Efficacy Of Repetitive Transcranial Magnetic Stimulation Research Articles

The Efficacy of High- or Low-Frequency Transcranial Magnetic Stimulation in Alzheimer's Disease Patients with Behavioral and Psychological Symptoms of Dementia.

Alzheimer's disease (AD) is usually accompanied by different degrees of behavioral and psychological symptoms of dementia (BPSD). Transcranial magnetic stimulation (TMS) has been applied for the treatment of AD as a painless and noninvasive therapy. However, the efficacy of repetitive TMS (rTMS) with different frequencies in AD with BPSD remains unknown. A total of 32 AD patients with psychobehavioral symptoms were selected as the study subjects. Among them, 16 patients were included in the high-frequency TMS group with an average disease duration of 6.22 ± 2.55years. The low-frequency TMS group was gender and age matched with a disease course of 7.02 ± 3.33-year average duration. The high-frequency TMS group received TMS treatment twice per day for 4weeks under 80% MT stimulation intensity, 10-Hz frequency for 0.5h each time, and the low-frequency TMS group received TMS treatment of 2-Hz frequency for 0.5h each time. Neuropsychological status was assessed by the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD) score. The behavioral ability was assessed by the Abilities of Daily Living (ADL) scale; cognitive function was evaluated by Mini-Mental State Examination (MMSE). The levels of β amyloid 40 and 42 (Aβ40 and Aβ42) in plasma were detected using a double-antibody sandwich enzyme-linked immunosorbent assay. All patients underwent brain magnetic resonance imaging (MRI) before and after the experiment. After 2weeks of treatment, the BEHAVE-AD and ADL scores of the patients in the high-frequency group were significantly lower than those before the treatment, and they continued to decrease after 4weeks of treatment. The BEHAVE-AD and ADL scores of the low-frequency TMS group were also significantly lower than before treatment. The comparison between groups at different time points showed that the BEHAVE-AD and ADL scores of the patients in the high-frequency group were significantly lower than those of the patients in the low-frequency TMS group. The MMSE of high-frequency TMS-treated patients increased from 14.22 ± 3.55 before treatment to 14.67 ± 2.22 at 2week's treatment and 17.33 ± 3.11 at 4week's treatment (p < 0.01) in contrast to 14.19 ± 3.47, 14.28 ± 3.41, and 14.49 ± 2.79, respectively, found in the low-frequency TMS group. At week 4, the high-frequency TMS-treated group's plasma Aβ40 did not change compared to that before treatment. No effects on plasma Aβ42 were observed between the high- vs. low-frequency TMS groups. The incidence of adverse reactions during treatment was comparable between groups. These results indicate that high-frequency TMS has the advantages of fast results, good efficacy, and high safety for the treatment of psychobehavioral abnormalities in AD patients. In addition, our study suggests that high-frequency TMS intervention can further improve the cognitive function of AD patients.

Examining and Modulating Neural Circuits in Psychiatric Disorders With Transcranial Magnetic Stimulation and Electroencephalography: Present Practices and Future Developments.

Transcranial magnetic stimulation (TMS) is a noninvasive brain stimulation technique uniquely equipped to both examine and modulate neural systems and related cognitive and behavioral functions in humans. As an examination tool, TMS can be used in combination with EEG (TMS-EEG) to elucidate directly, objectively, and noninvasively the intrinsic properties of a specific cortical region, including excitation, inhibition, reactivity, and oscillatory activity, irrespective of the individual's conscious effort. Additionally, when applied in repetitive patterns, TMS has been shown to modulate brain networks in healthy individuals, as well as ameliorate symptoms in individuals with psychiatric disorders. The key role of TMS in assessing and modulating neural dysfunctions and associated clinical and cognitive deficits in psychiatric populations is therefore becoming increasingly evident. In this article, the authors review TMS-EEG studies in schizophrenia and mood disorders, as most TMS-EEG studies to date have focused on individuals with these disorders. The authors present the evidence on the efficacy of repetitive TMS (rTMS) and theta burst stimulation (TBS), when targeting specific cortical areas, in modulating neural circuits and ameliorating symptoms and abnormal behaviors in individuals with psychiatric disorders, especially when informed by resting-state and task-related neuroimaging measures. Examples of how the combination of TMS-EEG assessments and rTMS and TBS paradigms can be utilized to both characterize and modulate neural circuit alterations in individuals with psychiatric disorders are also provided. This approach, along with the evaluation of the behavioral effects of TMS-related neuromodulation, has the potential to lead to the development of more effective and personalized interventions for individuals with psychiatric disorders.

Repetitive Transcranial Magnetic Stimulation in the Treatment of a Difficult to Treat Condition, Borderline Personality Disorder.

Borderline personality disorder (BPD) is a serious mental disorder characterized by a pervasive pattern of instability in affect regulation and interpersonal relationships, poor self-image and behavioral control, self-injurious behavior, suicidality, and other high-risk behaviors. It is also characterized by a high mortality rate by suicide. The published literature on repetitive transcranial magnetic stimulation (TMS), theta-burst stimulation (TBS), and deep TMS in the treatment of BPD were reviewed. Four clinical studies (2 randomized trials and 2 case studies) with limited sample sizes found that TMS and TBS were safe and potentially effective in the reduction of symptoms of BPD. Given the limited clinical evidence for efficacy on the basis of the results of these studies, future controlled studies involving larger samples and optimal stimulus parameters should be designed to confirm the short-term and long-term safety and efficacy of repetitive TMS and TBS in the treatment of BPD.

Efficacy of repetitive transcranial magnetic stimulation versus electroconvulsive therapy in the treatment of medication resistant major depressive disorder: a systematic review protocol

Review question/ objective The aim of this review is to compare the efficacy of repetitive transcranial-magnetic stimulation (rTMS) with electroconvulsive therapy (ECT) in the treatment of medication resistant major depressive disorder. Inclusion Criteria Types of participants This review will consider all randomized controlled trials that attempt to compare the efficacy of rTMS versus ECT in the treatment of medication resistant major depressive disorder; given for patients of any age and gender with a diagnosis of major depression disorder, with or without psychotic features according to either the DSM–IV (American Psychiatric Association, 1994) or ICD–10 (World Health Organization, 1993) diagnostic criteria. All patients included in this study have to have been judged as clinically appropriate for a course of ECT or rTMS based on the chronicity and severity of depression, presence of multiple medication trials and/or lack of adequate response or intolerance to pharmacotherapy. Types of intervention(s) This particular review will include all randomized controlled trial studies that compared the efficacy of rTMS with ECT therapy in the treatment of medication resistant major depressive disorder, given for patients of any age and gender. Types of outcomes The primary outcome measure of this review will be the score on the Hamilton Depression Rating Scale (HAM-D) and the proportion of patients with remissions (Hamilton score, < 8) after treatment with rTMS or ECT. Secondary outcomes will include mood self-ratings on the Beck Depression Inventory-II and Visual Analogue Mood Scales, Brief Psychiatric Rating Scale (BPRS) score, Young Mania Rating Scale (YMS), Clinical Global Impression scale (CGI) and both self-reported and observer-rated cognitive changes.

Treating refractory obsessive compulsive disorder with combination of paroxetine and repetitive transcranial magnetic stimulation: a double-blind sham controlled study

Objective To study the efficacy of repetitive transcranial magneticstimulation(rTMS) of the right prefrontal cortex combined paroxetine for patients with obsessive-compulsive disorder ( OCD) under doubleblind , sham-controlled conditions. Methods Patients were randomly assigned to 2 sessions of real ( n = 32) or sham ( n = 31) rTMS and both group received Paroxetine treatment. rTMS treatments lasted 20 minutes,and the frequency was 10 Hz and the intensity was 100% of motor threshold for real rTMS. Psychopathology was assessed by HAMA.Y-BOCS before the treatment,immediately after the experimental treatment,and 1,2,4,6 weeks after the experimental treatment by an independent reviewer. Results In combined therapy group,9(32. 14% ) recovered, 10(35.71% ) remitted,5( 17. 86% ) improved,4( 14. 29% ) remained unresponsive. In contrast,there were 4(16.36%) recovery,5(21.82%) remission, 10(38.18% ) improvement,6(23.64% ) unresponse in drug therapy group. The outcome of ITT showed all the patients in the two groups significant improvement (the scores of YBOCS( F=56.258, P=0.000) ;the scores of HAMA( F=41.675, P=0.000) after the treatment,but the effectiveness in the combined therapy group was better than that in the drug therapy group (the scores of Y-BOCS, F= 13.652, P=0.028;the scores of HAMA, F= 11.632, P=0.031). Conclusions Repetitive transcranial rTMS of the right prefrontal cortex combined paroxetine is more effective than paroxetine only in treatment of refractory OCD. Key words: Obsessive compulsive disorder ; Refractory ; Repetitive transcranial magnetic stimulation ; Proxetine ;