Efficacy and clinical predictors of response to rTMS treatment in pharmacoresistant obsessive-compulsive disorder (OCD): A retrospective study

Background: Application of repetitive transcranial magnetic stimulation (rTMS) for treating obsessive-compulsive disorder (OCD) has been promising, but effects differ between patients. Knowledge about clinical predictors of rTMS response may help to increase clinical efficacy but is not available so far. Methods: In a retrospective study, we investigated the efficacy of rTMS over the dorsolateral prefrontal cortex (DLPFC) or supplementary motor area (SMA) in 65 pharmaco-resistant OCD outpatients recruited for rTMS treatment from July 2015 to May 2017. Patients received either SMA rTMS or bilateral DLPFC rTMS in case of reporting higher affective and depressive symptoms in addition to the primary OCD symptoms. OCD symptoms and depression/anxiety states were measured at baseline (before the 1 st session) and after the 20th session of rTMS. Additionally, we performed a binary logistic regression analysis on the demographic and clinical variables based on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) 3-factor and 2-factor models and individual items to investigate potential predictors of rTMS response. Results: Patients’ scores in Y-BOCS and Beck anxiety/depression inventories were significantly decreased following rTMS treatment. 46.2% of all patients responded to rTMS, based on the criterion of at least a 30% reduction in Y-BOCS scores. Both stimulation protocols had similar effects in patients with similar baseline clinical-demographic characteristics. No significant demographic predictors of rTMS efficacy were identified. The factors “Obsession severity”, “resistance” and “disturbance” and the “Interference due to obsessions” and “resistance against compulsions” items of the Y-BOCS significantly predicted response to rTMS. Conclusions: In patients with less intrusive/interfering thoughts, and low scores in the “obsession severity”, “disturbance”, and “resistance factors, rTMS might have superior effects. Identification of clinical and non-clinical predictors of response is relevant to personalize and adapt rTMS protocols in pharmaco-resistant OCD patients. Interpretation of rTMS efficacy should be done with caution due to the lack of a sham intervention condition.

Efficacy and clinical predictors of response to rTMS treatment in obsessive-compulsive disorder (OCD): A retrospective study

Background: Application of the repetitive transcranial magnetic stimulation (rTMS) for treating obsessive-compulsive disorder (OCD) has been promising but effects differ between patients. Knowledge about clinical predictors of rTMS response would help to increase clinical efficacy but is not available so far. Methods: In a retrospective study, we investigated the efficacy of rTMS over the dorsolateral prefrontal cortex (DLPFC) or supplementary motor area (SMA) in 65 OCD outpatients recruited for the rTMS treatment from July 2015 to May 2017. Patients were divided into two groups and received either SMA rTMS or bilateral DLPFC rTMS. OCD symptoms and depression/anxiety states were measured before and after the 20th session of rTMS. Additionally, we performed a binary logistic regression analysis on the demographic variables and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) items to investigate demographic and clinical predictors for rTMS response in responders and non-responders. Results: Patients’ scores in Y-BOCS and Beck anxiety/depression inventories were significantly decreased following rTMS treatment. Specifically, 46.2% of all patients responded to rTMS, based on at least 30% reduction of the Y-BOCS scores. Stimulation target (DLPFC vs. SMA) did not significantly differ in rTMS efficacy. No significant demographic predictors were found. Interference due to obsessions and resistance against compulsions were the only two clinical predictors of rTMS treatment response that could significantly predict response failure to rTMS. Conclusions: rTMS treatment should be adapted to the clinical profile of OCD patients including the symptoms. Patients with less intrusive and interfering thoughts might benefit more from rTMS treatment. Identifying clinical and non-clinical predictors of response are needed to personalize and adapt rTMS protocols in pharmaco-resistant OCD patients.

Russia-China fighter deal strengthens defence ties

Subject Su-35 fighter-jet deal. Significance At the 20th session of the Russian-Chinese Intergovernmental Commission on Military-Technical Cooperation, which met in Moscow on November 17, the Kremlin and Beijing finally agreed on China purchasing 24 Sukhoi-35 (NATO designation Flanker-E) multi-role fighter planes from Russia. Beijing has therefore become the first foreign customer for the Su-35. The transaction is also the first new Chinese contract for a Russian warplane in almost a decade. Impacts The planes will enable Chinese military aviation to conduct longer patrols in contested maritime categories. Growing cooperation with Beijing could be problematic for President Vladimir Putin's relations with South-east Asian states such as Vietnam. The Su-35 sale to China is likely to increase calls from the Russian military for more T-50 stealth fighters to maintain the advantage. The Russia-Turkey clash and Moscow's wider tensions with NATO will push Russia to make more concessions to China.

Latin America climate change progress requires aid

Subject Latin America's climate change action. Significance The agreement reached during the 20th session of the UN Climate Change Conference (COP 20) held in Lima in December 2014 committed all countries, developed and developing, to make public their commitments to reducing greenhouse gas (GHG) emissions. These will form the basis for the crucial next session (COP 21) in Paris this December. However, political and economic factors reduce the chances of a legally binding agreement emerging from the process, providing wriggle room for those governments not wanting to meet their future commitments. Impacts Countries in the region will face growing international pressure to publicise new or revised commitments to cutting emissions post-2020. If targets are to be met, countries with significant rainforests will have to improve on their logging records. The increasing budget deficits of many countries in the region will make the adaptation to climate impacts even harder.

Opto-magnetic imaging spectroscopy in characterization of the tissues during hyperbaric oxygen therapy

Background/Aim. Opto-magnetic imaging spectroscopy (OMIS) was used as a novel method to determine tissue molecular conformation changes during hyperbaric oxygen (HBO) therapy. The aim of this study was to examine the usefulness of OMIS for the assessment of HBO therapy effectiveness on the diseased tissue. Method. OMIS is concerned with obtaining paramagnetic/diamagnetic properties of materials, related to the presence of unpaired/paired electrons based on their interaction with visible light. The basic tool is light of wavelength in the range between 400 nm and 700 nm and its interaction with tissue. The study included 22 subjects: 16 angiopathy patients and 6 healthy subjects as the control group. OMIS was used with patients on the 1st, 10th and 20th session and with the control group on the 1st, 10th and 20th day without HBO therapy in between. Results. The obtained results showed that healthy skin of all the control group subjects had the same shape curve. In the angiopathy patient group, before the first session OMIS showed tissue disorder and after the last session results resembled more closely the results in healthy tissue. The differences in the tissue state in the angiopathy group before each session were noticeable, showing normalized tissue under the influence of HBO. Conclusion. The results showed that OMIS could be used as a diagnostic tool for detection of the tissue state before and after the HBO therapy.

Level cortisol at patients under the influence of ultralow temperature in the conditions of criochamber

IntroductionThe general air criothepapy - the method of short-term assignment of warmth from all surface body of the patient by a laminar stream dry air, temperature from −110 to −120 °C. Such influence is stressful for a human.AimsEstimation level changes cortisol at patients in the course of treatment in ultralow temperature in conditions criochamber.MethodsResearches have been spent with use criochamber «Zimmer Mеdizin Systeme» (Germany). In research has taken part 145 peoples. Duration of sessions influence of ultralow temperature made in the first day of 0,5 mines, then, increasing by 0,5 mines daily and reached 3,0 minute durations by 6–7 day of a course. The course crio influence made 20 sessions. Level cortisol blood was defined once a week after each 5 sessions with the analyzer «Biotec ЕL 800».ResultsLevel cortisol before carrying out criotherapy at patients averaged 436 ± 26,6 nmol/l, after carrying out 5 sessions crio influence its values have been fixed at level - 420 ± 21,05 nmol/l, after 10th session level cortisol has on the average decreased to values - 401 ± 21,05 nmol/l, after 15 sessions to - 391 ± 21,5 nmol/l. After course end crio influence the average level cortisol has made 365 ± 31,5 nmol/l that was authentic more low, than indicator reference values (р < 0,05).ConclusionsIn the course crio influence there was a gradual decrease in level cortisol that speaks about decrease in stress at these persons, and also about human body adaptation to ultralow temperature influence at such a mode to 20th session.