scholarly journals TMS-Induced Seizure during FDA-Approved Bilateral DMPFC Protocol for Treating OCD: A Case Report

2021 ◽  
pp. 584-590
Author(s):  
Georgios Mikellides ◽  
Panayiota Michael ◽  
Teresa Schuhmann ◽  
Alexander T Sack
Keyword(s):  
Adverse Event ◽  
Magnetic Stimulation ◽  
Risk Group ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Target Area ◽  
Treatment Resistant ◽  
Noninvasive Brain Stimulation ◽  
Serious Adverse Event ◽  
Optimal Target ◽  
Left And Right

Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain stimulation therapy that has become a method of choice for the treatment of several neuropsychiatric disorders such as depression and OCD. It is considered to be a safe and well-tolerated treatment, with only few side effects. The most serious adverse event during any rTMS treatment is the potential induction of a seizure. rTMS has shown very encouraging results for treatment-resistant OCD, although the optimal target area and the stimulation frequency are still matters of controversy. Here, we present a 19-year-old female patient with OCD who experienced seizure during the 7th session of her rTMS treatment using the FDA-approved 20-Hz protocol for OCD applied bilaterally over the left and right DMPFC using a double-cone coil. Nonetheless, it still unknown whether the seizure occurred as a consequence of rTMS, as the patient was also in a specific seizure risk group. Future reviews are needed to further clarify the mechanisms that may trigger seizures during rTMS treatments in order to reduce the likelihood of rTMS-induced seizures.

scholarly journals Long-Term Efficacy of Combination Therapy of Transcranial Magnetic Stimulation with Ketamine for Patients with Treatment-Resistant Depression

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 171-171
Author(s):  
Steve Best ◽  
Dan G. Pavel ◽  
Natalie Haustrup
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Nmda Receptor Antagonist ◽  
Primary Diagnosis ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Invasive Treatment ◽  
Novel Approach ◽  
Resistant Depression

AbstractBackgroundRepetitive transcranial magnetic stimulation (rTMS) is a safe, effective and non-invasive treatment for many psychiatric illnesses, including treatment-resistant depression (TRD). Ketamine, an NMDA receptor antagonist, is also an effective antidepressant. This retrospective review examined the clinical benefits of combining these two established treatments for patients suffering from TRD in a novel approach coined combination TMS with ketamine (CTK).MethodsA group of 28 adult patients with a primary diagnosis of unipolar (n=18) or bipolar (n=10) depression received three CTK treatments a week at a private neuropsychiatric practice. Patients were given a concurrent treatment of rTMS (1Hz; 40 minutes; 130% of motor threshold) with bio-marker-determined IV ketamine infusions (0.2–4.7 mg/kg; 30 minutes). The TMS coil was positioned on the mid-prefrontal area. Frequency of treatment was dependent on patient responsiveness (10–30 sessions), which was measured as symptom reduction on the Clinical Global Impression (CGI) scale. CGI data was evaluated pre-treatment, post-treatment and at two-year follow-up.ResultsMean reduction in CGI severity for the patient group following CTK was 4.46 ± 0.54 at a 99% confidence interval and was deemed statistically significant using a paired t-test (a=0.01, t=22.81, p < 0.0001). This significant reduction in CGI severity was sustained for at least 2 years following treatment completion.ConclusionsDespite years of unsuccessful treatments, all 28 patients in this trial obtained substantial and enduring reductions in their depressive symptoms following CTK therapy. Further research into method optimization and randomized controlled trials are warranted.

Repetitive Transcranial Magnetic Stimulation Improves Depersonalization: A Case Report

CNS Spectrums ◽  
2004 ◽  
Vol 9 (5) ◽  
pp. 375-376 ◽  
Author(s):  
Alejandro M. Jiménez-Genchi
Keyword(s):  
Prefrontal Cortex ◽  
Case Report ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Dorsolateral Prefrontal Cortex ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Treatment Resistant ◽  
Depersonalization Disorder ◽  
Dorsolateral Prefrontal

AbstractDepersonalization disorder is a poorly understood and treatment-resistant condition. This report describes a patient with depersonalization disorder who underwent six sessions of repetitive transcranial magnetic stimulation on the left dorsolateral prefrontal cortex. Repetitive transcranial magnetic stimulation produced a 28% reduction on depersonalization scores.

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