Correction: Shaped Magnetic Field Pulses by Multi-Coil Repetitive Transcranial Magnetic Stimulation (rTMS) Differentially Modulate Anterior Cingulate Cortex Responses and Pain in Volunteers and Fibromyalgia Patients

BackgroundAlcohol dependence has long been related to impaired processing and handling of negative emotions. This is the first study to compare emotion regulation (ER) at a behavioral and neural level in alcohol dependent patients (ADPs) and healthy controls (HCs). It also examines the effects of high-frequency repetitive transcranial magnetic stimulation (rTMS) on ER abilities and related craving levels in ADPs.MethodThirty-six ADPs and 32 HCs matched on age, sex, and education, were included in a within-subject fixed-order study with one functional magnetic resonance imaging (fMRI) session and one rTMS plus fMRI session, with high-frequency (10 Hz) rTMS over the right dorsolateral prefrontal cortex (dlPFC). An fMRI emotion regulation task (ERT) was administered during both sessions and craving was measured before and after each ERT.ResultsADPs were impaired in the regulation of negative emotion and showed a higher activation of ER related brain areas compared to HCs. Furthermore, active rTMS improved ER abilities in both ADPs and HCs, but was accompanied by a decrease in anterior cingulate and left dlPFC activity only in ADPs. In addition, the ERT-induced increase in craving levels in ADPs was trend-significantly reduced by active rTMS, with a large effect size.ConclusionsADPs are impaired in the regulation of negative emotion and show enhanced neural activity in the ER brain circuit. High-frequency rTMS improves ER in ADPs and HCs and normalizes neural activity and tends to reduce craving in ADPs. Future studies are needed to test the long-term effects of (multiple session) rTMS on ER, craving, and drinking.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Time to remission analysis for major depressive disorder after repetitive transcranial magnetic stimulation (rTMS)

Mental Illness ◽

10.1108/mi.2019.8141 ◽

2019 ◽

Vol 11 (1) ◽

pp. 26-30

Author(s):

Ann M. Manzardo ◽

Brianna Ely ◽

Maria Cristina Davila

Keyword(s):

Magnetic Field ◽

Major Depressive Disorder ◽

Clinical Practice ◽

Transcranial Magnetic Stimulation ◽

Depressive Disorder ◽

Magnetic Stimulation ◽

Psychiatric Hospitalization ◽

Repetitive Transcranial Magnetic Stimulation ◽

Individual Factors ◽

Major Depressive

We previously examined the efficacy of rTMS for major depressive disorder in an applied clinical practice. Clinical response was related to severity of depression as well as the rTMS instrument utilized suggesting a relationship to instrument or magnetic field parameters and individual factors. The effectiveness of repetitive transcranial magnetic stimulation (rTMS) in the treatment of major depressive disorder was further evaluated using Log-Rank statistics for time to remission outcomes. A follow-up retrospective medical records study was carried out on patients with major depressive disorder undergoing rTMS therapy at AwakeningsKC Clinical Neuroscience Institute (CNI), a suburban tertiary psychiatric clinic. Cox Proportional Hazard with Log-Rank statistics were applied and the time course to clinical remission was evaluated over a 6-week period with respect to age, gender, and depression severity. Clinical response was observed referencing two different rTMS instruments (MagVenture; NeuroStar). Time to remission studies of 247 case reports (N=98 males; N=149 females) showed consistently greater clinically defined remission rates after 6 weeks of rTMS treatment for patients using the MagVenture vs NeuroStar instrument. Patients previously admitted for inpatient psychiatric hospitalization exhibited higher response rates when treated with the MagVenture rTMS unit. Stepwise Cox Proportional Hazards Regression final model of time to remission included rTMS unit, inpatient psychiatric hospitalization and obese body habitus. Response to rTMS in applied clinical practice is related to severity of psychiatric illness and may require consideration of magnetic field parameters of the rTMS unit with respect to individual factors such as sex or body composition.

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Anterior Cingulate Implant for Alcohol Dependence

Neurosurgery ◽

10.1227/neu.0000000000001248 ◽

2016 ◽

Vol 78 (6) ◽

pp. E883-E893 ◽

Cited By ~ 14

Author(s):

Dirk De Ridder ◽

Patrick Manning ◽

Paul Glue ◽

Gavin Cape ◽

Berthold Langguth ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Transcranial Magnetic Stimulation ◽

Magnetic Resonance ◽

Alcohol Dependence ◽

Magnetic Stimulation ◽

Repetitive Transcranial Magnetic Stimulation ◽

Anterior Cingulate ◽

Functional Magnetic Resonance ◽

Resonance Imaging ◽

Dorsal Anterior Cingulate Cortex

Abstract BACKGROUND AND IMPORTANCE: Alcohol dependence is related to dysfunctional brain processes, in which a genetic background and environmental factors shape brain mechanisms involved with alcohol consumption. Craving, a major component determining relapses in alcohol abuse, has been linked to abnormal brain activity. CLINICAL PRESENTATION: We report the results of a treatment-intractable, alcohol-addicted patient with associated agoraphobia and anxiety. Functional imaging studies consisting of functional magnetic resonance imaging and resting-state electroencephalogram were performed as a means to localize craving-related brain activation and for identification of a target for repetitive transcranial magnetic stimulation and implant insertion. Repetitive transcranial magnetic stimulation of the dorsal anterior cingulate cortex with a double-cone coil transiently suppressed his very severe alcohol craving for up to 6 weeks. For ongoing stimulation, 2 “back-to-back” paddle electrodes were implanted with functional magnetic resonance imaging neuronavigation guidance for bilateral dorsal anterior cingulate cortex stimulation. Using a recently developed novel stimulation design, burst stimulation, a quick improvement was obtained on craving, agoraphobia, and associated anxiety without the expected withdrawal symptoms. The patient has remained free of alcohol intake and relieved of agoraphobia and anxiety for over 18 months, associated with normalization of his alpha and beta activity on electroencephalogram in the stimulated area. He perceives a mental freedom by not being constantly focused on alcohol. CONCLUSION: This case report proposes a new pathophysiology-based target for the surgical treatment of alcohol dependence and suggests that larger studies are warranted to explore this potentially promising avenue for the treatment of intractable alcohol dependence with or without anxiety and agoraphobia.

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