Evidence from Indian studies on safety and efficacy of therapeutic transcranial magnetic stimulation across neuropsychiatric disorders- A systematic review and meta-analysis

Research on clinical aspects of bipolar disorder: A review of Indian studies

Background

Bipolar disorder is one of the severe mental disorders that are associated with significant morbidity of the patients. Despite advancements in our understanding about the disorder, it remains a challenging proposition to treat bipolar disorder, largely since the prophylactic treatment of the disorder requires assessment of complex clinical algorithms. The revisions of the classificatory systems have also changed the conceptualization of the disorder. In this background, we conducted a review of the Indian studies conducted on the clinical aspects of bipolar disorder.

Methods

A narrative review was conducted with focus on the literature published from India. The databases searched included PubMed, Scopus, and Google Scholar, and articles published over the last 15 years by Indian authors were included for this review.

Results

In our review, we could access a substantial volume of research published from India. We could identify studies that catered to most of the relevant themes in bipolar disorder including epidemiology, etiology, comorbidities, stigma, disability, clinical course, cognitive profile, pathways to care, and recovery.

Conclusion

The research trajectory was in line with the research conducted elsewhere in the world. However, certain dissimilarities in terms of focus could also be observed. The possible reason behind this deviation could be the difference in clinical need and unique challenges faced in the management and rehabilitation of patients in bipolar disorder in Indian scenario.

Neuromodulation Techniques for Headache Management

This narrative review aims to summarize evidence regarding the current utilization and future applications of neuromodulation in patients with headaches, with special attention paid to migraine and chronic cluster headache. A search was conducted in PubMed in August of 2023 to survey the current literature on neuromodulation for the treatment of headache. In total, the search yielded 1989 results, which were further filtered to include only systematic reviews published between 2022 to 2023 to capture the most up-to-date and comprehensive research on this topic. The citation lists of these articles were reviewed to find additional research on neuromodulation and supplement the results presented in this paper with primary literature. Research on the use of neuromodulation for the treatment of headache has predominantly focused on four neuromodulation techniques: peripheral nerve stimulation (PNS), transcranial magnetic stimulation (TMS), deep brain stimulation (DBS), and spinal cord stimulation (SCS). Outcome measures reported in this article include impact on migraine and headache frequency and/or pain intensity, adverse effects of the neuromodulation technique, and associated costs, when available. We found that neuromodulation has developed utility as an alternative treatment for both chronic cluster headaches and migraines, with a reduction in frequency and intensity of headache most elucidated from the articles mentioned in this review.

Indian research on transcranial magnetic stimulation: A bibliometric analysis

Background

A significant body of evidence on the role of TMS in neurology and psychiatry has emerged from Indian studies.

Aims

We aimed to assess the existing and emerging trends of research on TMS as a diagnostic or therapeutic tool in India using bibliometric analysis.

Results

A total of 146 publications, retrieved from various databases, were analyzed using Microsoft Excel and VOSviewer. We found a linear positive growth of publications in India in the field of TMS and neuropsychiatry, with about 3000 citations so far. The most researched diagnosis was schizophrenia. NIMHANS, Bengaluru, had the highest number of publications. The journal with the highest number of publications was the Asian Journal of Psychiatry, and that with the highest citations was the Journal of Affective disorders.

Conclusion

The growth of Indian research in the field of TMS corresponds to that of the global one but also suggests the need for more studies to match the research output from other countries.