scholarly journals Repetitive Transcranial Magnetic Stimulation as a Probe of Episodic Memory Neurocircuitry in Schizophrenia

2020 ◽  
Vol 3 ◽  
Author(s):  
Taylor Kleyn ◽  
Michael Francis ◽  
Andrew Visco ◽  
Tom Hummer
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Episodic Memory ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Brain Activity ◽  
Recognition Task ◽  
Treatment Session ◽  
Sham Stimulation ◽  
Lower Accuracy ◽  
Resistant Depression

Background and Hypothesis:   People with schizophrenia often experience impairments with episodic memory (EM). Due in part to a lack of understanding regarding the neural mechanisms of EM, there are no effective treatments. Recent research indicates that the precuneus may be associated with EM impairment. Repetitive transcranial magnetic stimulation (rTMS) is a commonly employed intervention for treatment resistant depression, but its potential for investigating other psychiatric disorders such as schizophrenia is unclear. We hypothesize that, compared to sham stimulation, 1 Hz rTMS will decrease precuneus activity and 20 Hz rTMS will increase precuneus activity during an EM task.    Experimental Design:   Seven patients with early phase psychosis underwent a baseline fMRI scan during an EM recognition task that required participants to accurately identify which images were previously shown (targets) or not shown (foils). Next, participants had three separate rTMS sessions targeting the precuneus, each one week apart, in a randomized order: inhibitory (1 Hz) rTMS, excitatory (20Hz) rTMS, and sham stimulation. Each rTMS session was immediately followed by fMRI during the EM task.    Results:   We currently remain blind to the conditions because the study is ongoing. Participants had relatively lower accuracy during foil trials in one treatment session. During this same session, precuneus activity was relatively stronger to foils than targets, compared to other treatment sessions. These preliminary results suggest that rTMS applied to the precuneus may impact episodic memory and related brain activity in early psychosis    Conclusion and Potential Impact:   Data from this study will help determine whether targeting the precuneus with rTMS impacts functional activation in patients with schizophrenia during EM tasks. Additionally, relationships between EM performance and changes in precuneus activity will be identified. If effective, rTMS may represent a novel treatment for EM deficits in schizophrenia.  

scholarly journals Task-Modulated Brain Activity Predicts Antidepressant Responses of Prefrontal Repetitive Transcranial Magnetic Stimulation: A Randomized Sham-Control Study

2021 ◽  
Vol 5 ◽  
pp. 247054702110068
Author(s):  
Cheng-Ta Li ◽  
Chih-Ming Cheng ◽  
Chi-Hung Juan ◽  
Yi-Chun Tsai ◽  
Mu-Hong Chen ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Antidepressant Treatment ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Brain Activity ◽  
Characteristic Curve ◽  
Depression Score ◽  
Double Blind ◽  
Antidepressant Efficacy ◽  
Group B

Background Prolonged intermittent theta-burst stimulation (piTBS) and repetitive transcranial magnetic stimulation (rTMS) are effective antidepressant interventions for major depressive disorder (MDD). Cognition-modulated frontal theta (frontalθ) activity had been identified to predict the antidepressant response to 10-Hz left prefrontal rTMS. However, whether this marker also predicts that of piTBS needs further investigation. Methods The present double-blind randomized trial recruited 105 patients with MDD who showed no response to at least one adequate antidepressant treatment in the current episode. The recruited patients were randomly assigned to one of three groups: group A received piTBS monotherapy; group B received rTMS monotherapy; and group C received sham stimulation. Before a 2-week acute treatment period, electroencephalopgraphy (EEG) and cognition-modulated frontal theta changes (Δfrontalθ) were measured. Depression scores were evaluated at baseline, 1 week, and 2 weeks after the initiation of treatment. Results The Δfrontalθ at baseline was significantly correlated with depression score changes at week 1 (r = −0.383, p = 0.025) and at week 2 for rTMS group (r = −0.419, p = 0.014), but not for the piTBS and sham groups. The area under the receiver operating characteristic curve for Δfrontalθ was 0.800 for the rTMS group (p = 0.003) and was 0.549 for the piTBS group (p = 0.619). Conclusion The predictive value of higher baseline Δfrontalθ for antidepressant efficacy for rTMS not only replicates previous results but also implies that the antidepressant responses to rTMS could be predicted reliably at baseline and both piTBS and rTMS could be effective through different neurobiological mechanisms.

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.

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.

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