1
|
Cash RFH, Udupa K, Gunraj CA, Mazzella F, Daskalakis ZJ, Wong AHC, Kennedy JL, Chen R. Influence of BDNF Val66Met polymorphism on excitatory-inhibitory balance and plasticity in human motor cortex. Clin Neurophysiol 2021; 132:2827-2839. [PMID: 34592560 DOI: 10.1016/j.clinph.2021.07.029] [Citation(s) in RCA: 3] [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: 02/10/2021] [Revised: 06/30/2021] [Accepted: 07/27/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE While previous studies showed that the single nucleotide polymorphism (Val66Met) of brain-derived neurotrophic factor (BDNF) can impact neuroplasticity, the influence of BDNF genotype on cortical circuitry and relationship to neuroplasticity remain relatively unexplored in human. METHODS Using individualised transcranial magnetic stimulation (TMS) parameters, we explored the influence of the BDNF Val66Met polymorphism on excitatory and inhibitory neural circuitry, its relation to I-wave TMS (ITMS) plasticity and effect on the excitatory/inhibitory (E/I) balance in 18 healthy individuals. RESULTS Excitatory and inhibitory indexes of neurotransmission were reduced in Met allele carriers. An E/I balance was evident, which was influenced by BDNF with higher E/I ratios in Val/Val homozygotes. Both long-term potentiation (LTP-) and depression (LTD-) like ITMS plasticity were greater in Val/Val homozygotes. LTP- but not LTD-like effects were restored in Met allele carriers by increasing stimulus intensity to compensate for reduced excitatory transmission. CONCLUSIONS The influence of BDNF genotype may extend beyond neuroplasticity to neurotransmission. The E/I balance was evident in human motor cortex, modulated by BDNF and measurable using TMS. Given the limited sample, these preliminary findings warrant further investigation. SIGNIFICANCE These novel findings suggest a broader role of BDNF genotype on neurocircuitry in human motor cortex.
Collapse
Affiliation(s)
- R F H Cash
- Division of Neurology, Department of Medicine, University of Toronto and Krembil Brain Institute, Toronto, Ontario, Canada; Melbourne Neuropsychiatry Centre, The University of Melbourne, Victoria 3010, Australia; Department of Biomedical Engineering, The University of Melbourne, Victoria 3010, Australia.
| | - K Udupa
- Division of Neurology, Department of Medicine, University of Toronto and Krembil Brain Institute, Toronto, Ontario, Canada; Dept of Neurophysiology, NIMHANS, Bengaluru, India
| | - C A Gunraj
- Division of Neurology, Department of Medicine, University of Toronto and Krembil Brain Institute, Toronto, Ontario, Canada
| | - F Mazzella
- Division of Neurology, Department of Medicine, University of Toronto and Krembil Brain Institute, Toronto, Ontario, Canada
| | - Z J Daskalakis
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, UC San Diego Health, San Diego, CA 92093, USA
| | - A H C Wong
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - J L Kennedy
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - R Chen
- Division of Neurology, Department of Medicine, University of Toronto and Krembil Brain Institute, Toronto, Ontario, Canada
| |
Collapse
|
2
|
Hill A, Zomorrodi R, Hadas I, Farzan F, Voineskos D, Throop A, Fitzgerald P, Blumberger D, Daskalakis Z. P7 Characterising functional connectivity changes following magnetic seizure therapy for major depressive disorder: A resting-state EEG analysis. Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2019.12.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
3
|
Noda Y, Barr M, Zomorrodi R, Cash R, Rajji T, Lioumis P, Chen R, Daskalakis Z, Blumberger D. Spatiotemporal characteristics of single-pulse TMS-evoked potentials from M1 and DLPFC in healthy participants and patients with schizophrenia. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
4
|
Iseger T, Vila-Rodriguez F, Padberg F, Downar J, Daskalakis Z, Blumberger D, Kenemans L, Arns M. The heart-brain pathway in depression: Optimizing TMS treatment for depression using cardiac response (Neuro-Cardiac-Guided-TMS). Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
5
|
Zomorrodi R, Rajji T, Blumberger D, Daskalakis Z. The association between cross-frequency coupling and neuroplasticity via paired associative stimulation: TMS-EEG study. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
6
|
Mulsant L, Daskalakis A, Zomorrodi R, Rajji T, Blumberger D, Daskalakis Z. The Association Between Transcranial Magnetic Stimulation Evoked Potential Response and Resting Electroencephalography. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
7
|
Moffa A, Martin D, Brunoni A, Alonzo A, Blumberger D, Bennabi D, Daskalakis Z, Fregni F, Padberg F, Palm U, Sampaio-Junior B, Loo C. Transcranial direct current stimulation for acute major depressive episodes: An updated meta-analysis of individual patient data. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
8
|
Daskalakis Z. Neurophysiological Mechanisms of rTMS Efficacy in Treatment Resistant Depression. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
9
|
Croarkin P, Lewis C, Sonmez I, Camsari DD, Daskalakis Z. Monitoring and modulating adolescent depression and suicidality. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
10
|
Dunlop K, Shen J, Woodside B, Feffer K, Blumberger D, Daskalakis Z, Giacobbe P, Downar J. Dorsomedial prefrontal rTMS as a treatment for treatment-resistant depression: A 3-arm, sham-controlled trial. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
11
|
Dhami P, Atluri S, Lee J, Knyahntska Y, Courtney D, Shim S, Voineskos A, Croarkin P, Blumberger D, Daskalakis Z, Farzan F. Youth treatment resistant depression and TMS-EEG: insight into neurophysiological alterations of inhibition, excitability, and connectivity in depressed youth prior to rTMS therapy. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
12
|
Vigod S, Murphy K, Dennis C, Oberlander T, Ray J, Daskalakis Z, Blumberger D. Transcranial direct current stimulation (tDCS) for depression in pregnancy: a pilot randomized controlled trial. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
13
|
Hui J, Zomorrodi R, Salavati B, Lioumis P, Rajji T, Blumberger D, Daskalakis Z. The Pharmacology of Interhemispheric Signal Propagation in the Motor Cortex. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
14
|
Humaira A, Gao S, Wu L, Blumberger D, Downar J, Daskalakis Z, Rodriguez FV. Are side effect trajectories during rTMS for depression associated to treatment response? Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
15
|
Ge R, Downar J, Blumberger D, Daskalakis Z, Lam R, Vila-Rodriguez F. Long-term effects of rTMS on the functional brain networks in treatment-resistant depression. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
16
|
Bailey NW, Hoy KE, Rogasch NC, Thomson RH, McQueen S, Elliot D, Sullivan CM, Fulcher BD, Daskalakis ZJ, Fitzgerald PB. Differentiating responders and non-responders to rTMS treatment for depression after one week using resting EEG connectivity measures. J Affect Disord 2019; 242:68-79. [PMID: 30172227 DOI: 10.1016/j.jad.2018.08.058] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 07/30/2018] [Accepted: 08/12/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Non-response to repetitive transcranial magnetic stimulation (rTMS) treatment for depression is costly for both patients and clinics. Simple and cheap methods to predict response would reduce this burden. Resting EEG measures differentiate responders from non-responders, so may have utility for response prediction. METHODS Fifty patients with treatment resistant depression and 21 controls had resting electroencephalography (EEG) recorded at baseline (BL). Patients underwent 5-8 weeks of rTMS treatment, with EEG recordings repeated at week 1 (W1). Forty-two participants had valid BL and W1 EEG data, and 12 were responders. Responders and non-responders were compared at BL and W1 in measures of theta (4-8 Hz) and alpha (8-13 Hz) power and connectivity, frontal theta cordance and alpha peak frequency. Control group comparisons were made for measures that differed between responders and non-responders. A machine learning algorithm assessed the potential to differentiate responders from non-responders using EEG measures in combination with change in depression scores from BL to W1. RESULTS Responders showed elevated theta connectivity across BL and W1. No other EEG measures differed between groups. Responders could be distinguished from non-responders with a mean sensitivity of 0.84 (p = 0.001) and specificity of 0.89 (p = 0.002) using cross-validated machine learning classification on the combination of all EEG and mood measures. LIMITATIONS The low response rate limited our sample size to only 12 responders. CONCLUSION Resting theta connectivity at BL and W1 differ between responders and non-responders, and show potential for predicting response to rTMS treatment for depression.
Collapse
Affiliation(s)
- N W Bailey
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, Commercial Rd, Melbourne, Victoria, Australia..
| | - K E Hoy
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, Commercial Rd, Melbourne, Victoria, Australia
| | - N C Rogasch
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton 3168, Victoria, Australia
| | - R H Thomson
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, Commercial Rd, Melbourne, Victoria, Australia
| | - S McQueen
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, Commercial Rd, Melbourne, Victoria, Australia
| | - D Elliot
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, Commercial Rd, Melbourne, Victoria, Australia
| | - C M Sullivan
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, Commercial Rd, Melbourne, Victoria, Australia
| | - B D Fulcher
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton 3168, Victoria, Australia
| | - Z J Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - P B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, Commercial Rd, Melbourne, Victoria, Australia.; Epworth Healthcare, The Epworth Clinic, Camberwell 3004, Victoria, Australia
| |
Collapse
|
17
|
Bailey NW, Hoy KE, Rogasch NC, Thomson RH, McQueen S, Elliot D, Sullivan CM, Fulcher BD, Daskalakis ZJ, Fitzgerald PB. Responders to rTMS for depression show increased fronto-midline theta and theta connectivity compared to non-responders. Brain Stimul 2018; 11:190-203. [PMID: 29128490 DOI: 10.1016/j.brs.2017.10.015] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 10/11/2017] [Accepted: 10/15/2017] [Indexed: 02/01/2023] Open
Affiliation(s)
- N W Bailey
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, Commercial Rd, Melbourne, Victoria, Australia.
| | - K E Hoy
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, Commercial Rd, Melbourne, Victoria, Australia
| | - N C Rogasch
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, 3168 VIC, Australia
| | - R H Thomson
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, Commercial Rd, Melbourne, Victoria, Australia
| | - S McQueen
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, Commercial Rd, Melbourne, Victoria, Australia
| | - D Elliot
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, Commercial Rd, Melbourne, Victoria, Australia
| | - C M Sullivan
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, Commercial Rd, Melbourne, Victoria, Australia
| | - B D Fulcher
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, 3168 VIC, Australia
| | - Z J Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - P B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, Commercial Rd, Melbourne, Victoria, Australia; Epworth Healthcare, The Epworth Clinic, Camberwell, 3004, Victoria, Australia
| |
Collapse
|
18
|
Blumberger DM, Seitz DP, Herrmann N, Kirkham JG, Ng R, Reimer C, Kurdyak P, Gruneir A, Rapoport MJ, Daskalakis ZJ, Mulsant BH, Vigod SN. Low medical morbidity and mortality after acute courses of electroconvulsive therapy in a population-based sample. Acta Psychiatr Scand 2017; 136:583-593. [PMID: 28922451 DOI: 10.1111/acps.12815] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND To determine event rates for specific medical events and mortality among individuals receiving electroconvulsive therapy (ECT). METHOD Population-based cohort study using health administrative data of acute ECT treatments delivered in Ontario, Canada, from 2003 to 2011. We measured the following medical event rates, per 10 000 ECT treatments, up to 7 and 30 days post-treatment: stroke, seizure, acute myocardial infarction, arrhythmia, pneumonia, pulmonary embolus, deep vein thrombosis, gastrointestinal bleeding, falls, hip fracture, and mortality. RESULTS A total of 135 831 ECT treatments were delivered to 8810 unique patients. Overall medical event rates were 9.1 and 16.8 per 10 000 ECT treatments respectively. The most common medical events were falls (2.7 and 5.5 per 10 000 ECT treatments) and pneumonia (1.8 and 3.8 per 10 000 ECT treatments). Fewer than six deaths occurred on the day of an ECT treatment. This corresponded to a mortality rate of less than 0.4 per 10 000 treatments. Deaths within 7 and 30 days of an ECT treatment, excluding deaths due to external causes (e.g., accidental and intentional causes of death), were 1.0 and 2.4 per 10 000 ECT treatments respectively. CONCLUSION Morbidity and mortality events after ECT treatments were relatively low, supporting ECT as a low-risk medical procedure.
Collapse
Affiliation(s)
- D M Blumberger
- Centre for Addiction and Mental Health, Campbell Family Research Institute, Toronto, ON, Canada.,Faculty of Medicine, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - D P Seitz
- Department of Psychiatry, Providence Care Mental Health Services, Queen's University, Kingston, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - N Herrmann
- Faculty of Medicine, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - J G Kirkham
- Department of Psychiatry, Providence Care Mental Health Services, Queen's University, Kingston, ON, Canada
| | - R Ng
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - C Reimer
- Department of Anesthesia, Providence Care Mental Health Services, Queen's University, Kingston, ON, Canada
| | - P Kurdyak
- Centre for Addiction and Mental Health, Campbell Family Research Institute, Toronto, ON, Canada.,Faculty of Medicine, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - A Gruneir
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Alberta, Edmonton, AB, Canada
| | - M J Rapoport
- Faculty of Medicine, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Z J Daskalakis
- Centre for Addiction and Mental Health, Campbell Family Research Institute, Toronto, ON, Canada.,Faculty of Medicine, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - B H Mulsant
- Centre for Addiction and Mental Health, Campbell Family Research Institute, Toronto, ON, Canada.,Faculty of Medicine, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - S N Vigod
- Faculty of Medicine, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.,Women's College Hospital and Research Institute, Toronto, ON, Canada
| |
Collapse
|
19
|
Noda Y, Barr M, Zomorrodi R, Cash R, Rajji T, Chen R, Daskalakis Z, Blumberger D. P279 Short-latency afferent inhibition from the dorsolateral prefrontal cortex in patients with schizophrenia: A TMS-EEG study. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2016.10.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
20
|
Veronezi BP, Moffa AH, Carvalho AF, Galhardoni R, Simis M, Benseñor IM, Lotufo PA, Machado-Vieira R, Daskalakis ZJ, Brunoni AR. Evidence for increased motor cortical facilitation and decreased inhibition in atypical depression. Acta Psychiatr Scand 2016; 134:172-82. [PMID: 27028276 DOI: 10.1111/acps.12565] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/10/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Major depressive disorder (MDD) is a clinically heterogeneous condition. However, the role of cortical glutamate and gamma-aminobutyric acid (GABA) receptor-mediated activity, implicated in MDD pathophysiology, has not been explored in different MDD subtypes. Our aim was to assess the atypical and melancholic depression subtypes regarding potential differences in GABA and glutamate receptor-mediated activity through established transcranial magnetic stimulation (TMS) neurophysiological measures from the motor cortex. METHOD We evaluated 81 subjects free of antidepressant medication, including 21 healthy controls and 20 patients with atypical, 20 with melancholic, and 20 with undifferentiated MDD. Single and paired-pulse TMS paradigms were used to evaluate intracortical facilitation (ICF), cortical silent period (CSP), and short intracortical inhibition (SICI), which index glutamate, GABAB receptor-, and GABAA receptor-mediated activity respectively. RESULTS Patients with MDD demonstrated significantly decreased mean CSP values than healthy controls (Cohen's d = 0.22-0.3, P < 0.01 for all comparisons). Atypical depression presented a distinct cortical excitability pattern of decreased cortical inhibition and increased cortical facilitation, that is, an increased mean ICF and SICI ratios than other depression subtypes (d = 0.22-0.33, P < 0.01 for all comparisons). CONCLUSION Different MDD subtypes may demonstrate different neurophysiology in relation to GABAA and glutamatergic activity. TMS as an investigational tool might be useful to distinguish between different MDD subtypes.
Collapse
Affiliation(s)
- B P Veronezi
- Interdisciplinary Center for Applied Neuromodulation, University Hospital, University of Sao Paulo, São Paulo, Brazil
| | - A H Moffa
- Interdisciplinary Center for Applied Neuromodulation, University Hospital, University of Sao Paulo, São Paulo, Brazil
| | - A F Carvalho
- Department of Psychiatry and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, Ceara, Brazil
| | - R Galhardoni
- Service of Interdisciplinary Neuromodulation, Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.,School of Arts, Science and Humanities, University of São Paulo, São Paulo, Brazil.,Pain Center, Department of Neurology, University of São Paulo, São Paulo, Brazil.,Medicine School of University City of São Paulo (UNICID), São Paulo, Brazil
| | - M Simis
- Institute of Physical Medicine and Rehabilitation, Clinics Hospital of the University of Sao Paulo Medical School, São Paulo, Brazil
| | - I M Benseñor
- Interdisciplinary Center for Applied Neuromodulation, University Hospital, University of Sao Paulo, São Paulo, Brazil
| | - P A Lotufo
- Interdisciplinary Center for Applied Neuromodulation, University Hospital, University of Sao Paulo, São Paulo, Brazil
| | - R Machado-Vieira
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health (NIH), Bethesda, MD, USA
| | - Z J Daskalakis
- Temerty Centre for Therapeutic Brain Intervention and Campbell Family Research Institute, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - A R Brunoni
- Interdisciplinary Center for Applied Neuromodulation, University Hospital, University of Sao Paulo, São Paulo, Brazil.,Service of Interdisciplinary Neuromodulation, Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
21
|
Krystal JH, Abi-Dargham A, Akbarian S, Arnsten AFT, Barch DM, Bearden CE, Braff DL, Brown ES, Bullmore ET, Carlezon WA, Carter CS, Cook EH, Daskalakis ZJ, DiLeone RJ, Duman RS, Grace AA, Hariri AR, Harrison PJ, Hiroi N, Kenny PJ, Kleinman JE, Krystal AD, Lewis DA, Lipska BK, Marder SR, Mason GF, Mathalon DH, McClung CA, McDougle CJ, McIntosh AM, McMahon FJ, Mirnics K, Monteggia LM, Narendran R, Nestler EJ, Neumeister A, O’Donovan MC, Öngür D, Pariante CM, Paulus MP, Pearlson G, Phillips ML, Pine DS, Pizzagalli DA, Pletnikov MV, Ragland JD, Rapoport JL, Ressler KJ, Russo SJ, Sanacora G, Sawa A, Schatzberg AF, Shaham Y, Shamay-Tsoory SG, Sklar P, State MW, Stein MB, Strakowski SM, Taylor SF, Turecki G, Turetsky BI, Weissman MM, Zachariou V, Zarate CA, Zubieta JK. Constance E. Lieber, Theodore R. Stanley, and the Enduring Impact of Philanthropy on Psychiatry Research. Biol Psychiatry 2016; 80:84-86. [PMID: 27346079 PMCID: PMC6150945 DOI: 10.1016/j.biopsych.2016.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 05/09/2016] [Accepted: 05/09/2016] [Indexed: 10/21/2022]
Affiliation(s)
- JH Krystal
- Department of Psychiatry and Neuroscience, Yale University School of Medicine, New Haven, Connecticut; Behavioral Health Services, Yale New Haven Hospital, New Haven, Connecticut; Clinical Neuroscience Division, VA Connecticut Healthcare System, West Haven, Connecticut; Departments of Psychiatry and Radiology, Columbia University, New York, New York.
| | - A Abi-Dargham
- The New York State Psychiatric Institute, New York, New York
| | - S Akbarian
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - AFT Arnsten
- Department of Psychiatry and Neuroscience, Yale University School of Medicine, New Haven, Connecticut; Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| | - DM Barch
- Departments of Psychology and Radiology, Washington University in St. Louis, St. Louis, Missouri
| | - CE Bearden
- Departments of Psychiatry and Psychology and the Brain Research Institute, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California
| | - DL Braff
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - ES Brown
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - ET Bullmore
- Department of Psychiatry and Behavioral and Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom; ImmunoPsychiatry, GlaxoSmithKline, Cambridge, United Kingdom
| | - WA Carlezon
- Department of Psychiatry and Neuroscience, Harvard Medical School, McLean Hospital, Belmont, Massachusetts
| | - CS Carter
- Department of Psychiatry and Behavioral Sciences, Imaging Research Center, and Center for Neuroscience, University of California at Davis, Davis, California
| | - EH Cook
- Institute of Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - ZJ Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Mood and Anxiety Division Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - RJ DiLeone
- Department of Psychiatry, Yale University, New Haven, Connecticut
| | - RS Duman
- Department of Psychiatry and Neuroscience, Yale University School of Medicine, New Haven, Connecticut
| | - AA Grace
- Departments of Neuroscience, Psychiatry, and Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - AR Hariri
- Department of Psychology & Neuroscience, Duke University, Durham, North Carolina
| | - PJ Harrison
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - N Hiroi
- Departments of Psychiatry and Behavioral Sciences, Neuroscience, and Genetics, Albert Einstein College of Medicine, Bronx, New York
| | - PJ Kenny
- Department of Pharmacology & Systems Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - JE Kleinman
- Genetic Neuropathology Section, Lieber Institute for Brain Development, and Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - AD Krystal
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
| | - DA Lewis
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - BK Lipska
- Human Brain Collection Core, Division of Intramural Research Programs, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - SR Marder
- Semel Institute for Neuroscience, University of California at Los Angeles, Los Angeles, California; VA Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, California
| | - GF Mason
- Departments of Radiology & Biomedical Imaging and Psychiatry, Yale University, School of Medicine, New Haven, Connecticut
| | - DH Mathalon
- Department of Psychiatry, University of California at San Francisco, San Francisco, California; Psychiatry Service, San Francisco VA Medical Center, San Francisco, California
| | - CA McClung
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - CJ McDougle
- Massachusetts General Hospital and MassGeneral Hospital for Children, Lurie Center for Autism, Lexington, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - AM McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - FJ McMahon
- Human Genetics Branch and Genetic Basis of Mood and Anxiety Disorders Section, National Institute of Mental Health, Intramural Research Program, Bethesda, Maryland
| | - K Mirnics
- Department of Psychiatry, Vanderbilt University, Nashville, Tennessee
| | - LM Monteggia
- Department of Neuroscience, University of Texas Southwestern Medical Center, Dallas, Texas
| | - R Narendran
- Departments of Radiology and Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - EJ Nestler
- Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - A Neumeister
- Mitsubishi Tanabe Pharma Development America, Inc., Jersey City, New Jersey
| | - MC O’Donovan
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
| | - D Öngür
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - CM Pariante
- Departments of Psychology and Neuroscience, Institute of Psychiatry, King’s College London, London, United Kingdom; Psychiatry and Immunology Lab & Perinatal Psychiatry, The Maurice Wohl Clinical Neuroscience Institute, London, United Kingdom
| | - MP Paulus
- Laureate Institute for Brain Research, Tulsa, Oklahoma
| | - G Pearlson
- Departments of Psychiatry and Neurobiology, Yale University and Olin Neuropsychiatric Research Center, Hartford, Connecticut
| | - ML Phillips
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - DS Pine
- National Institute of Mental Health, Intramural Research Program, Bethesda, Maryland
| | - DA Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; McLean Imaging Center, McLean Hospital, Belmont, Massachusetts
| | - MV Pletnikov
- Departments of Neuroscience and Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - JD Ragland
- Department of Psychiatry and Behavioral Sciences, Imaging Research Center, University of California at Davis, Sacramento, California
| | - JL Rapoport
- Child Psychiatry Branch, Division of Intramural Research, National Institute of Mental Health, Bethesda, Maryland
| | - KJ Ressler
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - SJ Russo
- Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - G Sanacora
- Department of Psychiatry, Yale University, New Haven, Connecticut
| | - A Sawa
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - AF Schatzberg
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Y Shaham
- Behavioral Neuroscience Branch, NIDA-IRP, Baltimore, Maryland
| | - SG Shamay-Tsoory
- Department of Psychology, University of Haifa, Mount Carmel, Haifa, Israel
| | - P Sklar
- Division of Psychiatric Genomics, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - MW State
- Department of Psychiatry, University of California at San Francisco, San Francisco, California
| | - MB Stein
- Departments of Psychiatry and Family Medicine & Public Health, School of Medicine, University of California at San Diego, La Jolla, California
| | - SM Strakowski
- Department of Psychiatry, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - SF Taylor
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - G Turecki
- Department of Psychiatry, McGill University, Montreal, Canada
| | - BI Turetsky
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - MM Weissman
- New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York
| | - V Zachariou
- Fishberg Department of Neuroscience, Mount Sinai School of Medicine, New York, New York
| | - CA Zarate
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - JK Zubieta
- Department of Psychiatry, University Neuropsychiatric Institute, University of Utah Health Sciences Center, Salt Lake City, Utah
| |
Collapse
|
22
|
Noda Y, Silverstein WK, Barr MS, Vila-Rodriguez F, Downar J, Rajji TK, Fitzgerald PB, Mulsant BH, Vigod SN, Daskalakis ZJ, Blumberger DM. Neurobiological mechanisms of repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex in depression: a systematic review. Psychol Med 2015; 45:3411-3432. [PMID: 26349810 DOI: 10.1017/s0033291715001609] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Depression is one of the most prevalent mental illnesses worldwide and a leading cause of disability, especially in the setting of treatment resistance. In recent years, repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising alternative strategy for treatment-resistant depression and its clinical efficacy has been investigated intensively across the world. However, the underlying neurobiological mechanisms of the antidepressant effect of rTMS are still not fully understood. This review aims to systematically synthesize the literature on the neurobiological mechanisms of treatment response to rTMS in patients with depression. Medline (1996-2014), Embase (1980-2014) and PsycINFO (1806-2014) were searched under set terms. Three authors reviewed each article and came to consensus on the inclusion and exclusion criteria. All eligible studies were reviewed, duplicates were removed, and data were extracted individually. Of 1647 articles identified, 66 studies met both inclusion and exclusion criteria. rTMS affects various biological factors that can be measured by current biological techniques. Although a number of studies have explored the neurobiological mechanisms of rTMS, a large variety of rTMS protocols and parameters limits the ability to synthesize these findings into a coherent understanding. However, a convergence of findings suggest that rTMS exerts its therapeutic effects by altering levels of various neurochemicals, electrophysiology as well as blood flow and activity in the brain in a frequency-dependent manner. More research is needed to delineate the neurobiological mechanisms of the antidepressant effect of rTMS. The incorporation of biological assessments into future rTMS clinical trials will help in this regard.
Collapse
Affiliation(s)
- Y Noda
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health,Toronto,Ontario,Canada
| | - W K Silverstein
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health,Toronto,Ontario,Canada
| | - M S Barr
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health,Toronto,Ontario,Canada
| | - F Vila-Rodriguez
- Non-Invasive Neurostimulation Therapies Laboratory,Department of Psychiatry,Faculty of Medicine,University of British Columbia,Vancouver,British Columbia,Canada
| | - J Downar
- Department of Psychiatry,University of Toronto,Toronto,Ontario,Canada
| | - T K Rajji
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health,Toronto,Ontario,Canada
| | - P B Fitzgerald
- Monash Alfred Psychiatry Research Centre,The Alfred and Monash University Central Clinical School,Melbourne,Victoria,Australia
| | - B H Mulsant
- Department of Psychiatry,University of Toronto,Toronto,Ontario,Canada
| | - S N Vigod
- Department of Psychiatry,University of Toronto,Toronto,Ontario,Canada
| | - Z J Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health,Toronto,Ontario,Canada
| | - D M Blumberger
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health,Toronto,Ontario,Canada
| |
Collapse
|
23
|
Rossini PM, Burke D, Chen R, Cohen LG, Daskalakis Z, Di Iorio R, Di Lazzaro V, Ferreri F, Fitzgerald PB, George MS, Hallett M, Lefaucheur JP, Langguth B, Matsumoto H, Miniussi C, Nitsche MA, Pascual-Leone A, Paulus W, Rossi S, Rothwell JC, Siebner HR, Ugawa Y, Walsh V, Ziemann U. Non-invasive electrical and magnetic stimulation of the brain, spinal cord, roots and peripheral nerves: Basic principles and procedures for routine clinical and research application. An updated report from an I.F.C.N. Committee. Clin Neurophysiol 2015; 126:1071-1107. [PMID: 25797650 PMCID: PMC6350257 DOI: 10.1016/j.clinph.2015.02.001] [Citation(s) in RCA: 1684] [Impact Index Per Article: 187.1] [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: 12/30/2014] [Revised: 01/22/2015] [Accepted: 02/01/2015] [Indexed: 12/14/2022]
Abstract
These guidelines provide an up-date of previous IFCN report on “Non-invasive electrical and magnetic stimulation of the brain, spinal cord and roots: basic principles and procedures for routine clinical application” (Rossini et al., 1994). A new Committee, composed of international experts, some of whom were in the panel of the 1994 “Report”, was selected to produce a current state-of-the-art review of non-invasive stimulation both for clinical application and research in neuroscience. Since 1994, the international scientific community has seen a rapid increase in non-invasive brain stimulation in studying cognition, brain–behavior relationship and pathophysiology of various neurologic and psychiatric disorders. New paradigms of stimulation and new techniques have been developed. Furthermore, a large number of studies and clinical trials have demonstrated potential therapeutic applications of non-invasive brain stimulation, especially for TMS. Recent guidelines can be found in the literature covering specific aspects of non-invasive brain stimulation, such as safety (Rossi et al., 2009), methodology (Groppa et al., 2012) and therapeutic applications (Lefaucheur et al., 2014). This up-dated review covers theoretical, physiological and practical aspects of non-invasive stimulation of brain, spinal cord, nerve roots and peripheral nerves in the light of more updated knowledge, and include some recent extensions and developments.
Collapse
Affiliation(s)
- P M Rossini
- Institute of Neurology, Department of Geriatrics, Neuroscience and Orthopedics, Catholic University, Policlinic A. Gemelli, Rome, Italy
| | - D Burke
- Department of Neurology, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia
| | - R Chen
- Division of Neurology, Toronto Western Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - L G Cohen
- Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA
| | - Z Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - R Di Iorio
- Institute of Neurology, Department of Geriatrics, Neuroscience and Orthopedics, Catholic University, Policlinic A. Gemelli, Rome, Italy.
| | - V Di Lazzaro
- Department of Neurology, University Campus Bio-medico, Rome, Italy
| | - F Ferreri
- Department of Neurology, University Campus Bio-medico, Rome, Italy; Department of Clinical Neurophysiology, University of Eastern Finland, Kuopio, Finland
| | - P B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and The Alfred, Melbourne, Australia
| | - M S George
- Medical University of South Carolina, Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - M Hallett
- Human Motor Control Section, Medical Neurology Branch, NINDS, NIH, Bethesda, MD, USA
| | - J P Lefaucheur
- Department of Physiology, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris, Créteil, France; EA 4391, Nerve Excitability and Therapeutic Team, Faculty of Medicine, Paris Est Créteil University, Créteil, France
| | - B Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - H Matsumoto
- Department of Neurology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - C Miniussi
- Department of Clinical and Experimental Sciences University of Brescia, Brescia, Italy; IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - M A Nitsche
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Georg-August-University, Göttingen, Germany
| | - A Pascual-Leone
- Berenson-Allen Center for Non-invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - W Paulus
- Department of Clinical Neurophysiology, Georg-August University, Göttingen, Germany
| | - S Rossi
- Brain Investigation & Neuromodulation Lab, Unit of Neurology and Clinical Neurophysiology, Department of Neuroscience, University of Siena, Siena, Italy
| | - J C Rothwell
- Institute of Neurology, University College London, London, United Kingdom
| | - H R Siebner
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Y Ugawa
- Department of Neurology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - V Walsh
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - U Ziemann
- Department of Neurology & Stroke, and Hertie Institute for Clinical Brain Research, Eberhard Karls University, Tübingen, Germany
| |
Collapse
|
24
|
Berlim MT, van den Eynde F, Tovar-Perdomo S, Daskalakis ZJ. Response, remission and drop-out rates following high-frequency repetitive transcranial magnetic stimulation (rTMS) for treating major depression: a systematic review and meta-analysis of randomized, double-blind and sham-controlled trials. Psychol Med 2014; 44:225-239. [PMID: 23507264 DOI: 10.1017/s0033291713000512] [Citation(s) in RCA: 330] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Meta-analyses have shown that high-frequency (HF) repetitive transcranial magnetic stimulation (rTMS) has antidepressant properties when compared with sham rTMS. However, its overall response and remission rates in major depression (MD) remain unclear. Thus, we have systematically and quantitatively assessed the efficacy of HF-rTMS for MD based on randomized, double-blind and sham-controlled trials (RCTs). METHOD We searched the literature from 1995 through to July 2012 using MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, SCOPUS, and ProQuest Dissertations & Theses. We used a random-effects model, odds ratios (ORs) and the number needed to treat (NNT). RESULTS Data from 29 RCTs were included, totaling 1371 subjects with MD. Following approximately 13 sessions, 29.3% and 18.6% of subjects receiving HF-rTMS were classified as responders and remitters, respectively (compared with 10.4% and 5% of those receiving sham rTMS). The pooled OR was 3.3 (p < 0.0001) for both response and remission rates (with associated NNTs of 6 and 8, respectively). Furthermore, we found HF-rTMS to be equally effective as an augmentation strategy or as a monotherapy for MD, and when used in samples with primary unipolar MD or in mixed samples with unipolar and bipolar MD. Also, alternative stimulation parameters were not associated with differential efficacy estimates. Moreover, baseline depression severity and drop-out rates at study end were comparable between the HF-rTMS and sham rTMS groups. Finally, heterogeneity between the included RCTs was not statistically significant. CONCLUSIONS HF-rTMS seems to be associated with clinically relevant antidepressant effects and with a benign tolerability profile.
Collapse
Affiliation(s)
- M T Berlim
- Neuromodulation Research Clinic, Douglas Mental Health University Institute and McGill University, Montréal, Québec, Canada
| | - F van den Eynde
- Neuromodulation Research Clinic, Douglas Mental Health University Institute and McGill University, Montréal, Québec, Canada
| | - S Tovar-Perdomo
- Neuromodulation Research Clinic, Douglas Mental Health University Institute and McGill University, Montréal, Québec, Canada
| | - Z J Daskalakis
- Brain Stimulation Treatment and Research Program, Centre for Addiction and Mental Health and University of Toronto, Ontario, Canada
| |
Collapse
|
25
|
Berlim MT, Van den Eynde F, Daskalakis ZJ. A systematic review and meta-analysis on the efficacy and acceptability of bilateral repetitive transcranial magnetic stimulation (rTMS) for treating major depression. Psychol Med 2013; 43:2245-2254. [PMID: 23200131 DOI: 10.1017/s0033291712002802] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Bilateral repetitive magnetic stimulation (rTMS) is a promising novel therapeutic intervention for major depression (MD). However, clinical trials to date have reported conflicting evidence concerning its overall efficacy, which might have resulted from low statistical power. Thus, meta-analytical approaches could be useful in examining this issue by allowing the integration of findings from multiple studies and thus producing more accurate estimates of the treatment effect. METHOD We searched the literature for randomized, double-blind and sham-controlled trials (RCTs) on bilateral rTMS for treating MD from 1995 to July 2012 using EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, SCOPUS, and ProQuest Dissertations and Theses, and from October 2008 until May 2012 using Medline. The main outcome measures were response and remission rates. We used a random-effects model, odds ratios (ORs) and the number needed to treat. RESULTS Data were obtained from seven RCTs, totaling 279 subjects with MD. After an average of 12.9 (s.d. = 2.7) sessions, 24.7% (40/162) and 6.8% (8/117) of subjects receiving active bilateral rTMS and sham rTMS were classified as responders [OR 4.3, 95% confidence interval (CI) 1.95-9.52, p < 0.0001]. Also, 19% (23/121) and 2.6% (2/77) of subjects were remitters following active bilateral rTMS and sham rTMS, respectively (OR 6.0, 95% CI 1.65-21.8, p = 0.006). No difference between baseline mean depression scores for the bilateral and sham rTMS groups was found, and the former was comparable with the latter in terms of drop-out rates at study end. Furthermore, we did not find significant differences efficacy- and acceptability-wise between active bilateral and unilateral rTMS at study end. Finally, heterogeneity between the included RCTs was not significant, and the risk of publication bias was found to be low. CONCLUSIONS Bilateral rTMS is a promising treatment for MD as it provides clinically meaningful benefits that are comparable with those of standard antidepressants and unilateral rTMS. Furthermore, bilateral rTMS seems to be an acceptable treatment for depressed subjects.
Collapse
Affiliation(s)
- M T Berlim
- Neuromodulation Research Clinic, Douglas Mental Health University Institute and McGill University, Montréal, Québec, Canada
| | | | | |
Collapse
|
26
|
Daskalakis Z. IS 33. NBS in schizophrenia. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.04.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
27
|
Slotema CW, Aleman A, Daskalakis ZJ, Sommer IE. Meta-analysis of repetitive transcranial magnetic stimulation in the treatment of auditory verbal hallucinations: update and effects after one month. Schizophr Res 2012; 142:40-5. [PMID: 23031191 DOI: 10.1016/j.schres.2012.08.025] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 08/20/2012] [Accepted: 08/28/2012] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Several meta-analyses considering repetitive transcranial magnetic stimulation (rTMS) for auditory verbal hallucinations (AVH) have been performed with moderate to high mean weighted effect sizes. Since then several negative findings were reported in relatively large samples. The aim of this study was to provide an update of the literature on the efficacy of rTMS for AVH and to investigate the effect of rTMS one month after the end of treatment. DATA SOURCES A literature search was performed from 1966 through August 2012 using Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Embase Psychiatry, Ovid Medline, PsycINFO and PubMed. Randomized, double blind, sham-controlled studies with severity of AVH or severity of psychosis as an outcome measure were included. STUDY SELECTION Data were obtained from 17 randomized studies of rTMS for AVH. Five studies fulfilled the criteria for the meta-analysis on the effect of rTMS one month after the end of treatment. DATA EXTRACTION Standardized mean weighted effect sizes of rTMS versus sham were computed on pre- and posttreatment comparisons. DATA SYNTHESIS The mean weighted effect size of rTMS directed at the left temporoparietal area was 0.44 (95% CI 0.19-0.68). A separate meta-analysis including studies directing rTMS at other brain regions revealed a mean weighted effect size of 0.33 (95% CI 0.17-0.50) in favor of real TMS. The effect of rTMS was no longer significant at one month of follow-up (mean weighted effect size=0.40, 95% CI -0.23-0.102). Side effects were mild and the number of dropouts in the real TMS group was not significantly higher than in the sham group. CONCLUSIONS With the inclusion of studies with larger patient samples, the mean weighted effect size of rTMS directed at the left temporoparietal area for AVH has decreased, although the effect is still significant. The duration of the effect of rTMS may be less than one month. More research is needed in order to optimize parameters and further evaluate the clinical relevance of this intervention.
Collapse
Affiliation(s)
- C W Slotema
- Parnassia Bavo Psychiatric Institute, Lijnbaan 4, 2512 VA The Hague, The Netherlands.
| | | | | | | |
Collapse
|
28
|
Fitzgerald PB, Hoy K, Gunewardene R, Slack C, Ibrahim S, Bailey M, Daskalakis ZJ. A randomized trial of unilateral and bilateral prefrontal cortex transcranial magnetic stimulation in treatment-resistant major depression. Psychol Med 2011; 41:1187-1196. [PMID: 20925972 DOI: 10.1017/s0033291710001923] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although several studies have reported that repetitive transcranial magnetic stimulation (rTMS) treatment has demonstrable efficacy in patients with depression, the parameters needed to optimize therapeutic efficacy remain unclear. To this end we determined the efficacy of low-frequency right rTMS to the dorsolateral prefrontal cortex (DLPFC) compared to two forms of bilateral rTMS to the DLPFC: (1) sequential low-frequency right-sided followed by high-frequency left-sided rTMS and (2) sequential low-frequency rTMS to both hemispheres. METHOD A total of 219 patients with treatment-resistant depression (TRD) were randomized to a 4-week course of rTMS applied with one of the three treatment conditions. Outcomes were assessed with standard rating scales. RESULTS Overall, slightly more than 50% of the patients achieved clinical response criteria. There was no substantial difference in response between the unilateral and bilateral treatment groups. Successful response to rTMS was predicted by a greater degree of baseline depression severity. CONCLUSIONS There is no substantial difference in efficacy between unilateral right-sided rTMS and the two forms of bilateral rTMS assessed in the study. Furthermore, our results call into question the specificity between frequency and laterality and rTMS response.
Collapse
Affiliation(s)
- P B Fitzgerald
- The Alfred and Monash University School of Psychology and Psychiatry, Melbourne, Victoria, Australia.
| | | | | | | | | | | | | |
Collapse
|
29
|
Barr MS, Farzan F, Tran LC, Chen R, Fitzgerald PB, Daskalakis ZJ. Evidence for excessive frontal evoked gamma oscillatory activity in schizophrenia during working memory. Schizophr Res 2010; 121:146-52. [PMID: 20598857 DOI: 10.1016/j.schres.2010.05.023] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2010] [Revised: 05/18/2010] [Accepted: 05/19/2010] [Indexed: 10/19/2022]
Abstract
Gamma (gamma) oscillations (30-50 Hz) elicited during working memory (WM) are altered in schizophrenia (SCZ). However, the nature of the relationship between evoked frontal oscillatory activity, WM performance and symptom severity has yet to be ascertained. This study had two objectives. First, to extend previous studies by examining delta, theta, alpha, beta, and gamma (delta, theta, alpha, beta, and gamma) oscillatory activities during the N-back task in SCZ patients compared to healthy subjects; second, to evaluate the relationship between oscillatory activities elicited during the N-back, performance, and clinical symptoms in SCZ patients. Patients with SCZ elicited excessive frontal gamma oscillatory activity that was most pronounced in the 3-back condition compared to healthy subjects. Reduced frontal beta activity at all WM loads was also observed in patients with SCZ compared to healthy subjects. Task performance was inversely correlated with negative symptoms but not with positive symptoms. Our findings suggest that evoked frontal oscillatory activities during WM are selectively altered in the gamma and beta frequency bands that may contribute to WM impairment in SCZ patients. These findings may provide important insights into the pathophysiology underlying WM deficits, its relationship to negative symptoms and may represent a potential neurobiological marker for cognitive enhancing strategies in SCZ.
Collapse
Affiliation(s)
- M S Barr
- Schizophrenia Program, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | | | | | | | | | | |
Collapse
|
30
|
Abstract
OBJECTIVE To identify possible differences in the mean midsagittal corpus callosum (CC) total and subdivision areas in treatment-resistant schizophrenia and depression (TRS and TRD) patients. METHOD Areas of the total CC and its five equidistant subregions (from CC1 to CC5) obtained by parallel grid partitioning schemes were manually segmented from brain MRI of 42 TRS, 45 TRD patients and 30 healthy controls. The intracranial volume (ICV) normalized areas were calculated and compared between groups. RESULTS When compared with controls, patients with TRS had reduced ICV and a larger CC5, and TRD patients had a smaller CC4 while no significant difference in CC total area in patients with TRS or TRD was found. Multiple individual segments and total CC areas were significantly larger in TRS than TRD patients after normalization. CONCLUSION Patients with TRS and TRD have different CC morphological characteristics, and therefore there may be aberrant interhemispheric connectivity in schizophrenia and major depressive disorder patients.
Collapse
Affiliation(s)
- J Sun
- Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | | | | | | | | |
Collapse
|
31
|
Cooper NR, Fitzgerald PB, Croft RJ, Upton DJ, Segrave RA, Daskalakis ZJ, Kulkarni J. Effects of rTMS on an auditory oddball task: a pilot study of cortical plasticity and the EEG. Clin EEG Neurosci 2008; 39:139-43. [PMID: 18751563 DOI: 10.1177/155005940803900308] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The objective of this study was to explore the effects of 1Hz repetitive transcranial magnetic stimulation (rTMS) applied to dorsal lateral prefrontal cortex (DLPFC) on both an EEG index of cortical excitation and inhibition, event-related desynchronization/ synchronization (ERDIS) and on the P300 component of an auditory oddball-induced ERP. Eight normal participants received 15 minutes of 1Hz rTMS at 110% of the resting motor threshold to right DLPFC. ERDIS of alpha and beta bands was measured during an auditory oddball task immediately before and after stimulation. There was significantly less alpha desynchronization post-TMS, and this effect was widespread excepting posterior midline sites. No changes were found to oddball-P300 amplitudes or latencies. In conclusion, the findings of less alpha desynchronization post-TMS are compatible with notions of slow rTMS causing a decrease in cortical excitation.
Collapse
Affiliation(s)
- N R Cooper
- Alfred Psychiatry Research Centre, Department of Psychological Medicine, Monash University, Melbourne, Australia
| | | | | | | | | | | | | |
Collapse
|
32
|
Daskalakis Z, Moller B, Gunraj C, Chen R. FC40.1 The effects of repetitive transcranial magnetic stimulation on cortical inhibition in healthy human subjects. Clin Neurophysiol 2006. [DOI: 10.1016/j.clinph.2006.06.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
33
|
Abstract
A considerable body of imaging research has demonstrated morphological changes in the corpus callosum (CC) of patients with schizophrenia. Transcranial magnetic stimulation (TMS) allows the possibility for the in vivo investigation of a variety of aspects of brain function including the spread of information across the CC. We aimed to investigate whether patients with schizophrenia demonstrate abnormalities of transcallosal inhibition (TCI), a TMS parameter measured with both single and paired pulse experiments. 25 patients with DSM-IV schizophrenia and 20 normal volunteers participated in the study. Electromyographic (EMG) recordings from the bilateral abductor pollicis brevis (APB) muscle were made during focal TMS stimulation to the motor cortex. Experimental paradigms were utilised to measure both the timing and degree of the effect of TCI. The patient group demonstrated a reduction in the degree of TCI at rest and during a sustained muscle contraction. TCI commenced at the same time in the patient and the control group but was of prolonged duration in the patient group although the length of TCI correlated with medication dose. Patients with schizophrenia demonstrate a reduction in the degree of TCI that appeared independent of medication dose. The latency of TCI is not altered in the patient group suggesting that cortical inhibitory mechanisms, rather than corpus callosal ones, are likely to be the cause of these TCI alterations.
Collapse
Affiliation(s)
- P B Fitzgerald
- Dandenong Psychiatry Research Centre, Monash University and Dandenong Area Mental Health Service, P.O. Box 956, Dandenong, Vic. 3175, Australia.
| | | | | | | | | |
Collapse
|
34
|
Abstract
OBJECTIVE Over recent years transcranial magnetic stimulation (TMS) has become widely applied in the study of neuropsychiatric disorders. The aim of this article is to review the application of TMS as an investigative tool and as a potential therapeutic modality in psychiatric disorders. METHOD A comprehensive literature review. RESULTS When applied as an investigative tool, TMS provides innovative ways to directly study the excitability of the cortex, cortical regional connectivity, the plasticity of brain responses and cognitive functioning in illness and disease states. A number of studies suggest the potential of treatment with TMS in disease states, especially in patients with depression, although difficulties exist with the interpretation of the published literature. CONCLUSION TMS has a considerable role in neuropsychiatric research. It appears to have considerable potential as a therapeutic tool in depression, and perhaps a role in several other disorders, although widespread application requires larger trials and establishment of sustained response.
Collapse
Affiliation(s)
- P B Fitzgerald
- Dandenong Psychiatry Research Centre, Department of Psychological Medicine, Monash University, PO Box 956, Dandenong, Victoria 3175, Australia.
| | | | | |
Collapse
|