Beneficial Effects Of rTMS Research Articles

Repetitive transcranial magnetic stimulation and fluoxetine attenuate astroglial activation and benefit behaviours in a chronic unpredictable mild stress mouse model of depression

Objectives: Repetitive transcranial magnetic stimulation (rTMS) has been considered as an effective antidepressant treatment; however, the mechanism of its antidepressant effect is still unclear. Fluoxetine, a selective serotonin reuptake inhibitor antidepressant, may be neuroprotective. The objective of the present study was to evaluate the effect and underlying possible neuroprotective mechanism of rTMS and fluoxetine on abnormal behaviours in a depressive mouse model induced by chronic unpredictable mild stress (CUMS).Methods: After 28 days of CUMS exposure, mice were chronically treated with rTMS (10 Hz for 5 s per train, total 20 trains per day) and (or) fluoxetine (5 mg/kg/day, intraperitoneally) for 28 days targeting on the frontal cortex. After the behavioural tests, the protein expressions of glial fibrillary acidic protein (GFAP), brain-derived neurotrophic factor (BDNF) and tyrosine kinase B (TrkB) were measured by immunohistochemistry and (or) Western Blot.Results: The results showed rTMS and (or) fluoxetine attenuated the locomotion decrease, anxiety and depressive like behaviours in the CUMS-exposed mice.Conclusion: Our results suggest that both rTMS and fluoxetine could benefit the CUMS-induced abnormal behaviours including depressive-like behaviours, and the beneficial effects of rTMS as well as fluoxetine on depression might be partly related to their neuroprotective effect on attenuating astroglial activation and BDNF decrease

Stimulation Parameters Used During Repetitive Transcranial Magnetic Stimulation for Motor Recovery and Corticospinal Excitability Modulation in SCI: A Scoping Review.

There is a growing interest in non-invasive stimulation interventions as treatment strategies to improve functional outcomes and recovery after spinal cord injury (SCI). Repetitive transcranial magnetic stimulation (rTMS) is a neuromodulatory intervention which has the potential to reinforce the residual spinal and supraspinal pathways and induce plasticity. Recent reviews have highlighted the therapeutic potential and the beneficial effects of rTMS on motor function, spasticity, and corticospinal excitability modulation in SCI individuals. For this scoping review, we focus on the stimulation parameters used in 20 rTMS protocols. We extracted the rTMS parameters from 16 published rTMS studies involving SCI individuals and were able to infer preliminary associations between specific parameters and the effects observed. Future investigations will need to consider timing, intervention duration and dosage (in terms of number of sessions and number of pulses) that may depend on the stage, the level, and the severity of the injury. There is a need for more real vs. sham rTMS studies, reporting similar designs with sufficient information for replication, to achieve a significant level of evidence regarding the use of rTMS in SCI.

Repetitive transcranial magnetic stimulation of the prefrontal cortex for fibromyalgia syndrome: a randomised controlled trial with 6-months follow up

ObjectivesFibromyalgia Syndrome (FMS), is a chronic pain disorder with poorly understood pathophysiology. In recent years, repetitive transcranial magnetic stimulation (rTMS) has been recommended for pain relief in various chronic pain disorders. The objective of the present research was to study the effect of low frequency rTMS over the right dorsolateral prefrontal cortex (DLPFC) on pain status in FMS.MethodsNinety diagnosed cases of FMS were randomized into Sham-rTMS and Real-rTMS groups. Real rTMS (1 Hz/1200 pulses/8 trains/90% resting motor threshold) was delivered over the right DLPFC for 5 consecutive days/week for 4 weeks. Pain was assessed by subjective and objective methods along with oxidative stress markers. Patients were followed up for 6 months (post-rTMS;15 days, 3 months and 6 months).ResultsIn Real-rTMS group, average pain ratings and associated symptoms showed significant improvement post rTMS. The beneficial effects of rTMS lasted up to 6 months in the follow-up phase. In Sham-rTMS group, no significant change in pain ratings was observed.ConclusionRight DLPFC rTMS can significantly reduce pain and associated symptoms of FMS probably through targeting spinal pain circuits and top-down pain modulation .Trial registration: Ref No: CTRI/2013/12/004228.

Beneficial Effects of Theta-Burst Transcranial Magnetic Stimulation on Stroke Injury via Improving Neuronal Microenvironment and Mitochondrial Integrity.

Recent work suggests that repetitive transcranial magnetic stimulation (rTMS) may beneficially alter the pathological status of several neurological disorders, although the mechanism remains unclear. The current study was designed to investigate the effects of rTMS on behavioral deficits and potential underlying mechanisms in a rat photothrombotic (PT) stroke model. From day 0 (3h) to day 5 after the establishment of PT stroke, 5-min daily continuous theta-burst rTMS (3 pulses of 50Hz repeated every 200ms, intensity at 200G) was applied on the infarct hemisphere. We report that rTMS significantly attenuated behavioral deficits and infarct volume after PT stroke. Further investigation demonstrated that rTMS remarkably reduced synaptic loss and neuronal degeneration in the peri-infarct cortical region. Mechanistic studies displayed that beneficial effects of rTMS were associated with robust suppression of reactive micro/astrogliosis and the overproduction of pro-inflammatory cytokines, as well as oxidative stress and oxidative neuronal damage especially at the late stage following PT stroke. Intriguingly, rTMS could effectively induce a shift in microglial M1/M2 phenotype activation and an A1 to A2 switch in astrocytic phenotypes. In addition, the release of anti-inflammatory cytokines and mitochondrial MnSOD in peri-infarct regions were elevated following rTMS treatment. Finally, rTMS treatment efficaciously preserved mitochondrial membrane integrity and suppressed the intrinsic mitochondrial caspase-9/3 apoptotic pathway within the peri-infarct cortex. Our novel findings indicate that rTMS treatment exerted robust neuroprotection when applied at least 3h after ischemic stroke. The underlying mechanisms are partially associated with improvement of the local neuronal microenvironment by altering inflammatory and oxidative status and preserving mitochondrial integrity in the peri-infarct zone. These findings provide strong support for the promising therapeutic effect of rTMS against ischemic neuronal injury and functional deficits following stroke.

Transcranial Magnetic Stimulation Treatment for Motor Symptoms in Parkinson’s Disease: A Review of Two Decades of Studies

In the last two decades, repetitive Transcranial Magnetic Stimulation (rTMS) has been increasingly employed in Parkinson’s disease (PD) to enhance and restore motor function. Different cortical regions have been investigated as treatment targets (i.e. primary motor cortex, dorsolateral prefrontal cortex and supplementary motor area) and stimulation parameters (frequency, intensity, number of pulses) showed high heterogeneity between studies. Herein we review 40 studies, both open-label and randomized controlled trials: mixed results have been yielded regarding the effectiveness of rTMS treatment for motor symptoms in PD, due to the high variability of employed protocols, sham procedures and target regions. Although overall results seem to support the notion of potential beneficial effects of rTMS in PD, further research is needed to identify the optimal treatment parameters and to evaluate the potential conjunct use of rTMS in patients with deep brain stimulation (DBS) implants.

Repetitive transkranielle Magnetstimulation (rTMS) bei Angsterkrankungen - eine mögliche Therapieoption?

Anxiety disorders rank among the most frequent psychiatric disorders. Effective psychotherapeutic and psychopharmacological interventions exist, although a considerable number of patients does not respond to standard interventions. Repetitive transcranial magnetic stimulation (rTMS) is capable of modulating cortical activity locally and non-invasively. Therefore, rTMS is discussed as a possible alternative treatment approach in psychiatric disorders. The present paper aims to provide a systematic review of randomised controlled studies, open studies, and case reports examining the potential therapeutic effects of rTMS in anxiety disorders. Overall, these studies suggest beneficial effects of rTMS on anxiety symptoms. Nevertheless, larger randomised controlled studies are warranted to allow a more comprehensive evaluation of the therapeutic efficacy of rTMS in anxiety disorders.

Noninvasive brain stimulation: repetitive transcranial magnetic stimulation and transcranial direct current stimulation

Noninvasive brain stimulation provides an effective means of modulating the function of specific neural structures and shows potential for the rehabilitation of patients with brain disorders. Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are two of the most promising noninvasive brain stimulation methods. They can help to avoid surgical risks and provide theoretical advantages of neuromodulation of specific neural circuits. rTMS has been used in two ways: low-frequency stimulation to reduce cortical excitability or high-frequency stimulation to facilitate cortical excitability. Also, the anodal stimulation of tDCS increases the neuronal excitability of the brain area being stimulated and cathodal stimulation of tDCS decreases the neuronal excitability. These neuromodulative effects of rTMS and tDCS have been intensively studied in the field of neuromodulation and neurorehabilitation of patients with brain disorders during the last few decades. Most studies have shown beneficial effects of rTMS or tDCS on clinical symptoms in patients with brain disorders such as stroke and Parkinson's disease. However, stimulation parameters have widely varied, and the small sample size of most studies reduces the strength of the evidence. Nevertheless, minimal side effects, positive evidence, and unveiling the mechanisms of neuromodulation using functional neuroimaging methods have made rTMS and tDCS attractive among the emerging neurorehabilitation tools.

Functional Imaging and Neurocognitive Correlates of Targeted High Frequency Repetitive Transcranial Magnetic Stimulation in Patients with Alzheimer's Disease (P04.190)

Objective: To assess whether 1) repetitive transcranial magnetic stimulation (rTMS) can ameliorate aphasia in Alzheimer9s disease (AD) patients and 2) whether there are changes in activation patterns in relevant cortical areas using functional brain imaging subsequent to rTMS. Background Among the earliest manifestations of AD are deficits in language that significantly impair patients9 quality of life. Currently approved agents for slowing progression of AD do not target aphasia. Studies have demonstrated beneficial effects of rTMS in improving cognition and language deficits in patients with neurological disorders. rTMS may be a potential therapeutic tool to help improve aphasia in AD patients. Design/Methods: Eleven AD patients with aphasia underwent 4 sessions of rTMS applied to the dorsolateral prefrontal cortex at a frequency of 10-15 Hz over two weeks. They underwent standardized cognitive tests at baseline, immediately after completing the course of rTMS, and 4-weeks after the last rTMS treatment. All patients underwent concomitant functional MRI (fMRI) scans at the time of the tests while performing cognitive paradigms in the scanner. Results: All patients completed the cognitive portions of the study. Three patients could not tolerate imaging and therefore did not complete the imaging portion of the study. There was improvement in verbal and non-verbal agility on testing that was seen 4-weeks post-treatment relative to baseline (p Conclusions: These preliminary results suggest that rTMS may serve as an effective adjunctive treatment for aphasia found in AD patients. Further research using control stimulation is needed. Disclosure: Dr. Devi has nothing to disclose. Dr. Levine has nothing to disclose. Dr. Voss has nothing to disclose. Dr. de Boisblanc has nothing to disclose. Dr. Heier has nothing to disclose. Dr. Halper has nothing to disclose.

Effects of 20 Hz repetitive transcranial magnetic stimulation with different intensities on neurobehavior and glial fibrillary acidic protein in rats with cerebral infarction

Objective To investigate the effects of 20 Hz repetitive transcranial magnetic stimulation (rTMS) with different intensities on neurobehavior and expression of glial fibrillary acidic protein (GFAP) in ischemic penumbra of rats with cerebral infarction,so as to explore the probable mechanism. Methods Forty-three rats were randomly divided into a blank control group( n =7 ),a model control group( n =7),a sham stimulation control group(n =8) and a rTMS group (n =21) ; the rTMS group was further subdivided into 3 subgroups:80％ MT subgroup,100％ MT subgroup and 120％ MT subgroup,with 7 rats in each subgroup.The cerebral infarction model was established by right middle cerebral artery occlusion (MCAO) in each group except the blank control group.The 3 rTMS subgroups were given 14 successive blocks of 20 Hz rTMS with corresponding intensity.The sham stimulation control group received sham treatment (without any output).The model control group was given no stimulation,and the blank control group did not receive any special treatment.Functional assessments were performed at 3 different time points.After 14-day treatment,the expression of GFAP proteins in ischemic penumbra were detected by immunohistochemistry technique. Results Functional outcome reflected from 3 behavioral tests in 100％ MT subgroup after 14-day stimulation was better than 1 day after operation,while in the other rTMS subgroups functional outcomes were just better in 2 behavioral tests.The expressions of GFAP in 3 rTMS subgroups were all less than that in model control group. Conclusions The 20 Hz rTMS with 80％ MT and 100％ MT might be safe and effective to improve the functional outcome in rats with acute cerebral infarction,especially 100％ MT.Decrease of expression of GFAP in ischemic penumbra might be one of the mechanisms of beneficial effects of rTMS in ischemia brain injury. Key words: Cerebral infarction; Repetitive transcranial magnetic stimulation; Functional assessment; Glial fibrillary acidic protein

Effects of repetitive transcranial magnetic stimulation on chronic tinnitus: a randomised, crossover, double blind, placebo controlled study

Background: Chronic tinnitus is a disabling, almost untreatable, condition, usually accompanied by psychiatric distress. In patients with complex neuropsychiatric diseases, such as chronic pain, with which tinnitus shares pathophysiological similarities,...