Brain stimulation methods for patients with schizophrenia – new therapies on the horizon?

2016 ◽  
Vol 13 (03) ◽  
pp. 145-151
Author(s):  
U. Palm ◽  
F. Padberg ◽  
T. Wobrock ◽  
A. Hasan
Keyword(s):  
Clinical Efficacy ◽  
Brain Stimulation ◽  
Negative Symptoms ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Treatment Options ◽  
Temporal Cortex ◽  
Small Sample ◽  
Good Tolerability ◽  
Non Invasive ◽  
Meta Analyses

Summary Background: Non-invasive brain stimulation (NIBS) techniques offer new promising treatment options in schizophrenia. However, the evidence from meta-analyses and randomized clinical studies is limited. Results: For repetitive transcranial magnetic stimulation (rTMS) the clinical efficacy is highest for the 1-Hz rTMS over the left temporal cortex to improve auditory hallucinations, nevertheless there are studies showing no benefit. For negative symptoms rTMS could be offered keeping in mind the good tolerability. Transcranial direct current stimulation (tDCS) has a good risk-benefit ratio, but the evidence for schizophrenia symptoms is still derived from small sample studies. Electroconvulsive therapy (ECT) is the treatment option with the highest clinical efficacy for treatment-resistant schizophrenia, catatonia or other defined treatment circumstances, but has more adverse side effects. More research is needed to understand which stimulation technique could be recommended for a certain patient.

scholarly journals Non-Invasive Cerebellar Stimulation in Neurodegenerative Ataxia: A Literature Review

2020 ◽  
Vol 21 (6) ◽  
pp. 1948 ◽  
Author(s):  
Alberto Benussi ◽  
Alvaro Pascual-Leone ◽  
Barbara Borroni
Keyword(s):  
Brain Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Physiological Activity ◽  
Treatment Options ◽  
Non Invasive ◽  
Therapeutic Trials ◽  
Degenerative Disorders ◽  
Heterogenous Group ◽  
Cerebellar Ataxias ◽  
Specific Stimulation

Cerebellar ataxias are a heterogenous group of degenerative disorders for which we currently lack effective and disease-modifying interventions. The field of non-invasive brain stimulation has made much progress in the development of specific stimulation protocols to modulate cerebellar excitability and try to restore the physiological activity of the cerebellum in patients with ataxia. In light of limited evidence-based pharmacologic and non-pharmacologic treatment options for patients with ataxia, several different non-invasive brain stimulation protocols have emerged, particularly employing repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) techniques. In this review, we summarize the most relevant rTMS and tDCS therapeutic trials and discuss their implications in the care of patients with degenerative ataxias.

scholarly journals Implicit Motor Imagery and the Lateral Occipitotemporal Cortex: Hints for Tailoring Non-Invasive Brain Stimulation

2020 ◽  
Vol 17 (16) ◽  
pp. 5851 ◽  
Author(s):  
Massimiliano Conson ◽  
Roberta Cecere ◽  
Chiara Baiano ◽  
Francesco De Bellis ◽  
Gabriela Forgione ◽  
...  
Keyword(s):  
Motor Imagery ◽  
Brain Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Dominant Hand ◽  
Non Invasive ◽  
Implicit Motor ◽  
Left And Right ◽  
Occipitotemporal Cortex ◽  
Biomechanical Effect ◽  
Motor Representations

Background: Recent evidence has converged in showing that the lateral occipitotemporal cortex is over-recruited during implicit motor imagery in elderly and in patients with neurodegenerative disorders, such as Parkinson’s disease. These data suggest that when automatically imaging movements, individuals exploit neural resources in the visual areas to compensate for the decline in activating motor representations. Thus, the occipitotemporal cortex could represent a cortical target of non-invasive brain stimulation combined with cognitive training to enhance motor imagery performance. Here, we aimed at shedding light on the role of the left and right lateral occipitotemporal cortex in implicit motor imagery. Methods: We applied online, high-frequency, repetitive transcranial magnetic stimulation (rTMS) over the left and right lateral occipitotemporal cortex while healthy right-handers judged the laterality of hand images. Results: With respect to the sham condition, left hemisphere stimulation specifically reduced accuracy in judging the laterality of right-hand images. Instead, the hallmark of motor simulation, i.e., the biomechanical effect, was never influenced by rTMS. Conclusions: The lateral occipitotemporal cortex seems to be involved in mental representation of the dominant hand, at least in right-handers, but not in reactivating sensorimotor information during simulation. These findings provide useful hints for developing combined brain stimulation and behavioural trainings to improve motor imagery.

Non-invasive brain stimulation for negative symptoms in schizophrenia: An updated systematic review and meta-analysis

2018 ◽  
Vol 197 ◽  
pp. 34-44 ◽  
Author(s):  
Caio Osoegawa ◽  
July Silveira Gomes ◽  
Ruth Bartelli Grigolon ◽  
Elisa Brietzke ◽  
Ary Gadelha ◽  
...  
Keyword(s):  
Systematic Review ◽  
Brain Stimulation ◽  
Negative Symptoms ◽  
Meta Analysis ◽  
Non Invasive

Pharmacological treatment in patients with C4, C5 and C6 venous disease

2010 ◽  
Vol 25 (1_suppl) ◽  
pp. 35-41 ◽  
Author(s):  
M S Gohel ◽  
A H Davies
Keyword(s):  
Treatment Options ◽  
Venous Ulcer ◽  
Small Sample ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Pharmacological Agents ◽  
Synthetic Drugs ◽  
Compression Bandaging ◽  
Clinical Benefits ◽  
Meta Analyses

Background A range of surgical, endovenous, physical and medical treatments are available for patients with chronic venous disease. The aim of this review was to evaluate the evidence for pharmacological agents used for the treatment of chronic venous disease. Methods A literature search was performed using Pubmed, Embase, Cochrane and Google Scholar databases. The initial search terms ‘varicose vein’, ‘venous ulcer’, ‘venous disease’ and ‘lipodermatosclerosis’ were used to identify relevant clinical studies of pharmacotherapy in patients with chronic venous disease (C4–C6). Results A huge range of naturally occurring and synthetic drugs have been studied in patients with chronic venous disease. For patients with C4 venous disease, micronized purified flavonoid fraction (MPFF), oxerutin, rutosides and calcium dobesilate may reduce venous symptoms and oedema. MPFF and pentoxifylline have been shown to improve venous ulcer healing when used in addition to multilayer compression bandaging. The clinical benefits of other medications remain unproven. Reliability of meta-analyses was limited by study heterogeneity, small sample sizes and lack of long-term follow-up. Conclusions In prospective randomized studies, MPFF (Daflon®), other flavonoid derivatives and pentoxifylline have demonstrated clinical benefits in patients with C4–C6 venous disease. Pharmacotherapy should be part of a range of treatment options in the modern management of patients with chronic venous disorders.

scholarly journals The heart side of brain neuromodulation

2016 ◽  
Vol 374 (2067) ◽  
pp. 20150187 ◽  
Author(s):  
Simone Rossi ◽  
Emiliano Santarnecchi ◽  
Gaetano Valenza ◽  
Monica Ulivelli
Keyword(s):  
Basal Ganglia ◽  
Brain Stimulation ◽  
Therapeutic Potential ◽  
Heart Function ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Brain Regions ◽  
Long Term Effects ◽  
Pharmacoresistant Epilepsy ◽  
Non Invasive ◽  
Vital Functions

Neuromodulation refers to invasive, minimally invasive or non-invasive techniques to stimulate discrete cortical or subcortical brain regions with therapeutic purposes in otherwise intractable patients: for example, thousands of advanced Parkinsonian patients, as well as patients with tremor or dystonia, benefited by deep brain stimulation (DBS) procedures (neural targets: basal ganglia nuclei). A new era for DBS is currently opening for patients with drug-resistant depression, obsessive-compulsive disorders, severe epilepsy, migraine and chronic pain (neural targets: basal ganglia and other subcortical nuclei or associative fibres). Vagal nerve stimulation (VNS) has shown clinical benefits in patients with pharmacoresistant epilepsy and depression. Non-invasive brain stimulation neuromodulatory techniques such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are also being increasingly investigated for their therapeutic potential in several neurological and psychiatric disorders. In this review, we first address the most common neural targets of each of the mentioned brain stimulation techniques, and the known mechanisms of their neuromodulatory action on stimulated brain networks. Then, we discuss how DBS, VNS, rTMS and tDCS could impact on the function of brainstem centres controlling vital functions, critically reviewing their acute and long-term effects on brain sympathetic outflow controlling heart function and blood pressure. Finally, as there is clear experimental evidence in animals that brain stimulation can affect autonomic and heart functions, we will try to give a critical perspective on how it may enhance our understanding of the cortical/subcortical mechanisms of autonomic cardiovascular regulation, and also if it might find a place among therapeutic opportunities in patients with otherwise intractable autonomic dysfunctions.

scholarly journals European clinical guidelines for Tourette syndrome and other tic disorders—version 2.0. Part IV: deep brain stimulation

2021 ◽  
Author(s):  
Natalia Szejko ◽  
Yulia Worbe ◽  
Andreas Hartmann ◽  
Veerle Visser-Vandewalle ◽  
Linda Ackermans ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Tourette Syndrome ◽  
Brain Stimulation ◽  
Clinical Guidelines ◽  
Expert Knowledge ◽  
Experimental Treatment ◽  
Small Sample ◽  
Tic Disorders ◽  
Meta Analyses ◽  
Deep Brain

AbstractIn 2011 the European Society for the Study of Tourette Syndrome (ESSTS) published its first European clinical guidelines for the treatment of Tourette Syndrome (TS) with part IV on deep brain stimulation (DBS). Here, we present a revised version of these guidelines with updated recommendations based on the current literature covering the last decade as well as a survey among ESSTS experts. Currently, data from the International Tourette DBS Registry and Database, two meta-analyses, and eight randomized controlled trials (RCTs) are available. Interpretation of outcomes is limited by small sample sizes and short follow-up periods. Compared to open uncontrolled case studies, RCTs report less favorable outcomes with conflicting results. This could be related to several different aspects including methodological issues, but also substantial placebo effects. These guidelines, therefore, not only present currently available data from open and controlled studies, but also include expert knowledge. Although the overall database has increased in size since 2011, definite conclusions regarding the efficacy and tolerability of DBS in TS are still open to debate. Therefore, we continue to consider DBS for TS as an experimental treatment that should be used only in carefully selected, severely affected and otherwise treatment-resistant patients.

scholarly journals Non‐Invasive Brain Stimulation for Negative Symptoms in Schizophrenia: An Updated Systematic Review and Meta‐Analysis

2018 ◽  
Vol 32 (S1) ◽  
Author(s):  
Mirna Duarte Barros ◽  
Caio duarte Osoegawa ◽  
Quirino duarte Cordeiro ◽  
July Silveira Gomes ◽  
Elisa duarte Brietzke ◽  
...  
Keyword(s):  
Systematic Review ◽  
Brain Stimulation ◽  
Negative Symptoms ◽  
Meta Analysis ◽  
Non Invasive

scholarly journals Imaging human brain networks to improve the clinical efficacy of non-invasive brain stimulation

2015 ◽  
Vol 57 ◽  
pp. 187-198 ◽  
Author(s):  
Martin V. Sale ◽  
Jason B. Mattingley ◽  
Andrew Zalesky ◽  
Luca Cocchi
Keyword(s):  
Human Brain ◽  
Clinical Efficacy ◽  
Brain Stimulation ◽  
Brain Networks ◽  
Non Invasive

Enhancement of neuroplasticity by cortical stimulation

2015 ◽  
pp. 174-192
Author(s):  
Orlando Swayne ◽  
John Rothwell
Keyword(s):  
Brain Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Cortical Stimulation ◽  
Low Frequencies ◽  
High Frequencies ◽  
Beneficial Effects ◽  
Non Invasive ◽  
Healthy Humans ◽  
Motor Cortex Excitability ◽  
Cathodal Stimulation

There is evidence that behavioural gains made by patients undergoing neurorehabilitation depend at least in part on training-induced synaptic plasticity. Non-invasive cortical stimulation induces changes in synaptic strength in healthy humans which outlast the period of stimulation, and therefore may interact with and potentially enhance the process of rehabilitation in patients. Repetitive transcranial magnetic stimulation can reduce motor cortex excitability at low frequencies or increase it at high frequencies. Anodal transcranial direct current stimulation can increase excitability while cathodal stimulation can reduce it.. Brain stimulation has mainly been examined in patients with stroke, aiming to increase excitability in the stroke hemisphere or reduce it in the contralesional hemisphere. Beneficial effects have been reported but it has proved difficult to reproduce results with greater numbers. This likely reflects a lack of understanding of stimulation mechanisms, high response variability with current protocols, and the diversity of protocols tested.These issues must be resolved before brain stimulation can enter clinical practice.

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