scholarly journals Attenuation of antidepressive effects of transcranial magnetic stimulation in patients whose medication includes drugs for psychosis

2020 ◽  
Vol 34 (10) ◽  
pp. 1119-1124
Author(s):  
Tobias Hebel ◽  
Mohamed Abdelnaim ◽  
Markus Deppe ◽  
Berthold Langguth ◽  
Martin Schecklmann
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Rating Scale ◽  
Analysis Of Covariance ◽  
Antipsychotic Treatment ◽  
Number Needed To Treat ◽  
Significant Group ◽  
Small Effect Size ◽  
Severity Of Depression ◽  
Antidepressive Effects

Objective: To assess whether concomitant antipsychotic treatment has an influence on the antidepressive effects of repetitive transcranial magnetic stimulation (rTMS). Methods: We analyzed severity of depression before and after treatment with rTMS in a sample of 299 depressed in- and outpatients in retrospect in relation to treatment with drugs for psychosis. The sample consisted of real-life patients in a tertiary hospital. We ran group contrasts between the group taking and the group not taking drugs for psychosis, testing for differences in Hamilton Depression Rating Scale (HDRS). Effect sizes for HDRS group contrasts were reported as Cohen’s d and number needed to treat (NNT) calculated from d. To control for group differences we repeated the Student t-tests for the change in the HDRS using analysis of covariance including confounding variables. Results: Depressed patients taking drugs for psychosis showed significantly less amelioration of depressive symptoms after rTMS treatment as measured by absolute and relative change in HDRS with small effect size or NNT of 4.5 to 8.4, respectively. Controlling significant group contrasts revealed that the effect of taking drugs for psychosis does not depend on age, number of applied TMS pulses, type or severity of depression at baseline, comorbidities or differences in the intake of additional medication. Conclusion: Drugs for psychosis attenuate antidepressive effects of rTMS independently of confounding factors. The effect is statistically significant and of potentially great clinical importance. The exact mechanism remains to be elucidated and further studies are warranted.

scholarly journals Intracortical and Intercortical Motor Disinhibition to Transcranial Magnetic Stimulation in Newly Diagnosed Celiac Disease Patients

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1530
Author(s):  
Francesco Fisicaro ◽  
Giuseppe Lanza ◽  
Carmela Cinzia D’Agate ◽  
Raffaele Ferri ◽  
Mariagiovanna Cantone ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Rating Scale ◽  
De Novo ◽  
Motor Evoked Potentials ◽  
Silent Period ◽  
Cross Sectional ◽  
Transcallosal Inhibition ◽  
Resting Motor Threshold

Background: Celiac disease (CD) may present or be complicated by neurological and neuropsychiatric manifestations. Transcranial magnetic stimulation (TMS) probes brain excitability non-invasively, also preclinically. We previously demonstrated an intracortical motor disinhibition and hyperfacilitation in de novo CD patients, which revert back after a long-term gluten-free diet (GFD). In this cross-sectional study, we explored the interhemispheric excitability by transcallosal inhibition, which has never been investigated in CD. Methods: A total of 15 right-handed de novo, neurologically asymptomatic, CD patients and 15 age-matched healthy controls were screened for cognitive and depressive symptoms to the Montreal Cognitive Assessment (MoCA) and the 17-item Hamilton Depression Rating Scale (HDRS), respectively. TMS consisted of resting motor threshold, amplitude, latency, and duration of the motor evoked potentials, duration and latency of the contralateral silent period (cSP). Transcallosal inhibition was evaluated as duration and latency of the ipsilateral silent period (iSP). Results: MoCA and HDRS scored significantly worse in patients. The iSP and cSP were significantly shorter in duration in patients, with a positive correlation between the MoCA and iSP. Conclusions: An intracortical and interhemispheric motor disinhibition was observed in CD, suggesting the involvement of GABA-mediated cortical and callosal circuitries. Further studies correlating clinical, TMS, and neuroimaging data are needed.

A 6-month follow-up study on response and relapse rates following an acute trial of repetitive transcranial magnetic stimulation in patients with major depression

CNS Spectrums ◽  
2020 ◽  
pp. 1-6
Author(s):  
Chiara Arici ◽  
Beatrice Benatti ◽  
Rita Cafaro ◽  
Laura Cremaschi ◽  
Luca Degoni ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Major Depression ◽  
Magnetic Stimulation ◽  
Rating Scale ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
High Rate ◽  
Late Response ◽  
Young Mania ◽  
Relapse Rates

Abstract Background Little is known about the post-acute effects of repetitive transcranial magnetic stimulation (rTMS) in patients with major depression. The present study focused on the 6-month follow-up of a sample of patients with major depression, after the completion of an acute 4 weeks rTMS trial, with the aim of evaluating response (in terms of sustained and late response) and relapse rates. Methods Following the completion of an acute trial of rTMS (T0-T4), 31 drug-resistant depressed patients (bipolar or unipolar) entered a naturalistic follow-up period of 6 months, with three timepoints (T5, T6, and T7) during which they were assessed with the Hamilton Depression Rating Scale and the Young Mania Rating Scale. Results Results showed that in the 6 months following an acute transcranial magnetic stimulation (TMS) trial, a higher rate of late responders was observed among previously acute TMS nonresponders (63.64%, 7 out of 11) compared to the rate of relapse among those who had acutely responded to TMS (10%, 2 out of 20). In addition, an overall high rate of maintained response (90%) was observed. Conclusion Present findings seem to support the possibility of obtaining a clinical response also after the end of an acute TMS trial in patients with major depression. The concomitant low rate of relapse observed at the end of follow-up along with a high rate of maintained response provides further support to the post-acute efficacy of TMS. Nonetheless, further controlled studies, with larger samples and longer follow-up observation, are needed to confirm the reported results.

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

2013 ◽  
Vol 16 (9) ◽  
pp. 1975-1984 ◽  
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.

Transcranial magnetic stimulation for depression and other psychiatric disorders

2001 ◽  
Vol 31 (7) ◽  
pp. 1141-1146 ◽  
Author(s):  
B. McNAMARA ◽  
J. L. RAY ◽  
O. J. ARTHURS ◽  
S. BONIFACE
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Beneficial Effect ◽  
Mood Disorders ◽  
Electroconvulsive Therapy ◽  
Magnetic Stimulation ◽  
Right Hemisphere ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Bipolar Affective Disorder ◽  
Controlled Trials ◽  
Number Needed To Treat

Introduction. Repetitive transcranial magnetic stimulation (rTMS) has been proposed as a possible alternative to electroconvulsive therapy for the treatment of selected patients with depression, bipolar affective disorder and schizophrenia. The aim of this study was to evaluate the evidence for the effectiveness of rTMS in mood disorders and schizophrenia.Methods. Studies were identified using MEDLINE (1966 to January 2000), EMBASE/Excerpta Medica (1980 to January 2000), Biological Abstracts and Index to Scientific and Technical Proceedings. A number of biomedical and TMS related websites were also searched. We estimated the number needed to treat to show beneficial effect of rTMS when compared with the placebo controlled group.Results. Seven controlled trials of rTMS depression were identified. Five of these were suitable for meta-analysis and show a beneficial effect of rTMS compared to placebo, with a number needed to treat of 2·3 with a 95% confidence interval 1·6 to 4·0, total; 81 patients. A single trial of rTMS has also been performed in mania, which shows a beneficial effect of right hemisphere stimulation when compared with left hemisphere stimulation. A controlled trial in schizophrenia failed to show any benefit of rTMS.Discussion. rTMS has demonstrable beneficial effects in depression. The extent and the duration of the anti-depressant effect of rTMS has yet to be defined. There now needs to be randomized controlled trials to compare rTMS directly with standardized electroconvulsive therapy in order to take this subject forward. With regard to the treatment of other mood disorders and schizophrenia, we are at an early stage in the assessment of further studies that are needed to examine any potential role for rTMS.

Effects of smoking status and MADRS retardation factor on response to low frequency repetitive transcranial magnetic stimulation for depression

2016 ◽  
Vol 38 ◽  
pp. 40-44 ◽  
Author(s):  
E. Poulet ◽  
F. Galvao ◽  
E. Haffen ◽  
D. Szekely ◽  
C. Brault ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Clinical Outcome ◽  
Magnetic Stimulation ◽  
Rating Scale ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Smoking Status ◽  
Low Frequency ◽  
Retardation Factor ◽  
Significant Difference ◽  
Low Frequency Rtms

AbstractBackgroundDespite growing evidence supporting the clinical interest of repetitive transcranial magnetic stimulation (rTMS) in treatment-resistant depression (TRD), little is known regarding the effects of clinical and sociodemographic factors on the clinical outcome in patients.MethodsWe retrospectively investigated the effects of clinical (using the 3-factor model of the Montgomery-Åsberg depression rating scale [MADRS] encompassing dysphoria, retardation and vegetative symptoms) and sociodemographic characteristics of participants on clinical outcome in a sample of 54 TRD patients receiving low frequency rTMS (1 Hz, 360 pulses) applied over the right dorsolateral prefrontal cortex combined with sham venlafaxine.ResultsResponders (n= 29) displayed lower retardation baseline scores (13.6 ± 2.9) than non-responders (15.6 ± 2.9;n= 25;P= 0.02). We also observed a significant difference between the numbers of ex-smokers in responders and non-responders groups; all ex-smokers (n= 8) were responders to rTMS (P= 0.005).ConclusionLow MADRS retardation factor and ex-smoker status is highly prevalent in responders to low frequency rTMS. Further studies are needed to investigate the predictive value of these factors.

scholarly journals Disrupted Central Inhibition after Transcranial Magnetic Stimulation of Motor Cortex in Schizophrenia with Long-Term Antipsychotic Treatment

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Aulikki Ahlgrén-Rimpiläinen ◽  
Hannu Lauerma ◽  
Seppo Kähkönen ◽  
Ilpo Rimpiläinen
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Motor Cortex ◽  
Magnetic Stimulation ◽  
Motor Evoked Potentials ◽  
Silent Period ◽  
Single Pulse ◽  
Contralateral Side ◽  
Antipsychotic Treatment ◽  
Stimulation Of

Aims. Schizophrenia is a neuropsychiatric disorder associated with mental and motor disturbances. We aimed to investigate motor control, especially central silent period (CSP) in subjects with schizophrenia (n=11) on long-term antipsychotic treatment compared to healthy controls (n=9). Methods. Latency and duration of motor evoked potentials (MEPs) and CSPs were measured with the help of single pulse transcranial magnetic stimulation (TMS) and intramuscular electrodes. After stimulation of the dominant and nondominant motor cortex of abductor digiti minimi (ADM) and tibialis anterior (TA) muscle areas, respective responses were measured on the contralateral side. Results. MEPs did not differ significantly between the groups. Multiple CSPs were found predominantly in subjects with schizophrenia, which showed a higher number of CSPs in the dominant ADM and the longest summarized duration of CSPs in the nondominant ADM (P<0.05) compared to controls. Conclusions. There were multiple CSPs predominantly in the upper extremities and in the dominant body side in subjects with schizophrenia. Behind multiple CSPs may lie an impaired regulation of excitatory or inhibitory neurotransmitter systems in central motor pathways. Further research is needed to clarify the role of the intramuscular recording methods and the effect of antipsychotics on the results.

scholarly journals Oxolipidomics profile in major depressive disorder: Comparing remitters and non-remitters to repetitive transcranial magnetic stimulation treatment

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246592
Author(s):  
Hannah Stirton ◽  
Benjamin P. Meek ◽  
Andrea L. Edel ◽  
Zahra Solati ◽  
Arun Surendran ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Major Depressive Disorder ◽  
Transcranial Magnetic Stimulation ◽  
Depressive Disorder ◽  
Treatment Response ◽  
Magnetic Stimulation ◽  
Rating Scale ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Major Depressive ◽  
Predict Treatment Response

Background Repetitive Transcranial Magnetic Stimulation [rTMS] is increasingly being used to treat Major Depressive Disorder [MDD]. Given that not all patients respond to rTMS, it would be clinically useful to have reliable biomarkers that predict treatment response. Oxidized phosphatidylcholine [OxPC] and some oxylipins are important plasma biomarkers of oxidative stress and inflammation. Not only is depression associated with oxidative stress, but rTMS has been shown to have anti-oxidative effects. Objectives To investigate whether plasma oxolipidomics profiles could predict treatment response in patients with treatment resistant MDD. Methods Fourty-eight patients undergoing rTMS treatment for MDD were recruited along with nine healthy control subjects. Plasma OxPCs and oxylipins were extracted and analyzed through high performance liquid chromatography coupled with mass spectrometry. Patients with a Hamilton Depression Rating Scale score [Ham-D] ≤7 post-treatment were defined as having entered remission. Results Fifty-seven OxPC and 32 oxylipin species were identified in our subjects. MDD patients who entered remission following rTMS had significantly higher pre-rTMS levels of total and fragmented OxPCs compared to non-remitters and controls [one-way ANOVA, p<0.05]. However, no significant changes in OxPC levels were found as a result of rTMS, regardless of treatment response [p>0.05]. No differences in plasma oxylipins were found between remitters and non-remitters at baseline. Conclusion Certain categories of OxPCs may be useful predictive biomarkers for response to rTMS treatment in MDD. Given that elevated oxidized lipids may indicate higher levels of oxidative stress and inflammation in the brain, patients with this phenotype of depression may be more receptive to rTMS treatment.

scholarly journals The efficacy of transcranial magnetic stimulation (TMS) for negative symptoms in schizophrenia: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Rasmus Lorentzen ◽  
Tuan Dang Nguyen ◽  
Alexander McGirr ◽  
Fredrik Hieronymus ◽  
Soren Dinesen Ostergaard
Keyword(s):  
Systematic Review ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Negative Symptoms ◽  
Meta Analysis ◽  
Preliminary Evidence ◽  
Pooled Analysis ◽  
P Value ◽  
Number Needed To Treat ◽  
Double Blind

Several trials have shown preliminary evidence for efficacy using Transcranial Magnetic Stimulation (TMS) as a treatment for negative symptoms in schizophrenia. Here, we synthesize this literature using a systematic review and quantitative meta-analysis of double-blind randomized controlled trials of TMS in patients with schizophrenia. Specifically, MEDLINE, EMBASE, Web of Science, and PsycINFO were searched for sham-controlled, randomized trials of TMS among patients with schizophrenia. The standardized mean difference (SMD, Cohen's d) with 95% confidence intervals (CI) was calculated for each study (TMS vs. sham) and pooled across studies using an inverse variance random effects model. We identified 56 studies with a total of 2550 participants that were included in the meta-analysis. The pooled analysis showed statistically significant superiority of TMS (SMD=0.37, 95%CI: 0.23; 0.52, p-value <0.00001), corresponding to a number needed to treat of 4.85. Furthermore, stratified analyses suggested that TMS targeting the left dorsolateral prefrontal cortex, using a stimulation frequency >1 Hz, and a stimulation intensity at or above the motor threshold, was most efficacious. There was, however, substantial heterogeneity and high risk of bias among the included studies. In conclusion, TMS appears to be an efficacious treatment option for patients with schizophrenia suffering from negative symptoms, but the optimal TMS parameters have yet to be resolved.

Effect of Augmentatory Repetitive Transcranial Magnetic Stimulation on Auditory Hallucinations in Schizophrenia: Randomized Controlled Study

2009 ◽  
Vol 43 (4) ◽  
pp. 386-392 ◽  
Author(s):  
Dhruv Bagati ◽  
Shamshul Haque Nizamie ◽  
Ravi Prakash
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Low Frequency ◽  
Auditory Hallucinations ◽  
Controlled Study ◽  
Control Group ◽  
Antipsychotic Treatment ◽  
Experimental Group ◽  
Low Frequency Rtms

Objective: Auditory hallucinations are a characteristic symptom of schizophrenia and are usually resistant to treatment. The present study was conducted to further support the findings that repetitive transcranial magnetic stimulation (rTMS) reduces auditory hallucinations, and to evaluate the effect of low-frequency rTMS on auditory hallucinations in schizophrenia. Methods: Forty schizophrenia patients were included in the study. Patients were randomized to control or experimental group. Low-frequency rTMS (1 Hz, 90% motor threshold) was applied to the left temporoparietal cortex of patients in the experimental group for 10 days following the standard guidelines as an addition to antipsychotic treatment. The control group received only antipsychotics. The changes in the psychopathology scores for the auditory hallucinations were recorded using auditory hallucination recording scale. The rater was blind to the intervention procedure. Results: A significant improvement was found in auditory hallucinations in the experimental group as compared to the control group. Conclusion: Left temporoparietal rTMS warrants further study as an intervention for auditory hallucinations. Data suggest that this intervention selectively alters neurobiological factors determining frequency of these hallucinations.

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