scholarly journals High-Frequency Repetitive Transcranial Magnetic Stimulation Over the Left Dorsolateral Prefrontal Cortex Shortly Alleviates Fatigue in Patients With Multiple System Atrophy: A Randomized Controlled Trial

2022 ◽  
Vol 12 ◽  
Author(s):  
Jing Pan ◽  
Tao-Mian Mi ◽  
Jing-Hong Ma ◽  
Hong Sun ◽  
Piu Chan
Keyword(s):  
Prefrontal Cortex ◽  
Transcranial Magnetic Stimulation ◽  
Multiple System Atrophy ◽  
High Frequency ◽  
Magnetic Stimulation ◽  
Dorsolateral Prefrontal Cortex ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Hamilton Depression Scale ◽  
Left Dlpfc ◽  
Dorsolateral Prefrontal

Background: Fatigue is a common symptom in patients with Multiple system atrophy (MSA), but effective treatments remain elusive. The present study aims to investigate whether high-frequency repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) could relieve fatigue in patients with MSA.Methods: This is a single-center, randomized and double-blind trial. Twenty-two patients with MSA and fatigue were randomly allocated to receive 10 sessions of either active (N = 11) or sham (N = 11) 10 Hz rTMS over the left DLPFC. The participants were assessed at baseline (T0), after the last session of treatment (T1), and at 2-week (T2), and 4-week (T3) follow-up timepoints. The primary outcomes were Fatigue Severity Scale-9 (FSS-9) scores, with Unified Multiple System Atrophy Rating Scale (UMSARS), 17-item Hamilton Depression Scale (HAMD-17), and Hamilton Anxiety Scale (HAMA) as secondary outcomes.Results: Two-way repeated ANOVAs revealed significant group × time interactions for FSS-9 scores (p < 0.001), HAMD-17 scores (p = 0.01), HAMA scores (p = 0.01), and UMRSA part II (p = 0.05). Post-hoc analyses showed that compared to T0, the active group exhibited remarkable improvements in FSS-9 and UMRSA part II scores at T1 and T2, but not at T3, and also in HAMD-17 and HAMA scores at T1, T2, and T3. No significant improvement was found in the sham group.Conclusion: High-frequency rTMS over the left DLPFC could provide short-term improvements for alleviating fatigue in patients with MSA, but the beneficial effects last no more than 4 weeks.

Antidepressant efficacy of high-frequency transcranial magnetic stimulation over the left dorsolateral prefrontal cortex in double-blind sham-controlled designs: a meta-analysis

2008 ◽  
Vol 39 (1) ◽  
pp. 65-75 ◽  
Author(s):  
D. J. L. G. Schutter
Keyword(s):  
Prefrontal Cortex ◽  
Transcranial Magnetic Stimulation ◽  
Effect Size ◽  
High Frequency ◽  
Magnetic Stimulation ◽  
Dorsolateral Prefrontal Cortex ◽  
Meta Analysis ◽  
Double Blind ◽  
Left Dlpfc ◽  
Dorsolateral Prefrontal

BackgroundFor more than a decade high-frequency repetitive transcranial magnetic stimulation (rTMS) has been applied to the left dorsolateral prefrontal cortex (DLPFC) in search of an alternative treatment for depression. The aim of this study was to provide an update on its clinical efficacy by performing a meta-analysis involving double-blind sham-controlled studies.MethodA literature search was conducted in the databases PubMed and Web of Science in the period between January 1980 and November 2007 with the search terms ‘depression’ and ‘transcranial magnetic stimulation’. Thirty double-blind sham-controlled parallel studies with 1164 patients comparing the percentage change in depression scores from baseline to endpoint of activeversussham treatment were included. A random effects meta-analysis was performed to investigate the clinical efficacy of fast-frequency rTMS over the left DLPFC in depression.ResultsThe test for heterogeneity was not significant (QT=30.46,p=0.39). A significant overall weighted mean effect size,d=0.39 [95% confidence interval (CI) 0.25–0.54], for active treatment was observed (z=6.52,p<0.0001). Medication resistance and intensity of rTMS did not play a role in the effect size.ConclusionsThese findings show that high-frequency rTMS over the left DLPFC is superior to sham in the treatment of depression. The effect size is robust and comparable to at least a subset of commercially available antidepressant drug agents. Current limitations and future prospects are discussed.

scholarly journals Functional and Structural Connectivity Between the Left Dorsolateral Prefrontal Cortex and Insula Could Predict the Antidepressant Effects of Repetitive Transcranial Magnetic Stimulation

2021 ◽  
Vol 15 ◽  
Author(s):  
Yixiao Fu ◽  
Zhiliang Long ◽  
Qinghua Luo ◽  
Zhen Xu ◽  
Yisijia Xiang ◽  
...  
Keyword(s):  
Prefrontal Cortex ◽  
Transcranial Magnetic Stimulation ◽  
Clinical Efficacy ◽  
Magnetic Stimulation ◽  
Dorsolateral Prefrontal Cortex ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Structural Connectivity ◽  
Left Dlpfc ◽  
Dorsolateral Prefrontal ◽  
Connectivity Strength

BackgroundThe efficacy of repetitive transcranial magnetic stimulation (rTMS) in depression is nonuniform across patients. This study aims to determine whether baseline neuroimaging characters can provide a pretreatment predictive effect for rTMS.MethodsTwenty-seven treatment-naive patients with major depressive disorder (MDD) were enrolled and scanned with resting-state functional magnetic resonance imaging (fMRI) and diffusion tensor imaging. Clinical symptoms were assessed pre- and post-rTMS. Functional and structural connectivity between the left dorsolateral prefrontal cortex (DLPFC) and bilateral insula were measured, and the connectivity strength in each modality was then correlated to the clinical efficacy of rTMS.ResultsWhen the coordinates of left DLPFC were located as a node in the central executive network, the clinical efficacy of rTMS was significantly correlated with the functional connectivity strength between left DLPFC and bilateral insula (left insula: r = 0.66; right insula: r = 0.65). The structural connectivity strength between the left DLPFC and left insular cortex also had a significantly positive correlation with symptom improvement (rs = 0.458).ConclusionThis study provides implications that rTMS might act more effectively when the pretreatment functional and structural connectivity between the insula and left DLPFC is stronger.

Influencing negative symptoms of schizophrenia with repetitive transcranial magnetic stimulation: a case study

2007 ◽  
Vol 19 (1) ◽  
pp. 53-55 ◽  
Author(s):  
Radovan Prikryl ◽  
Simona Skotakova ◽  
Tomas Kasparek ◽  
Eva Ceskova ◽  
Hana Kucerova ◽  
...  
Keyword(s):  
Prefrontal Cortex ◽  
Depressive Symptoms ◽  
Transcranial Magnetic Stimulation ◽  
High Frequency ◽  
Magnetic Stimulation ◽  
Dorsolateral Prefrontal Cortex ◽  
Negative Symptoms ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
High Frequency Stimulation ◽  
Dorsolateral Prefrontal

Background:The present trial was designed to investigate the influence of repetitive transcranial magnetic stimulation (rTMS) on negative schizophrenic symptoms using high-frequency stimulation of the left dorsolateral prefrontal cortex in a simple blind randomized design.Methods:The study was carried out on a 42-year-old patient with schizophrenia (paranoid subtype) with prominent negative symptoms who was first treated with sham rTMS during the first 3 weeks and then with real high frequency during the following 3 weeks. He was rated before and after the sham and after the real rTMS therapy for positive, negative and depressive symptoms.Results:rTMS was superior to sham treatment in reduction of negative and depressive symptoms.Conclusion:High-frequency rTMS applied over the left dorsolateral prefrontal cortex led to a reduction of severity of negative symptoms in a patient with chronic schizophrenia and may be beneficial as an augmentation option to antipsychotics in the treatment of negative symptoms of schizophrenia.

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