Adverse effects in repetitive transcranial magnetic stimulation – prevention and management

2016 ◽  
Vol 33 (S1) ◽  
pp. S555-S556
Author(s):  
G. Sobreira ◽  
M.A. Aleixo ◽  
C. Moreia ◽  
J. Oliveira
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Adverse Effects ◽  
Brain Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Screening Tools ◽  
Noninvasive Treatment ◽  
Pubmed Database ◽  
Invaluable Tool ◽  
Competing Interest

IntroductionRepetitive Transcranial Magnetic Stimulation (rTMS), through modulation of cortical activity, has become an invaluable tool in experimental and clinical neurosciences. Although this form of noninvasive treatment is considered safer than other means of brain stimulation it has been associated with adverse effects (AE).ObjectiveTo make a brief review, concerning the AE of rTMS, their prevention and management.AimsTo understand and be able to deal with the most common AE associated with rTMS.MethodsA PubMed database search, using as keywords “Transcranial magnetic stimulation”, “Repetitive Transcranial magnetic stimulation”; “adverse effects”; “management” and “guidelines” between the year 1998 and 2015.ResultsAE caused by rTMS are rare. They can be classified into severe (seizures) and mild (syncope, and transient hearing impairment, acute psychiatric changes, headache, local pain, neck pain, toothache, paresthesia and cognitive/neuropsychological changes) and into early and late AE. In order to obviate and avoid them, guidelines have been created; some state that to apply rTMS the technician needs to obtain the patient's informed consent and assess the risks/benefit ratio. To meet these criteria, screening tools have been created, and since then the number of AE has reduced.ConclusionsEven though rTMS is considered safer than other forms of brain stimulation it is still associated with AE. In order to avoid them, screening tools have been created allowing the clinician to assess the risks and benefits of applying this technique.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A review of transcranial magnetic stimulation for treating negative symptoms of schizophrenia

2016 ◽  
Vol 33 (S1) ◽  
pp. S554-S555
Author(s):  
J. Oliveira ◽  
G. Sobreira ◽  
C.A. Moreira ◽  
M.A. Aleixo ◽  
S. Brissos
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Negative Symptoms ◽  
Current Evidence ◽  
Positive Effects ◽  
Prefrontal Function ◽  
Prefrontal Dysfunction ◽  
Pubmed Database ◽  
Dorsolateral Prefrontal ◽  
Competing Interest

IntroductionThe finding of prefrontal dysfunction in schizophrenia patients with negative symptoms (NS) has raised interest in using transcranial magnetic stimulation (TMS), which can modulate prefrontal function and dopamine release, as potential treatment for NS.ObjectiveTo briefly review current literature concerning the use of TMS as treatment for NS.AimsTo assess whether current evidence supports the use of TMS for NS.MethodsNarrative review of articles found through a PubMed database search using the keywords “transcranial magnetic stimulation”, “schizophrenia”, and “negative symptoms” between 1998 and 2015.ResultsUp to date, reviews of randomized sham-controlled studies found positive effects of TMS in NS. However, they exposed several methodological difficulties. More recent studies, reviewed in this poster, tried to overcome these, using results from multiple centers, larger samples and blinding. Various TMS techniques were studied, differing in frequency, motor threshold (MT), stimulus location, and treatment duration. Overall, TMS continues to show promising results in reducing NS; particularly rTMS 10 Hz, for at least 15 sessions on the left dorsolateral prefrontal cortex (DLPFC) at a 110% MT.ConclusionsTMS may be a useful treatment for NS for patients not responding to pharmacological treatment alone. Studies remain difficult to compare due to different measures of outcome (PANSS and SANS being the most commonly used) and techniques. Furthermore, possible modulators of response include duration of illness, cognitive symptoms amelioration, medication and their dose, and different NS may respond differently to TMS. More studies are needed to better understand the utility of TMS in NS.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Focal brain stimulation with repetitive transcranial magnetic stimulation (rTMS): implications for the neural circuitry of depression

2002 ◽  
Vol 33 (1) ◽  
pp. 7-13 ◽  
Author(s):  
SARAH H. LISANBY
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Side Effects ◽  
Major Depression ◽  
Brain Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Severe Depression ◽  
Medical Procedure ◽  
Variable Degree ◽  
Cognitive Side Effects

BRAIN STIMULATION IN THE TREATMENT OF MAJOR DEPRESSIONRepetitive transcranial magnetic stimulation (rTMS) is an experimental medical procedure that is currently under investigation for its potential therapeutic value in major depression and other psychiatric and neurological disorders (Wassermann & Lisanby, 2001). The idea of using brain stimulation to treat depression dates back to the origins of ECT, and includes more recently developed techniques such as deep brain stimulation and vagus nerve stimulation. The value of brain stimulation in psychiatry is still most clearly seen in the, as yet, unparalleled efficacy of ECT in treating severe depression (American Psychiatric Association, 2001). While ECT is the most effective and most rapidly acting treatment for depression, it also causes a variable degree of undesirable cognitive side effects that limit its clinical utility and prevent many patients who could benefit from receiving this often life-saving treatment (McElhiney et al. 1995; Lisanby et al. 2000b). The search for an effective somatic treatment for medication resistant depression with fewer cognitive side effects than ECT has motivated much of the work with rTMS in psychiatry.

scholarly journals Noninvasive brain stimulation in rehabilitation of hemispatial neglect after stroke

CNS Spectrums ◽  
2019 ◽  
Vol 25 (1) ◽  
pp. 38-49 ◽  
Author(s):  
Jitka Veldema ◽  
Kathrin Bösl ◽  
Günter Neumann ◽  
Geert Verheyden ◽  
Dennis Alexander Nowak
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Brain Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Current Data ◽  
Comparative Approach ◽  
Hemispatial Neglect ◽  
Inclusion Criteria ◽  
Noninvasive Brain Stimulation ◽  
Pertinent Literature

BackgroundNoninvasive brain stimulation can modulate neural processing within the motor cortex and thereby might be beneficial in the rehabilitation of hemispatial neglect after stroke.MethodsWe review the pertinent literature regarding the use of transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation in order to facilitate recovery of hemispatial neglect after stroke.ResultsTwenty controlled trials (including 443 stroke patients) matched our inclusion criteria. Methodology and results of each study are presented in a comparative approach. Current data seem to indicate a better efficiency of repetitive transcranial magnetic stimulation, compared to tDCS to ameliorate hemispatial neglect after stroke.ConclusionsNoninvasive brain stimulation has the potential to facilitate recovery of hemispatial neglect after stroke, but until today, there are not enough data to claim its routine use.

scholarly journals Are We Right about the Right TPJ? A Review of Brain Stimulation and Social Cognition in the Right Temporal Parietal Junction

Symmetry ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2219
Author(s):  
Nathira Ahmad ◽  
Samantha Zorns ◽  
Katherine Chavarria ◽  
Janet Brenya ◽  
Aleksandra Janowska ◽  
...  
Keyword(s):  
Social Cognition ◽  
Transcranial Magnetic Stimulation ◽  
Brain Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Type I ◽  
Self And Other ◽  
The Past ◽  
The Right

In the past decade, the functional role of the TPJ (Temporal Parietal Junction) has become more evident in terms of its contribution to social cognition. Studies have revealed the TPJ as a ‘distinguisher’ of self and other with research focused on non-clinical populations as well as in individuals with Autism and Type I Schizophrenia. Further research has focused on the integration of self-other distinctions with proprioception. Much of what we now know about the causal role of the right TPJ derives from TMS (Transcranial Magnetic Stimulation), rTMS repetitive Transcranial Magnetic Stimulation), and tDCS (transcranial Direct Cortical Stimulation). In this review, we focus on the role of the right TPJ as a moderator of self, which is integrated and distinct from ‘other’ and how brain stimulation has established the causal relationship between the underlying cortex and agency.

scholarly journals Meta-Review of Metanalytic Studies with Repetitive Transcranial Magnetic Stimulation (rTMS) for the Treatment of Major Depression

2011 ◽  
Vol 7 (1) ◽  
pp. 167-177 ◽  
Author(s):  
Bernardo Dell’Osso ◽  
Giulia Camuri ◽  
Filippo Castellano ◽  
Vittoria Vecchi ◽  
Matteo Benedetti ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Major Depression ◽  
Brain Stimulation ◽  
Magnetic Stimulation ◽  
Depressive Disorders ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Effective Parameters ◽  
Duration Of Treatment ◽  
Meta Analyses ◽  
Stimulation Technique

Background:Major Depression (MD) and treatment-resistant depression (TRD) are worldwide leading causes of disability and therapeutic strategies for these impairing and prevalent conditions include pharmacological augmentation strategies and brain stimulation techniques. In this perspective, repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique with a favorable profile of tolerability which, despite being recently approved by the Food and Drug Administration (FDA) for the treatment of patients with medication-refractory unipolar depression, still raises some doubts about most effective parameters of stimulation.Methods:A literature search was performed using PubMed for the years 2001 through February 2011 in order to review meta-analytic studies assessing efficacy and safety issues for rTMS in depressive disorders. Fifteen meta-analyses were identified and critically discussed in order to provide an updated and comprehensive overview of the topic with specific emphasis on potentially optimal parameters of stimulation.Results:First meta-analyses on the efficacy of rTMS for the treatment of MD and TRD have shown mixed results. On the other hand, more recent meta-analytic studies seem to support the antidepressant efficacy of the technique to a greater extent, also in light of longer periods of stimulation (e.g. > 2 weeks).Conclusion:rTMS seems to be an effective and safe brain stimulation technique for the treatment of medication refractory depression. Nevertheless, further studies are needed to better define specific stimulation-related issues, such as duration of treatment as well as durability of effects and predictors of response.

scholarly journals Repetitive Transcranial Magnetic Stimulation Improves Handwriting in Parkinson’s Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Bubblepreet K. Randhawa ◽  
Becky G. Farley ◽  
Lara A. Boyd
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Brain Stimulation ◽  
Magnetic Stimulation ◽  
Primary Motor Cortex ◽  
Cortical Excitability ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Motor Task ◽  
Brain Regions ◽  
Fine Motor ◽  
The Impact

Background. Parkinson disease (PD) is characterized by hypometric movements resulting from loss of dopaminergic neurons in the substantia nigra. PD leads to decreased activation of the supplementary motor area (SMA); the net result of these changes is a poverty of movement. The present study determined the impact of 5 Hz repetitive transcranial magnetic stimulation (rTMS) over the SMA on a fine motor movement, handwriting (writing cursive “l”s), and on cortical excitability, in individuals with PD.Methods. In a cross-over design, ten individuals with PD were randomized to receive either 5 Hz or control stimulation over the SMA. Immediately following brain stimulation right handed writing was assessed.Results. 5 Hz stimulation increased vertical size of handwriting and diminished axial pressure. In addition, 5 Hz rTMS significantly decreased the threshold for excitability in the primary motor cortex.Conclusions. These data suggest that in the short term 5 Hz rTMS benefits functional fine motor task performance, perhaps by altering cortical excitability across a network of brain regions. Further, these data may provide the foundation for a larger investigation of the effects of noninvasive brain stimulation over the SMA in individuals with PD.

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