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Antal A, Ganho-Ávila A, Assecondi S, Barbour T, Bjekić J, Blumberger DM, Bolognini N, Brunelin J, Chanes L, Dale M, Dubbioso R, D'Urso G, Filipcic I, Filipović SR, Hirnstein M, Konings F, Langguth B, Leocani L, Sorkhabi MM, Mulder M, Nikander M, Nowak R, Oliviero A, Onarheim B, O'Shea J, Pallanti S, Rachid F, Rajão-Saraiva J, Rossi S, Sack AT, Sauvaget A, van der Scheer R, Schellhorn K, Soria-Frisch A, Szekely D, Tankisi H, Cj Taylor P, Tendolkar I, Uusitalo S, Baeken C. The consequences of the new European reclassification of non-invasive brain stimulation devices and the medical device regulations pose an existential threat to research and treatment: An invited opinion paper. Clin Neurophysiol 2024:S1388-2457(24)00118-4. [PMID: 38679530 DOI: 10.1016/j.clinph.2024.03.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 03/19/2024] [Accepted: 03/21/2024] [Indexed: 05/01/2024]
Abstract
A significant amount of European basic and clinical neuroscience research includes the use of transcranial magnetic stimulation (TMS) and low intensity transcranial electrical stimulation (tES), mainly transcranial direct current stimulation (tDCS). Two recent changes in the EU regulations, the introduction of the Medical Device Regulation (MDR) (2017/745) and the Annex XVI have caused significant problems and confusions in the brain stimulation field. The negative consequences of the MDR for non-invasive brain stimulation (NIBS) have been largely overlooked and until today, have not been consequently addressed by National Competent Authorities, local ethical committees, politicians and by the scientific communities. In addition, a rushed bureaucratic decision led to seemingly wrong classification of NIBS products without an intended medical purpose into the same risk group III as invasive stimulators. Overregulation is detrimental for any research and for future developments, therefore researchers, clinicians, industry, patient representatives and an ethicist were invited to contribute to this document with the aim of starting a constructive dialogue and enacting positive changes in the regulatory environment.
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Affiliation(s)
- Andrea Antal
- Department of Neurology, University Medical Center Göttingen, Göttingen. Germany.
| | - Ana Ganho-Ávila
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Sara Assecondi
- Centre for Mind/Brain Sciences - CIMeC, University of Trento, Rovereto (TN), Italy
| | - Tracy Barbour
- Massachusetts General Hospital, Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jovana Bjekić
- University of Belgrade, Institute for Medical Research, Human Neuroscience Group and Centre for Neuroscience and Neuromodulation Belgrade, Serbia
| | - Daniel M Blumberger
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health and Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Nadia Bolognini
- Department of Psychology, University of Milano Bicocca, and Laboratory of Neuropsychology, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Jerome Brunelin
- CH Le Vinatier, Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL, Bron, France
| | - Lorena Chanes
- Department of Clinical and Health Psychology-Institute of Neurosciences, Universitat Autònoma de Barcelona, Barcelone, Spain
| | - Matthew Dale
- Magstim, Spring Gardens, Whitland, Carmarthenshire, SA34 0HR, UK
| | - Raffaele Dubbioso
- Neurophysiology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples, Naples, Italy
| | - Giordano D'Urso
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | | | - Saša R Filipović
- University of Belgrade, Institute for Medical Research, Human Neuroscience Group and Centre for Neuroscience and Neuromodulation, Belgrade, Serbia
| | - Marco Hirnstein
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Femke Konings
- Independent expert by experience contributor, Amsterdam, the Netherlands
| | - Berthold Langguth
- Chair of the German Society for Brain Stimulation in Psychiatry, Department of Psychiatry and Psychotherapy, Bezirksklinikum, University of Regensburg, Germany
| | - Letizia Leocani
- Experimental Neurophysiology Unit, Institute of Experimental Neurology-INSPE, San Raffaele Scientific Institute, Milan, Italy; Faculty of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | | | - Marc Mulder
- Independent expert by experience contributor, The Hague, the Netherlands
| | | | | | - Antonio Oliviero
- FENNSI Group, Hospital Nacional de PArapléjicos, SESCAM, Toledo, Spain; Center for Clinical Neuroscience - Hospital "Los Madroños", Brunete (Madrid), Spain
| | - Balder Onarheim
- School of Psychology and Humanities, University of Central Lancashire, U.K
| | | | - Stefano Pallanti
- Istituto di Neuroscienze (Italy) and Albert Einstein College of Medicine (NY. USA) Chair of ECNP Network on Neuromodulation
| | - Fady Rachid
- Private Practice, 7, place de la Fusterie, 1204, Geneva, Switzerland
| | | | - Simone Rossi
- Siena Brain Investigation and Neuromodulation Lab (SiBIN Lab), Department of Medicine, Surgery and Neuroscience, University of Siena, Italy
| | - Alexander T Sack
- Section Brain Stimulation and Cognition, Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University (UM); Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Brain+Nerve Centre, Maastricht University Medical Center (MUMC+), Center for Integrative Neuroscience (CIN), the Netherlands
| | - Anne Sauvaget
- Department of Psychiatry, University Hospital of Nantes, France
| | - Rik van der Scheer
- Independent Patient Representative Advisor in Adult, Child & Adolescent Psychiatry, Venlo, the Netherlands
| | | | | | - David Szekely
- Deputy Head of Neuromodulation Unit of Princess Grace Hospital Centre, Monaco
| | - Hatice Tankisi
- Head of the Europa, Middle East, Africa Chapter of the International Federation of Clinical Neurophysiology, Department of Clinical Neurophysiology, Aarhus University Hospital and Department of Clinical Institute, Aarhus University, Aarhus, Denmark
| | | | - Indira Tendolkar
- Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Radboud University Nijmegen, Netherlands
| | | | - Chris Baeken
- Department of Head and Skin - Psychiatry and Medical Psychology, Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium; Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Psychiatry, Brussels, Belgium; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
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Perret M, Neige C, Brunelin J, Mondino M. Unraveling the brain mechanisms of source monitoring with non-invasive brain stimulation: A systematic review. Int J Clin Health Psychol 2024; 24:100449. [PMID: 38406179 PMCID: PMC10884508 DOI: 10.1016/j.ijchp.2024.100449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/14/2024] [Indexed: 02/27/2024] Open
Abstract
Background/Objective Source monitoring refers to the ability to determine the source of memories and encompasses three subprocesses: internal source monitoring, reality monitoring, and external source monitoring. Neuroimaging studies provide valuable insights about neural correlates of source monitoring, but the causal relationship between brain and behavior is lacking. This study aimed to identify brain circuits involved in source monitoring by synthesizing the effects of brain stimulation on source monitoring as a function of the targeted brain regions or circuits. Method We conducted a systematic review of interventional studies that have examined the effects of brain stimulation on source monitoring across six databases. The principal outcome was the difference of source monitoring performance between active and control stimulation conditions. Results 23 studies (920 healthy participants and 54 patients with schizophrenia) were included. Our findings revealed the involvement of i) the lateral prefrontal and temporoparietal cortices in internal source monitoring, ii) the medial prefrontal and temporoparietal cortices in reality monitoring, and iii) the precuneus and the left angular gyrus in external source monitoring. Conclusions These findings deepen our understanding of the brain mechanisms of source monitoring and highlight specific stimulation targets to alleviate source monitoring deficits.
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Affiliation(s)
- Mélanie Perret
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, F-69500 Bron, France
- Centre Hospitalier Le Vinatier, 95 Boulevard Pinel, F-69500 Bron, France
| | - Cécilia Neige
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, F-69500 Bron, France
- Centre Hospitalier Le Vinatier, 95 Boulevard Pinel, F-69500 Bron, France
| | - Jerome Brunelin
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, F-69500 Bron, France
- Centre Hospitalier Le Vinatier, 95 Boulevard Pinel, F-69500 Bron, France
| | - Marine Mondino
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, F-69500 Bron, France
- Centre Hospitalier Le Vinatier, 95 Boulevard Pinel, F-69500 Bron, France
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Brunelin J, Neige C, Eche J, Galvao F, Bation R, Mondino M. Case report: accelerated cathodal HD-tDCS over the right dorsolateral prefrontal cortex in hoarding disorder. Front Hum Neurosci 2024; 17:1327811. [PMID: 38529211 PMCID: PMC10961415 DOI: 10.3389/fnhum.2023.1327811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 11/23/2023] [Indexed: 03/27/2024] Open
Abstract
Hoarding disorder is an under-recognized condition characterized by the excessive acquisition of possessions and difficulty in disposing of them, which can have dramatic consequences. As hoarding disorder is difficult to treat and associated with high levels of disability in all areas of functioning, there appears to be a critical need to develop novel, tailored therapeutic strategies. Non-invasive brain stimulation techniques hold promise as potential therapeutic interventions for various psychiatric conditions and as a tool to modulate impulsivity when applied over the dorsolateral prefrontal cortex (DLPFC). Therefore, we hypothesized that delivering accelerated cathodal high-definition direct transcranial stimulation (HD-tDCS) over the right DLPFC could be a suitable approach to alleviate symptoms in patients with hoarding disorder. In a case report, we observed beneficial clinical effects on acquisition and depressive symptoms after 15 sessions of three daily 20-min sessions. Accelerated cathodal HD-tDCS over the right DLPFC appears to be a safe and appropriate intervention for patients with hoarding disorder. However, randomized, sham-controlled trials are needed to further validate these encouraging findings.
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Affiliation(s)
- Jerome Brunelin
- Centre Hospitalier Le Vinatier, Bron, France
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Bron, France
| | - Cécilia Neige
- Centre Hospitalier Le Vinatier, Bron, France
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Bron, France
| | - Julien Eche
- Centre Hospitalier Le Vinatier, Bron, France
| | | | - Rémy Bation
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Bron, France
- Hospices Civils de Lyon, Service de Psychiatrie de Liaison, Groupement Hospitalier Sud, Pierre Benite, France
| | - Marine Mondino
- Centre Hospitalier Le Vinatier, Bron, France
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Bron, France
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Magnin C, Poulet E, Fanton L, Vignaud P, Brunelin J. A non-randomized pilot trial of the use of prazosin in the prevention of transition from acute stress disorder to post-traumatic stress disorder. Eur J Psychotraumatol 2023; 14:2251250. [PMID: 38154074 PMCID: PMC10484028 DOI: 10.1080/20008066.2023.2251250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/05/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND Following a traumatic event, 40-80% of the patients with acute stress disorder (ASD) will develop post-traumatic stress disorder (PTSD), 67% at 6 months. Alpha1-blockers are effective in treating some symptoms of PTSD but their usefulness in acute stress situations remains unclear. We hypothesized that reducing noradrenergic hyperactivity with an alpha1-blocker during the acute phase after a traumatic event could prevent the transition to PTSD in patients with ASD. OBJECTIVE To investigate the efficacy and safety of a 1-month course of alpha1-blocker (prazosin) to prevent the transition to PTSD in patients with ASD at 6 months. METHOD In a monocentric open-label prospective pilot study, 15 patients with ASD were included within 3-7 days of exposure to a traumatic event. After enrolment, they received prazosin LP at home at bedtime at 2.5 mg/day for 7 days and then 5 mg/day for 21 days. Incidence of PTSD was assessed at 6 months using the Clinician Administrated PTSD Scale (CAPS). RESULTS At 6 months, 22% of patients who completed the study (2/9) met the diagnostic criteria for PTSD. This rate was significantly lower than that observed in previous studies (67%; p = .047). The treatment was well tolerated and there were no serious adverse events. CONCLUSIONS These preliminary findings indicating the safety of prazosin and suggesting its potential to prevent the development of PTSD in ASD require to be replicated in large-scale randomized placebo-controlled studies.Trial registration: The study was pre-registered on a public database (www.clinicalTrials.gov identifier: NCT03045016).
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Affiliation(s)
- Charline Magnin
- Psychiatric Emergency Service, Hospices civils de Lyon, Lyon, France
| | - Emmanuel Poulet
- Psychiatric Emergency Service, Hospices civils de Lyon, Lyon, France
- CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Université Claude Bernard Lyon 1, Bron, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Laurent Fanton
- Service of Legal Medicine, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon, France
- Lyon-Est Medical School, Université de Lyon, Claude-Bernard Lyon 1 University, Lyon, France
| | - Philippe Vignaud
- CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Université Claude Bernard Lyon 1, Bron, France
- Regional Centre for Psychotraumatic Disorders, Edouard Herriot Hospital, Lyon, France
- Emergency medical service, cellule d’urgences medico-psychologiques, Edouard Herriot Hospital, Lyon, France
| | - Jerome Brunelin
- CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Université Claude Bernard Lyon 1, Bron, France
- Centre Hospitalier Le Vinatier, Bron, France
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Fivel L, Mondino M, Brunelin J, Haesebaert F. Basic auditory processing and its relationship with symptoms in patients with schizophrenia: A systematic review. Psychiatry Res 2023; 323:115144. [PMID: 36940586 DOI: 10.1016/j.psychres.2023.115144] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/09/2023] [Accepted: 03/01/2023] [Indexed: 03/23/2023]
Abstract
Processing of basic auditory features, one of the earliest stages of auditory perception, has been the focus of considerable investigations in schizophrenia. Although numerous studies have shown abnormalities in pitch perception in schizophrenia, other basic auditory features such as intensity, duration, and sound localization have been less explored. Additionally, the relationship between basic auditory features and symptom severity shows inconsistent results, preventing concrete conclusions. Our aim was to present a comprehensive overview of basic auditory processing in schizophrenia and its relationship with symptoms. We conducted a systematic review according to the PRISMA guidelines. PubMed, Embase, and PsycINFO databases were searched for studies exploring auditory perception in schizophrenia compared to controls, with at least one behavioral task investigating basic auditory processing using pure tones. Forty-one studies were included. The majority investigated pitch processing while the others investigated intensity, duration and sound localization. The results revealed that patients have a significant deficit in the processing of all basic auditory features. Although the search for a relationship with symptoms was limited, auditory hallucinations experience appears to have an impact on basic auditory processing. Further research may examine correlations with clinical symptoms to explore the performance of patient subgroups and possibly implement remediation strategies.
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Affiliation(s)
- Laure Fivel
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Bron F-69500, France
| | - Marine Mondino
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Bron F-69500, France; Centre Hospitalier Le Vinatier, 95 Boulevard Pinel, Bron F-69500, France.
| | - Jerome Brunelin
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Bron F-69500, France; Centre Hospitalier Le Vinatier, 95 Boulevard Pinel, Bron F-69500, France
| | - Frédéric Haesebaert
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Bron F-69500, France; Centre Hospitalier Le Vinatier, 95 Boulevard Pinel, Bron F-69500, France
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Baeken C, Arns M, Brunelin J, Chanes L, Filipcic I, Ganho-Ávila A, Hirnstein M, Rachid F, Sack AT, O'shea J, D'urso G, Antal A. European reclassification of non-invasive brain stimulation as class III medical devices: A call to action. Brain Stimul 2023; 16:564-566. [PMID: 36870602 DOI: 10.1016/j.brs.2023.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/22/2023] [Indexed: 03/06/2023] Open
Affiliation(s)
- Chris Baeken
- Faculty of Medicine and Health Sciences, Department of Head and Skin, Ghent Experimental Psychiatry (GHEP) lab, Ghent University, Ghent, Belgium; Department of Psychiatry, University Hospital (UZBrussel), Brussels, Belgium; Eindhoven University of Technology, Department of Electrical Engineering, Eindhoven, the Netherlands
| | - Martijn Arns
- Research Institute Brainclinics, Nijmegen, the Netherlands
| | - Jerome Brunelin
- CH Le Vinatier, Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, F-69500, Bron, France
| | - Lorena Chanes
- Department of Clinical and Health Psychology-Institut de Neurociències, Universitat Autònoma de Barcelona, Catalunya, Spain; Serra Húnter Programme, Generalitat de Catalunya Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Spain
| | | | - Ana Ganho-Ávila
- Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115, Coimbra, Portugal
| | - Marco Hirnstein
- Department of biological and medical psychology, University of Bergen, Bergen, Norway
| | - Fady Rachid
- Private Practice, 7, place de la Fusterie, 1204, Geneva, Switzerland
| | - Alexander T Sack
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Brain+Nerve Centre, Maastricht University Medical Centre+ (MUMC+), the Netherlands
| | - Jacinta O'shea
- Oxford Centre for Human Brain Activity (OHBA), Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 9DU, UK
| | - Giordano D'urso
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Andrea Antal
- Department of Neurology, University Medical Center Göttingen, Germany.
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Brunelin J, Bouaziz N, Dollfus S, Kallel L, Jardri R, Rachid F, Mondino M. Letter to the editor: Safety of "accelerated" rTMS protocols with twice-daily sessions in patients with schizophrenia - A comment on Caulfield et al. J Psychiatr Res 2022; 156:754-757. [PMID: 36088124 DOI: 10.1016/j.jpsychires.2022.08.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 08/25/2022] [Indexed: 01/20/2023]
Affiliation(s)
- Jerome Brunelin
- Centre Hospitalier Le Vinatier, F-69500, Bron, France; Inserm U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Université Claude Bernard Lyon 1, Université Jean Monnet, F-69000, Lyon, France.
| | - Noomane Bouaziz
- Unité de Recherche Clinique, Pôle 93G03, EPS de Ville Evrard, Neuilly sur Marne, France
| | - Sonia Dollfus
- UNICAEN, Inserm UMR-S 1237, GIP Cyceron, Caen, F-14000, France; CHU Caen, Centre Esquirol, Caen, F-14000, France
| | | | - Renaud Jardri
- Laboratoire de Neurosciences Cognitives & Computationnelles (LNC(2)), ENS, INSERM U-960, PSL Research University, Paris, France; Univ Lille, INSERM U-1172, Lille Neurosciences & Cognition Centre, Plasticity and Subjectivity Team, & CHU Lille, Fontan Hospital, CURE Platform, Lille, France
| | - Fady Rachid
- Private Practice 7, Place de la Fusterie, 1204, Geneva, Switzerland
| | - Marine Mondino
- Centre Hospitalier Le Vinatier, F-69500, Bron, France; Inserm U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Université Claude Bernard Lyon 1, Université Jean Monnet, F-69000, Lyon, France
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8
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Brunoni AR, Ekhtiari H, Antal A, Auvichayapat P, Baeken C, Benseñor IM, Bikson M, Boggio P, Borroni B, Brighina F, Brunelin J, Carvalho S, Caumo W, Ciechanski P, Charvet L, Clark VP, Cohen Kadosh R, Cotelli M, Datta A, Deng ZD, De Raedt R, De Ridder D, Fitzgerald PB, Floel A, Frohlich F, George MS, Ghobadi-Azbari P, Goerigk S, Hamilton RH, Jaberzadeh SJ, Hoy K, Kidgell DJ, Zonoozi AK, Kirton A, Laureys S, Lavidor M, Lee K, Leite J, Lisanby SH, Loo C, Martin DM, Miniussi C, Mondino M, Monte-Silva K, Morales-Quezada L, Nitsche MA, Okano AH, Oliveira CS, Onarheim B, Pacheco-Barrios K, Padberg F, Nakamura-Palacios EM, Palm U, Paulus W, Plewnia C, Priori A, Rajji TK, Razza LB, Rehn EM, Ruffini G, Schellhorn K, Zare-Bidoky M, Simis M, Skorupinski P, Suen P, Thibaut A, Valiengo LCL, Vanderhasselt MA, Vanneste S, Venkatasubramanian G, Violante IR, Wexler A, Woods AJ, Fregni F. Digitalized transcranial electrical stimulation: A consensus statement. Clin Neurophysiol 2022; 143:154-165. [PMID: 36115809 PMCID: PMC10031774 DOI: 10.1016/j.clinph.2022.08.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 08/16/2022] [Accepted: 08/20/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Although relatively costly and non-scalable, non-invasive neuromodulation interventions are treatment alternatives for neuropsychiatric disorders. The recent developments of highly-deployable transcranial electric stimulation (tES) systems, combined with mobile-Health technologies, could be incorporated in digital trials to overcome methodological barriers and increase equity of access. The study aims are to discuss the implementation of tES digital trials by performing a systematic scoping review and strategic process mapping, evaluate methodological aspects of tES digital trial designs, and provide Delphi-based recommendations for implementing digital trials using tES. METHODS We convened 61 highly-productive specialists and contacted 8 tES companies to assess 71 issues related to tES digitalization readiness, and processes, barriers, advantages, and opportunities for implementing tES digital trials. Delphi-based recommendations (>60% agreement) were provided. RESULTS The main strengths/opportunities of tES were: (i) non-pharmacological nature (92% of agreement), safety of these techniques (80%), affordability (88%), and potential scalability (78%). As for weaknesses/threats, we listed insufficient supervision (76%) and unclear regulatory status (69%). Many issues related to methodological biases did not reach consensus. Device appraisal showed moderate digitalization readiness, with high safety and potential for trial implementation, but low connectivity. CONCLUSIONS Panelists recognized the potential of tES for scalability, generalizability, and leverage of digital trials processes; with no consensus about aspects regarding methodological biases. SIGNIFICANCE We further propose and discuss a conceptual framework for exploiting shared aspects between mobile-Health tES technologies with digital trials methodology to drive future efforts for digitizing tES trials.
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Affiliation(s)
- Andre R Brunoni
- Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo & Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil; Laboratory of Neurosciences (LIM-27), Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Service of Interdisciplinary Neuromodulation (SIN), Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
| | - Hamed Ekhtiari
- Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA
| | - Andrea Antal
- Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Paradee Auvichayapat
- Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chris Baeken
- Vrije Universiteit Brussel (VUB): Department of Psychiatry University Hospital (UZBrussel), Brussels, Belgium; Department of Head and Skin, Ghent University Hospital, Ghent University, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium; Eindhoven University of Technology, Department of Electrical Engineering, the Netherlands
| | - Isabela M Benseñor
- Center for Clinical and Epidemiological Research, University of São Paulo, São Paulo, Brazil
| | - Marom Bikson
- The Department of Biomedical Engineering, The City College of New York, The City University of New York, NY, USA
| | - Paulo Boggio
- Social and Cognitive Neuroscience Laboratory, Center for Biological Science and Health, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Barbara Borroni
- Centre for Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Filippo Brighina
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy
| | - Jerome Brunelin
- Centre Hospitalier le Vinatier, Bron, France; INSERM U1028, CNRS UMR 5292, PSYR2 Team, Centre de recherche en Neurosciences de Lyon (CRNL), Université Lyon 1, Lyon, France
| | - Sandra Carvalho
- Translational Neuropsychology Lab, Department of Education and Psychology and William James Center for Research (WJCR), University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Wolnei Caumo
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; Laboratory of Pain and Neuromodulation at Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil; Pain and Palliative Care Service at HCPA, Brazil; Department of Surgery, School of Medicine, UFRGS, Brazil
| | - Patrick Ciechanski
- Faculty of Medicine and Dentistry, University of Alberta, 1-002 Katz Group Centre for Pharmacy and Health Research, Edmonton, Alberta, Canada
| | - Leigh Charvet
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, USA
| | - Vincent P Clark
- Psychology Clinical Neuroscience Center, Department of Psychology, The University of New Mexico, Albuquerque, NM, USA
| | - Roi Cohen Kadosh
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Abhishek Datta
- Research and Development, Soterix Medical Inc., New York, USA
| | - Zhi-De Deng
- Noninvasive Neuromodulation Unit, Experimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Rudi De Raedt
- Department of Experimental Clinical and Health Psychology, Ghent University, Belgium
| | - Dirk De Ridder
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Paul B Fitzgerald
- Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Monash University Department of Psychiatry, Camberwell, Victoria, Australia
| | - Agnes Floel
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany; German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA; Carolina Center for Neurostimulation, University of North Carolina, Chapel Hill, NC, USA; Neuroscience Center, University of North Carolina, Chapel Hill, NC, USA; Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC, USA; Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, USA; Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
| | - Mark S George
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Peyman Ghobadi-Azbari
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran; Department of Biomedical Engineering, Shahed University, Tehran, Iran
| | - Stephan Goerigk
- Department of Psychiatry and Psychotherapy, LMU Hospital, Munich, Germany; Department of Psychological Methodology and Assessment, LMU, Munich, Germany; Hochschule Fresenius, University of Applied Sciences, Munich, Germany
| | - Roy H Hamilton
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Shapour J Jaberzadeh
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Kate Hoy
- Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Monash University Department of Psychiatry, Camberwell, Victoria, Australia
| | - Dawson J Kidgell
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
| | - Arash Khojasteh Zonoozi
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran; Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Adam Kirton
- Department of Clinical Neurosciences and Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University of Liège, Liege, Belgium
| | - Michal Lavidor
- Bar Ilan University, Department of Psychology, and the Gonda Brain Research Center, Israel
| | - Kiwon Lee
- Ybrain Corporation, Gyeonggi-do, Republic of Korea
| | - Jorge Leite
- INPP, Portucalense University, Porto, Portugal
| | - Sarah H Lisanby
- Noninvasive Neuromodulation Unit, Experimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Colleen Loo
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Black Dog Institute, Sydney, NSW, Australia
| | - Donel M Martin
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Black Dog Institute, Sydney, NSW, Australia
| | - Carlo Miniussi
- Center for Mind/Brain Sciences - CIMeC, University of Trento, Rovereto, Italy
| | - Marine Mondino
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy; Centre Hospitalier le Vinatier, Bron, France
| | - Katia Monte-Silva
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, UFPE, Recife, PE, Brazil; NAPeN Network (Núcleo de Assistência e Pesquisa em Neuromodulação), Brazil
| | - Leon Morales-Quezada
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA 02215, USA
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Alexandre H Okano
- NAPeN Network (Núcleo de Assistência e Pesquisa em Neuromodulação), Brazil; Center for Mathematics, Computation, and Cognition, Universidade Federal do ABC, São Bernardo do Campo, Brazil; Brazilian Institute of Neuroscience and Neurotechnology (BRAINN/CEPID-FAPESP), University of Campinas, Campinas, São Paulo, Brazil
| | - Claudia S Oliveira
- Master's and Doctoral Program in Health Sciences, Faculty of Medical Sciences, Santa Casa de São Paulo, São Paulo, Brazil; Master's and Doctoral Program in Human Movement and Rehabilitation, Evangelical University of Goiás, Anápolis, Brazil
| | | | - Kevin Pacheco-Barrios
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Ester M Nakamura-Palacios
- Laboratory of Cognitive Sciences and Neuropsychopharmacology, Program of Post-Graduation in Physiological Sciences, Health Sciences Center, Federal University of Espirito Santo, Vitória, ES, Brazil
| | - Ulrich Palm
- Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany; Medical Park Chiemseeblick, Rasthausstr. 25, 83233 Bernau-Felden, Germany
| | - Walter Paulus
- Department of Neurology. Ludwig Maximilians University Munich, Klinikum Großhadern, Marchioninistr, München, Germany
| | - Christian Plewnia
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), Neurophysiology and Interventional Neuropsychiatry, University of Tübingen, Tübingen, Germany
| | - Alberto Priori
- Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, Milan, Italy
| | - Tarek K Rajji
- Centre for Addiction and Mental Health, Toronto, Canada; Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Toronto Dementia Research Alliance, Toronto, Canada
| | - Lais B Razza
- Service of Interdisciplinary Neuromodulation (SIN), Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | | | - Mehran Zare-Bidoky
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran; School of Medicine, Shahid-Sadoughi University of Medical Sciences, Yazd, Iran
| | - Marcel Simis
- Physical and Rehabilitation Medicine Institute, General Hospital, Medical School of the University of Sao Paulo, São Paulo, Brazil
| | | | - Paulo Suen
- Service of Interdisciplinary Neuromodulation (SIN), Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Aurore Thibaut
- Coma Science Group, GIGA-Consciousness & Centre du Cerveau, University and University Hospital of Liège, Liège, Belgium
| | - Leandro C L Valiengo
- Laboratory of Neurosciences (LIM-27), Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Service of Interdisciplinary Neuromodulation (SIN), Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Marie-Anne Vanderhasselt
- Department of Head and Skin, Ghent University Hospital, Ghent University, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium
| | - Sven Vanneste
- Lab for Clinical & Integrative Neuroscience, Trinity College of Neuroscience, Trinity College Dublin, Ireland
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Ines R Violante
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Anna Wexler
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA; Department of Neuroscience, University of Florida, Gainesville, FL, USA
| | - Felipe Fregni
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Brunelin J, Adam O, Favre E, Prange S, Zante E, Demily C. Noninvasive electrical stimulation for psychiatric care in Down's syndrome. Brain Stimul 2022; 15:678-679. [DOI: 10.1016/j.brs.2022.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 04/18/2022] [Indexed: 11/02/2022] Open
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Brunelin J, Mondino M, Haesebaert J, Attal J, Benoit M, Chupin M, Dollfus S, El-Hage W, Galvao F, Jardri R, Llorca PM, Magaud L, Plaze M, Schott-Pethelaz AM, Suaud-Chagny MF, Szekely D, Fakra E, Poulet E. Examining transcranial random noise stimulation as an add-on treatment for persistent symptoms in schizophrenia (STIM'Zo): a study protocol for a multicentre, double-blind, randomized sham-controlled clinical trial. Trials 2021; 22:964. [PMID: 34963486 PMCID: PMC8715588 DOI: 10.1186/s13063-021-05928-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/08/2021] [Indexed: 12/26/2022] Open
Abstract
Background One out of three patients with schizophrenia failed to respond adequately to antipsychotics and continue to experience debilitating symptoms such as auditory hallucinations and negative symptoms. The development of additional therapeutic approaches for these persistent symptoms constitutes a major goal for patients. Here, we develop a randomized-controlled trial testing the efficacy of high-frequency transcranial random noise stimulation (hf-tRNS) for the treatment of resistant/persistent symptoms of schizophrenia in patients with various profiles of symptoms, cognitive deficits and illness duration. We also aim to investigate the biological and cognitive effects of hf-tRNS and to identify the predictors of clinical response. Methods In a randomized, double-blind, 2-arm parallel-group, controlled, multicentre study, 144 patients with schizophrenia and persistent symptoms despite the prescription of at least one antipsychotic treatment will be randomly allocated to receive either active (n = 72) or sham (n = 72) hf-tRNS. hf-tRNS (100–500 Hz) will be delivered for 20 min with a current intensity of 2 mA and a 1-mA offset twice a day on 5 consecutive weekdays. The anode will be placed over the left dorsolateral prefrontal cortex and the cathode over the left temporoparietal junction. Patients’ symptoms will be assessed prior to hf-tRNS (baseline), after the 10 sessions, and at 1-, 3- and 6-month follow-up. The primary outcome will be the number of responders defined as a reduction of at least 25% from the baseline scores on the Positive and Negative Syndrome Scale (PANSS) after the 10 sessions. Secondary outcomes will include brain activity and connectivity, source monitoring performances, social cognition, other clinical (including auditory hallucinations) and biological variables, and attitude toward treatment. Discussion The results of this trial will constitute a first step toward establishing the usefulness of hf-tRNS in schizophrenia whatever the stage of the illness and the level of treatment resistance. We hypothesize a long-lasting effect of active hf-tRNS on the severity of schizophrenia symptoms as compared to sham. This trial will also have implications for the use of hf-tRNS as a preventive intervention of relapse in patients with schizophrenia. Trial registration ClinicalTrials.gov NCT02744989. Prospectively registered on 20 April 2016
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Affiliation(s)
- Jerome Brunelin
- Centre Hospitalier Le Vinatier, PSYR2 team, Bat 416 - 1st floor; 95 boulevard Pinel, 69678, F-69500, Bron cedex, France. .,INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, PSYR2 Team, F-69000, Lyon, France. .,Lyon 1 University, F-69000, Villeurbanne, France. .,Université Jean Monnet Saint Etienne, F-42000, Saint Etienne, France.
| | - Marine Mondino
- Centre Hospitalier Le Vinatier, PSYR2 team, Bat 416 - 1st floor; 95 boulevard Pinel, 69678, F-69500, Bron cedex, France.,INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, PSYR2 Team, F-69000, Lyon, France.,Lyon 1 University, F-69000, Villeurbanne, France.,Université Jean Monnet Saint Etienne, F-42000, Saint Etienne, France
| | - Julie Haesebaert
- Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie Cliniques, F-69003, Lyon, France.,Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Villeurbanne, France
| | | | | | - Marie Chupin
- Paris Brain Institute - Institut du Cerveau (ICM), Inserm U 1127, CNRS UMR 7225, Sorbonne Université, F-75013, Paris, France.,CATI Multicenter Neuroimaging Platform, F-75000, Paris, France
| | | | - Wissam El-Hage
- CHRU de Tours, CIC 1415, INSERM, Tours; UMR 1253, iBrain, Université de Tours, INSERM, F-37044, Tours, France
| | - Filipe Galvao
- Centre Hospitalier Le Vinatier, PSYR2 team, Bat 416 - 1st floor; 95 boulevard Pinel, 69678, F-69500, Bron cedex, France
| | - Renaud Jardri
- University in Lille, INSERM U1172, CHU Lille, Lille Neuroscience & Cognition Research Centre, Plasticity & SubjectivitY (PSY) team, CURE Platform, Lille, France
| | | | - Laurent Magaud
- Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie Cliniques, F-69003, Lyon, France
| | - Marion Plaze
- GHU PARIS Psychiatrie & Neurosciences, site Sainte-Anne, Service Hospitalo-Universitaire, F-75014, Paris, France.,Université de Paris, F-75005, Paris, France
| | - Anne Marie Schott-Pethelaz
- Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie Cliniques, F-69003, Lyon, France.,Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Marie-Françoise Suaud-Chagny
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, PSYR2 Team, F-69000, Lyon, France.,Lyon 1 University, F-69000, Villeurbanne, France.,Université Jean Monnet Saint Etienne, F-42000, Saint Etienne, France
| | | | - Eric Fakra
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, PSYR2 Team, F-69000, Lyon, France.,Lyon 1 University, F-69000, Villeurbanne, France.,Université Jean Monnet Saint Etienne, F-42000, Saint Etienne, France.,CHU de Saint Etienne, F-42000, Saint Etienne, France
| | - Emmanuel Poulet
- Centre Hospitalier Le Vinatier, PSYR2 team, Bat 416 - 1st floor; 95 boulevard Pinel, 69678, F-69500, Bron cedex, France.,INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, PSYR2 Team, F-69000, Lyon, France.,Lyon 1 University, F-69000, Villeurbanne, France.,Université Jean Monnet Saint Etienne, F-42000, Saint Etienne, France.,Psychiatric emergency service, Hospices civils de Lyon, F-69005, Lyon, France
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11
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Dondé C, Laprévote V, Lavallé L, Haesebaert F, Fakra E, Brunelin J. Cognitive insight in individuals with an at-risk mental state for psychosis: A meta-analysis. Early Interv Psychiatry 2021; 15:449-456. [PMID: 32452629 DOI: 10.1111/eip.12993] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/09/2020] [Accepted: 04/28/2020] [Indexed: 01/01/2023]
Abstract
AIM To compare cognitive insight abilities measured with the Beck Cognitive Insight Scale (BCIS) between individuals with an at-risk mental state (ARMS) and healthy controls. METHOD Review and meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS A search for articles investigating cognitive insight in ARMS in the MEDLINE and ScienceDirect databases revealed five studies including 303 ARMS and 376 controls. Regarding BCIS subscales, ARMS individuals displayed significant higher scores for self-certainty than controls with a small-to-moderate effect size (ESg = 0.45 [0.23;0.67], P < .005), whereas no significant difference was observed for self-reflectiveness (ESg = -0.56 [-0.18;1.29], P = .14). No significant differences were observed between ARMS and controls for overall cognitive insight abilities as indexed by the BCIS composite score (ESg = -0.24 [-0.43;0.91], P = .45). CONCLUSIONS Self-certainty abnormalities seem to predate the expression of full-blown psychotic episode and to be higher in ARMS than in healthy controls. By contrast, ARMS did not display abnormal self-reflectiveness and overall cognitive insight abilities.
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Affiliation(s)
- Clément Dondé
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response, PSYR2 Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - Vincent Laprévote
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France.,INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France.,Faculté de Médecine, Université de Lorraine, Nancy, France
| | - Layla Lavallé
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response, PSYR2 Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - Frédéric Haesebaert
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response, PSYR2 Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - Eric Fakra
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response, PSYR2 Team, Lyon, France.,Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Jerome Brunelin
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response, PSYR2 Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
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Dondé C, Pouchon A, Brunelin J, Polosan M. tDCS as a first-choice agent in individuals at high-risk for psychosis? Encephale 2021; 48:472-473. [PMID: 33994158 DOI: 10.1016/j.encep.2021.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/08/2021] [Indexed: 11/27/2022]
Affiliation(s)
- C Dondé
- Université Grenoble Alpes, 38000 Grenoble, France; INSERM, U1216, 38000 Grenoble, France; Adult Psychiatry Department, CHU de Grenoble Alpes, 38000 Grenoble, France; Adult Psychiatry Department, CH Alpes-Isère, 38000 Saint-Egrève, France.
| | - A Pouchon
- Université Grenoble Alpes, 38000 Grenoble, France; INSERM, U1216, 38000 Grenoble, France; Adult Psychiatry Department, CHU de Grenoble Alpes, 38000 Grenoble, France
| | - J Brunelin
- INSERM, U1028; CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response, PSYR2 Team, 69000 Lyon, France; University Lyon 1, 69000 Villeurbanne, France; Centre hspitalier Le Vinatier, Bron, France
| | - M Polosan
- Université Grenoble Alpes, 38000 Grenoble, France; INSERM, U1216, 38000 Grenoble, France; Adult Psychiatry Department, CHU de Grenoble Alpes, 38000 Grenoble, France
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Fregni F, El-Hagrassy MM, Pacheco-Barrios K, Carvalho S, Leite J, Simis M, Brunelin J, Nakamura-Palacios EM, Marangolo P, Venkatasubramanian G, San-Juan D, Caumo W, Bikson M, Brunoni AR. Evidence-Based Guidelines and Secondary Meta-Analysis for the Use of Transcranial Direct Current Stimulation in Neurological and Psychiatric Disorders. Int J Neuropsychopharmacol 2021; 24:256-313. [PMID: 32710772 PMCID: PMC8059493 DOI: 10.1093/ijnp/pyaa051] [Citation(s) in RCA: 226] [Impact Index Per Article: 75.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/21/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Transcranial direct current stimulation has shown promising clinical results, leading to increased demand for an evidence-based review on its clinical effects. OBJECTIVE We convened a team of transcranial direct current stimulation experts to conduct a systematic review of clinical trials with more than 1 session of stimulation testing: pain, Parkinson's disease motor function and cognition, stroke motor function and language, epilepsy, major depressive disorder, obsessive compulsive disorder, Tourette syndrome, schizophrenia, and drug addiction. METHODS Experts were asked to conduct this systematic review according to the search methodology from PRISMA guidelines. Recommendations on efficacy were categorized into Levels A (definitely effective), B (probably effective), C (possibly effective), or no recommendation. We assessed risk of bias for all included studies to confirm whether results were driven by potentially biased studies. RESULTS Although most of the clinical trials have been designed as proof-of-concept trials, some of the indications analyzed in this review can be considered as definitely effective (Level A), such as depression, and probably effective (Level B), such as neuropathic pain, fibromyalgia, migraine, post-operative patient-controlled analgesia and pain, Parkinson's disease (motor and cognition), stroke (motor), epilepsy, schizophrenia, and alcohol addiction. Assessment of bias showed that most of the studies had low risk of biases, and sensitivity analysis for bias did not change these results. Effect sizes vary from 0.01 to 0.70 and were significant in about 8 conditions, with the largest effect size being in postoperative acute pain and smaller in stroke motor recovery (nonsignificant when combined with robotic therapy). CONCLUSION All recommendations listed here are based on current published PubMed-indexed data. Despite high levels of evidence in some conditions, it must be underscored that effect sizes and duration of effects are often limited; thus, real clinical impact needs to be further determined with different study designs.
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Affiliation(s)
- Felipe Fregni
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston, Massachusetts
| | - Mirret M El-Hagrassy
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston, Massachusetts
| | - Kevin Pacheco-Barrios
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston, Massachusetts
- Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru
| | - Sandra Carvalho
- Neurotherapeutics and experimental Psychopathology Group (NEP), Psychological Neuroscience Laboratory, CIPsi, School of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal
| | - Jorge Leite
- I2P-Portucalense Institute for Psychology, Universidade Portucalense, Porto, Portugal
| | - Marcel Simis
- Physical and Rehabilitation Medicine Institute of the University of Sao Paulo Medical School General Hospital, Sao Paulo, Brazil
| | - Jerome Brunelin
- CH Le Vinatier, PSYR2 team, Lyon Neuroscience Research Center, UCB Lyon 1, Bron, France
| | - Ester Miyuki Nakamura-Palacios
- Laboratory of Cognitive Sciences and Neuropsychopharmacology, Department of Physiological Sciences, Federal University of Espírito Santo, Espírito Santo, Brasil (Dr Nakamura-Palacios)
| | - Paola Marangolo
- Dipartimento di Studi Umanistici, Università Federico II, Naples, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Ganesan Venkatasubramanian
- Translational Psychiatry Laboratory, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Daniel San-Juan
- Neurophysiology Department, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico
| | - Wolnei Caumo
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS) Surgery Department, School of Medicine, UFRGS; Pain and Palliative Care Service at Hospital de Clínicas de Porto Alegre (HCPA) Laboratory of Pain and Neuromodulation at HCPA, Porto Alegre, Brazil
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of New York of CUNY, New York, New York
| | - André R Brunoni
- Service of Interdisciplinary Neuromodulation, Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry & Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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14
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Mondino M, Fonteneau C, Simon L, Dondé C, Haesebaert F, Poulet E, Brunelin J. Advancing clinical response characterization to frontotemporal transcranial direct current stimulation with electric field distribution in patients with schizophrenia and auditory hallucinations: a pilot study. Eur Arch Psychiatry Clin Neurosci 2021; 271:85-92. [PMID: 32533249 DOI: 10.1007/s00406-020-01149-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 05/29/2020] [Indexed: 12/25/2022]
Abstract
Transcranial direct current stimulation (tDCS) has been proposed as a therapeutic option for treatment-resistant auditory verbal hallucinations (AVH) in schizophrenia. In such cases, repeated sessions of tDCS are delivered with the anode over the left prefrontal cortex and the cathode over the left temporoparietal junction. Despite promising findings, the clinical response to tDCS is highly heterogeneous among patients. Here, we explored baseline differences between responders and nonresponders to frontotemporal tDCS using electric field modeling. We hypothesized that responders would display different tDCS-induced electric field strength in the brain areas involved in AVH compared to nonresponders.Using baseline structural MRI scans of 17 patients with schizophrenia and daily AVH who received 10 sessions of active frontotemporal tDCS, we constructed individual realistic whole brain models estimating electric field strength. Electric field maps were compared between responders (n = 6) and nonresponders to tDCS (n = 11) using an independent two-sample t test. Clinical response was defined as at least a 50% decrease of AVH 1 month after the last tDCS session.Results from the electric field map comparison showed that responders to tDCS displayed higher electric field strength in the left transverse temporal gyrus at baseline compared to nonresponders (T = 2.37; p = 0.016; 32 voxels).These preliminary findings suggested that the strength of the tDCS-induced electric field reaching the left transverse temporal gyrus could play an important role in the response to frontotemporal tDCS. In addition, this work suggests the interest of using electric field modeling to individualize tDCS and increase response rate.
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Affiliation(s)
- Marine Mondino
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center; PSYR2 Team, 95 bd pinel, F-69000, Lyon, France
- Lyon University, Université Lyon 1, UCBL, 69000, Villeurbanne, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Clara Fonteneau
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center; PSYR2 Team, 95 bd pinel, F-69000, Lyon, France
- Lyon University, Université Lyon 1, UCBL, 69000, Villeurbanne, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Louis Simon
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center; PSYR2 Team, 95 bd pinel, F-69000, Lyon, France
- Lyon University, Université Lyon 1, UCBL, 69000, Villeurbanne, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Clément Dondé
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center; PSYR2 Team, 95 bd pinel, F-69000, Lyon, France
- Lyon University, Université Lyon 1, UCBL, 69000, Villeurbanne, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Frédéric Haesebaert
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center; PSYR2 Team, 95 bd pinel, F-69000, Lyon, France
- Lyon University, Université Lyon 1, UCBL, 69000, Villeurbanne, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Emmanuel Poulet
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center; PSYR2 Team, 95 bd pinel, F-69000, Lyon, France
- Lyon University, Université Lyon 1, UCBL, 69000, Villeurbanne, France
- Centre Hospitalier Le Vinatier, Bron, France
- Emergency Psychiatry Unit, Edouard Herriot Hospital, Lyon University Hospital, Lyon, France
| | - Jerome Brunelin
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center; PSYR2 Team, 95 bd pinel, F-69000, Lyon, France.
- Lyon University, Université Lyon 1, UCBL, 69000, Villeurbanne, France.
- Centre Hospitalier Le Vinatier, Bron, France.
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15
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Haller N, Hasan A, Padberg F, Strube W, da Costa Lane Valiengo L, Brunoni AR, Brunelin J, Palm U. [Transcranial electrical brain stimulation methods for treatment of negative symptoms in schizophrenia]. Nervenarzt 2021; 93:41-50. [PMID: 33492411 PMCID: PMC8763819 DOI: 10.1007/s00115-021-01065-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/08/2021] [Indexed: 11/24/2022]
Abstract
Über die letzten Jahre entwickelten sich Neuromodulationsverfahren zu einer dritten Säule neben Pharmakotherapie und Psychotherapie in der Behandlung psychischer Erkrankungen. Besonders in der Behandlung von Menschen mit einer Schizophrenie könnten Hirnstimulationsverfahren eine Alternative oder Ergänzung zu den etablierten Therapiestrategien darstellen. Die meist vorhandenen Positivsymptome können zumeist mit Antipsychotika adäquat behandelt werden. Gerade bei Patienten mit Schizophrenie besitzen jedoch Negativsymptome einen überdauernden Krankheitswert und beeinflussen den Verlauf durch globale Antriebsverarmung und beeinträchtigte Kognition im alltäglichen Leben negativ. Dieser Übersichtsartikel stellt eine Zusammenfassung über die verschiedenen nichtinvasiven Hirnstimulationsverfahren transkranielle Gleichstromstimulation (transcranial direct current stimulation, tDCS), Wechselstromstimulation (transcranial alternating current stimulation, tACS) sowie Rauschstromstimulation (transcranial random noise stimulation, tRNS) zur Behandlung der Negativsymptomatik bei Schizophrenie dar. Die neuen transkraniellen Hirnstimulationsverfahren könnten dabei helfen, gestörte neuronale Vernetzungen wieder herzustellen und die Konnektivität vor allem der dorsolateralen präfrontalen Anteile des Kortex zu verbessern. Einige Studien weisen auf eine Verbesserung der Negativsymptome durch Behandlung mit tDCS, tACS bzw. tRNS hin und könnten so neue Therapiemöglichkeiten in der Behandlung der Schizophrenie darstellen.
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Affiliation(s)
- Nikolas Haller
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München, Deutschland
| | - Alkomiet Hasan
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München, Deutschland.,Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Universität Augsburg, Medizinische Fakultät, BKH Augsburg, Augsburg, Deutschland
| | - Frank Padberg
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München, Deutschland
| | - Wolfgang Strube
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Universität Augsburg, Medizinische Fakultät, BKH Augsburg, Augsburg, Deutschland
| | - Leandro da Costa Lane Valiengo
- Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasilien
| | - Andre R Brunoni
- Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasilien
| | - Jerome Brunelin
- CH le Vinatier, INSERM U 1028, CNRS UMR 5292, PSYR2 Team, Centre de recherche en neuroscience de Lyon, Université de Lyon, Lyon, Frankreich
| | - Ulrich Palm
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München, Deutschland. .,Medical Park Chiemseeblick, Rasthausstr. 25, 83233, Bernau-Felden, Deutschland.
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16
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Wagner E, Honer WG, Sommer IE, Koops S, Blumberger DM, Daskalakis ZJ, Dlabac-De Lange JJ, Bais L, Knegtering H, Aleman A, Novak T, Klirova M, Slotema C, Brunelin J, Poulet E, Kujovic M, Cordes J, Wobrock T, Siskind D, Falkai P, Schneider-Axmann T, Hasan A. Repetitive transcranial magnetic stimulation (rTMS) for schizophrenia patients treated with clozapine. World J Biol Psychiatry 2021; 22:14-26. [PMID: 32081071 DOI: 10.1080/15622975.2020.1733080] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES Biological strategies to improve treatment efficacy in clozapine-treated patients are urgently needed. Repetitive transcranial magnetic stimulation (rTMS) merits consideration as intervention for patients with persistent auditory hallucinations (AH) or negative symptoms (NS) not responding sufficiently to clozapine treatment. METHODS Data from 10 international RCTs of rTMS for patients being treated with clozapine were pooled. Two levels of symptomatic response were defined: improvement of ≥20% and ≥50% on study-specific primary endpoint scales. Changes in the positive and negative syndrome scale (PANSS) from baseline to endpoint assessment were also analysed. RESULTS Analyses of 131 patients did not reveal a significant difference for ≥20% and ≥50% response thresholds for improvement of AH, negative or total symptoms between active and sham rTMS groups. The number needed to treat (NNT) for an improvement in persistent AH was nine following active rTMS. PANSS scores did not improve significantly from baseline to endpoint between active and sham groups in studies investigating NS and AH. CONCLUSIONS rTMS as a treatment for persistent symptoms in clozapine-treated patients did not show a beneficial effect of active compared to sham treatment. For AH, the size of the NNTs indicates a possible beneficial effect of rTMS.
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Affiliation(s)
- Elias Wagner
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - William G Honer
- Department of Psychiatry, The University of British Columbia, Vancouver, Canada
| | - Iris E Sommer
- Department of Biomedical Sciences of Cells and Systems, Section Cognitive Neuropsychology, University Medical Center Groningen, Groningen, the Netherlands
| | - Sanne Koops
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Daniel M Blumberger
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Canada.,Campbell Family Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Zafiris J Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Canada.,Campbell Family Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Jozarni J Dlabac-De Lange
- Lentis Psychiatric Institute, Groningen, the Netherlands.,University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Leonie Bais
- Lentis Psychiatric Institute, Groningen, the Netherlands
| | - Henderikus Knegtering
- Lentis Psychiatric Institute, Groningen, the Netherlands.,University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - André Aleman
- Lentis Psychiatric Institute, Groningen, the Netherlands.,University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Tomas Novak
- Klecany and Third Faculty of Medicine, Charles University, National Institute of Mental Health, Prague, Czech Republic
| | - Monika Klirova
- Klecany and Third Faculty of Medicine, Charles University, National Institute of Mental Health, Prague, Czech Republic
| | - Christina Slotema
- Department of Personality Disorders, Parnassia Psychiatric Institute, the Hague, Netherlands
| | - Jerome Brunelin
- INSERM U1028, CNRS UMR 5292, CRNL, Centre Hospitalier Le Vinatier, Bron, France
| | - Emmanuel Poulet
- INSERM U1028, CNRS UMR 5292, CRNL, Centre Hospitalier Le Vinatier, Bron, France
| | - Milenko Kujovic
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University Hospital, Düsseldorf, Germany
| | - Joachim Cordes
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University Hospital, Düsseldorf, Germany
| | - Thomas Wobrock
- Department of Psychiatry and Psychotherapy, Georg-August-University, Goettingen, Germany.,Centre of Mental Health, County Hospitals Darmstadt-Dieburg, Groß-Umstadt, Germany
| | - Dan Siskind
- School of Medicine, University of Queensland, Brisbane, Australia.,Metro South Addiction and Mental Health Service, Brisbane, Australia
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Thomas Schneider-Axmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Alkomiet Hasan
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
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17
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Simon L, Blay M, Galvao F, Brunelin J. Using EEG to Predict Clinical Response to Electroconvulsive Therapy in Patients With Major Depression: A Comprehensive Review. Front Psychiatry 2021; 12:643710. [PMID: 34248695 PMCID: PMC8264052 DOI: 10.3389/fpsyt.2021.643710] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 05/18/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: An important approach to improve the therapeutic effect of electroconvulsive therapy (ECT) may be to early characterize patients who are more likely to respond. Our objective was to explore whether baseline electroencephalography (EEG) settings before the beginning of ECT treatment can predict future clinical response to ECT in patients with depressive disorder. Methods: We conducted a systematic search in the MEDLINE, EMBASE, PsycINFO, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) databases to identify studies using EEG in adults with depressive disorder treated by ECT. To investigate the predictive value of baseline EEG on clinical outcomes of ECT, we extracted from the retrieved studies and qualitatively described the association between the baseline EEG markers characteristics and the rates of future responders and/or remitters to ECT. Results: The primary search yielded 2,531 potentially relevant citations, and 12 articles were selected according to inclusion criteria. Most of the studies were prospective studies with small sample size. Sociodemographic and clinical characteristics of patients, ECT settings, EEG settings, and outcomes were heterogeneous. Event-related potential (ERP) paradigms were used in three studies, polysomnography was used in three studies, and the six other studies used EEG to measure cerebral connectivity and activity. Conclusions: P300 amplitude, coherence, and connectivity measures were correlated with remission in patients with depression treated by ECT. Sleep EEG recordings seemed not to be correlated with remission after ECT. Further prospective studies with large sample size are needed to determine optimal EEG parameters associated with clinical response to ECT in depressive disorder. Systematic Review Registration: PROSPERO CRD42020181978.
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Affiliation(s)
- Louis Simon
- Centre Hospitalier Le Vinatier, Bron, France.,INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, PSYR2 Team, Lyon, France.,Lyon University, Université Lyon 1, Villeurbanne, France
| | - Martin Blay
- Centre Hospitalier Le Vinatier, Bron, France.,Lyon University, Université Lyon 1, Villeurbanne, France
| | | | - Jerome Brunelin
- Centre Hospitalier Le Vinatier, Bron, France.,INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, PSYR2 Team, Lyon, France.,Lyon University, Université Lyon 1, Villeurbanne, France
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18
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Dondé C, Brunelin J, Micoulaud-Franchi JA, Maruani J, Lejoyeux M, Polosan M, Geoffroy PA. The Effects of Transcranial Electrical Stimulation of the Brain on Sleep: A Systematic Review. Front Psychiatry 2021; 12:646569. [PMID: 34163380 PMCID: PMC8215269 DOI: 10.3389/fpsyt.2021.646569] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 04/19/2021] [Indexed: 01/23/2023] Open
Abstract
Transcranial Electrical Stimulation (tES) is a promising non-invasive brain modulation tool. Over the past years, there have been several attempts to modulate sleep with tES-based approaches in both the healthy and pathological brains. However, data about the impact on measurable aspects of sleep remain scattered between studies, which prevent us from drawing firm conclusions. We conducted a systematic review of studies that explored the impact of tES on neurophysiological sleep oscillations, sleep patterns measured objectively with polysomnography, and subjective psychometric assessments of sleep in both healthy and clinical samples. We searched four main electronic databases to identify studies until February 2020. Forty studies were selected including 511 healthy participants and 452 patients. tES can modify endogenous brain oscillations during sleep. Results concerning changes in sleep patterns are conflicting, whereas subjective assessments show clear improvements after tES. Possible stimulation-induced mechanisms within specific cortico-subcortical sleep structures and networks are discussed. Although these findings cannot be directly transferred to the clinical practice and sleep-enhancing devices development for healthy populations, they might help to pave the way for future researches in these areas. PROSPERO registration number 178910.
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Affiliation(s)
- Clément Dondé
- University Grenoble Alpes, Grenoble, France.,U1216 INSERM, Grenoble Institut of Neuroscience, La Tronche, France.,Psychiatry Department, CHU Grenoble Alpes, Grenoble, France
| | - Jerome Brunelin
- INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, PSY-R2 Team, Lyon, France.,Lyon University, Lyon, France.,Centre Hospitalier le Vinatier, Batiment 416, Bron, France
| | - Jean-Arthur Micoulaud-Franchi
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, Bordeaux, France.,USR CNRS 3413 SANPSY, University Hospital Pellegrin, University of Bordeaux, Bordeaux, France
| | - Julia Maruani
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Assistance Publique des Hôpitaux de Paris (APHP), Paris, France.,Université de Paris, Paris, France.,INSERM U1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France
| | - Michel Lejoyeux
- Paris Diderot University-Paris VII, 5 Rue Thomas Mann, Paris, France.,University Hospital Bichat-Claude Bernard, 46 rue Henri Huchard, Paris, France
| | - Mircea Polosan
- University Grenoble Alpes, Grenoble, France.,U1216 INSERM, Grenoble Institut of Neuroscience, La Tronche, France.,Psychiatry Department, CHU Grenoble Alpes, Grenoble, France
| | - Pierre A Geoffroy
- Paris Diderot University-Paris VII, 5 Rue Thomas Mann, Paris, France.,University Hospital Bichat-Claude Bernard, 46 rue Henri Huchard, Paris, France.,Université de Paris, NeuroDiderot, Inserm, Paris, France
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19
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Haller N, Hasan A, Padberg F, da Costa Lane Valiengo L, Brunelin J, Palm U. Gamma transcranial alternating current stimulation for treatment of negative symptoms in schizophrenia: Report of two cases. Asian J Psychiatr 2020; 54:102423. [PMID: 33271707 DOI: 10.1016/j.ajp.2020.102423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/06/2020] [Accepted: 09/10/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Nikolas Haller
- Department of Psychiatry and Psychotherapy, Hospital of the University of Munich, Munich, Germany
| | - Alkomiet Hasan
- Department of Psychiatry and Psychotherapy, Hospital of the University of Munich, Munich, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics of the University of Augsburg, Bezirkskrankenhaus Augsburg, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, Hospital of the University of Munich, Munich, Germany
| | - Leandro da Costa Lane Valiengo
- Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Jerome Brunelin
- CH le Vinatier, INSERM U 1028, CNRS UMR 5292, PSYR2 Team, Lyon Neuroscience Research Center, University Lyon, Lyon, France
| | - Ulrich Palm
- Department of Psychiatry and Psychotherapy, Hospital of the University of Munich, Munich, Germany; Medical Park Chiemseeblick, Bernau-Felden, Germany.
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20
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Mondino M, Szekely D, Bubrovszky M, Bulteau S, Downar J, Poulet E, Brunelin J. Predicting treatment response to 1Hz rTMS using early self-rated clinical changes in major depression. Brain Stimul 2020; 13:1603-1605. [PMID: 33065360 DOI: 10.1016/j.brs.2020.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/01/2020] [Accepted: 10/11/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Marine Mondino
- Centre Hospitalier Le Vinatier, F69500, Bron, France; INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, PSYR2 Team, F-69000 Lyon, France; Lyon University, Université Lyon 1, F-69100, Villeurbanne, France.
| | - David Szekely
- Department of Psychiatry, Centre Hospitalier Princesse-Grace, 98000 Monaco.
| | - Maxime Bubrovszky
- Secteur de Psychiatrie Générale 59G11, EPSM de l'Agglomération Lilloise, BP 4 - 59871 Saint André Lez Lille, France.
| | - Samuel Bulteau
- UMR 1246 SPHERE, University of Nantes, University of Tours, INSERM, Nantes, France; CHU Nantes, Department of Addictology and Psychiatry, F 44000 Nantes, France.
| | - Jonathan Downar
- Department of Psychiatry and Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Emmanuel Poulet
- Centre Hospitalier Le Vinatier, F69500, Bron, France; INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, PSYR2 Team, F-69000 Lyon, France; Lyon University, Université Lyon 1, F-69100, Villeurbanne, France; Department of Emergency Psychiatry, University Hospital Edouard Herriot, Hospices Civils de Lyon, F-69000, Lyon, France.
| | - Jerome Brunelin
- Centre Hospitalier Le Vinatier, F69500, Bron, France; INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, PSYR2 Team, F-69000 Lyon, France; Lyon University, Université Lyon 1, F-69100, Villeurbanne, France.
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21
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Brunelin J, Iceta S, Plaze M, Gaillard R, Simon L, Suaud-Chagny MF, Galvao F, Poulet E. The Combination of Propofol and Ketamine Does Not Enhance Clinical Responses to Electroconvulsive Therapy in Major Depression-The Results From the KEOpS Study. Front Pharmacol 2020; 11:562137. [PMID: 33041803 PMCID: PMC7522396 DOI: 10.3389/fphar.2020.562137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 08/24/2020] [Indexed: 11/13/2022] Open
Abstract
Objective We investigated the clinical effects of the combination of ketamine and propofol as anesthetic agents during electroconvulsive therapy (ECT) in patients with uni- or bipolar major depressive episodes. We hypothesized that ketamine may confer short- and long- term advantages in improving depressive symptoms at the early stages of ECT. Methods In a randomized placebo-controlled trial, remission rates after 4 and 8 weeks of ECT were compared between patients who were randomly allocated to receive either the combination of ketamine (0.5 mg/kg) + propofol (n= 11) or placebo + propofol (n = 16). Depressive symptoms were assessed weekly using the Montgomery-Åsberg Depression Rating Scale (MADRS); ECT sessions were administered twice per week for a maximum of 8 weeks (16 sessions). Results After 4 weeks, we observed significantly fewer remitters (MADRS score < 10) in the ketamine + propofol group (0/11; 0%) than in the placebo + propofol group (5/16; 31%; χ2 = 4.22; p = 0.040). No significant difference was observed between the two groups regarding the number of patients who achieved remission weekly throughout the study period (Chi² = 3.588; p = 0.058). The mean duration of seizures was significantly shorter in the ketamine + propofol group than in the placebo + propofol group. Conclusions The results from the current study corroborated results from previously published studies and did not support the use of the combination of ketamine + propofol as an anesthetic agent for ECT in patients with major depressive episodes in clinical settings.
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Affiliation(s)
- Jerome Brunelin
- CH Le Vinatier, Bron, France.,INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, PSYR2 Team, Université de Lyon, Lyon, France
| | - Sylvain Iceta
- CH Le Vinatier, Bron, France.,INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, PSYR2 Team, Université de Lyon, Lyon, France.,Obesity Research Center, Quebec Heart and Lung Institute (IUCPQ), Québec, QC, Canada.,School of Nutrition, Laval University, Québec, QC, Canada
| | - Marion Plaze
- GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, Paris, France
| | - Raphaël Gaillard
- GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, Paris, France
| | - Louis Simon
- CH Le Vinatier, Bron, France.,INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, PSYR2 Team, Université de Lyon, Lyon, France
| | - Marie-Françoise Suaud-Chagny
- CH Le Vinatier, Bron, France.,INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, PSYR2 Team, Université de Lyon, Lyon, France
| | | | - Emmanuel Poulet
- CH Le Vinatier, Bron, France.,INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, PSYR2 Team, Université de Lyon, Lyon, France.,Service de psychiatrie des urgences, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
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22
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Vallet W, Hone-Blanchet A, Brunelin J. Abnormalities of the late positive potential during emotional processing in individuals with psychopathic traits: a meta-analysis. Psychol Med 2020; 50:2085-2095. [PMID: 31477196 DOI: 10.1017/s0033291719002216] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Individuals with psychopathic traits display deficits in emotional processing. A key event-related potential component involved in emotional processing is the late positive potential (LPP). In healthy controls, LPP amplitude is greater in response to negative stimuli than to positive or neutral stimuli. In the current study, we aimed to compare LPP amplitudes between individuals with psychopathic traits and control subjects when presented with negative, positive or neutral stimuli. We hypothesized that LPP amplitude evoked by emotional stimuli would be reduced in individuals with psychopathic traits compared to healthy controls. METHODS After a systematic review of the literature, we conducted a meta-analysis to compare LPP amplitude elicited by emotional stimuli in individuals with psychopathic traits and healthy controls. RESULTS Individuals with psychopathic traits showed significantly reduced LPP amplitude evoked by negative stimuli (mean effect size = -0.47; 95% CI -0.60 to -0.33; p < 0.005) compared to healthy controls. No significant differences between groups were observed for the processing of positive (mean effect size = -0.15; 95% CI -0.42 to 0.12; p = 0.28) and neutral stimuli (mean effect size = -0.12; 95% CI 0.31 to 0.07; p = 0.21). CONCLUSIONS Measured by LPP amplitude, individuals with psychopathic traits displayed abnormalities in the processing of emotional stimuli with negative valence whereas processing of stimuli with positive and neutral valence was unchanged as compared with healthy controls.
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Affiliation(s)
- William Vallet
- CH Le Vinatier, Lyon, Bron, France
- Cognitive Neuroimaging Unit, CEA DRF/Joliot, INSERM, Université Paris-Sud, Université Paris Saclay, NeuroSpin center, 91191Gif-sur-Yvette, France
| | | | - Jerome Brunelin
- CH Le Vinatier, Lyon, Bron, France
- INSERM-U1028, CNRS-UMR5292, Lyon Neuroscience Research Center, PSYR2 Team, Université de Lyon, Lyon, France
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Haller N, Hasan A, Padberg F, Brunelin J, da Costa Lane Valiengo L, Palm U. Gamma transcranial alternating current stimulation in patients with negative symptoms in schizophrenia: A case series. Neurophysiol Clin 2020; 50:301-304. [PMID: 32631667 DOI: 10.1016/j.neucli.2020.06.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 06/09/2020] [Accepted: 06/09/2020] [Indexed: 10/23/2022] Open
Abstract
Non-invasive transcranial brain stimulation therapies, such as transcranial direct current stimulation, have been found to improve negative symptoms in schizophrenia. Another new technique is transcranial alternating current stimulation (tACS). Here we report a series of three patient treated with twice-daily 10min prefrontal 40Hz tACS stimulation over ten days. Patients showed an improvement in the Positive and Negative Syndrome Scale, Scale for the Assessment of Negative Symptoms, and subjective well-being. Furthermore, there was an improvement in the Trail Making Test and word fluency. ytACS merits further investigation in the treatment of schizophrenia symptoms.
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Affiliation(s)
- Nikolas Haller
- Department. of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany
| | - Alkomiet Hasan
- Department. of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany; Klinik für Psychiatrie, Psychotherapie und Psychosomatik der Universität Augsburg, Bezirkskrankenhaus Augsburg, Medizinische Fakultät, Universität Augsburg, Augsburg, Germany
| | - Frank Padberg
- Department. of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany
| | - Jerome Brunelin
- CH de le Vinatier, INSERM U 1028, CNRS UMR 5292, PSYR2 Team, Centre de recherche en neuroscience de Lyon, Université de Lyon, France
| | - Leandro da Costa Lane Valiengo
- Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Ulrich Palm
- Department. of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany; Medical Park Chiemseeblick, 25, Rasthausstr, 83233 Bernau-Felden, Germany.
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24
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Brunoni AR, Arns M, Baeken C, Blumberger D, Brunelin J, Carpenter LL, Downar J, Keeser D, Langguth B, Rachid F, Sack AT, Vila-Rodriguez F, Padberg F. Mixing Apples and Oranges in Assessing Outcomes of Repetitive Transcranial Stimulation Meta-Analyses. Psychother Psychosom 2020; 89:106-107. [PMID: 31794971 DOI: 10.1159/000504653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 11/07/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Andre R Brunoni
- Department of Psychiatry and Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil,
| | - Martijn Arns
- Research Institute, Brainclinics Foundation, Nijmegen, The Netherlands
| | - Chris Baeken
- Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium.,Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium.,Department of Psychiatry, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Daniel Blumberger
- Center for Addiction and Mental Health and University of Toronto, Toronto, Ontario, Canada
| | - Jerome Brunelin
- CH Le Vinatier, INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, PSYR2 Team, Université de Lyon, Lyon, France
| | - Linda L Carpenter
- Brown University Department of Psychiatry/Butler Hospial, Providence, Rhode Island, USA
| | - Jonathan Downar
- Department of Psychiatry and Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital LMU Munich, Munich, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | | | - Alexander T Sack
- Section Brain Stimulation and Cognition, Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University and Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Brain and Nerve Centre, Maastricht University Medical Centre+ (MUMC+), Masstricht, The Netherlands
| | - Fidel Vila-Rodriguez
- Non-Invasive Neurostimulation Therapies Laboratory, Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital LMU Munich, Munich, Germany
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25
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Dondé C, Brunelin J, Haesebaert F. Duration, pitch and intensity features reveal different magnitudes of tone-matching deficit in schizophrenia. Schizophr Res 2020; 215:460-462. [PMID: 31615741 DOI: 10.1016/j.schres.2019.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 09/29/2019] [Accepted: 10/06/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Clément Dondé
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, F-69000, France; University Lyon 1, Villeurbanne, F-69000, France; Centre Hospitalier Le Vinatier, Bron, France.
| | - Jerome Brunelin
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, F-69000, France; University Lyon 1, Villeurbanne, F-69000, France; Centre Hospitalier Le Vinatier, Bron, France
| | - Frédéric Haesebaert
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, F-69000, France; University Lyon 1, Villeurbanne, F-69000, France; Centre Hospitalier Le Vinatier, Bron, France
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26
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Moirand R, Galvao F, Brunelin J. Early shifts of emotional attention as a possible predictor of remission in patients with depression receiving ECT: Preliminary results of an eye-tracker study. Encephale 2019. [DOI: 10.1016/j.encep.2019.04.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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27
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Delamarre L, Galvao F, Gohier B, Poulet E, Brunelin J. Benzodiazepines enhance efficacy of electroconvulsive therapy in depression. Encephale 2019. [DOI: 10.1016/j.encep.2019.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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28
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Brunelin J, Mondino M, Arns M, Baeken C, Brem AK, Filipčić I, Ganho-Avila A, Palm U, Poleszczyk A, Sauvaget A, O'Shea J, D'Urso G, Poulet E. 3rd European Conference on brain stimulation in psychiatry - From mechanism to medicine. Encephale 2019; 45 Suppl 2:S47-S49. [PMID: 31104764 DOI: 10.1016/j.encep.2019.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- J Brunelin
- Inserm U1028, CNRS UMR 5292, Lyon Neuroscience Research Center - PSYR2 team, centre hospitalier le Vinatier, Lyon university, Lyon, France.
| | - M Mondino
- Inserm U1028, CNRS UMR 5292, Lyon Neuroscience Research Center - PSYR2 team, centre hospitalier le Vinatier, Lyon university, Lyon, France
| | - M Arns
- Research Institute Brainclinics, Nijmegen, The Netherlands; Utrecht University, Department Experimental Psychology, Utrecht, The Netherlands
| | - C Baeken
- Ghent University, Department of Psychiatry and Medical Psychology, Ghent, Belgium; Ghent University, Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium; Vrije Universiteit Brussel (VUB), Department of Psychiatry, Universitair Ziekenhuis Brussel (UZBrussel), Laarbeeklaan 101, 1090 Brussels, Belgium
| | - A-K Brem
- Max Planck Institute of Psychiatry, Munich, Germany; Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Interventional Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - I Filipčić
- Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia; Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
| | - A Ganho-Avila
- Proaction Laboratory, Faculty of Psychology and Educational Sciences, University of Coimbra, 3001-802 Coimbra, Portugal; Psychological Neuroscience Lab, CIPsi, School of Psychology, University of Minho, 4710-057 Braga, Portugal
| | - U Palm
- Department of Psychiatry and Psychotherapy, University Hospital, LMU, Munich, Germany
| | - A Poleszczyk
- Department of Clinical Neurophysiology, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - A Sauvaget
- Psychiatry Neuromodulation Unit, Addictology and Liaison Psychiatry Department, CHU de Nantes, Nantes, France; Faculty of Sport Sciences, Laboratory "Movement, Interactions, Performance" (E.A. 4334), University of Nantes, Nantes, France
| | - J O'Shea
- Wellcome Centre for Integrative Neuroimaging (WIN), University of Oxford, UK
| | - G D'Urso
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - E Poulet
- Inserm U1028, CNRS UMR 5292, Lyon Neuroscience Research Center - PSYR2 team, centre hospitalier le Vinatier, Lyon university, Lyon, France
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29
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Leaune E, Dealberto MJ, Luck D, Grot S, Zeroug-Vial H, Poulet E, Brunelin J. Ethnic minority position and migrant status as risk factors for psychotic symptoms in the general population: a meta-analysis. Psychol Med 2019; 49:545-558. [PMID: 30178719 DOI: 10.1017/s0033291718002271] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Psychotic symptoms (PS) are experienced by a substantial proportion of the general population. When not reaching a threshold of clinical relevance, these symptoms are defined as psychotic experiences (PEs) and may exist on a continuum with psychotic disorders. Unfavorable socio-environmental conditions, such as ethnic minority position (EMP) and migrant status (MS), may increase the risk of developing PS and PEs. We conducted an electronic systematic review and a meta-analysis assessing the role of EMP and MS for the development and persistence of PS in the general population. Sub-group analyses were performed investigating the influence of ethnic groups, host countries, age, types of PS, and scales. Twenty-four studies met our inclusion criteria. EMP was a relevant risk factor for reporting PS [odds ratio (OR) 1.44, 95% confidence interval (CI) 1.22-1.70) and PEs (OR 1.36, 95% CI 1.16-1.60). The greatest risk was observed in people from the Maghreb and the Middle East ethnic groups in Europe (OR 3.30, 95% CI 2.09-5.21), in Hispanic in the USA (OR 1.98, 95% CI 1.43-2.73), and in the Black populations (OR 1.85, 95% CI 1.39-2.47). We found a significant association between MS and delusional symptoms (OR 1.47, 95% CI 1.33-1.62). We found no association between EMP and persistence of PEs.EMP was associated with increased risk of reporting PS and PEs, and the risk was higher in ethnic groups facing deprivation and discrimination. We found an association between MS and delusional symptoms. These results raise questions about the precise role of socio-environmental factors along the psychosis continuum.
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Affiliation(s)
| | | | - David Luck
- Centre de recherche, Institut Universitaire en Santé Mentale de Montréal,Canada
| | - Stéphanie Grot
- Centre de recherche, Institut Universitaire en Santé Mentale de Montréal,Canada
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30
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31
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Osoegawa C, Gomes JS, Grigolon RB, Brietzke E, Gadelha A, Lacerda ALT, Dias ÁM, Cordeiro Q, Laranjeira R, de Jesus D, Daskalakis ZJ, Brunelin J, Cordes J, Trevizol AP. Non-invasive brain stimulation for negative symptoms in schizophrenia: An updated systematic review and meta-analysis. Schizophr Res 2018; 197:34-44. [PMID: 29397282 DOI: 10.1016/j.schres.2018.01.010] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 01/17/2018] [Accepted: 01/17/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Schizophrenia is a mental disorder with significant socioeconomic burden. Although current pharmacological treatments are effective for treating positive symptoms, medications have little-to-no effect in the treatment of negative symptoms. OBJECTIVE To assess the efficacy of non-invasive brain stimulation (NIBS) for negative symptoms in schizophrenia in randomized clinical trials (RCTs). METHODS A systematic review in Medline and Cochrane Library databases was performed up to May 31, 2017. The primary outcome was Hedges' g for continuous scores in a random-effects model. Heterogeneity was evaluated with the I2 and χ2 tests. Publication bias was assessed using Begg's funnel plot. RESULTS 31 RCTs (n = 1272) were included, most with small-to-modest sample sizes. Both repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) were superior to sham (Hedges' g = 0.19; 95% CI 0.07-0.32; and 0.5; 0.02-0.97, respectively). Only one study evaluated the use of transcutaneous auricular vagus nerve stimulation (taVNS). The funnel plot and Eggers test showed that the risk of publication bias was low. In relation to heterogeneity, we found an I2 of 0% (p = 0.749) and 51.3% (0.055) for rTMS and tDCS, respectively. CONCLUSION Both rTMS and tDCS were superior to sham stimulation for ameliorating negative symptoms in schizophrenia. We found no considerable heterogeneity or publication bias in our analysis, corroborating the strength of our findings. Not enough studies on other NIBS techniques, such as taVNS, were found for an isolated analysis. Further RCTs with larger sample sizes are needed to clarify the specific impact of NIBS on negative symptoms in schizophrenia.
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Affiliation(s)
| | - July Silveira Gomes
- Federal University of São Paulo, Brazil; Schizophrenia Program, Federal University of São Paulo (PROESQ), Brazil
| | | | - Elisa Brietzke
- Federal University of São Paulo, Brazil; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada; University of Toronto, Canada
| | - Ary Gadelha
- Federal University of São Paulo, Brazil; Schizophrenia Program, Federal University of São Paulo (PROESQ), Brazil
| | - Acioly L T Lacerda
- Federal University of São Paulo, Brazil; Center for Research and Clinical Trials Sinapse-Bairral, Instituto Bairral de Psiquiatria, Brazil
| | | | | | | | | | | | - Jerome Brunelin
- Lyon Neuroscience Research Center, Lyon 1 University, Lyon, France
| | - Joachim Cordes
- Department of Psychiatry and Psychotherapy, Heinrich-Heine University of Düsseldorf, Germany
| | - Alisson Paulino Trevizol
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada; University of Toronto, Canada.
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Servan A, Brunelin J, Poulet E. The effects of oxytocin on social cognition in borderline personality disorder. L'Encéphale 2018; 44:46-51. [DOI: 10.1016/j.encep.2017.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 05/16/2017] [Accepted: 11/14/2017] [Indexed: 10/18/2022]
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Moirand R, Galvao F, Lecompte M, Poulet E, Haesebaert F, Brunelin J. Usefulness of the Montreal Cognitive Assessment (MoCA) to monitor cognitive impairments in depressed patients receiving electroconvulsive therapy. Psychiatry Res 2018; 259:476-481. [PMID: 29149717 DOI: 10.1016/j.psychres.2017.11.022] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 10/27/2017] [Accepted: 11/06/2017] [Indexed: 01/03/2023]
Abstract
There is a lack of consensual tools for evaluating the cognitive side-effects in patients with depression who are treated with electroconvulsive therapy (ECT). The objective of this study was to evaluate the usefulness of the Montreal Cognitive Assessment (MoCA) and of the Mini Mental State Examination (MMSE) to monitor cognitive changes in patients with depression receiving ECT. Cognitive functioning was assessed prospectively in 48 patients with unipolar or bipolar depression before and after an ECT course. ECT-induced cognitive impairments were defined as a decrease of at least 2 points on the MoCA and the MMSE total scores and of at least one point on each sub-score. At baseline, the MoCA detected a higher number of patients with cognitive deficits than the MMSE. After ECT, the MoCA and MMSE total scores were comparable, but the MoCA detected more impairments than did the MMSE for visuo-executive, memory and language subscores. ECT significantly decreased the language capacities but improved the visuo-executive and abstraction performances measured by MoCA. In remitters, the MoCA total score and visuo-executive and abstraction performances were significantly improved, while other cognitive functions remained unchanged. The MoCA is a useful screening tool for monitoring cognitive functioning during an ECT course.
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Affiliation(s)
- Rémi Moirand
- INSERM, U1028, Lyon Neuroscience Research Center, PSY-R2 Team, Lyon F-69000, France; CNRS, UMR5292, Lyon Neuroscience Research Center, PSY-R2 Team, Lyon F-69000, France; University Lyon, F-69000, France; Centre Hospitalier le Vinatier, Batiment 416, 95 Bd Pinel, 69678 Bron, France.
| | - Filipe Galvao
- INSERM, U1028, Lyon Neuroscience Research Center, PSY-R2 Team, Lyon F-69000, France; CNRS, UMR5292, Lyon Neuroscience Research Center, PSY-R2 Team, Lyon F-69000, France; University Lyon, F-69000, France; Centre Hospitalier le Vinatier, Batiment 416, 95 Bd Pinel, 69678 Bron, France
| | - Maxime Lecompte
- Centre Hospitalier le Vinatier, Batiment 416, 95 Bd Pinel, 69678 Bron, France
| | - Emmanuel Poulet
- INSERM, U1028, Lyon Neuroscience Research Center, PSY-R2 Team, Lyon F-69000, France; CNRS, UMR5292, Lyon Neuroscience Research Center, PSY-R2 Team, Lyon F-69000, France; University Lyon, F-69000, France; Centre Hospitalier le Vinatier, Batiment 416, 95 Bd Pinel, 69678 Bron, France; Department of Emergency Psychiatry, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Frédéric Haesebaert
- INSERM, U1028, Lyon Neuroscience Research Center, PSY-R2 Team, Lyon F-69000, France; CNRS, UMR5292, Lyon Neuroscience Research Center, PSY-R2 Team, Lyon F-69000, France; University Lyon, F-69000, France; Centre Hospitalier le Vinatier, Batiment 416, 95 Bd Pinel, 69678 Bron, France
| | - Jerome Brunelin
- INSERM, U1028, Lyon Neuroscience Research Center, PSY-R2 Team, Lyon F-69000, France; CNRS, UMR5292, Lyon Neuroscience Research Center, PSY-R2 Team, Lyon F-69000, France; University Lyon, F-69000, France; Centre Hospitalier le Vinatier, Batiment 416, 95 Bd Pinel, 69678 Bron, France
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35
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Brunelin J. T005 Transcranial Direct Current stimulation (tDCS) for schizophrenia. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2016.10.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Psomiades M, Mondino M, Poulet E, Haesebaert F, Suaud-Chagny M, Brunelin J. Fronto-temporal transcranial direct-current stimulation reduces auditory verbal hallucinations and n-acetylaspartate-glutamate level in the left temporoparietal junction in patients with schizophrenia. Brain Stimul 2017. [DOI: 10.1016/j.brs.2017.01.510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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37
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Fonteneau C, Haesebaert F, Redoute J, Le Bars D, Costes N, Brunelin J, Suaud-Chagny M. Online transcranial direct current stimulation of the frontal cortex induces dopamine release in the striatum – a spatial and temporal analysis in healthy humans. Brain Stimul 2017. [DOI: 10.1016/j.brs.2017.01.507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Gay A, Boutet C, Sigaud T, Kamgoue A, Sevos J, Brunelin J, Massoubre C. A single session of repetitive transcranial magnetic stimulation of the prefrontal cortex reduces cue-induced craving in patients with gambling disorder. Eur Psychiatry 2017; 41:68-74. [PMID: 28049084 DOI: 10.1016/j.eurpsy.2016.11.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 10/30/2016] [Accepted: 11/02/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Gambling disorder (GD) is common and disabling addictive disorder. In patients with substance use disorders, the application of repetitive transcranial magnetic stimulation (rTMS) over the dorsolateral prefrontal cortex (DLPFC) offers promise to alleviate craving. We hypothesized that applying real compared to sham rTMS over the left DLPFC would reduce gambling craving in patients with GD. METHODS In a randomized sham-controlled crossover design, 22 treatment-seeking patients with GD received real or sham treatment with high frequency rTMS over the left DLPFC followed a week later by the other type of treatment. Before and after each rTMS session, participants rated their gambling craving (from 0 to 100) before and after viewing a gambling video used as a cue. We used the Yale-Brown Obsessive Compulsive Scale adapted for Pathological Gambling to assess gambling behavior before and 7 days after each rTMS session. RESULTS As compared to sham (mean +0.74; standard deviation±3.03), real rTMS significantly decreased cue-induced craving (-2.12±3.39; F(1,19)=4.87; P=0.04; partial η2=0.05; 95% CI: 0.00-0.21). No significant effect of rTMS was observed on gambling behavior. CONCLUSIONS Patients with GD reported decreased cue-induced craving following a single session of high frequency rTMS applied over the left DLPFC. Further large randomized controlled studies are needed to determine the usefulness of rTMS in GD.
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Affiliation(s)
- A Gay
- University hospital center of Saint-Étienne, university department of psychiatry and addiction, 42055 Saint-Étienne, France; TAPE laboratory, EA7423, Jean-Monnet university, Saint-Étienne, France.
| | - C Boutet
- INSERM, U1059, university of Lyon, 42023 Saint-Étienne, France; Radiology department, university hospital center of Saint-Étienne, 42055 Saint-Étienne, France
| | - T Sigaud
- University hospital center of Saint-Étienne, university department of psychiatry and addiction, 42055 Saint-Étienne, France; TAPE laboratory, EA7423, Jean-Monnet university, Saint-Étienne, France
| | - A Kamgoue
- University hospital center of Saint-Étienne, university department of psychiatry and addiction, 42055 Saint-Étienne, France
| | - J Sevos
- University hospital center of Saint-Étienne, university department of psychiatry and addiction, 42055 Saint-Étienne, France; TAPE laboratory, EA7423, Jean-Monnet university, Saint-Étienne, France
| | - J Brunelin
- INSERM, U1028, CNRS, UMR5292, Lyon neuroscience research center, university of Lyon, ΨR2 Team, 69000 Lyon, France; Lyon 1 university, 69000 Villeurbanne, France; Hospital center Le Vinatier, 69678 Bron, France
| | - C Massoubre
- University hospital center of Saint-Étienne, university department of psychiatry and addiction, 42055 Saint-Étienne, France; TAPE laboratory, EA7423, Jean-Monnet university, Saint-Étienne, France
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Brevet-Aeby C, Brunelin J, Iceta S, Padovan C, Poulet E. Prefrontal cortex and impulsivity: Interest of noninvasive brain stimulation. Neurosci Biobehav Rev 2016; 71:112-134. [DOI: 10.1016/j.neubiorev.2016.08.028] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 08/18/2016] [Accepted: 08/26/2016] [Indexed: 01/21/2023]
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Poulet E, Galvao F, Haffen E, Szekely D, Brault C, Haesebaert F, Brunelin J. Effects of smoking status and MADRS retardation factor on response to low frequency repetitive transcranial magnetic stimulation for depression. Eur Psychiatry 2016; 38:40-44. [PMID: 27657664 DOI: 10.1016/j.eurpsy.2016.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 04/05/2016] [Accepted: 04/06/2016] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Despite growing evidence supporting the clinical interest of repetitive transcranial magnetic stimulation (rTMS) in treatment-resistant depression (TRD), little is known regarding the effects of clinical and sociodemographic factors on the clinical outcome in patients. METHODS We retrospectively investigated the effects of clinical (using the 3-factor model of the Montgomery-Åsberg depression rating scale [MADRS] encompassing dysphoria, retardation and vegetative symptoms) and sociodemographic characteristics of participants on clinical outcome in a sample of 54 TRD patients receiving low frequency rTMS (1Hz, 360 pulses) applied over the right dorsolateral prefrontal cortex combined with sham venlafaxine. RESULTS Responders (n=29) displayed lower retardation baseline scores (13.6±2.9) than non-responders (15.6±2.9; n=25; P=0.02). We also observed a significant difference between the numbers of ex-smokers in responders and non-responders groups; all ex-smokers (n=8) were responders to rTMS (P=0.005). CONCLUSION Low MADRS retardation factor and ex-smoker status is highly prevalent in responders to low frequency rTMS. Further studies are needed to investigate the predictive value of these factors.
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Affiliation(s)
- E Poulet
- Inserm, U1028, CNRS, UMR5292, Lyon neuroscience research center, ΨR2 Team, université de Lyon, 69000 Lyon, France; University Lyon 1, 69000 Villeurbanne, France; Centre hospitalier Le Vinatier, 69678 Bron, France; Service de psychiatrie des urgences, hôpital Édouard-Herriot, CHU de Lyon, 69000 Lyon, France.
| | - F Galvao
- Inserm, U1028, CNRS, UMR5292, Lyon neuroscience research center, ΨR2 Team, université de Lyon, 69000 Lyon, France; University Lyon 1, 69000 Villeurbanne, France; Centre hospitalier Le Vinatier, 69678 Bron, France
| | - E Haffen
- Department of clinical psychiatry, CIC-1431 Inserm, university hospital of Besançon, 25000 Besançon, France; EA-481, université Bourgogne Franche-Comté, université Franche-Comté, 25000 Besançon, France; FondaMental foundation, 94000 Créteil, France
| | - D Szekely
- Princess Grace hospital, department of psychiatry, 98012 Monaco, France
| | - C Brault
- Pôle « information médicale évaluation recherche » (IMER), CHU de Lyon, 62, avenue Lacassagne, bâtiment A, 69424 Lyon cedex 03, France
| | - F Haesebaert
- Inserm, U1028, CNRS, UMR5292, Lyon neuroscience research center, ΨR2 Team, université de Lyon, 69000 Lyon, France; University Lyon 1, 69000 Villeurbanne, France; Centre hospitalier Le Vinatier, 69678 Bron, France
| | - J Brunelin
- Inserm, U1028, CNRS, UMR5292, Lyon neuroscience research center, ΨR2 Team, université de Lyon, 69000 Lyon, France; University Lyon 1, 69000 Villeurbanne, France; Centre hospitalier Le Vinatier, 69678 Bron, France
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Mondino M, Poulet E, Suaud-Chagny MF, Brunelin J. Anodal tDCS targeting the left temporo-parietal junction disrupts verbal reality-monitoring. Neuropsychologia 2016; 89:478-484. [PMID: 27452837 DOI: 10.1016/j.neuropsychologia.2016.07.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 07/18/2016] [Accepted: 07/19/2016] [Indexed: 11/27/2022]
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Kallel L, Mondino M, Brunelin J. Effects of theta-rhythm transcranial alternating current stimulation (4.5 Hz-tACS) in patients with clozapine-resistant negative symptoms of schizophrenia: a case series. J Neural Transm (Vienna) 2016; 123:1213-7. [PMID: 27194229 DOI: 10.1007/s00702-016-1574-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 05/09/2016] [Indexed: 10/21/2022]
Abstract
Our aim was to assess the efficacy and safety of theta-rhythm transcranial Alternating Current Stimulation (4.5 Hz-tACS) in patients with clozapine-resistant symptoms of schizophrenia. In an open case series, 3 patients received 20 sessions of 4.5 Hz-tACS (20 min, 2 mA) applied over the dorsolateral prefrontal cortex. The patients exhibited a decrease of negative symptoms (-10 %), general symptoms (-18 %) and an improvement of insight into the illness (-25 %). 4.5 Hz-tACS might be a suitable alternative treatment for clozapine-resistant symptoms of schizophrenia.
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Affiliation(s)
| | - Marine Mondino
- Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale, Centre de Recherche de l'Institut Universitaire en Santé Mentale, Medical School, Université Laval, Québec, QC, Canada
| | - Jerome Brunelin
- Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale, Centre de Recherche de l'Institut Universitaire en Santé Mentale, Medical School, Université Laval, Québec, QC, Canada. .,INSERM U1028, CNRS UMR5292, Lyon University, University Lyon 1, Lyon Neuroscience Research Center, PSYR2 team: Psychiatric Disorders: from Resistance to Response Team, Centre Hospitalier Le Vinatier, 69678, Bron, France.
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Psomiades M, Fonteneau C, Mondino M, Luck D, Haesebaert F, Suaud-Chagny MF, Brunelin J. Integrity of the arcuate fasciculus in patients with schizophrenia with auditory verbal hallucinations: A DTI-tractography study. Neuroimage Clin 2016; 12:970-975. [PMID: 27995063 PMCID: PMC5153606 DOI: 10.1016/j.nicl.2016.04.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 04/25/2016] [Accepted: 04/27/2016] [Indexed: 12/15/2022]
Abstract
Auditory verbal hallucinations (AVH) of schizophrenia are associated with a disrupted connectivity between frontal and temporoparietal language areas. We hypothesized that this dysconnectivity is underpinned by white matter abnormalities in the left arcuate fasciculus, the main fiber bundle connecting speech production and perception areas. We therefore investigated the relationship between AVH severity and the integrity of the arcuate fasciculus measured by diffusion tensor imaging (DTI) tractography in patients with schizophrenia. Thirty-eight patients with treatment-resistant schizophrenia were included: 26 presented with daily severe treatment-resistant AVH, 12 reported prominent negative symptoms and no AVH. Fractional anisotropy (FA) was measured along the length of the left and right anterior arcuate fasciculi and severity of AVH was assessed using P3 PANSS item. FA values were significantly higher in the left arcuate fasciculus in patients with AVH than in no AVH patients (F(1,35) = 3.86; p = 0.05). No difference was observed in the right arcuate fasciculus. There was a significant positive correlation between FA value in the left arcuate fasciculus and the severity of AVH (r = 0.36; p = 0.02). No correlation was observed between FA values and PANSS total score suggesting a specific relationship between AVH severity and the left arcuate fasciculus integrity. These results support the hypothesis of a relationship between left frontotemporal connectivity and AVH in patients with schizophrenia and suggest that whilst a disruption of frontotemporal connectivity might be present to ensure the emergence of AVH, more severe anatomical alterations may prevent the occurrence of AVH in patients with schizophrenia. Fractional anisotropy (FA) in the left arcuate fasciculus (AF) correlated with severity of hallucinations. Hallucinating patients had greater FA in the left AF than non-hallucinating patients. We did not find any association between hallucinations and FA in the right AF.
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Affiliation(s)
- Marion Psomiades
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France
| | - Clara Fonteneau
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France
| | - Marine Mondino
- Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale (CIRRIS), Centre de Recherche de l'Institut Universitaire en Santé Mentale (CRIUSM), Université Laval, Québec, QC, Canada
| | - David Luck
- Institut Universitaire en Santé Mentale de Montréal Research Center, Québec, QC, Canada; Department of Psychiatry, University of Montreal, QC, Canada
| | - Frederic Haesebaert
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France
| | - Marie-Françoise Suaud-Chagny
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France
| | - Jerome Brunelin
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France; Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale (CIRRIS), Centre de Recherche de l'Institut Universitaire en Santé Mentale (CRIUSM), Université Laval, Québec, QC, Canada
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Mondino M, Brunelin J, Palm U, Brunoni AR, Poulet E, Fecteau S. Transcranial Direct Current Stimulation for the Treatment of Refractory Symptoms of Schizophrenia. Current Evidence and Future Directions. Curr Pharm Des 2016; 21:3373-83. [PMID: 26088110 DOI: 10.2174/1381612821666150619093648] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 06/11/2015] [Indexed: 11/22/2022]
Abstract
Schizophrenia is a severe and frequent neuropsychiatric disorder. Despite antipsychotic medications, up to 30% of patients with schizophrenia still report disabling treatment-resistant symptoms. Transcranial direct current stimulation (tDCS) has been proposed as a novel method to alleviate such symptoms. Here, we review studies investigating the effects of tDCS on symptoms, cognition, brain activity and cortical plasticity in patients with schizophrenia. We provide an up-to-date and comprehensive overview of the use of tDCS in patients with schizophrenia. More specifically, we first present the effects of tDCS on treatment-resistant symptoms of schizophrenia. We report that tDCS applied over the frontotemporal regions reduced auditory hallucinations, with a mean 34% reduction of symptoms. Moreover, tDCS applied over both prefrontal cortices reduced negative symptoms and catatonia. We discuss the need for further sham-controlled studies to confirm these effects. Second, we present the impact of tDCS on cognitive functions in patients with schizophrenia. Positive effects of tDCS have been reported on learning, working memory, attention and source-monitoring. Third, we review the effects of tDCS on brain activity in patients with schizophrenia. Although only few studies investigated the effects of tDCS using neuroimaging technics, these studies are helpful at identifying the mechanisms of action of tDCS in schizophrenia. Fourth, we present tDCS studies on cortical plasticity showing reduced cortical plasticity in patients with schizophrenia that tDCS may beneficially modulate. Lastly, we discuss the safety aspects of tDCS in patients with schizophrenia and potential directions to improve efficacy for this clinical populations.
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Baeken C, Brunelin J, Duprat R, Vanderhasselt MA. The application of tDCS in psychiatric disorders: a brain imaging view. Socioaffect Neurosci Psychol 2016; 6:29588. [PMID: 26993785 PMCID: PMC4799388 DOI: 10.3402/snp.v6.29588] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 11/20/2015] [Accepted: 01/11/2016] [Indexed: 12/24/2022]
Abstract
Background Transcranial direct current stimulation (tDCS) is a non-invasive, non-convulsive technique for modulating brain function. In contrast to other non-invasive brain stimulation techniques, where costs, clinical applicability, and availability limit their large-scale use in clinical practices, the low-cost, portable, and easy-to-use tDCS devices may overcome these restrictions. Objective Despite numerous clinical applications in large numbers of patients suffering from psychiatric disorders, it is not quite clear how tDCS influences the mentally affected human brain. In order to decipher potential neural mechanisms of action of tDCS in patients with psychiatric conditions, we focused on the combination of tDCS with neuroimaging techniques. Design We propose a contemporary overview on the currently available neurophysiological and neuroimaging data where tDCS has been used as a research or treatment tool in patients with psychiatric disorders. Results Over a reasonably short period of time, tDCS has been broadly used as a research tool to examine neuronal processes in the healthy brain. tDCS has also commonly been applied as a treatment application in a variety of mental disorders, with to date no straightforward clinical outcome and not always accompanied by brain imaging techniques. Conclusion tDCS, as do other neuromodulation devices, clearly affects the underlying neuronal processes. However, research on these mechanisms in psychiatric patients is rather limited. A better comprehension of how tDCS modulates brain function will help us to define optimal parameters of stimulation in each indication and may result in the detection of biomarkers in favor of clinical response.
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Affiliation(s)
- Chris Baeken
- Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium.,Department of Psychiatry University Hospital (UZBrussel), Brussels, Belgium.,Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium;
| | - Jerome Brunelin
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Villeurbanne, France.,CIRRIS-Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale, Université Laval, Québec, Canada
| | - Romain Duprat
- Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium.,Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium
| | - Marie-Anne Vanderhasselt
- Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium.,Faculty of Medicine and Pharmacy, Free University Brussels, Brussels, Belgium
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Bation R, Poulet E, Haesebaert F, Saoud M, Brunelin J. Transcranial direct current stimulation in treatment-resistant obsessive-compulsive disorder: An open-label pilot study. Prog Neuropsychopharmacol Biol Psychiatry 2016; 65:153-7. [PMID: 26439873 DOI: 10.1016/j.pnpbp.2015.10.001] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 09/17/2015] [Accepted: 10/02/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a severe mental illness. OCD symptoms are often resistant to available treatments. Abnormalities within the orbitofronto-striato-pallido-thalamic circuitry, especially orbitofrontal cortex (OFC) hyperactivity and cerebellar hypoactivity have been observed in patients. Non-invasive brain stimulation studies have indicated that transcranial direct current stimulation (tDCS) may be a useful alternative to alleviate treatment-resistant symptoms in various neuropsychiatric conditions. METHODS In an open-label pilot study, 8 patients with treatment-resistant OCD received 10 sessions (twice a day) of 2mA tDCS applied with the cathode over the left OFC and the anode over the right cerebellum. OCD (Y-BOCS and OCD-VAS) as well as depressive (MADRS) symptoms were measured 4 times: one time before tDCS and 3 times after (immediately after, 1 and 3months after the 10th tDCS session). RESULTS We reported a significant 26.4% (±15.8) decrease of Y-BOCS score (p=0.002). The beneficial effect lasted during the 3month follow-up. No effect of tDCS was observed on depressive symptoms. At end point, 5 out of 8 patients had a decrease of ≥25%; and 3 out of 8 patients had a decrease of ≥35% in Y-BOCS score. tDCS was well tolerated. CONCLUSION tDCS with the cathode placed over the left OFC combined with the anode placed over the right cerebellum is a suitable and safe approach to decrease OCD symptoms in patients with treatment-resistant OCD. Large scale randomized controlled studies are needed to confirm this promising result.
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Affiliation(s)
- Remy Bation
- Université de Lyon, F-69003, Université Claude Bernard Lyon I, EA 4615, Centre Hospitalier le Vinatier, Bron, France.
| | - Emmanuel Poulet
- Université de Lyon, F-69003, Université Claude Bernard Lyon I, EA 4615, Centre Hospitalier le Vinatier, Bron, France; CHU de Lyon - Groupement Hospitalier Edouard Herriot - Service de Psychiatrie des Urgences, France
| | - Frederic Haesebaert
- Université de Lyon, F-69003, Université Claude Bernard Lyon I, EA 4615, Centre Hospitalier le Vinatier, Bron, France
| | - Mohamed Saoud
- Université de Lyon, F-69003, Université Claude Bernard Lyon I, EA 4615, Centre Hospitalier le Vinatier, Bron, France; CHU de Lyon - Groupement Hospitalier Est - Hôpital Pierre Wertheimer - Psychiatrie adultes - Consultations/Liaison, France
| | - Jerome Brunelin
- Université de Lyon, F-69003, Université Claude Bernard Lyon I, EA 4615, Centre Hospitalier le Vinatier, Bron, France
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Brunelin J, Hasan A, Haesebaert F, Nitsche MA, Poulet E. Nicotine Smoking Prevents the Effects of Frontotemporal Transcranial Direct Current Stimulation (tDCS) in Hallucinating Patients With Schizophrenia. Brain Stimul 2015; 8:1225-7. [DOI: 10.1016/j.brs.2015.08.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 08/05/2015] [Indexed: 12/27/2022] Open
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Cachia A, Amad A, Brunelin J, Krebs MO, Plaze M, Thomas P, Jardri R. Deviations in cortex sulcation associated with visual hallucinations in schizophrenia. Mol Psychiatry 2015; 20:1101-7. [PMID: 25349166 DOI: 10.1038/mp.2014.140] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 08/12/2014] [Accepted: 09/10/2014] [Indexed: 01/02/2023]
Abstract
Hallucinations, and auditory hallucinations (AH) in particular, constitute the most typical and disabling schizophrenia symptoms. Although visual hallucinations (VH) have been largely neglected in psychiatric disorders, a recent review reported a 27% mean prevalence of VH in schizophrenia patients. The pathophysiology underlying VH in schizophrenia remains elusive. Several schizophrenia studies reported a significant effect of age on VH; therefore, we tested the hypothesis that the neurodevelopmental model of schizophrenia may explain VH occurrence. We analyzed cortex sulcation, a marker of brain development, in healthy controls (HCs) and two subgroups of carefully selected schizophrenia patients suffering from hallucinations: patients with only AH (that is, patients who never reported VH) and patients with audio-visual hallucinations (A+VH). Different cortical sulcation and left-right sulcal asymmetry were found between A+VH and AH patients, with decreased sulcation in both A+VH and AH patients in comparison with the HCs. Although a specific association between VH and neurodegenerative mechanisms, for example, in Body-Lewy Dementia or Parkinson's Disease, has previously been reported in the literature, the current study provides the first neuroimaging evidence of an association between VH and neurodevelopmental mechanisms.
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Affiliation(s)
- A Cachia
- INSERM UMR 894, Centre de Psychiatrie & Neurosciences, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,CNRS UMR 8240, Laboratoire de Psychologie du développement et de l'Éducation de l'Enfant, Paris, France.,Institut Universitaire de France, Paris, France
| | - A Amad
- Université de Lille, SCA-lab, PSYchiC team, Lille, France.,Centre Hospitalier Régional Universitaire de Lille (CHULille), Psychiatry and Pediatric Psychiatry Department, Lille, France
| | - J Brunelin
- Université Claude Bernard Lyon 1 (UCBL), EA 4615, Centre Hospitalier Le Vinatier, Bron, France
| | - M-O Krebs
- INSERM UMR 894, Centre de Psychiatrie & Neurosciences, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - M Plaze
- INSERM UMR 894, Centre de Psychiatrie & Neurosciences, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - P Thomas
- Université de Lille, SCA-lab, PSYchiC team, Lille, France.,Centre Hospitalier Régional Universitaire de Lille (CHULille), Psychiatry and Pediatric Psychiatry Department, Lille, France
| | - R Jardri
- Université de Lille, SCA-lab, PSYchiC team, Lille, France.,Centre Hospitalier Régional Universitaire de Lille (CHULille), Psychiatry and Pediatric Psychiatry Department, Lille, France
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Tortella G, Casati R, Aparicio LVM, Mantovani A, Senço N, D’Urso G, Brunelin J, Guarienti F, Selingardi PML, Muszkat D, Junior BDSP, Valiengo L, Moffa AH, Simis M, Borrione L, Brunoni AR. Transcranial direct current stimulation in psychiatric disorders. World J Psychiatry 2015; 5:88-102. [PMID: 25815258 PMCID: PMC4369553 DOI: 10.5498/wjp.v5.i1.88] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 12/12/2014] [Accepted: 12/29/2014] [Indexed: 02/05/2023] Open
Abstract
The interest in non-invasive brain stimulation techniques is increasing in recent years. Among these techniques, transcranial direct current stimulation (tDCS) has been the subject of great interest among researchers because of its easiness to use, low cost, benign profile of side effects and encouraging results of research in the field. This interest has generated several studies and randomized clinical trials, particularly in psychiatry. In this review, we provide a summary of the development of the technique and its mechanism of action as well as a review of the methodological aspects of randomized clinical trials in psychiatry, including studies in affective disorders, schizophrenia, obsessive compulsive disorder, child psychiatry and substance use disorder. Finally, we provide an overview of tDCS use in cognitive enhancement as well as a discussion regarding its clinical use and regulatory and ethical issues. Although many promising results regarding tDCS efficacy were described, the total number of studies is still low, highlighting the need of further studies aiming to replicate these findings in larger samples as to provide a definite picture regarding tDCS efficacy in psychiatry.
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50
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Fregni F, Nitsche MA, Loo CK, Brunoni AR, Marangolo P, Leite J, Carvalho S, Bolognini N, Caumo W, Paik NJ, Simis M, Ueda K, Ekhitari H, Luu P, Tucker DM, Tyler WJ, Brunelin J, Datta A, Juan CH, Venkatasubramanian G, Boggio PS, Bikson M. Regulatory Considerations for the Clinical and Research Use of Transcranial Direct Current Stimulation (tDCS): review and recommendations from an expert panel. Clin Res Regul Aff 2015; 32:22-35. [PMID: 25983531 PMCID: PMC4431691 DOI: 10.3109/10601333.2015.980944] [Citation(s) in RCA: 174] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The field of transcranial electrical stimulation (tES) has experienced significant growth in the past 15 years. One of the tES techniques leading this increased interest is transcranial direct current stimulation (tDCS). Significant research efforts have been devoted to determining the clinical potential of tDCS in humans. Despite the promising results obtained with tDCS in basic and clinical neuroscience, further progress has been impeded by a lack of clarity on international regulatory pathways. We therefore convened a group of research and clinician experts on tDCS to review the research and clinical use of tDCS. In this report, we review the regulatory status of tDCS, and we summarize the results according to research, off-label and compassionate use of tDCS in the following countries: Australia, Brazil, France, Germany, India, Iran, Italy, Portugal, South Korea, Taiwan and United States. Research use, off label treatment and compassionate use of tDCS are employed in most of the countries reviewed in this study. It is critical that a global or local effort is organized to pursue definite evidence to either approve and regulate or restrict the use of tDCS in clinical practice on the basis of adequate randomized controlled treatment trials.
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Affiliation(s)
- F Fregni
- Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - M A Nitsche
- Department of Clinical Neurophysiology, Georg-August-University, Göttingen, Germany
| | - C K Loo
- School of Psychiatry & The Black Dog Institute, University of New South Wales, Sydney, Australia
| | - A R Brunoni
- Service of Interdisciplinary Neuromodulation, Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil and Division of Neurology, Santa Casa Medicak School, Sao Paulo, Brazil
| | - P Marangolo
- Department of Experimental and Clinical Medicine, University Politecnica delle Marche, Ancona, and IRCCS Fondazione Santa Lucia, Roma, Italy
| | - J Leite
- Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA ; Neuropsychophysiology Laboratory, CIPsi, School of Psychology (EPsi), University of Minho, Campus de Gualtar, Braga, Portugal
| | - S Carvalho
- Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA ; Neuropsychophysiology Laboratory, CIPsi, School of Psychology (EPsi), University of Minho, Campus de Gualtar, Braga, Portugal
| | - N Bolognini
- Department of Psychology, University of Milano Bicocca, and Laboratory of Neuropsychology, IRCC Instituto Auxologico Italiano, Milano, Italy
| | - W Caumo
- Laboratory of Pain & Neuromodulation at Hospital de Clínicas de Porto Alegre at UFRGS
| | - N J Paik
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, South Korea
| | - M Simis
- Service of Interdisciplinary Neuromodulation, Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil and Division of Neurology, Santa Casa Medicak School, Sao Paulo, Brazil
| | - K Ueda
- National Cardiovascular Center, Osaka, Japan
| | - H Ekhitari
- Translational Neuroscience Program, Institute for Cognitive Science Studies, Tehran, Iran ; Neurocognitive Laboratory, Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - P Luu
- Electrical Geodesics, Inc., and University of Oregon, Eugene, Oregon, USA
| | - D M Tucker
- Electrical Geodesics, Inc., and University of Oregon, Eugene, Oregon, USA
| | - W J Tyler
- Virginia Tech Carilion Research Institute, Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, and School of Biomedical Engineering and Sciences, Virginia Tech, Roanoke, VA USA
| | - J Brunelin
- EA 4615, Centre Hospitalier le Vinatier, Université de Lyon, F-69003, Université Claude Bernard Lyon I, Bron, France
| | - A Datta
- Department of Biomedical Engineering, Neural Engineering Laboratory, The City College of the City University of New York New York, NY, USA
| | - C H Juan
- Institute of Cognitive Neuroscience, National Central University, Taiwan
| | - G Venkatasubramanian
- Translational Psychiatry Laboratory, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - P S Boggio
- Social and Cognitive Neuroscience Laboratory and Developmental Disorders Program, Center for Healthy and Biological Sciences, Mackenzie Presbyterian University, Sao Paulo, Brazil
| | - M Bikson
- Department of Biomedical Engineering, Neural Engineering Laboratory, The City College of the City University of New York New York, NY, USA
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