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Giglia G, Gambino G, Cuffaro L, Aleo F, Sardo P, Ferraro G, Blandino V, Brighina F, Gangitano M, Piccoli T. Modulating Long Term Memory at Late-Encoding Phase: An rTMS Study. Brain Topogr 2021; 34:834-839. [PMID: 34674095 DOI: 10.1007/s10548-021-00872-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/18/2021] [Indexed: 11/29/2022]
Abstract
Despite a huge effort of the scientific community, the functioning of Long-Term Memory (LTM) processes is still debated and far from being elucidated. Functional and neurophysiological data point to an involvement of Dorsolateral Prefrontal Cortex (DLPFC) in both encoding and retrieval phases. However, the recently proposed Explicit/Implicit Memory Encoding and Retrieval (EIMER) model proposes that LTM at the encoding phase consists of anatomically and chronologically different sub-phases. On this basis, we aimed to investigate the role of right DLPFC during a late-encoding phase by means of low-frequency rTMS. Thirty right-handed healthy subjects were divided into three experimental groups. Inhibitory rTMS was applied over right-DLPFC immediately after the encoding phase (Late-Encoding Group) or before recognition phase (Pre-Recognition Group), 24 h after, of an LTM task. Both groups also received sham stimulation during the non-target phase, while the third group (Sham Group) received only sham stimulation in both phases. The Late-Encoding Group collected a lower number of correct responses compared with Sham Group (p = 0.00), while Pre-Retrieval Group increased accuracy as compared to the Sham Group (p = 0.0). rTMS-inhibition of the right DLPFC seems able to interfere with LTM memory performances when delivered at a late stage of the encoding phase, with opposite effects at the pre-retrieval phase.
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Affiliation(s)
- Giuseppe Giglia
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy.,Euro Mediterranean Institute of Science and Technology- I.E.ME.S.T., Palermo, Italy
| | - Giuditta Gambino
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy
| | - Luca Cuffaro
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy.
| | - Fabio Aleo
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy
| | - Pierangelo Sardo
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy.
| | - Giuseppe Ferraro
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy
| | - Valeria Blandino
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy
| | - Filippo Brighina
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy
| | - Massimo Gangitano
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy
| | - Tommaso Piccoli
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy
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2
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Nordberg J, Taiminen T, Virtanen L, Jääskeläinen SK, Scheinin NM. Successful suppression of musical hallucinations with low-frequency rTMS of the left temporo-parietal junction: A case report. Brain Stimul 2021; 14:1467-1469. [PMID: 34597855 DOI: 10.1016/j.brs.2021.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 09/23/2021] [Accepted: 09/26/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Inhibitory low frequency repetitive transcranial magnetic stimulation (rTMS) of the temporo-parietal area has been applied to treat both auditory verbal hallucinations as well as tinnitus. OBJECTIVE We hypothesized that 1 Hz rTMS to the left temporoparietal junction (TPJ) may be beneficial in alleviating musical hallucinations (MH), another condition with auditory experiences in the absence of an external source. METHODS Here we describe a patient with almost insufferable life-long MH with comorbid depression, who received inhibitory rTMS to the left TPJ as well as the right dorsolateral prefrontal cortex (DLPFC). RESULTS The intrusiveness and frequency of her MH as well as her depressive symptoms alleviated quickly and substantially, and once-a-week maintenance therapy with rTMS seemed to preserve this amelioration. Future studies will hopefully reveal whether this is a viable treatment approach for other patients suffering from MH with or without comorbid depression.
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Affiliation(s)
- Janne Nordberg
- Department of Clinical Neurophysiology, University of Turku and Turku University Hospital, Turku, Finland.
| | - Tero Taiminen
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Lauri Virtanen
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Satu K Jääskeläinen
- Department of Clinical Neurophysiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Noora M Scheinin
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
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Sex Differences in Neuromodulation Treatment Approaches for Traumatic Brain Injury: A Scoping Review. J Head Trauma Rehabil 2020; 35:412-429. [PMID: 33165154 DOI: 10.1097/htr.0000000000000631] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Neuromodulatory brain stimulation interventions for traumatic brain injury (TBI)-related health sequelae, such as psychiatric, cognitive, and pain disorders, are on the rise. Because of disproportionate recruitment and epidemiological reporting of TBI-related research in men, there is limited understanding of TBI development, pathophysiology, and treatment intervention outcomes in women. With data suggesting sex-related variances in treatment outcomes, it is important that these gaps are addressed in emerging, neuromodulatory treatment approaches for TBI populations. METHODS Four research databases (PubMED, EMBASE, CINAHL, and PsycINFO) were electronically searched in February 2020. DESIGN This PRISMA Scoping Review (PRISMA-ScR)-guided report contextualizes the importance of reporting sex differences in TBI + neuromodulatory intervention studies and summarizes the current state of reporting sex differences when investigating 3 emerging interventions for TBI outcomes. RESULTS Fifty-four studies were identified for the final review including 12 controlled trials, 16 single or case series reports, and 26 empirical studies. Across all studies reviewed, 68% of participants were male, and only 7 studies reported sex differences as a part of their methodological approach, analysis, or discussion. CONCLUSION This review is hoped to update the TBI community on the current state of evidence in reporting sex differences across these 3 neuromodulatory treatments of post-TBI sequelae. The proposed recommendations aim to improve future research and clinical treatment of all individuals suffering from post-TBI sequelae.
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Zein M, Sher Y. Musical Memories-Musical Hallucinations in a Lung Transplant Recipient: Case Report and Literature Review. J Acad Consult Liaison Psychiatry 2020; 62:140-149. [PMID: 32977990 DOI: 10.1016/j.psym.2020.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Mira Zein
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA.
| | - Yelizaveta Sher
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
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Nardone R, Sebastianelli L, Versace V, Brigo F, Golaszewski S, Manganotti P, Saltuari L, Trinka E. Repetitive transcranial magnetic stimulation in traumatic brain injury: Evidence from animal and human studies. Brain Res Bull 2020; 159:44-52. [PMID: 32251693 DOI: 10.1016/j.brainresbull.2020.03.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 03/16/2020] [Accepted: 03/23/2020] [Indexed: 12/19/2022]
Abstract
We provide here the first systematic review on the studies dealing with repetitive transcranial magnetic stimulation (rTMS) for traumatic brain injury (TBI) in animals and humans. Several experimental studies in animal models have explored with promising results the use of rTMS to enhance neuroprotection and recovery after TBI. However, there are surprisingly few studies that have obtained substantial evidence regarding effects of rTMS in humans with TBI, many of them are case reports investigating the heterogeneous conditions linked to TBI. The most studies have investigated the effects of rTMS in subjects with post-traumatic depression and variable effects have been observed. rTMS has been proposed as an experimental approach for the treatment of disorders of consciousness (DOC), but in subjects with TBI therapeutic effects on DOC have also been variously documented. Beneficial effects have been reported in subjects with cognitive/emotional disturbances and auditory dysfunction (tinnitus and hallucinations), although the results are somewhat conflicting. rTMS applied over the left prefrontal cortex may relieve, at least transiently, post-traumatic headache. Isolated rTMS studies have been performed in TBI patients with motor impairment, chronic dizziness or pain. Especially whether provided in combination, rTMS and neurorehabilitation may be synergistic in the potential to translate experimental findings in the clinical practice. In order to reach definitive conclusions, well-designed randomized controlled studies with larger patient samples, improved design and optimized rTMS setup, are warranted to verify and corroborate the initial promising findings.
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Affiliation(s)
- Raffaele Nardone
- Department of Neurology, Franz Tappeiner Hospital, Merano, Italy; Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Spinal Cord Injury and Tissue Regeneration Center, Salzburg, Austria; Karl Landsteiner Institut für Neurorehabilitation und Raumfahrtneurologie, Salzburg, Austria.
| | - Luca Sebastianelli
- Department of Neurorehabilitation, Hospital of Vipiteno, Vipiteno, Italy; Research Unit for Neurorehabilitation South Tyrol, Bolzano, Italy
| | - Viviana Versace
- Department of Neurorehabilitation, Hospital of Vipiteno, Vipiteno, Italy; Research Unit for Neurorehabilitation South Tyrol, Bolzano, Italy
| | - Francesco Brigo
- Department of Neurology, Franz Tappeiner Hospital, Merano, Italy; Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Italy
| | - Stefan Golaszewski
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Karl Landsteiner Institut für Neurorehabilitation und Raumfahrtneurologie, Salzburg, Austria
| | | | - Leopold Saltuari
- Department of Neurorehabilitation, Hospital of Vipiteno, Vipiteno, Italy; Research Unit for Neurorehabilitation South Tyrol, Bolzano, Italy
| | - Eugen Trinka
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Centre for Cognitive Neurosciences Salzburg, Salzburg, Austria; University for Medical Informatics and Health Technology, UMIT, Hall in Tirol, Austria
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6
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Pink AE, Williams C, Alderman N, Stoffels M. The use of repetitive transcranial magnetic stimulation (rTMS) following traumatic brain injury (TBI): A scoping review. Neuropsychol Rehabil 2019; 31:479-505. [PMID: 31880207 DOI: 10.1080/09602011.2019.1706585] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
There is continued interest in developing effective and innovative treatment approaches to manage and improve outcomes after traumatic brain injury (TBI). Included in this, is the potential use of repetitive transcranial magnetic stimulation (rTMS), a neuromodulatory tool currently recommended by the National Institute for Health and Care Excellence as a treatment for depression. This review considers the application of rTMS after TBI, focussing on its therapeutic efficacy for a broad range of sequalae, whether an optimal and safe rTMS protocol can be determined, and recommendations for future clinical and research work. Five research databases (MEDLINE, CINAHL, PsychINFO, SCOPUS, and Web of Science) were electronically searched, identifying 30 empirical studies (single and multiple subject case reports; randomized controlled trials) for the full review. Evidence suggests that rTMS has the potential to be an efficacious therapeutic intervention for multiple symptoms after TBI, including depression, dizziness, central pain, and visual neglect. However, the picture is less encouraging for prolonged disorders of consciousness and mixed for cognitive outcomes. Overall, rTMS was well-tolerated by patients, although some incidents of side effects and seizures have been reported. Recommendations are made for more comprehensive guidelines and sufficient reporting of rTMS parameters and procedures.
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Affiliation(s)
- Aimee E Pink
- Department of Psychology, Swansea University, Swansea, UK.,Independent Neurorehabilitation Providers Alliance, Newcastle upon Tyne, UK
| | | | - Nick Alderman
- Department of Psychology, Swansea University, Swansea, UK.,Elysium Neurological Services, Elysium Healthcare, Daventry, UK
| | - Martine Stoffels
- Priory Neurobehavioural Brain Injury Services, Burton Park Brain Injury Hospital, Priory Group, Melton Mowbray, UK
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Neville IS, Zaninotto AL, Hayashi CY, Rodrigues PA, Galhardoni R, Ciampi de Andrade D, Brunoni AR, Amorim RLO, Teixeira MJ, Paiva WS. Repetitive TMS does not improve cognition in patients with TBI: A randomized double-blind trial. Neurology 2019; 93:e190-e199. [PMID: 31175209 PMCID: PMC6656650 DOI: 10.1212/wnl.0000000000007748] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 03/01/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine whether high-frequency repetitive transcranial magnetic stimulation (rTMS) improves cognition in patients with severe traumatic brain injury. METHODS A single-center, randomized, double-blind, placebo-controlled study of rTMS was conducted in patients aged 18-60 years with chronic (>12 months postinjury) diffuse axonal injury (DAI). Patients were randomized to either a sham or real group in a 1:1 ratio. A 10-session rTMS protocol was used with 10-Hz stimulation over the left dorsolateral prefrontal cortex (DLPFC). Neuropsychological assessments were performed at 3 time points: at baseline, after the 10th rTMS session, and 90 days after intervention. The primary outcome was change in executive function evaluated using the Trail Making Test Part B. RESULTS Thirty patients with chronic DAI met the study criteria. Between-group comparisons of performance on TMT Part B at baseline and after the 10th rTMS session did not differ between groups (p = 0.680 and p = 0.341, respectively). No significant differences were observed on other neuropsychological tests. No differences in adverse events between treatment groups were observed. CONCLUSIONS Cognitive function in individuals with chronic DAI is not improved by high-frequency rTMS over the left DLPFC, though it appears safe and well-tolerated in this population. CLINICALTRIALSGOV IDENTIFIER NCT02167971. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that for individuals with chronic DAI, high-frequency rTMS over the left DLPFC does not significantly improve cognition.
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Affiliation(s)
- Iuri Santana Neville
- From the Division of Neurosurgery/LIM-62 (I.S.N., A.L.Z., C.Y.H., P.A.R., R.G., D.C.d.A., R.L.O.A., M.J.T., W.S.P.) and Department of Psychiatry, Instituto de Psiquiatria (A.R.B.), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, and Service of Interdisciplinary Neuromodulation (I.S.N., C.Y.H., R.G., D.C.d.A., A.R.B., M.J.T., W.S.P.), Universidade de Sao Paulo, Brazil; Neuromodulation Center (A.L.Z.), Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA; School of Medicine (R.G.), Universidade da Cidade de Sao Paulo UNICID, Sao Paulo; and Department of Neurology (R.L.O.A.), Universidade Federal do Amazonas, Manaus, Brazil.
| | - Ana Luiza Zaninotto
- From the Division of Neurosurgery/LIM-62 (I.S.N., A.L.Z., C.Y.H., P.A.R., R.G., D.C.d.A., R.L.O.A., M.J.T., W.S.P.) and Department of Psychiatry, Instituto de Psiquiatria (A.R.B.), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, and Service of Interdisciplinary Neuromodulation (I.S.N., C.Y.H., R.G., D.C.d.A., A.R.B., M.J.T., W.S.P.), Universidade de Sao Paulo, Brazil; Neuromodulation Center (A.L.Z.), Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA; School of Medicine (R.G.), Universidade da Cidade de Sao Paulo UNICID, Sao Paulo; and Department of Neurology (R.L.O.A.), Universidade Federal do Amazonas, Manaus, Brazil
| | - Cintya Yukie Hayashi
- From the Division of Neurosurgery/LIM-62 (I.S.N., A.L.Z., C.Y.H., P.A.R., R.G., D.C.d.A., R.L.O.A., M.J.T., W.S.P.) and Department of Psychiatry, Instituto de Psiquiatria (A.R.B.), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, and Service of Interdisciplinary Neuromodulation (I.S.N., C.Y.H., R.G., D.C.d.A., A.R.B., M.J.T., W.S.P.), Universidade de Sao Paulo, Brazil; Neuromodulation Center (A.L.Z.), Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA; School of Medicine (R.G.), Universidade da Cidade de Sao Paulo UNICID, Sao Paulo; and Department of Neurology (R.L.O.A.), Universidade Federal do Amazonas, Manaus, Brazil
| | - Priscila Aparecida Rodrigues
- From the Division of Neurosurgery/LIM-62 (I.S.N., A.L.Z., C.Y.H., P.A.R., R.G., D.C.d.A., R.L.O.A., M.J.T., W.S.P.) and Department of Psychiatry, Instituto de Psiquiatria (A.R.B.), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, and Service of Interdisciplinary Neuromodulation (I.S.N., C.Y.H., R.G., D.C.d.A., A.R.B., M.J.T., W.S.P.), Universidade de Sao Paulo, Brazil; Neuromodulation Center (A.L.Z.), Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA; School of Medicine (R.G.), Universidade da Cidade de Sao Paulo UNICID, Sao Paulo; and Department of Neurology (R.L.O.A.), Universidade Federal do Amazonas, Manaus, Brazil
| | - Ricardo Galhardoni
- From the Division of Neurosurgery/LIM-62 (I.S.N., A.L.Z., C.Y.H., P.A.R., R.G., D.C.d.A., R.L.O.A., M.J.T., W.S.P.) and Department of Psychiatry, Instituto de Psiquiatria (A.R.B.), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, and Service of Interdisciplinary Neuromodulation (I.S.N., C.Y.H., R.G., D.C.d.A., A.R.B., M.J.T., W.S.P.), Universidade de Sao Paulo, Brazil; Neuromodulation Center (A.L.Z.), Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA; School of Medicine (R.G.), Universidade da Cidade de Sao Paulo UNICID, Sao Paulo; and Department of Neurology (R.L.O.A.), Universidade Federal do Amazonas, Manaus, Brazil
| | - Daniel Ciampi de Andrade
- From the Division of Neurosurgery/LIM-62 (I.S.N., A.L.Z., C.Y.H., P.A.R., R.G., D.C.d.A., R.L.O.A., M.J.T., W.S.P.) and Department of Psychiatry, Instituto de Psiquiatria (A.R.B.), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, and Service of Interdisciplinary Neuromodulation (I.S.N., C.Y.H., R.G., D.C.d.A., A.R.B., M.J.T., W.S.P.), Universidade de Sao Paulo, Brazil; Neuromodulation Center (A.L.Z.), Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA; School of Medicine (R.G.), Universidade da Cidade de Sao Paulo UNICID, Sao Paulo; and Department of Neurology (R.L.O.A.), Universidade Federal do Amazonas, Manaus, Brazil
| | - Andre Russowsky Brunoni
- From the Division of Neurosurgery/LIM-62 (I.S.N., A.L.Z., C.Y.H., P.A.R., R.G., D.C.d.A., R.L.O.A., M.J.T., W.S.P.) and Department of Psychiatry, Instituto de Psiquiatria (A.R.B.), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, and Service of Interdisciplinary Neuromodulation (I.S.N., C.Y.H., R.G., D.C.d.A., A.R.B., M.J.T., W.S.P.), Universidade de Sao Paulo, Brazil; Neuromodulation Center (A.L.Z.), Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA; School of Medicine (R.G.), Universidade da Cidade de Sao Paulo UNICID, Sao Paulo; and Department of Neurology (R.L.O.A.), Universidade Federal do Amazonas, Manaus, Brazil
| | - Robson L Oliveira Amorim
- From the Division of Neurosurgery/LIM-62 (I.S.N., A.L.Z., C.Y.H., P.A.R., R.G., D.C.d.A., R.L.O.A., M.J.T., W.S.P.) and Department of Psychiatry, Instituto de Psiquiatria (A.R.B.), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, and Service of Interdisciplinary Neuromodulation (I.S.N., C.Y.H., R.G., D.C.d.A., A.R.B., M.J.T., W.S.P.), Universidade de Sao Paulo, Brazil; Neuromodulation Center (A.L.Z.), Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA; School of Medicine (R.G.), Universidade da Cidade de Sao Paulo UNICID, Sao Paulo; and Department of Neurology (R.L.O.A.), Universidade Federal do Amazonas, Manaus, Brazil
| | - Manoel Jacobsen Teixeira
- From the Division of Neurosurgery/LIM-62 (I.S.N., A.L.Z., C.Y.H., P.A.R., R.G., D.C.d.A., R.L.O.A., M.J.T., W.S.P.) and Department of Psychiatry, Instituto de Psiquiatria (A.R.B.), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, and Service of Interdisciplinary Neuromodulation (I.S.N., C.Y.H., R.G., D.C.d.A., A.R.B., M.J.T., W.S.P.), Universidade de Sao Paulo, Brazil; Neuromodulation Center (A.L.Z.), Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA; School of Medicine (R.G.), Universidade da Cidade de Sao Paulo UNICID, Sao Paulo; and Department of Neurology (R.L.O.A.), Universidade Federal do Amazonas, Manaus, Brazil
| | - Wellingson Silva Paiva
- From the Division of Neurosurgery/LIM-62 (I.S.N., A.L.Z., C.Y.H., P.A.R., R.G., D.C.d.A., R.L.O.A., M.J.T., W.S.P.) and Department of Psychiatry, Instituto de Psiquiatria (A.R.B.), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, and Service of Interdisciplinary Neuromodulation (I.S.N., C.Y.H., R.G., D.C.d.A., A.R.B., M.J.T., W.S.P.), Universidade de Sao Paulo, Brazil; Neuromodulation Center (A.L.Z.), Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA; School of Medicine (R.G.), Universidade da Cidade de Sao Paulo UNICID, Sao Paulo; and Department of Neurology (R.L.O.A.), Universidade Federal do Amazonas, Manaus, Brazil
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Coebergh JAF, Lauw RF, Sommer IEC, Blom JD. Musical hallucinations and their relation with epilepsy. J Neurol 2019; 266:1501-1515. [PMID: 30972497 PMCID: PMC6517562 DOI: 10.1007/s00415-019-09289-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 02/24/2019] [Accepted: 02/26/2019] [Indexed: 02/05/2023]
Abstract
Musical hallucinations are poorly understood phenomena. Their relation with epilepsy was first described over a century ago, but never systematically explored. We, therefore, reviewed the literature, and assessed all descriptions of musical hallucinations attributed to epileptic activity. Our search yielded 191 articles, which together describe 983 unique patients, with 24 detailed descriptions of musical hallucinations related to epilepsy. We also describe six of our own patients. Based on the phenomenological descriptions and neurophysiological data, we distinguish four subgroups of epilepsy-related musical hallucination, comprising auras/ictal, inter-ictal and post-ictal phenomena, and phenomena related to brain stimulation. The case descriptions suggest that musical hallucinations in epilepsy can be conceptualised as lying on a continuum with other auditory hallucinations, including verbal auditory hallucinations, and—notably—tinnitus. To account for the underlying mechanism we propose a Bayesian model involving top-down and bottom-up prediction errors within the auditory network that incorporates findings from EEG and MEG studies. An analysis of phenomenological characteristics, pharmacological triggers, and treatment effects suggests wider ramifications for understanding musical hallucinations. We, therefore, conclude that musical hallucinations in epilepsy open a window to understanding these phenomena in a variety of conditions.
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Affiliation(s)
- J A F Coebergh
- Department of Neurology, Haga Hospital, The Hague, The Netherlands.,Department of Neurology, Ashford and St. Peter's Hospital, Chertsey, UK.,Department of Neurology, St. George's Hospital NHS Foundation Trust, Tooting, London, England, UK
| | - R F Lauw
- Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - I E C Sommer
- Department of Psychiatry, University of Groningen, Groningen, The Netherlands
| | - J D Blom
- Parnassia Psychiatric Institute, The Hague, The Netherlands. .,Department of Psychiatry, University of Groningen, Groningen, The Netherlands. .,Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands.
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9
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Cavaliere C, Longarzo M, Orsini M, Aiello M, Grossi D. Fronto-Temporal Circuits in Musical Hallucinations: A PET-MR Case Study. Front Hum Neurosci 2018; 12:385. [PMID: 30319380 PMCID: PMC6170624 DOI: 10.3389/fnhum.2018.00385] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 09/05/2018] [Indexed: 11/13/2022] Open
Abstract
The aim of the study is to investigate morphofunctional circuits underlying musical hallucinations (MH) in a 72-years old female that underwent a simultaneous 18fluoredeoxyglucose positron emission tomography (PET) and advanced magnetic resonance (MR) exam. This represents a particular case of MH occurred in an healthy subject, not displaying neurological or psychopathological disorders, and studied simultaneously with a multimodal approach. For the resting-state fMRI analysis a seed to seed approach was chosen. For the task-based fMRI, 4 different auditory stimuli were presented. Imaging findings were compared with data obtained by ten healthy controls matched for age and sex. Neuropsychological evaluation and questionnaires investigating depression and anxiety were also administered. PET findings showed hypermetabolism of: superior temporal gyri, anterior cingulate, left orbital frontal, and medial temporal cortices. Structural MRI did not show macroscopical lesions except for gliotic spots along the uncinate fascicle pathways with an increased cortical thickness for the right orbitofrontal cortex (p = 0.003). DTI showed increased fractional anisotropy values in the left uncinate fascicle, when compared to controls (p = 0.04). Resting-state fMRI showed increased functional connectivity between the left inferior frontal gyrus and the left temporal fusiform cortex (p = 0.01). Task-based fMRI confirmed PET findings showing an increased activation of the superior temporal gyrus in all the auditory tasks except for the monotone stimulus, with a significant activation of the left orbital frontal cortex only during the song in foreign language, object of MH. Results on cognitive test did not show cognitive impairment, excepting for the performance on Frontal Assessment Battery where the patient fails in the cognitive domains of conceptualization, sensitive to interference, and inhibitory control. The subject did not show depressive or anxiety symptoms. Summarizing, multimodal imaging analyses in the MH case showed a microstructural alteration of the left uncinate fascicle paralleled by an increased metabolism and functional connectivity of cortical regions that receive left uncinate projections (orbital frontal cortex, and medial temporal cortex). This alteration of fronto-hyppocampal circuits could be responsible of retrieval of known songs even in the absence of real stimuli.
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Affiliation(s)
- Carlo Cavaliere
- NAPLab, IRCCS SDN Istituto di Ricerca Diagnostica e Nucleare, Naples, Italy
| | | | - Mario Orsini
- NAPLab, IRCCS SDN Istituto di Ricerca Diagnostica e Nucleare, Naples, Italy
| | - Marco Aiello
- NAPLab, IRCCS SDN Istituto di Ricerca Diagnostica e Nucleare, Naples, Italy
| | - Dario Grossi
- Department of Psychology, University of Campania Luigi Vanvitelli, Naples, Italy
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Verdugo-Diaz L, Estrada-Rojo F, Garcia-Espinoza A, Hernandez-Lopez E, Hernandez-Chavez A, Guzman-Uribe C, Martinez-Vargas M, Perez-Arredondo A, Calvario T, Elias-Viñas D, Navarro L. Effect of Intermediate-Frequency Repetitive Transcranial Magnetic Stimulation on Recovery following Traumatic Brain Injury in Rats. BIOMED RESEARCH INTERNATIONAL 2017; 2017:4540291. [PMID: 29318150 PMCID: PMC5727566 DOI: 10.1155/2017/4540291] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 10/05/2017] [Accepted: 10/29/2017] [Indexed: 11/25/2022]
Abstract
Traumatic brain injury (TBI) represents a significant public health concern and has been associated with high rates of morbidity and mortality. Although several research groups have proposed the use of repetitive transcranial magnetic stimulation (rTMS) to enhance neuroprotection and recovery in patients with TBI, few studies have obtained sufficient evidence regarding its effects in this population. Therefore, we aimed to analyze the effect of intermediate-frequency rTMS (2 Hz) on behavioral and histological recovery following TBI in rats. Male Wistar rats were divided into six groups: three groups without TBI (no manipulation, movement restriction plus sham rTMS, and movement restriction plus rTMS) and three groups subjected to TBI (TBI only, TBI plus movement restriction and sham rTMS, and TBI plus movement restriction and rTMS). The movement restriction groups were included so that rTMS could be applied without anesthesia. Our results indicate that the restriction of movement and sham rTMS per se promotes recovery, as measured using a neurobehavioral scale, although rTMS was associated with faster and superior recovery. We also observed that TBI caused alterations in the CA1 and CA3 subregions of the hippocampus, which are partly restored by movement restriction and rTMS. Our findings indicated that movement restriction prevents damage caused by TBI and that intermediate-frequency rTMS promotes behavioral and histologic recovery after TBI.
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Affiliation(s)
- Leticia Verdugo-Diaz
- Department of Physiology, School of Medicine, Universidad Nacional Autonoma de Mexico, Apartado Postal 70-250, 04510 Ciudad de México, Mexico
| | - Francisco Estrada-Rojo
- Department of Physiology, School of Medicine, Universidad Nacional Autonoma de Mexico, Apartado Postal 70-250, 04510 Ciudad de México, Mexico
| | - Aron Garcia-Espinoza
- Department of Physiology, School of Medicine, Universidad Nacional Autonoma de Mexico, Apartado Postal 70-250, 04510 Ciudad de México, Mexico
| | - Eduardo Hernandez-Lopez
- Department of Physiology, School of Medicine, Universidad Nacional Autonoma de Mexico, Apartado Postal 70-250, 04510 Ciudad de México, Mexico
| | - Alejandro Hernandez-Chavez
- Department of Physiology, School of Medicine, Universidad Nacional Autonoma de Mexico, Apartado Postal 70-250, 04510 Ciudad de México, Mexico
| | - Carlos Guzman-Uribe
- Department of Physiology, School of Medicine, Universidad Nacional Autonoma de Mexico, Apartado Postal 70-250, 04510 Ciudad de México, Mexico
| | - Marina Martinez-Vargas
- Department of Physiology, School of Medicine, Universidad Nacional Autonoma de Mexico, Apartado Postal 70-250, 04510 Ciudad de México, Mexico
| | - Adan Perez-Arredondo
- Department of Physiology, School of Medicine, Universidad Nacional Autonoma de Mexico, Apartado Postal 70-250, 04510 Ciudad de México, Mexico
| | - Tomas Calvario
- Department of Electrical Engineering, Bioelectronics Section, CINVESTAV, IPN, Av. Politecnico Nacional 2508, Col. San Pedro Zacatenco, 07360 Ciudad de México, Mexico
| | - David Elias-Viñas
- Department of Electrical Engineering, Bioelectronics Section, CINVESTAV, IPN, Av. Politecnico Nacional 2508, Col. San Pedro Zacatenco, 07360 Ciudad de México, Mexico
| | - Luz Navarro
- Department of Physiology, School of Medicine, Universidad Nacional Autonoma de Mexico, Apartado Postal 70-250, 04510 Ciudad de México, Mexico
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Abstract
Musical hallucinations are uncommon phenomena characterized by intrusive and frequently distressful auditory musical percepts without an external source, often associated with hypoacusis, psychiatric illness, focal brain lesion, epilepsy, and intoxication/pharmacology. Their physiological basis is thought to involve diverse mechanisms, including "release" from normal sensory or inhibitory inputs as well as stimulation during seizures, or they can be produced by functional or structural disorders in diverse cortical and subcortical areas. The aim of this review is to further explore their pathophysiology, describing the functional neuroimaging findings regarding musical hallucinations. A literature search of the PubMed electronic database was conducted through to 29 December 2015. Search terms included "musical hallucinations" combined with the names of specific functional neuroimaging techniques. A total of 18 articles, all clinical case reports, providing data on 23 patients, comprised the set we reviewed. Diverse pathological processes and patient populations with musical hallucinations were included in the studies. Converging data from multiple studies suggest that the superior temporal sulcus is the most common site and that activation is the most common mechanism. Further neurobiological research is needed to clarify the pathophysiology of musical hallucinations.
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12
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Neuroprosthetics in amputee and brain injury rehabilitation. Exp Neurol 2016; 287:479-485. [PMID: 27519275 DOI: 10.1016/j.expneurol.2016.08.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 08/08/2016] [Indexed: 01/07/2023]
Abstract
The goals of rehabilitation medicine programs are to promote health, restore functional impairments and improve quality of life. The field of neuroprosthetics has evolved over the last decade given an improved understanding of neuroscience and the incorporation of advanced biotechnology and neuroengineering in the rehabilitation setting to develop adaptable applications to help facilitate recovery for individuals with amputations and brain injury. These applications may include a simple cognitive prosthetics aid for impaired memory in brain-injured individuals to myoelectric prosthetics arms with artificial proprioceptive feedback for those with upper extremity amputations. The integration of neuroprosthetics into the existing framework of current rehabilitation approaches not only improves quality-of-care and outcomes but help broadens current rehabilitation treatment paradigms. Although, we are in the infancy of the understanding the true benefit of neuroprosthetics and its clinical applications in the rehabilitation setting there is tremendous amount of promise for future research and development of tools to help facilitate recovery and improve quality of life in individuals with disabilities.
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Koski L, Kolivakis T, Yu C, Chen JK, Delaney S, Ptito A. Noninvasive brain stimulation for persistent postconcussion symptoms in mild traumatic brain injury. J Neurotrauma 2015; 32:38-44. [PMID: 24955920 DOI: 10.1089/neu.2014.3449] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Mild traumatic brain injury (mTBI) is typically followed by various postconcussive symptoms (PCS), including headache, depression, and cognitive deficits. In 15-25% of cases, PCS persists beyond the usual 3-month recovery period, interfering with activities of daily living and responding poorly to pharmacotherapy. We tested the safety, tolerability, and efficacy of repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) for alleviating PCS. Fifteen eligible patients with mTBI and PCS > 3 months postinjury consented to 20 sessions of rTMS (20 × 5-sec trains; 10 Hz at 110% threshold), with clinical and functional magnetic resonance imaging (fMRI) assessments before and after intervention and clinical assessment at 3-month follow-up. Primary outcomes were tolerability, safety, and efficacy, as measured with the PCS Scale. Secondary outcomes included the Cognitive Symptoms Questionnaire, neuropsychological test performance, and working memory task-associated activity as assessed with fMRI. Twelve patients completed all sessions. Three withdrew because of worsening symptoms or for an unrelated event. Stimulation intensity was increased gradually across sessions, and all subjects tolerated the protocol by the sixth session. Commonly reported side effects among completers were increased headache (n = 3) and greater sleep disturbance (n = 3). Participants also reported positive outcomes such as less sleep disturbance (n = 3), and better mental focus (n = 3). On average, PCS scores declined by 14.6 points (p = 0.009) and fMRI task-related activation peaks in the DLPFC increased after rTMS. rTMS is safe, tolerated by most patients with mTBI, and associated with both a reduction in severity of PCS and an increase in task-related activations in DLPFC. Assessment of this intervention in a randomized, control trial is warranted.
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Affiliation(s)
- Lisa Koski
- 1 Department of Psychology, McGill University Health Center (MUHC), Department of Neurology/Neurosurgery and Department of Psychology, McGill University, and Mental Illness and Addiction Axis, Research Institute of the MUHC, McGill University , Montreal, Quebec, Canada
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14
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Coebergh JAF, Lauw RF, Bots R, Sommer IEC, Blom JD. Musical hallucinations: review of treatment effects. Front Psychol 2015; 6:814. [PMID: 26136708 PMCID: PMC4468361 DOI: 10.3389/fpsyg.2015.00814] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 05/28/2015] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Despite an increased scientific interest in musical hallucinations over the past 25 years, treatment protocols are still lacking. This may well be due to the fact that musical hallucinations have multiple causes, and that published cases are relatively rare. OBJECTIVE To review the effects of published treatment methods for musical hallucinations. METHODS A literature search yielded 175 articles discussing a total number of 516 cases, of which 147 articles discussed treatment in 276 individuals. We analyzed the treatment results in relation to the etiological factor considered responsible for the mediation of the musical hallucinations, i.e., idiopathic/hypoacusis, psychiatric disorder, brain lesion, and other pathology, epilepsy or intoxication/pharmacology. RESULTS Musical hallucinations can disappear without intervention. When hallucinations are bearable, patients can be reassured without any other treatment. However, in other patients musical hallucinations are so disturbing that treatment is indicated. Distinct etiological groups appear to respond differently to treatment. In the hypoacusis group, treating the hearing impairment can yield significant improvement and coping strategies (e.g., more acoustic stimulation) are frequently helpful. Pharmacological treatment methods can also be successful, with antidepressants being possibly more helpful than antiepileptics (which are still better than antipsychotics). The limited use of acetylcholinesterase inhibitors has looked promising. Musical hallucinations occurring as part of a psychiatric disorder tend to respond well to psychopharmacological treatments targeting the underlying disorder. Musical hallucinations experienced in the context of brain injuries and epilepsy tend to respond well to antiepileptics, but their natural course is often benign, irrespective of any pharmacological treatment. When intoxication/pharmacology is the main etiological factor, it is important to stop or switch the causative substance or medication. CONCLUSION Treatments for musical hallucinations tend to yield favorable results when they target the main etiological factor of these phenomena. There is a need to establish the natural course of musical hallucinations, their response to non-pharmacological treatments, and their effects on the patient's quality of life. There is also a need to standardize the assessment of treatment responses, and document long-term follow up.
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Affiliation(s)
- Jan A. F. Coebergh
- Department of Neurology, Haga HospitalThe Hague, Netherlands
- Department of Neurology, Ashford/St. Peter's HospitalChertsey, UK
- Department of Neurology, St. George's HospitalLondon, UK
| | - R. F. Lauw
- Parnassia Psychiatric InstituteThe Hague, Netherlands
| | - R. Bots
- ‘S Heeren LooNoordwijk, Netherlands
| | - I. E. C. Sommer
- Department of Psychiatry, University Medical Center UtrechtUtrecht, Netherlands
- Brain Centre Rudolf MagnusUtrecht, Netherlands
| | - J. D. Blom
- Parnassia Psychiatric InstituteThe Hague, Netherlands
- Department of Psychiatry, University of GroningenGroningen, Netherlands
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15
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Reti IM, Schwarz N, Bower A, Tibbs M, Rao V. Transcranial magnetic stimulation: A potential new treatment for depression associated with traumatic brain injury. Brain Inj 2015; 29:789-97. [PMID: 25950260 DOI: 10.3109/02699052.2015.1009168] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Each year, more than 1.7 million Americans suffer a traumatic brain injury (TBI) and the lifetime prevalence of major depressive disorder following TBI is between 25-50%. There are no validated established strategies to treat TBI depression. Repetitive transcranial magnetic stimulation (rTMS) is a novel putative treatment option for post-TBI depression, which, compared with standard pharmacological agents, may provide a more targeted treatment with fewer side-effects. However, TBI is associated with an increased risk of both early and late spontaneous seizures, a significant consideration in evaluating rTMS as a potential treatment for TBI depression. Whilst the risk of seizure from rTMS is low, underlying neuropathology may somewhat increase that risk. REVIEW This review focuses on the safety aspects of rTMS in TBI patients. The authors review why low frequency rTMS might be less likely to trigger a seizure than high frequency rTMS and propose low frequency rTMS as a safer option in TBI patients. Because there is little data on the safety of rTMS in TBI, the authors also review the safety of rTMS in patients with other brain pathology. CONCLUSION It is concluded that pilot safety and tolerability studies should be first conducted in persons with TBI and neuropsychiatric comorbidities. These results could be used to help design larger randomized controlled trials.
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Affiliation(s)
- Irving M Reti
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University , Baltimore, MD , USA
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16
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Li S, Zaninotto AL, Neville IS, Paiva WS, Nunn D, Fregni F. Clinical utility of brain stimulation modalities following traumatic brain injury: current evidence. Neuropsychiatr Dis Treat 2015; 11:1573-86. [PMID: 26170670 PMCID: PMC4494620 DOI: 10.2147/ndt.s65816] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Traumatic brain injury (TBI) remains the main cause of disability and a major public health problem worldwide. This review focuses on the neurophysiology of TBI, and the rationale and current state of evidence of clinical application of brain stimulation to promote TBI recovery, particularly on consciousness, cognitive function, motor impairments, and psychiatric conditions. We discuss the mechanisms of different brain stimulation techniques including major noninvasive and invasive stimulations. Thus far, most noninvasive brain stimulation interventions have been nontargeted and focused on the chronic phase of recovery after TBI. In the acute stages, there is limited available evidence of the efficacy and safety of brain stimulation to improve functional outcomes. Comparing the studies across different techniques, transcranial direct current stimulation is the intervention that currently has the higher number of properly designed clinical trials, though total number is still small. We recognize the need for larger studies with target neuroplasticity modulation to fully explore the benefits of brain stimulation to effect TBI recovery during different stages of recovery.
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Affiliation(s)
- Shasha Li
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China ; Spaulding Neuromodulation Center, Harvard Medical School, Boston, MA, USA
| | - Ana Luiza Zaninotto
- Spaulding Neuromodulation Center, Harvard Medical School, Boston, MA, USA ; Division of Psychology, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
| | - Iuri Santana Neville
- Division of Neurosurgery, University of São Paulo Medical School, São Paulo, São Paulo, Brazil
| | - Wellingson Silva Paiva
- Division of Neurosurgery, University of São Paulo Medical School, São Paulo, São Paulo, Brazil
| | - Danuza Nunn
- Spaulding Neuromodulation Center, Harvard Medical School, Boston, MA, USA
| | - Felipe Fregni
- Spaulding Neuromodulation Center, Harvard Medical School, Boston, MA, USA
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17
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Dhaliwal SK, Meek BP, Modirrousta MM. Non-Invasive Brain Stimulation for the Treatment of Symptoms Following Traumatic Brain Injury. Front Psychiatry 2015; 6:119. [PMID: 26379560 PMCID: PMC4549551 DOI: 10.3389/fpsyt.2015.00119] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 08/10/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) is a common cause of physical, psychological, and cognitive impairment, but many current treatments for TBI are ineffective or produce adverse side effects. Non-invasive methods of brain stimulation could help ameliorate some common trauma-induced symptoms. OBJECTIVE This review summarizes instances in which repetitive Transcranial Magnetic Stimulation (rTMS) and transcranial Direct Current Stimulation (tDCS) have been used to treat symptoms following a TBI. A subsequent discussion attempts to determine the value of these methods in light of their potential risks. METHODS The research databases of PubMed/MEDLINE and PsycINFO were electronically searched using terms relevant to the use of rTMS and tDCS as a tool to decrease symptoms in the context of rehabilitation post-TBI. RESULTS Eight case-studies and four multi-subject reports using rTMS and six multi--subject studies using tDCS were found. Two instances of seizure are discussed. CONCLUSION There is evidence that rTMS can be an effective treatment option for some post-TBI symptoms, such as depression, tinnitus, and neglect. Although the safety of this method remains uncertain, the use of rTMS in cases of mild TBI without obvious structural damage may be justified. Evidence on the effectiveness of tDCS is mixed, highlighting the need for additional investigations.
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Affiliation(s)
| | - Benjamin P Meek
- Department of Psychiatry, University of Manitoba , Winnipeg, MB , Canada
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Herrold AA, Kletzel SL, Harton BC, Chambers RA, Jordan N, Pape TLB. Transcranial magnetic stimulation: potential treatment for co-occurring alcohol, traumatic brain injury and posttraumatic stress disorders. Neural Regen Res 2014; 9:1712-30. [PMID: 25422632 PMCID: PMC4238159 DOI: 10.4103/1673-5374.143408] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2014] [Indexed: 12/13/2022] Open
Abstract
Alcohol use disorder (AUD), mild traumatic brain injury (mTBI), and posttraumatic stress disorder (PTSD) commonly co-occur (AUD + mTBI + PTSD). These conditions have overlapping symptoms which are, in part, reflective of overlapping neuropathology. These conditions become problematic because their co-occurrence can exacerbate symptoms. Therefore, treatments must be developed that are inclusive to all three conditions. Repetitive transcranial magnetic stimulation (rTMS) is non-invasive and may be an ideal treatment for co-occurring AUD + mTBI + PTSD. There is accumulating evidence on rTMS as a treatment for people with AUD, mTBI, and PTSD each alone. However, there are no published studies to date on rTMS as a treatment for co-occurring AUD + mTBI + PTSD. This review article advances the knowledge base for rTMS as a treatment for AUD + mTBI + PTSD. This review provides background information about these co-occurring conditions as well as rTMS. The existing literature on rTMS as a treatment for people with AUD, TBI, and PTSD each alone is reviewed. Finally, neurobiological findings in support of a theoretical model are discussed to inform TMS as a treatment for co-occurring AUD + mTBI + PTSD. The peer-reviewed literature was identified by targeted literature searches using PubMed and supplemented by cross-referencing the bibliographies of relevant review articles. The existing evidence on rTMS as a treatment for these conditions in isolation, coupled with the overlapping neuropathology and symptomology of these conditions, suggests that rTMS may be well suited for the treatment of these conditions together.
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Affiliation(s)
- Amy A. Herrold
- Edward Hines Jr. VA Hospital, Research Service PO Box 5000 (M/C 151H), Hines, IL, USA
- The Department of Veterans Affairs (VA), Center for Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, PO Box 5000 (M/C 151H), Hines, IL, USA
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, 446 East Ontario, #7-200, Chicago, IL, USA
| | - Sandra L. Kletzel
- The Department of Veterans Affairs (VA), Center for Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, PO Box 5000 (M/C 151H), Hines, IL, USA
| | - Brett C. Harton
- Chicago Association for Research and Education in Science, Hines, IL, USA
| | - R. Andrew Chambers
- Department of Psychiatry, Laboratory for Translational Neuroscience of Dual Diagnosis & Development, Neuroscience Research Center, Indiana University School of Medicine, 320 West 15 Street, Indianapolis, IN, USA
| | - Neil Jordan
- The Department of Veterans Affairs (VA), Center for Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, PO Box 5000 (M/C 151H), Hines, IL, USA
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, 446 East Ontario, #7-200, Chicago, IL, USA
| | - Theresa Louise-Bender Pape
- Edward Hines Jr. VA Hospital, Research Service PO Box 5000 (M/C 151H), Hines, IL, USA
- The Department of Veterans Affairs (VA), Center for Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, PO Box 5000 (M/C 151H), Hines, IL, USA
- Northwestern University Feinberg School of Medicine, Department of Physical Medicine and Rehabilitation, Office of Medical Educ. (1574), 345 E. Superior St., Chicago, IL, USA
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Repetitive Transcranial Magnetic Stimulation for the Treatment of Chronic Tinnitus After Traumatic Brain Injury. J Head Trauma Rehabil 2013; 28:386-9. [DOI: 10.1097/htr.0b013e318254736e] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Muller PA, Pascual-Leone A, Rotenberg A. Safety and tolerability of repetitive transcranial magnetic stimulation in patients with pathologic positive sensory phenomena: a review of literature. Brain Stimul 2011; 5:320-329.e27. [PMID: 22322098 DOI: 10.1016/j.brs.2011.05.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Revised: 04/11/2011] [Accepted: 04/12/2011] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) is emerging as a valuable therapeutic and diagnostic tool. rTMS appears particularly promising for disorders characterized by positive sensory phenomena that are attributable to alterations in sensory cortical excitability. Among these are tinnitus, auditory and visual hallucinations, and pain syndromes. OBJECTIVE Despite studies addressing rTMS efficacy in suppression of positive sensory symptoms, the safety of stimulation of potentially hyperexcitable cortex has not been fully addressed. We performed a systematic literature review and metaanalysis to describe the rTMS safety profile in these disorders. METHODS Using the PubMed database, we performed an English-language literature search from January 1985 to April 2011 to review all pertinent publications. Per study, we noted and listed pertinent details. From these data we also calculated a crude per-subject risk for each adverse event. RESULTS One hundred six publications (n = 1815) were identified with patients undergoing rTMS for pathologic positive sensory phenomena. Adverse events associated with rTMS were generally mild and occurred in 16.7% of subjects. Seizure was the most serious adverse event, and occurred in three patients with a 0.16% crude per-subject risk. The second most severe adverse event involved aggravation of sensory phenomena, occurring in 1.54%. CONCLUSIONS The published data suggest rTMS for the treatment or diagnosis of pathologic positive sensory phenomena appears to be a relatively safe and well-tolerated procedure. However, published data are lacking in systematic reporting of adverse events, and safety risks of rTMS in these patient populations will have to be addressed in future prospective trials.
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Affiliation(s)
- Paul A Muller
- Department of Neurology, Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Institut Guttmann de Neurorehabilitació, Universitat Autónoma, Barcelona, Spain
| | - Alexander Rotenberg
- Department of Neurology, Children's Hospital, Harvard Medical School, Boston, Massachusetts; Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
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