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Liu L, Hu H, Wu J, Koleske AJ, Chen H, Wang N, Yu K, Wu Y, Xiao X, Zhang Q. Integrin α3 is required for high-frequency repetitive transcranial magnetic stimulation-induced glutamatergic synaptic transmission in mice with ischemia. CNS Neurosci Ther 2024; 30:e14498. [PMID: 37867481 PMCID: PMC11017422 DOI: 10.1111/cns.14498] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 09/16/2023] [Accepted: 10/01/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) is an effective therapy in post-stroke motor recovery. However, the underlying mechanisms of rTMS regulates long-lasting changes with synaptic transmission and glutamate receptors function (including AMPARs or NMDARs) remains unclear. METHODS Mice were received 10-Hz rTMS treatment once daily on the third day after photothrombotic (PT) stroke for 18 days. Motor behaviors and the Western blot were used to evaluate the therapeutic efficacy of 10-Hz rTMS in the mice with PT model. Moreover, we used wild-type (WT) and NEX-α3-/- mice to further explore the 10-Hz rTMS effect. RESULTS We found that 10-Hz rTMS improved the post-stroke motor performance in the PT mice. Moreover, the levels of AMPAR, vGlut1, and integrin α3 in the peri-infarct were significantly increased in the rTMS group. In contrast, 10-Hz rTMS did not induce these aforementioned effects in NEX-α3-/- mice. The amplitude of AMPAR-mediated miniature excitatory postsynaptic currents (EPSCs) and evoked EPSCs was increased in the WT + rTMS group, but did not change in NEX-α3-/- mice with rTMS. CONCLUSIONS In this study, 10-Hz rTMS improved the glutamatergic synaptic transmission in the peri-infract cortex through effects on integrin α3 and AMPARs, which resulted in motor function recovery after stroke.
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Affiliation(s)
- Li Liu
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
| | - Han Hu
- Behavioral and Cognitive Neuroscience CenterInstitute of Science and Technology for Brain‐Inspired Intelligence, Fudan UniversityShanghaiChina
| | - Junfa Wu
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
| | - Anthony J. Koleske
- Departments of Molecular Biophysics and Biochemistry and NeuroscienceYale UniversityNew HavenConnecticutUSA
| | - Hongting Chen
- Behavioral and Cognitive Neuroscience CenterInstitute of Science and Technology for Brain‐Inspired Intelligence, Fudan UniversityShanghaiChina
| | - Nianhong Wang
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
| | - Kewei Yu
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
| | - Yi Wu
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
| | - Xiao Xiao
- Behavioral and Cognitive Neuroscience CenterInstitute of Science and Technology for Brain‐Inspired Intelligence, Fudan UniversityShanghaiChina
| | - Qun Zhang
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
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Jin L, Wang H, Dong Y, Chen Q, Li L, Li Y. Choosing the optimal target area for repeated transcranial magnetic stimulation in treating neuropathic pain in spinal cord injury patients: a comparative analysis. Front Neurol 2024; 15:1370420. [PMID: 38601340 PMCID: PMC11004227 DOI: 10.3389/fneur.2024.1370420] [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: 01/14/2024] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
Objective The specific target area of repeated transcranial magnetic stimulation (rTMS) in treating neuropathic pain resulting from spinal cord injury (SCI-NP) remains uncertain. Methods Thirty-four participants with SCI-NP were allocated into three groups, namely, the motor cortex (M1, A) group, the left dorsolateral prefrontal cortex (LDLPFC, B) group, and the control (sham stimulation, C) group. The intervention was administered totally 10 times. Outcome measures assessed pre-(T0) and post-(T1)intervention, including Numerical Rating scale (NRS), anxiety (SAS), depression (SDS), sleep quality (PSQI), brief pain inventory (BPI), and impression of change. Results All outcomes in groups A and B significantly changed after intervention (p < 0.05), and the delta value (T1-T0) also significantly changed than group C (p < 0.05). The delta value of SDS in the group B was better than the group A, and the change of pain degree in the group B was moderately correlated with the change in PSQI (r = 0.575, p < 0.05). Both patients in the groups A and B showed significant impression of change about their received therapy (p < 0.05). Conclusion Both targets are effective, but LDLPFC is more effective in reducing depression in SCI-NP. Healthcare providers might select the suitable area according to the specific attributes of their patients.
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Affiliation(s)
- Lihua Jin
- Department of Rehabilitation Medicine, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Haonan Wang
- Department of Rehabilitation, Kunming Medical University, Kunming, Yunnan, China
- Department of Burn and Plastic Medicine, The Fourth Medical Center of the Chinese PLA General Hospital, Beijing, Beijing, China
| | - Yifei Dong
- Department of Rehabilitation, Kunming Medical University, Kunming, Yunnan, China
| | - Qian Chen
- Department of Rehabilitation Medicine, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Linrong Li
- Department of Rehabilitation Medicine, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yongmei Li
- Department of Rehabilitation Medicine, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
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Leuchter MK, Citrenbaum C, Wilson AC, Tibbe TD, Jackson NJ, Krantz DE, Wilke SA, Corlier J, Strouse TB, Hoftman GD, Tadayonnejad R, Koek RJ, Slan AR, Ginder ND, Distler MG, Artin H, Lee JH, Adelekun AE, Einstein EH, Oughli HA, Leuchter AF. The effect of older age on outcomes of rTMS treatment for treatment-resistant depression. Int Psychogeriatr 2024:1-6. [PMID: 38525670 DOI: 10.1017/s1041610224000462] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
Clinical outcomes of repetitive transcranial magnetic stimulation (rTMS) for treatment of treatment-resistant depression (TRD) vary widely and there is no mood rating scale that is standard for assessing rTMS outcome. It remains unclear whether TMS is as efficacious in older adults with late-life depression (LLD) compared to younger adults with major depressive disorder (MDD). This study examined the effect of age on outcomes of rTMS treatment of adults with TRD. Self-report and observer mood ratings were measured weekly in 687 subjects ages 16-100 years undergoing rTMS treatment using the Inventory of Depressive Symptomatology 30-item Self-Report (IDS-SR), Patient Health Questionnaire 9-item (PHQ), Profile of Mood States 30-item, and Hamilton Depression Rating Scale 17-item (HDRS). All rating scales detected significant improvement with treatment; response and remission rates varied by scale but not by age (response/remission ≥ 60: 38%-57%/25%-33%; <60: 32%-49%/18%-25%). Proportional hazards models showed early improvement predicted later improvement across ages, though early improvements in PHQ and HDRS were more predictive of remission in those < 60 years (relative to those ≥ 60) and greater baseline IDS burden was more predictive of non-remission in those ≥ 60 years (relative to those < 60). These results indicate there is no significant effect of age on treatment outcomes in rTMS for TRD, though rating instruments may differ in assessment of symptom burden between younger and older adults during treatment.
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Affiliation(s)
- Michael K Leuchter
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Cole Citrenbaum
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Andrew C Wilson
- Cooperative Institute for Research in Environmental Sciences (CIRES), University of Colorado Boulder, Boulder, CO, USA
- NOAA National Centers for Environmental Information (NCEI), Boulder, CO, USA
| | - Tristan D Tibbe
- Department of Psychology, University of California, Los Angeles, CA, USA
- Department of Medicine Statistics Core, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Nicholas J Jackson
- Department of Medicine Statistics Core, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - David E Krantz
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Scott A Wilke
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Juliana Corlier
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Thomas B Strouse
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Gil D Hoftman
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Reza Tadayonnejad
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Division of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, USA
| | - Ralph J Koek
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Aaron R Slan
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Nathaniel D Ginder
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Margaret G Distler
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Hewa Artin
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - John H Lee
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Adesewa E Adelekun
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Evan H Einstein
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Hanadi A Oughli
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Andrew F Leuchter
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Berman ZR, Citrenbaum C, Corlier J, Leuchter AF, Folmer RL, Leuchter MK. Sequential Multilocus Repetitive Transcranial Magnetic Stimulation for Treatment of Tinnitus With and Without Comorbid Major Depressive Disorder. Neuromodulation 2024:S1094-7159(24)00035-7. [PMID: 38385935 DOI: 10.1016/j.neurom.2024.01.001] [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: 11/01/2023] [Revised: 01/10/2024] [Accepted: 01/16/2024] [Indexed: 02/23/2024]
Abstract
OBJECTIVE Repetitive transcranial magnetic stimulation (rTMS) is a promising treatment for tinnitus, although outcomes are highly variable. We previously described a multilocus sequential rTMS treatment protocol for tinnitus involving stimulation of both prefrontal and auditory targets. In this study, we report results using this approach in an open-label treatment study of tinnitus with and without comorbid major depressive disorder (MDD). MATERIALS AND METHODS Forty patients with chronic tinnitus (mean age 56 years, ten female) and with (n = 17) or without (n = 23) MDD received multilocus rTMS administered sequentially to 1) left dorsolateral prefrontal cortex, followed by 2) auditory cortex (Heschel's gyrus). Patients completed weekly self-report ratings using the Tinnitus Functional Index (TFI) and Tinnitus Handicap Inventory, and patients with MDD completed the Inventory of Depressive Symptomatology Self-Report 30-item. RESULTS Patients showed significant mean improvement in tinnitus at sessions 5 (mean TFI improvement 6.8 points ± 12.2, p = 0.002) and 10 (mean improvement 9.2 points ± 14.1, p = 0.002), with 48% of patients responding within ten treatment sessions. Responders were significantly older than nonresponders (61.5 ± 15 years vs 51.3 ± 16 years), and there was a trend toward decreased likelihood of response in subjects with comorbid MDD compared with subjects without comorbidity (odds ratio = 0.28, p = 0.06). Patients with comorbid MDD reported significantly less improvement after ten sessions than did those with tinnitus alone (4.3 ± 10.3 vs 14.7 ± 15.0 points, p = 0.04). Post hoc analyses suggested that the comorbid group achieved improvement comparable to that of the tinnitus-only group after 30 treatments. CONCLUSIONS Patients showed significant improvement in tinnitus from multilocus sequential rTMS treatment, and those with tinnitus alone improved more quickly. Those with depression who continued rTMS through a full 30-session course further improved, indicating that tinnitus with comorbid MDD may respond with extended treatment.
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Affiliation(s)
- Zoe R Berman
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at University of California Los Angeles, Los Angeles, CA, USA; McGovern Medical School, University of Texas Health Sciences Center at Houston, Houston, TX, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - Cole Citrenbaum
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at University of California Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - Juliana Corlier
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at University of California Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - Andrew F Leuchter
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at University of California Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - Robert L Folmer
- Department of Otolaryngology, Oregon Health & Science University, Portland, OR, USA; National Center for Rehabilitative Auditory Research, VA Portland Medical Center, Portland, OR, USA
| | - Michael K Leuchter
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at University of California Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA.
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Chiriac VF, Ciurescu D, Moșoiu DV. Cancer Pain and Non-Invasive Brain Stimulation-A Narrative Review. Medicina (Kaunas) 2023; 59:1957. [PMID: 38004006 PMCID: PMC10673188 DOI: 10.3390/medicina59111957] [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] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/22/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: Pain is the most prevalent symptom in cancer patients. There is a paucity of data regarding non-invasive brain stimulation (NIBS) for the treatment of chronic pain in patients with cancer. The purpose of this article is to review the techniques of NIBS and present the published experiences of the oncological population. Materials and Methods: Databases including MEDLINE, Scopus, Web of Science, and the Cochrane Library were searched for articles on cancer patients with pain that was managed with non-invasive brain stimulation techniques. We included articles in English that were published from inception to January 2023. As studies were limited in number and had different designs and methodologies, a narrative review was considered as the best option to integrate data. Results: Four studies focusing on transcranial magnetic stimulation, six articles on transcranial direct current stimulation, and three articles regarding cranial electric stimulation were found and reviewed. Conclusions: Data are limited and not robust. Further studies in this field are required. Guidelines on NIBS for non-malignant chronic pain conditions provide good premises for cancer-related chronic pain.
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Affiliation(s)
- Valentina-Fineta Chiriac
- Departament of Medical Oncology, “Dr Pompei Samarian” County Emergency Hospital, 910071 Călărași, Romania
- Faculty of Medicine, Transilvania University, 500036 Brașov, Romania
| | - Daniel Ciurescu
- Faculty of Medicine, Transilvania University, 500036 Brașov, Romania
| | - Daniela-Viorica Moșoiu
- Faculty of Medicine, Transilvania University, 500036 Brașov, Romania
- HOSPICE Casa Sperantei, 500074 Brașov, Romania
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6
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Zhang JH, Liang J, Yang ZW. Non-invasive brain stimulation for fibromyalgia: current trends and future perspectives. Front Neurosci 2023; 17:1288765. [PMID: 37928733 PMCID: PMC10620708 DOI: 10.3389/fnins.2023.1288765] [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: 09/04/2023] [Accepted: 10/05/2023] [Indexed: 11/07/2023] Open
Abstract
Fibromyalgia, a common and enduring pain disorder, ranks as the second most prevalent rheumatic disease after osteoarthritis. Recent years have witnessed successful treatment using non-invasive brain stimulation. Transcranial magnetic stimulation, transcranial direct current stimulation, and electroconvulsion therapy have shown promise in treating chronic pain. This article reviews the literature concerning non-invasive stimulation for fibromyalgia treatment, its mechanisms, and establishes a scientific basis for rehabilitation, and discusses the future directions for research and development prospects of these techniques are discussed.
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Affiliation(s)
- Jia-Hao Zhang
- Laboratory of Laser Sports Medicine, School of Physical Education and Sports Science, South China Normal University, Guangzhou, China
| | - Jian Liang
- Laboratory of Sports Rehabilitation, School of Physical Education and Sports Science, South China Normal University, Guangzhou, China
| | - Zhong-Wei Yang
- Laboratory of Sports Rehabilitation, School of Physical Education and Sports Science, South China Normal University, Guangzhou, China
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Liu C, Zhao N, Dong Y. Editorial: Basic and clinical research on neurostimulation techniques in major depressive disorder. Front Psychiatry 2023; 14:1287617. [PMID: 37886117 PMCID: PMC10599135 DOI: 10.3389/fpsyt.2023.1287617] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 10/02/2023] [Indexed: 10/28/2023] Open
Affiliation(s)
- Chaomeng Liu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Na Zhao
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Yuanjun Dong
- College of Health and Life Sciences, University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
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Dong L, Li H, Dang H, Zhang X, Yue S, Zhang H. Corrigendum: Efficacy of non-invasive brain stimulation for disorders of consciousness: a systematic review and meta-analysis. Front Neurosci 2023; 17:1293703. [PMID: 37829726 PMCID: PMC10565647 DOI: 10.3389/fnins.2023.1293703] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 10/14/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fnins.2023.1219043.].
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Affiliation(s)
- Linghui Dong
- Shandong University, Jinan, Shandong, China
- China Rehabilitation Research Center, Beijing, China
- University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
| | - Hui Li
- Shandong University, Jinan, Shandong, China
- China Rehabilitation Research Center, Beijing, China
- University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
| | - Hui Dang
- Shandong University, Jinan, Shandong, China
- China Rehabilitation Research Center, Beijing, China
- University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
| | | | - Shouwei Yue
- Shandong University, Jinan, Shandong, China
- University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
| | - Hao Zhang
- Shandong University, Jinan, Shandong, China
- China Rehabilitation Research Center, Beijing, China
- University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
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Al-Ruhaili I, Al-Huseini S, Al-Kaabi S, Mahadevan S, Al-Sibani N, Al Balushi N, Islam MM, Jose S, Mehr GK, Al-Adawi S. An Evaluation of the Effectiveness of Repetitive Transcranial Magnetic Stimulation (rTMS) for the Management of Treatment-Resistant Depression with Somatic Attributes: A Hospital-Based Study in Oman. Brain Sci 2023; 13:1289. [PMID: 37759890 PMCID: PMC10526207 DOI: 10.3390/brainsci13091289] [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: 07/15/2023] [Revised: 08/17/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
Depressive illnesses in non-Western societies are often masked by somatic attributes that are sometimes impervious to pharmacological agents. This study explores the effectiveness of repetitive transcranial magnetic stimulation (rTMS) for people experiencing treatment-resistant depression (TRD) accompanied by physical symptoms. Data were obtained from a prospective study conducted among patients with TRD and some somatic manifestations who underwent 20 sessions of rTMS intervention from January to June 2020. The Hamilton Rating Scale for Depression (HAMD) was used for clinical evaluation. Data were analysed using descriptive and inferential techniques (multiple logistic regression) in SPSS. Among the 49 participants (mean age: 42.5 ± 13.3), there was a significant reduction in posttreatment HAMD scores compared to baseline (t = 10.819, p < 0.0001, and 95% CI = 8.574-12.488), indicating a clinical response. Approximately 37% of the patients responded to treatment, with higher response rates among men and those who remained in urban areas, had a history of alcohol use, and were subjected to the standard 10 HZ protocol. After adjusting for all extraneous variables, the rTMS protocol emerged as the only significant predictor of response to the rTMS intervention. To our knowledge, this is the first study to examine the effectiveness of rTMS in the treatment of somatic depression.
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Affiliation(s)
- Intisar Al-Ruhaili
- Psychiatry Residency Program, Oman Medical Specialty Board, Muscat 130, Oman;
| | - Salim Al-Huseini
- Department of Psychiatry, Al Masarra Hospital, Ministry of Health, Muscat 113, Oman; (S.A.-H.); (S.A.-K.)
| | - Said Al-Kaabi
- Department of Psychiatry, Al Masarra Hospital, Ministry of Health, Muscat 113, Oman; (S.A.-H.); (S.A.-K.)
| | - Sangeetha Mahadevan
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat 123, Oman; (S.M.); (N.A.B.)
| | - Nasser Al-Sibani
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat 123, Oman; (S.M.); (N.A.B.)
| | - Naser Al Balushi
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat 123, Oman; (S.M.); (N.A.B.)
| | - M. Mazharul Islam
- Department of Statistics, College of Science, Sultan Qaboos University, Muscat 123, Oman;
| | - Sachin Jose
- Studies and Research Section, Oman Medical Specialty Board, Muscat 130, Oman;
| | - Gilda Kiani Mehr
- Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran 14588-89694, Iran;
| | - Samir Al-Adawi
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat 123, Oman; (S.M.); (N.A.B.)
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Makale MT, Nybo C, Keifer J, Blum K, Dennen CA, Baron D, Sunder K, Elman I, Makale MR, Thanos PK, Murphy KT. Preliminary Observations of Personalized Repetitive Magnetic Stimulation (PrTMS) Guided by EEG Spectra for Concussion. Brain Sci 2023; 13:1179. [PMID: 37626535 PMCID: PMC10452199 DOI: 10.3390/brainsci13081179] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/02/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
There are no FDA-approved treatments for the chronic sequelae of concussion. Repetitive magnetic transcranial stimulation (rTMS) has been explored as a therapy but outcomes have been inconsistent. To address this we developed a personalized rTMS (PrTMS) protocol involving continual rTMS stimulus frequency adjustment and progressive activation of multiple cortical sites, guided by spectral electroencephalogram (EEG)-based analyses and psychological questionnaires. We acquired pilot clinical data for 185 symptomatic brain concussion patients who underwent the PrTMS protocol over an approximate 6 week period. The PrTMS protocol used a proprietary EEG spectral frequency algorithm to define an initial stimulation frequency based on an anteriorly graded projection of the measured occipital alpha center peak, which was then used to interpolate and adjust regional stimulation frequency according to weekly EEG spectral acquisitions. PrTMS improved concussion indices and normalized the cortical alpha band center frequency and peak EEG amplitude. This potentially reflected changed neurotransmitter, cognitive, and perceptual status. PrTMS may be a promising treatment choice for patients with persistent concussion symptoms. This clinical observational study was limited in that there was no control group and a number of variables were not recorded, such as time since injury and levels of depression. While the present observations are indeed preliminary and cursory, they may suggest further prospective research on PrTMS in concussion, and exploration of the spectral EEG as a concussion biomarker, with the ultimate goals of confirmation and determining optimal PrTMS treatment parameters.
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Affiliation(s)
- Milan T. Makale
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA 92093, USA
| | - Chad Nybo
- CrossTx Inc., Bozeman, MT 59715, USA
| | | | - Kenneth Blum
- Department of Clinical Psychology and Addiction, Institute of Psychology, Faculty of Education and Psychology, Eötvös Loránd University, 1075 Budapest, Hungary
- Department of Psychiatry, Wright University, Boonshoft School of Medicine, Dayton, OH 45324, USA
- Department of Molecular Biology and Adelson School of Medicine, Ariel University, Ariel 40700, Israel
- Division of Addiction Research & Education, Center for Sports, Exercise & Global Mental Health, Western University Health Sciences, Pomona, CA 91766, USA
| | - Catherine A. Dennen
- Department of Family Medicine, Jefferson Health NE, Philadelphia, PA 19107, USA
| | - David Baron
- Division of Addiction Research & Education, Center for Sports, Exercise & Global Mental Health, Western University Health Sciences, Pomona, CA 91766, USA
| | - Keerthy Sunder
- School of Medicine, University of California Riverside, Riverside, CA 92521, USA
| | - Igor Elman
- Cambridge Health Alliance, Harvard Medical School, Cambridge, MA 02143, USA
| | - Miles R. Makale
- Department of Psychology, University of California San Diego, La Jolla, CA 92093, USA
| | - Panayotis K. Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biosciences, State University of New York at Buffalo, Buffalo, NY 14203, USA
- Department of Psychology, State University of New York at Buffalo, Buffalo, NY 14203, USA
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Tian L, Ma S, Li Y, Zhao MF, Xu C, Wang C, Zhang X, Gao L. Repetitive transcranial magnetic stimulation can improve the fixation of eyes rather than the fixation preference in children with autism spectrum disorder. Front Neurosci 2023; 17:1188648. [PMID: 37547145 PMCID: PMC10400712 DOI: 10.3389/fnins.2023.1188648] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 07/03/2023] [Indexed: 08/08/2023] Open
Abstract
Background Transcranial magnetic stimulation (TMS) has been introduced into the intervention of autism spectrum disorders (ASD) as a possible new therapeutic option for modifying pathological neuroplasticity. However, the stimulating protocols of rTMS for ASD have not been approved unanimously, which affects the clinical popularization and application of rTMS. In addition, there is little research on the improvement of social processing of autistic children by rTMS. Methods We explored the clinical efficacy of rTMS and improvement of face processing with the protocol of left high-frequency and right low-frequency on bilateral dorsolateral prefrontal cortex (DLPFC), with a sample of 45 ASD participants aged 2-18. Results Our results showed that both the score on the Childhood Autism Rating Scale (CARS) and the fixations on the eyes of the human faces improved by two-session rTMS intervention, except for the percentage of eyes fixation. The mediation analysis indicated the item of "Adaptation to Change" of CARS mediated dominantly the improvement of eye-gaze behavior of ASD participants by rTMS. Conclusion Our study revealed the mechanism of rTMS in improving the eye-gaze behavior of the autism population, deepened the understanding of the function of rTMS in treating autistic social disorders, and provided a reference for combined treatment for ASD.
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Affiliation(s)
- Li Tian
- Tianjin Anding Hospital, Tianjin, China
| | - Shuai Ma
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yin Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Meng-fei Zhao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Chang Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Chen Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xin Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Lei Gao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
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Yang C, Bi Y, Hu L, Gong L, Li Z, Zhang N, Wang Q, Li J. Effects of different transcranial magnetic stimulations on neuropathic pain after spinal cord injury. Front Neurol 2023; 14:1141973. [PMID: 37521294 PMCID: PMC10374342 DOI: 10.3389/fneur.2023.1141973] [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: 01/11/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction Repetitive transcranial magnetic stimulation (rTMS) is an effective non-invasive cortical stimulation technique in the treatment of neuropathic pain. As a new rTMS technique, intermittent theta burst stimulation (iTBS) is also effective at relieving pain. We aimed to establish the pain-relieving effectiveness of different modalities on neuropathic pain. The study was conducted in individuals with spinal cord injury (SCI) and different modalities of rTMS. Methods Thirty-seven individuals with SCI were randomly allocated to three groups, in which the "iTBS" group received iTBS, the "rTMS" group received 10 Hz rTMS, and the "iTBS + rTMS" group received iTBS and 10 Hz rTMS successively of the primary motor cortex 5 days a week for 4 weeks, and they all underwent the full procedures. The primary outcome measure was change in the visual analog scale (VAS), and the secondary outcomes were measured using the Hamilton Rating Scale for Depression (HAM-D) and the Pittsburgh Sleep Quality Index (PSQI). All the outcomes were evaluated at 1 day before stimulation (baseline), 1 day after the first week of stimulation (S1), and 1 day after the last stimulation (S2). Results The VAS scores showed significant pain improvement after 4 weeks of stimulation (p = 0.0396, p = 0.0396, and p = 0.0309, respectively) but not after 1 week of stimulation. HAM-D scores declined, but the decreases were not significant until 4 weeks later (p = 0.0444, p = 0.0315, and p = 0.0447, respectively). PSQI scores were also significantly decreased after 4 weeks of stimulation (p = 0.0446, p = 0.0244, and p = 0.0088, respectively). Comparing the three modalities, VAS, HAM-D, and PSQI scores at S1 showed no differences, and, at S2, VAS scores showed significant differences (p = 0.0120; multiple comparisons showed significant differences between iTBS and iTBS + rTMS, p = 0.0091), while the HAM-D and PSQI scores showed no differences. Discussion The primary and secondary outcomes all showed significant improvement, indicating that the three different modalities were all effective at relieving the pain. However, not all the three stimulations were of same effectiveness after treatment; there were statistical differences in the treatment of neuropathic pain between iTBS as a priming stimulus and as a single procedure.
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Affiliation(s)
- Chuanmei Yang
- Department of Rehabilitation Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yunfeng Bi
- Department of Rehabilitation Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Luoman Hu
- Department of Rehabilitation Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lili Gong
- Department of Rehabilitation Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zhanfei Li
- Department of Rehabilitation Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Nanyang Zhang
- Medical Research Center, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Qiang Wang
- Department of Rehabilitation Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jiang Li
- Department of Rehabilitation Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
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Dong L, Li H, Dang H, Zhang X, Yue S, Zhang H. Efficacy of non-invasive brain stimulation for disorders of consciousness: a systematic review and meta-analysis. Front Neurosci 2023; 17:1219043. [PMID: 37496734 PMCID: PMC10366382 DOI: 10.3389/fnins.2023.1219043] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 06/26/2023] [Indexed: 07/28/2023] Open
Abstract
Objective The aim of this study is to evaluate the efficacy of non-invasive brain stimulation (NIBS) in patients with disorders of consciousness (DoC) and compare differences in efficacy between different stimulation modalities. Methods We searched the PubMed, Cochrane Library, Web of Science, and EMBASE databases for all studies published in English from inception to April 2023. Literature screening and quality assessment were performed independently by two investigators. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were used to evaluate the therapeutic effects of NIBS. The Cochrane Q test and I2 statistic were used to evaluate heterogeneity between studies. Subgroup analysis was performed to identify the source of heterogeneity, and differences in efficacy between different stimulation modalities were compared by Bayesian analysis. Results A total of 17 studies with 377 DoC patients were included. NIBS significantly improved the state of consciousness in DoC patients when compared to sham stimulation (WMD: 0.81; 95% CI: 0.46, 1.17; I2 = 78.2%, p = 0.000). When divided into subgroups according to stimulation modalities, the heterogeneity of each subgroup was significantly lower than before (I2: 0.00-30.4%, p >0.05); different stimulation modalities may be the main source of such heterogeneity. Bayesian analysis, based on different stimulation modalities, indicated that a patient's state of consciousness improved most significantly after repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC). Diagnosis-based subgroup analysis showed that NIBS significantly improved the state of consciousness in patients with a minimal consciousness state (WMD: 1.11; 95% CI: 0.37, 1.86) but not in patients with unresponsive wakefulness syndrome or a vegetative state (WMD: 0.31; 95% CI: -0.09, 0.71). Subgroup analysis based on observation time showed that single treatment did not improve the state of consciousness in DoC patients (WMD: 0.28; 95% CI: -0.27, 0.82) while multiple treatments could (WMD: 1.05; 95% CI: 0.49, 1.61). Furthermore, NIBS had long-term effects on DoC patients (WMD: 0.79; 95% CI: 0.08-1.49). Conclusion Available evidence suggests that the use of NIBS on patients with DoC is more effective than sham stimulation, and that rTMS of the left DLPFC may be the most prominent stimulation modality.
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Affiliation(s)
- Linghui Dong
- Shandong University, Jinan, Shandong, China
- China Rehabilitation Research Center, Beijing, China
- University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
| | - Hui Li
- Shandong University, Jinan, Shandong, China
- China Rehabilitation Research Center, Beijing, China
- University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
| | - Hui Dang
- Shandong University, Jinan, Shandong, China
- China Rehabilitation Research Center, Beijing, China
- University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
| | | | - Shouwei Yue
- Shandong University, Jinan, Shandong, China
- University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
| | - Hao Zhang
- Shandong University, Jinan, Shandong, China
- China Rehabilitation Research Center, Beijing, China
- University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
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Verisezan Rosu O, Jemna N, Hapca E, Benedek I, Vadan I, Muresanu I, Chira D, Radu C, Cherecheş R, Strilciuc S, Muresanu D. Cerebrolysin and repetitive transcranial magnetic stimulation (rTMS) in patients with traumatic brain injury: a three-arm randomized trial. Front Neurosci 2023; 17:1186751. [PMID: 37360156 PMCID: PMC10285097 DOI: 10.3389/fnins.2023.1186751] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Traumatic brain injury (TBI) is a major public health problem affecting millions worldwide. Despite significant advances in medical care, there are limited effective interventions for improving cognitive and functional outcomes in TBI patients. Methods This randomized controlled trial investigated the safety and efficacy of combining repetitive transcranial magnetic stimulation (rTMS) and Cerebrolysin in improving cognitive and functional outcomes in TBI patients. Ninety-three patients with TBI were randomized to receive either Cerebrolysin and rTMS (CRB + rTMS), Cerebrolysin and sham stimulation (CRB + SHM), or placebo and sham stimulation (PLC + SHM). The primary outcome measures were the composite cognitive outcome scores at 3 and 6 months after TBI. Safety and tolerability were also assessed. Results The study results demonstrated that the combined intervention of rTMS and Cerebrolysin was safe and well-tolerated by patients with TBI. Although no statistically significant differences were observed in the primary outcome measures, the descriptive trends in the study support existing literature on the efficacy and safety of rTMS and Cerebrolysin. Discussion The findings of this study suggest that rTMS and Cerebrolysin may be effective interventions for improving cognitive and functional outcomes in TBI patients. However, limitations of the study, such as the small sample size and exclusion of specific patient populations, should be considered when interpreting the results. This study provides preliminary evidence for the safety and potential efficacy of combining rTMS and Cerebrolysin in improving cognitive and functional outcomes in TBI patients. The study highlights the importance of multidisciplinary approaches in TBI rehabilitation and the potential for combining neuropsychological measurements and interventions to optimize patient outcomes. Conclusion Further research is needed to establish these findings' generalizability and identify the optimal dosages and treatment protocols for rTMS and Cerebrolysin.
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Affiliation(s)
- Olivia Verisezan Rosu
- Department of Neurosciences, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Nicoleta Jemna
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Elian Hapca
- Department of Neurosciences, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Irina Benedek
- Department of Neurosciences, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Iulia Vadan
- Department of Neurosciences, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Ioana Muresanu
- Department of Neurosciences, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Diana Chira
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Constantin Radu
- Yale School of Public Health, Yale University, New Haven, CT, United States
| | - Răzvan Cherecheş
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
- Department of Public Health, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Stefan Strilciuc
- Department of Neurosciences, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Dafin Muresanu
- Department of Neurosciences, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
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Li Y, Pang J, Wang J, Wang W, Bo Q, Lei L, Wang X, Wang M. High-frequency rTMS over the left DLPFC improves the response inhibition control of young healthy participants: an ERP combined 1H-MRS study. Front Psychol 2023; 14:1144757. [PMID: 37275686 PMCID: PMC10233929 DOI: 10.3389/fpsyg.2023.1144757] [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: 02/14/2023] [Accepted: 04/25/2023] [Indexed: 06/07/2023] Open
Abstract
Introduction Unlike the effect of repetitive transcranial magnetic stimulation (rTMS) in treating neuropsychiatric diseases, little is known about how personal factors might account for the disparity of results from studies of cognition and rTMS. In this study, we investigated the effects of high-frequency rTMS on response inhibition control and explored the time course changes in cognitive processing and brain metabolic mechanisms after rTMS using event-related potentials (ERPs) and magnetic resonance spectroscopy (1H-MRS). Methods Participants were all right-handed and were naive to rTMS and the Go/NoGo task. Twenty-five healthy young participants underwent one 10 Hz rTMS session per day in which stimulation was applied over the left dorsolateral prefrontal cortex (DLPFC), and a homogeneous participant group of 25 individuals received a sham rTMS treatment for 1 week. A Go/NoGo task was performed, an electroencephalogram (EEG) was recorded, and 1H-MRS was performed. Results The results revealed that there was a strong trend of decreasing commission errors of NoGo stimuli by high frequency rTMS over the left DLPFC, whereas there was no significant difference between before and after rTMS treatment with respect to these parameters in the sham rTMS group. High-frequency rTMS significantly increased the amplitude of NoGo-N2 but not Go-N2, Go-P3, or NoGo-P3. The myo-inositol /creatine complex (MI/Cr) ratio, indexing cerebral metabolism, in the left DLPFC was decreased in the rTMS treated group. Discussion This observation supports the view that high-frequency rTMS over the left DLPFC has the strong tendency of reducing commission errors behaviorally, increase the amplitude of NoGo-N2 and improve the response inhibition control of healthy young participants. The results are consistent with the excitatory properties of high frequency rTMS. We suggest that the increase in the NoGo-N2 amplitude may be related to the increased excitability of the DLPFC-anterior cingulate cortex (ACC) neural loop. Metabolic changes in the DLPFC may be a possible mechanism for the improvement of the response inhibition control of rTMS.
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Affiliation(s)
- Yanmin Li
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Brain Aging and Cognitive Neuroscience Laboratory of Hebei Province, Shijiazhuang, Hebei, China
- Department of Neurology, Hebei Hospital of Xuanwu Hospital Capital Medical University, Shijiazhuang, Hebei, China
| | - Jianmin Pang
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Jing Wang
- Department of Respiratory Medicine, Harrison International Peace Hospital, Hengshui, Hebei, China
| | - Wei Wang
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Brain Aging and Cognitive Neuroscience Laboratory of Hebei Province, Shijiazhuang, Hebei, China
- Department of Neurology, Hebei Hospital of Xuanwu Hospital Capital Medical University, Shijiazhuang, Hebei, China
| | - Qianlan Bo
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Brain Aging and Cognitive Neuroscience Laboratory of Hebei Province, Shijiazhuang, Hebei, China
- Department of Neurology, Hebei Hospital of Xuanwu Hospital Capital Medical University, Shijiazhuang, Hebei, China
| | - Licun Lei
- Department of Radiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Xiayue Wang
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Brain Aging and Cognitive Neuroscience Laboratory of Hebei Province, Shijiazhuang, Hebei, China
- Department of Neurology, Hebei Hospital of Xuanwu Hospital Capital Medical University, Shijiazhuang, Hebei, China
| | - Mingwei Wang
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Brain Aging and Cognitive Neuroscience Laboratory of Hebei Province, Shijiazhuang, Hebei, China
- Department of Neurology, Hebei Hospital of Xuanwu Hospital Capital Medical University, Shijiazhuang, Hebei, China
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Tsai YC, Li CT, Juan CH. A review of critical brain oscillations in depression and the efficacy of transcranial magnetic stimulation treatment. Front Psychiatry 2023; 14:1073984. [PMID: 37260762 PMCID: PMC10228658 DOI: 10.3389/fpsyt.2023.1073984] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 04/11/2023] [Indexed: 06/02/2023] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) and intermittent theta burst stimulation (iTBS) have been proven effective non-invasive treatments for patients with drug-resistant major depressive disorder (MDD). However, some depressed patients do not respond to these treatments. Therefore, the investigation of reliable and valid brain oscillations as potential indices for facilitating the precision of diagnosis and treatment protocols has become a critical issue. The current review focuses on brain oscillations that, mostly based on EEG power analysis and connectivity, distinguish between MDD and controls, responders and non-responders, and potential depression severity indices, prognostic indicators, and potential biomarkers for rTMS or iTBS treatment. The possible roles of each biomarker and the potential reasons for heterogeneous results are discussed, and the directions of future studies are proposed.
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Affiliation(s)
- Yi-Chun Tsai
- Institute of Cognitive Neuroscience, College of Health Sciences and Technology, National Central University, Taoyuan City, Taiwan
| | - Cheng-Ta Li
- Institute of Cognitive Neuroscience, College of Health Sciences and Technology, National Central University, Taoyuan City, Taiwan
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Division of Psychiatry, Faculty of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Chi-Hung Juan
- Institute of Cognitive Neuroscience, College of Health Sciences and Technology, National Central University, Taoyuan City, Taiwan
- Cognitive Intelligence and Precision Healthcare Center, National Central University, Taoyuan City, Taiwan
- Department of Psychology, Kaohsiung Medical University, Kaohsiung, Taiwan
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Cosmo C, Zandvakili A, Petrosino NJ, Toutain TGLDO, Miranda JGV, Philip NS. Examining the neural mechanisms of rTMS: a naturalistic pilot study of acute and serial effects in pharmacoresistant depression. Front Neural Circuits 2023; 17:1161826. [PMID: 37206978 PMCID: PMC10188923 DOI: 10.3389/fncir.2023.1161826] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/10/2023] [Indexed: 05/21/2023] Open
Abstract
Introduction Previous studies have demonstrated the effectiveness of therapeutic repetitive transcranial magnetic stimulation (rTMS) to treat pharmacoresistant depression. Nevertheless, these trials have primarily focused on the therapeutic and neurophysiological effects of rTMS following a long-term treatment course. Identifying brain-based biomarkers of early rTMS therapeutic response remains an important unanswered question. In this pilot study, we examined the effects of rTMS on individuals with pharmacoresistant depression using a graph-based method, called Functional Cortical Networks (FCN), and serial electroencephalography (EEG). We hypothesized that changes in brain activity would occur early in treatment course. Methods A total of 15 patients with pharmacoresistant depression underwent five rTMS sessions (5Hz over the left dorsolateral prefrontal cortex, 120%MT, up to 4,000 pulses/session). Five participants received additional rTMS treatment, up to 40 sessions. Resting EEG activity was measured at baseline and following every five sessions, using 64-channel EEG, for 10 minutes with eyes closed. An FCN model was constructed using time-varying graphs and motif synchronization. The primary outcome was acute changes in weighted-node degree. Secondary outcomes included serial FFT-based power spectral analysis and changes in depressive symptoms measured by the 9-Item Patient Health Questionnaire (PHQ-9) and the 30-item Inventory of Depressive Symptoms-Self Report (IDS-SR). Results We found a significant acute effect over the left posterior area after five sessions, as evidenced by an increase in weighted-node degree of 37,824.59 (95% CI, 468.20 to 75,180.98) and a marginal enhancement in the left frontal region (t (14) = 2.0820, p = 0.056). One-way repeated measures ANOVA indicated a significant decrease in absolute beta power over the left prefrontal cortex (F (7, 28) = 2.37, p = 0.048) following ten rTMS sessions. Furthermore, a significant clinical improvement was observed following five rTMS sessions on both PHQ-9 (t (14) = 2.7093, p = 0.017) and IDS-SR (t (14) = 2.5278, p = 0.024) and progressed along the treatment course. Discussion Our findings suggest that FCN models and serial EEG may contribute to a deeper understanding of mechanisms underlying rTMS treatment. Additional research is required to investigate the acute and serial effects of rTMS in pharmacoresistant depression and assess whether early EEG changes could serve as predictors of therapeutic rTMS response.
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Affiliation(s)
- Camila Cosmo
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Brown University, Providence, RI, United States
- VA RR&D Center for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, United States
| | - Amin Zandvakili
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Brown University, Providence, RI, United States
- VA RR&D Center for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, United States
| | - Nicholas J. Petrosino
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Brown University, Providence, RI, United States
- VA RR&D Center for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, United States
| | | | | | - Noah S. Philip
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Brown University, Providence, RI, United States
- VA RR&D Center for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, United States
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Lv Y, Wang M, Yang J, Shi J, Xuan T, Zhang J, Du D, Cheng J, Li H. Cerebellar repetitive transcranial magnetic stimulation versus propranolol for essential tremor. Brain Behav 2023; 13:e2926. [PMID: 36806734 PMCID: PMC10013940 DOI: 10.1002/brb3.2926] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 11/03/2022] [Revised: 02/05/2023] [Accepted: 02/05/2023] [Indexed: 02/20/2023] Open
Abstract
BACKGROUND Propranolol, a nonselective beta-adrenergic blocker, has long been used as one of the standard treatments for essential tremor (ET). Repetitive transcranial magnetic stimulation (rTMS) has also been used for a long time as a substitution therapy for ET patients. OBJECTIVE The main aim of this study was to evaluate the antitremor effect of 1-Hz (low-frequency) cerebellar rTMS and compare it to the use of propranolol in ET patients. METHODS In this single-blinded, randomized, controlled pilot study, a total of 38 patients with ET were randomized into two groups. One group (n = 20) received 1200 pulses of 1-Hz rTMS at an intensity of 90% of the resting motor threshold to the bilateral cerebellar region for 10 days. Another group (n = 18) received oral propranolol for 30 days. The initial dose was 30 mg/day, which was increased to 60 mg/day after 5 days, then to 90 mg/day on the 11th day, and continued thereafter for 20 days. The Fahn-Tolosa-Marin (FTM) clinical scale was assessed at baseline and at days 5, 10, and 30 to evaluate tremor severity, specific motor tasks, and functional disability. RESULTS Low-frequency rTMS of the cerebellum significantly improved tremor severity, specific motor tasks (writing, spiral drawing, and pouring), and FTM total scores on days 10 and 30. Nevertheless, we found no significant difference in functional disability at any point in time (p > .05). There were no statistically significant differences in FTM Part A, Part B, Part C scores and total scores of patients in propranolol group on days 5 and 10 compared with before treatment (p > .05). However, FTM total scores and FTM Part A, Part B, and Part C scores were significantly improved for patients when the dose of propranolol was 90 mg/day on day 30. Our study showed that there was no statistically significant difference in the total FTM scores and FTM Part A, Part B, and Part C scores between rTMS and propranolol on days 5, 10, and 30 (p > .05). CONCLUSION We conclude that both cerebellar low-frequency rTMS and propranolol could be effective treatment options for patients with ET, but it is not clear which method is more effective.
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Affiliation(s)
- Yue Lv
- Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, China.,School of Clinical Medicine, Ningxia Medical University, Yinchuan, China
| | - Mengran Wang
- Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, China.,School of Clinical Medicine, Ningxia Medical University, Yinchuan, China
| | - Juan Yang
- Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, China.,Diagnosis and Treatment Engineering Technology Research Center of Nervous System Diseases of Ningxia Hui Autonomous Region, Yinchuan, China
| | - Jin Shi
- Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, China.,School of Clinical Medicine, Ningxia Medical University, Yinchuan, China
| | - Tingting Xuan
- Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, China.,School of Clinical Medicine, Ningxia Medical University, Yinchuan, China
| | - Junmei Zhang
- Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, China.,School of Clinical Medicine, Ningxia Medical University, Yinchuan, China
| | - Dandan Du
- Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, China.,School of Clinical Medicine, Ningxia Medical University, Yinchuan, China
| | - Jiang Cheng
- Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, China.,Diagnosis and Treatment Engineering Technology Research Center of Nervous System Diseases of Ningxia Hui Autonomous Region, Yinchuan, China
| | - Haining Li
- Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, China.,Diagnosis and Treatment Engineering Technology Research Center of Nervous System Diseases of Ningxia Hui Autonomous Region, Yinchuan, China
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19
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Zhang X, Ren H, Pei Z, Lian C, Su X, Lan X, Chen C, Lei Y, Li B, Guo Y. Dual-targeted repetitive transcranial magnetic stimulation modulates brain functional network connectivity to improve cognition in mild cognitive impairment patients. Front Physiol 2022; 13:1066290. [PMID: 36467674 PMCID: PMC9716076 DOI: 10.3389/fphys.2022.1066290] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 10/10/2022] [Accepted: 11/07/2022] [Indexed: 10/15/2023] Open
Abstract
Background: Mild cognitive impairment (MCI) is a condition between normal aging and dementia; nearly 10-15% of MCI patients develop dementia annually. There are no effective interventions for MCI progression. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique that has attempted to improve the overall cognitive function of MCI patients. However, it does not affect episodic memory improvement. Methods: In this study, we engaged 15 clinically diagnosed MCI patients and normal controls to explore the effect of dual-targeted rTMS on progressing cognitive function, particularly episodic memory in MCI patients. Resting-state EEG recordings and neuropsychological assessments were conducted before and after the intervention. EEG features were extracted using an adaptive algorithm to calculate functional connectivity alterations in relevant brain regions and the mechanisms of altered brain functional networks in response to dual-target rTMS. Results: The study revealed that the functional brain connectivity between the right posterior cingulate gyrus (PCC) and the right dorsal caudate nucleus (DC) was significantly reduced in MCI patients compared to normal controls (p < 0.001). Dual-target rTMS increased the strength of the reduced functional connectivity (p < 0.001), which was related to cognitive enhancement (p < 0.05). Conclusion: This study provides a new stimulation protocol for rTMS intervention. Improving the functional connectivity of the right PCC to the right DC is a possible mechanism by which rTMS improves overall cognitive and memory function in MCI patients.
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Affiliation(s)
- Xinqi Zhang
- Department of Neurology, Shenzhen People’s Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Huixia Ren
- Department of Geriatrics, Shenzhen People’s Hospital (The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology), Shenzhen, China
| | - Zian Pei
- Shenzhen Bay Laboratory, Institute of Neurological Disease, Shenzhen, China
| | - Chongyuan Lian
- Shenzhen Bay Laboratory, Institute of Neurological Disease, Shenzhen, China
| | - XiaoLin Su
- Department of Neurology, Shenzhen People’s Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Xiaoyong Lan
- Shenzhen Bay Laboratory, Institute of Neurological Disease, Shenzhen, China
| | - Chanjuan Chen
- Department of Neurology, Shenzhen People’s Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - YuHua Lei
- Department of Neurology, Shenzhen People’s Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Baima Li
- Department of Neurology, Shenzhen People’s Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Yi Guo
- Department of Neurology, Shenzhen People’s Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
- Shenzhen Bay Laboratory, Institute of Neurological Disease, Shenzhen, China
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20
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Yin ZL, Ge S, Huang LH, Cao XX, Wu JH. [Acupuncture combined with repetitive transcranial magnetic stimulation for post-stroke depression: a randomized controlled trial]. Zhongguo Zhen Jiu 2022; 42:1216-1220. [PMID: 36397217 DOI: 10.13703/j.0255-2930.20211221-0002] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To observe the curative effect of Shugan Tiaoshen (soothing liver and regulating mind) acupuncture combined with repetitive transcranial magnetic stimulation (rTMS) in the treatment of post-stroke depression (PSD), and to explore its mechanism. METHODS Ninety patients of PSD were randomly divided into an acupuncture+rTMS combination group (30 cases), a rTMS combination group (30 cases, 1 case dropped off) and a western medication group (30 cases, 1 case dropped off). The western medication group was treated with escitalopram oxalate tablets, 10 mg orally each time, once a day; on the basis of the treatment in the western medication group, the rTMS combination group was additionally given rTMS, and the frequency was 20 Hz, 20 min each time, once a day, 5 times a week; on the basis of the treatment in the rTMS combination group, the acupuncture+rTMS combination group was additionally treated with Shugan Tiaoshen acupuncture at Baihui (GV 20), Sishencong (EX-HN 1), Yintang (GV 24+), Shenting (GV 24), etc. for 40 min each time, once a day, weekly 5 times, and each group was treated for 4 weeks. Before and after treatment, the scores of Hamilton depression scale-17 (HAMD-17), Montreal cognitive assessment scale (MoCA), Pittsburgh sleep quality index (PSQI) were observed, and serum levels of 5-hydroxytryptamine (5-HT) and brain-derived neurotrophic factor (BDNF) were detected in each group. RESULTS After treatment, the HAMD-17 scores in the three groups were lower than those before treatment (P<0.01), and the PSQI scores in the acupuncture+rTMS combination group and the rTMS combination group were lower than those before treatment (P<0.01); the above indexes in the acupuncture+rTMS combination group and the rTMS combination group were lower than those in the western medication group (P<0.05), and the PSQI score in the acupuncture+rTMS combination group was lower than that in the rTMS combination group (P<0.05). After treatment, the MoCA scores and serum BDNF levels in the acupuncture+rTMS combination group and the rTMS combination group were higher than those before treatment (P<0.01), and the serum 5-HT levels in the three groups were higher than those before treatment (P<0.01); and the above indexes in the acupuncture+rTMS combination group and the rTMS combination group were higher than those in the western medication group (P<0.05), and which in the acupuncture+rTMS combination group were higher than those in the rTMS combination group (P<0.05). CONCLUSION On the basis of western medication escitalopram oxalate, the addition of Shugan Tiaoshen acupuncture combined with rTMS therapy can effectively improve cognitive function and sleep quality in patients with PSD, and the effect is better than that of western medication alone or rTMS combined with western medication. Its mechanism of action may be related to the increase of peripheral serum 5-HT and BDNF levels.
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Affiliation(s)
- Zheng-Lu Yin
- Department of Rehabilitation, Subei People's Hospital, Clinical Medical College of Yangzhou University, Yangzhou 225002, Jiangsu Province, China
| | - Sheng Ge
- Department of Rehabilitation, Subei People's Hospital, Clinical Medical College of Yangzhou University, Yangzhou 225002, Jiangsu Province, China
| | - Ling-Hui Huang
- Department of Rehabilitation, Subei People's Hospital, Clinical Medical College of Yangzhou University, Yangzhou 225002, Jiangsu Province, China
| | - Xing-Xing Cao
- Department of Rehabilitation, Subei People's Hospital, Clinical Medical College of Yangzhou University, Yangzhou 225002, Jiangsu Province, China
| | - Jia-Hao Wu
- Department of Rehabilitation, Subei People's Hospital, Clinical Medical College of Yangzhou University, Yangzhou 225002, Jiangsu Province, China
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21
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Chen YF, Zhu GY, Mao MC, Zheng Y, Huang H, Liu LL, Chen SY, Cao LY, Xu DS. Study protocol of a randomized controlled trial for the synergizing effects of rTMS and Tui Na on upper limb motor function and cortical activity in ischemic stroke. Front Neurol 2022; 13:993227. [PMID: 36438962 PMCID: PMC9691988 DOI: 10.3389/fneur.2022.993227] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 07/15/2022] [Accepted: 10/27/2022] [Indexed: 09/23/2023] Open
Abstract
Upper limb motor dysfunction after stroke is a serious threat to the living quality of patients and their families. Recovery of upper limb motor function after stroke largely relies on the activation and remodeling of neural circuits. rTMS (repetitive transcranial magnetic stimulation) has been proved to promote the reconstruction of neural synapses and neural circuits. However, there are still a large number of patients who cannot fully recover and leave behind varying degrees of dysfunction. Considering the systemic pathology after stroke, in addition to focal brain injury, stroke can also cause extensive dysfunction of peripheral organs. The rehabilitation strategy for stroke should combine the treatment of primary brain lesions with the intervention of secondary systemic damage. The aim of this trial is to verify the efficacy of rTMS synergize with Tui Na (Chinese Massage) on upper limb motor function after ischemic stroke, and to explore the mechanism of activation and remodeling of sensorimotor neural circuits with functional near-infrared spectroscopy. Ninety patients will be randomly assigned to either rTMS + Tui Na + conventional rehabilitation group (the experimental group) or rTMS + conventional rehabilitation group (the control group) in 1:1 ratio. Intervention is conducted five sessions a week, with a total of twenty sessions. The primary outcome is Fugl-Meyer Assessment, and the secondary outcomes include Muscle Strength, Modified Ashworth Assessment, Modified Barthel Index Assessment, motor evoked potentials and functional near-infrared spectroscopy. There are four time points for the evaluation, including baseline, 2 weeks and 4 weeks after the start of treatment, and 4 weeks after the end of treatment. This study is a randomized controlled trial. This study was approved by Institutional Ethics Committee of Shanghai Third Rehabilitation Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (approval No. SH3RH-2021-EC-012) on December, 16th, 2021. The protocol was registered with Chinese Clinical Trial Registry (ChiCTR2200056266), on February 3th, 2022. Patient recruitment was initiated on February 10th, 2022, and the study will be continued until December 2023.
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Affiliation(s)
- Yu-Feng Chen
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Tui Na, Hangzhou Dingqiao's Hospital, Hangzhou, China
| | - Guang-Yue Zhu
- Rehabilitation Medical Center, Tongji Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
| | - Meng-Chai Mao
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China
| | - Ya Zheng
- Rehabilitation Medical Center, Tongji Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
| | - Hao Huang
- Department of Rehabilitation Medicine, Shanghai Third Rehabilitation Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lan-Lan Liu
- Department of Rehabilitation Medicine, Shanghai Third Rehabilitation Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Si-Yun Chen
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ling-Yun Cao
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Dong-Sheng Xu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
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22
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Yingli B, Zunke G, Wei C, Shiyan W. Cerebral activity manipulation of low-frequency repetitive transcranial magnetic stimulation in post-stroke patients with cognitive impairment. Front Neurol 2022; 13:951209. [PMID: 36425802 PMCID: PMC9679635 DOI: 10.3389/fneur.2022.951209] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 05/23/2022] [Accepted: 10/10/2022] [Indexed: 08/04/2023] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the therapeutic effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) on post-stroke cognitive impairment (PSCI). METHODS Thirty-six PSCI patients were randomly divided into treatment and control groups of equal size. Both groups were pre-treated with conventional cognitive rehabilitation training. Subsequently, the treatment group was exposed to 1 Hz low-frequency repetitive transcranial magnetic stimulations for 8 weeks, with 5 days per week. Meanwhile, the control group was treated with placebo stimulations. Patients were evaluated via the LOTCA scale assessments and changes in P300 latencies and amplitudes before and after 8 weeks of treatment. RESULTS Before treatment, there were no significant differences between the two groups in LOTCA scores, P300 latencies, and amplitudes (P > 0.05). After treatment, LOTCA scores for both groups improved (P < 0.05), and those of the treatment group were higher than those of the control (P < 0.05). For both groups, P300 latencies were not only shortened but also had greater amplitudes (P < 0.05), and those for the treatment group were significantly shorter and larger than those of the control (P < 0.05). CONCLUSION As a therapy, rTMS improved cognitive function in PSCI patients, possibly via regulation of neural electrical activity of the cerebral cortex.
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Affiliation(s)
- Bi Yingli
- Xuzhou Rehabilitation Hospital, Xuzhou, China
- Department of Rehabilitation Medicine, Xuzhou Central Hospital, Xuzhou, China
| | - Gong Zunke
- Xuzhou Rehabilitation Hospital, Xuzhou, China
- Department of Rehabilitation Medicine, Xuzhou Central Hospital, Xuzhou, China
| | - Chen Wei
- Xuzhou Rehabilitation Hospital, Xuzhou, China
- Department of Rehabilitation Medicine, Xuzhou Central Hospital, Xuzhou, China
| | - Wang Shiyan
- Department of Rehabilitation Medicine, Xuzhou Central Hospital, Xuzhou, China
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23
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Yamada Y, Inagawa T, Hirabayashi N, Sumiyoshi T. Emotion Recognition Deficits in Psychiatric Disorders as a Target of Non-invasive Neuromodulation: A Systematic Review. Clin EEG Neurosci 2022; 53:506-512. [PMID: 33587001 PMCID: PMC9548945 DOI: 10.1177/1550059421991688] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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] [Indexed: 02/06/2023]
Abstract
Background. Social cognition deficits are a core feature of psychiatric disorders, such as schizophrenia and mood disorder, and deteriorate the functionality of patients. However, no definite strategy has been established to treat social cognition (eg, emotion recognition) impairments in these illnesses. Here, we provide a systematic review of the literature regarding transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) for the treatment of social cognition deficits in individuals with psychiatric disorders. Methods. A literature search was conducted on English articles identified by PubMed, PsycINFO, and Web of Science databases, according to the guidelines of the PRISMA statement. We defined the inclusion criteria as follows: (1) randomized controlled trials (RCTs), (2) targeting patients with psychiatric disorders (included in F20-F39 of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems [ICD-10]), (3) evaluating the effect of tDCS or rTMS, (4) reporting at least one standardized social cognition test. Results. Five papers (3 articles on tDCS and 2 articles on rTMS) met the inclusion criteria which deal with schizophrenia or depression. The significant effects of tDCS or rTMS targeting the left dorsolateral prefrontal cortex on the emotion recognition domain were reported in patients with schizophrenia or depression. In addition, rTMS on the right inferior parietal lobe was shown to ameliorate social perception impairments of schizophrenia. Conclusions. tDCS and rTMS may enhance some domains of social cognition in patients with psychiatric disorders. Further research is warranted to identify optimal parameters to maximize the cognitive benefits of these neuromodulation methods.
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Affiliation(s)
- Yuji Yamada
- Department of Psychiatry, National Center Hospital, 26353National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takuma Inagawa
- Department of Psychiatry, National Center Hospital, 26353National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Naotsugu Hirabayashi
- Department of Psychiatry, National Center Hospital, 26353National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Tomiki Sumiyoshi
- Department of Preventive Intervention, National Institute of Mental Health, 26353National Center of Neurology and Psychiatry, Tokyo, Japan
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Zamar AC, Kouimtsidis C, Lulsegged A, Roberts R, Koutsomitros T, Stahl D. A New Treatment Protocol of Combined High-Dose Levothyroxine and Repetitive Transcranial Magnetic Stimulation for the Treatment of Rapid-Cycling Bipolar Spectrum Disorders: A Cohort Evaluation of 55 Patients. J Clin Med 2022; 11:jcm11195830. [PMID: 36233698 PMCID: PMC9572106 DOI: 10.3390/jcm11195830] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/05/2022] [Accepted: 09/27/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Bipolar spectrum disorders (BSD) are highly disabling, with rapid cycling being treatment resistant. High-dose levothyroxine (HDT) has been reported to be effective. Diagnosis is associated with mutations in thyroid-activating enzymes and cerebral transporter protein carrier. Repetitive transcranial magnetic stimulation (rTMS) has neuroplastic effects. Methods: We report data on 55 severely symptomatic patients with rapid-cycling BSD treated with a combination protocol of HDT and rTMS. Of the patients, 31 patients (56.4%) were female and 40 (72.7%) had at least one additional diagnosis. Results: Patients were evaluated at three monthly intervals after acute treatment. Remission was measured using the Sheehan Disability Scale (SDS). The average number of medications prescribed was 1.8, with 32 patients (58.2%) needing only levothyroxine. The average dose of levothyroxine was 303.7 mcg (50 mcg−1000 mcg). A total of 53 patients were in remission (96.4%), with an average duration of 2.0 years. The SDS scores decreased significantly (Cohen’s d = 2.61 (95% C.I. 1.81 to 2.83, p < 0.001). One patient had reversible side effects. A total of 52 (94.3%) patients had Deiodinase 1 and 2 (DiO1/DiO2) or SLCO1C1 protein carrier gene mutations. Conclusion: The data support the safety and acceptability of combined HDT/rTMS. Patients achieved long remissions with substantial improvements in quality of life.
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Affiliation(s)
- Antonis C. Zamar
- The London Psychiatry Centre, London W1G 7HG, UK
- Correspondence: ; Tel.: +44-2075804224
| | - Christos Kouimtsidis
- The London Psychiatry Centre, London W1G 7HG, UK
- Imperial College, London SW7 2BX, UK
| | | | | | - Theodoros Koutsomitros
- Greek rTMS Clinic, Medical Psychotherapeutic Centre (ΙΨΚ), 546 24 Thessaloniki, Greece
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, 6211 LK Maastricht, The Netherlands
| | - Daniel Stahl
- Statistics Kings College, Strand, London WC2R 2LS, UK
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25
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Adeel M, Lin BS, Chen HC, Lai CH, Liou JC, Wu CW, Chan WP, Peng CW. Motor Neuroplastic Effects of a Novel Paired Stimulation Technology in an Incomplete Spinal Cord Injury Animal Model. Int J Mol Sci 2022; 23:ijms23169447. [PMID: 36012710 PMCID: PMC9409074 DOI: 10.3390/ijms23169447] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/13/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
Paired stimulation of the brain and spinal cord can remodel the central nervous tissue circuitry in an animal model to induce motor neuroplasticity. The effects of simultaneous stimulation vary according to the extent and severity of spinal cord injury. Therefore, our study aimed to determine the significant effects on an incomplete SCI rat brain and spinal cord through 3 min and 20 min stimulations after 4 weeks of intervention. Thirty-three Sprague Dawley rats were classified into six groups: (1) normal, (2) sham, (3) iTBS/tsDCS, (4) iTBS/ts-iTBS, (5) rTMS/tsDCS, and (6) rTMS/ts-iTBS. Paired stimulation of the brain cortex and spinal cord thoracic (T10) level was applied simultaneously for 3−20 min. The motor evoked potential (MEP) and Basso, Beattie, and Bresnahan (BBB) scores were recorded after every week of intervention for four weeks along with wheel training for 20 min. Three-minute stimulation with the iTBS/tsDCS intervention induced a significant (p < 0.050 *) increase in MEP after week 2 and week 4 treatments, while 3 min iTBS/ts-iTBS significantly improved MEP (p < 0.050 *) only after the week 3 intervention. The 20 min rTMS/ts-iTBS intervention showed a significant change only in post_5 min after week 4. The BBB score also changed significantly in all groups except for the 20 min rTMS/tsDCS intervention. iTBS/tsDCS and rTMS/ts-iTBS interventions induce neuroplasticity in an incomplete SCI animal model by significantly changing electrophysiological (MEP) and locomotion (BBB) outcomes.
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Affiliation(s)
- Muhammad Adeel
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110, Taiwan
- International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110, Taiwan
- Department of Computer Science and Information Engineering, National Taipei University, New Taipei City 237, Taiwan
| | - Bor-Shing Lin
- Department of Computer Science and Information Engineering, National Taipei University, New Taipei City 237, Taiwan
| | - Hung-Chou Chen
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan
| | - Chien-Hung Lai
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei 110, Taiwan
| | - Jian-Chiun Liou
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110, Taiwan
- International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110, Taiwan
| | - Chun-Wei Wu
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110, Taiwan
| | - Wing P. Chan
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Chih-Wei Peng
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110, Taiwan
- International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110, Taiwan
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei 110, Taiwan
- Research Center of Biomedical Device, Taipei Medical University, Taipei 110, Taiwan
- Correspondence: ; Tel./Fax: +886-2-2736-1661 (ext. 3070)
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26
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Mi Y, Ji Y, Lou Z, Hou Y, Ruan L. Left intermittent theta burst stimulation combined with right low-frequency rTMS as an additional treatment for major depression: A retrospective study. Indian J Psychiatry 2022; 64:364-369. [PMID: 36060727 PMCID: PMC9435624 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_905_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 04/16/2022] [Accepted: 05/09/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for major depression (MD). We retrospectively analyzed the efficacy of intermittent theta burst stimulation (iTBS) on the left dorsolateral prefrontal cortex (DLPFC) combined with low-frequency rTMS (LF-rTMS) on the right DLPFC as an additional therapy to standard medication treatment. MATERIALS AND METHODS The study included 54 patients with MD who completed 10 courses (5 days per week) of rTMS as an add-on therapy. Thirty patients were treated in the combination group (120% resting motor threshold; left DLPFC, iTBS, 600 stimuli + right DLPFC, 1-Hz rTMS, 600 stimuli), while 24 patients were in the high-frequency rTMS (HF-rTMS) group (120% resting motor threshold; left DLPFC, 10-Hz rTMS, 3000 stimuli). The outcome was assessed based on the changes in scores of 24-item Hamilton Depression Scale (HAMD-24) and 14-item Hamilton Anxiety Scale (HAMA-14). RESULTS Both depression and anxiety were significantly improved after 2 weeks of treatment by rTMS combined with medication. The combination of iTBS and LF-rTMS was significantly superior to HF-rTMS in improving the scores of HAMD-24 (P = 0.041) and HAMA-14 (P = 0.0095), and the response rate (P = 0.027). CONCLUSION The pilot study showed that the combination of iTBS and LF-rTMS may hold promise as a potentially effective alternative therapy for MD due to its efficacy and time-saving benefit. The preliminary results shed light on the study of the efficacy and acceptability of the combination of iTBS and LF-rTMS for MD.
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Affiliation(s)
- Yuwei Mi
- School of Medicine, Ningbo University, Ningbo, Zhejiang, P.R. China.,Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo, Zhejiang, P.R. China
| | - Yunxin Ji
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo, Zhejiang, P.R. China
| | - Zhongze Lou
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo, Zhejiang, P.R. China.,Medical Research Center, Ningbo First Hospital, Ningbo, Zhejiang, P.R. China
| | - Yanbin Hou
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo, Zhejiang, P.R. China
| | - Liemin Ruan
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo, Zhejiang, P.R. China
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Li Y, Li K, Feng R, Li Y, Li Y, Luo H, Yu Q. Mechanisms of Repetitive Transcranial Magnetic Stimulation on Post-stroke Depression: A Resting-State Functional Magnetic Resonance Imaging Study. Brain Topogr 2022. [PMID: 35286526 DOI: 10.1007/s10548-022-00894-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 02/21/2022] [Indexed: 12/25/2022]
Abstract
We aimed to identify neural mechanisms underlying clinical response to repetitive transcranial magnetic stimulation (rTMS) in post-stroke depression (PSD) by the Resting-state functional magnetic resonance imaging (rs-fMRI). Thirty-two depressed patients after ischemic stroke were randomized in a 1:1 ratio to receive 20 min of 5 Hz rTMS or sham over left dorsolateral prefrontal cortex (DLPFC) in addition to routine supportive treatments. The clinical outcome was measured by the 17-item Hamilton Depression Rating Scale (HDRS-17), while the imaging results were acquired from rs-fMRI, including regional homogeneity (ReHo), fractional amplitude of low-frequency fluctuation (fALFF) and seed-based dynamic functional connection (dFC). HRSD-17 scores were improved in the two groups after treatment (P < 0.01), while greater mood improvement was observed in the rTMS group (P < 0.05). Compared with the sham group, the rTMS group demonstrated regions with higher ReHo and fALFF values locating mainly in the left hemisphere and highly consistent with the default mode network (DMN) (p < 0.05). Using the medial prefrontal cortex (mPFC) and posterior cingulate cortex (PCC) as seeds, significant difference between the two groups in dFC within the DMN was found after treatment, including 10 connections with increased connectivity strength and 2 connections with reduced connectivity strength. The ReHo, fALFF and dFC values within DMN in the rTMS group were negatively correlated with the HDRS scores after treatment (P < 0.05). Our results indicated reductions in depressive symptoms following rTMS in PSD are associated with functional alterations of different depression-related areas within the DMN.
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28
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Dalton B, Austin A, Ching BCF, Potterton R, McClelland J, Bartholdy S, Kekic M, Campbell IC, Schmidt U. 'My dad was like "it's your brain, what are you doing?"': Participant experiences of repetitive transcranial magnetic stimulation treatment in severe enduring anorexia nervosa. Eur Eat Disord Rev 2022; 30:237-249. [PMID: 35150473 PMCID: PMC9304183 DOI: 10.1002/erv.2890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 07/30/2021] [Revised: 11/22/2021] [Accepted: 01/27/2022] [Indexed: 01/14/2023]
Abstract
Objective Repetitive transcranial magnetic stimulation (rTMS) is a promising emerging treatment for anorexia nervosa (AN). However, to date, patients' views and experiences of this treatment have not been fully explored. To assess these, we integrated a qualitative study into a feasibility randomised controlled trial of rTMS in individuals with severe enduring AN. Method Twenty‐nine (of 34) trial participants contributed to this study. Semi‐structured interviews were conducted 3‐months following the completion of rTMS treatment (4‐months post‐randomisation), prior to unblinding. Transcripts were analysed using content analysis. Results rTMS was deemed an acceptable but time‐consuming treatment. Many emphasised how their lives had changed to some extent during, but mainly after treatment by making them more positive, open‐minded, flexible and willing to try new things in relation to their AN and other aspects of their lives. Conclusions These qualitative data will be valuable in shaping participant information, recruitment and planning of future large‐scale trials of rTMS in AN. Trial Registration ISRCTN14329415, registered 23rd July 2015, https://www.isrctn.com/ISRCTN14329415 This study is the first to systematically explore participants' experiences of repetitive transcranial magnetic stimulation (rTMS) treatment for severe enduring anorexia nervosa (AN), as part of a randomised controlled feasibility trial. Participants expressed that rTMS was an acceptable but time‐consuming treatment. Many participants who received real rTMS described positive changes in relation to AN and quality of life. Findings from this qualitative study will help to shape future research of rTMS treatment for AN.
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Affiliation(s)
- Bethan Dalton
- Department of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Amelia Austin
- Department of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Brian C F Ching
- Department of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Rachel Potterton
- Department of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Jessica McClelland
- Department of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Savani Bartholdy
- Department of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Maria Kekic
- Department of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Iain C Campbell
- Department of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Ulrike Schmidt
- Department of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
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29
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Mano T. Application of Repetitive Transcranial Magnetic Stimulation over the Dorsolateral Prefrontal Cortex in Alzheimer's Disease: A Pilot Study. J Clin Med 2022; 11:798. [PMID: 35160250 DOI: 10.3390/jcm11030798] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/24/2022] [Accepted: 01/29/2022] [Indexed: 02/05/2023] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is reportedly a potential tool to understand the neural network; however, the pathophysiological mechanisms underlying cognitive function change remain unclear. This study aimed to explore the cognitive function changes by rTMS over the bilateral dorsolateral prefrontal cortex (DLPFC) in Alzheimer’s disease (AD). We evaluated the feasibility of rTMS application for mild cognitive dysfunction in patients with AD in an open-label trial (UMIN000027013). An rTMS session involved 15 trains at 120% resting motor threshold on each side (40 pulses/train at 10 Hz). Efficacy outcome measures were changes from baseline in cognitive function, assessed based on the AD Assessment Scale-cognitive subscale, Mini-Mental State Examination, Japanese version of Montreal Cognitive Assessment (MoCA-J), Behavioral and Psychological Symptom of Dementia, and Instrumental Activity of Daily Living scores. Sixteen patients with AD underwent five daily sessions of high-frequency rTMS over the bilateral DLPFC for 2 weeks. All participants completed the study; no major adverse effects were recorded. The MoCA-J score increased by 1.4 points (±0.15%) following 2 weeks of stimulation. At 1 month following rTMS cessation, all cognitive functional scores returned to the original state. Our findings suggest that the DLPFC plays an important role in the neural network in AD.
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30
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Mirman AM, Corlier J, Wilson AC, Tadayonnejad R, Marder KG, Pleman CM, Krantz DE, Wilke SA, Levitt JG, Ginder ND, Ojha R, Daskalakis ZJ, Leuchter AF, Lee JC. Absence of early mood improvement as a robust predictor of rTMS nonresponse in major depressive disorder. Depress Anxiety 2022; 39:123-133. [PMID: 34990046 DOI: 10.1002/da.23237] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 04/05/2021] [Revised: 10/06/2021] [Accepted: 12/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Symptoms of major depressive disorder (MDD) are reported to change early in treatment with repetitive transcranial magnetic stimulation (rTMS). We evaluated early changes in sleep, anxiety, and mood as predictors of nonresponse to rTMS treatment. METHODS Three hundred twenty-nine subjects with nonpsychotic MDD completed a 6-week course of rTMS treatment. Subjects were stratified by the severity of their baseline depression, and had their overall depressive symptoms recorded every week of treatment. We evaluated lack of improvement in sleep, anxiety, and mood symptoms after 1 and 2 weeks as potential predictors of eventual nonresponse, defined as <50% improvement in compositive depressive symptoms after 6 weeks. This was measured as negative predictive value (NPV; the likelihood that lack of early symptom improvement accurately predicted eventual treatment nonresponse). RESULTS Subjects with severe or very severe baseline depression achieving <20% improvement in mood at 1 week were correctly predicted as nonresponders with NPVs largely >90%. At 2 weeks, subjects with very severe baseline depression who failed to demonstrate any improvement in mood were all nonresponders. Lack of improvement in sleep at 2 weeks was also a significant predictor. CONCLUSIONS Identifying a lack of early mood improvement is a practical and robust method to predict rTMS nonresponse. This suggests a treatment protocol change may be indicated in patients with more severe baseline depression showing minimal early mood improvement.
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Affiliation(s)
- Alex M Mirman
- Neuromodulation Division, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Juliana Corlier
- Neuromodulation Division, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Andrew C Wilson
- Neuromodulation Division, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Reza Tadayonnejad
- Neuromodulation Division, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA.,Division of the Humanities and Social Sciences, California Institute of Technology, Pasadena, California, USA
| | - Katharine G Marder
- Neuromodulation Division, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Christopher M Pleman
- Neuromodulation Division, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - David E Krantz
- Neuromodulation Division, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Scott A Wilke
- Neuromodulation Division, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Jennifer G Levitt
- Neuromodulation Division, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Nathaniel D Ginder
- Neuromodulation Division, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA.,VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Rashi Ojha
- Neuromodulation Division, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Zafiris J Daskalakis
- Department of Psychiatry, University of California San Diego School of Medicine, La Jolla, California, USA
| | - Andrew F Leuchter
- Neuromodulation Division, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Jonathan C Lee
- Neuromodulation Division, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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31
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Gao L, Wang C, Song XR, Tian L, Qu ZY, Han Y, Zhang X. The Sensory Abnormality Mediated Partially the Efficacy of Repetitive Transcranial Magnetic Stimulation on Treating Comorbid Sleep Disorder in Autism Spectrum Disorder Children. Front Psychiatry 2022; 12:820598. [PMID: 35140641 PMCID: PMC8818693 DOI: 10.3389/fpsyt.2021.820598] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 11/23/2021] [Accepted: 12/15/2021] [Indexed: 12/22/2022] Open
Abstract
Sleep disorder emerges as a common comorbidity in children with autism spectrum disorder (ASD), and the interaction between the core symptoms of ASD and its sleep disorder remains unclear. Repetitive transcranial magnetic stimulation (rTMS) was used on the bilateral dorsolateral prefrontal cortex (DLPFC) to investigate the efficacy of rTMS on the core symptoms of ASD and comorbid sleep problems as well as the mediation role of the ASD symptoms between rTMS intervention and sleep improvement. A total of 41 Chinese children with ASD and who met the criteria in the fifth edition of the American Diagnostic and Statistical Manual of Mental Disorders were recruited, and 39 of them (mean age: 9.0 ± 4.4 years old; the male-female ratio was 3.9: 1) completed the study with the stimulating protocol of high frequency on the left DLPFC and low frequency on the right DLPFC. They were all assessed three times (before, at 4 weeks after, and at 8 weeks after the stimulation) by the Children's Sleep Habits Questionnaire (CSHQ), Strengths and Difficulties Questionnaire (SDQ), Childhood Autism Rating Scale, Repetitive Behavior Questionnaire-2, and Short Sensory Profile (SSP). The repeated-measures ANOVA showed that the main effect of "intervention time" of CSHQ (F = 25.103, P < 0.001), SSP (F = 6.345, P = 0.003), and SDQ (F = 9.975, P < 0.001) was statistically significant. By Bayesian mediation analysis, we only found that the total score of SSP mediated the treating efficacy of rTMS on CSHQ (αβ = 5.11 ± 1.51, 95% CI: 2.50-8.41). The percentage of mediation effect in total effect was 37.94%. Our results indicated the treating efficacy of rTMS modulation on bilateral DLPFC for both autistic symptoms and sleep disturbances. The sensory abnormality of ASD mediated the improvement of rTMS on sleep problems of ASD.
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Affiliation(s)
- Lei Gao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Chen Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xiao-rong Song
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Li Tian
- Department of Cerebral Functional Therapy, Tianjin Anding Hospital (Tianjin Mental Health Center), Tianjin, China
| | - Zhi-yi Qu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yu Han
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xin Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
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Leuchter MK, Rosenberg BM, Schapira G, Wong NR, Leuchter AF, McGlade AL, Krantz DE, Ginder ND, Lee JC, Wilke SA, Tadayonnejad R, Levitt J, Marder KG, Craske MG, Iacoboni M. Treatment of Spider Phobia Using Repeated Exposures and Adjunctive Repetitive Transcranial Magnetic Stimulation: A Proof-of-Concept Study. Front Psychiatry 2022; 13:823158. [PMID: 35370840 PMCID: PMC8965447 DOI: 10.3389/fpsyt.2022.823158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/26/2021] [Accepted: 02/10/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Specific phobias represent the largest category of anxiety disorders. Previous work demonstrated that stimulating the ventromedial prefrontal cortex (vmPFC) with repetitive Transcranial Magnetic Stimulation (rTMS) may improve response to exposure therapy for acrophobia. OBJECTIVE To examine feasibility of accelerating extinction learning in subjects with spider phobia using intermittent Theta Burst Stimulation (iTBS) rTMS of vmPFC. METHODS In total, 17 subjects with spider phobia determined by spider phobia questionnaires [Spider Phobia Questionnaire (SPQ) and Fear of Spiders questionnaire (FSQ)] underwent ratings of fear of spiders as well as behavioral and skin conductance data during a behavioral avoidance test (BAT). Subjects then received a sequential protocol of in vivo spider exposure followed by iTBS for three sessions administered to either active or control treatment sites (vmPFC [n = 8] or vertex [n = 9], respectively), followed 1 week later by repetition of questionnaires and BAT. RESULTS All subjects improved significantly regardless of group across both questionnaires (FSQ η2 = 0.43, p = 0.004; SPQ η2 = 0.39, p = 0.008) and skin conductance levels during BAT (Wald χ2 = 30.9, p < 0.001). Subjects in the vmPFC group tolerated lower treatment intensity than in the control group, and there was a significant correlation between treatment intensity, BAT subjective distress improvement, and physiologic measures (all ρ > 0.5). CONCLUSION This proof-of-concept study provides preliminary evidence that a sequential exposure and iTBS over vmPFC is feasible and may have rTMS intensity-dependent effects on treatment outcomes, providing evidence for future areas of study in the use of rTMS for phobias.
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Affiliation(s)
- Michael K Leuchter
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Benjamin M Rosenberg
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Giuditta Schapira
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Nicole R Wong
- David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Andrew F Leuchter
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Anastasia L McGlade
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - David E Krantz
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Nathaniel D Ginder
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Jonathan C Lee
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Scott A Wilke
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Reza Tadayonnejad
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.,Division of the Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, United States
| | - Jennifer Levitt
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Katharine G Marder
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Marco Iacoboni
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
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Ward HB, Brady RO, Halko MA, Lizano P. Noninvasive Brain Stimulation for Nicotine Dependence in Schizophrenia: A Mini Review. Front Psychiatry 2022; 13:824878. [PMID: 35222123 PMCID: PMC8863675 DOI: 10.3389/fpsyt.2022.824878] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/14/2022] [Indexed: 11/13/2022] Open
Abstract
Individuals with schizophrenia are 10 times more likely to have a tobacco use disorder than the general population. Up to 80% of those with schizophrenia smoke tobacco regularly, a prevalence three-times that of the general population. Despite the striking prevalence of tobacco use in schizophrenia, current treatments are not tailored to the pathophysiology of this population. There is growing support for use of noninvasive brain stimulation (NIBS) to treat substance use disorders (SUDs), particularly for tobacco use in neurotypical smokers. NIBS interventions targeting the dorsolateral prefrontal cortex have been effective for nicotine dependence in control populations-so much so that transcranial magnetic stimulation is now FDA-approved for smoking cessation. However, this has not borne out in the studies using this approach in schizophrenia. We performed a literature search to identify articles using NIBS for the treatment of nicotine dependence in people with schizophrenia, which identified six studies. These studies yielded mixed results. Is it possible that nicotine has a unique effect in schizophrenia that is different than its effect in neurotypical smokers? Individuals with schizophrenia may receive additional benefit from nicotine's pro-cognitive effects than control populations and may use nicotine to improve brain network abnormalities from their illness. Therefore, clinical trials of NIBS interventions should test a schizophrenia-specific target for smoking cessation. We propose a generalized approach whereby schizophrenia-specific brain circuitry related to SUDs is be identified and then targeted with NIBS interventions.
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Affiliation(s)
- Heather Burrell Ward
- Department of Neurology, Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Boston, MA, United States.,Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
| | - Roscoe O Brady
- Department of Neurology, Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Boston, MA, United States.,Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States.,McLean Hospital, Belmont, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Mark A Halko
- McLean Hospital, Belmont, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Paulo Lizano
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
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34
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Chang CH, Liou MF, Liu CY, Lu WH, Chen SJ. Efficacy of Repetitive Transcranial Magnetic Stimulation in Patients With Methamphetamine Use Disorder: A Systematic Review and Meta-Analysis of Double-Blind Randomized Controlled Trials. Front Psychiatry 2022; 13:904252. [PMID: 35711590 PMCID: PMC9197111 DOI: 10.3389/fpsyt.2022.904252] [Citation(s) in RCA: 4] [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: 03/25/2022] [Accepted: 04/27/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) has demonstrated therapeutic potential for treating patients with methamphetamine use disorder (MUD). However, the most effective target and stimulation frequency of rTMS for treating MUD remains unclear. This meta-analysis explored the effect of rTMS on MUD. METHODS In this study, PubMed, Cochrane Systematic Reviews, and the Cochrane Collaboration Central Register of Controlled Clinical Trials were searched electronically for double-blind randomized controlled trials that used rTMS for treating MUD. We used published trials to investigate the efficacy of rTMS in MUD up to March 5, 2022, and pooled studies using a random-effect model to compare rTMS treatment effects. Patients who were diagnosed with MUD according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders were recruited. Clinical craving scores between baseline and after rTMS were compared using the standardized mean difference (SMD) with 95% confidence intervals (CIs). The heterogeneity of the included trials was evaluated through a visual inspection of funnel plots and the I2 statistic. RESULTS We identified seven trials with 462 participants with MUD that met the inclusion criteria. All the studies evaluated craving scores, with rTMS demonstrating a more significant effect than the sham treatment on reducing craving scores (SMD = 0.983, CI = 0.620-1.345, p ≤ 0.001). A subgroup meta-analysis revealed that intermittent theta-burst stimulation (iTBS) had a greater positive effect than 10-Hz rTMS. A metaregression revealed that the SMDs increased with the increase in baseline craving scores, whereas they decreased with the increase in the proportion of men and duration of abstinence. CONCLUSION The meta-analysis suggests that rTMS may be associated with treatment effect on craving symptoms in patients with MUD. iTBS may have a greater positive effect on craving reduction than 10-z rTMS.
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Affiliation(s)
- Chun-Hung Chang
- An Nan Hospital, China Medical University, Tainan City, Taiwan.,Institute of Clinical Medical Science, China Medical University, Taichung City, Taiwan.,Department of Psychiatry and Brain Disease Research Center, China Medical University Hospital, Taichung City, Taiwan
| | - Meng-Fen Liou
- An Nan Hospital, China Medical University, Tainan City, Taiwan
| | - Chieh-Yu Liu
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.,Biostatistical Consulting Lab, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Wei-Hsin Lu
- Department of Psychiatry, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan
| | - Shaw-Ji Chen
- Department of Psychiatry, Taitung MacKay Memorial Hospital, Taitung, Taiwan.,Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
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Chen X, Zhang T, Shan X, Yang Q, Zhang P, Zhu H, Jiang F, Liu C, Li Y, Li W, Xu J, Shen H. High-frequency repetitive transcranial magnetic stimulation alleviates the cognitive side effects of electroconvulsive therapy in major depression. Front Psychiatry 2022; 13:1002809. [PMID: 36262627 PMCID: PMC9575950 DOI: 10.3389/fpsyt.2022.1002809] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 07/25/2022] [Accepted: 09/12/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The retrospective study aimed to explore the difference in mood outcomes and cognitive function between high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) over dorsolateral prefrontal cortex (DLPFC) and electroconvulsive therapy in major depression disorder (MDD) patients and to examine the improvement of HF-rTMS on cognitive impairment evoked by electroconvulsive therapy (ECT). MATERIALS AND METHODS A total of 116 participants with MDD, who completed a 4-week follow-up assessment, were enrolled. The cohort consisted of 26 cases classed as control, 46 participants administrated with HF-rTMS (HF-rTMS group), 22 patients treated with ECT (ECT group), and 23 cases treated with HF-rTMS and ECT at the course of hospitalization (HF-rTMS + ECT group). Medication was kept constant as well in all participants. The 17-item Hamilton Depression Rating Scale for Depression (HAMD-17) and 14-item Hamilton Anxiety Rating Scale (HAMA-14) were used to assess depression and anxiety, respectively. Montreal Cognitive Assessment (MoCA) was to elevate cognitive function. RESULTS No statistical significance was found for baseline in sociodemographic, characteristics of depression, anxiety and cognition, and psychopharmaceutic dosages among control, HF-rTMS, ECT, and HF-rTMS + ECT groups (p > 0.05). Compared with baseline level, total scores of HAMD-17 and HAMA-14 significantly decreased at the end of 4 weeks after treatment (p < 0.001). Furthermore, the decline in scores of HAMD-17 and its sleep disorder and retardation factors from baseline to post-treatment was greater in HF-rTMS, ECT, and HF-rTMS + ECT group than in control (p < 0.05), and there was a significant difference between control and HF-rTMS group in the decline of psychological factor of HAMA-14 (p < 0.01). ECT treatment evoked total score of MoCA to decrease significantly at the end of 4-week after intervention (p < 0.001), and the decline in scores of MoCA and its delayed recall and language performances from baseline to post-treatment was greater in ECT than control, HF-rTMS, and HF-rTMS + ECT (p < 0.05). CONCLUSION High-frequency repetitive transcranial magnetic stimulation improved psychological anxiety and ameliorated the cognition impairment evoked by ECT though it had the same anti-depressant efficacy as ECT.
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Affiliation(s)
- Xing Chen
- Laboratory of Biological Psychiatry, Nantong Mental Health Center & Nantong Brain Hospital, Nantong, China
| | - Tongtong Zhang
- Laboratory of Biological Psychiatry, Nantong Mental Health Center & Nantong Brain Hospital, Nantong, China
| | - Xiaoyan Shan
- Laboratory of Biological Psychiatry, Nantong Mental Health Center & Nantong Brain Hospital, Nantong, China
| | - Qun Yang
- Laboratory of Biological Psychiatry, Nantong Mental Health Center & Nantong Brain Hospital, Nantong, China
| | - Peiyun Zhang
- Laboratory of Biological Psychiatry, Nantong Mental Health Center & Nantong Brain Hospital, Nantong, China
| | - Haijiao Zhu
- Laboratory of Biological Psychiatry, Nantong Mental Health Center & Nantong Brain Hospital, Nantong, China
| | - Fei Jiang
- Laboratory of Biological Psychiatry, Nantong Mental Health Center & Nantong Brain Hospital, Nantong, China
| | - Chao Liu
- Laboratory of Biological Psychiatry, Nantong Mental Health Center & Nantong Brain Hospital, Nantong, China
| | - Yanzhong Li
- Laboratory of Biological Psychiatry, Nantong Mental Health Center & Nantong Brain Hospital, Nantong, China
| | - Weijun Li
- Laboratory of Biological Psychiatry, Nantong Mental Health Center & Nantong Brain Hospital, Nantong, China
| | - Jian Xu
- Laboratory of Biological Psychiatry, Nantong Mental Health Center & Nantong Brain Hospital, Nantong, China
| | - Hongmei Shen
- Laboratory of Biological Psychiatry, Nantong Mental Health Center & Nantong Brain Hospital, Nantong, China.,Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-innovation Center of Neuroregeneration, Nantong University, Nantong, China
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Thirugnanasambandam N, Kasten FH, Udupa K. Editorial: Novel Multimodal Approaches in Non-invasive Brain Stimulation. Front Hum Neurosci 2021; 15:784637. [PMID: 34867248 PMCID: PMC8639513 DOI: 10.3389/fnhum.2021.784637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 10/28/2021] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Florian H Kasten
- Experimental Psychology Lab, Department of Psychology, European Medical School, Cluster of Excellence "Hearing4All", Carl von Ossietzky University, Oldenburg, Germany
| | - Kaviraja Udupa
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
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Mori N, Hosomi K, Nishi A, Dong D, Yanagisawa T, Khoo HM, Tani N, Oshino S, Saitoh Y, Kishima H. Difference in Analgesic Effects of Repetitive Transcranial Magnetic Stimulation According to the Site of Pain. Front Hum Neurosci 2021; 15:786225. [PMID: 34899224 PMCID: PMC8662379 DOI: 10.3389/fnhum.2021.786225] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 10/29/2021] [Indexed: 01/09/2023] Open
Abstract
High-frequency repetitive transcranial magnetic stimulation (rTMS) of the primary motor cortex for neuropathic pain has been shown to be effective, according to systematic reviews and therapeutic guidelines. However, our large, rigorous, investigator-initiated, registration-directed clinical trial failed to show a positive primary outcome, and its subgroup analysis suggested that the analgesic effect varied according to the site of pain. The aim of this study was to investigate the differences in analgesic effects of rTMS for neuropathic pain between different pain sites by reviewing our previous clinical trials. We included three clinical trials in this mini meta-analysis: a multicenter randomized controlled trial at seven hospitals (N = 64), an investigator-initiated registration-directed clinical trial at three hospitals (N = 142), and an exploratory clinical trial examining different stimulation parameters (N = 22). The primary efficacy endpoint (change in pain scale) was extracted for each patient group with pain in the face, upper limb, or lower limb, and a meta-analysis of the efficacy of active rTMS against sham stimulation was performed. Standardized mean difference (SMD) with 95% confidence interval (CI) was calculated for pain change using a random-effects model. The analgesic effect of rTMS for upper limb pain was favorable (SMD = -0.45, 95% CI: -0.77 to -0.13). In contrast, rTMS did not produce significant pain relief on lower limb pain (SMD = 0.04, 95% CI: -0.33 to 0.41) or face (SMD = -0.24, 95% CI: -1.59 to 1.12). In conclusion, these findings suggest that rTMS provides analgesic effects in patients with neuropathic pain in the upper limb, but not in the lower limb or face, under the conditions of previous clinical trials. Owing to the main limitation of small number of studies included, many aspects should be clarified by further research and high-quality studies in these patients.
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Affiliation(s)
- Nobuhiko Mori
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Koichi Hosomi
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan,*Correspondence: Koichi Hosomi,
| | - Asaya Nishi
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Dong Dong
- Department of Mechanical Science and Bioengineering, Osaka University Graduate School of Engineering Science, Toyonaka, Japan
| | - Takufumi Yanagisawa
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan,Osaka University Institute for Advanced Co-Creation Studies, Suita, Japan
| | - Hui Ming Khoo
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Naoki Tani
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Satoru Oshino
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Youichi Saitoh
- Department of Mechanical Science and Bioengineering, Osaka University Graduate School of Engineering Science, Toyonaka, Japan,Tokuyukai Rehabilitation Clinic, Toyonaka, Japan
| | - Haruhiko Kishima
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan
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Cuppone D, Gómez Pérez LJ, Cardullo S, Cellini N, Sarlo M, Soldatesca S, Chindamo S, Madeo G, Gallimberti L. The role of repetitive transcranial magnetic stimulation (rTMS) in the treatment of behavioral addictions: Two case reports and review of the literature. J Behav Addict 2021; 10:361-370. [PMID: 34232905 PMCID: PMC8996794 DOI: 10.1556/2006.2021.00032] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/14/2021] [Accepted: 05/15/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Several behaviors, besides consumption of psychoactive substances, produce short-term reward that may lead to persistent aberrant behavior despite adverse consequences. Growing evidence suggests that these behaviors warrant consideration as nonsubstance or "behavioral" addictions, such as pathological gambling, internet gaming disorder and internet addiction. CASE PRESENTATION Here, we report two cases of behavioral addictions (BA), compulsive sexual behavior disorder for online porn use and internet gaming disorder. A 57-years-old male referred a loss of control over his online pornography use, started 15 years before, while a 21-years-old male university student reported an excessive online gaming activity undermining his academic productivity and social life. Both patients underwent a high-frequency repetitive transcranial magnetic stimulation (rTMS) protocol over the left dorsolateral prefrontal cortex (l-DLPFC) in a multidisciplinary therapeutic setting. A decrease of addictive symptoms and an improvement of executive control were observed in both cases. DISCUSSION Starting from these clinical observations, we provide a systematic review of the literature suggesting that BAs share similar neurobiological mechanisms to those underlying substance use disorders (SUD). Moreover, we discuss whether neurocircuit-based interventions, such as rTMS, might represent a potential effective treatment for BAs.
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Affiliation(s)
- Diego Cuppone
- Novella Fronda Foundation
,
Piazza Castello, 16 - 35141
,
Padua
,
Italy
| | | | - Stefano Cardullo
- Novella Fronda Foundation
,
Piazza Castello, 16 - 35141
,
Padua
,
Italy
| | - Nicola Cellini
- Department of General Psychology, University of Padua
,
Padova
,
Italy,Department of Biomedical Sciences, University of Padova
,
Padova
,
Italy,Padova Neuroscience Center, University of Padova
,
Padova
,
Italy,Human Inspired Technology Center, University of Padova
,
Padova
,
Italy
| | - Michela Sarlo
- Department of Communication Sciences, Humanities and International Studies, University of Urbino Carlo Bo
,
Urbino
,
Italy
| | - Silvia Soldatesca
- Novella Fronda Foundation
,
Piazza Castello, 16 - 35141
,
Padua
,
Italy
| | - Sonia Chindamo
- Novella Fronda Foundation
,
Piazza Castello, 16 - 35141
,
Padua
,
Italy
| | - Graziella Madeo
- Novella Fronda Foundation
,
Piazza Castello, 16 - 35141
,
Padua
,
Italy
| | - Luigi Gallimberti
- Novella Fronda Foundation
,
Piazza Castello, 16 - 35141
,
Padua
,
Italy,
Corresponding author. E-mail:
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Horowitz AJ, Guger C, Korostenskaja M. What External Variables Affect Sensorimotor Rhythm Brain-Computer Interface (SMR-BCI) Performance? HCA Healthc J Med 2021; 2:143-162. [PMID: 37427002 PMCID: PMC10324824 DOI: 10.36518/2689-0216.1188] [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] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Description Sensorimotor rhythm-based brain-computer interfaces (SMR-BCIs) are used for the acquisition and translation of motor imagery-related brain signals into machine control commands, bypassing the usual central nervous system output. The selection of optimal external variable configuration can maximize SMR-BCI performance in both healthy and disabled people. This performance is especially important now when the BCI is targeted for everyday use in the environment beyond strictly regulated laboratory settings. In this review article, we summarize and critically evaluate the current body of knowledge pertaining to the effect of the external variables on SMR-BCI performance. When assessing the relationship between SMR-BCI performance and external variables, we broadly characterize them as elements that are less dependent on the BCI user and originate from beyond the user. These elements include such factors as BCI type, distractors, training, visual and auditory feedback, virtual reality and magneto electric feedback, proprioceptive and haptic feedback, carefulness of electroencephalography (EEG) system assembling and positioning of EEG electrodes as well as recording-related artifacts. At the end of this review paper, future developments are proposed regarding the research into the effects of external variables on SMR-BCI performance. We believe that our critical review will be of value for academic BCI scientists and developers and clinical professionals working in the field of BCIs as well as for SMR-BCI users.
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Affiliation(s)
- Alex J. Horowitz
- Functional Brain Mapping and Brain Computer Interface Lab, Neuroscience Institute, AdventHealth Orlando, Orlando, FL,
USA
- University of Central Florida/HCA Healthcare GME Consortium, Gainesville, Florida
| | | | - Milena Korostenskaja
- Functional Brain Mapping and Brain Computer Interface Lab, Neuroscience Institute, AdventHealth Orlando, Orlando, FL,
USA
- MEG Lab, AdventHealth for Children, Orlando, FL,
USA
- Department of Psychology, College of Arts and Sciences, University of North Florida, Jacksonville, FL,
USA
- Comprehensive Epilepsy Center, AdventHealth Orlando, Orlando, FL,
USA
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40
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Monem RG, Okusaga OO. Repetitive Transcranial Magnetic Stimulation: A Potential Treatment for Obesity in Patients with Schizophrenia. Behav Sci (Basel) 2021; 11:86. [PMID: 34208079 DOI: 10.3390/bs11060086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 05/28/2021] [Accepted: 06/09/2021] [Indexed: 11/21/2022] Open
Abstract
Obesity is highly prevalent in patients with schizophrenia and, in association with metabolic syndrome, contributes to premature deaths of patients due to cardiovascular disease complications. Moreover, pharmacologic, and behavioral interventions have not stemmed the tide of obesity in schizophrenia. Therefore, novel effective interventions are urgently needed. Repetitive transcranial magnetic stimulation (rTMS) has shown efficacy for inducing weight loss in obese non-psychiatric samples but this promising intervention has not been evaluated as a weight loss intervention in patients with schizophrenia. In this narrative review, we describe three brain mechanisms (hypothalamic inflammation, dysregulated mesocorticolimbic reward system, and impaired prefrontal cortex function) implicated in the pathogenesis and pathophysiology of obesity and emphasize how the three mechanisms have also been implicated in the neurobiology of schizophrenia. We then argue that, based on the three overlapping brain mechanisms in obesity and schizophrenia, rTMS would be effective as a weight loss intervention in patients with schizophrenia and comorbid obesity. We end this review by describing how deep TMS, relative to conventional TMS, could potentially result in larger effect size for weight loss. While this review is mainly conceptual and based on an extrapolation of findings from non-schizophrenia samples, our aim is to stimulate research in the use of rTMS for weight loss in patients with schizophrenia.
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Rotolo MC, Pacifici R, Pellegrini M, Cardullo S, Pérez LJG, Cuppone D, Gallimberti L, Madeo G. Hair Testing for Classic Drugs of Abuse to Monitor Cocaine Use Disorder in Patients Following Transcranial Magnetic Stimulation Protocol Treatment. Biology (Basel) 2021; 10:403. [PMID: 34062953 DOI: 10.3390/biology10050403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 04/27/2021] [Accepted: 05/02/2021] [Indexed: 11/17/2022]
Abstract
Simple Summary Hair testing for classic drugs of abuse offers the possibility of longer detection times (for drug substances) when compared to urine analysis. Hair analysis is routinely used to detect drug abuse in forensic cases and clinical toxicology, whereas it is rarely used at addiction clinics to monitor the clinical efficacy of therapeutic interventions. Here, we explore for the first time whether hair analysis might represent a valid tool to track the clinical improvements in a population of patients with cocaine use disorder (CocUD) who underwent a repetitive transcranial magnetic stimulation (rTMS) treatment. Abstract In recent years, hair has become an alternative biological specimen for drug testing in the fields of forensic and clinical toxicology. The advantages of hair testing include larger detection windows (months/years), depending on the length of the hair shaft, compared to those of urine/blood (hours to 2–4 days for most drugs). Segmental hair analysis can disclose a month-to-month (considering 1 cm segment cuts) information of drug exposure (single or repeated) and potentially identify patterns of drug use/administration. Repetitive transcranial magnetic stimulation (rTMS) was recently proposed as a valid tool for therapeutic purposes in addictions, including cocaine use disorder (CocUD). Here, we proposed hair testing analyses of classic drugs of abuse in a clinical setting to monitor the clinical changes in treatment-seeker CocUD patients undergoing protocol treatments with rTMS stimulating the left dorsolateral prefrontal cortex (l-DLPFC). We collected hair samples from nine CocUD patients at different stages from the beginning of treatments. Hair sample analyses revealed significant changes in the patterns of cocaine use, according to the negativity of urine screening tests and the clinical reductions of craving. These data, albeit preliminary, suggest that hair testing analysis of classic drugs of abuse could be extended to clinical settings to monitor the clinical efficacy of innovative therapeutic interventions, such as rTMS.
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Valiuliene G, Valiulis V, Dapsys K, Vitkeviciene A, Gerulskis G, Navakauskiene R, Germanavicius A. Brain stimulation effects on serum BDNF, VEGF, and TNFα in treatment-resistant psychiatric disorders. Eur J Neurosci 2021; 53:3791-3802. [PMID: 33861484 DOI: 10.1111/ejn.15232] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 08/07/2020] [Revised: 04/01/2021] [Accepted: 04/08/2021] [Indexed: 02/06/2023]
Abstract
Resistance to pharmacological treatment poses a notable challenge for psychiatry. Such cases are usually treated with brain stimulation techniques, including repetitive transcranial magnetic stimulation (rTMS) and electroconvulsive therapy (ECT). Empirical evidence links treatment resistance to insufficient brain plasticity and chronic inflammation. Therefore, this study encompasses analysis of neurotrophic and inflammatory factors in psychiatric patients undergoing rTMS and ECT in order to refine the selection of patients and predict clinical outcomes. This study enrolled 25 drug-resistant depressive patients undergoing rTMS and 31 drug-resistant schizophrenia patients undergoing ECT. Clinical efficacy of brain stimulation therapies was gauged using MADRS and HAM-D scales in the depression group and PANSS scale in the schizophrenia group. Blood-derived BDNF, VEGF, and TNFα were analysed during the treatment course. For reference, 19 healthy control subjects were also enrolled. After statistical analysis, no significant differences were detected in BDNF, VEGF, and TNFα concentrations among healthy, depressive, and schizophrenic subject groups before the treatment. However, depressive patient treatment with rTMS has increased BDNF concentration, while schizophrenic patient treatment with ECT has lowered the concentration of TNFα. Our findings suggest that a lower initial TNFα concentration could be a marker for treatment success in depressed patients undergoing rTMS, whereas in schizophrenic patient group treated with ECT, a higher concentration of VEGF correlates to milder symptoms post-treatment, especially in the negative scale.
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Affiliation(s)
- Giedre Valiuliene
- Life Sciences Center, Institute of Biochemistry, Vilnius University, Vilnius, Lithuania
| | - Vladas Valiulis
- Life Sciences Center, Institute of Biochemistry, Vilnius University, Vilnius, Lithuania.,Republican Vilnius Psychiatric Hospital, Vilnius, Lithuania
| | - Kastytis Dapsys
- Life Sciences Center, Institute of Biochemistry, Vilnius University, Vilnius, Lithuania.,Republican Vilnius Psychiatric Hospital, Vilnius, Lithuania.,Life Sciences Center, Institute of Biosciences, Vilnius University, Vilnius, Lithuania
| | - Aida Vitkeviciene
- Life Sciences Center, Institute of Biochemistry, Vilnius University, Vilnius, Lithuania
| | - Giedrius Gerulskis
- Life Sciences Center, Institute of Biochemistry, Vilnius University, Vilnius, Lithuania.,Republican Vilnius Psychiatric Hospital, Vilnius, Lithuania
| | - Ruta Navakauskiene
- Life Sciences Center, Institute of Biochemistry, Vilnius University, Vilnius, Lithuania
| | - Arunas Germanavicius
- Life Sciences Center, Institute of Biochemistry, Vilnius University, Vilnius, Lithuania.,Republican Vilnius Psychiatric Hospital, Vilnius, Lithuania.,Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Wei N, Chen J. Repetitive Transcranial Magnetic Stimulation for Alzheimer's Disease Based on Apolipoprotein E Genotyping: Protocol for a Randomized Controlled Study. Front Aging Neurosci 2021; 13:758765. [PMID: 34924994 PMCID: PMC8675398 DOI: 10.3389/fnagi.2021.758765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 08/15/2021] [Accepted: 11/03/2021] [Indexed: 02/05/2023] Open
Abstract
To date, there is a shortage of effective treatment strategies for Alzheimer's disease (AD), and although repetitive transcranial magnetic stimulation (rTMS) can improve AD cognitive function, there are obvious individual differences, which may be related to different apolipoprotein E (APOE) genotypes. As the risk and pathogenesis of AD varies greatly among different genotypes precise treatment strategies should be implemented depending upon genotype, which has not been proved by clinical studies. Apart from that, the published clinical studies are highly heterogeneous, and therefore, systematic and well-developed randomized controlled Trails (RCT) and demonstration of precise administration protocols are required. To verify this hypothesis, this project designed a RCT study, and randomly divided apoE4 carrier AD and non-carrier AD into high-frequency rTMS (HF-rTMS) or low-frequency rTMS (LF-rTMS) treatment groups. Specifically, 80 patients with AD, namely 48 APOE4 carriers and 32 non-APOE4 carriers will be included in the study. After that, based on different stimulation frequencies of rTMS, they will be divided into the HF-rTMS group and the LF-rTMS group, when patients with AD will be randomly assigned to different treatment groups. After AD patients are involved in the study, their memory, cognition, anxiety, depression and activities of daily living will be tested before and during 2 weeks of rTMS. Furthermore, peripheral blood will be collected before and after treatment to detect changes in pathological indexes via MSD platform (Meso Scale Discovery), while 32-channel EEG data will be also collected to detect and analyze changes in gamma oscillation. In addition, these patients will be followed up for 6 months and their neuropsychological scale was also evaluated every month. At present, our study has included 18 AD patients (10 APOE4 carriers; 8 non-carriers). Our study is still in progress. The grouping has not been unblinded. But the preliminary data demonstrated that non-carriers had better MoCA score improvement than APOE4 carriers. The results indicated that the two populations of AD patients should be treated differently. Thus, this project will provide direction for precision rTMS in AD and also promotes a shift in relevant treatment philosophy. Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [ChiCTR2100041625].
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Bhattacharyya P, Anand A, Lin J, Altinay M. Left Dorsolateral Prefrontal Cortex Glx/tCr Predicts Efficacy of High Frequency 4- to 6-Week rTMS Treatment and Is Associated With Symptom Improvement in Adults With Major Depressive Disorder: Findings From a Pilot Study. Front Psychiatry 2021; 12:665347. [PMID: 34925079 PMCID: PMC8677827 DOI: 10.3389/fpsyt.2021.665347] [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: 02/07/2021] [Accepted: 11/08/2021] [Indexed: 12/05/2022] Open
Abstract
About 20-40% of estimated 121 million patients with major depressive disorder (MDD) are not adequately responsive to medication treatment. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive, non-convulsive neuromodulation/neurostimulation method, has gained popularity in treatment of MDD. Because of the high cost involved in rTMS therapy, ability to predict the therapy effectiveness is both clinically and cost wise significant. This study seeks an imaging biomarker to predict efficacy of rTMS treatment using a standard high frequency 10-Hz 4- to 6-week protocol in adult population. Given the significance of excitatory and inhibitory neurotransmitters glutamate (Glu) and gamma aminobutyric acid (GABA) in the pathophysiology of MDD, and the involvement of the site of rTMS application, left dorsolateral prefrontal cortex (lDLPFC), in MDD, we explored lDLPFC Glx (Glu + glutamine) and GABA levels, measured by single voxel magnetic resonance spectroscopy (MRS) with total creatine (tCr; sum of creatine and phosphocreatine) as reference, as possible biomarkers of rTMS response prediction. Mescher-Garwood point-resolved spectroscopy (MEGA-PRESS) MRS data from 7 patients (40-74 y) were used in the study; 6 of these patients were scanned before and after 6 weeks of rTMS therapy. Findings from this study show inverse correlation between pretreatment lDLPFC Glx/tCr and (i) posttreatment depression score and (ii) change in depression score, suggesting higher Glx/tCr as a predictor of treatment efficacy. In addition association was observed between changes in depression scores and changes in Glx/tCr ratio. The preliminary findings did not show any such association between GABA/tCr and depression score.
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Affiliation(s)
- Pallab Bhattacharyya
- Cleveland Clinic, Imaging Institute, Cleveland, OH, United States.,Department of Radiology, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, United States
| | - Amit Anand
- Cleveland Clinic, Neurological Institute, Cleveland, OH, United States
| | - Jian Lin
- Cleveland Clinic, Imaging Institute, Cleveland, OH, United States
| | - Murat Altinay
- Cleveland Clinic, Neurological Institute, Cleveland, OH, United States
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Chen J, Ma N, Hu G, Nousayhah A, Xue C, Qi W, Xu W, Chen S, Rao J, Liu W, Zhang F, Zhang X. rTMS modulates precuneus-hippocampal subregion circuit in patients with subjective cognitive decline. Aging (Albany NY) 2020; 13:1314-1331. [PMID: 33260151 PMCID: PMC7835048 DOI: 10.18632/aging.202313] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 08/25/2020] [Accepted: 10/22/2020] [Indexed: 12/20/2022]
Abstract
Hippocampal subregions (HIPsub) and their network connectivities are generally aberrant in patients with subjective cognitive decline (SCD). This study aimed to investigate whether repetitive transcranial magnetic stimulation (rTMS) could ameliorate HIPsub network connectivity by modulating one node of HIPsub network in SCD. In the first cohort, the functional connectivity (FC) of three HIPsub (i.e., hippocampal emotional, cognitive, and perceptual regions: HIPe, HIPc, and HIPp) were analyzed so as to identify alterations in HIPsub connectivity associated with SCD. Afterwards, a support vector machine (SVM) approach was applied using the alterations in order to evaluate to what extent we could distinguish SCD from healthy controls (CN). In the second cohort, a 2-week rTMS course of 5-day, once-daily, was used to activate the altered HIPsub network connectivity in a sham-controlled design. SCD subjects exhibited distinct patterns alterations of HIPsub network connectivity compared to CN in the first cohort. SVM classifier indicated that the abnormalities had a high power to discriminate SCD from CN, with 92.9% area under the receiver operating characteristic curve (AUC), 86.0% accuracy, 83.8% sensitivity and 89.1% specificity. In the second cohort, changes of HIPc connectivity with the left parahippocampal gyrus and HIPp connectivity with the left middle temporal gyrus demonstrated an amelioration of episodic memory in SCD after rTMS. In addition, SCD exhibited improved episodic memory after the rTMS course. rTMS therapy could improve the posterior hippocampus connectivity by modulating the precuneus in SCD. Simultaneous correction of the breakdown in HIPc and HIPp could ameliorate episodic memory in SCD. Thus, these findings suggested that rTMS manipulation of precuneus-hippocampal circuit might prevent disease progression by improving memory as the earliest at-risk state of Alzheimer’s disease in clinical trials and in practice.
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Affiliation(s)
- Jiu Chen
- Institute of Neuropsychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing 210029, China
| | - Nan Ma
- Department of Neurology, Xi'an Children's Hospital, Xi'an 710003, Shaanxi, China
| | - Guanjie Hu
- Institute of Neuropsychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing 210029, China
| | - Amdanee Nousayhah
- Department of Geriatric Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Chen Xue
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing 210029, China.,Department of Radiology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Wenzhang Qi
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing 210029, China.,Department of Radiology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Wenwen Xu
- Department of Neurology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210009, China
| | - Shanshan Chen
- Department of Neurology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210009, China
| | - Jiang Rao
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing 210029, China.,Department of Rehabilitation, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Wan Liu
- Department of Rehabilitation, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Fuquan Zhang
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xiangrong Zhang
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing 210029, China.,Department of Geriatric Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
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46
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Corlier J, Wilson A, Hunter AM, Vince-Cruz N, Krantz D, Levitt J, Minzenberg MJ, Ginder N, Cook IA, Leuchter AF. Changes in Functional Connectivity Predict Outcome of Repetitive Transcranial Magnetic Stimulation Treatment of Major Depressive Disorder. Cereb Cortex 2020; 29:4958-4967. [PMID: 30953441 DOI: 10.1093/cercor/bhz035] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [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: 09/24/2018] [Revised: 01/28/2019] [Accepted: 02/12/2019] [Indexed: 12/15/2022] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) treatment of major depressive disorder (MDD) is associated with changes in brain functional connectivity (FC). These changes may be related to the mechanism of action of rTMS and explain the variability in clinical outcome. We examined changes in electroencephalographic FC during the first rTMS treatment in 109 subjects treated with 10 Hz stimulation to left dorsolateral prefrontal cortex. All subjects subsequently received 30 treatments and clinical response was defined as ≥40% improvement in the inventory of depressive symptomatology-30 SR score at treatment 30. Connectivity change was assessed with coherence, envelope correlation, and a novel measure, alpha spectral correlation (αSC). Machine learning was used to develop predictive models of outcome for each connectivity measure, which were compared with prediction based upon early clinical improvement. Significant connectivity changes were associated with clinical outcome (P < 0.001). Machine learning models based on αSC yielded the most accurate prediction (area under the curve, AUC = 0.83), and performance improved when combined with early clinical improvement measures (AUC = 0.91). The initial rTMS treatment session produced robust changes in FC, which were significant predictors of clinical outcome of a full course of treatment for MDD.
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Affiliation(s)
- Juliana Corlier
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles CA 90024, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Andrew Wilson
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles CA 90024, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Aimee M Hunter
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles CA 90024, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Nikita Vince-Cruz
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles CA 90024, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - David Krantz
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles CA 90024, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Jennifer Levitt
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles CA 90024, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Michael J Minzenberg
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles CA 90024, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Nathaniel Ginder
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles CA 90024, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Ian A Cook
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles CA 90024, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA.,Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences at UCLA, Los Angeles, CA 90024, USA
| | - Andrew F Leuchter
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles CA 90024, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
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Li Y, Luo H, Yu Q, Yin L, Li K, Li Y, Fu J. Cerebral Functional Manipulation of Repetitive Transcranial Magnetic Stimulation in Cognitive Impairment Patients After Stroke: An fMRI Study. Front Neurol 2020; 11:977. [PMID: 33013646 PMCID: PMC7506052 DOI: 10.3389/fneur.2020.00977] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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: 11/09/2019] [Accepted: 07/27/2020] [Indexed: 12/12/2022] Open
Abstract
Objective: Recently, the area of repetitive transcranial magnetic stimulation (rTMS) targeting neurological rehabilitation has been advanced as a potential treatment for post-stroke cognitive impairment (PSCI). However, the underlying mechanisms remains to be elusived. This study aims to figure out cerebral functional manipulation of rTMS in patients with PSCI through using the resting-state functional magnetic resonance imaging (rs-fMRI). Methods: Thirty patients with PSCI were recruited and randomly allocated into two groups: the rTMS intervention group and control group. The rTMS intervention group was given 20 min of 5 Hz rTMS (or control) over left dorsolateral prefrontal cortex (DLPFC) besides routine cognitive intervention training for 3 consecutive weeks, five times per week, on weekdays. Cognition performance was assessed by the Minimum Mental State Examination (MMSE) and Montreal cognitive assessment (MoCA). Neural activity and functional connectivity (FC) changes were acquired by rs-fMRI with fractional amplitude of low-frequency fluctuation (fALFF) and seed-based correlation analysis. Results: Cognition improvements were observed both in rTMS intervention group and control group (P < 0.01), while the rTMS group got more significant improvent than control group (P < 0.05). To be specified, compared with the control group, the rTMS group got higher fALFF values in these brain regions including superior temporal gyrus, inferior frontal gyrus and parahippocampal gyrus, while lower fALFF values in middle temporal gyrus, middle frontal gyrus and fusiform gyrus. In addition, the rTMS group showed increased FC between LDPFC and toprecuneus, inferior temporal gyrus, middle and inferior frontal gyrus and marginal gyrus, while decreased FC between LDPFC and middle temporal gyrus and thalamus. Conclusion: The increase and decrease of neural activity and FC in cognition-related regions detected by rs-fMRI are good indicators to clarify the underlining mechanisms of rTMS on PSCI.
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Affiliation(s)
- Yamei Li
- Department of Rehabilitation Medicine, School of Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Hong Luo
- Department of Rehabilitation Medicine, School of Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Qian Yu
- Department of Rehabilitation Medicine, School of Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Longlin Yin
- Department of Radiology, School of Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Kuide Li
- Department of Radiology, School of Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yi Li
- Department of Rehabilitation Medicine, School of Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jing Fu
- Department of Rehabilitation Medicine, School of Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
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48
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Naro A, Pignolo L, Billeri L, Porcari B, Portaro S, Tonin P, Calabrò RS. A Case of Psychogenic Myoclonus Responding to a Novel Transcranial Magnetic Stimulation Approach: Rationale, Feasibility, and Possible Neurophysiological Basis. Front Hum Neurosci 2020; 14:292. [PMID: 32848667 PMCID: PMC7396578 DOI: 10.3389/fnhum.2020.00292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 04/01/2020] [Accepted: 06/29/2020] [Indexed: 01/11/2023] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) can relieve motor symptoms related to psychogenic movement disorders (PMDs), but the subtending neurophysiological basis is unclear. We report on a 50-year-old woman with a diagnosis of psychogenic myoclonus in the right lower limb, who was treated with a daily session (in the late morning/early afternoon) of 1 Hz rTMS over the left premotor cortex (PMC), five times a week for 6 weeks. Clinical data and EEG at rest were collected before and immediately and 2-month after the rTMS protocol completion. The patient reported a significant reduction of involuntary movement frequency and intensity and the related disability burden up to the follow-up. In parallel, any abnormality in terms of source current density within and connectivity between the frontal and parietal areas was reset. The short follow–up period, the lack of extensive neurophysiological measures, and the lack of control treatment represent the main limitation of the study. However, low-frequency rTMS over PMC seems a safe and promising approach for the management of psychogenic myoclonus owing to the combination of cortical neuromodulation and non-specific mechanisms suggesting cognitive-behavioral effects.
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Affiliation(s)
- Antonino Naro
- IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
| | - Loris Pignolo
- Sant'Anna Institute, Research in Advanced Neurorehabilitation (RAN), Crotone, Italy
| | - Luana Billeri
- IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
| | - Bruno Porcari
- IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
| | | | - Paolo Tonin
- Sant'Anna Institute, Research in Advanced Neurorehabilitation (RAN), Crotone, Italy
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Su H, Chen T, Zhong N, Jiang H, Du J, Xiao K, Xu D, Wang Z, Zhao M. γ-aminobutyric acid and glutamate/glutamine alterations of the left prefrontal cortex in individuals with methamphetamine use disorder: a combined transcranial magnetic stimulation-magnetic resonance spectroscopy study. Ann Transl Med 2020; 8:347. [PMID: 32355791 PMCID: PMC7186735 DOI: 10.21037/atm.2020.02.95] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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] [Indexed: 12/16/2022]
Abstract
Background GABAergic and glutamatergic neurotransmitter systems are critical in the pathophysiology of addiction and represent potential targets for repetitive transcranial magnetic stimulation (rTMS). This study aims to investigate changes in γ-aminobutyric acid (GABA) levels, the combined resonance of glutamate and glutamine (Glx) in the left dorsolateral prefrontal cortex (DLPFC), and cognitive function of patients with methamphetamine dependence following rTMS intervention, using proton magnetic resonance spectroscopy (1H MRS). Methods Fifty methamphetamine-dependent patients were randomized to a 4-week course of active or sham rTMS, with 1H MRS measurement of DLPFC GABA and Glx levels relative to n-acetyl-aspartate (NAA) and craving and cognitive function measured at baseline and post-intervention. Results We observed significant reductions of GABA/NAA concentration in the active group and Glx/NAA concentration in the group receiving sham rTMS. There was a significant association between changes in GABA concentration and problem solving/error monitoring. Conclusions The effect of rTMS on cognitive function in individuals with methamphetamine dependence may be related to changes in GABA levels in the prefrontal cortex, and warrants further investigation.
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Affiliation(s)
- Hang Su
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Tianzhen Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Na Zhong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Haifeng Jiang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Jiang Du
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Ke Xiao
- Shanghai Drug Rehabilitation Administration Bureau, Shanghai 200080, China
| | - Ding Xu
- Shanghai Drug Rehabilitation Administration Bureau, Shanghai 200080, China
| | - Zheng Wang
- Institute of Neuroscience, CAS Center for Excellence in Brain Science and Intelligence Technology, State Key laboratory of Neuroscience, CAS Key Laboratory of Primate Neurobiology, Chinese Academy of Sciences, Shanghai 200031, China.,University of Chinese Academy of Sciences, Beijing 100049, China.,CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai 200031, China
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.,CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai 200031, China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai 201108, China.,Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai 200030, China
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50
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Ishida T, Dierks T, Strik W, Morishima Y. Converging Resting State Networks Unravels Potential Remote Effects of Transcranial Magnetic Stimulation for Major Depression. Front Psychiatry 2020; 11:836. [PMID: 32973580 PMCID: PMC7468386 DOI: 10.3389/fpsyt.2020.00836] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 07/31/2020] [Indexed: 12/20/2022] Open
Abstract
Despite being a commonly used protocol to treat major depressive disorder (MDD), the underlying mechanism of repetitive transcranial magnetic stimulation (rTMS) on dorsolateral prefrontal cortex (DLPFC) remains unclear. In the current study, we investigated the resting-state fMRI data of 100 healthy subjects by exploring three overlapping functional networks associated with the psychopathologically MDD-related areas (the nucleus accumbens, amygdala, and ventromedial prefrontal cortex). Our results showed that these networks converged at the bilateral DLPFC, which suggested that rTMS over DLPFC might improve MDD by remotely modulating the MDD-related areas synergistically. Additionally, they functionally converged at the DMPFC and bilateral insula which are known to be associated with MDD. These two areas could also be potential targets for rTMS treatment. Dynamic causal modelling (DCM) and Granger causality analysis (GCA) revealed that all pairwise connections among bilateral DLPFC, DMPFC, bilateral insula, and three psychopathologically MDD-related areas contained significant causality. The DCM results also suggested that most of the functional interactions between MDD-related areas and bilateral DLPFC, DMPFC, and bilateral insula can predominantly be explained by the effective connectivity from the psychopathologically MDD-related areas to the rTMS stimulation sites. Finally, we found the conventional functional connectivity to be a more representative measure to obtain connectivity parameters compared to GCA and DCM analysis. Our research helped inspecting the convergence of the functional networks related to a psychiatry disorder. The results identified potential targets for brain stimulation treatment and contributed to the optimization of patient-specific brain stimulation protocols.
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Affiliation(s)
- Takuya Ishida
- Center for Evolutionary Cognitive Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Meguro-ku, Japan.,Department of Neuropsychiatry, Graduate School of Wakayama Medical University, Kimiidera, Japan.,Division of Systems Neuroscience of Psychopathology, Translational Research Centre, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Thomas Dierks
- Division of Systems Neuroscience of Psychopathology, Translational Research Centre, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Werner Strik
- University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Yosuke Morishima
- Division of Systems Neuroscience of Psychopathology, Translational Research Centre, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
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