scholarly journals Diagnosis and therapy of functional tremor a systematic review illustrated by a case report

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Michael Bartl ◽  
Rebekka Kewitsch ◽  
Mark Hallett ◽  
Martin Tegenthoff ◽  
Walter Paulus
Keyword(s):  
Magnetic Stimulation ◽  
Rating Scales ◽  
Psychiatric Symptoms ◽  
Psychological Treatment ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Clinical Feature ◽  
Diagnostic Feature ◽  
Therapeutic Effects ◽  
Relaxation Techniques ◽  
Diagnosis And Therapy

Abstract Background Diagnosis of functional movement disorders and specifically functional tremor (FT) (representing 50% of them) remains demanding. Additionally, due to heterogeneity of the disorders, structured concepts and guidelines for diagnosis and therapy are difficult to establish. Ascertaining the state of knowledge to derive instructions for operating procedures is the aim of this review. Main text Based on a standardized systematic literature research using the term “psychogenic tremor” in the MEDLINE database dating back ten years, 76 studies were evaluated. Conventional features of FT are variability of frequency and amplitude. Further, response to distraction by motor and cognitive tasks is a key diagnostic feature in differentiation between organic and functional origin. A variety of electrophysiological tests have been evaluated including surface electromyography and accelerometry to establish laboratory-supported criteria for diagnosing tremor. Also, finger tapping tests have been used to identify FT, showing positive potential as supplementary evidence. Imaging studies in general are mostly underpowered and imaging cannot be used on an individual basis. Therapeutic studies in FT often have a diagnostic component. Cognitive behavioral therapy should be the preferred psychological treatment independent of additional psychiatric symptoms. Other psychotherapeutic methods show lack of evidence concerning FT. Relaxation techniques and physiotherapy are an important additional feature, especially in children and adolescents. In regard to drug therapy, randomized and blinded trials are not available. A significant decrease in rating scales could be detected after active, not sham repetitive transcranial magnetic stimulation with a long-lasting effect. Also root magnetic stimulation seems to be effective. The clinical feature of tremor entrainment in FT can be used in combination with biofeedback as so-called tremor retrainment, using self-modulation of frequency and severity, to bring the movements under volitional control. Conclusion Diagnosis and treatment of FT is challenging and should include a combination of intensive clinical examination and targeted addition of standardized testing, especially electrophysiological methods. Often therapeutic effects have a diagnostic component. A multimodal strategy, considering psychological factors as a potential origin as well as maintaining effects seems to be most effective.

scholarly journals Predictive Role of Executive Function in the Efficacy of Intermittent Theta Burst Transcranial Magnetic Stimulation Modalities for Treating Methamphetamine Use Disorder—A Randomized Clinical Trial

2021 ◽  
Vol 12 ◽  
Author(s):  
Li-Jin Wang ◽  
Lin-Lin Mu ◽  
Zi-Xuan Ren ◽  
Hua-Jun Tang ◽  
Ya-Dong Wei ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Working Memory ◽  
Executive Function ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Therapeutic Effects ◽  
Sham Stimulation ◽  
Theta Burst ◽  
Stimulation Group

Background: Repetitive transcranial magnetic stimulation (rTMS) has therapeutic effects on craving in methamphetamine (METH) use disorder (MUD). The chronic abuse of METH causes impairments in executive function, and improving executive function reduces relapse and improves treatment outcomes for drug use disorder. The purpose of this study was to determine whether executive function helped predict patients' responses to rTMS treatment.Methods: This study employed intermittent theta burst stimulation (iTBS) rTMS modalities and observed their therapeutic effects on executive function and craving in MUD patients. MUD patients from an isolated Drug Rehabilitation Institute in China were chosen and randomly allocated to the iTBS group and sham-stimulation group. All participants underwent the Behavior Rating Inventory of Executive Function - Adult Version Scale (BRIEF-A) and Visual Analog Scales (VAS) measurements. Sixty-five healthy adults matched to the general condition of MUD patients were also recruited as healthy controls.Findings: Patients with MUD had significantly worse executive function. iTBS groups had better treatment effects on the MUD group than the sham-stimulation group. Further Spearman rank correlation and stepwise multivariate regression analysis revealed that reduction rates of the total score of the BRIEF-A and subscale scores of the inhibition factor and working memory factor in the iTBS group positively correlated with improvements in craving. ROC curve analysis showed that working memory (AUC = 87.4%; 95% CI = 0.220, 0.631) and GEC (AUC = 0.761%; 95% CI = 0.209, 0.659) had predictive power to iTBS therapeutic efficacy. The cutoff values are 13.393 and 59.804, respectively.Conclusions: The iTBS rTMS had a better therapeutic effect on the executive function of patients with MUD, and the improved executive function had the potential to become a predictor for the efficacy of iTBS modality for MUD treatment.Clinical Trial Registration:ClinicalTrials.gov, identifier: ChiCTR2100046954.

scholarly journals Synergistic Effects of Scalp Acupuncture and Repetitive Transcranial Magnetic Stimulation on Cerebral Infarction: A Randomized Controlled Pilot Trial

2020 ◽  
Vol 10 (2) ◽  
pp. 87
Author(s):  
Jae-Hong Kim ◽  
Jae-Young Han ◽  
Min-Keun Song ◽  
Gwang-Cheon Park ◽  
Jeong-Soon Lee
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Cerebral Infarction ◽  
Upper Extremity ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Synergistic Effects ◽  
Scalp Acupuncture ◽  
Control Group ◽  
Therapeutic Effects ◽  
Randomized Controlled

This study investigated the synergistic effects of scalp acupuncture (SA) and repetitive transcranial magnetic stimulation (rTMS), known to be effective for cerebral infarction. This outcome-assessor-blinded, randomized controlled clinical trial included a per-protocol analysis to compare the efficacy of SA and electromagnetic convergence stimulation (SAEM-CS) and single or no stimulation. The trial was conducted with 42 cerebral infarction patients (control group, 12; SA group, 11; rTMS group, 8; SAEM-CS group, 11). All patient groups underwent two sessions of CSRT per day. SA, rTMS, and SAEM-CS were conducted once per day, 5 days per week, for 3 weeks. The primary outcome was evaluated using the Fugl–Mayer assessment (FMA). FMA Upper Extremity, FMA total, MBI, and FIM scores significantly increased in the rTMS group compared with the control group. Additionally, FMA Upper Extremity, FMA total, MBI and FIM scores significantly increased in the rTMS group compared with the SAEM-CS group. However, there were no significant changes in the SA or SAEM-CS groups. In conclusion, low-frequency rTMS in the contralesional hemisphere may have long-term therapeutic effects on upper extremity motor function recovery and improvements in activities of daily living. SAEM-CS did not show positive synergistic effects of SA and rTMS.

Neurobiological mechanisms of repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex in depression: a systematic review

2015 ◽  
Vol 45 (16) ◽  
pp. 3411-3432 ◽  
Author(s):  
Y. Noda ◽  
W. K. Silverstein ◽  
M. S. Barr ◽  
F. Vila-Rodriguez ◽  
J. Downar ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Treatment Resistance ◽  
Mental Illnesses ◽  
Antidepressant Effect ◽  
Therapeutic Effects ◽  
Dependent Manner ◽  
Exclusion Criteria ◽  
Promising Alternative

Depression is one of the most prevalent mental illnesses worldwide and a leading cause of disability, especially in the setting of treatment resistance. In recent years, repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising alternative strategy for treatment-resistant depression and its clinical efficacy has been investigated intensively across the world. However, the underlying neurobiological mechanisms of the antidepressant effect of rTMS are still not fully understood. This review aims to systematically synthesize the literature on the neurobiological mechanisms of treatment response to rTMS in patients with depression. Medline (1996–2014), Embase (1980–2014) and PsycINFO (1806–2014) were searched under set terms. Three authors reviewed each article and came to consensus on the inclusion and exclusion criteria. All eligible studies were reviewed, duplicates were removed, and data were extracted individually. Of 1647 articles identified, 66 studies met both inclusion and exclusion criteria. rTMS affects various biological factors that can be measured by current biological techniques. Although a number of studies have explored the neurobiological mechanisms of rTMS, a large variety of rTMS protocols and parameters limits the ability to synthesize these findings into a coherent understanding. However, a convergence of findings suggest that rTMS exerts its therapeutic effects by altering levels of various neurochemicals, electrophysiology as well as blood flow and activity in the brain in a frequency-dependent manner. More research is needed to delineate the neurobiological mechanisms of the antidepressant effect of rTMS. The incorporation of biological assessments into future rTMS clinical trials will help in this regard.

scholarly journals Synergistic Effects of Mesenchymal Stem Cell Transplantation and Repetitive Transcranial Magnetic Stimulation on Promoting Autophagy and Synaptic Plasticity in Vascular Dementia

2018 ◽  
Vol 74 (9) ◽  
pp. 1341-1350 ◽  
Author(s):  
Fei Wang ◽  
Chi Zhang ◽  
Siyuan Hou ◽  
Xin Geng
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Vascular Dementia ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Synergistic Effects ◽  
Morris Water Maze Test ◽  
Control Group ◽  
Sham Operation ◽  
Therapeutic Effects ◽  
Mesenchymal Stem Cell Transplantation

Abstract Repetitive transcranial magnetic stimulation (rTMS) and mesenchymal stem cells (MSCs) transplantation both showed therapeutic effects on cognition impairment in vascular dementia (VD) model rats. However, whether these two therapies have synergistic effects and the molecular mechanisms remain unclear. In our present study, rats were randomly divided into six groups: control group, sham operation group, VD group, MSC group, rTMS group, and MSC+rTMS group. The VD model rats were prepared using a modified 2VO method. rTMS treatment was implemented at a frequency of 5 Hz, the stimulation intensity for 0.5 Tesla, 20 strings every day with 10 pulses per string and six treatment courses. The results of the Morris water maze test showed that the learning and memory abilities of the MSC group, rTMS group, and MSC+rTMS group were better than that of the VD group, and the MSC+rTMS group showed the most significant effect. The protein expression levels of brain-derived neurotrophic factor, NR1, LC3-II, and Beclin-1 were the highest and p62 protein was the lowest in the MSC+rTMS group. Our findings demonstrated that rTMS could further enhance the effect of MSC transplantation on VD rats and provided an important basis for the combined application of MSC transplantation and rTMS to treat VD or other neurological diseases.

scholarly journals Antidepressant effects of augmentative transcranial magnetic stimulation

2007 ◽  
Vol 191 (5) ◽  
pp. 441-448 ◽  
Author(s):  
Uwe Herwig ◽  
Andreas J. Fallgatter ◽  
Jacqueline Höppner ◽  
Gerhard W. Eschweiler ◽  
Martina Kron ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Rating Scales ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Antidepressant Medication ◽  
Antidepressant Effect ◽  
Double Blind ◽  
Treatment Groups ◽  
New Treatment ◽  
Depressive Episodes

BackgroundRepetitive transcranial magnetic stimulation (rTMS) has been proposed as a new treatment option for depression. Previous studies were performed with low sample sizes in single centres and reported heterogeneous results.AimsTo investigate the efficacy of rTMS as augmentative treatment in depression.MethodIn a randomised, double-blind, sham-controlled multicentre trial 127 patients with moderate to severe depressive episodes were randomly assigned to real or sham stimulation for 3 weeks in addition to simultaneously initiated antidepressant medication.ResultsWe found no difference in the responder rates of the real and the sham treatment groups (31% in each) or in the decrease of the scores on the depression rating scales.ConclusionsThe data do not support previous reports from smaller samples indicating an augmenting or accelerating antidepressant effect of rTMS. Further exploration of the possible efficacy of other stimulation protocols or within selected sub-populations of patients is necessary.

scholarly journals The use of repetitive transcranial magnetic stimulation for treatment of obsessive-compulsive disorder: a scoping review

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Medard Kofi Adu ◽  
Ejemai Eboreime ◽  
Adegboyega Oyekunbi Sapara ◽  
Andrew James Greenshaw ◽  
Pierre Chue ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Scoping Review ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Therapeutic Effects ◽  
Obsessive Compulsive ◽  
Content Type ◽  
Compulsive Disorder ◽  
Data Search

Purpose This paper aims to explore the relevant literature available regarding the use of repetitive transcranial magnetic stimulation (rTMS) as a mode of treatment for obsessive-compulsive disorder (OCD); to evaluate the evidence to support the use of rTMS as a treatment option for OCD. Design/methodology/approach The authors electronically conducted data search in five research databases (MEDLINE, CINAHL, Psych INFO, SCOPUS and EMBASE) using all identified keywords and index terms across all the databases to identify empirical studies and randomized controlled trials. The authors included articles published with randomized control designs, which aimed at the treatment of OCD with rTMS. Only full-text published articles written in English were reviewed. Review articles on treatment for conditions other than OCD were excluded. The Covidence software was used to manage and streamline the review. Findings Despite the inconsistencies in the published literature, the application of rTMS over the supplementary motor area and the orbitofrontal cortex has proven to be promising in efficacy and tolerability compared with other target regions such as the prefrontal cortex for the treatment of OCD. Despite the diversity in terms of the outcomes and clinical variability of the studies under review, rTMS appears to be a promising treatment intervention for OCD. Research limitations/implications The authors of this scoping review acknowledge several limitations. First, the search strategy considered only studies published in English and the results are up to date as the last day of the electronic data search of December 10, 2020. Though every effort was made to identify all relevant studies for the purposes of this review per the eligibility criteria, the authors still may have missed some relevant studies, especially those published in other languages. Originality/value This review brought to bare the varying literature on the application of rTMS and what is considered gaps in the knowledge in this area in an attempt to evaluate and provide information on the potential therapeutic effects of rTMS for OCD.

scholarly journals Early Repetitive Transcranial Magnetic Stimulation Exerts Neuroprotective Effects and Improves Motor Functions in Hemiparkinsonian Rats

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Tsung-Hsun Hsieh ◽  
Xiao-Kuo He ◽  
Hui-Hua Liu ◽  
Jia-Jin J. Chen ◽  
Chih-Wei Peng ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Rat Model ◽  
Dopaminergic Neurons ◽  
Magnetic Stimulation ◽  
Therapeutic Potential ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Therapeutic Effects ◽  
Neuroprotective Effects ◽  
Motor Functions

Repetitive transcranial magnetic stimulation (rTMS) is a popular noninvasive technique for modulating motor cortical plasticity and has therapeutic potential for the treatment of Parkinson’s disease (PD). However, the therapeutic benefits and related mechanisms of rTMS in PD are still uncertain. Accordingly, preclinical animal research is helpful for enabling translational research to explore an effective therapeutic strategy and for better understanding the underlying mechanisms. Therefore, the current study was designed to identify the therapeutic effects of rTMS on hemiparkinsonian rats. A hemiparkinsonian rat model, induced by unilateral injection of 6-hydroxydopamine (6-OHDA), was applied to evaluate the therapeutic potential of rTMS in motor functions and neuroprotective effect of dopaminergic neurons. Following early and long-term rTMS intervention with an intermittent theta burst stimulation (iTBS) paradigm (starting 24 h post-6-OHDA lesion, 1 session/day, 7 days/week, for a total of 4 weeks) in awake hemiparkinsonian rats, the effects of rTMS on the performance in detailed functional behavioral tests, including video-based gait analysis, the bar test for akinesia, apomorphine-induced rotational analysis, and tests of the degeneration level of dopaminergic neurons, were identified. We found that four weeks of rTMS intervention significantly reduced the aggravation of PD-related symptoms post-6-OHDA lesion. Immunohistochemically, the results showed that tyrosine hydroxylase- (TH-) positive neurons in the substantia nigra pars compacta (SNpc) and fibers in the striatum were significantly preserved in the rTMS treatment group. These findings suggest that early and long-term rTMS with the iTBS paradigm exerts neuroprotective effects and mitigates motor impairments in a hemiparkinsonian rat model. These results further highlight the potential therapeutic effects of rTMS and confirm that long-term rTMS treatment might have clinical relevance and usefulness as an additional treatment approach in individuals with PD.

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