Effects of deep transcranial magnetic stimulation (dTMS) on cognition

Efficacy of Adjunctive High-Frequency Deep Transcranial Magnetic Stimulation for Improving Negative Symptoms in Schizophrenia: A Feasibility Study

BACKGROUND

Negative symptoms of schizophrenia are disabling and respond inadequately to antipsychotic treatment. Hypofunctioning of cortical areas such as anterior cingulate cortex and medial prefrontal cortex has been implicated in negative symptoms. Repetitive transcranial magnetic stimulation is efficacious for the negative symptoms. Deep transcranial magnetic stimulation (dTMS) has the benefits of repetitive transcranial magnetic stimulation with the advantage of stimulating deeper brain targets.

OBJECTIVE

The aim of the study was to explore the efficacy of high-frequency dTMS for improving negative symptoms in schizophrenia.

METHODS

This was a sham-controlled, rater, and subject-blinded study. Forty-six patients were randomly assigned into active and sham groups. Ten sessions of high-frequency dTMS at 10 Hz were given at 100% of resting motor threshold using H7 coil over 2 weeks. The Positive and Negative Syndrome Scale, Scale for Assessment of Negative Symptoms, and Clinical Global Impressions were assessed at baseline, at 2 weeks, and at 4 weeks after completion of dTMS.

RESULT

Forty-three patients completed the study. Although both active and sham groups shown improvement over the time, active dTMS group showed significant improvement in negative symptoms as indicated by significant improvement in the Scale for Assessment of Negative Symptoms score as compared to sham dTMS group (P = 0.003, η2 = 0.158), further substantiated by improvement in negative subscale of Positive and Negative Syndrome Scale (P = 0.044, η2 = 0.079).

DISCUSSION

Findings from our study suggest that adjunctive high-frequency dTMS significantly improves negative symptoms and severity of illness among patients with schizophrenia. Future studies with larger sample sizes will add our knowledge in the beneficial effects of this newer modality of noninvasive brain stimulation.

Deep transcranial magnetic stimulation for treatment-resistant obsessive-compulsive disorder: A meta-analysis of randomized-controlled trials

BACKGROUND

Deep transcranial magnetic stimulation (dTMS), an advancement of transcranial magnetic stimulation, was created to reach wider and possibly more profound regions of the brain. At present, there is insufficient high-quality evidence to support the effectiveness and safety of dTMS in treating obsessive-compulsive disorder (OCD).

OBJECTIVE

This study used a meta-analysis to evaluate the effectiveness and safety of dTMS for treating OCD.

METHODS

Four randomized controlled trials were found by searching PubMed, Embase, Web of Science, and Cochrane Library up to February 2024. The fixed effects meta-analysis model was used for the purpose of data merging in Stata17. The risk ratio (RR) value was used as the measure of effect size to compare response rates and dropout rates between active and sham dTMS.

RESULTS

The meta-analysis included four randomized-controlled trials involving 252 patients with treatment-resistant OCD. Active dTMS showed a notably greater rate of response on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) in comparison to sham dTMS after treatment (Y-BOCS: RR = 3.71, 95% confidence interval [CI] 2.06 to 6.69) and at the one-month follow-up (Y-BOCS: RR = 2.60, 95% CI 1.59 to 4.26). Subgroup analysis revealed that active dTMS with H-coils was more effective than sham dTMS (RR = 3.57, 95%CI 1.93 to 6.60). No serious adverse events were documented in the studies that were included.

CONCLUSION

The findings suggest that dTMS demonstrates notable efficacy and safety in treating patients with treatment-resistant OCD compared to sham dTMS, with sustained effectiveness noted throughout the one-month post-treatment period.

Research hotspots and trends in transcranial magnetic stimulation for cognitive impairment: A bibliometric analysis from 2014 to 2023

BACKGROUND

Cognitive impairment, which manifests as a limited deterioration of specific functions associated with a particular disease, can lead to a general deterioration of the patient’s standard of living. Transcranial magnetic stimulation, a non-invasive neuromodulation technique, is frequently employed to treat cognitive impairment in neuropsychiatric disorders.

AIM

To analyzed the state of international research on neuromodulation methods for treating cognitive impairment between 2014 and 2023, with the aim of exploring the state of research worldwide and the most recent developments in this particular area.

METHODS

Articles and reviews pertaining to neuromodulation methods for cognitive impairment were examined using the web of science database between January 2014 and December 2023. Publications, nations, organizations, writers, journals, citations, and keywords data from the identified studies were systematically analyzed using the CiteSpace 6.3. R1 software.

RESULTS

A total of 2371 documents with 11750 authors and 9461 institutions, with some co-occurrences, were retrieved. The quantity of yearly publications is showing an increasing trend. The United States and China have emerged as important contributors. Among the institutes, Harvard University had the highest number of publications, while Rossi S an author who is frequently cited. Initially, the primary keywords included human motor cortex, placebo-controlled trials, and serotonin reuptake inhibitors. However, the emphasis gradually moved to substance use disorders, supplementary motor areas, neural mechanisms, and exercise.

CONCLUSION

The use of neuromodulation techniques to treat cognitive impairment has drawn interest from academics all around the world. This study revealed hotspots and new trends in the research of transcranial magnetic stimulation as a cognitive impairment rehabilitation treatment. These findings are hold significant potential to guide further research and thus promote transcranial magnetic stimulation as a treatment method for cognitive impairment.

Magnetic nanomaterials mediate precise magnetic therapy

Magnetic nanoparticle (MNP)-mediated precision magnet therapy plays a crucial role in treating various diseases. This therapeutic strategy compensates for the limitations of low spatial resolution and low focusing of magnetic stimulation, and realizes the goal of wireless teletherapy with precise targeting of focal areas. This paper summarizes the preparation methods of magnetic nanomaterials, the properties of magnetic nanoparticles, the biological effects, and the measurement methods for detecting magnetism; discusses the research progress of precision magnetotherapy in the treatment of psychiatric disorders, neurological injuries, metabolic disorders, and bone-related disorders, and looks forward to the future development trend of precision magnet therapy.

Does deep TMS really works for smoking cessation? A prospective, double blind, randomized, sham controlled study

INTRODUCTION

A substantial proportion of smokers wishing to quit do not stop smoking when using current therapies to aid cessation. Magnetic pulses to specific brain areas designated as transcranial magnetic stimulation may modulate brain activity and thereby change chemical dependencies. Deep transcranial magnetic stimulation (dTMS) with the H4 coil stimulates neuronal pathways in the lateral prefrontal cortex and insula bilaterally, areas involved in tobacco addiction.

OBJECTIVE

To evaluate the efficacy and safety of dTMS with T4 coil in smoking cessation.

METHODS

In a double blind, controlled clinical trial, adult smokers of at least 10 cigarettes/day were randomized to active (n = 50) versus sham dTMS (n = 50). The protocol involved up to 21 sessions administered over up to 12 weeks. Tobacco use was monitored by self-report and confirmed by expired air monoximetry (at each dTMS visit) and blood cotinine (at the screening visit and at the end of sessions). Participants completed abstinence, mood and cognition scales at determined timepoints during follow-up.

RESULTS

In the intention to-treat-analysis, the cessation rate of the intervention and control groups was 14.0%. The reported side effects were as expected for this procedure. Although there were no serious adverse events, three participants were withdrawn according to safety criteria.

CONCLUSION

Active treatment with dTMS H4 coil was safe but not effective for smoking cessation.