scholarly journals Antiepileptic Efficacy and Network Connectivity Modulation of Repetitive Transcranial Magnetic Stimulation by Vertex Suppression

2021 ◽  
Vol 15 ◽  
Author(s):  
Cong Fu ◽  
Aikedan Aisikaer ◽  
Zhijuan Chen ◽  
Qing Yu ◽  
Jianzhong Yin ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Seizure Frequency ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Reduction Rate ◽  
Network Connectivity ◽  
Hamilton Depression Scale ◽  
Depression And Anxiety ◽  
Epileptiform Discharges ◽  
The Impact

A core feature of drug-resistant epilepsy is hyperexcitability in the motor cortex, and low-frequency repetitive transcranial magnetic stimulation (rTMS) is a suitable treatment for seizures. However, the antiepileptic effect causing network reorganization has rarely been studied. Here, we assessed the impact of rTMS on functional network connectivity (FNC) in resting functional networks (RSNs) and their relation to treatment response. Fourteen patients with medically intractable epilepsy received inhibitive rTMS with a figure-of-eight coil over the vertex for 10 days spread across two weeks. We designed a 6-week follow-up phase divided into four time points to investigate FNC and rTMS-induced timing-dependent plasticity, such as seizure frequency and abnormal interictal discharges on electroencephalography (EEG). For psychiatric comorbidities, the Hamilton Depression Scale (HAM-D) and the Hamilton Anxiety Scale (HAM-A) were applied to measure depression and anxiety before and after rTMS. FNC was also compared to that of a cohort of 17 healthy control subjects. The after-effects of rTMS included all subjects that achieved the significant decrease rate of more than 50% in interictal epileptiform discharges and seizure frequency, 12 (14) patients with the reduction rate above 50% compared to the baseline, as well as emotional improvements in depression and anxiety (p < 0.05). In the analysis of RSNs, we found a higher synchronization between the sensorimotor network (SMN) and posterior default-mode network (pDMN) in epileptic patients than in healthy controls. In contrast to pre-rTMS, the results demonstrated a weaker FNC between the anterior DMN (aDMN) and SMN after rTMS, while the FNC between the aDMN and dorsal attention network (DAN) was greater (p < 0.05, FDR corrected). Importantly, the depressive score was anticorrelated with the FNC of the aDMN-SMN (r = −0.67, p = 0.0022), which was markedly different in the good and bad response groups treated with rTMS (p = 0.0115). Based on the vertex suppression by rTMS, it is possible to achieve temporary clinical efficacy by modulating network reorganization in the DMN and SMN for patients with refractory epilepsy.

scholarly journals Repetitive Transcranial Magnetic Stimulation as an Add-On Treatment for Cognitive Impairment in Alzheimer’s Disease and Its Impact on Self-Rated Quality of Life and Caregiver’s Burden

2021 ◽  
Vol 11 (6) ◽  
pp. 740
Author(s):  
Juliana Teti Mayer ◽  
Caroline Masse ◽  
Gilles Chopard ◽  
Magali Nicolier ◽  
Matthieu Bereau ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Rating Scale ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Depression And Anxiety ◽  
The Impact

Alzheimer’s disease (AD) is associated with progressive memory loss and decline in executive functions, as well as neuropsychiatric symptoms. Patients usually consider quality of life (QoL) and mood as more important for their health status than disease-specific physical and mental symptoms. In this open-label uncontrolled trial, 12 subjects diagnosed with AD underwent 10 sessions of repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (10 Hz, 20 min, 2000 pulses/day, 110% MT). Outcomes were measured before and 30 days after treatment. Our primary objective was to test the efficacy of rTMS as an add-on treatment for AD on the global cognitive function, assessed through the Mini-Mental State Examination (MMSE) and the Mattis Dementia Rating Scale (MDRS). As secondary objectives, the detailed effect on cognitive functions, depression and anxiety symptoms, QoL, and functionality in daily life activities were evaluated, as well as correlations between QoL and cognition, depression and anxiety scores. The treatment significantly enhanced semantic memory and reduced anxiety. Improvement of these features in AD could become an important target for treatment strategies. Although limited by its design, this trial may contribute with another perspective on the analysis and the impact of rTMS on AD.

Pain Psychiatry of Trigeminal Neuralgia

2018 ◽  
pp. 243-264
Author(s):  
Lily H. Kim ◽  
Michael Bret Schneider
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Depression And Anxiety ◽  
Surgical Interventions ◽  
Holistic Treatment ◽  
Carbamazepine Therapy ◽  
High Incidence

In addition to the repeated episodes of paroxysmal, electrical facial pain classically associated with the disease, many patients with trigeminal neuralgia (TN) suffer from severe emotional distress. At present, there is no universally agreed pathophysiological explanation for the high incidence of depression and anxiety within this patient population. Despite the unclear understanding, the psychiatric comorbidities should be addressed as a part of comprehensive, multi-modal approach. Anticonvulsants or serotonin and norepineprhine reuptake inhibitors are viable pharmacological options that can supplement the currently used carbamazepine therapy. For medically refractory cases, surgical interventions are being suggested as effective alternatives in managing both the pain and the psychiatric complaints of TN. Examples include microvascular decompression, stereotactic radiosurgery, and repetitive transcranial magnetic stimulation. Continued research to understand TN should take into account the psychiatric burden in this population in order to promote a holistic treatment approach.

Role of d-serine in the beneficial effects of repetitive transcranial magnetic stimulation in post-stroke patients

2020 ◽  
Vol 32 (3) ◽  
pp. 128-134 ◽  
Author(s):  
Masachika Niimi ◽  
Yuko Fujita ◽  
Tamaki Ishima ◽  
Kenji Hashimoto ◽  
Nobuyuki Sasaki ◽  
...  
Keyword(s):  
Amino Acids ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Stroke Patients ◽  
Post Stroke ◽  
Beneficial Effects ◽  
Depressed Patients ◽  
Before And After ◽  
The Impact

AbstractObjective:Abnormalities in neurotransmission via N-methyl-d-aspartic acid receptor (NMDAR) play a role in the pathophysiology of neuropsychiatric disorders. The impact of repetitive transcranial magnetic stimulation (rTMS) on NMDAR-related amino acids remains unknown. We aim to investigate the effects of rTMS on NMDAR-related amino acids in serum of post-stroke patients.Methods:Ninety-five consecutive post-stroke patients with upper limb hemiparesis were recruited. In 27 patients, the Beck Depression Inventory (BDI) score was 10 or higher. Twelve depressed patients underwent rehabilitation in combination with rTMS and 15 non-depressed patients underwent rehabilitation only without rTMS for 14 days. 1 Hz rTMS was applied to the primary motor area in the non-lesional hemisphere. BDI was conducted before and after treatment. Serum glutamine, glutamate, glycine, l-serine, and d-serine levels were measured before and after treatment.Results:There were no differences between depressed patients and non-depressed patients in clinical characteristics, levels of the five amino acids in serum, and the ratio of amino acids. However, in 27 depressed patients, there was a significant correlation between levels of glutamate in serum and BDI (ρ = 0.428, p = 0.026). BDI decreased significantly in depressed patients after treatment with or without rTMS. d-serine decreased in the rehabilitation with rTMS group, but increased in the rehabilitation without rTMS group. l-serine increased in the rehabilitation with rTMS group, but decreased in the rehabilitation without rTMS group.Conclusion:The results suggest that rTMS can modulate NMDAR-related amino acids in blood, producing beneficial effects.

Impact of Low-Frequency Transcranial Magnetic Stimulation on Brain Automatic Information Processing

2006 ◽  
Vol 20 (4) ◽  
pp. 267-275 ◽  
Author(s):  
O. Laloyaux ◽  
M. Ansseau ◽  
M. Hansenne
Keyword(s):  
Information Processing ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Low Frequency ◽  
Automatic Information Processing ◽  
Automatic Information ◽  
Before And After ◽  
Left And Right ◽  
The Impact

Repetitive transcranial magnetic stimulation (rTMS) is considered a powerful method for the study of the relationships between cortical activity and cognitive processes. Previous ERPs studies that focused on P300 response have shown that inhibitory/excitatory effects on prefrontal cortex (PFC), induced by low- and high-frequency rTMS, were able to modulate controlled but not automatic information processing. The present study assessed the impact of inhibition over left and right PFC induced by rTMS on mismatch negativity (MMN), which is known to represent automatic cerebral processes for detecting change. Auditory MMN was recorded in 20 subjects before and after application of left and right PFC 1-Hz rTMS for 15 min. MMN was also recorded before and after a sham-occipital 1-Hz rTMS as control condition. Results showed that 1-Hz rTMS induced no modification to either MMN latency or amplitude. In addition, N100 and P200 components to the frequent tones were not affected by rTMS. These results are consistent with previous findings showing that rTMS over both PFC is unable to disrupt automatic information processing. However, since two sites were stimulated in the present study, no definite conclusions about the inability of rTMS to disrupt automatic processing can be made.

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.

Hippocampal-Subregion Mechanisms of Repetitive Transcranial Magnetic Stimulation Causally Associated with Amelioration of Episodic Memory in Amnestic Mild Cognitive Impairment

2021 ◽  
pp. 1-14
Author(s):  
Jiu Chen ◽  
Rong Chen ◽  
Chen Xue ◽  
Wenzhang Qi ◽  
Guanjie Hu ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Transcranial Magnetic Stimulation ◽  
Episodic Memory ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Network Connectivity ◽  
Amnestic Mild Cognitive Impairment ◽  
Equation Modeling ◽  
Memory Decline

Background: Altered hippocampal subregions (HIPsub) and their network connectivity relate to episodic memory decline in amnestic mild cognitive impairment (aMCI), which is significantly limited by over-dependence on correlational associations. Objective: To identify whether restoration of HIPsub and its network connectivity using repetitive transcranial magnetic stimulation (rTMS) is causally linked to amelioration of episodic memory in aMCI. Methods: In the first cohort, analysis of HIPsub grey matter (GM) and its functional connectivity was performed to identify an episodic memory-related circuit in aMCI by using a pattern classification approach. In the second cohort, this circuit was experimentally modulated with rTMS. Structural equation modeling was employed to investigate rTMS regulatory mechanism in amelioration of episodic memory. Results: First, in the first cohort, this study identified HIPsub circuit pathology of episodic memory decline in aMCI patients. Second, in the second cohort, restoration of HIPc GM and its connectivity with left middle temporal gyrus (MTG.L) are causally associated with amelioration of episodic memory in aMCI after 4 weeks of rTMS. Especially important, the effects of HIPc GM changes on the improvement of episodic memory were significantly mediated by HIPc connectivity with MTG.L changes in aMCI. Conclusion: This study provides novel experimental evidence about a biological substrate for the treatment of the disabling episodic memory in aMCI patients. Correction of breakdown in HIPc structure and its connectivity with MTG can causally ameliorate episodic memory in aMCI.

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