High-frequency Transcranial Magnetic Stimulation Research Articles

A Pilot Study of High-Frequency Transcranial Magnetic Stimulation for Bipolar Depression.

A Pilot Study of High-Frequency Transcranial Magnetic Stimulation for Bipolar Depression.

Effects of different modalities of transcranial magnetic stimulation on post-stroke cognitive impairment: a network meta-analysis.

The study aimed to evaluate, using a network meta-analysis, the effects of different transcranial magnetic stimulation (TMS) modalities on improving cognitive function after stroke. Computer searches of the Cochrane Library, PubMed, Web of Science, Embass, Google Scholar, CNKI, and Wanfang databases were conducted to collect randomized controlled clinical studies on the use of TMS to improve cognitive function in stroke patients, published from the time of database construction to November 2023. A total of 29 studies and 2123 patients were included, comprising five interventions: high-frequency rTMS (HF-rTMS), low-frequency rTMS (LF-rTMS), intermittent theta rhythm stimulation (iTBS), sham stimulation (SS), and conventional rehabilitation therapy (CRT). A reticulated meta-analysis showed that the rankings of different TMS intervention modalities in terms of the Montreal Cognitive Assessment (MoCA) scores, Mini-Mental State Examination scores (MMSE), and Modified Barthel Index (MBI) scores were: HF-rTMS > LF-rTMS > iTBS > SS > CRT; the rankings of different TMS intervention modalities in terms of the event-related potential P300. amplitude scores were HF-rTMS > LF-rTMS > iTBS > CRT > SS; the rankings of different TMS intervention modalities in terms of the P300 latency scores were: iTBS > HF-rTMS > LF-rTMS > SS > CRT. Subgroup analyses of secondary outcome indicators showed that HF-rTMS significantly improved Rivermead Behavior Memory Test scores and Functional Independence Measurement-Cognitive scores. High-frequency TMS stimulation has a better overall effect on improving cognitive functions and activities of daily living, such as attention and memory in stroke patients.

Repetitive Transcranial Magnetic Stimulation (rTMS) in Post-Traumatic Stress Disorder: Study Protocol of a Nationwide Randomized Controlled Clinical Trial of Neuro-Enhanced Psychotherapy "TraumaStim".

The use of high-frequency Transcranial Magnetic Stimulation (HF-rTMS) of the right dorsolateral prefrontal cortex (DLPFC) in treating Post-traumatic Stress Disorder (PTSD) is currently regarded as a level B intervention (probable effectiveness). HF-rTMS has attracted interest as a neuromodulation therapeutic method for PTSD. Prolonged exposure and reactivation therapy are also regarded as first-line treatments for PTSD. Randomized controlled clinical studies examining the effectiveness of several HF-rTMS sessions coupled with psychotherapy have not yet been completed. In total, 102 patients with refractory PTSD will be randomly assigned (1:1) to reactivation therapy, in addition to either active HF-rTMS (20 Hz) or sham HF-rTMS, for 12 sessions in a nationwide, multicenter, double-blind controlled trial. The impact on PTSD symptoms and neurocognitive functioning will be assessed. The primary outcome is the PTSD severity score measured based on the Clinician-Administered PTSD Scale (CAPS-5) at one month. If this additional therapy is successful, it may strengthen the case for regulatory authorities to approve this additional technique of treating PTSD. Additionally, it expands the field of neurostimulation-assisted psychotherapy.

Better Fields or Currents? A Head-to-Head Comparison of Transcranial Magnetic (rTMS) Versus Direct Current Stimulation (tDCS) for Neuropathic Pain.

While high-frequency transcranial magnetic stimulation (HF-rTMS) is now included in the armamentarium to treat chronic neuropathic pain (NP), direct-current anodal stimulation (a-tDCS) to the same cortical targets may represent a valuable alternative in terms of feasibility and cost. Here we performed a head-to-head, randomized, single-blinded, cross-over comparison of HF-rTMS versus a-tDCS over the motor cortex in 56 patients with drug-resistant NP, who received 5 daily sessions of each procedure, with a washout of at least 4weeks. Daily scores of pain, sleep, and fatigue were obtained during 5 consecutive weeks, and functional magnetic resonance imaging (fMRI) to a motor task was performed in a subgroup of 31 patients. The percentage of responders, defined by a reduction in pain scores of > 2 SDs from pre-stimulus levels, was similar to both techniques (42.0% vs. 42.3%), while the magnitude of "best pain relief" was significantly skewed towards rTMS. Mean pain ratings in responders decreased by 32.6% (rTMS) and 29.6% (tDCS), with half of them being sensitive to only one technique. Movement-related fMRI showed significant activations in motor and premotor areas, which did not change after 5days of stimulation, and did not discriminate responders from non-responders. Both HF-rTMS and a-tDCS showed efficacy at 1month in drug-resistant NP, with magnitude of relief slightly favoring rTMS. Since a significant proportion of patients responded to one procedure only, both modalities should be tested before declaring a patient as unresponsive.

Delayed improvements in visual memory task performance among chronic schizophrenia patients after high-frequency repetitive transcranial magnetic stimulation.

BACKGROUNDCognitive impairments are core characteristics of schizophrenia, but are largely resistant to current treatments. Several recent studies have shown that high-frequency repetitive transcranial magnetic stimulation (rTMS) of the left dor-solateral prefrontal cortex (DLPFC) can reduce negative symptoms and improve certain cognitive deficits in schizophrenia patients. However, results are inconsistent across studies.AIMTo examine if high-frequency rTMS of the DLPFC can improve visual memory deficits in patients with schizophrenia.METHODSForty-seven chronic schizophrenia patients with severe negative symptoms on stable treatment regimens were randomly assigned to receive active rTMS to the DLPFC (n = 25) or sham stimulation (n = 22) on weekdays for four consecutive weeks. Patients performed the pattern recognition memory (PRM) task from the Cambridge Neuropsychological Test Automated Battery at baseline, at the end of rTMS treatment (week 4), and 4 wk after rTMS treatment (week 8). Clinical symptoms were also measured at these same time points using the Scale for the Assessment of Negative Symptoms (SANS) and the Positive and Negative Syndrome Scale (PANSS).RESULTSThere were no significant differences in PRM performance metrics, SANS total score, SANS subscores, PANSS total score, and PANSS subscores between active and sham rTMS groups at the end of the 4-wk treatment period, but PRM performance metrics (percent correct and number correct) and changes in these metrics from baseline were significantly greater in the active rTMS group at week 8 compared to the sham group (all P < 0.05). Active rTMS treatment also significantly reduced SANS score at week 8 compared to sham treatment. Moreover, the improvement in visual memory was correlated with the reduction in negative symptoms at week 8. In contrast, there were no between-group differences in PANSS total score and subscale scores at either week 4 or week 8 (all P > 0.05).CONCLUSIONHigh-frequency transcranial magnetic stimulation improves visual memory and reduces negative symptoms in schizophrenia, but these effects are delayed, potentially due to the requirement for extensive neuroplastic changes within DLPFC networks.

High-Frequency Transcranial Magnetic Stimulation Combined With Functional Magnetic Resonance Imaging Reveals Distinct Activation Patterns Associated With Different Dorsolateral Prefrontal Cortex Stimulation Sites

ObjectivesTranscranial magnetic stimulation (TMS) has been extensively used for the treatment of depression, obsessive-compulsive disorder, and certain neurologic disorders. Despite having promising treatment efficacy, the fundamental neural mechanisms of TMS remain understudied. Materials and MethodsIn this study, 15 healthy adult participants received simultaneous TMS and functional magnetic resonance imaging to map the modulatory effect of TMS when it was applied over three different sites in the dorsolateral prefrontal cortex. Independent component analysis (ICA) was used to identify the networks affected by TMS when applied over the different sites. The standard general linear model (GLM) analysis was used for comparison. ResultsICA showed that TMS affected the stimulation sites as well as remote brain areas, some areas/networks common across all TMS sites, and other areas/networks specific to each TMS site. In particular, TMS site and laterality differences were observed at the left executive control network. In addition, laterality differences also were observed at the dorsal anterior cingulate cortex and dorsolateral/dorsomedial prefrontal cortex. In contrast with the ICA findings, the GLM-based results mainly showed activation of auditory cortices regardless of the TMS sites. ConclusionsOur findings support the notion that TMS could act through a top-down mechanism, indirectly modulating deep subcortical nodes by directly stimulating cortical regions. Clinical Trial RegistrationThe Clinicaltrials.gov registration number for the study is NCT03394066.

Corticomotor plasticity as a predictor of response to high frequency transcranial magnetic stimulation treatment for major depressive disorder

BackgroundMany patients with treatment-resistant depression (TRD) respond to repetitive transcranial magnetic stimulation (rTMS) treatment. This study aimed to investigate whether modulation of corticomotor excitability by rTMS predicts response to rTMS treatment for TRD in 10 Hz and intermittent theta-burst stimulation (iTBS) protocols. MethodsThirteen TRD patients underwent two evaluations of corticomotor plasticity—assessed as the post-rTMS (10 Hz, iTBS) percent change (%∆) in motor evoked potential (MEP) amplitude elicited by single-pulse TMS. Following corticomotor plasticity evaluations, patients subsequently underwent a standard 6-week course of 10 Hz rTMS (4 s train, 26 s inter-train interval, 3000 total pulses, 120% of motor threshold) to the left dorsolateral prefrontal cortex. Treatment efficacy was assessed by the Beck Depression Inventory II (BDI-II) and Hamilton Depression Rating Scale (HAM-D). The change in MEPs was compared between 10 Hz and iTBS conditions and related to the change in BDI-II and HAM-D scores. ResultsAnalyses of variance revealed that across all time-points, higher post-10 Hz MEP change was a significant predictor of greater improvement on the BDI-II (p < 0.001) and HAM-D (p = 0.022). This relationship was not observed with iTBS (p-values≥0.100). Post-hoc tests revealed the MEP change 20 min post-10 Hz was the strongest predictor of BDI-II improvement. LimitationsCortical excitability was measured from the motor cortex, rather than the dorsolateral prefrontal cortex, where treatment is applied. The 10 Hz and iTBS protocols were performed at different intensities consistent with common practice. ConclusionsModulation of corticomotor excitability by 10 Hz can predict response to rTMS treatment with 10 Hz rTMS.

The Effectiveness of the Repetitive Transcranial Magnetic Stimulation (rTMS)with high frequency (20 Hz) on Auditory Hallucinations, Inner Speech and Working Memory in Schizophrenic Patients

Background: The purpose of the present study was to investigate the effectiveness of high frequency transcranial magnetic stimulation (rTMS) treatment (20 Hz) on auditory hallucinations, inner speech and working memory in schizophrenic patients. Materials and Methods: This study was a pretest-posttest experimental design with control group. The statistical population of this study consisted of all schizophrenic patients referring to the outpatient department of Imam Hossein hospital in 2019, 12 of whom were selected by available sampling based on inclusion and exclusion criteria then were assigned randomly into two groups of 6 each. High frequency transcranial magnetic stimulation (r TMS) treatment (20 Hz) was used for experimental group but the control group received no intervention during the study. The instruments were the positive and negative syndrome scale in schizophrenia, the inner speech questionnaire, and the Daneman and Carpenter working memory questionnaire before and after the intervention. The data were analyzed by descriptive statistics, and one-way covariance analysis (ANCOVA) and multivariate covariance analysis (MANCOVA) were used to analyze the data. Results: The results showed that there were significant differences between experimental and control group (p&lt;0.005). The rate of auditory hallucinations and inner speech significantly decreased in comparison with pretest and control group, but the rate of active memory increased. Conclusion: Repetitive transcranial magnetic stimulation (r TMS) treatment (20 Hz) significantly reduced auditory hallucinations, inner speech and improved active memory.

High Frequency and Low Intensity Transcranial Magnetic Stimulation for Smoking Cessation.

Introduction Tobacco consumption is one of the main causes of mortality in the world. Because of its effect on health, smoking cessation should be prioritized as an important health intervention; however, current interventions have shown low success rates as only 31% of the cases can stop smoking. In this paper, an intervention with high frequency and low intensity transcranial magnetic stimulation (HFLI TMS) was applied to determine if this type of neuromodulation could have an effect in decreasing tobacco addiction. Methods Retrospective data from ten ambulatory smoker patients that underwent 24 sessions of HFLI TMS over 8 weeks were retrieved and are here presented. Results Exhaled CO concentrations were statistically significantly different from baseline at the weeks 3, 5, 6, and 8. After the 24 sessions, all patients stopped smoking; this was confirmed directly by exhaled carbon monoxide and the smoking diary. Three months after intervention, eight out of ten subjects continued without smoking. No severe adverse effects were reported by participants. Conclusions Overall, employing HFLI TMS appears to have acceptable result; however, further evidence is needed to determine with more certainty its therapeutic effect and adverse effects for addiction intervention.

Characteristics of Attention Bias in Patients With Depression Disorder, and the Influence of High Frequency Transcranial Magnetic Stimulation Therapy on the Attention Bias

We propose a general model to entirely describe XPM effects induced by 16QAM channels in hybrid QPSK/16QAM wavelength division multiplexed (WDM) systems. A power spectral density (PSD) formula is presented to predict the statistical properties of XPM effects at the end of dispersion management (DM) fiber links. We derive the analytical expression of phase error variance for optimizing block length of QPSK channel coherent receiver with decision-aided (DA) maximum-likelihood (ML) phase estimation (PE). With our theoretical analysis, the optimum block length can be employed to improve the performance of coherent receiver. Bit error rate (BER) performance in QPSK channel is evaluated and compared through both theoretical derivation and Monte Carlo simulation. The results show that by using the DA-ML with optimum block length, bit signal-to-noise ratio (SNR) improvement over DA-ML with fixed block length of 10, 20 and 40 at BER of 10−3 is 0.18 dB, 0.46 dB and 0.65 dB, respectively, when in-line residual dispersion is 0 ps/nm.

Effectiveness of High-Frequency Transcranial Magnetic Stimulation and Physical Exercise in Women With Fibromyalgia: A Randomized Controlled Trial.

Fibromyalgia (FM) is characterized by chronic widespread pain and both physical and emotional alterations, which in turn may affect the individual's quality of life. Thus, interventions aimed at treating such symptoms, without increasing fatigue, are needed. The aim of this study was to explore the effect of high-frequency transcranial magnetic stimulation (HF-TMS) and physical exercise (PE) on pain, impact of FM, physical conditioning, and emotional status in women with FM. Forty-nine women with FM were randomly allocated to: (1) a PE group (PEG, n=16), who underwent an 8-week (two 60-minute sessions/wk) low-intensity PE program; (2) a TMS group (TMSG, n=17) receiving a 2-week (five 20-minute sessions/wk) HF-TMS intervention; and (3) a control group (CG, n=16). Pain (ie, perceived pain and average pressure pain threshold), perceived impact of FM (ie, overall impact, symptoms, and perceived physical function), physical conditioning (ie, endurance and functional capacity, fatigue, gait velocity, and power), and emotional status (ie, anxiety, depression, stress, and satisfaction) were assessed at baseline (T0) and after the intervention (T1, at 2weeks for TMSG and at 8weeks for PEG and CG). The TMSG showed significant improvement in all studied variables after the intervention except for satisfaction, whereas the PEG showed improved average pressure pain threshold, perceived overall impact of FM and total score, endurance and functional capacity, velocity and power, anxiety, depression, and stress. In contrast, the CG showed no improvements in any variable. Both PE and HF-TMS are effective in improving pain, impact of FM, physical conditioning, and emotional status in people with FM; HF-TMS achieved larger improvements in emotional status than PE. TMS and PE have similar benefits for physical status, whereas TMS has greater benefits than PE for emotional status in women with FM.

Comparing theta burst stimulation with standard left high frequency transcranial magnetic stimulation in the treatment of depression in a randomized controlled study: A preliminary comparison study

Abstract Background Theta Burst stimulation (TBS) is a promising alternative to standard repetitive transcranial magnetic stimulation (rTMS) for treatment-resistant depression (TRD). TBS treatment is delivered over a much shorter time than rTMS, enabling more patients to be treated with the same resources. The aim of this preliminary study was to explore the efficacy of an intensive bilateral TBS protocol (BL TBS) compared to a standard rTMS protocol. Methods Thirty-two outpatients with TRD were randomized to a standard rTMS protocol and 34 outpatients were randomized to a TBS protocol. Treatment was delivered over two week or four weeks. Both treatment groups received twenty treatments in total. Patients were assessed at baseline, week 1, week 2 and week 4. Results There were no major differences in baseline depression severity between the randomized treatment groups. There was no significant difference in response and remission rates between the two groups. In the standard rTMS group, 40.6% met criteria for response and 25% met criteria for remission. These rates were 20.6% and 25.5% respectively for the TBS group. There was a significant reduction in mean depression scores for both treatment groups (p Limitations This was not a sham-controlled study, so placebo response rates are not known. Conclusion TBS provided clinical benefit, which on most outcome measures did not differ significantly from outcomes with a standard course of rTMS treatment, and could be advantageous from a clinical, service and patient perspective.

Effect of High Frequency Transcranial Magnetic Stimulation on Recovery of Chronic Post-Stroke Aphasia

BackgroundBoth hemispheres have role in post-stroke aphasia recovery but better recovery is expected with the restoration of function by the left hemisphere. Transcranial stimulation has been used to favor recruitment of left-hemispheric language networks and increase activity of the left hemisphere, thus helps aphasia recovery . ObjectiveThe aim of this study is to evaluate the effect of excitatory repetitive transcranial magnetic stimulation (rTMS) on recovery of post stroke aphasic patients . Materials and methodsTwenty patients with post stroke chronic aphasia were enrolled in the study. Aphasia severity was assessed using Aphasia Severity Rating Scale (ASRS). Linguistic deficits were assessed using Kasr Al-Aini Arabic Aphasia test (KAAT). Real rTMS was applied three for 10 sessions of 10-Hz stimulation, positioned over the left Broca's area of the affected hemisphere. All patients were evaluated before, after the end of treatment sessions and one month later . ResultsThere was a significant improvement in the mean total score and mean scores of components of KAAT scale before, immediately after and after one month of rTMS (P< 0.05). Moreover, there was a significant improvement in mean scores of ASRS before, immediately after and after one month of rTMS (P= 0.000). There was a significant difference in mean scores of ASRS and KAAT before, immediately after the last session and after one month between small, medium and large brain infarcts. (P< 0.05). ConclusionExcitatory rTMS is a beneficial adjuvant therapy that improves language skills in patients with chronic post-stroke non-fluent aphasia in short and long term.The protocol of this observational study was registered in clinical trial registration: www.ClinicalTrials.gov, identifier: NCT04708197

Pilot Study of High Frequency Transcranial Magnetic Stimulation for Bipolar Depression

Transcranial Magnetic Stimulation (TMS) is now a standard treatment approach for treatment resistant major depressive disorder. There is growing clinical experience to support the use of TMS in bipolar depression. This study sought to collect open label safety and effectiveness data in a sample of patients with bipolar depression.

Seizure threshold manipulation in electroconvulsive therapy via repetitive transcranial magnetic stimulation. A novel way of augmentation?

IntroductionA high seizure threshold (ST) is an impeding factor in certain patients, potentially preventing a successful electroconvulsive therapy (ECT) treatment. Several pharmacological and non-pharmacological methods have been put forward to augment ECT in such patients, however, to this date, only a handful of case reports existed about the potential role of repetitive transcranial magnetic stimulation (rTMS), as an augmentation method. Objectivesand Methods: In this randomized, double-blinded, sham controlled study, we set out to test the hypothesis of whether the application of high frequency transcranial magnetic stimulation (HF rTMS) lowers the seizure threshold for electroconvulsive therapy and whether it has an effect on other aspects of ECT treatment, such as seizure duration (SD), efficacy and safety. Results46 patients treated for a major depressive episode, indicated for ECT, were recruited to this study. A significantly lower seizure threshold was observed in the experimental group during ECT titration, on average a decrease by 34.55%, from 34.23 mC to 22.4 mC, p < 0.001 (Wilcox test). We had not observed a significant effect of TMS stimulation before ECT on seizure duration or clinical outcome. Another potentially important observation of this study is that 4 patients in the experimental group developed transient symptoms of hypomania/mania, all of which were stabilized after the combined stimulation protocol was halted spontaneously within a week, without the need to administer mood stabilizers. ConclusionIt is likely that HF rTMS stimulation prior to ECT is a novel and simple way of reducing the ST, which is useful in certain groups of patients undergoing this important treatment modality.

S196. TRANSCRANIAL MAGNETIC STIMULATION IN SCHIZOPHRENIA WITH PROMINENT NEGATIVE SYMPTOMS- A REVIEW OF THE LITERATURE

BackgroundNegative symptoms in schizophrenia are associated with lower quality of life, worse functional prognosis and poorer response to the psychopharmacological treatment [1]. Many efforts have been made to find new approaches for negative symptoms, and neuromodulation techniques may represent a solution for these patients when antipsychotics have reached their limits of efficacy [2]. Transcranial magnetic stimulation (TMS) is based on the use of alternating magnetic fields to induce electrical current in the cortical areas, being mainly used for patients with treatment-resistant depression and it is considered safe and well tolerated [3].MethodsA narrative review of data regarding the efficacy of transcranial magnetic stimulation for patients with schizophrenia with prominent negative symptoms was performed. Papers published between January 2000 and July 2019 in the main electronic databases (PubMed, Cochrane, EMBASE, CINAHL) were included in this review. The keywords used for database search were “schizophrenia” and “negative symptoms” and “transcranial magnetic stimulation” or “repetitive transcranial magnetic stimulation”.ResultsThe treatment of negative symptoms in schizophrenia with high frequency TMS has been associated with favorable results in clinical trials. The targeted zones were dorsolateral prefrontal cortex, either bilaterally or only on the left side. The results varied upon the stimulation regimen, including duration, frequency, uni- versus bilaterally application etc. Two meta-analyses were identified and their results supported an effect size from 0.58 to 0.63 [2,3]. However, negative results derived from well designed clinical trials exist, which show no difference in the Positive and Negative Syndromes Scale (PANSS) - negative symptom score between rTMS and sham rTMS [4,5]. An exploratory analysis of a large-scale trial showed the impact of rTMS on different negative symptom domains confirmed no additional beneficial effect of the actove comparative to sham rTMS [5]. Also, data exist about the potential of rTMS for increasing task-related in frontal areas in patients with schizophrenia with negative predominant symptoms, which may grant further exploration of the mechanisms underlying the effects of rTMS.DiscussionData about the efficacy of TMS in schizophrenia with negative symptoms are controversial, because both evidence to support its efficacy and its lack of efficacy exist in clinical trials. However, meta-analyses support an important size effect which may be comparable to that of the pharmacological treatment.ReferencesVasiliu O, Vasile D, Făinărea AF, et al. Analysis of risk factors for antipsychotic-resistant schizophrenia in young patients- a retrospective analysis. Romanian Journal of Military Medicine 2018;CXXI(1):25–29.Dlabac-de Lange J, Knegtering R, Aleman A. Repetitive transcranial magnetic stimulation for negative symptoms of schizophrenia: review and meta-analysis. J ClinPsychiatry 2010;71:411–418.Freitas C, Fregni F, Pascual_leone A. Meta-analysis of the effects of repetitive transcranial magnetic stimulation (rTMS) on negative and positive symptoms in schizophrenia. Schizophr Res 2009;108:11–24.Mogg A, Purvis R, Eranti S, et al. Repetitive transcranial magnetic stimulation for negative symptoms of schizophrenia: a randomized controlled pilot study. Schizophr Res 2007;93:221–228.Hansbauer M, Wobrock T, Kunze B, et al. Efficacy of high-frequency repetitive transcranial magnetic stimulation on PANSS factors in schizophrenia with predominant negative symptoms- results from an exploratory re-analysis. Psychiatry Res 2018;263:22–29.

Effect of High Frequency Transcranial Magnetic Stimulation (TMS) on Extensor Digitorum Communis Muscle Strength in Ischemic Stroke Patients

Abstract Background: Stroke may disrupt a patient’s motor function, consequently affecting the quality of life. A stroke surviving brain has the ability to repair itself through neuroplasticity mechanism. Transcranial Magnetic Stimulation (TMS) is a non-invasive device which can be used to stimulate the lesioned part of the brain in hope of triggering neuroplasticity.Aims: To find prove of the repetitive Transcranial Magnetic Stimulation (rTMS) effect on extensor digitorum communis muscle strength improvement in ischemic stroke patients.Methods: Subjects suitable with the inclusion criteria (N=18) were divided into two groups, control group and intervention group. The control group underwent conventional therapy exclusively every day for 5 days in a row, while the intervention group underwent rTMS therapy and conventional therapy every day for 5 days in a row. Extensor digitorum communis muscle strength was measured using surface electromyography (sEMG) before and after treatment.Result: Significant increase of sEMG numbers were found on control group (p=0,003) and intervention group (p=0,001). The increase from the intervention group was not different when compared to the control group (p=0,067).Conclusion: TMS can increase extensor digitorum communis muscle strength but with no difference with a conventional therapy.

Effect of High Frequency Transcranial Magnetic Stimulation (TMS) on Extensor Digitorum Communis Muscle Strength in Ischemic Stroke Patients

Abstract Background: Stroke may disrupt a patient’s motor function, consequently affecting the quality of life. A stroke surviving brain has the ability to repair itself through neuroplasticity mechanism. Transcranial Magnetic Stimulation (TMS) is a non-invasive device which can be used to stimulate the lesioned part of the brain in hope of triggering neuroplasticity.Aims: To find prove of the repetitive Transcranial Magnetic Stimulation (rTMS) effect on extensor digitorum communis muscle strength improvement in ischemic stroke patients.Methods: Subjects suitable with the inclusion criteria (N=18) were divided into two groups, control group and intervention group. The control group underwent conventional therapy exclusively every day for 5 days in a row, while the intervention group underwent rTMS therapy and conventional therapy every day for 5 days in a row. Extensor digitorum communis muscle strength was measured using surface electromyography (sEMG) before and after treatment.Result: Significant increase of sEMG numbers were found on control group (p=0,003) and intervention group (p=0,001). The increase from the intervention group was not different when compared to the control group (p=0,067).Conclusion: TMS can increase extensor digitorum communis muscle strength but with no difference with a conventional therapy.

High frequency repetitive transcranial magnetic stimulation of supplementary motor cortex for obsessive compulsive disorder

Obsessive compulsive disorder (OCD) is a common psychiatric disorder that can lead to significant dysfunction. It is treated with medications and or cognitive behavior therapy. Many patients with OCD do not respond to above mentioned conventional treatments. OCD is also a disorder with well delineated neuropathology in brain areas that form cortico-striato-thalamocortical loop. Transcranial magnetic stimulation (TMS) can not only offer a noninvasive treatment modality for many of these patients but can also specifically and beneficially affect involved neuronal areas. TMS stimulation of various brain areas including supplementary motor cortex, dorsolateral prefrontal cortex, orbitofrontal cortex and anterior cingulate cortex has been found to be beneficial in alleviating OCD symptoms in various studies. Low frequency and less often high frequency TMS of these areas has been found to be effective. High frequency deep TMS, as opposed to conventional TMS, of medial prefrontal cortex and anterior cingulate cortex was found to be effective and is approved as an adjunctive treatment option for severe OCD. There is no consensus as to the target stimulation site and optimal TMS stimulation protocol that can achieve maximum improvement in OCD symptoms. We hypothesize that high frequency r-TMS of supplementary motor cortex will alleviate OCD symptoms.

Effects of Ten Sessions of High Frequency Repetitive Transcranial Magnetic Stimulation (HF-rTMS) Add-on Treatment on Impulsivity in Alcohol Use Disorder.

IntroductionAlcohol use disorder (AUD) is characterized by increased impulsivity, which is multifactorial and can be assessed by tests like the delay discounting, Go-Nogo, and stop signal task (SST). Impulsivity has been related to poor treatment outcomes in substance use disorders, including AUD. In order to decrease impulsivity or improve inhibitory control, high frequency transcranial magnetic stimulation (HF-rTMS) has gained interest. Studies applying HF-rTMS over the DLPFC of individuals suffering from AUD assessing its effects on impulsivity measures are scarce, and results are inconclusive.MethodsThe current study (registered in Netherlands Trial Register with trial number 5291: https://www.trialregister.nl/trial/5151) applied 10 sessions of HF-rTMS [sixty 10 Hz trains of 5 s at 110% motor threshold (MT)] over the right DLPFC of 80 alcohol dependent patients in clinical treatment on 10 consecutive workdays. At baseline, halfway and after the HF-rTMS treatment, the delay discounting, Go-NoGo, and SST were assessed.ResultsTen sessions of HF-rTMS over the right DLPFC versus sham HF-rTMS did not affect performance on the delay discounting, Go-NoGo, and SSTs. A significant effect of age was found for the Go-NoGo task, with higher age associated with better performance. Furthermore, no significant correlations were found between difference scores of task performance and baseline impulsivity or severity of AUD.DiscussionResults of this study, in combination with other studies using HF-rTMS studies in alcohol and substance use disorder, indicate mixed and inconclusive findings of HF-rTMS on impulsivity. Future studies within patient groups hospitalized at the same department are recommended to consider using a sham coil that mimics the sensations on the scalp of active HF-rTMS and to measure motivation across test sessions.