043, Shannxi Province, China
| | - Ling-Jiang Li
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Wei-Hui Li
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
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21
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Ma KH, Cheng CY, Chan WH, Chen SY, Kao LT, Sung CS, Hueng DY, Yeh CC. Pulsed Radiofrequency Upregulates Serotonin Transporters and Alleviates Neuropathic Pain-Induced Depression in a Spared Nerve Injury Rat Model. Biomedicines 2021; 9:biomedicines9101489. [PMID: 34680606 PMCID: PMC8533300 DOI: 10.3390/biomedicines9101489] [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: 09/27/2021] [Revised: 10/10/2021] [Accepted: 10/14/2021] [Indexed: 02/06/2023] Open
Abstract
Neuropathic pain (NP) is difficult to treat due to complex pathophysiological mechanisms. Pulsed radiofrequency (RRF) has been used widely with neuromodulation effect in refractory chronic pain treatment. A recent study found that PRF treatment may decrease chronic pain-related anxiety-depressant symptoms in patients, even though the mechanisms are unclear. Additionally, accumulated evidence has shown serotonin uptake is correlated with various neuropsychiatric diseases. Therefore, we investigated the effects and underlying mechanisms of PRF on depression-like behaviors, resulting from spared nerve injury (SNI)-induced NP. We examined the indexes of mechanical allodynia, cold allodynia, depression-like behavior, and blood cytokines by dynamic plantar aesthesiometry, acetone spray test, forced swimming test, and ProcartaPlex multiplex immunoassays in male Wistar rats, respectively. Serotonin transporters (SERTs) in rat brains were examined by using 4-[18F]-ADAM/PET imaging. We found that specific uptake ratios (SURs) of SERTs were significantly decreased in the brain regions of the thalamus and striatum in rats with SNI-induced NP and depression-like behaviors. Additionally, the decrease in SERT density was correlated with the development of a depression-like behavior indicated by the forced swimming test results and pronounced IL-6 cytokines. Moreover, we demonstrated that PRF application could modulate the descending serotoninergic pathway to relieve pain and depression behaviors.
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Affiliation(s)
- Kuo-Hsing Ma
- Department of Biology and Anatomy, National Defense Medical Center, Taipei 115, Taiwan;
| | - Cheng-Yi Cheng
- Department of Nuclear Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 115, Taiwan;
| | - Wei-Hung Chan
- Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei 115, Taiwan; (W.-H.C.); (S.-Y.C.)
| | - Shih-Yu Chen
- Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei 115, Taiwan; (W.-H.C.); (S.-Y.C.)
| | - Li-Ting Kao
- Department of Pharmacy Practice, Tri-Service General Hospital, National Defense Medical Center, Taipei 115, Taiwan;
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 115, Taiwan
| | - Chun-Sung Sung
- Department of Anesthesiology, Taipei Veterans General Hospital, Taipei 112, Taiwan;
- School of Medicine, National Yang-Ming Chiao-Tung University, Taipei 112, Taiwan
| | - Dueng-Yuan Hueng
- Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 115, Taiwan;
| | - Chun-Chang Yeh
- Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei 115, Taiwan; (W.-H.C.); (S.-Y.C.)
- Integrated Pain Management Center, Tri-Service General Hospital, National Defense Medical Center, Taipei 115, Taiwan
- Correspondence:
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22
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Kim HC, Lee W, Kunes J, Yoon K, Lee JE, Foley L, Kowsari K, Yoo SS. Transcranial focused ultrasound modulates cortical and thalamic motor activity in awake sheep. Sci Rep 2021; 11:19274. [PMID: 34588588 PMCID: PMC8481295 DOI: 10.1038/s41598-021-98920-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 09/08/2021] [Indexed: 11/09/2022] Open
Abstract
Transcranial application of pulsed low-intensity focused ultrasound (FUS) modulates the excitability of region-specific brain areas, and anesthetic confounders on brain activity warrant the evaluation of the technique in awake animals. We examined the neuromodulatory effects of FUS in unanesthetized sheep by developing a custom-fit headgear capable of reproducibly placing an acoustic focus on the unilateral motor cortex (M1) and corresponding thalamic area. The efferent responses to sonication, based on the acoustic parameters previously identified in anesthetized sheep, were measured using electromyography (EMG) from both hind limbs across three experimental conditions: on-target sonication, off-target sonication, and without sonication. Excitatory sonication yielded greater amplitude of EMG signals obtained from the hind limb contralateral to sonication than that from the ipsilateral limb. Spurious appearance of motion-related EMG signals limited the amount of analyzed data (~ 10% selection of acquired data) during excitatory sonication, and the averaged EMG response rates elicited by the M1 and thalamic stimulations were 7.5 ± 1.4% and 6.7 ± 1.5%, respectively. Suppressive sonication, while sheep walked on the treadmill, temporarily reduced the EMG amplitude from the limb contralateral to sonication. No significant change was found in the EMG amplitudes during the off-target sonication. Behavioral observation throughout the study and histological analysis showed no sign of brain tissue damage caused by the acoustic stimulation. Marginal response rates observed during excitatory sonication call for technical refinement to reduce motion artifacts during EMG acquisitions as well as acoustic aberration correction schemes to improve spatial accuracy of sonication. Yet, our results indicate that low-intensity FUS modulated the excitability of regional brain tissues reversibly and safely in awake sheep, supporting its potential in theragnostic applications.
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Affiliation(s)
- Hyun-Chul Kim
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Wonhye Lee
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Jennifer Kunes
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Kyungho Yoon
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Ji Eun Lee
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Lori Foley
- Translational Discovery Laboratory, Brigham and Women's Hospital, Boston, MA, USA
| | - Kavin Kowsari
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Seung-Schik Yoo
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
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23
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Rubia K, Westwood S, Aggensteiner PM, Brandeis D. Neurotherapeutics for Attention Deficit/Hyperactivity Disorder (ADHD): A Review. Cells 2021; 10:cells10082156. [PMID: 34440925 PMCID: PMC8394071 DOI: 10.3390/cells10082156] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/07/2021] [Accepted: 08/18/2021] [Indexed: 01/19/2023] Open
Abstract
This review focuses on the evidence for neurotherapeutics for attention deficit/hyperactivity disorder (ADHD). EEG-neurofeedback has been tested for about 45 years, with the latest meta-analyses of randomised controlled trials (RCT) showing small/medium effects compared to non-active controls only. Three small studies piloted neurofeedback of frontal activations in ADHD using functional magnetic resonance imaging or near-infrared spectroscopy, finding no superior effects over control conditions. Brain stimulation has been applied to ADHD using mostly repetitive transcranial magnetic and direct current stimulation (rTMS/tDCS). rTMS has shown mostly negative findings on improving cognition or symptoms. Meta-analyses of tDCS studies targeting mostly the dorsolateral prefrontal cortex show small effects on cognitive improvements with only two out of three studies showing clinical improvements. Trigeminal nerve stimulation has been shown to improve ADHD symptoms with medium effect in one RCT. Modern neurotherapeutics are attractive due to their relative safety and potential neuroplastic effects. However, they need to be thoroughly tested for clinical and cognitive efficacy across settings and beyond core symptoms and for their potential for individualised treatment.
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Affiliation(s)
- Katya Rubia
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neurosciences, King’s College London, De Crespigny Park, London SE5 8AF, UK;
- Department of Social Genetics and Developmental Psychiatry, Institute of Psychiatry, Psychology & Neurosciences, King’s College London, De Crespigny Park, London SE5 8AF, UK
- Department of Child & Adolescent Psychiatry, Transcampus, Dresden University, 01307 Dresden, Germany
- Correspondence:
| | - Samuel Westwood
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neurosciences, King’s College London, De Crespigny Park, London SE5 8AF, UK;
- Department of Social Genetics and Developmental Psychiatry, Institute of Psychiatry, Psychology & Neurosciences, King’s College London, De Crespigny Park, London SE5 8AF, UK
- Department of Psychology, Wolverhampton University, Wolverhampton WV1 1LY, UK
| | - Pascal-M. Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, 68159 Mannheim, Germany; (P.-M.A.); (D.B.)
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, 68159 Mannheim, Germany; (P.-M.A.); (D.B.)
- Department of Child and Adolescent Psychiatry and Psychotherapy, Hospital of Psychiatry, Psychiatric Hospital University, University of Zürich, 8032 Zürich, Switzerland
- Neuroscience Center Zürich, Swiss Federal Institute of Technology and University of Zürich, 8057 Zürich, Switzerland
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24
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Guo H, Baker G, Hartle K, Fujiwara E, Wang J, Zhang Y, Xing J, Lyu H, Li XM, Chen J. Exploratory study on neurochemical effects of low-intensity pulsed ultrasound in brains of mice. Med Biol Eng Comput 2021; 59:1099-1110. [PMID: 33881705 DOI: 10.1007/s11517-021-02351-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 03/19/2021] [Indexed: 01/25/2023]
Abstract
There is now a relatively large body of evidence suggesting a relationship between dysfunction of myelin and oligodendrocytes and the etiology of several neuropsychiatric disorders, including depression and schizophrenia, and also suggesting that ultrasound methods may alleviate some of the symptoms of depression. We have applied low-intensity pulsed ultrasound (LIPUS) to the brains of mice treated with the demyelinating drug cuprizone, a drug that has been used as the basis for a rodent model relevant to a number of psychiatric and neurologic disorders including depression, schizophrenia, and multiple sclerosis. Prior to conducting the studies in mice, preliminary studies were carried out on the effects of LIPUS in vitro in neuron-like SH-SY5Y cells and primary glial cells. In subsequent studies in mice, female C57BL/6 mice were restrained in plastic tubes for 20 min daily with the ultrasound transducer near the end of the tube directly above the mouse's head. LIPUS was used at an intensity of 25 mW/cm2 once daily for 22 days in control mice and in mice undergoing daily repetitive restraint stress (RRS). Behavioral or neurochemical studies were done on the mice or the brain tissue obtained from them. The studies in vitro indicated that LIPUS stimulation at an intensity of 15 mW/cm2 delivered for 5 min daily for 3 days in an enclosed sterile cell culture plate in an incubator increased the viability of SH-SY5Y and primary glial cells. In the studies in mice, LIPUS elevated levels of doublecortin, a marker for neurogenesis, in the cortex compared to levels in the RRS mice and caused a trend in elevation of brain levels of brain-derived neurotrophic factor in the hippocampus relative to control levels. LIPUS also increased sucrose preference (a measure of the attenuation of anhedonia, a common symptom of several psychiatric disorders) in the RRS model in mice. The ability of LIPUS administered daily to rescue damaged myelin and oligodendrocytes was studied in mice treated chronically with cuprizone for 35 days. LIPUS increased cortex and corpus callosum levels of myelin basic protein, a protein marker for mature oligodendrocytes, and neural/glial antigen 2, a protein marker for oligodendrocyte precursor cells, relative to levels in the cuprizone + sham animals. These results of this exploratory study suggest that future comprehensive time-related studies with LIPUS on brain chemistry and behavior related to neuropsychiatric disorders are warranted. Exploratory Study on Neurochemical Effects of Low Intensity Pulsed Ultrasound in Brains of Mice. Upper part of figure: LIPUS device and in-vitro cell experimental set-up. The center image is the LIPUS generating box; the image in the upper left shows the cell experiment set-up; the image in the upper right shows a zoomed-in sketch for the cell experiment; the image in the lower left shows the set-up of repetitive restraint stress (RRS) with a mouse; the image in the lower middle shows the set-up of LIPUS treatment of a mouse; the image in the lower right shows a zoomed-in sketch for the LIPUS treatment of a mouse.
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Affiliation(s)
- Huining Guo
- Department of Psychiatry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, TGG 2B7, Canada
| | - Glen Baker
- Department of Psychiatry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, TGG 2B7, Canada.,Neuroscience & Mental Health Institute, University of Alberta, Edmonton, AB, Canada
| | - Kelly Hartle
- Department of Psychiatry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, TGG 2B7, Canada.,Neuroscience & Mental Health Institute, University of Alberta, Edmonton, AB, Canada
| | - Esther Fujiwara
- Department of Psychiatry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, TGG 2B7, Canada.,Neuroscience & Mental Health Institute, University of Alberta, Edmonton, AB, Canada
| | - Junhui Wang
- Department of Psychiatry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, TGG 2B7, Canada
| | - Yanbo Zhang
- Department of Psychiatry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, TGG 2B7, Canada.,Neuroscience & Mental Health Institute, University of Alberta, Edmonton, AB, Canada
| | - Jida Xing
- Department of Electrical and Computer Engineering, Faculty of Engineering, University of Alberta, Edmonton, Canada
| | - Haiyan Lyu
- Department of Pharmacy, Xianyue Hospital, Xiamen, China
| | - Xin-Min Li
- Department of Psychiatry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, TGG 2B7, Canada. .,Neuroscience & Mental Health Institute, University of Alberta, Edmonton, AB, Canada.
| | - Jie Chen
- Department of Electrical and Computer Engineering, Faculty of Engineering, University of Alberta, Edmonton, Canada. .,Department of Biomedical Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB, T6G 1H9, Canada.
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25
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Velioglu HA, Hanoglu L, Bayraktaroglu Z, Toprak G, Guler EM, Bektay MY, Mutlu-Burnaz O, Yulug B. Left lateral parietal rTMS improves cognition and modulates resting brain connectivity in patients with Alzheimer's disease: Possible role of BDNF and oxidative stress. Neurobiol Learn Mem 2021; 180:107410. [PMID: 33610772 DOI: 10.1016/j.nlm.2021.107410] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 01/11/2021] [Accepted: 02/14/2021] [Indexed: 12/22/2022]
Abstract
Repetitive Transcranial Magnetic Stimulation (rTMS) is a non-invasive neuromodulation technique which is increasingly used for cognitive impairment in Alzheimer's Disease (AD). Although rTMS has been shown to modify Brain-Derived Neurotrophic Factor (BDNF) and oxidative stress levels in many neurological and psychiatric diseases, there is still no study evaluating the relationship between memory performance, BDNF, oxidative stress, and resting brain connectivity following rTMS in Alzheimer's patients. Furthermore, there are increasing clinical data showing that the stimulation of strategic brain regions may lead to more robust improvements in memory functions compared to conventional rTMS. In this study, we aimed to evaluate the possible disease-modifying effects of rTMS on the lateral parietal cortex in AD patients who have the highest connectivity with the hippocampus. To fill the mentioned research gaps, we have evaluated the relationships between resting-state Functional Magnetic Resonance Imaging (fMRI), cognitive scores, blood BDNF levels, and total oxidative/antioxidant status to explain the therapeutic and potential disease-modifying effects of rTMS which has been applied at 20 Hz frequencies for two weeks. Our results showed significantly increased visual recognition memory functions and clock drawing test scores which were associated with elevated peripheral BDNF levels, and decreased oxidant status after two weeks of left lateral parietal TMS stimulation. Clinically our findings suggest that the left parietal region targeted rTMS application leads to significant improvement in familiarity-based cognition associated with the network connections between the left parietal region and the hippocampus.
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Affiliation(s)
- Halil Aziz Velioglu
- Istanbul Medipol University, Health Sciences and Technology Research Institute (SABITA), Regenerative and Restorative Medicine Research Center (REMER), functional Imaging and Cognitive-Affective Neuroscience Lab (fINCAN), Istanbul, Turkey
| | - Lutfu Hanoglu
- Istanbul Medipol University, Health Sciences and Technology Research Institute (SABITA), Regenerative and Restorative Medicine Research Center (REMER), functional Imaging and Cognitive-Affective Neuroscience Lab (fINCAN), Istanbul, Turkey; Istanbul Medipol University School of Medicine, Department of Neurology, Istanbul, Turkey
| | - Zubeyir Bayraktaroglu
- Istanbul Medipol University, Health Sciences and Technology Research Institute (SABITA), Regenerative and Restorative Medicine Research Center (REMER), functional Imaging and Cognitive-Affective Neuroscience Lab (fINCAN), Istanbul, Turkey; Istanbul Medipol University, International School of Medicine Department of Physiology, Istanbul, Turkey
| | - Guven Toprak
- Istanbul Medipol University, Health Sciences and Technology Research Institute (SABITA), Regenerative and Restorative Medicine Research Center (REMER), functional Imaging and Cognitive-Affective Neuroscience Lab (fINCAN), Istanbul, Turkey
| | - Eray Metin Guler
- University of Health Sciences Hamidiye School of Medicine, Department of Medical Biochemistry, Istanbul, Turkey; University of Health Sciences, Haydarpasa Numune Health Application and Research Center, Department of Medical Biochemistry, Istanbul, Turkey
| | - Muhammed Yunus Bektay
- Bezmialem Vakif University School of Pharmacy, Department of Clinical Pharmacy, Istanbul, Turkey; Marmara University School of Pharmacy, Department of Clinical Pharmacy, Istanbul, Turkey
| | - Ozlem Mutlu-Burnaz
- Istanbul Medipol University, Health Sciences and Technology Research Institute (SABITA), Regenerative and Restorative Medicine Research Center (REMER), functional Imaging and Cognitive-Affective Neuroscience Lab (fINCAN), Istanbul, Turkey
| | - Burak Yulug
- Alanya Alaaddin Keykubat University School of Medicine, Department of Neurology, Alanya/Antalya, Turkey.
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26
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Effects of unilateral tDCS over left prefrontal cortex on emotion regulation in depression: Evidence from concurrent functional magnetic resonance imaging. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2021; 21:14-34. [PMID: 33432545 DOI: 10.3758/s13415-020-00830-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/03/2020] [Indexed: 12/20/2022]
Abstract
Major depressive disorder (MDD) is the most common mood disorder and a primary cause of disability worldwide. MDD symptomatology entails disturbances in emotion regulation, namely one's ability to modify the intensity and duration of emotional reactions towards affective events. Transcranial direct current stimulation (tDCS) has emerged as a promising treatment for MDD. Yet, positive tDCS outcomes vary across studies, while the precise effects of the procedure for cortical excitability in MDD during emotion regulation remain largely unexplored. Here, we leveraged functional magnetic resonance imaging (fMRI)-compatible tDCS technology to examine the functional consequences of a unilateral anodal tDCS montage at 1.5 mA over left PFC (area F3; with the reference electrode over an extracephalic location) for brain activity during an emotion-regulation task in MDD patients and age-matched healthy control subjects. Our results revealed down-regulation of negative emotions in the right amygdala and visual cortex of healthy controls but not MDD patients prior to stimulation, the degree of which correlated with the magnitude of the participants' reappraisal scores. TDCS did not elicit significant changes in neural activation patterns for either group. These findings contribute to the literature on the pathophysiology of MDD by showing that a key disturbance in the disorder entails the ineffective down-regulation of activity not only within the amygdala, but also within visual cortical areas in response to negative information. Further, these results suggest that relative to bifrontal tDCS montages, unilateral stimulation of moderate intensity over left PFC may not be sufficient to elicit therapeutic effects for MDD.
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27
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Mikellides G, Michael P, Psalta L, Schuhmann T, Sack AT. A Retrospective Naturalistic Study Comparing the Efficacy of Ketamine and Repetitive Transcranial Magnetic Stimulation for Treatment-Resistant Depression. Front Psychiatry 2021; 12:784830. [PMID: 35095600 PMCID: PMC8792891 DOI: 10.3389/fpsyt.2021.784830] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/15/2021] [Indexed: 11/13/2022] Open
Abstract
Depression is a common mental disorder that affects many people worldwide, while a significant proportion of patients remain non-responsive to antidepressant medications. Alternative treatment options such as ketamine therapy and repetitive transcranial magnetic stimulation (rTMS) therapy are offered nowadays. This study aims to describe and compare the acute antidepressive efficacy of both, intramuscular ketamine and rTMS in depression patients seeking help in a naturalistic clinical mental health setting. The clinical records of 24 patients with treatment resistant depression were collected from the clinical base of a real life clinic. Twelve patients were treated with intramuscular ketamine, twice weekly for 8 sessions, and twelve patients were treated with 30 sessions of left dorsolateral prefrontal cortex - intermittent theta-burst stimulation (DLPFC-iTBS). Using three clinical assessments (HDRS, HAM-A, BDI-II), our data reveal that both therapies led to significant improvement in symptoms from pre- to post- treatment, as well as that the two experimental groups did not differ significantly with respect to pre- to post- depressive and anxiety symptoms, indicating that the effect of both experimental groups in our sample was equally effective. Furthermore, our results showed high remission and response rates in both groups, with no statistical differences between the patients of ketamine group and rTMS group in remission and response rates. We show a significant pre- to post- treatment reduction in depressive and anxiety symptoms, with no significant differences between the two experimental groups, indicating that the effect of both therapies was equally effective in our limited sample.
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Affiliation(s)
- Georgios Mikellides
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.,Cyprus rTMS Centre, Larnaca, Cyprus
| | | | - Lilia Psalta
- Department of Psychology, University of Cyprus, Nicosia, Cyprus.,School of Science, University of Central Lancashire, Preston, Cyprus
| | - Teresa Schuhmann
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Alexander T Sack
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.,Department of Psychiatry and Neuropsychology, Brain + Nerve Centre, School for Mental Health and Neuroscience, Maastricht University Medical Centre+, Maastricht, Netherlands
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28
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Westwood SJ, Radua J, Rubia K. Noninvasive brain stimulation in children and adults with attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. J Psychiatry Neurosci 2021; 46:E14-E33. [PMID: 33009906 PMCID: PMC7955851 DOI: 10.1503/jpn.190179] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) could provide treatment alternatives to stimulant medication for attention-deficit/hyperactivity disorder (ADHD), given some evidence for improvements in cognition and clinical symptoms. However, despite a lack of solid evidence for their use, rTMS and tDCS are already offered clinically and commercially in ADHD. This systematic review and meta-analysis aimed to critically appraise rTMS and tDCS studies in ADHD to inform good research and clinical practice. METHODS A systematic search (up to February 2019) identified 18 studies (rTMS 4, tDCS 14; 311 children and adults with ADHD) stimulating mainly the dorsolateral prefrontal cortex (dlPFC). We included 12 anodal tDCS studies (232 children and adults with ADHD) in 3 random-effects meta-analyses of cognitive measures of attention, inhibition and processing speed. RESULTS The review of rTMS and tDCS showed positive effects in some functions but not others, and little evidence for clinical improvement. The meta-analyses of 1 to 5 sessions of anodal tDCS over mainly the left or bilateral dlPFC showed trend-level improvements in inhibition and processing speed, but not in attention. LIMITATIONS Heterogeneity in stimulation parameters, patient age and outcome measures limited the interpretation of findings. CONCLUSION The review and meta-analysis showed limited evidence that 1 to 5 sessions of rTMS and tDCS, mostly of the dlPFC, improved clinical or cognitive measures of ADHD. These findings did not support using rTMS or tDCS of the dlPFC as an alternative neurotherapy for ADHD as yet. Larger, multi-session stimulation studies identifying more optimal sites and stimulation parameters in combination with cognitive training could achieve larger effects.
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Affiliation(s)
- Samuel J Westwood
- From the Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom (Westwood, Rubia); the Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain (Radua); the Mental Health Research Networking Centre (CIBERSAM), Madrid, Spain (Radua); the Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Tomtebodavägen 18A, Stockholm, Sweden (Radua); and the Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, United Kingdom (Radua)
| | - Joaquim Radua
- From the Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom (Westwood, Rubia); the Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain (Radua); the Mental Health Research Networking Centre (CIBERSAM), Madrid, Spain (Radua); the Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Tomtebodavägen 18A, Stockholm, Sweden (Radua); and the Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, United Kingdom (Radua)
| | - Katya Rubia
- From the Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom (Westwood, Rubia); the Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain (Radua); the Mental Health Research Networking Centre (CIBERSAM), Madrid, Spain (Radua); the Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Tomtebodavägen 18A, Stockholm, Sweden (Radua); and the Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, United Kingdom (Radua)
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29
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The role of left prefrontal transcranial magnetic stimulation in episodic migraine prophylaxis. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-019-0140-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Abstract
Objective
The aim of the study was to examine the prophylactic role of repetitive transcranial magnetic stimulation (rTMS) on the frequency, and severity of migraine attacks in episodic migraineurs who failed medical treatment.
Methods
A randomized double-blinded placebo-controlled study was designed to assess the effect of 5 Hz rTMS applied over the left dorsolateral prefrontal cortex (LDLPFC ) in 33 migraineurs. Patients were followed up for 1 month before receiving rTMS, and for another month after the sessions by a headache diary. The primary outcome measure was the achievement of 50% reduction in the number of migraine attacks. Secondary outcome measures included migraine days, assessment of migraine attack severity, disability by HIT-6, and side-effects to the procedure.
Results
The study revealed that 69.2% of the active treatment group achieved 50% or more reduction in the number of migraine attacks versus 25% of cases in the control group (p = 0.02). The absolute number of migraine attacks was reduced by 3.1 vs 1.5 in the active and control group, respectively. The number of cases with severe HIT-6 scores was reduced by 46.2% in active treatment group versus a 7.1% reduction in the control group (p = 0.02).
Conclusion
High-frequency rTMS applied to LDLPFC can reduce the number of migraine attacks by 50% or more in almost 70% of a sample of episodic migraineurs with a concomitant decrease in functional disability.
Trial registration
ClinicalTrials.gov, Identifier: NCT04031781. Registered 23 July 2019—retrospectively registered at https://clinicaltrials.gov/ct2/show/NCT04031781?term=Migraine+Prophylaxis&recrs=ce&type=Intr&cond=Migraine&rank=9
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30
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Conde-Antón Á, Hernando-Garijo I, Jiménez-Del-Barrio S, Mingo-Gómez MT, Medrano-de-la-Fuente R, Ceballos-Laita L. Effects of transcranial direct current stimulation and transcranial magnetic stimulation in patients with fibromyalgia. A systematic review. Neurologia 2020; 38:S0213-4853(20)30278-4. [PMID: 33071017 DOI: 10.1016/j.nrl.2020.07.024] [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] [Received: 06/06/2020] [Revised: 07/11/2020] [Accepted: 07/19/2020] [Indexed: 10/23/2022] Open
Abstract
INTRODUCTION Fibromyalgia syndrome (FM) is a chronic pathology characterized by widespread pain commonly associated with psychological distress affecting quality of life. In recent years, transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) have been investigated to treat chronic pain. The aim of the current review is to determine the effects of tDCS and TMS on the main symptoms of patients with FM. DEVELOPMENT A systematic review based on PRISMA guidelines was carried out. The search strategy was performed in Medline, Scopus, PEDro and Cochrane Library. Randomized controlled trials based on the effects of tDCS and TMS on pain, pressure pain threshold, fatigue, anxiety and depression, catastrophizing and quality of life in patients with FM were analysed. Fourteen studies were included. CONCLUSIONS The application of tDCS to the motor cortex is the only intervention shown to decrease pain in the short and medium-term in patients with FM. The application of both interventions showed improvements in pressure pain threshold, catastrophizing and quality of life when applied to the motor cortex, and in fatigue when applied to the dorsolateral prefrontal cortex. The effects of these interventions on anxiety and depression are unclear.
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Affiliation(s)
- Á Conde-Antón
- Facultad de Fisioterapia, Universidad de Valladolid, Soria, España
| | | | | | - M T Mingo-Gómez
- Facultad de Fisioterapia, Universidad de Valladolid, Soria, España
| | | | - L Ceballos-Laita
- Facultad de Fisioterapia, Universidad de Valladolid, Soria, España.
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Dowling NL, Bonwick R, Dharwadkar NP, Ng CH. Repetitive transcranial magnetic stimulation for major depression: A naturalistic observational study in an Australian private hospital. Psychiatry Res 2020; 291:113275. [PMID: 32763538 DOI: 10.1016/j.psychres.2020.113275] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 07/01/2020] [Accepted: 07/01/2020] [Indexed: 01/06/2023]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is an effective and evidence-based treatment for major depression, which is now as a mainstream treatment in clinical practice. However, there is limited data concerning its use in Australian private psychiatric hospital settings. This retrospective study examined routinely collected data of 153 inpatients, who received 20 rTMS treatments over four weeks. Primary outcomes measures were the 17-item Hamilton Depression Rating Scale (HAMD-17) and the 21-item Depression, Anxiety and Stress Scale (DASS-21). At post-treatment, response and remission rates were 54% and 28%, respectively, for the HAMD-17; and 53% response and 16% remission rates, for the DASS-21 Depression subscale, respectively. Although no gender differences were observed, younger patients demonstrated more improvements during acute rTMS but the effect was not significant after accounting for pre-treatment symptom severity. The findings of this naturalistic study suggest that an acute course of rTMS provided in private clinical settings resulted in similar response and remission rates to longer rTMS courses. Shorter rTMS courses appear to have satisfactory efficacy in treating major depression, in clinically diverse and real-world practice.
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Affiliation(s)
- Nathan L Dowling
- Professorial Unit, The Melbourne Clinic, Department of Psychiatry, University of Melbourne, 130 Church St, Richmond, Melbourne 3121, Australia.
| | - Richard Bonwick
- Professorial Unit, The Melbourne Clinic, Department of Psychiatry, University of Melbourne, 130 Church St, Richmond, Melbourne 3121, Australia
| | - Nitin P Dharwadkar
- The Melbourne Clinic, Melbourne, Australia; Monash Alfred Research Centre, Monash University, Melbourne, Australia
| | - Chee H Ng
- Professorial Unit, The Melbourne Clinic, Department of Psychiatry, University of Melbourne, 130 Church St, Richmond, Melbourne 3121, Australia
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Conder A, Conder R, Friesen C. Neurorehabilitation of Persistent Sport-Related Post-Concussion Syndrome. NeuroRehabilitation 2020; 46:167-180. [PMID: 32083597 DOI: 10.3233/nre-192966] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Persistent Sport-Related Post-Concussion Syndrome is often diagnosed with any type of prolonged PCS symptoms. However, there are not specific diagnostic criteria for PPCS such that misdiagnosis often occurs. Further, the signs and symptoms of PCS overlap with other common illnesses such as depression, anxiety, migraines, ADHD and others. Misdiagnosis may lead to less than efficacious treatment, resulting in prolonged symptoms. OBJECTIVE This article will review relevant evidence-based literature on PCS, pointing out the lack of a systemic diagnostic framework. It will also provide evidence that highlights the multiple conflicting findings in the literature. This article will posit the BioPsychoSocial framework as the best diagnostic framework for understanding the impact of concussions on the person and to generate individualized and personal interventions. METHODS A narrative review of sport concussion-related articles was conducted, after extensive searches of relevant and non-relevant literature by each author, as well as articles recommended by colleagues. Articles varied from American Academy of Neurology Class I to IV for evaluation and critique. Class IV articles were reviewed, as there is much public misconception regarding sport and other concussion treatment that needed identification and discussion. RESULTS Articles reviewed varied by quality of research design and methodology. Multiple symptoms, recovery patterns and rehabilitation treatment approaches are purported in the sport-related concussion literature. Current consensus data as well as the mixed and contradictory findings were explored. CONCLUSIONS Persistent Sport-Related Post-Concussion Syndrome is a topic of great interest to both professionals and the general public. There is much misunderstanding about the etiology, causation, diagnostic formulations, symptom presentation, prolonging factors and treatment involved in this syndrome. This article posits an individualized multi-system diagnostic formulation, examining all relevant factors, as generating the best interventions for neurorehabilitation of Persistent Sport-Related Post-Concussion Syndrome.
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Affiliation(s)
- Alanna Conder
- Carolina Neuropsychological Service, Raleigh, NC, USA
| | - Robert Conder
- Carolina Neuropsychological Service, Raleigh, NC, USA
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Pain trajectories of dorsomedial prefrontal intermittent theta burst stimulation versus sham treatment in depression. BMC Neurol 2020; 20:311. [PMID: 32819321 PMCID: PMC7439669 DOI: 10.1186/s12883-020-01881-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 08/06/2020] [Indexed: 12/03/2022] Open
Abstract
Background Prefrontal repetitive transcranial magnetic stimulation is an established add-on treatment for major depressive disorder and is increasingly feasible with protocols of short duration, such as intermittent theta burst stimulation (iTBS). The most common and limiting side effect is pain at the site of application. Our objective was to investigate how pain develops over time in patients with depression receiving iTBS compared to sham stimulation. Methods This is a subsample from a randomized clinical trial. Patients received daily sessions of 2400 pulses of dorsomedial prefrontal iTBS or sham stimulation with transcutaneous electric stimulation during 2 to 3 weeks. After unmasking of treatment allocation, patients receiving sham treatment were offered active iTBS in an open phase. Patients rated pain on a scale from 0 to 10 after the last train of stimulation on the first, fifth and final treatment day. A Mann-Whitney U-test was conducted to test for group differences and related-samples Friedman’s tests to analyze changes in pain ratings over time. Results The scalp pain in the group receiving iTBS was rated higher than sham treatment on the first (U = 263.5, p = 0.035) and fifth day (U = 271.0, p = 0.020) but not on the final day (U = 210.5, p = 0.121). The pain decreased mainly during the first 5 days of treatment (χ2 = 0.875, p = 0.040). In the open phase the pain decreased from the first day to the final day (χ2 = 1.194, p = 0.001). Conclusions The subjective pain perception of active dorsomedial iTBS was higher than sham treatment but decreased over time, indicating an analgesic effect, or habituation. The result from this study can be used to inform patients about what to expect regarding pain during an iTBS treatment course. Trial registration Clinicaltrials.gov, NCT02905604. Registered 19 September 2016.
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Makunts T, Wollmer MA, Abagyan R. Postmarketing safety surveillance data reveals antidepressant effects of botulinum toxin across various indications and injection sites. Sci Rep 2020; 10:12851. [PMID: 32732918 PMCID: PMC7393507 DOI: 10.1038/s41598-020-69773-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 07/20/2020] [Indexed: 02/07/2023] Open
Abstract
The World Health Organization estimates the number of people suffering from depression to be over 264 million. Current monoamine transmission modulating therapeutics, even with proper adherence and acceptable tolerability, are not effective for nearly one third of the patients, leading clinicians to explore other therapeutic options such as electroconvulsive therapy, transcranial magnetic stimulation, ketamine infusions, and, more recently, glabellar botulinum toxin, BoNT, injections. The scale and mechanism of antidepressant action of BoNT is unclear and maybe hypothetically attributed to the disruption of proprioceptive facial feedback reinforcing negative emotions. Here we verify the antidepressant effect of botulinum toxin by analysis of over 40 thousand BoNT treatment reports out of thirteen million postmarketing safety reports in the FDA Adverse Event Reporting System, FAERS. The results of the analysis indicate that patients who received BoNT injections to treat hyperhidrosis, facial wrinkles, migraine prophylaxis, spasticity, and spasms, had a significantly lower number of depression reports when compared to patients undergoing different treatments for the same conditions. These findings suggest that the antidepressant effect of BoNT is significant, and, surprisingly, is observed for a broad range of injection sites.
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Affiliation(s)
- Tigran Makunts
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, USA.,Oak Ridge Institute of Science and Education Fellowship at Office of Clinical Pharmacology, United States Food and Drug Administration, Silver Spring, MD, USA
| | - Marc Axel Wollmer
- Asklepios Clinic North-Ochsenzoll, Asklepios Campus Hamburg, Medical Faculty, Semmelweis University, Hamburg, Germany
| | - Ruben Abagyan
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, USA.
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Freire RC, Cabrera-Abreu C, Milev R. Neurostimulation in Anxiety Disorders, Post-traumatic Stress Disorder, and Obsessive-Compulsive Disorder. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:331-346. [PMID: 32002936 DOI: 10.1007/978-981-32-9705-0_18] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Many pharmacological treatments were proved effective in the treatment of panic disorder (PD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD); still many patients do not achieve remission with these treatments. Neurostimulation techniques have been studied as promising alternatives or augmentation treatments to pharmacological and psychological therapies. The most studied neurostimulation method for anxiety disorders, PTSD, and OCD was repetitive transcranial magnetic stimulation (rTMS). This neurostimulation technique had the highest level of evidence for GAD. There were also randomized sham-controlled trials indicating that rTMS may be effective in the treatment of PTSD and OCD, but there were conflicting findings regarding these two disorders. There is indication that rTMS may be effective in the treatment of panic disorder, but the level of evidence is low. Deep brain stimulation (DBS) was most studied for treatment of OCD, but the randomized sham-controlled trials had mixed findings. Preliminary findings indicate that DBS could be affective for PTSD. There is weak evidence indicating that electroconvulsive therapy, transcranial direct current stimulation, vagus nerve stimulation, and trigeminal nerve stimulation could be effective in the treatment of anxiety disorders, PTSD, and OCD. Regarding these disorders, there is no support in the current literature for the use of neurostimulation in clinical practice. Large high-quality studies are warranted.
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Affiliation(s)
- Rafael Christophe Freire
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
- Department of Psychiatry, Queen's University, Kingston, ON, Canada.
| | - Casimiro Cabrera-Abreu
- Department of Psychiatry, Queen's University and Providence Care Hospital, Kingston, ON, Canada
| | - Roumen Milev
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
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Rosenich E, Gill S, Clarke P, Paterson T, Hahn L, Galletly C. Does rTMS reduce depressive symptoms in young people who have not responded to antidepressants? Early Interv Psychiatry 2019; 13:1129-1135. [PMID: 30303308 DOI: 10.1111/eip.12743] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 08/22/2018] [Accepted: 09/09/2018] [Indexed: 12/17/2022]
Abstract
AIM Depression is common in young people, and there is a need for safe, effective treatments. This study examined the efficacy of repetitive transcranial magnetic stimulation in a sample of young people aged 17 to 25 years. METHODS This retrospective study included 15 people aged 17 to 25 years referred by their private psychiatrists affiliated with Ramsay Health Care, South Australia Mental Health Services. All patients met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for treatment-resistant Major Depressive Disorder. Eleven patients received right unilateral treatment and four patients received bilateral treatment. Patients were assessed at baseline and after treatment. RESULTS There was a significant improvement on the Hamilton Rating Scale for Depression (t(14) = 4.71, P < 0.0001); Montgomery-Åsperg Depression Rating Scale (t(14) = 3.96, P < 0.01) and the Zung Self-Rating Depression Scale (t(14) = 4.13, P < 0.01). There was no difference in response by gender or age. The response rates in these young people did not differ significantly from those of adults aged 25 to 82 years. CONCLUSION This open label, naturalistic study suggests that repetitive transcranial magnetic stimulation is an effective treatment in young adults who have treatment-resistant depression. Randomized sham-controlled studies are needed to further investigate the efficacy of this treatment in this age group.
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Affiliation(s)
- Emily Rosenich
- International Centre for Allied Health Evidence, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Shane Gill
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.,The Adelaide Clinic, Ramsay Health Care (SA) Mental Health Services, Adelaide, South Australia, Australia.,South Australian Psychiatry Training Committee, Central Adelaide Local Health Network-Mental Health Directorate, Adelaide, South Australia, Australia
| | - Patrick Clarke
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.,The Adelaide Clinic, Ramsay Health Care (SA) Mental Health Services, Adelaide, South Australia, Australia
| | - Tom Paterson
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.,The Adelaide Clinic, Ramsay Health Care (SA) Mental Health Services, Adelaide, South Australia, Australia
| | - Lisa Hahn
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.,The Adelaide Clinic, Ramsay Health Care (SA) Mental Health Services, Adelaide, South Australia, Australia
| | - Cherrie Galletly
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.,The Adelaide Clinic, Ramsay Health Care (SA) Mental Health Services, Adelaide, South Australia, Australia.,Northern Adelaide Local Health Network, Adelaide, South Australia, Australia
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Alkhasli I, Sakreida K, Mottaghy FM, Binkofski F. Modulation of Fronto-Striatal Functional Connectivity Using Transcranial Magnetic Stimulation. Front Hum Neurosci 2019; 13:190. [PMID: 31263404 PMCID: PMC6585467 DOI: 10.3389/fnhum.2019.00190] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 05/22/2019] [Indexed: 12/25/2022] Open
Abstract
Background: The fronto-striatal network is involved in various motor, cognitive, and emotional processes, such as spatial attention, working memory, decision-making, and emotion regulation. Intermittent theta burst transcranial magnetic stimulation (iTBS) has been shown to modulate functional connectivity of brain networks. Long stimulation intervals, as well as high stimulation intensities are typically applied in transcranial magnetic stimulation (TMS) therapy for mood disorders. The role of stimulation intensity on network function and homeostasis has not been explored systematically yet. Objective: In this pilot study, we aimed to modulate fronto-striatal connectivity by applying iTBS at different intensities to the left dorso-lateral prefrontal cortex (DLPFC). We measured individual and group changes by comparing resting state functional magnetic resonance imaging (rsfMRI) both pre-iTBS and post-iTBS. Differential effects of individual sub- vs. supra-resting motor-threshold stimulation intensities were assessed. Methods: Sixteen healthy subjects underwent excitatory iTBS at two intensities [90% and 120% of individual resting motor threshold (rMT)] on separate days. Six-hundred pulses (2 s trains, 8 s pauses, duration of 3 min, 20 s) were applied over the left DLPFC. Directly before and 7 min after stimulation, task-free rsfMRI sessions, lasting 10 min each, were conducted. Individual seed-to-seed functional connectivity changes were calculated for 10 fronto-striatal and amygdala regions of interest with the SPM toolbox DPABI. Results: Sub-threshold-iTBS increased functional connectivity directly between the left DLPFC and the left and right caudate, respectively. Supra-threshold stimulation did not change fronto-striatal functional connectivity but increased functional connectivity between the right amygdala and the right caudate. Conclusion: A short iTBS protocol applied at sub-threshold intensities was not only sufficient, but favorable, in order to increase bilateral fronto-striatal functional connectivity, while minimizing side effects. The absence of an increase in functional connectivity after supra-threshold stimulation was possibly caused by network homeostatic effects.
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Affiliation(s)
- Isabel Alkhasli
- Section Clinical Cognitive Sciences, Department of Neurology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Katrin Sakreida
- Department of Neurosurgery, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Felix M. Mottaghy
- Department of Nuclear Medicine, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), Maastricht, Netherlands
- Juelich Aachen Research Alliance (JARA)—BRAIN, Juelich, Germany
| | - Ferdinand Binkofski
- Section Clinical Cognitive Sciences, Department of Neurology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Juelich Aachen Research Alliance (JARA)—BRAIN, Juelich, Germany
- Research Centre Juelich, Institute of Neuroscience and Medicine (INM-4), Juelich, Germany
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Griffiths C, O'Neill-Kerr A, Millward T, da Silva K. Repetitive transcranial magnetic stimulation (rTMS) for depression: outcomes in a United Kingdom (UK) clinical practice. Int J Psychiatry Clin Pract 2019; 23:122-127. [PMID: 30931656 DOI: 10.1080/13651501.2018.1562077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Objective: The aim of this paper is to present the outcomes data from the largest United Kingdom's (UK) National Health Service (NHS) clinical rTMS service treating treatment resistant depression (TRD). Methods: The study was a retrospective investigation of routinely collected data on patients receiving rTMS between 2015 and 2017. Measures used were the clinician-rated Clinical Global Impression (CGI) and Hamilton Depression Rating Scale (HAM-D), and patient rated Beck Depression Inventory (BDI). The outcome data of 73 patients with TRD were analysed. The sample included patients with co-morbid psychiatric diagnosis. Results: Response and remission rates, respectively, were 40.4% and 25.5% for the HAM-D; 35.6% and 20.8% for the BDI; and 51.1% and 52.1% for the CGI. Effect sizes were medium (0.54, 0.52 and 0.56, respectively). Conclusions: The results show that a UK-based clinical service achieves similar results to those published internationally and that clinical rTMS can have significant impact on symptoms of depression in many patients with TRD. Health services are under pressure to make financial savings, investment in rTMS could reduce the long-term treatment costs associated with TRD.
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Affiliation(s)
- Chris Griffiths
- a Innovation and Research Department , Northamptonshire Healthcare NHS Foundation Trust , Northampton , UK
| | - Alex O'Neill-Kerr
- a Innovation and Research Department , Northamptonshire Healthcare NHS Foundation Trust , Northampton , UK
| | - Timothy Millward
- a Innovation and Research Department , Northamptonshire Healthcare NHS Foundation Trust , Northampton , UK
| | - Ksenija da Silva
- b Psychology Department, Faculty of Health and Society , University of Northampton , Northampton , UK
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Abstract
Transcranial magnetic stimulation (TMS), a research tool with various effects on brain cells, can depolarize cerebral neurons noninvasively. This method offers temporal and spatial resolution and can be combined with other neurocognitive and neuro-experimental techniques. Prefrontal TMS therapy repeated daily for four to six weeks is a neuromodulation technique approved by the US Food and Drug Administration for the treatment of major depressive disorder (MDD) in patients resistant to medications. This technique utilizes electromagnetic induction to excite neuronal cells. Several recent studies have enhanced our understanding of this novel treatment intervention. This report reviews recent studies on the mechanism of action, patient eligibility, effectiveness, and safety of TMS in treating depression.
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Affiliation(s)
- Sukaina Rizvi
- Psychiatry, Manhattan Psychiatric Center, Manhattan, USA
| | - Ali M Khan
- Psychiatry, University of Texas Rio Grande Valley, Harlingen, USA
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Wilkinson ST, Holtzheimer PE, Gao S, Kirwin DS, Price RB. Leveraging Neuroplasticity to Enhance Adaptive Learning: The Potential for Synergistic Somatic-Behavioral Treatment Combinations to Improve Clinical Outcomes in Depression. Biol Psychiatry 2019; 85:454-465. [PMID: 30528745 PMCID: PMC6380941 DOI: 10.1016/j.biopsych.2018.09.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/30/2018] [Accepted: 09/11/2018] [Indexed: 12/17/2022]
Abstract
Until recently, therapeutic development in psychiatry was targeted solely toward symptom reduction. While this is a worthwhile goal, it has yielded little progress in improved therapeutics in the last several decades in the field of mood disorders. Recent advancements in our understanding of pathophysiology suggests that an impairment of neuroplasticity may be a critical part of the development of neuropsychiatric disorders. Interventions that enhance or modulate neuroplasticity often reduce depressive symptoms when applied as stand-alone treatments. Unfortunately, when treatments are discontinued, the disease state often returns as patients relapse. However, treatments that enhance or modulate plasticity not only reduce symptom burden, but also may provide an opportune window wherein cognitive or behavioral interventions could be introduced to harness a state of enhanced neuroplasticity and lead to improved longer-term clinical outcomes. Here, we review the potential of synergistically combining plasticity-enhancing and behavioral therapies to develop novel translational treatment approaches for depression. After reviewing relevant neuroplasticity deficits in depression, we survey biological treatments that appear to reverse such deficits in humans, including N-methyl-D-aspartate receptor modulators (ketamine, D-cycloserine), electroconvulsive therapy, and transcranial brain stimulation. We then review evidence that either directly or indirectly supports the hypothesis that a robust enhancement of neuroplasticity through these methods might promote the uptake of cognitive and behavioral interventions to enhance longer-term treatment outcomes through a synergistic effect. We identify key missing pieces of evidence and discuss future directions to enhance this emerging line of research.
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Affiliation(s)
- Samuel T. Wilkinson
- Department of Psychiatry, Yale School of Medicine and Yale Psychiatric Hospital, New Haven, Connecticut
| | - Paul E. Holtzheimer
- National Center for PTSD, Executive Division, White River Junction VA Medical Center, White River Junction, Vermont;,Department of Psychiatry and Surgery, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Shan Gao
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - David S. Kirwin
- Department of Psychiatry, Yale School of Medicine and Yale Psychiatric Hospital, New Haven, Connecticut
| | - Rebecca B. Price
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
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Griffiths C, da Silva K, De Vai R, O’Neill-Kerr A. Repetitive Transcranial Magnetic Stimulation (rTMS) in Treatment Resistant Depression: Retrospective Data Analysis from Clinical Practice. ACTA ACUST UNITED AC 2019. [DOI: 10.4236/ojd.2019.81003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Becker JE, Shultz EKB, Maley CT. Transcranial Magnetic Stimulation in Conditions Other than Major Depressive Disorder. Child Adolesc Psychiatr Clin N Am 2019; 28:45-52. [PMID: 30389075 DOI: 10.1016/j.chc.2018.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Transcranial magnetic stimulation (TMS) is a treatment approved by the Food and Drug Administration for major depressive disorder (MDD). TMS is a neuromodulation technique that works by creating a focal magnetic field that induces a small electric current. Compared with other neuromodulation techniques, TMS is a noninvasive treatment modality that is generally well-tolerated. Because of the success of TMS in treating depression, there has been interest in applications for other neuropsychiatric diseases. The purpose of this article was to review potential uses for TMS for children and adolescents in conditions other than MDD.
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Affiliation(s)
- Jonathan Essary Becker
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Avenue South, Nashville, TN 37212, USA.
| | - Elizabeth K B Shultz
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Avenue South, Nashville, TN 37212, USA
| | - Christopher Todd Maley
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Avenue South, Nashville, TN 37212, USA
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Tripathi SJ, Chakraborty S, Srikumar B, Raju T, Shankaranarayana Rao B. Prevention of chronic immobilization stress-induced enhanced expression of glucocorticoid receptors in the prefrontal cortex by inactivation of basolateral amygdala. J Chem Neuroanat 2019; 95:134-145. [DOI: 10.1016/j.jchemneu.2017.12.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 12/16/2017] [Accepted: 12/21/2017] [Indexed: 10/18/2022]
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Dondé C, Vignaud P, Poulet E, Brunelin J, Haesebaert F. Management of depression in patients with schizophrenia spectrum disorders: a critical review of international guidelines. Acta Psychiatr Scand 2018; 138:289-299. [PMID: 29974451 DOI: 10.1111/acps.12939] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/14/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Depression is a frequent but potentially treatable clinical dimension in patients with schizophrenia spectrum disorders (PWS). However, there is a lack of consensual recommendations regarding the optimal strategy to manage depression in PWS. In this study, we aimed to compare the various proposed strategies to define a core set of valid care recommendations for depression management in PWS. METHODS After a systematic search of the literature, the methodological quality of 10 international guidelines from four continents was compared using a validated guideline appraisal instrument (AGREE II). Key recommendations for the management of depression in PWS were subsequently reviewed and discussed. RESULTS The methodological quality of the guidelines was heterogeneous. Although all guidelines proposed pharmacotherapy, psychosocial interventions were a minor concern. Waiting for antipsychotic effects mostly was recommended during the acute phase of schizophrenia. During the postpsychotic phase of the illness, a switch to a second-generation antipsychotic and/or the adjunction of an antidepressant were the primary recommendations. Cognitive behavioural therapy and other medications were considered with strong variations. CONCLUSIONS Further studies are needed to strengthen the level of evidence for antidepressive approaches in PWS. The inclusion of PWS as stakeholders is also considered to be a major issue for future guideline development.
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Affiliation(s)
- C Dondé
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: From Resistance to Response Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - P Vignaud
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: From Resistance to Response Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - E Poulet
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: From Resistance to Response Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France.,Department of Psychiatry Emergencies, CHU Lyon, Hôpital Edouard Herriot, Lyon, France
| | - J Brunelin
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: From Resistance to Response Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - F Haesebaert
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: From Resistance to Response Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France.,CERVO Brain Research Center, Québec, QC, Canada.,Département de Psychiatrie et Neurosciences, Faculté de Médecine, Université Laval, Québec, QC, Canada
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Dinčić M, Krstić DZ, Čolović MB, Nešović Ostojić J, Kovačević S, De Luka SR, Djordjević DM, Ćirković S, Brkić P, Todorović J. Modulation of rat synaptosomal ATPases and acetylcholinesterase activities induced by chronic exposure to the static magnetic field. Int J Radiat Biol 2018; 94:1062-1071. [PMID: 30238840 DOI: 10.1080/09553002.2018.1518611] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE It is considered that exposure to static magnetic fields (SMF) may have both detrimental and therapeutic effect, but the mechanism of SMF influence on the living organisms is not well understood. Since the adenosine triphosphatases (ATPases) and acetylcholinesterase (AChE) are involved in both physiological and pathological processes, the modulation of Na+/K+-ATPase, ecto-ATPases and AChE activities, as well as oxidative stress responses were followed in synaptosomes isolated from rats after chronic exposure toward differently oriented SMF. MATERIAL AND METHODS Wistar albino rats were randomly divided into three experimental groups (six animals per group): Up and Down group - exposed to upward and downward oriented SMF, respectively, and Control group. After 50 days, the rats were sacrificed, and synaptosomes were isolated from the whole rat brain and used for testing the enzyme activities and oxidative stress parameters. RESULTS Chronic exposure to 1 mT SMF significantly increased ATPases, AChE activities, and malondialdehyde (MDA) level in both exposed groups, compared to control values. The significant decrease in synaptosomal catalase activity (1.48 ± 0.17 U/mg protein) induced by exposure to the downward oriented field, compared to those obtained for Control group (2.60 ± 0.29 U/mg protein), and Up group (2.72 ± 0.21 U/mg protein). CONCLUSIONS It could be concluded that chronic exposure to differently oriented SMF increases ATPases and AChE activities in rat synaptosomes. Since brain ATPases and AChE have important roles in the pathogenesis of several neurological diseases, SMF influence on the activity of these enzymes may have potential therapeutic importance.
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Affiliation(s)
- Marko Dinčić
- a Institute of Pathological Physiology, Faculty of Medicine , University of Belgrade , Belgrade , Serbia
| | - Danijela Z Krstić
- b Institute of Medical Chemistry, Faculty of Medicine , University of Belgrade , Belgrade , Serbia
| | - Mirjana B Čolović
- c Department of Physical Chemistry , Vinča Institute of Nuclear Sciences, University of Belgrade , Belgrade , Serbia
| | - Jelena Nešović Ostojić
- a Institute of Pathological Physiology, Faculty of Medicine , University of Belgrade , Belgrade , Serbia
| | - Sanjin Kovačević
- a Institute of Pathological Physiology, Faculty of Medicine , University of Belgrade , Belgrade , Serbia
| | - Silvio R De Luka
- a Institute of Pathological Physiology, Faculty of Medicine , University of Belgrade , Belgrade , Serbia
| | - Drago M Djordjević
- a Institute of Pathological Physiology, Faculty of Medicine , University of Belgrade , Belgrade , Serbia
| | - Saša Ćirković
- d Institute of Physics , University of Belgrade , Belgrade , Serbia
| | - Predrag Brkić
- e Institute of Physiology, Faculty of Medicine , University of Belgrade , Serbia
| | - Jasna Todorović
- a Institute of Pathological Physiology, Faculty of Medicine , University of Belgrade , Belgrade , Serbia
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Huang PC, Chaney EJ, Shelton RL, Boppart SA. Magnetomotive Displacement of the Tympanic Membrane Using Magnetic Nanoparticles: Toward Enhancement of Sound Perception. IEEE Trans Biomed Eng 2018; 65:2837-2846. [PMID: 29993404 DOI: 10.1109/tbme.2018.2819649] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE A novel hearing-aid scheme using magnetomotive nanoparticles (MNPs) as transducers in the tympanic membrane (TM) is proposed, aiming to noninvasively and directly induce a modulated vibration on the TM. METHODS In this feasibility study, iron oxide (Fe3O4) nanoparticles were applied on ex vivo rat TM tissues and allowed to diffuse over ∼2 h. Subsequently, magnetic force was exerted on the MNP-laden TM via a programmable electromagnetic solenoid to induce the magnetomotion. Optical coherence tomography (OCT), along with its phase-sensitive measurement capabilities, was utilized to visualize and quantify the nanometer-scale vibrations generated on the TM tissues. RESULTS The magnetomotive displacements induced on the TM were significantly greater than the baseline vibration of the TM without MNPs. In addition to a pure frequency tone, a chirped excitation and the corresponding spectroscopic response were also successfully generated and obtained. Finally, visualization of volumetric TM dynamics was achieved. CONCLUSION This study demonstrates the effectiveness of magnetically inducing vibrations on TMs containing iron oxide nanoparticles, manipulating the amplitude and the frequency of the induced TM motions, and the capability of assessing the magnetomotive dynamics via OCT. SIGNIFICANCE The results demonstrated here suggest the potential use of this noninvasive magnetomotive approach in future hearing aid applications. OCT can be utilized to investigate the magnetomotive dynamics of the TM, which may either enhance sound perception or magnetically induce the perception of sound without the need for acoustic speech signals.
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Chen M, Lixandrão MC, Prudente CN, Summers RLS, Kimberley TJ. Short Interval Intracortical Inhibition Responses to Low-Frequency Repetitive Transcranial Magnetic Stimulation Under Multiple Interstimulus Intervals and Conditioning Intensities. Neuromodulation 2018; 21:368-375. [PMID: 29566289 DOI: 10.1111/ner.12773] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 01/13/2018] [Accepted: 01/31/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND The extent to which short interval intracortical inhibition (SICI) responds to low-frequency repetitive transcranial magnetic stimulation (rTMS) remains inconclusive with reports of increased, decreased and unchanged response following modulation. The aim of this study was to systematically investigate if the variability of SICI following rTMS is explained by the interstimulus interval (ISI) and/or the conditioning stimulus intensity (CSI). METHODS Two experiments with pretesting/posttesting and an rTMS session (1 Hz, 90% RMT, 900 pulses) were done. Experiment I (N = 15): SICI with multiple ISIs (1.0-4.0 msec, 0.2 msec increment). Experiment II (N = 15): SICI with CSIs (50-95% of RMT, 5% increment). In both experiments, the cortical silent period (cSP) was also collected. RESULTS After low-frequency rTMS, no significant change (p > 0.10) in SICI at any specific ISI or CSI was observed, nor did the optimal ISI or CSI change. However, a significant decrease was observed in SICI responses when assessed under the range of ISIs (p = 0.0001), but not CSIs. cSP inhibition increased significantly (p < 0.0015) for both experiments. CONCLUSIONS The optimal ISI or CSI did not shift or reveal SICI changes after inhibitory rTMS. However, when the whole curve of SICI responses were evaluated from a wide range of ISIs, a decrease in inhibition was found. The contrast between the results of individual ISI tests and the wide range of ISI assessment may be due to higher intersubject variability of SICI and/or sample size, rendering traditional SICI testing methods ineffective for measuring changes in inhibition. Further, it is possible that rTMS modulates GABAA and GABAB mediated inhibitory processes differently, which would explain the conflicting results for SICI and cSP.
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Affiliation(s)
- Mo Chen
- Division of Physical Therapy, Department of Rehabilitation Medicine, School of Medicine, University of Minnesota, Minneapolis, MN, USA.,Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Maíra C Lixandrão
- Division of Physical Therapy, Department of Rehabilitation Medicine, School of Medicine, University of Minnesota, Minneapolis, MN, USA.,Physical Therapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Cecília N Prudente
- Division of Physical Therapy, Department of Rehabilitation Medicine, School of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Rebekah L S Summers
- Division of Physical Therapy, Department of Rehabilitation Medicine, School of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Teresa J Kimberley
- Division of Physical Therapy, Department of Rehabilitation Medicine, School of Medicine, University of Minnesota, Minneapolis, MN, USA.,Department of Physical Therapy, MGH Institute of Health Professions Charlestown Navy Yard, Boston, MA, USA
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Lesenskyj AM, Samples MP, Farmer JM, Maxwell CR. Treating refractory depression in Parkinson's disease: a meta-analysis of transcranial magnetic stimulation. Transl Neurodegener 2018; 7:8. [PMID: 29588852 PMCID: PMC5863446 DOI: 10.1186/s40035-018-0113-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 03/06/2018] [Indexed: 02/07/2023] Open
Abstract
Background Parkinson’s disease (PD) is often accompanied by clinically identified depression. Providing effective pharmacotherapies that concomitantly treat both motor and psychological symptoms can pose a challenge to physicians. For this reason, alternatives to standard anti-depressant treatments, such as repetitive transcranial magnetic stimulation (rTMS), have been evaluated within the Parkinson’s population. Methods A literature search was conducted on the PubMed database for all studies that evaluated rTMS as a treatment in patients with both depression and PD. A meta-analysis was performed on all studies that reported mean pre- and post-rTMS depression inventory scores. Widely used depression inventories included both self-report and clinician-administered measures. Effect size for individual study groups and across all studies was calculated. Results Six of 7 studies meeting inclusion criteria reported significantly improved depression scores, large effect sizes, and significant p-values. Total weighted average effect size was calculated at 1.32 across all study groups that applied rTMS. Conclusions Across all but one study, rTMS appears to effectively reduce depression scores among self-reported and clinician administered inventories. The total weight average effect size showed that, when considering study sample sizes and degree of findings, this form of neurostimulation can relieve PD patients of their depressive symptoms. Further, rTMS is a promising alternative to traditional anti-depressant therapies when treating refractory depression in patients with PD.
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Affiliation(s)
| | - Megan P Samples
- 2Drexel Neurosciences Institute, 245 N 15th Street ms 423, Philadelphia, PA 19102 USA
| | - Jill M Farmer
- 2Drexel Neurosciences Institute, 245 N 15th Street ms 423, Philadelphia, PA 19102 USA
| | - Christina R Maxwell
- 2Drexel Neurosciences Institute, 245 N 15th Street ms 423, Philadelphia, PA 19102 USA
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Stimulated left DLPFC-nucleus accumbens functional connectivity predicts the anti-depression and anti-anxiety effects of rTMS for depression. Transl Psychiatry 2018; 7:3. [PMID: 29520002 PMCID: PMC5843586 DOI: 10.1038/s41398-017-0005-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Not all depression patients effectively respond to repeated transcranial magnetic stimulation (rTMS). We tested whether the intrinsic functional connectivity (FC) strength between the stimulated left dorsolateral prefrontal cortex (DLPFC) and left nucleus accumbens (NAcc) might predict effects of rTMS. Twenty-two medication-naïve depression patients received rTMS on left DLPFC for 2 weeks and underwent baseline functional magnetic resonance imaging (fMRI). We compared the amplitude of the low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) in the stimulated target (the cortex region directly stimulated by rTMS) located in the left DLPFC, and the left NAcc, as well as the intrinsic FC of the DLPFC-NAcc between early improvers and non-improvers. We evaluated the association between the baseline brain imaging features (ALFF, ReHo, and FC) and improvements in depression and anxiety symptoms. We found that the pretreatment ALFF and ReHo in the stimulated DLPFC and left NAcc did not significantly differ between the subgroups. The early improvers displayed increased negative FC strength between the stimulated DLPFC and left NAcc with respect to non-improvers. The stimulated DLPFC-NAcc FC strength negatively correlated with improved depressive and anxious symptoms. This study is the first to demonstrate that the resting-state FC of the stimulated DLPFC-NAcc, rather than regional brain activity or local synchronization in the stimulated target, might predict the anti-depression and anti-anxiety effects of rTMS for depression.
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