Partial clinical response to 2 weeks of 2 Hz repetitive transcranial magnetic stimulation to the right parietal cortex in depression

Objectives: Social anxiety disorder (SAD) is a common and debilitating anxiety disorders. However, few studies had been dedicated to the neurobiology underlying SAD until the last decade. Rates of non-responders to standard methods of treatment remain unsatisfactorily high of approximately 25%, including SAD. Advances in our understanding of SAD could lead to new treatment strategies. A potential non invasive therapeutic option is repetitive transcranial magnetic stimulation (rTMS). Thus, we reported two cases of SAD treated with rTMS Methods: The bibliographical search used Pubmed/Medline, ISI Web of Knowledge and Scielo databases. The terms chosen for the search were: anxiety disorders, neuroimaging, repetitive transcranial magnetic stimulation. Results: In most of the studies conducted on anxiety disorders, except SAD, the right prefrontal cortex (PFC), more specifically dorsolateral PFC was stimulated, with marked results when applying high-rTMS compared with studies stimulating the opposite side. However, according to the “valence hypothesis”, anxiety disorders might be characterized by an interhemispheric imbalance associated with increased right-hemispheric activity. With regard to the two cases treated with rTMS, we found a decrease in BDI, BAI and LSAS scores from baseline to follow-up. Conclusion: We hypothesize that the application of low-rTMS over the right medial PFC (mPFC; the main structure involved in SAD circuitry) combined with high-rTMS over the left mPFC, for at least 4 weeks on consecutive weekdays, may induce a balance in brain activity, opening an attractive therapeutic option for the treatment of SAD.

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Effects of 10 Hz repetitive transcranial magnetic stimulation of the right dorsolateral prefrontal cortex in the vegetative state

Experimental and Therapeutic Medicine ◽

10.3892/etm.2021.9626 ◽

2021 ◽

Vol 21 (3) ◽

Author(s):

Xin Ge ◽

Yue Zhang ◽

Tian Xin ◽

Xue Luan

Keyword(s):

Prefrontal Cortex ◽

Transcranial Magnetic Stimulation ◽

Magnetic Stimulation ◽

Dorsolateral Prefrontal Cortex ◽

Repetitive Transcranial Magnetic Stimulation ◽

Vegetative State ◽

Dorsolateral Prefrontal ◽

The Right ◽

Stimulation Of

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Relationship between body mass and clinical response to repetitive transcranial magnetic stimulation (rTMS) for major depressive disorder

Mental Illness ◽

10.1108/mi.2019.8116 ◽

2019 ◽

Vol 11 (1) ◽

pp. 18-21

Author(s):

Maria Cristina Davila ◽

Brianna Ely ◽

Ann M. Manzardo

Keyword(s):

Body Composition ◽

Major Depressive Disorder ◽

Transcranial Magnetic Stimulation ◽

Depressive Disorder ◽

Clinical Response ◽

Body Mass ◽

Magnetic Stimulation ◽

Remission Rate ◽

Repetitive Transcranial Magnetic Stimulation ◽

Major Depressive

Repetitive transcranial magnetic stimulation (rTMS) has been proven to be efficacious in the treatment of Major Depressive Disorder (MDD). We previously examined the effectiveness of rTMS for MDD in an applied clinical setting, AwakeningsKC Clinical Neuroscience Institute (CNI) and found high remission rates for patients diagnosed with MDD following rTMS treatment. An unexpected relationship with body composition and rTMS unit was discovered. This sub-study extends the previous investigation through a focused analysis of the effects of body composition on response to rTMS in the treatment of MDD. We utilized data collected from a retrospective review of medical records for patients diagnosed with MDD undergoing rTMS therapy at AwakeningsKC CNI. Patient Health Questionnaire 9 (PHQ-9) scores, time to remission status and body mass index (BMI) at baseline were considered while referencing two different rTMS instruments (MagVenture; NeuroStar). We found 23 (9%) of 247 participants met criteria for obese status (BMI?30) with an average baseline PHQ-9 score of 22±4, classified as “severe depression”. Obesity status was differentially impacted by the rTMS instrument used for treatment. Patients with obesity showed a shorter time to remission (mean 2.7±0.27 vs. mean 3.4±0.3 weeks) and proportionately greater remission rate (100% vs. 71%) when treated using the MagVenture relative to the NeuroStar instrument. Clinical response to rTMS therapy for MDD appears to be guided by individual factors including body composition and rTMS parameters such as the unit used for treatment. Further study of these influences could aid in the optimization of clinical response to rTMS.

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Interference of Left and Right Cerebellar rTMS with Procedural Learning

Journal of Cognitive Neuroscience ◽

10.1162/0898929042568488 ◽

2004 ◽

Vol 16 (9) ◽

pp. 1605-1611 ◽

Cited By ~ 72

Author(s):

Sara Torriero ◽

Massimiliano Oliveri ◽

Giacomo Koch ◽

Carlo Caltagirone ◽

Laura Petrosini

Keyword(s):

Transcranial Magnetic Stimulation ◽

Magnetic Stimulation ◽

Repetitive Transcranial Magnetic Stimulation ◽

Reaction Time Task ◽

Normal Subjects ◽

Serial Reaction Time Task ◽

Procedural Learning ◽

Cerebellar Hemisphere ◽

Serial Reaction ◽

The Right

Increasing evidence suggests cerebellar involvement in procedural learning. To further analyze its role and to assess whether it has a lateralized influence, in the present study we used a repetitive transcranial magnetic stimulation interference approach in a group of normal subjects performing a serial reaction time task. We studied 36 normal volunteers: 13 subjects underwent repetitive transcranial magnetic stimulation on the left cerebellum and performed the task with the right (6 subjects) or left (7 subjects) hand; 10 subjects underwent repetitive transcranial magnetic stimulation on the right cerebellum and performed the task with the hand ipsilateral (5 subjects) or contralateral (5 subjects) to the stimulation; another 13 subjects served as controls and were not submitted to repetitive transcranial magnetic stimulation; 7 of them performed the task with the right hand and 6 with the left hand. The main results show that interference with the activity of the lateral cerebellum induces a significant decrease of procedural learning: Interference with the right cerebellar hemisphere activity induces a significant decrease in procedural learning regardless of the hand used to perform the serial reaction time task, whereas left cerebellar hemisphere activity seems more linked with procedural learning through the ipsilateral hand. In conclusion, the present study shows for the first time that a transient interference with the functions of the cerebellar cortex results in an impairment of procedural learning in normal subjects and it provides new evidences for interhemispheric differences in the lateral cerebellum.

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Equivalent beneficial effects of unilateral and bilateral prefrontal cortex transcranial magnetic stimulation in a large randomized trial in treatment-resistant major depression

The International Journal of Neuropsychopharmacology ◽

10.1017/s1461145713000369 ◽

2013 ◽

Vol 16 (9) ◽

pp. 1975-1984 ◽

Cited By ~ 25

Author(s):

Paul B. Fitzgerald ◽

Kate E. Hoy ◽

Ajeet Singh ◽

Ranil Gunewardene ◽

Christopher Slack ◽

...

Keyword(s):

Transcranial Magnetic Stimulation ◽

Clinical Response ◽

Magnetic Stimulation ◽

Rating Scale ◽

Remission Rate ◽

Repetitive Transcranial Magnetic Stimulation ◽

Controlled Trial ◽

Treatment Resistant ◽

Previous Response ◽

Beneficial Effects

Abstract Repetitive transcranial magnetic stimulation treatment (rTMS) is an effective treatment for depression but the optimal methods of administration have yet to be determined. Recent studies have produced conflicting results as to whether unilateral rTMS is more or less effective than sequentially applied bilateral rTMS. To address this we conducted a trial comparing sequential bilateral rTMS to right-sided unilateral rTMS using a priming protocol. Patients with treatment-resistant depression (n = 179) were enrolled in a two-arm randomized controlled trial across a 4-wk time period. The primary outcome assessment was the Hamilton Depression Rating Scale. Overall, there was a substantial response rate of >50% (and a 40% remission rate); however, there were no significant differences in clinical response between the two treatment groups. rTMS was well tolerated with a very low discontinuation rate. There was no relationship between response in the current trial and previous response, or non-response, to electroconvulsive therapy. We found no significant differences in clinical response between sequential bilateral rTMS and right-sided unilateral rTMS applied with a priming protocol. The results of this study do not support superior efficacy of bilateral rTMS and instead suggest that other approaches should be explored to increase treatment efficacy.

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