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Sample records for repetitive transcranial magnetive

  1. 76 FR 44489 - Medical Devices; Neurological Devices; Classification of Repetitive Transcranial Magnetic...

    Science.gov (United States)

    2011-07-26

    ... transcranial magnetic stimulation (rTMS) system into class II (special controls). The Agency is classifying...; Classification of Repetitive Transcranial Magnetic Stimulation System AGENCY: Food and Drug Administration, HHS... entitled ``Class II Special Controls Guidance Document: Repetitive Transcranial Magnetic......

  2. Outcomes in spasticity after repetitive transcranial magnetic and transcranial direct current stimulations

    OpenAIRE

    Gunduz, Aysegul; Kumru, Hatice; Pascual-Leone, Alvaro

    2014-01-01

    Non-invasive brain stimulations mainly consist of repetitive transcranial magnetic stimulation and transcranial direct current stimulation. Repetitive transcranial magnetic stimulation exhibits satisfactory outcomes in improving multiple sclerosis, stroke, spinal cord injury and cerebral palsy-induced spasticity. By contrast, transcranial direct current stimulation has only been studied in post-stroke spasticity. To better validate the efficacy of non-invasive brain stimulations in improving ...

  3. Clinical application of repetitive transcranial magnetic stimulation in stroke rehabilitation☆

    Science.gov (United States)

    Shin, Joonho; Yang, EunJoo; Cho, KyeHee; Barcenas, Carmelo L; Kim, Woo Jin; Min, Yusun; Paik, Nam-Jong

    2012-01-01

    Proper stimulation to affected cerebral hemisphere would promote the functional recovery of patients with stroke. Effects of repetitive transcranial magnetic stimulation on cortical excitability can be can be altered by the stimulation frequency, intensity and duration. There has been no consistent recognition regarding the best stimulation frequency and intensity. This study reviews the intervention effects of repetitive transcranial stimulation on motor impairment, dysphagia, visuospatial neglect and aphasia, and summarizes the stimulation frequency, intensity and area for repetitive transcranial magnetic stimulation to yield the best therapeutic effects. PMID:25745455

  4. Clinical application of repetitive transcranial magnetic stimulation in stroke rehabilitation

    Institute of Scientific and Technical Information of China (English)

    Joonho Shin; EunJoo Yang; KyeHee Cho; Carmelo L Barcenas; Woo Jin Kim; Yusun Min; Nam-Jong Paik

    2012-01-01

    Proper stimulation to affected cerebral hemisphere would promote the functional recovery of patients with stroke. Effects of repetitive transcranial magnetic stimulation on cortical excitability can be can be altered by the stimulation frequency, intensity and duration. There has been no consistent recognition regarding the best stimulation frequency and intensity. This study reviews the intervention effects of repetitive transcranial stimulation on motor impairment, dysphagia, visuospatial neglect and aphasia, and summarizes the stimulation frequency, intensity and area for repetitive transcranial magnetic stimulation to yield the best therapeutic effects.

  5. Illusory sensation of movement induced by repetitive transcranial magnetic stimulation

    DEFF Research Database (Denmark)

    Christensen, Mark Schram; Lundbye-Jensen, J.; Grey, M.J.;

    2010-01-01

    Human movement sense relies on both somatosensory feedback and on knowledge of the motor commands used to produce the movement. We have induced a movement illusion using repetitive transcranial magnetic stimulation over primary motor cortex and dorsal premotor cortex in the absence of limb moveme...... premotor cortex stimulation was less affected by sensory and motor deprivation than was primary motor cortex stimulation. We propose that repetitive transcranial magnetic stimulation over dorsal premotor cortex produces a corollary discharge that is perceived as movement....

  6. [Rehabilitation Using Repetitive Transcranial Magnetic Stimulation].

    Science.gov (United States)

    Takeuchi, Naoyuki; Izumi, Shin-Ichi

    2017-03-01

    Various novel stroke rehabilitative methods have been developed based on findings in basic science and clinical research. Recently, many reports have shown that repetitive transcranial magnetic stimulation (rTMS) improves function in stroke patients by altering the excitability of the human cortex. The interhemispheric competition model proposes that deficits in stroke patients are due to reduced output from the affected hemisphere and excessive interhemispheric inhibition from the unaffected hemisphere to the affected hemisphere. The interhemispheric competition model indicates that improvement in deficits can be achieved either by increasing the excitability of the affected hemisphere using excitatory rTMS or by decreasing the excitability of the unaffected hemisphere using inhibitory rTMS. Recovery after stroke is related to neural plasticity, which involves developing new neural connections, acquiring new functions, and compensating for impairments. Artificially modulating the neural network by rTMS may induce a more suitable environment for use-dependent plasticity and also may interfere with maladaptive neural activation, which weakens function and limits recovery. There is potential, therefore, for rTMS to be used as an adjuvant therapy for developed neurorehabilitation techniques in stroke patients.

  7. Repetitive transcranial magnetic stimulation and drug addiction.

    Science.gov (United States)

    Barr, Mera S; Farzan, Faranak; Wing, Victoria C; George, Tony P; Fitzgerald, Paul B; Daskalakis, Zafiris J

    2011-10-01

    Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique that is now being tested for its ability to treat addiction. This review discusses current research approaches and results of studies which measured the therapeutic use of rTMS to treat tobacco, alcohol and illicit drug addiction. The research in this area is limited and therefore all studies evaluating the therapeutic use of rTMS in tobacco, alcohol or illicit drug addiction were retained including case studies through NCBI PubMed ( http://www.ncbi.nlm.nih.gov ) and manual searches. A total of eight studies were identified that examined the ability of rTMS to treat tobacco, alcohol and cocaine addiction. The results of this review indicate that rTMS is effective in reducing the level of cravings for smoking, alcohol, and cocaine when applied at high frequencies to the dorsolateral prefrontal cortex (DLPFC). Furthermore, these studies suggest that repeated sessions of high frequency rTMS over the DLPFC may be most effective in reducing the level of smoking and alcohol consumption. Although work in this area is limited, this review indicates that rTMS is a promising modality for treating drug addiction.

  8. Repetitive transcranial magnetic stimulation in psychiatry

    Directory of Open Access Journals (Sweden)

    Biswa Ranjan Mishra

    2011-01-01

    Full Text Available Repetitive transcranial magnetic stimulation (rTMS is a non-invasive and relatively painless tool that has been used to study various cognitive functions as well as to understand the brain-behavior relationship in normal individuals as well as in those with various neuropsychiatric disorders. It has also been used as a therapeutic tool in various neuropsychiatric disorders because of its ability to specifically modulate distinct brain areas. Studies have shown that repeated stimulation at low frequency produces long-lasting inhibition, which is called as long-term depression, whereas repeated high-frequency stimulation can produce excitation through long-term potentiation. This paper reviews the current status of rTMS as an investigative and therapeutic modality in various neuropsychiatric disorders. It has been used to study the cortical and subcortical functions, neural plasticity and brain mapping in normal individuals and in various neuropsychiatric disorders. rTMS has been most promising in the treatment of depression, with an overall milder adverse effect profile compared with electroconvulsive therapy. In other neuropsychiatric disorders such as schizophrenia, mania, epilepsy and substance abuse, it has been found to be useful, although further studies are required to establish therapeutic efficacy. It appears to be ineffective in the treatment of obsessive compulsive disorder. There is a paucity of studies of efficacy and safety of rTMS in pediatric and geriatric population. Although it appears safe, further research is required to optimize its efficacy and reduce the side-effects. Magnetic seizure therapy, which involves producing seizures akin to electroconvulsive therapy, appears to be of comparable efficacy in the treatment of depression with less cognitive adverse effects.

  9. Outcomes in spasticity after repetitive transcranial magnetic and transcranial direct current stimulations

    Institute of Scientific and Technical Information of China (English)

    Aysegul Gunduz; Hatice Kumru; Alvaro Pascual-Leone

    2014-01-01

    Non-invasive brain stimulations mainly consist of repetitive transcranial magnetic stimulation and transcranial direct current stimulation. Repetitive transcranial magnetic stimulation exhib-its satisfactory outcomes in improving multiple sclerosis, stroke, spinal cord injury and cerebral palsy-induced spasticity. By contrast, transcranial direct current stimulation has only been studied in post-stroke spasticity. To better validate the effcacy of non-invasive brain stimulations in im-proving the spasticity post-stroke, more prospective cohort studies involving large sample sizes are needed.

  10. Handedness, repetitive transcranial magnetic stimulation and bulimic disorders.

    Science.gov (United States)

    Van den Eynde, F; Broadbent, H; Guillaume, S; Claudino, A; Campbell, I C; Schmidt, U

    2012-05-01

    Repetitive Transcranial Magnetic Stimulation (rTMS) research in psychiatry mostly excludes left-handed participants. We recruited left-handed people with a bulimic disorder and found that stimulation of the left prefrontal cortex may result in different effects in left- and right-handed people. This highlights the importance of handedness and cortex lateralisation for rTMS.

  11. Use of Repetitive Transcranial Magnetic Stimulation for Treatment in Psychiatry

    NARCIS (Netherlands)

    Aleman, Andre

    The potential of noninvasive neurostimulation by repetitive transcranial magnetic stimulation (rTMS) for improving psychiatric disorders has been studied increasingly over the past two decades. This is especially the case for major depression and for auditory verbal hallucinations in schizophrenia.

  12. Illusory sensation of movement induced by repetitive transcranial magnetic stimulation.

    Directory of Open Access Journals (Sweden)

    Mark Schram Christensen

    Full Text Available Human movement sense relies on both somatosensory feedback and on knowledge of the motor commands used to produce the movement. We have induced a movement illusion using repetitive transcranial magnetic stimulation over primary motor cortex and dorsal premotor cortex in the absence of limb movement and its associated somatosensory feedback. Afferent and efferent neural signalling was abolished in the arm with ischemic nerve block, and in the leg with spinal nerve block. Movement sensation was assessed following trains of high-frequency repetitive transcranial magnetic stimulation applied over primary motor cortex, dorsal premotor cortex, and a control area (posterior parietal cortex. Magnetic stimulation over primary motor cortex and dorsal premotor cortex produced a movement sensation that was significantly greater than stimulation over the control region. Movement sensation after dorsal premotor cortex stimulation was less affected by sensory and motor deprivation than was primary motor cortex stimulation. We propose that repetitive transcranial magnetic stimulation over dorsal premotor cortex produces a corollary discharge that is perceived as movement.

  13. Improved Discrimination of Visual Stimuli Following Repetitive Transcranial Magnetic Stimulation

    OpenAIRE

    Waterston, Michael L.; Pack, Christopher C.

    2010-01-01

    BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) at certain frequencies increases thresholds for motor-evoked potentials and phosphenes following stimulation of cortex. Consequently rTMS is often assumed to introduce a "virtual lesion" in stimulated brain regions, with correspondingly diminished behavioral performance. METHODOLOGY/PRINCIPAL FINDINGS: Here we investigated the effects of rTMS to visual cortex on subjects' ability to perform visual psychophysical tasks. Contrary t...

  14. Illusory sensation of movement induced by repetitive transcranial magnetic stimulation

    OpenAIRE

    Mark Schram Christensen; Jesper Lundbye-Jensen; Michael James Grey; Alexandra Damgaard Vejlby; Bo Belhage; Jens Bo Nielsen

    2010-01-01

    Human movement sense relies on both somatosensory feedback and on knowledge of the motor commands used to produce the movement. We have induced a movement illusion using repetitive transcranial magnetic stimulation over primary motor cortex and dorsal premotor cortex in the absence of limb movement and its associated somatosensory feedback. Afferent and efferent neural signalling was abolished in the arm with ischemic nerve block, and in the leg with spinal nerve block. Movement sensation was...

  15. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS)

    DEFF Research Database (Denmark)

    Lefaucheur, Jean-Pascal; André-Obadia, Nathalie; Antal, Andrea

    2014-01-01

    A group of European experts was commissioned to establish guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS) from evidence published up until March 2014, regarding pain, movement disorders, stroke, amyotrophic lateral sclerosis, multiple sclerosis, epilepsy...

  16. Repetitive transcranial magnetic stimulation for hallucination in schizophrenia spectrum disorders A meta-analysis***

    Institute of Scientific and Technical Information of China (English)

    Yingli Zhang; Wei Liang; Shichang Yang; Ping Dai; Lijuan Shen; Changhong Wang

    2013-01-01

    OBJECTIVE: This study assessed the efficacy and tolerability of repetitive transcranial magnetic stimulation for treatment of auditory hal ucination of patients with schizophrenia spectrum disorders. DATA SOURCES: Online literature retrieval was conducted using PubMed, ISI Web of Science, EMBASE, Medline and Cochrane Central Register of Control ed Trials databases from January 1985 to May 2012. Key words were “transcranial magnetic stimulation”, “TMS”, “repetitive transcranial magnetic stimulation”, and “hal ucination”. STUDY SELECTION: Selected studies were randomized control ed trials assessing therapeutic ef-ficacy of repetitive transcranial magnetic stimulation for hal ucination in patients with schizophrenia spectrum disorders. Experimental intervention was low-frequency repetitive transcranial magnetic stimulation in left temporoparietal cortex for treatment of auditory hal ucination in schizophrenia spectrum disorders. Control groups received sham stimulation. MAIN OUTCOME MEASURES: The primary outcome was total scores of Auditory Hal ucinations Rating Scale, Auditory Hal ucination Subscale of Psychotic Symptom Rating Scale, Positive and Negative Symptom Scale-Auditory Hal ucination item, and Hal ucination Change Scale. Secondary outcomes included response rate, global mental state, adverse effects and cognitive function. RESULTS: Seventeen studies addressing repetitive transcranial magnetic stimulation for treatment of schizophrenia spectrum disorders were screened, with controls receiving sham stimulation. Al data were completely effective, involving 398 patients. Overal mean weighted effect size for repeti-tive transcranial magnetic stimulation versus sham stimulation was statistical y significant (MD =-0.42, 95%CI: -0.64 to -0.20, P = 0.000 2). Patients receiving repetitive transcranial magnetic stimulation responded more frequently than sham stimulation (OR = 2.94, 95%CI: 1.39 to 6.24, P =0.005). No significant differences were found

  17. A feasible repetitive transcranial magnetic stimulation clinical protocol in migraine prevention

    Directory of Open Access Journals (Sweden)

    Shawn Zardouz

    2016-10-01

    Full Text Available Objective: This case series was conducted to determine the clinical feasibility of a repetitive transcranial magnetic stimulation protocol for the prevention of migraine (with and without aura. Methods: Five patients with migraines underwent five repetitive transcranial magnetic stimulation sessions separated in 1- to 2-week intervals for a period of 2 months at a single tertiary medical center. Repetitive transcranial magnetic stimulation was applied to the left motor cortex with 2000 pulses (20 trains with 1s inter-train interval delivered per session, at a frequency of 10 Hz and 80% resting motor threshold. Pre- and post-treatment numerical rating pain scales were collected, and percent reductions in intensity, frequency, and duration were generated. Results: An average decrease in 37.8%, 32.1%, and 31.2% were noted in the intensity, frequency, and duration of migraines post-repetitive transcranial magnetic stimulation, respectively. A mean decrease in 1.9±1.0 (numerical rating pain scale ± standard deviation; range: 0.4–2.8 in headache intensity scores was noted after the repetitive transcranial magnetic stimulation sessions. Conclusion: The tested repetitive transcranial magnetic stimulation protocol is a well-tolerated, safe, and effective method for migraine prevention.

  18. Improved discrimination of visual stimuli following repetitive transcranial magnetic stimulation.

    Directory of Open Access Journals (Sweden)

    Michael L Waterston

    Full Text Available BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS at certain frequencies increases thresholds for motor-evoked potentials and phosphenes following stimulation of cortex. Consequently rTMS is often assumed to introduce a "virtual lesion" in stimulated brain regions, with correspondingly diminished behavioral performance. METHODOLOGY/PRINCIPAL FINDINGS: Here we investigated the effects of rTMS to visual cortex on subjects' ability to perform visual psychophysical tasks. Contrary to expectations of a visual deficit, we find that rTMS often improves the discrimination of visual features. For coarse orientation tasks, discrimination of a static stimulus improved consistently following theta-burst stimulation of the occipital lobe. Using a reaction-time task, we found that these improvements occurred throughout the visual field and lasted beyond one hour post-rTMS. Low-frequency (1 Hz stimulation yielded similar improvements. In contrast, we did not find consistent effects of rTMS on performance in a fine orientation discrimination task. CONCLUSIONS/SIGNIFICANCE: Overall our results suggest that rTMS generally improves or has no effect on visual acuity, with the nature of the effect depending on the type of stimulation and the task. We interpret our results in the context of an ideal-observer model of visual perception.

  19. Use of repetitive transcranial magnetic stimulation for treatment in psychiatry.

    Science.gov (United States)

    Aleman, André

    2013-08-01

    The potential of noninvasive neurostimulation by repetitive transcranial magnetic stimulation (rTMS) for improving psychiatric disorders has been studied increasingly over the past two decades. This is especially the case for major depression and for auditory-verbal hallucinations in schizophrenia. The present review briefly describes the background of this novel treatment modality and summarizes evidence from clinical trials into the efficacy of rTMS for depression and hallucinations. Evidence for efficacy in depression is stronger than for hallucinations, although a number of studies have reported clinically relevant improvements for hallucinations too. Different stimulation parameters (frequency, duration, location of stimulation) are discussed. There is a paucity of research into other psychiatric disorders, but initial evidence suggests that rTMS may also hold promise for the treatment of negative symptoms in schizophrenia, obsessive compulsive disorder and post-traumatic stress disorder. It can be concluded that rTMS induces alterations in neural networks relevant for psychiatric disorders and that more research is needed to elucidate efficacy and underlying mechanisms of action.

  20. [Repetitive transcranial magnetic stimulation: A potential therapy for cognitive disorders?

    Science.gov (United States)

    Nouhaud, C; Sherrard, R M; Belmin, J

    2017-03-01

    Considering the limited effectiveness of drugs treatments in cognitive disorders, the emergence of noninvasive techniques to modify brain function is very interesting. Among these techniques, repetitive transcranial magnetic stimulation (rTMS) can modulate cortical excitability and have potential therapeutic effects on cognition and behaviour. These effects are due to physiological modifications in the stimulated cortical tissue and their associated circuits, which depend on the parameters of stimulation. The objective of this article is to specify current knowledge and efficacy of rTMS in cognitive disorders. Previous studies found very encouraging results with significant improvement of higher brain functions. Nevertheless, these few studies have limits: a few patients were enrolled, the lack of control of the mechanisms of action by brain imaging, insufficiently formalized technique and variability of cognitive tests. It is therefore necessary to perform more studies, which identify statistical significant improvement and to specify underlying mechanisms of action and the parameters of use of the rTMS to offer rTMS as a routine therapy for cognitive dysfunction.

  1. Repetitive transcranial magnetic stimulator with controllable pulse parameters

    Science.gov (United States)

    Peterchev, Angel V.; Murphy, David L.; Lisanby, Sarah H.

    2011-06-01

    The characteristics of transcranial magnetic stimulation (TMS) pulses influence the physiological effect of TMS. However, available TMS devices allow very limited adjustment of the pulse parameters. We describe a novel TMS device that uses a circuit topology incorporating two energy storage capacitors and two insulated-gate bipolar transistor (IGBT) modules to generate near-rectangular electric field pulses with adjustable number, polarity, duration, and amplitude of the pulse phases. This controllable pulse parameter TMS (cTMS) device can induce electric field pulses with phase widths of 10-310 µs and positive/negative phase amplitude ratio of 1-56. Compared to conventional monophasic and biphasic TMS, cTMS reduces energy dissipation up to 82% and 57% and decreases coil heating up to 33% and 41%, respectively. We demonstrate repetitive TMS trains of 3000 pulses at frequencies up to 50 Hz with electric field pulse amplitude and width variability less than the measurement resolution (1.7% and 1%, respectively). Offering flexible pulse parameter adjustment and reduced power consumption and coil heating, cTMS enhances existing TMS paradigms, enables novel research applications and could lead to clinical applications with potentially enhanced potency.

  2. An evaluation of factors affecting duration of treatment with repetitive transcranial magnetic stimulation for depression

    Directory of Open Access Journals (Sweden)

    Roni Broder Cohen

    2007-12-01

    Full Text Available Objective: To investigate the effects of repetitive transcranialmagnetic stimulation in patients with major depression who weresubmitted to this treatment during the period from 2000 to 2006.Methods: A retrospective study with 204 patients who underwenttreatment with repetitive transcranial magnetic stimulation, collectingdata from those who experienced remission (defined as a HDRS scoreequal to or lower than 7. The patients were followed for up to 6 monthsafter treatment. Mean duration of remission for this cohort of patientswas 70.2 (± 58.4 days. Results: The only variable associated withthe duration of remission in the linear regression model was numberof repetitive transcranial magnetic stimulation sessions. Conclusion:Our findings suggest that the greater the number of sessions, the longerthe duration of repetitive transcranial magnetic stimulation effects.Consequently, future research investigating the effects of repetitivetranscranial magnetic stimulation should explore this variable in orderto maximize the therapeutic effects of this new brain stimulationtechnique.

  3. Role of repetitive transcranial magnetic stimulation in stroke rehabilitation.

    Science.gov (United States)

    Pinter, Michaela M; Brainin, Michael

    2013-01-01

    In recent years, efforts have focused on investigating the neurophysiological changes that occur in the brain after stroke, and on developing novel strategies such as additional brain stimulation to enhance sensorimotor and cognitive recovery. In the 1990s, repetitive transcranial magnetic stimulation (rTMS) was introduced as a therapeutic tool for improving the efficacy of rehabilitation for recovery after stroke. It is evident that disturbances of interhemispheric processes after stroke result in a pathological hyperactivity of the intact hemisphere. The rationale of using rTMS as a complementary therapy is mainly to decrease the cortical excitability in regions that are presumed to hinder optimal recovery by low-frequency rTMS delivered to the unaffected hemisphere, while high-frequency rTMS delivered to the affected hemisphere facilitates cortical excitability. However, the exact mechanisms of how rTMS works are still under investigation. There is a growing body of research in stroke patients investigating the effect of rTMS on facilitating recovery by modifying cortical and subcortical networks. Clinical trials applying rTMS already yielded promising results in improving recovery of sensorimotor and cognitive functions. Altogether, in combination with conventional therapeutic approaches, rTMS has a potential to become a complementary strategy to enhance stroke recovery by modulating the excitability of targeted brain areas. In future studies, emphasis should be placed on selecting patient populations to determine whether treatment response depends on age, lesion acuteness, or stroke severity. Furthermore, it is important to identify parameters optimizing the beneficial effects of rTMS on stroke recovery, and to monitor their long-term effects.

  4. Low-frequency repetitive transcranial magnetic simulation prevents chronic epileptic seizure*

    Institute of Scientific and Technical Information of China (English)

    Yinxu Wang; Xiaoming Wang; Sha Ke; Juan Tan; Litian Hu; Yaodan Zhang; Wenjuan Cui

    2013-01-01

    Although low-frequency repetitive transcranial magnetic simulation can potentially treat epilepsy, its underlying mechanism remains unclear. This study investigated the influence of low-frequency re-petitive transcranial magnetic simulation on changes in several nonlinear dynamic electroenceph-alographic parameters in rats with chronic epilepsy and explored the mechanism underlying repeti-tive transcranial magnetic simulation-induced antiepileptic effects. An epilepsy model was estab-lished using lithium-pilocarpine intraperitoneal injection into adult Sprague-Dawley rats, which were then treated with repetitive transcranial magnetic simulation for 7 consecutive days. Nonlinear elec-electroencephalographic parameters were obtained from the rats at 7, 14, and 28 days post-stimulation. Results showed significantly lower mean correlation-dimension and Kolmogo-rov-entropy values for stimulated rats than for non-stimulated rats. At 28 days, the complexity and point-wise correlation dimensional values were lower in stimulated rats. Low-frequency repetitive transcranial magnetic simulation has suppressive effects on electrical activity in epileptic rats, thus explaining its effectiveness in treating epilepsy.

  5. Repetitive transcranial magnetic stimulation improves consciousness disturbance in stroke patients A quantitative electroencephalography spectral power analysis

    Institute of Scientific and Technical Information of China (English)

    Ying Xie; Tong Zhang

    2012-01-01

    Repetitive transcranial magnetic stimulation is a noninvasive treatment technique that can directly alter cortical excitability and improve cerebral functional activity in unconscious patients. To investigate the effects and the electrophysiological changes of repetitive transcranial magnetic stimulation cortical treatment, 10 stroke patients with non-severe brainstem lesions and with disturbance of consciousness were treated with repetitive transcranial magnetic stimulation. A quantitative electroencephalography spectral power analysis was also performed. The absolute power in the alpha band was increased immediately after the first repetitive transcranial magnetic stimulation treatment, and the energy was reduced in the delta band. The alpha band relative power values slightly decreased at 1 day post-treatment, then increased and reached a stable level at 2 weeks post-treatment. Glasgow Coma Score and JFK Coma Recovery Scale-Revised score were improved. Relative power value in the alpha band was positively related to Glasgow Coma Score and JFK Coma Recovery Scale-Revised score. These data suggest that repetitive transcranial magnetic stimulation is a noninvasive, safe, and effective treatment technology for improving brain functional activity and promoting awakening in unconscious stroke patients.

  6. Repetitive transcranial magnetic stimulation and transcranial direct current stimulation in motor rehabilitation after stroke: an update.

    Science.gov (United States)

    Klomjai, W; Lackmy-Vallée, A; Roche, N; Pradat-Diehl, P; Marchand-Pauvert, V; Katz, R

    2015-09-01

    Stroke is a leading cause of adult motor disability. The number of stroke survivors is increasing in industrialized countries, and despite available treatments used in rehabilitation, the recovery of motor functions after stroke is often incomplete. Studies in the 1980s showed that non-invasive brain stimulation (mainly repetitive transcranial magnetic stimulation [rTMS] and transcranial direct current stimulation [tDCS]) could modulate cortical excitability and induce plasticity in healthy humans. These findings have opened the way to the therapeutic use of the 2 techniques for stroke. The mechanisms underlying the cortical effect of rTMS and tDCS differ. This paper summarizes data obtained in healthy subjects and gives a general review of the use of rTMS and tDCS in stroke patients with altered motor functions. From 1988 to 2012, approximately 1400 publications were devoted to the study of non-invasive brain stimulation in humans. However, for stroke patients with limb motor deficit, only 141 publications have been devoted to the effects of rTMS and 132 to those of tDCS. The Cochrane review devoted to the effects of rTMS found 19 randomized controlled trials involving 588 patients, and that devoted to tDCS found 18 randomized controlled trials involving 450 patients. Without doubt, rTMS and tDCS contribute to physiological and pathophysiological studies in motor control. However, despite the increasing number of studies devoted to the possible therapeutic use of non-invasive brain stimulation to improve motor recovery after stroke, further studies will be necessary to specify their use in rehabilitation.

  7. Transcranial direct current stimulation and repetitive transcranial magnetic stimulation in consultation-liaison psychiatry

    Directory of Open Access Journals (Sweden)

    L.C.L. Valiengo

    2013-10-01

    Full Text Available Patients with clinical diseases often present psychiatric conditions whose pharmacological treatment is hampered due to hazardous interactions with the clinical treatment and/or disease. This is particularly relevant for major depressive disorder, the most common psychiatric disorder in the general hospital. In this context, nonpharmacological interventions could be useful therapies; and, among those, noninvasive brain stimulation (NIBS might be an interesting option. The main methods of NIBS are repetitive transcranial magnetic stimulation (rTMS, which was recently approved as a nonresearch treatment for some psychiatric conditions, and transcranial direct current stimulation (tDCS, a technique that is currently limited to research scenarios but has shown promising results. Therefore, our aim was to review the main medical conditions associated with high depression rates, the main obstacles for depression treatment, and whether these therapies could be a useful intervention for such conditions. We found that depression is an important and prevalent comorbidity in a variety of diseases such as epilepsy, stroke, Parkinson's disease, myocardial infarction, cancer, and in other conditions such as pregnancy and in patients without enteral access. We found that treatment of depression is often suboptimal within the above contexts and that rTMS and tDCS therapies have been insufficiently appraised. We discuss whether rTMS and tDCS could have a significant impact in treating depression that develops within a clinical context, considering its unique characteristics such as the absence of pharmacological interactions, the use of a nonenteral route, and as an augmentation therapy for antidepressants.

  8. Repetitive transcranial magnetic stimulation for levodopa-induced dyskinesias in Parkinson's disease.

    NARCIS (Netherlands)

    Filipovic, S.R.; Rothwell, J.C.; Warrenburg, B.P.C. van de; Bhatia, K.P.

    2009-01-01

    In a placebo-controlled, single-blinded, crossover study, we assessed the effect of "real" repetitive transcranial magnetic stimulation (rTMS) versus "sham" rTMS (placebo) on peak dose dyskinesias in patients with Parkinson's disease (PD). Ten patients with PD and prominent dyskinesias had rTMS (1,8

  9. Reductions in CI amplitude after repetitive transcranial magnetic stimulation (rTMS) over the striate cortex

    NARCIS (Netherlands)

    Schutter, D.J.L.G.; Honk, E.J. van

    2003-01-01

    Slow repetitive transcranial magnetic stimulation (rTMS) is a method capable of transiently inhibiting cortical excitability and disrupting information processing in the visual system. This method can be used to topographically map the functional contribution of different cortical brain areas in vis

  10. Repetitive Transcranial Magnetic Stimulation for Negative Symptoms of Schizophrenia : Review and Meta-Analysis

    NARCIS (Netherlands)

    Dlabac-de Lange, Jozarni J.; Knegtering, Rikus; Aleman, Andre

    2010-01-01

    Background: Repetitive transcranial magnetic stimulation (rTMS) has been proposed as a treatment for the negative symptoms of schizophrenia. During the past decade, several trials have reported on the efficacy of rTMS treatment; however, the results were inconsistent. Objective: To assess the effica

  11. Therapeutic benefit of repetitive transcranial magnetic stimulation for severe mirror movements A case report

    Institute of Scientific and Technical Information of China (English)

    Han Sun Kim; Sung Ho Jang; Zee-Ihn Lee; Mi Young Lee; Yun Woo Cho; Migyoung Kweon; Su Min Son

    2013-01-01

    Congenital mirror movements retard typical hand functions, but no definite therapeutic modality is available to treat such movements. We report an 8-year-old boy with severe mirror movements of both hands. His mirror movements were assessed using the Woods and Teuber grading scale and his fine motor skills were also evaluated by the Purdue Pegboard Test. A 2-week regimen of repetitive transcranial magnetic stimulation produced markedly diminished mirror movement symptoms and increased the fine motor skills of both hands. Two weeks after the completion of the regimen, mirror movement grades had improved from grade 4 to 1 in both hands and the Purdue Pegboard Test results of the right and left hands also improved from 12 to 14 or 13. These improvements were maintained for 1 month after the 2-week repetitive transcranial magnetic stimulation regimen. After 18 months, the mirror movement grade was maintained and the Purdue Pegboard test score had improved to 15 for the right hand while the left hand score was maintained at 13. This occurred without any additional repetitive transcranial magnetic stimulation or other treatment. These findings suggest that repetitive transcranial magnetic stimulation for this patient had a therapeutic and long-term effect on mirror movements.

  12. Repetitive Transcranial Magnetic Stimulation in Resistant Visual Hallucinations in a Woman With Schizophrenia: A Case Report.

    Science.gov (United States)

    Ghanbari Jolfaei, Atefeh; Naji, Borzooyeh; Nasr Esfehani, Mehdi

    2016-03-01

    A 29-year-old woman with schizophrenia introduced for application of repetitive transcranial magnetic stimulation for refractory visual hallucinations. Following inhibitory rTMS on visual cortex she reported significant reduction in severity and simplification of complexity of hallucinations, which lasted for three months. rTMS can be considered as a possibly potent treatment for visual hallucinations.

  13. Repetitive Transcranial Magnetic Stimulation to the Primary Motor Cortex Interferes with Motor Learning by Observing

    Science.gov (United States)

    Brown, Liana E.; Wilson, Elizabeth T.; Gribble, Paul L.

    2009-01-01

    Neural representations of novel motor skills can be acquired through visual observation. We used repetitive transcranial magnetic stimulation (rTMS) to test the idea that this "motor learning by observing" is based on engagement of neural processes for learning in the primary motor cortex (M1). Human subjects who observed another person learning…

  14. Update on repetitive transcranial magnetic stimulation in obsessive-compulsive disorder: different targets

    NARCIS (Netherlands)

    Blom, R.M.; Figee, M.; Vulink, N.; Denys, D.

    2011-01-01

    Obsessive-compulsive disorder (OCD) is a chronic, disabling disorder. Ten percent of patients remain treatment refractory despite several treatments. For these severe, treatment-refractory patients, repetitive transcranial magnetic stimulation (rTMS) has been suggested as a treatment option. Since

  15. Tibialis anterior stretch reflex in early stance is suppressed by repetitive transcranial magnetic stimulation

    DEFF Research Database (Denmark)

    Zuur, Abraham T; Christensen, Mark Schram; Sinkjær, Thomas

    2009-01-01

    Abstract A rapid plantar flexion perturbation in the early stance phase of walking elicits a large stretch reflex in tibialis anterior (TA). In this study we use repetitive Transcranial Magnetic Stimulation (rTMS) to test if this response is mediated through a transcortical pathway. TA stretch...

  16. Multiple sessions of low-frequency repetitive transcranial magnetic stimulation in focal hand dystonia

    DEFF Research Database (Denmark)

    Kimberley, Teresa Jacobson; Borich, Michael R; Arora, Sanjeev

    2013-01-01

    Purpose: The ability of low-frequency repetitive transcranial magnetic stimulation (rTMS) to enhance intracortical inhibition has motivated its use as a potential therapeutic intervention in focal hand dystonia (FHD). In this preliminary investigation, we assessed the physiologic and behavioral...

  17. The Cerebellum in Emotion Regulation: A Repetitive Transcranial Magnetic Stimulation Study

    NARCIS (Netherlands)

    Schutter, D.J.L.G.; Honk, E.J. van

    2009-01-01

    Several lines of evidence suggest that the cerebellum may play a role in the regulation of emotion. The aim of this study was to investigate the hypothesis that inhibition of cerebellar function using slow repetitive transcranial magnetic stimulation (rTMS) would lead to increased negative mood as a

  18. Repetitive transcranial magnetic stimulation for the treatment of chronic tinnitus after traumatic brain injury: a case study.

    Science.gov (United States)

    Kreuzer, Peter Michael; Landgrebe, Michael; Frank, Elmar; Langguth, Berthold

    2013-01-01

    Tinnitus is a frequent symptom of traumatic brain injury, which is difficult to treat. Repetitive transcranial magnetic stimulation has shown beneficial effects in some forms of tinnitus. However, traumatic brain injury in the past has been considered as a relative contraindication for repetitive transcranial magnetic stimulation because of the increased risk of seizures. Here we present the case of a 53-year-old male patient suffering from severe tinnitus after traumatic brain injury with comorbid depression and alcohol abuse, who received 5 treatment series of repetitive transcranial magnetic stimulation (1 Hz stimulation protocol over left primary auditory cortex, 10 sessions of 2000 stimuli each, stimulation intensity 110% resting motor threshold). Repetitive transcranial magnetic stimulation was tolerated without any side effects and tinnitus complaints (measured by a validated tinnitus questionnaire and numeric rating scales) were improved in a replicable way throughout 5 courses of transcranial magnetic stimulation up to now.

  19. The Effect of 10 Hz Repetitive Transcranial Magnetic Stimulation of Posterior Parietal Cortex on Visual Attention

    OpenAIRE

    Isabel Dombrowe; Georgiana Juravle; Mohsen Alavash; Carsten Gießing; Claus C Hilgetag

    2015-01-01

    Repetitive transcranial magnetic stimulation (rTMS) of the posterior parietal cortex (PPC) at frequencies lower than 5 Hz transiently inhibits the stimulated area. In healthy participants, such a protocol can induce a transient attentional bias to the visual hemifield ipsilateral to the stimulated hemisphere. This bias might be due to a relatively less active stimulated hemisphere and a relatively more active unstimulated hemisphere. In a previous study, Jin and Hilgetag (2008) tried to switc...

  20. Rehabilitation interventions for chronic motor deficits with repetitive transcranial magnetic stimulation.

    Science.gov (United States)

    Paquette, C; Thiel, A

    2012-12-01

    Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive electrophysiological method to modulate cortical excitability. As such, rTMS can be used in conjunction with conventional physiotherapy or occupational therapy to facilitate rehabilitation of motor function in patients with focal brain lesions. This review summarizes the rationale for using rTMS in the rehabilitation of motor deficits as derived from imaging and electrophysiological studies of the human motor system. rTMS methodology and its various stimulation modalities are introduced and current evidence for rTMS as supportive therapy for the rehabilitation of chronic motor deficits is discussed.

  1. Repetitive Transcranial Magnetic Stimulation for Wernicke-Korsakoff Syndrome: A Case Report.

    Science.gov (United States)

    Chung, So Won; Park, Shin Who; Seo, Young Jae; Kim, Jae-Hyung; Lee, Chan Ho; Lim, Jong Youb

    2017-02-01

    A 57-year-old man who was diagnosed with Wernicke-Korsakoff syndrome showed severe impairment of cognitive function and a craving for alcohol, even after sufficient supplementation with thiamine. After completing 10 sessions of 10 Hz repetitive transcranial magnetic stimulation (rTMS) at 100% of the resting motor threshold over the left dorsolateral prefrontal cortex, dramatic improvement in cognitive function and a reduction in craving for alcohol were noted. This is the first case report of the efficacy of a high-frequency rTMS in the treatment of Wernicke-Korsakoff syndrome.

  2. Enhanced accuracy in novel mirror drawing after repetitive transcranial magnetic stimulation-induced proprioceptive deafferentation

    DEFF Research Database (Denmark)

    Balslev, Daniela; Christensen, Lars O.D.; Lee, Ji-hang

    2004-01-01

    a performance benefit. In this study, we tested whether deafferentation induced by repetitive transcranial magnetic stimulation (rTMS) can improve mirror tracing skills in normal subjects. Hand trajectory error during novel mirror drawing was compared across two groups of subjects that received either 1 Hz r......TMS over the somatosensory cortex contralateral to the hand or sham stimulation. Mirror tracing was more accurate after rTMS than after sham stimulation. Using a position-matching task, we confirmed that rTMS reduced proprioceptive acuity and that this reduction was largest when the coil was placed...

  3. Repetitive Transcranial Magnetic Stimulation for Wernicke-Korsakoff Syndrome: A Case Report

    Science.gov (United States)

    2017-01-01

    A 57-year-old man who was diagnosed with Wernicke-Korsakoff syndrome showed severe impairment of cognitive function and a craving for alcohol, even after sufficient supplementation with thiamine. After completing 10 sessions of 10 Hz repetitive transcranial magnetic stimulation (rTMS) at 100% of the resting motor threshold over the left dorsolateral prefrontal cortex, dramatic improvement in cognitive function and a reduction in craving for alcohol were noted. This is the first case report of the efficacy of a high-frequency rTMS in the treatment of Wernicke-Korsakoff syndrome. PMID:28289650

  4. Effects of Repetitive Transcranial Magnetic Stimulation in Performing Eye-Hand Integration Tasks: Four Preliminary Studies with Children Showing Low-Functioning Autism

    Science.gov (United States)

    Panerai, Simonetta; Tasca, Domenica; Lanuzza, Bartolo; Trubia, Grazia; Ferri, Raffaele; Musso, Sabrina; Alagona, Giovanna; Di Guardo, Giuseppe; Barone, Concetta; Gaglione, Maria P.; Elia, Maurizio

    2014-01-01

    This report, based on four studies with children with low-functioning autism, aimed at evaluating the effects of repetitive transcranial magnetic stimulation delivered on the left and right premotor cortices on eye-hand integration tasks; defining the long-lasting effects of high-frequency repetitive transcranial magnetic stimulation; and…

  5. A 3 month, follow-up, randomized, placebo-controlles study of repetitive transcranial magnetic stimulation in depression.

    NARCIS (Netherlands)

    Koerselman, F; Laman, D.M; van Duijn, H; van Duijn, M.A.J.; Willems, M.AM

    2004-01-01

    Background/Objective: There is evidence for an antidepressant effect of repetitive transcranial magnetic stimulation (rTMS), but little is known about posttreatment course. Therefore, we conducted a placebo-controlled, double-blind study in depressed patients in order to investigate the effect of rT

  6. Slow frequency repetitive transcranial magnetic stimulation affects reaction times, but not priming effects, in a masked prime task

    NARCIS (Netherlands)

    Schlaghecken, F.; Munchau, A.; Bloem, B.R.; Rothwell, J.C.; Eimer, M.

    2003-01-01

    OBJECTIVE: Slow frequency repetitive transcranial magnetic stimulation (rTMS) reduces motor cortex excitability, but it is unclear whether this has behavioural consequences in healthy subjects. METHODS: We examined the effects of 1 Hz rTMS (train of 20 min; stimulus intensity 80% of active motor thr

  7. A framework for targeting alternative brain regions with repetitive transcranial magnetic stimulation in the treatment of depression

    NARCIS (Netherlands)

    Schutter, D.J.L.G.; Honk, E.J. van

    2005-01-01

    It has been argued that clinical depression is accompanied by reductions in cortical excitability of the left prefrontal cortex (PFC). In support of this, repetitive transcranial magnetic stimulation (rTMS), which is a method of enhancing cortical excitability, has shown antidepressant efficacy when

  8. Efficacy of slow repetitive transcranial magnetic stimulation in the treatment of resistant auditory hallucinations in schizophrenia : A meta-analysis

    NARCIS (Netherlands)

    Aleman, Andre; Sommer, Iris E.; Kahn, Rene S.

    2007-01-01

    Objective: Slow repetitive transcranial magnetic stimulation (rTMS), at a frequency of 1 Hz, has been proposed as a treatment for auditory hallucinations. Several studies have now been reported regarding the efficacy of TMS treatment, but results were inconsistent. Therefore, meta-analytic integrati

  9. Sleep disturbances in obsessive-compulsive disorder: Association with non-response to repetitive transcranial magnetic stimulation (rTMS)

    NARCIS (Netherlands)

    Donse, L.; Sack, A.T.; Fitzgerald, P.B.; Arns, M.W.

    2017-01-01

    Background Repetitive transcranial magnetic stimulation (rTMS) is a promising augmentation strategy for treatment-refractory OCD. However, a substantial group still fails to respond. Sleep disorders, e.g. circadian rhythm sleep disorders (CRSD), are highly prevalent in OCD and might mediate

  10. Brain responses evoked by high-frequency repetitive transcranial magnetic stimulation: an event-related potential study

    NARCIS (Netherlands)

    M. Hamidi; H.A. Slagter; G. Tononi; B.R. Postle

    2010-01-01

    Background Many recent studies have used repetitive transcranial magnetic stimulation (rTMS) to study brain-behavior relationships. However, the pulse-to-pulse neural effects of rapid delivery of multiple TMS pulses are unknown largely because of TMS-evoked electrical artifacts limiting recording of

  11. Pressure pain thresholds increase after preconditioning 1 Hz repetitive transcranial magnetic stimulation with transcranial direct current stimulation.

    Science.gov (United States)

    Moloney, Tonya M; Witney, Alice G

    2014-01-01

    The primary motor cortex (M1) is an effective target of non-invasive cortical stimulation (NICS) for pain threshold modulation. It has been suggested that the initial level of cortical excitability of M1 plays a key role in the plastic effects of NICS. Here we investigate whether transcranial direct current stimulation (tDCS) primed 1 Hz repetitive transcranial magnetic stimulation (rTMS) modulates experimental pressure pain thresholds and if this is related to observed alterations in cortical excitability. 15 healthy, male participants received 10 min 1 mA anodal, cathodal and sham tDCS to the left M1 before 15 min 1 Hz rTMS in separate sessions over a period of 3 weeks. Motor cortical excitability was recorded at baseline, post-tDCS priming and post-rTMS through recording motor evoked potentials (MEPs) from right FDI muscle. Pressure pain thresholds were determined by quantitative sensory testing (QST) through a computerized algometer, on the palmar thenar of the right hand pre- and post-stimulation. Cathodal tDCS-primed 1 Hz-rTMS was found to reverse the expected suppressive effect of 1 Hz rTMS on cortical excitability; leading to an overall increase in activity (p<0.001) with a parallel increase in pressure pain thresholds (p<0.01). In contrast, anodal tDCS-primed 1 Hz-rTMS resulted in a corresponding decrease in cortical excitability (p<0.05), with no significant effect on pressure pain. This study demonstrates that priming the M1 before stimulation of 1 Hz-rTMS modulates experimental pressure pain thresholds in a safe and controlled manner, producing a form of analgesia.

  12. Repetitive transcranial magnetic stimulation to treat substance use disorders and compulsive behavior.

    Science.gov (United States)

    Protasio, Maria I B; da Silva, João P L; Arias-Carrión, Oscar; Nardi, Antonio E; Machado, Sergio; Cruz, Marcelo S

    2015-01-01

    Compulsions, like pathological gambling, binge-eating disorder, alcohol, tobacco or cocaine abuse and compulsive shopping have similar neurophysiological processing. This study aimed to examine the efficacy of repetitive transcranial magnetic stimulation (rTMS) in improving patient control over compulsive behavior. The rTMS modulatory role in cortical mesolimbic pathways possibly implies improvement of the inhibitory control system and compulsive consumption drive. Thus, craving reduction would be a component for control achievement. Within this context, 17 studies were found. Most studies applied rTMS over the left dorsolateral prefrontal cortex. Craving reduction was observed in 10 studies and was associated with improved control of compulsion in two of them. In one study reduction in consumption was found without reduction in craving. In addition, improvement in decision making was found in one study.

  13. Repetitive transcranial magnetic stimulation of human MT+ reduces apparent motion perception.

    Science.gov (United States)

    Matsuyoshi, Daisuke; Hirose, Nobuyuki; Mima, Tatsuya; Fukuyama, Hidenao; Osaka, Naoyuki

    2007-12-18

    We investigated the effects of repetitive transcranial magnetic stimulation (rTMS) over the human cerebral cortex on apparent motion perception. Previous studies have shown that human extrastriate visual area MT+ (V5) processes not only real but also apparent motion. However, the functional relevance of MT+ on long-range apparent motion perception remains unclear. Here, we show direct evidence for the involvement of MT+ in apparent motion perception using rTMS, which is known to temporarily inhibit a localized region in the cerebral cortex. The results showed that apparent motion perception decreased after applying rTMS over MT+, but not after applying rTMS over the control region (inferior temporal gyrus). The decrease in performance caused by applying rTMS to MT+ suggests that MT+ is a causally responsible region for apparent motion perception, and thus, further supports the idea that MT+ plays a major role in the perception of motion.

  14. Repetitive transcranial magnetic stimulation to improve mood and motor function in Parkinson's disease.

    Science.gov (United States)

    Helmich, Rick C; Siebner, Hartwig R; Bakker, Maaike; Münchau, Alexander; Bloem, Bastiaan R

    2006-10-25

    Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique that can produce lasting changes in excitability and activity in cortical regions underneath the stimulation coil (local effect), but also within functionally connected cortical or subcortical regions (remote effects). Since the clinical presentation of Parkinson's disease (PD) is related to abnormal neuronal activity within the basal ganglia and cortical regions, including the primary motor cortex, the premotor cortex and the prefrontal cortex, several studies have used rTMS to improve brain function in PD. Here, we review the studies that have investigated the possible therapeutic effects of rTMS on mood and motor function in PD patients. We highlight some methodological inconsistencies and problems, including the difficulty to define the most effective protocol for rTMS or to establish an appropriate placebo condition. We finally propose future directions of research that may help to improve the therapeutic efficacy of rTMS in PD.

  15. [Repetitive transcranial magnetic stimulation in depression; stimulation of the brain in order to cure the psyche].

    Science.gov (United States)

    Helmich, R C; Snijders, A H; Verkes, R J; Bloem, B R

    2004-02-28

    Transcranial magnetic stimulation (TMS) is a non-invasive approach to briefly stimulate or inhibit cortical brain areas. A novel approach entails the delivery of repetitive TMS pulses (rTMS) at a fixed frequency. In rTMS cortical activity is altered beyond the period of actual stimulation. The changes occur locally as well as at a distance in functionally connected brain areas. These features render rTMS a suitable tool to study normal brain functions and the pathophysiology of brain diseases. Furthermore, it is expected that rTMS could be used as a novel therapy for neurological or psychiatric diseases characterised by abnormal cortical activation. This possibility has been studied mostly in patients suffering from depression, where rTMS has been used to restore normal activity in the hypoactive prefrontal cortex. Despite statistically significant therapeutic effects in small sized trials, the clinical implications are still limited.

  16. Phantom Limb Pain: Low Frequency Repetitive Transcranial Magnetic Stimulation in Unaffected Hemisphere

    Directory of Open Access Journals (Sweden)

    Andrea Di Rollo

    2011-01-01

    Full Text Available Phantom limb pain is very common after limb amputation and is often difficult to treat. The motor cortex stimulation is a valid treatment for deafferentation pain that does not respond to conventional pain treatment, with relief for 50% to 70% of patients. This treatment is invasive as it uses implanted epidural electrodes. Cortical stimulation can be performed noninvasively by repetitive transcranial magnetic stimulation (rTMS. The stimulation of the hemisphere that isn't involved in phantom limb (unaffected hemisphere, remains unexplored. We report a case of phantom limb pain treated with 1 Hz rTMS stimulation over motor cortex in unaffected hemisphere. This stimulation produces a relevant clinical improvement of phantom limb pain; however, further studies are necessary to determine the efficacy of the method and the stimulation parameters.

  17. Effect of low-frequency repetitive transcranial magnetic stimulation combined with physical therapy on L-dopa-induced painful off-period dystonia in Parkinson's disease.

    Science.gov (United States)

    Kodama, Mitsuhiko; Kasahara, Takashi; Hyodo, Masaki; Aono, Koji; Sugaya, Mutsumi; Koyama, Yuji; Hanayama, Kozo; Masakado, Yoshihisa

    2011-02-01

    Previous research has shown that low-frequency repetitive transcranial magnetic stimulation over the primary motor area and supplementary motor area can reduce L-dopa-induced dyskinesias in Parkinson's disease; however, it involved only patients with peak-dose or diphasic dyskinesia. We report a case of a patient with severely painful off-period dystonia in the unilateral lower limb who underwent 0.9-Hz subthreshold repetitive transcranial magnetic stimulation over contralateral primary motor area and supplementary motor area. Repetitive transcranial magnetic stimulation over the primary motor area significantly reduced the painful dystonia and walking disturbances but repetitive transcranial magnetic stimulation over the supplementary motor area did not. The cortical silent period also prolonged after repetitive transcranial magnetic stimulation over the primary motor area. At 5 mos of approximately once a week repetitive transcranial magnetic stimulation over the primary motor area, the Unified Parkinson's Disease Rating Scale motor score also improved. This report shows that repetitive transcranial magnetic stimulation over the inhibitory primary motor area can be useful for rehabilitating patients with Parkinson's disease with off-period dystonia and suggests that this treatment should be further verified in such patients.

  18. Treatment of depression using sleep electroencephalogram modulated repetitive transcranial magnetic stimulation

    Institute of Scientific and Technical Information of China (English)

    HE Ming-li; GU Zheng-tian; WANG Xin-yi; SHI Heng-ping

    2011-01-01

    Background As a treatment of depression, the efficacy of conventional repetitive transcranial magnetic stimulation (rTMS) is limited, and symptoms recurrence is easy to occur after the treatment. This study aimed to examine the efficacy and safety of sleep electroencephalogram modulated repetitive rTMS (SEM-rTMS) in the treatment of depression.Methods After 7 days without psychoactive medication, 164 patients with clinically defined depression were randomly divided into 3 groups: SEM-rTMS group (n=57), conventional rTMS (C-rTMS, n=55) group and sham-rTMS group (n=S2). Every patient was treated with the corresponding method for 30 minutes everyday for 10 days. Before and after scores on the 24-item Hamilton rating scale for depression (HAMD-24) and the clinical outcome on the 10th day of therapy for all subjects were analyzed.Results Twenty-two cases in the SEM-rTMS group obtained improved mood as compared to 6 in the C-rTMS group and 2 in the sham-rTMS group (X2=15.89, P=0.0004). After completion of the rTMS phase of the protocol, a (51±5)% reduction of HAMD-24 scores from the baseline in the SEM-rTMS group was found compared with a (34±4)% in the C-rTMS group (g=26.09, P=0.001) and a (14±3)% in sham-rTMS group (q=57.53, P=0.000). The 88% total effective rate in the SEM-rTMS group was significantly higher than 68% in the C-rTMS group and 20% in the sham-rTMS group (X2=12.01, P=0.0025). No significant side effects were noted.Conclusion SEM-rTMS is an effective and safe way for treating depression with repetitive transcranial magnetic stimulation (ChiCTR-TRC-00000438).

  19. Transcranial magnetic stimulation (TMS)/repetitive TMS in mild cognitive impairment and Alzheimer's disease.

    Science.gov (United States)

    Nardone, R; Tezzon, F; Höller, Y; Golaszewski, S; Trinka, E; Brigo, F

    2014-06-01

    Several Transcranial Magnetic Stimulation (TMS) techniques can be applied to noninvasively measure cortical excitability and brain plasticity in humans. TMS has been used to assess neuroplastic changes in Alzheimer's disease (AD), corroborating findings that cortical physiology is altered in AD due to the underlying neurodegenerative process. In fact, many TMS studies have provided physiological evidence of abnormalities in cortical excitability, connectivity, and plasticity in patients with AD. Moreover, the combination of TMS with other neurophysiological techniques, such as high-density electroencephalography (EEG), makes it possible to study local and network cortical plasticity directly. Interestingly, several TMS studies revealed abnormalities in patients with early AD and even with mild cognitive impairment (MCI), thus enabling early identification of subjects in whom the cholinergic degeneration has occurred. Furthermore, TMS can influence brain function if delivered repetitively; repetitive TMS (rTMS) is capable of modulating cortical excitability and inducing long-lasting neuroplastic changes. Preliminary findings have suggested that rTMS can enhance performances on several cognitive functions impaired in AD and MCI. However, further well-controlled studies with appropriate methodology in larger patient cohorts are needed to replicate and extend the initial findings. The purpose of this paper was to provide an updated and comprehensive systematic review of the studies that have employed TMS/rTMS in patients with MCI and AD.

  20. Cerebral Functional Reorganization in Ischemic Stroke after Repetitive Transcranial Magnetic Stimulation: An fMRI Study.

    Science.gov (United States)

    Li, Jing; Zhang, Xue-Wei; Zuo, Zhen-Tao; Lu, Jie; Meng, Chun-Ling; Fang, Hong-Ying; Xue, Rong; Fan, Yong; Guan, Yu-Zhou; Zhang, Wei-Hong

    2016-12-01

    Our study aimed to figure out brain functional reorganization evidence after repetitive transcranial magnetic stimulation (rTMS) using the resting-state functional magnetic resonance imaging (rsfMRI). Twelve patients with unilateral subcortex lesion in the middle cerebral artery territory were recruited. Seven of them received a 10-day rTMS treatment beginning at about 5 days after stroke onset. The remaining five received sham treatment. RsfMRI and motor functional scores were obtained before and after rTMS or sham rTMS. The rTMS group showed motor recovery according to the behavioral testing scores, while there was no significant difference of motor functional scores in the sham group before and after the sham rTMS. It proved that rTMS facilitates motor recovery of early ischemic stroke patients. Compared with the sham, the rTMS treatment group achieved increased functional connectivity (FC) between ipsilesional M1 and contralesional M1, supplementary motor area, bilateral thalamus, and contralesional postcentral gyrus. And decreased FC was found between ipsilesional M1 and ipsilesional M1, postcentral gyrus and inferior and middle frontal gyrus. Increased or decreased FC detected by rsfMRI is an important finding to understand the mechanism of brain functional reorganization. The rTMS treatment is a promising therapeutic approach to facilitate motor rehabilitation for early stroke patients. © 2016 John Wiley & Sons Ltd.

  1. Prefrontal and parietal cortex in human episodic memory: an interference study by repetitive transcranial magnetic stimulation.

    Science.gov (United States)

    Rossi, Simone; Pasqualetti, Patrizio; Zito, Giancarlo; Vecchio, Fabrizio; Cappa, Stefano F; Miniussi, Carlo; Babiloni, Claudio; Rossini, Paolo M

    2006-02-01

    Neuroimaging findings, including repetitive transcranial magnetic stimulation (rTMS) interference, point to an engagement of prefrontal cortex (PFC) in learning and memory. Whether parietal cortex (PC) activity is causally linked to successful episodic encoding and retrieval is still uncertain. We compared the effects of event-related active or sham rTMS (a rapid-rate train coincident to the very first phases of memoranda presentation) to the left or right intraparietal sulcus, during a standardized episodic memory task of visual scenes, with those obtained in a fully matched sample of subjects who received rTMS on left or right dorsolateral PFC during the same task. In these subjects, specific hemispheric effects of rTMS included interference with encoding after left stimulation and disruption of retrieval after right stimulation. The interference of PC-rTMS on encoding/retrieval performance was negligible, lacking specificity even when higher intensities of stimulation were applied. However, right PC-rTMS of the same intensity lengthened reaction times in the context of a purely attentive visuospatial task. These results suggest that the activity of intraparietal sulci shown in several functional magnetic resonance studies on memory, unlike that of the dorsolateral PFC, is not causally engaged to a useful degree in memory encoding and retrieval of visual scenes. The parietal activations accompanying the memorization processes could reflect the engagement of a widespread brain attentional network, in which interference on a single 'node' is insufficient for an overt disruption of memory performance.

  2. A Retrospective Chart Review of 10 Hz Versus 20 Hz Repetitive Transcranial Magnetic Stimulation for Depression

    Directory of Open Access Journals (Sweden)

    Kristie L. DeBlasio

    2012-12-01

    Full Text Available We performed a retrospective chart review to examine the progress of patients with depression who received different frequencies of repetitive transcranial magnetic stimulation (rTMS delivered to the left dorsolateral prefrontal cortex (DLPFC. rTMS is a safe and effective alternative treatment for patients with various psychological and medical conditions. During treatment, a coil delivering a time-varying magnetic pulse placed over the scalp penetrates the skull, resulting in clinical improvement. There were 47 patients and three distinct treatment groups found: 10 Hz, 20 Hz, and a separate group who received both frequencies (10/20 Hz. The primary outcome indicator was the difference in Beck Depression Inventory–II (BDI-II scores. Secondary outcomes included categorical indicators of remission, response, and partial response rates as assessed with the BDI-II. In all 3 groups, the majority of patients had depression that remitted, with the highest rate occurring in the 20 Hz group. There were similar response rates in the 10 Hz and 20 Hz groups. There were no patients in the 10/20 Hz group whose depression responded and the highest partial response and nonresponse rates occurred in this group. Although within-group differences were significant from baseline to end of treatment, there were no between-group differences.

  3. Basic principles of transcranial magnetic stimulation (TMS) and repetitive TMS (rTMS).

    Science.gov (United States)

    Klomjai, Wanalee; Katz, Rose; Lackmy-Vallée, Alexandra

    2015-09-01

    Transcranial magnetic stimulation (TMS) and repetitive TMS (rTMS) are indirect and non-invasive methods used to induce excitability changes in the motor cortex via a wire coil generating a magnetic field that passes through the scalp. Today, TMS has become a key method to investigate brain functioning in humans. Moreover, because rTMS can lead to long-lasting after-effects in the brain, it is thought to be able to induce plasticity. This tool appears to be a potential therapy for neurological and psychiatric diseases. However, the physiological mechanisms underlying the effects induced by TMS and rTMS have not yet been clearly identified. The purpose of the present review is to summarize the main knowledge available for TMS and rTMS to allow for understanding their mode of action and to specify the different parameters that influence their effects. This review takes an inventory of the most-used rTMS paradigms in clinical research and exhibits the hypotheses commonly assumed to explain rTMS after-effects.

  4. Stroke recovery can be enhanced by using repetitive transcranial magnetic stimulation (rTMS).

    Science.gov (United States)

    Lefaucheur, J-P

    2006-01-01

    Post-stroke recovery is based on plastic changes in the central nervous system that can compensate the loss of activity in affected brain regions. In particular, monohemispheric stroke is thought to result in disinhibition of the contralesional unaffected hemisphere. Neurorehabilitation programs improve function partly by enhancing cortical reorganization. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive way of producing potent changes in cortical excitability. Therefore, the application of rTMS was recently proposed to promote functional recovery in stroke patients, owing to the induced neuroplasticity. This review discusses the first clinical results that were obtained by rTMS in patients with post-stroke motor deficit, visuospatial neglect, or aphasia. These results are promising and depend on the site and frequency of stimulation. In summary, functional recovery might be obtained either when rTMS is applied at low-frequency (around 1 Hz) over the disinhibited, unaffected hemisphere in order to restore defective inhibition or when rTMS is applied at high-frequency (5 Hz or more) over the affected hemisphere in order to reactivate hypoactive regions. The overall procedure remains to be optimized, in particular regarding the number of rTMS sessions and the time of rTMS application after stroke. Cortical stimulation is an exciting perspective for improving functional recovery from stroke. Transient application of non-invasive transcranial stimulation during the time of the rehabilitation process will be preferable to the temporary implantation of epidural cortical electrodes, as recently proposed. Therefore, in the future, acute or recent stroke might be a major indication of rTMS in neurological practice.

  5. Effects of low-frequency repetitive transcranial magnetic stimulation on event-related potential P300

    Science.gov (United States)

    Torii, Tetsuya; Sato, Aya; Iwahashi, Masakuni; Iramina, Keiji

    2012-04-01

    The present study analyzed the effects of repetitive transcranial magnetic stimulation (rTMS) on brain activity. P300 latency of event-related potential (ERP) was used to evaluate the effects of low-frequency and short-term rTMS by stimulating the supramarginal gyrus (SMG), which is considered to be the related area of P300 origin. In addition, the prolonged stimulation effects on P300 latency were analyzed after applying rTMS. A figure-eight coil was used to stimulate left-right SMG, and intensity of magnetic stimulation was 80% of motor threshold. A total of 100 magnetic pulses were applied for rTMS. The effects of stimulus frequency at 0.5 or 1 Hz were determined. Following rTMS, an odd-ball task was performed and P300 latency of ERP was measured. The odd-ball task was performed at 5, 10, and 15 min post-rTMS. ERP was measured prior to magnetic stimulation as a control. Electroencephalograph (EEG) was measured at Fz, Cz, and Pz that were indicated by the international 10-20 electrode system. Results demonstrated that different effects on P300 latency occurred between 0.5-1 Hz rTMS. With 1 Hz low-frequency magnetic stimulation to the left SMG, P300 latency decreased. Compared to the control, the latency time difference was approximately 15 ms at Cz. This decrease continued for approximately 10 min post-rTMS. In contrast, 0.5 Hz rTMS resulted in delayed P300 latency. Compared to the control, the latency time difference was approximately 20 ms at Fz, and this delayed effect continued for approximately 15 min post-rTMS. Results demonstrated that P300 latency varied according to rTMS frequency. Furthermore, the duration of the effect was not similar for stimulus frequency of low-frequency rTMS.

  6. Effect of high-frequency repetitive transcranial magnetic stimulation on motor cortical excitability and sensory nerve conduction velocity in subacute-stage incomplete spinal cord injury patients.

    Science.gov (United States)

    Cha, Hyun Gyu; Ji, Sang-Goo; Kim, Myoung-Kwon

    2016-07-01

    [Purpose] The aim of the present study was to determine whether repetitive transcranial magnetic stimulation can improve sensory recovery of the lower extremities in subacute-stage spinal cord injury patients. [Subjects and Methods] This study was conducted on 20 subjects with diagnosed paraplegia due to spinal cord injury. These 20 subjects were allocated to an experimental group of 10 subjects that underwent active repetitive transcranial magnetic stimulation or to a control group of 10 subjects that underwent sham repetitive transcranial magnetic stimulation. The SCI patients in the experimental group underwent active repetitive transcranial magnetic stimulation and conventional rehabilitation therapy, whereas the spinal cord injury patients in the control group underwent sham repetitive transcranial magnetic stimulation and conventional rehabilitation therapy. Participants in both groups received therapy five days per week for six-weeks. Latency, amplitude, and sensory nerve conduction velocity were assessed before and after the six week therapy period. [Results] A significant intergroup difference was observed for posttreatment velocity gains, but no significant intergroup difference was observed for amplitude or latency. [Conclusion] repetitive transcranial magnetic stimulation may be improve sensory recovery of the lower extremities in subacute-stage spinal cord injury patients.

  7. Long-lasting repetitive transcranial magnetic stimulation modulates electroencephalography oscillation in patients with disorders of consciousness.

    Science.gov (United States)

    Xia, Xiaoyu; Liu, Yang; Bai, Yang; Liu, Ziyuan; Yang, Yi; Guo, Yongkun; Xu, Ruxiang; Gao, Xiaorong; Li, Xiaoli; He, Jianghong

    2017-10-18

    Repetitive transcranial magnetic stimulation (rTMS) has been applied for the treatment of patients with disorders of consciousness (DOC). Timely and accurate assessments of its modulation effects are very useful. This study evaluated rTMS modulation effects on electroencephalography (EEG) oscillation in patients with chronic DOC. Eighteen patients with a diagnosis of DOC lasting more than 3 months were recruited. All patients received one session of 10-Hz rTMS at the left dorsolateral prefrontal cortex and then 12 of them received consecutive rTMS treatment everyday for 20 consecutive days. Resting-state EEGs were recorded before the experiment (T0) after one session of rTMS (T1) and after the entire treatment (T2). The JFK Coma Recovery Scale-Revised scale scores were also recorded at the time points. Our data showed that application of 10-Hz rTMS to the left dorsolateral prefrontal cortex decreased low-frequency band power and increased high-frequency band power in DOC patients, especially in minimal conscious state patients. Considering the correlation of the EEG spectrum with the consciousness level of patients with DOC, quantitative EEG might be useful for assessment of the effect of rTMS in DOC patients.

  8. Short-term effects of repetitive transcranial magnetic stimulation on sleep bruxism - a pilot study.

    Science.gov (United States)

    Zhou, Wei-Na; Fu, Hai-Yang; Du, Yi-Fei; Sun, Jian-Hua; Zhang, Jing-Lu; Wang, Chen; Svensson, Peter; Wang, Ke-Lun

    2016-03-30

    The purpose of this study was to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on patients with sleep bruxism (SB). Twelve patients with SB were included in an open, single-intervention pilot study. rTMS at 1 Hz and an intensity of 80% of the active motor threshold was applied to the 'hot spot' of the masseter muscle representation at the primary motor cortex bilaterally for 20 min per side each day for 5 consecutive days. The jaw-closing muscle electromyographic (EMG) activity during sleep was recorded with a portable EMG recorder at baseline, during rTMS treatment and at follow-up for 5 days. In addition, patients scored their jaw-closing muscle soreness on a 0-10 numerical rating scale (NRS). Data were analysed with analysis of variance. The intensity of the EMG activity was suppressed during and after rTMS compared to the baseline (P = 0.04; P = 0.02, respectively). The NRS score of soreness decreased significantly during and after rTMS compared with baseline (P < 0.01). These findings indicated a significant inhibition of jaw-closing muscle activity during sleep along with a decrease of muscle soreness. This pilot study raises the possibility of therapeutic benefits from rTMS in patients with bruxism and calls for further and more controlled studies.

  9. Short-term effects of repetitive transcranial magnetic stimulation on sleep bruxism – a pilot study

    Science.gov (United States)

    Zhou, Wei-Na; Fu, Hai-Yang; Du, Yi-Fei; Sun, Jian-Hua; Zhang, Jing-Lu; Wang, Chen; Svensson, Peter; Wang, Ke-Lun

    2016-01-01

    The purpose of this study was to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on patients with sleep bruxism (SB). Twelve patients with SB were included in an open, single-intervention pilot study. rTMS at 1 Hz and an intensity of 80% of the active motor threshold was applied to the ‘hot spot' of the masseter muscle representation at the primary motor cortex bilaterally for 20 min per side each day for 5 consecutive days. The jaw-closing muscle electromyographic (EMG) activity during sleep was recorded with a portable EMG recorder at baseline, during rTMS treatment and at follow-up for 5 days. In addition, patients scored their jaw-closing muscle soreness on a 0–10 numerical rating scale (NRS). Data were analysed with analysis of variance. The intensity of the EMG activity was suppressed during and after rTMS compared to the baseline (P = 0.04; P = 0.02, respectively). The NRS score of soreness decreased significantly during and after rTMS compared with baseline (P < 0.01). These findings indicated a significant inhibition of jaw-closing muscle activity during sleep along with a decrease of muscle soreness. This pilot study raises the possibility of therapeutic benefits from rTMS in patients with bruxism and calls for further and more controlled studies. PMID:27025267

  10. Short-term effects of repetitive transcranial magnetic stimulation on sleep bruxism-a pilot study

    Institute of Scientific and Technical Information of China (English)

    Wei-Na Zhou; Hai-Yang Fu; Yi-Fei Du; Jian-Hua Sun; Jing-Lu Zhang; Chen Wang; Peter Svensson; Ke-Lun Wang

    2016-01-01

    The purpose of this study was to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on patients with sleep bruxism (SB). Twelve patients with SB were included in an open, single-intervention pilot study. rTMS at 1 Hz and an intensity of 80% of the active motor threshold was applied to the ‘hot spot’ of the masseter muscle representation at the primary motor cortex bilaterally for 20 min per side each day for 5 consecutive days. The jaw-closing muscle electromyographic (EMG) activity during sleep was recorded with a portable EMG recorder at baseline, during rTMS treatment and at follow-up for 5 days. In addition, patients scored their jaw-closing muscle soreness on a 0–10 numerical rating scale (NRS). Data were analysed with analysis of variance. The intensity of the EMG activity was suppressed during and after rTMS compared to the baseline (P 5 0.04; P 5 0.02, respectively). The NRS score of soreness decreased significantly during and after rTMS compared with baseline (P,0.01). These findings indicated a significant inhibition of jaw-closing muscle activity during sleep along with a decrease of muscle soreness. This pilot study raises the possibility of therapeutic benefits from rTMS in patients with bruxism and calls for further and more controlled studies.

  11. The cerebellum in emotion regulation: a repetitive transcranial magnetic stimulation study.

    Science.gov (United States)

    Schutter, Dennis J L G; van Honk, Jack

    2009-03-01

    Several lines of evidence suggest that the cerebellum may play a role in the regulation of emotion. The aim of this study was to investigate the hypothesis that inhibition of cerebellar function using slow repetitive transcranial magnetic stimulation (rTMS) would lead to increased negative mood as a result of impaired emotion regulation. In a randomized counterbalanced within-subjects design, 12 healthy young right-handed volunteers received 20 min of cerebellar, occipital, or sham 1 Hz rTMS on three separate days. Mood state inventories were acquired prior to and immediately after rTMS and after an emotion regulation task (ERT). In the ERT, participants were instructed to either look at aversive and neutral scenes, or to suppress the negative feelings experienced while watching aversive scenes during which the electroencephalogram (EEG) was recorded. Results showing no changes in baseline-corrected mood were observed immediately after rTMS. However, significant increases in baseline-corrected negative mood following the ERT were reported after cerebellar rTMS exclusively. No effects on the EEG during the ERT were observed. These findings provide support for the view that the cerebellum is implicated in the regulation of emotion and mood, and concur with evidence of cerebellar abnormalities observed in disorders associated with emotion dysregulation. In order to clarify the underlying biological mechanisms involved, more research is needed.

  12. [Repetitive Transcranial Magnetic Stimulation (rTMS) for Higher Brain Function Deficits].

    Science.gov (United States)

    Inoue, Yukichi

    2016-12-01

    The management of higher brain dysfunctions such as stroke-induced unilateral spatial neglect (USN) or aphasia is crucial because these dysfunctions have devastating neurological repercussions on the patients' daily life and quality of life. Impairment of the physiological interhemispheric rivalry is often the result of brain insults such as strokes or traumatic injuries, and it may lead to USN or aphasia. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive brain stimulation method, is a promising tool for restoring the pathological imbalance in interhemispheric rivalry by either suppressing the hyperactivity of the unaffected hemisphere or facilitating hypoactivity in the affected hemisphere. The concept of paradoxical functional facilitation (Kapur, 1996) has important clinical implications when coupled with rTMS applications. In addition to conventional rTMS (c-rTMS), other clinically relevant protocols of patterned rTMS (p-rTMS) have been developed: the theta burst stimulation (TBS), the paired associative stimulation (PAS), and the quadripulse stimulation (QPS). TBS is commonly used in the rehabilitation of patients with post-stroke USN and those with non-fluent aphasia because of its prolonged beneficial effects and the short duration of stimulation. TBS may be considered an effective and safe protocol of rTMS. We foresee broader clinical applications of p-rTMS (TBS) and c-rTMS in the treatment of various neurological deficits.

  13. Repetitive Transcranial Magnetic Stimulation (rTMS)-Induced Trigeminal Autonomic Cephalalgia

    Science.gov (United States)

    DURMAZ, Onur; ATEŞ, Mehmet Alpay; ŞENOL, Mehmet Güney

    2015-01-01

    Repetitive transcranial magnetic stimulation (rTMS) is an effective and novel treatment method that has been approved for the treatment of refractory depression by the U.S. Food and Drug Administration. The most common side effects of rTMS are a transient headache that usually responds to simple analgesics, local discomfort in the stimulation area, dizziness, ipsilateral lacrimation and, very rarely, generalized seizure. TMS is also regarded as a beneficial tool for investigating mechanisms underlying headache. Although rTMS has considerable benefits in terms of headache, there is the potential for rare side effects. In this report, we present the case of a patient with no history of autonomic headache who underwent a course of rTMS for refractory unipolar depression caused by an inadequate response to pharmacotherapy. After his fourth rTMS session, the patient developed sudden headaches with characteristics of trigeminal autonomic cephalalgia on the stimulated side, representing a noteworthy example of the potential side effects of rTMS. PMID:28360729

  14. Effects of repetitive transcranial magnetic stimulation on synaptic plasticity and apoptosis in vascular dementia rats.

    Science.gov (United States)

    Yang, Hui-Yun; Liu, Yang; Xie, Jia-Cun; Liu, Nan-Nan; Tian, Xin

    2015-03-15

    This study aims to determine whether low-frequency repetitive transcranial magnetic stimulation (rTMS) protects pyramidal cells from apoptosis and promotes hippocampal synaptic plasticity in a vascular dementia (VaD) rat model. Following establishment of a VaD rat model using two-vessel occlusion (2VO), learning and memory were evaluated via the Morris Water Maze (MWM), hippocampal CA1 neuron ultrastructure was examined via electron microscopy, and hippocampal synaptic plasticity was assessed by long-term potentiation (LTP). Western blot was used to detect the expression of N-methyl-d-aspartic acid receptor 1 (NMDAR1), Bcl-2, and Bax. Compared with VaD group, rats treated with low-frequency rTMS had reduced-escape latencies, increased swimming time in the target quadrant (PCA3-CA1 synapses was enhanced (P<0.05). Low-frequency rTMS significantly up-regulated NMDAR1 and Bcl-2 expression and down-regulated Bax expression. Low-frequency rTMS improves learning and memory, protects the synapse, and increases synaptic plasticity in VaD model rats. Increased Bcl-2 expression and reduced Bax expression may be a novel protective mechanism of low-frequency rTMS treatment for VaD.

  15. Improvements in emotion regulation following repetitive transcranial magnetic stimulation for generalized anxiety disorder.

    Science.gov (United States)

    Diefenbach, Gretchen J; Assaf, Michal; Goethe, John W; Gueorguieva, Ralitza; Tolin, David F

    2016-10-01

    Generalized anxiety disorder (GAD) is characterized by emotion regulation difficulties, which are associated with abnormalities in neural circuits encompassing fronto-limbic regions including the dorsolateral prefrontal cortex (DLPFC). The aim of this study was to determine whether DLPFC neuromodulation improves emotion regulation in patients with GAD. This is a secondary analysis from a randomized-controlled trial comparing 30 sessions of low-frequency right-sided active (n=13) versus sham (n=12, sham coil) repetitive transcranial magnetic stimulation (rTMS) at the right DLPFC in patients with GAD. Results indicated statistically significant improvements in self-reported emotion regulation difficulties at posttreatment and 3-month follow-up in the active group only. Improvements were found primarily in the domains of goal-directed behaviors and impulse control and were significantly associated with a global clinician rating of improvement. These preliminary results support rTMS as a treatment for GAD and suggest improved emotion regulation as a possible mechanism of change. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Online repetitive transcranial magnetic stimulation (TMS) to the parietal operculum disrupts haptic memory for grasping.

    Science.gov (United States)

    Cattaneo, Luigi; Maule, Francesca; Tabarelli, Davide; Brochier, Thomas; Barchiesi, Guido

    2015-11-01

    The parietal operculum (OP) contains haptic memory on the geometry of objects that is readily transferrable to the motor cortex but a causal role of OP in memory-guided grasping is only speculative. We explored this issue by using online high-frequency repetitive transcranial magnetic stimulation (rTMS). The experimental task was performed by blindfolded participants acting on objects of variable size. Trials consisted in three phases: haptic exploration of an object, delay, and reach-grasp movement onto the explored object. Motor performance was evaluated by the kinematics of finger aperture. Online rTMS was applied to the left OP region separately in each of the three phases of the task. The results showed that rTMS altered grip aperture only when applied in the delay phase to the OP. In a second experiment a haptic discriminative (match-to-sample) task was carried out on objects similar to those used in the first experiment. Online rTMS was applied to the left OP. No psychophysical effects were induced by rTMS on the detection of explicit haptic object size. We conclude that neural activity in the OP region is necessary for proficient memory-guided haptic grasping. The function of OP seems to be critical while maintaining the haptic memory trace and less so while encoding it or retrieving it. © 2015 Wiley Periodicals, Inc.

  17. Repetitive transcranial magnetic stimulation decreases the kindling induced synaptic potentiation: effects of frequency and coil shape.

    Science.gov (United States)

    Yadollahpour, Ali; Firouzabadi, Seyed Mohammad; Shahpari, Marzieh; Mirnajafi-Zadeh, Javad

    2014-02-01

    The present study was aimed to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on kindling-induced synaptic potentiation and to study the effect of frequency and coil shape on rTMS effectiveness. Seizures were induced in rats by perforant path stimulation in a rapid kindling manner (12 stimulations/day). rTMS was applied at different frequencies (0.5, 1 and 2 Hz), using either figure-8 shaped or circular coils at different times (during or before kindling stimulations). rTMS had antiepileptogenic effect at all frequencies and imposed inhibitory effects on enhancement of population excitatory postsynaptic potential slope and population spike amplitude when applied during kindling acquisition. Furthermore, it prevented the kindling-induced changes in paired pulse indices. The inhibitory effect of rTMS was higher at the frequency of 1 Hz compared to 0.5 and 2 Hz. Application of rTMS 1Hz by circular coil imposed a weaker inhibitory action compared with the figure-8 coil. In addition, the results showed that pretreatment of animals by both coils had similar preventing effect on kindling acquisition as well as kindling-induced synaptic potentiation. Obtained results demonstrated that the antiepileptogenic effect of low frequency rTMS is accompanied with the preventing of the kindling induced potentiation. This effect is dependent on rTMS frequency and slightly on coil-type.

  18. Lateralized effects of prefrontal repetitive transcranial magnetic stimulation on emotional working memory.

    Science.gov (United States)

    Weigand, Anne; Grimm, Simone; Astalosch, Antje; Guo, Jia Shen; Briesemeister, Benny B; Lisanby, Sarah H; Luber, Bruce; Bajbouj, Malek

    2013-05-01

    Little is known about the neural correlates underlying the integration of working memory and emotion processing. We investigated the effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) applied over the left or right dorsolateral prefrontal cortex (DLPFC) on emotional working memory. In a sham-controlled crossover design, participants performed an emotional 3-back task (EMOBACK) at baseline and after stimulation (1 Hz, 15 min, 110 % of the resting motor threshold) in two subsequent sessions. Stimuli were words assigned to the distinct emotion categories fear and anger as well as neutral words. We found lateralized rTMS effects in the EMOBACK task accuracy for fear-related words, with enhanced performance after rTMS applied over the right DLPFC and impaired performance after rTMS applied over the left DLPFC. No significant stimulation effect could be found for anger-related and neutral words. Our findings are the first to demonstrate a causal role of the right DLPFC in working memory for negative, withdrawal-related words and provide further support for a hemispheric lateralization of emotion processing.

  19. Mechanisms of human motor cortex facilitation induced by subthreshold 5-Hz repetitive transcranial magnetic stimulation.

    Science.gov (United States)

    Sommer, Martin; Rummel, Milena; Norden, Christoph; Rothkegel, Holger; Lang, Nicolas; Paulus, Walter

    2013-06-01

    Our knowledge about the mechanisms of human motor cortex facilitation induced by repetitive transcranial magnetic stimulation (rTMS) is still incomplete. Here we used pharmacological conditioning with carbamazepine, dextrometorphan, lorazepam, and placebo to elucidate the type of plasticity underlying this facilitation, and to probe if mechanisms reminiscent of long-term potentiation are involved. Over the primary motor cortex of 10 healthy subjects, we applied biphasic rTMS pulses of effective posterior current direction in the brain. We used six blocks of 200 pulses at 5-Hz frequency and 90% active motor threshold intensity and controlled for corticospinal excitability changes using motor-evoked potential (MEP) amplitudes and latencies elicited by suprathreshold pulses before, in between, and after rTMS. Target muscle was the dominant abductor digiti minimi muscle; we coregistered the dominant extensor carpi radialis muscle. We found a lasting facilitation induced by this type of rTMS. The GABAergic medication lorazepam and to a lesser extent the ion channel blocker carbamazepine reduced the MEP facilitation after biphasic effective posteriorly oriented rTMS, whereas the N-methyl-d-aspartate receptor-antagonist dextrometorphan had no effect. Our main conclusion is that the mechanism of the facilitation induced by biphasic effective posterior rTMS is more likely posttetanic potentiation than long-term potentiation. Additional findings were prolonged MEP latency under carbamazepine, consistent with sodium channel blockade, and larger MEP amplitudes from extensor carpi radialis under lorazepam, suggesting GABAergic involvement in the center-surround balance of excitability.

  20. Effects of repetitive transcranial magnetic stimulation on recovery of function after spinal cord injury.

    Science.gov (United States)

    Tazoe, Toshiki; Perez, Monica A

    2015-04-01

    A major goal of rehabilitation strategies after spinal cord injury (SCI) is to enhance the recovery of function. One possible avenue to achieve this goal is to strengthen the efficacy of the residual neuronal pathways. Noninvasive repetitive transcranial magnetic stimulation (rTMS) has been used in patients with motor disorders as a tool to modulate activity of corticospinal, cortical, and subcortical pathways to promote functional recovery. This article reviews a series of studies published during the last decade that used rTMS in the acute and chronic stages of paraplegia and tetraplegia in humans with complete and incomplete SCI. In the studies, rTMS has been applied over the arm and leg representations of the primary motor cortex to target 3 main consequences of SCI: sensory and motor function impairments, spasticity, and neuropathic pain. Although some studies demonstrated that consecutive sessions of rTMS improve aspects of particular functions, other studies did not show similar effects. We discuss how rTMS parameters and postinjury reorganization in the corticospinal tract, motor cortical, and spinal cord circuits might be critical factors in understanding the advantages and disadvantages of using rTMS in patients with SCI. The available data highlight the limited information on the use of rTMS after SCI and the need to further understand the pathophysiology of neuronal structures affected by rTMS to maximize the potential beneficial effects of this technique in humans with SCI.

  1. Theta-burst repetitive transcranial magnetic stimulation suppresses specific excitatory circuits in the human motor cortex.

    Science.gov (United States)

    Di Lazzaro, V; Pilato, F; Saturno, E; Oliviero, A; Dileone, M; Mazzone, P; Insola, A; Tonali, P A; Ranieri, F; Huang, Y Z; Rothwell, J C

    2005-06-15

    In four conscious patients who had electrodes implanted in the cervical epidural space for the control of pain, we recorded corticospinal volleys evoked by single-pulse transcranial magnetic stimulation (TMS) over the motor cortex before and after a 20 s period of continuous theta-burst stimulation (cTBS). It has previously been reported that this form of repetitive TMS reduces the amplitude of motor-evoked potentials (MEPs), with the maximum effect occurring at 5-10 min after the end of stimulation. The present results show that cTBS preferentially decreases the amplitude of the corticospinal I1 wave, with approximately the same time course. This is consistent with a cortical origin of the effect on the MEP. However, other protocols that lead to MEP suppression, such as short-interval intracortical inhibition, are characterized by reduced excitability of late I waves (particularly I3), suggesting that cTBS suppresses MEPs through different mechanisms, such as long-term depression in excitatory synaptic connections.

  2. Repetitive Transcranial Magnetic Stimulation Improves Handwriting in Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Bubblepreet K. Randhawa

    2013-01-01

    Full Text Available Background. Parkinson disease (PD is characterized by hypometric movements resulting from loss of dopaminergic neurons in the substantia nigra. PD leads to decreased activation of the supplementary motor area (SMA; the net result of these changes is a poverty of movement. The present study determined the impact of 5 Hz repetitive transcranial magnetic stimulation (rTMS over the SMA on a fine motor movement, handwriting (writing cursive “l”s, and on cortical excitability, in individuals with PD. Methods. In a cross-over design, ten individuals with PD were randomized to receive either 5 Hz or control stimulation over the SMA. Immediately following brain stimulation right handed writing was assessed. Results. 5 Hz stimulation increased vertical size of handwriting and diminished axial pressure. In addition, 5 Hz rTMS significantly decreased the threshold for excitability in the primary motor cortex. Conclusions. These data suggest that in the short term 5 Hz rTMS benefits functional fine motor task performance, perhaps by altering cortical excitability across a network of brain regions. Further, these data may provide the foundation for a larger investigation of the effects of noninvasive brain stimulation over the SMA in individuals with PD.

  3. Repetitive transcranial magnetic stimulation in cervical dystonia: effect of site and repetition in a randomized pilot trial.

    Directory of Open Access Journals (Sweden)

    Sarah Pirio Richardson

    Full Text Available Dystonia is characterized by abnormal posturing due to sustained muscle contraction, which leads to pain and significant disability. New therapeutic targets are needed in this disorder. The objective of this randomized, sham-controlled, blinded exploratory study is to identify a specific motor system target for non-invasive neuromodulation and to evaluate this target in terms of safety and tolerability in the cervical dystonia (CD population. Eight CD subjects were given 15-minute sessions of low-frequency (0.2 Hz repetitive transcranial magnetic stimulation (rTMS over the primary motor cortex (MC, dorsal premotor cortex (dPM, supplementary motor area (SMA, anterior cingulate cortex (ACC and a sham condition with each session separated by at least two days. The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS score was rated in a blinded fashion immediately pre- and post-intervention. Secondary outcomes included physiology and tolerability ratings. The mean change in TWSTRS severity score by site was 0.25 ± 1.7 (ACC, -2.9 ± 3.4 (dPM, -3.0 ± 4.8 (MC, -0.5 ± 1.1 (SHAM, and -1.5 ± 3.2 (SMA with negative numbers indicating improvement in symptom control. TWSTRS scores decreased from Session 1 (15.1 ± 5.1 to Session 5 (11.0 ± 7.6. The treatment was tolerable and safe. Physiology data were acquired on 6 of 8 subjects and showed no change over time. These results suggest rTMS can modulate CD symptoms. Both dPM and MC are areas to be targeted in further rTMS studies. The improvement in TWSTRS scores over time with multiple rTMS sessions deserves further evaluation.

  4. Low and High Frequency Repetitive Transcranial Magnetic Stimulation for the Treatment of Spasticity

    Science.gov (United States)

    Valle, Angela C.; Dionisio, Karen; Pitskel, Naomi Bass; Pascual-Leone, Alvaro; Orsati, Fernanda; Ferreira, Merari J. L.; Boggio, Paulo S.; Lima, Moises C.; Rigonatti, Sergio P.; Fregni, Felipe

    2007-01-01

    The development of non-invasive techniques of cortical stimulation, such as transcranial magnetic stimulation (TMS), has opened new potential avenues for the treatment of neuropsychiatric diseases. We hypothesized that an increase in the activity in the motor cortex by cortical stimulation would increase its inhibitory influence on spinal…

  5. Low and High Frequency Repetitive Transcranial Magnetic Stimulation for the Treatment of Spasticity

    Science.gov (United States)

    Valle, Angela C.; Dionisio, Karen; Pitskel, Naomi Bass; Pascual-Leone, Alvaro; Orsati, Fernanda; Ferreira, Merari J. L.; Boggio, Paulo S.; Lima, Moises C.; Rigonatti, Sergio P.; Fregni, Felipe

    2007-01-01

    The development of non-invasive techniques of cortical stimulation, such as transcranial magnetic stimulation (TMS), has opened new potential avenues for the treatment of neuropsychiatric diseases. We hypothesized that an increase in the activity in the motor cortex by cortical stimulation would increase its inhibitory influence on spinal…

  6. Safety of repetitive transcranial magnetic stimulation in patients with epilepsy: A systematic review.

    Science.gov (United States)

    Pereira, Luisa Santos; Müller, Vanessa Teixeira; da Mota Gomes, Marleide; Rotenberg, Alexander; Fregni, Felipe

    2016-04-01

    Approximately one-third of patients with epilepsy remain with pharmacologically intractable seizures. An emerging therapeutic modality for seizure suppression is repetitive transcranial magnetic stimulation (rTMS). Despite being considered a safe technique, rTMS carries the risk of inducing seizures, among other milder adverse events, and thus, its safety in the population with epilepsy should be continuously assessed. We performed an updated systematic review on the safety and tolerability of rTMS in patients with epilepsy, similar to a previous report published in 2007 (Bae EH, Schrader LM, Machii K, Alonso-Alonso M, Riviello JJ, Pascual-Leone A, Rotenberg A. Safety and tolerability of repetitive transcranial magnetic stimulation in patients with epilepsy: a review of the literature. Epilepsy Behav. 2007; 10 (4): 521-8), and estimated the risk of seizures and other adverse events during or shortly after rTMS application. We searched the literature for reports of rTMS being applied on patients with epilepsy, with no time or language restrictions, and obtained studies published from January 1990 to August 2015. A total of 46 publications were identified, of which 16 were new studies published after the previous safety review of 2007. We noted the total number of subjects with epilepsy undergoing rTMS, medication usage, incidence of adverse events, and rTMS protocol parameters: frequency, intensity, total number of stimuli, train duration, intertrain intervals, coil type, and stimulation site. Our main data analysis included separate calculations for crude per subject risk of seizure and other adverse events, as well as risk per 1000 stimuli. We also performed an exploratory, secondary analysis on the risk of seizure and other adverse events according to the type of coil used (figure-of-8 or circular), stimulation frequency (≤ 1 Hz or > 1 Hz), pulse intensity in terms of motor threshold (rTMS with maximum stimulator output for speech arrest, clinically arising

  7. The Effectiveness of Repetitive Transcranial Magnetic Stimulation for Poststroke Apathy Is Associated with Improved Interhemispheric Functional Connectivity.

    Science.gov (United States)

    Mitaki, Shingo; Onoda, Keiichi; Abe, Satoshi; Oguro, Hiroaki; Yamaguchi, Shuhei

    2016-12-01

    Poststroke apathy is relatively common and has negative effects on the functional recovery of the patient; however, few reports have demonstrated the existence of effective treatments for poststroke apathy. Here, we describe a case of poststroke apathy that was successfully treated with repetitive transcranial magnetic stimulation (rTMS). Using resting-state functional magnetic resonance imaging, we detected improved interhemispheric functional connectivity that was correlated with the patient's recovery from poststroke apathy. Our case suggests that rTMS can improve the transfer of information through the corpus callosum, which is crucial for helping patients recover from poststroke apathy. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  8. Increased probability of repetitive spinal motoneuron activation by transcranial magnetic stimulation after muscle fatigue in healthy subjects

    DEFF Research Database (Denmark)

    Andersen, Birgit; Felding, Ulrik Ascanius; Krarup, Christian

    2012-01-01

    Triple stimulation technique (TST) has previously shown that transcranial magnetic stimulation (TMS) fails to activate a proportion of spinal motoneurons (MNs) during motor fatigue. The TST response depression without attenuation of the conventional motor evoked potential suggested increased prob...... the muscle is fatigued. Repetitive MN firing may provide an adaptive mechanism to maintain motor unit activation and task performance during sustained voluntary activity.......Triple stimulation technique (TST) has previously shown that transcranial magnetic stimulation (TMS) fails to activate a proportion of spinal motoneurons (MNs) during motor fatigue. The TST response depression without attenuation of the conventional motor evoked potential suggested increased......-exercise behavior of QuadS responses was related to the duration of the contraction pointing to a correlation between repeated activation of MNs and the subject's ability to maintain force. In conclusion, the study confirmed that an increased fraction of spinal MNs fire more than once in response to TMS when...

  9. Induction of central nervous system plasticity by repetitive transcranial magnetic stimulation to promote sensorimotor recovery in incomplete spinal cord injury

    Science.gov (United States)

    Ellaway, Peter H.; Vásquez, Natalia; Craggs, Michael

    2014-01-01

    Cortical and spinal cord plasticity may be induced with non-invasive transcranial magnetic stimulation to encourage long term potentiation or depression of neuronal circuits. Such plasticity inducing stimulation provides an attractive approach to promote changes in sensorimotor circuits that have been degraded by spinal cord injury (SCI). If residual corticospinal circuits can be conditioned appropriately there should be the possibility that the changes are accompanied by functional recovery. This article reviews the attempts that have been made to restore sensorimotor function and to obtain functional benefits from the application of repetitive transcranial magnetic stimulation (rTMS) of the cortex following incomplete spinal cord injury. The confounding issues that arise with the application of rTMS, specifically in SCI, are enumerated. Finally, consideration is given to the potential for rTMS to be used in the restoration of bladder and bowel sphincter function and consequent functional recovery of the guarding reflex. PMID:24904326

  10. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS).

    Science.gov (United States)

    Lefaucheur, Jean-Pascal; André-Obadia, Nathalie; Antal, Andrea; Ayache, Samar S; Baeken, Chris; Benninger, David H; Cantello, Roberto M; Cincotta, Massimo; de Carvalho, Mamede; De Ridder, Dirk; Devanne, Hervé; Di Lazzaro, Vincenzo; Filipović, Saša R; Hummel, Friedhelm C; Jääskeläinen, Satu K; Kimiskidis, Vasilios K; Koch, Giacomo; Langguth, Berthold; Nyffeler, Thomas; Oliviero, Antonio; Padberg, Frank; Poulet, Emmanuel; Rossi, Simone; Rossini, Paolo Maria; Rothwell, John C; Schönfeldt-Lecuona, Carlos; Siebner, Hartwig R; Slotema, Christina W; Stagg, Charlotte J; Valls-Sole, Josep; Ziemann, Ulf; Paulus, Walter; Garcia-Larrea, Luis

    2014-11-01

    A group of European experts was commissioned to establish guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS) from evidence published up until March 2014, regarding pain, movement disorders, stroke, amyotrophic lateral sclerosis, multiple sclerosis, epilepsy, consciousness disorders, tinnitus, depression, anxiety disorders, obsessive-compulsive disorder, schizophrenia, craving/addiction, and conversion. Despite unavoidable inhomogeneities, there is a sufficient body of evidence to accept with level A (definite efficacy) the analgesic effect of high-frequency (HF) rTMS of the primary motor cortex (M1) contralateral to the pain and the antidepressant effect of HF-rTMS of the left dorsolateral prefrontal cortex (DLPFC). A Level B recommendation (probable efficacy) is proposed for the antidepressant effect of low-frequency (LF) rTMS of the right DLPFC, HF-rTMS of the left DLPFC for the negative symptoms of schizophrenia, and LF-rTMS of contralesional M1 in chronic motor stroke. The effects of rTMS in a number of indications reach level C (possible efficacy), including LF-rTMS of the left temporoparietal cortex in tinnitus and auditory hallucinations. It remains to determine how to optimize rTMS protocols and techniques to give them relevance in routine clinical practice. In addition, professionals carrying out rTMS protocols should undergo rigorous training to ensure the quality of the technical realization, guarantee the proper care of patients, and maximize the chances of success. Under these conditions, the therapeutic use of rTMS should be able to develop in the coming years.

  11. Brain SPECT guided repetitive transcranial magnetic stimulation (rTMS) in treatment resistant major depressive disorder.

    Science.gov (United States)

    Jha, Shailesh; Chadda, Rakesh K; Kumar, Nand; Bal, C S

    2016-06-01

    Repetitive transcranial magnetic stimulation (rTMS) has emerged as a potential treatment in treatment resistant major depressive disorder (MDD). However, there is no consensus about the exact site of stimulation for rTMS. Single-photon emission computed tomography (SPECT) offers a potential technique in deciding the site of stimulation. The present study was conducted to assess the difference in outcome of brain SPECT assisted rTMS versus standard protocol of twenty sessions of high frequency rTMS as add on treatment in 20 patients with treatment resistant MDD, given over a period of 4 weeks. Thirteen subjects (group I) received high frequency rTMS over an area of hypoperfusion in the prefrontal cortex, as identified on SPECT, whereas 7 subjects (group II) were administered rTMS in the left dorsoslateral prefrontal cortex (DLPFC) area. Improvement was monitored using standardized instruments. Patients in the group I showed a significantly better response compared to those in the group II. In group I, 46% of the subjects were responders on MADRS, 38% on BDI and 77% on CGI. The parallel figures of responders in Group II were 0% on MADRS, 14% on BDI and 43% on CGI. There were no remitters in the study. No significant untoward side effects were noticed. The study had limitations of a small sample size and non-controlled design, and all the subjects were also receiving the standard antidepressant therapy. Administration of rTMS over brain SPECT specified area of hypoperfusion may have a better clinical outcome compared to the standard protocol.

  12. Effect of repetitive transcranial magnetic stimulation in drug resistant depressed patients

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    Chung, Yong An; Yoo, Ie Ryung; Kang, Bong Joo; Chae, Jeong Ho; Lee, Hye Won; Moon, Hyun Jin; Kim, Sung Hoon; Sohn, Hyung Sun; Chung, Soo Kyo [The Catholic University of Korea, Seoul (Korea, Republic of)

    2007-02-15

    Repetitive transcranial magnetic stimulation (rTMS) has recently been clinically applied in the treatment of drug resistant depressed patients. There are mixed findings about the efficacy of rTMS on depression. Furthermore, the influence of rTMS on the physiology of the brain is not clear. We prospectively evaluated changes of regional cerebral blood flow (rCBF) between pre- and post-rTMS treatment in patients with drug resistant depression. Twelve patients with drug-resistant depression (7 male, 5 female; age range; 19{approx} 52 years; mean age: 29.3 {+-} 9.3 years) were given rTMS on right prefrontal lobe with low frequency (1 Hz) and on left prefrontal lobe with high frequency (20 Hz), with 20-minute-duration each day for 3 weeks. Tc-99m ECD brain perfusion SPECT was obtained before and after rTMS treatment. The changes of cerebral perfusion were analyzed using statistical parametric mapping (SPM; t=3.14, uncorrected {rho} < 0.01, voxel = 100). Following areas showed significant increase in rCBF after 3 weeks rTMS treatment: the cingulate gyrus, fusiform gyrus of right temporal lobe, precuneus, and left lateral globus pallidus. Significant decrement was noted in the precental and middle frontal gyrus of right frontal lobe, and fusiform gyrus of left occipital lobe. Low-frequency rTMS on the right prefrontal cortex and high-frequency rTMS on the left prefrontal cortex for 3 weeks as an add-on regimen have increased and decreased rCBF in the specific brain regions in drug-resistant depressed patients. Further analyses correlating clinical characteristics and treatment paradigm with functional imaging data may be helpful in clarifying the pathophysiology of drug-resistant patients.

  13. Priming theta-burst repetitive transcranial magnetic stimulation with low- and high-frequency stimulation.

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    Todd, Gabrielle; Flavel, Stanley C; Ridding, Michael C

    2009-05-01

    Repetitive transcranial magnetic stimulation (rTMS) can be used to study metaplasticity in human motor cortex. The term metaplasticity describes a phenomenon where the prior synaptic history of a pathway can affect the subsequent induction of long-term potentiation or depression. In the current study, we investigated metaplasticity in human motor cortex with the use of inhibitory continuous theta-burst stimulation (cTBS). cTBS involves short bursts of high frequency (50 Hz) rTMS applied every 200 ms for 40 s. In the first series of experiments, cTBS was primed with 10 min of intermittent 2 or 6 Hz rTMS. Subjects (n = 20) received priming stimulation at 70% of active motor threshold or 90% of resting motor threshold. In another series of experiments, cTBS was primed with excitatory intermittent theta-burst stimulation (iTBS). iTBS involves a 2 s train of theta-burst stimulation delivered every 10 s for 190 s. Stimuli were delivered over the first dorsal interosseus motor area.. The effect of cTBS alone and primed cTBS on motor cortical excitability was investigated by recording motor-evoked potentials (MEP) in the first dorsal interosseus following single-pulse TMS. MEP area in the cTBS alone condition was not significantly different from cTBS primed with 2 or 6 Hz rTMS. However, priming cTBS with iTBS suppressed MEP area to a greater extent than in cTBS alone. Our results provide further evidence of metaplasticity in human motor cortex when appropriate priming protocols are employed.

  14. Suppression of motor cortical excitability in anesthetized rats by low frequency repetitive transcranial magnetic stimulation.

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    Paul A Muller

    Full Text Available Repetitive transcranial magnetic stimulation (rTMS is a widely-used method for modulating cortical excitability in humans, by mechanisms thought to involve use-dependent synaptic plasticity. For example, when low frequency rTMS (LF rTMS is applied over the motor cortex, in humans, it predictably leads to a suppression of the motor evoked potential (MEP, presumably reflecting long-term depression (LTD -like mechanisms. Yet how closely such rTMS effects actually match LTD is unknown. We therefore sought to (1 reproduce cortico-spinal depression by LF rTMS in rats, (2 establish a reliable animal model for rTMS effects that may enable mechanistic studies, and (3 test whether LTD-like properties are evident in the rat LF rTMS setup. Lateralized MEPs were obtained from anesthetized Long-Evans rats. To test frequency-dependence of LF rTMS, rats underwent rTMS at one of three frequencies, 0.25, 0.5, or 1 Hz. We next tested the dependence of rTMS effects on N-methyl-D-aspartate glutamate receptor (NMDAR, by application of two NMDAR antagonists. We find that 1 Hz rTMS preferentially depresses unilateral MEP in rats, and that this LTD-like effect is blocked by NMDAR antagonists. These are the first electrophysiological data showing depression of cortical excitability following LF rTMS in rats, and the first to demonstrate dependence of this form of cortical plasticity on the NMDAR. We also note that our report is the first to show that the capacity for LTD-type cortical suppression by rTMS is present under barbiturate anesthesia, suggesting that future neuromodulatory rTMS applications under anesthesia may be considered.

  15. Cortical excitability changes after high-frequency repetitive transcranial magnetic stimulation for central poststroke pain.

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    Hosomi, Koichi; Kishima, Haruhiko; Oshino, Satoru; Hirata, Masayuki; Tani, Naoki; Maruo, Tomoyuki; Yorifuji, Shiro; Yoshimine, Toshiki; Saitoh, Youichi

    2013-08-01

    Central poststroke pain (CPSP) is one of the most refractory chronic pain syndromes. Repetitive transcranial magnetic stimulation (rTMS) of the primary motor cortex has been demonstrated to provide moderate pain relief for CPSP. However, the mechanism underlying the pain relief remains unclear. The objective of this study was to assess changes in cortical excitability in patients with intractable CPSP before and after rTMS of the primary motor cortex. Subjects were 21 patients with CPSP of the hand who underwent rTMS. The resting motor threshold, the amplitude of the motor evoked potential, duration of the cortical silent period, short interval intracortical inhibition, and intracortical facilitation were measured as parameters of cortical excitability before and after navigation-guided 5 Hz rTMS of the primary motor cortex corresponding to the painful hand. Pain reduction from rTMS was assessed with a visual analog scale. The same parameters were measured in both hemispheres of 8 healthy controls. Eight of 21 patients experienced ≥ 30% pain reduction after rTMS (responders). The resting motor threshold in the patients was higher than those in the controls at baseline (P=.035). Intracortical facilitation in the responders was lower than in the controls and the nonresponders at baseline (P=.035 and P=.019), and significantly increased after rTMS (P=.039). There were no significant differences or changes in the other parameters. Our findings suggest that restoration of abnormal cortical excitability might be one of the mechanisms underlying pain relief as a result of rTMS in CPSP.

  16. 5 Hz repetitive transcranial magnetic stimulation over the ipsilesional sensory cortex enhances motor learning after stroke

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    Sonia M Brodie

    2014-03-01

    Full Text Available Sensory feedback is critical for motor learning, and thus to neurorehabilitation after stroke. Whether enhancing sensory feedback by applying excitatory repetitive transcranial magnetic stimulation (rTMS over the ipsilesional primary sensory cortex (IL-S1 might enhance motor learning in chronic stroke has yet to be investigated. The present study investigated the effects of 5 Hz rTMS over IL-S1 paired with skilled motor practice on motor learning, hemiparetic cutaneous somatosensation, and motor function. Individuals with unilateral chronic stroke were pseudo-randomly divided into either Active or Sham 5 Hz rTMS groups (n=11/group. Following stimulation, both groups practiced a Serial Tracking Task (STT with the hemiparetic arm; this was repeated for 5 days. Performance on the STT was quantified by response time, peak velocity, and cumulative distance tracked at baseline, during the 5 days of practice, and at a no-rTMS retention test. Cutaneous somatosensation was measured using two-point discrimination. Standardized sensorimotor tests were performed to assess whether the effects might generalize to impact hemiparetic arm function. The active 5Hz rTMS + training group demonstrated significantly greater improvements in STT performance [response time (F1,286.04=13.016, p< 0.0005, peak velocity (F1,285.95=4.111, p=0.044, and cumulative distance (F1,285.92=4.076, p=0.044] and cutaneous somatosensation (F1,21.15=8.793, p=0.007 across all sessions compared to the sham rTMS + training group. Measures of upper extremity motor function were not significantly different for either group. Our preliminary results suggest that, when paired with motor practice, 5Hz rTMS over IL-S1 enhances motor learning related change in individuals with chronic stroke, potentially as a consequence of improved cutaneous somatosensation, however no improvement in general upper extremity function was observed.

  17. Repetitive transcranial magnetic stimulation affects behavior by biasing endogenous cortical oscillations

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    Massihullah Hamidi

    2009-06-01

    Full Text Available A governing assumption about repetitive transcranial magnetic stimulation (rTMS has been that it interferes with task-related neuronal activity – in effect, by “injecting noise” into the brain – and thereby disrupts behavior. Recent reports of rTMS-produced behavioral enhancement, however, call this assumption into question. We investigated the neurophysiological effects of rTMS delivered during the delay period of a visual working memory task by simultaneously recording brain activity with electroencephalography (EEG. Subjects performed visual working memory for locations or for shapes, and in half the trials a 10-Hz train of rTMS was delivered to the superior parietal lobule or a control brain area. The wide range of individual differences in the effects of rTMS on task accuracy, from improvement to impairment, was predicted by individual differences in the effect of rTMS on power in the alpha-band of the EEG (~ 10 Hz: a decrease in alpha-band power corresponded to improved performance, whereas an increase in alpha-band power corresponded to the opposite. The EEG effect was localized to cortical sources encompassing the frontal eye fields and the intraparietal sulcus, and was specific to task (location, but not object memory and to rTMS target (superior parietal lobule, not control area. Furthermore, for the same task condition, rTMS-induced changes in cross-frequency phase synchrony between alpha- and gamma-band (> 40 Hz oscillations predicted changes in behavior. These results suggest that alpha-band oscillations play an active role cognitive processes and do not simply reflect absence of processing. Furthermore, this study shows that the complex effects of rTMS on behavior can result from biasing endogenous patterns of network-level oscillations.

  18. Investigating the Anticonvulsant Effects of Repetitive Transcranial Magnetic Stimulation on Perforant Path Kindling Model in Rats

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    Ali Yadollahpour

    2015-02-01

    Full Text Available Background: Almost 20% of epileptics are drug resistant. Studies have shown that low frequency repetitive transcranial magnetic stimulation (rTMS is with therapeutic effects on epilepsy-affected laboratory models. Anticonvulsant effects of rTMS depend on several parameters among which radiation frequency is the most important one. In this study, the therapeutic impacts of 1 and 2 Hz rTMS on convulsing parameters in epileptic model of electrical kindling stimulation of the perforant path were investigated. Materials and Methods: In this experimental study 21 rats were randomly divided into three groups, namely ‘1 Hz treatment group’ and ‘2 Hz treatment group’ and ‘kindling group’. The kindling group only received kindling stimulations for seven days. One Hz and 2 Hz frequency treatment groups received maximally 5 min rTMS after termination of kindling stimulation per day for a week. Stimulation and stability electrodes had been placed, in turn, on perforant path and dentate gyrus. For quantifying the duration of the subsequent discharge waves, two-way ANOVA test and Bonferroni post-test were employed. In addition, for quantifying the convulsive behaviors, Kruskal-Wallis and the Mann-Whitney U tests were used. Results: The results showed that 1 Hz and 2 Hz frequency rTMS have considerable inhibitory impact on the development of convulsive phases. Anticonvulsive effect was observed from the first day after rTMS was undertaken. In addition, the animals did not show fourth and fifth convulsive stages, and a significant reduction was evident in their recorded peak discharge waves compared with kindle group. Conclusion: Low frequency rTMS possesses significant anticonvulsive effects which depend upon sTMS stimulation frequency.

  19. Effects of Bilateral Repetitive Transcranial Magnetic Stimulation on Post-Stroke Dysphagia.

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    Park, Eunhee; Kim, Min Su; Chang, Won Hyuk; Oh, Su Mi; Kim, Yun Kwan; Lee, Ahee; Kim, Yun-Hee

    Optimal protocol of repetitive transcranial magnetic stimulation (rTMS) on post-stroke dysphagia remains uncertain with regard to its clinical efficacy. The aim of the present study is to investigate the effects of high-frequency rTMS at the bilateral motor cortices over the cortical representation of the mylohyoid muscles in the patients with post-stroke dysphagia. This study was a single-blind, randomized controlled study with a blinded observer. Thirty-five stroke patients were randomly divided into three intervention groups: the bilateral stimulation group, the unilateral stimulation group, and the sham stimulation group. For the bilateral stimulation group, 500 pulses of 10 Hz rTMS over the ipsilesional and 500 pulses of 10 Hz rTMS over the contralesional motor cortices over the cortical areas that project to the mylohyoid muscles were administered daily for 2 consecutive weeks. For the unilateral stimulation group, 500 pulses of 10 Hz rTMS over the ipsilesional motor cortex over the cortical representation of the mylohyoid muscle and the same amount of sham rTMS over the contralesional hemisphere were applied. For the sham stimulation group, sham rTMS was applied at the bilateral motor cortices. Clinical swallowing function and videofluoroscopic swallowing studies were assessed before the intervention (T0), immediately after the intervention (T1) and 3 weeks after the intervention (T2) using Clinical Dysphagia Scale (CDS), Dysphagia Outcome and Severity Scale (DOSS), Penetration Aspiration Scale (PAS), and Videofluoroscopic Dysphagia Scale (VDS). There were significant time and intervention interaction effects in the CDS, DOSS, PAS, and VDS scores (p dysphagia therapies. Copyright © 2016. Published by Elsevier Inc.

  20. The effect of 10 Hz repetitive transcranial magnetic stimulation of posterior parietal cortex on visual attention.

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    Dombrowe, Isabel; Juravle, Georgiana; Alavash, Mohsen; Gießing, Carsten; Hilgetag, Claus C

    2015-01-01

    Repetitive transcranial magnetic stimulation (rTMS) of the posterior parietal cortex (PPC) at frequencies lower than 5 Hz transiently inhibits the stimulated area. In healthy participants, such a protocol can induce a transient attentional bias to the visual hemifield ipsilateral to the stimulated hemisphere. This bias might be due to a relatively less active stimulated hemisphere and a relatively more active unstimulated hemisphere. In a previous study, Jin and Hilgetag (2008) tried to switch the attention bias from the hemifield ipsilateral to the hemifield contralateral to the stimulated hemisphere by applying high frequency rTMS. High frequency rTMS has been shown to excite, rather than inhibit, the stimulated brain area. However, the bias to the ipsilateral hemifield was still present. The participants' performance decreased when stimuli were presented in the hemifield contralateral to the stimulation site. In the present study we tested if this unexpected result was related to the fact that participants were passively resting during stimulation rather than performing a task. Using a fully crossed factorial design, we compared the effects of high frequency rTMS applied during a visual detection task and high frequency rTMS during passive rest on the subsequent offline performance in the same detection task. Our results were mixed. After sham stimulation, performance was better after rest than after task. After active 10 Hz rTMS, participants' performance was overall better after task than after rest. However, this effect did not reach statistical significance. The comparison of performance after rTMS with task and performance after sham stimulation with task showed that 10 Hz stimulation significantly improved performance in the whole visual field. Thus, although we found a trend to better performance after rTMS with task than after rTMS during rest, we could not reject the hypothesis that high frequency rTMS with task and high frequency rTMS during rest

  1. The effect of 10 Hz repetitive transcranial magnetic stimulation of posterior parietal cortex on visual attention.

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    Isabel Dombrowe

    Full Text Available Repetitive transcranial magnetic stimulation (rTMS of the posterior parietal cortex (PPC at frequencies lower than 5 Hz transiently inhibits the stimulated area. In healthy participants, such a protocol can induce a transient attentional bias to the visual hemifield ipsilateral to the stimulated hemisphere. This bias might be due to a relatively less active stimulated hemisphere and a relatively more active unstimulated hemisphere. In a previous study, Jin and Hilgetag (2008 tried to switch the attention bias from the hemifield ipsilateral to the hemifield contralateral to the stimulated hemisphere by applying high frequency rTMS. High frequency rTMS has been shown to excite, rather than inhibit, the stimulated brain area. However, the bias to the ipsilateral hemifield was still present. The participants' performance decreased when stimuli were presented in the hemifield contralateral to the stimulation site. In the present study we tested if this unexpected result was related to the fact that participants were passively resting during stimulation rather than performing a task. Using a fully crossed factorial design, we compared the effects of high frequency rTMS applied during a visual detection task and high frequency rTMS during passive rest on the subsequent offline performance in the same detection task. Our results were mixed. After sham stimulation, performance was better after rest than after task. After active 10 Hz rTMS, participants' performance was overall better after task than after rest. However, this effect did not reach statistical significance. The comparison of performance after rTMS with task and performance after sham stimulation with task showed that 10 Hz stimulation significantly improved performance in the whole visual field. Thus, although we found a trend to better performance after rTMS with task than after rTMS during rest, we could not reject the hypothesis that high frequency rTMS with task and high frequency r

  2. Repetitive transcranial magnetic stimulation as an adjuvant method in the treatment of depression: Preliminary results

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    Jovičić Milica

    2014-01-01

    Full Text Available Introduction. Repetitive transcranial magnetic stimulation (rTMS is a method of brain stimulation which is increasingly used in both clinical practice and research. Up-to-date studies have pointed out a potential antidepressive effect of rTMS, but definitive superiority over placebo has not yet been confirmed. Objective. The aim of the study was to examine the effect of rTMS as an adjuvant treatment with antidepressants during 18 weeks of evaluation starting from the initial application of the protocol. Methods. Four patients with the diagnosis of moderate/severe major depression were included in the study. The protocol involved 2000 stimuli per day (rTMS frequency of 10 Hz, intensity of 120% motor threshold administered over the left dorsolateral prefrontal cortex (DLPFC for 15 days. Subjective and objective depressive symptoms were measured before the initiation of rTMS and repeatedly evaluated at week 3, 6, 12 and 18 from the beginning of the stimulation. Results. After completion of rTMS protocol two patients demonstrated a reduction of depressive symptoms that was sustained throughout the 15-week follow-up period. One patient showed a tendency of remission during the first 12 weeks of the study, but relapsed in week 18. One patient showed no significant symptom reduction at any point of follow-up. Conclusion. Preliminary findings suggest that rTMS has a good tolerability and can be efficient in accelerating the effect of antidepressants, particularly in individuals with shorter duration of depressive episodes and moderate symptom severity. [Projekat Ministarstva nauke Republike Srbije, br. III41029 i br. ON175090

  3. Repetitive Transcranial Magnetic Stimulation for the Treatment of Restless Legs Syndrome

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    Yi-Cong Lin; Yang Feng; Shu-Qin Zhan; Ning Li; Yan Ding; Yue Hou; Li Wang

    2015-01-01

    Background:Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive technique used to alter cortex excitability that has been proposed as an efficient method for treating brain hyperexcitability or hypoexcitability disorders.The aim of this study was to investigate whether high-frequency rTMS could have any beneficial effects in restless legs syndrome (RLS).Methods:Fourteen patients with RLS were given high-frequency rTMS (15 Hz,100% motor threshold) to the leg representation motor cortex area of the frontal lobe for 14 sessions over 18 days.Patients were diagnosed according to the international criteria proposed by the International Restless Legs Syndrome Study Group in 2003.The International RLS Rating Scale (IRLS-RS),Pittsburgh Sleep Quality Index (PSQI),Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale were used to evaluate the severity of RLS,sleep quality,anxiety and depression,respectively.The scale scores were evaluated at four-time points (baseline,end of the 14th session,and at 1-and 2-month posttreatment).One-way analysis of variance was used to compare scale scores at different time points.Results:There was significant improvement in the IRLS-RS (from 23.86 ± 5.88 to 11.21 ± 7.23,P < 0.05),PSQI (from 15.00 ± 4.88 to 9.29 ± 3.91,P < 0.05),and HAMA (from 17.93 ± 7.11 to 10.36 ± 7.13,P < 0.05) scale scores at the end of 14th session,with ongoing effects lasting for at least 2 months.Conclusions:High-frequency rTMS can markedly alleviate the motor system symptoms,sleep disturbances,and anxiety in RLS patients.These results suggest that rTMS might be an option for treating RLS.

  4. Therapeutic effects of repetitive transcranial magnetic stimulation in an animal model of Parkinson's disease.

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    Lee, Ji Yong; Kim, Sung Hoon; Ko, Ah-Ra; Lee, Jin Suk; Yu, Ji Hea; Seo, Jung Hwa; Cho, Byung Pil; Cho, Sung-Rae

    2013-11-06

    Repetitive transcranial magnetic stimulation (rTMS) is used to treat neurological diseases such as stroke and Parkinson's disease (PD). Although rTMS has been used clinically, its underlying therapeutic mechanism remains unclear. The objective of the present study was to clarify the neuroprotective effect and therapeutic mechanism of rTMS in an animal model of PD. Adult Sprague-Dawley rats were unilaterally injected with 6-hydroxydopamine (6-OHDA) into the right striatum. Rats with PD were then treated with rTMS (circular coil, 10 Hz, 20 min/day) daily for 4 weeks. Behavioral assessments such as amphetamine-induced rotational test and treadmill locomotion test were performed, and the dopaminergic (DA) neurons of substantia nigra pas compacta (SNc) and striatum were histologically examined. Expression of neurotrophic/growth factors was also investigated by multiplex ELISA, western blotting analysis and immunohistochemistry 4 weeks after rTMS application. Among the results, the number of amphetamine-induced rotations was significantly lower in the rTMS group than in the control group at 4 weeks post-treatment. Treadmill locomotion was also significantly improved in the rTMS-treated rats. Tyrosine hydroxylase-positive DA neurons and DA fibers in rTMS group rats were greater than those in untreated group in both ipsilateral SNc and striatum, respectively. The expression levels of brain-derived neurotrophic factor, glial cell line-derived neurotrophic factor, platelet-derived growth factor, and vascular endothelial growth factor were elevated in both the 6-OHDA-injected hemisphere and the SNc of the rTMS-treated rats. In conclusion, rTMS treatment improved motor functions and survival of DA neurons, suggesting that the neuroprotective effect of rTMS treatment might be induced by upregulation of neurotrophic/growth factors in the PD animal model.

  5. Effect of daily repetitive transcranial magnetic stimulation on motor performance in Parkinson's disease.

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    Khedr, Eman M; Rothwell, John C; Shawky, Ola A; Ahmed, Mohamed A; Hamdy, Ahmed

    2006-12-01

    Previous studies in patients with Parkinson's disease have reported that a single session of repetitive transcranial magnetic stimulation (rTMS) can improve some or all of the motor symptoms for 30 to 60 minutes. A recent study suggested that repeated sessions of rTMS lead to effects that can last for at least 1 month. Here we report data that both confirm and extend this work. Fifty-five unmedicated PD patients were classified into four groups: two groups (early and late PD) received 25 Hz rTMS bilaterally on the motor arm and leg areas; other groups acted as control for frequency (10 Hz) and for site of stimulation (occipital stimulation). All patients received six consecutive daily sessions (3,000 pulses for each session). The first two groups then received a further three booster sessions (3 consecutive days of rTMS) after 1, 2, and 3 months, while the third group had only one additional session after the first month. Unified Parkinson's Disease Rating Scale (UPDRS), walking time, key-tapping speed, and self-assessment scale were measured for each patient before and after each rTMS session and before and after the monthly sessions. Compared to occipital stimulation, 25 Hz rTMS over motor areas improved all measures in both early and late groups; the group that received 10 Hz rTMS improved more than the occipital group but less than the 25 Hz groups. The effect built up gradually during the sessions and was maintained for 1 month after, with a slight reduction in efficacy. Interestingly, the effect was restored and maintained for the next month by the booster sessions. We conclude that 25 Hz rTMS can lead to cumulative and long-lasting effects on motor performance.

  6. Cognitive safety of dorsomedial prefrontal repetitive transcranial magnetic stimulation in major depression.

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    Schulze, Laura; Wheeler, Sarah; McAndrews, Mary Pat; Solomon, Chloe J E; Giacobbe, Peter; Downar, Jonathan

    2016-07-01

    The most widely used target for repetitive transcranial magnetic stimulation (rTMS) in treatment-resistant depression (TRD) is the dorsolateral prefrontal cortex (DLPFC). Despite convergent evidence that the dorsomedial prefrontal cortex (DMPFC) may be a promising alternative target for rTMS in TRD, its cognitive safety profile has not previously been assessed. Here, we applied 20 sessions of rTMS to the DMPFC in 21 TRD patients. Before and after treatment, a battery of neuropsychological tasks was administered to evaluate changes in cognition across three general cognitive domains: learning and memory, attention and processing speed, and cognitive flexibility. Subjects also completed the 17-item Hamilton Rating Scale for Depression (HamD17) prior to and following treatment to measure changes in severity of depressive symptoms, and to assess the relationship between mood and cognitive performance over the course of treatment. No serious adverse effects or significant deterioration in cognitive performance were observed. Overall, subjects improved significantly on Stroop Inhibition/Switching and on Trails B, and this improvement was independent of the degree of improvement in depression symptoms. No domains or items significantly predicted clinical outcome, with the exception of baseline performance on Visual Elevator Accuracy. Clinical improvement correlated to improved performance in the overall domain of attention and processing speed, although this effect was not evident following covariate adjustment. DMPFC-rTMS did not produce any detectable cognitive adverse effects during treatment of TRD. Performance did not deteriorate significantly on any measures. Taken together, the present findings support the tolerability and cognitive safety of DMPFC-rTMS in refractory depression.

  7. A Randomised Controlled Trial of Neuronavigated Repetitive Transcranial Magnetic Stimulation (rTMS) in Anorexia Nervosa.

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    McClelland, Jessica; Kekic, Maria; Bozhilova, Natali; Nestler, Steffen; Dew, Tracy; Van den Eynde, Frederique; David, Anthony S; Rubia, Katya; Campbell, Iain C; Schmidt, Ulrike

    2016-01-01

    Anorexia nervosa (AN) is associated with morbid fear of fatness, extreme food restriction and altered self-regulation. Neuroimaging data implicate fronto-striatal circuitry, including the dorsolateral prefrontal cortex (DLPFC). In this double-blind parallel group study, we investigated the effects of one session of sham-controlled high-frequency repetitive transcranial magnetic stimulation (rTMS) to the left DLPFC (l-DLPFC) in 60 individuals with AN. A food exposure task was administered before and after the procedure to elicit AN-related symptoms. The primary outcome measure was 'core AN symptoms', a variable which combined several subjective AN-related experiences. The effects of rTMS on other measures of psychopathology (e.g. mood), temporal discounting (TD; intertemporal choice behaviour) and on salivary cortisol concentrations were also investigated. Safety, tolerability and acceptability were assessed. Fourty-nine participants completed the study. Whilst there were no interaction effects of rTMS on core AN symptoms, there was a trend for group differences (p = 0.056): after controlling for pre-rTMS scores, individuals who received real rTMS had reduced symptoms post-rTMS and at 24-hour follow-up, relative to those who received sham stimulation. Other psychopathology was not altered differentially following real/sham rTMS. In relation to TD, there was an interaction trend (p = 0.060): real versus sham rTMS resulted in reduced rates of TD (more reflective choice behaviour). Salivary cortisol concentrations were unchanged by stimulation. rTMS was safe, well-tolerated and was considered an acceptable intervention. This study provides modest evidence that rTMS to the l-DLPFC transiently reduces core symptoms of AN and encourages prudent decision making. Importantly, individuals with AN considered rTMS to be a viable treatment option. These findings require replication in multiple-session studies to evaluate therapeutic efficacy. www.Controlled-Trials.com ISRCTN

  8. Repetitive transcranial magnetic stimulation for treatment of major depressive disorder with comorbid generalized anxiety disorder.

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    White, Daniela; Tavakoli, Sason

    2015-08-01

    Repetitive transcranial magnetic stimulation (rTMS) has shown promising results in treating individuals with behavioral disorders such as major depressive disorder (MDD), posttraumatic stress disorder, obsessive-compulsive disorder, and social anxiety disorder. A number of applications of rTMS to different regions of the left and right prefrontal cortex have been used to treat these disorders, but no study of treatment for MDD with generalized anxiety disorder (GAD) has been conducted with application of rTMS to both the left and right prefrontal cortex. We hypothesized that applying low-frequency rTMS to the right dorsolateral prefrontal cortex (DLPFC) before applying it to the left DLPFC for the treatment of depression would be anxiolytic in patients with MDD with GAD. Thirteen adult patients with comorbid MDD and GAD received treatment with rTMS in an outpatient setting. The number of treatments ranged from 24 to 36 over 5 to 6 weeks. Response was defined as a ≥ 50% reduction in symptoms from baseline, and remission was defined as a score of depressive symptoms on the 21-item Hamilton Rating Scale for Depression (HAM-D-21). At the end of the treatment period, for the GAD-7 scale, 11 out of 13 (84.6%) patients' anxiety symptoms were in remission, achieving a score of depressive symptoms. In this small pilot study of 13 patients with comorbid MDD and GAD, significant improvement in anxiety symptoms along with depressive symptoms was achieved in a majority of patients after bilateral rTMS application.

  9. Knowledge of and Attitude Toward Repetitive Transcranial Magnetic Stimulation Among Psychiatrists in Saudi Arabia

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    AlHadi, Ahmad N.; AlShiban, Abdulrahman M.; Alomar, Majed A.; Aljadoa, Othman F.; AlSayegh, Ahmed M.; Jameel, Mohammed A.

    2017-01-01

    Objectives The aims of this study were to assess psychiatrists' knowledge of and attitudes toward repetitive transcranial magnetic stimulation (rTMS) in Saudi Arabia and to determine the contributing factors. Methods A quantitative observational cross-sectional study was conducted using an online survey. The sample consisted of 96 psychiatrists in Saudi Arabia. A new valid and reliable questionnaire was developed. Results A total of 96 psychiatrists enrolled in the study, 81% of whom were men. Half of the participants were consultants. The sample mainly consisted of general psychiatrists (65%). The mean age of the participants was 37 years. The results showed that 80% of the psychiatrists had a sufficient level of knowledge about rTMS. Consultants had greater knowledge than residents. Training abroad was not significantly associated with the level of knowledge or the type of attitude. Most psychiatrists (79%) had a positive attitude toward rTMS. Only 53% of the psychiatrists said they would agree to receive rTMS if they experienced a psychotic depressive condition. A minority of psychiatrists (7%) said they would not refer their patients for rTMS. Conclusions Most of the psychiatrists surveyed had good knowledge of and a positive attitude toward rTMS. Those who had a high level of training and experience showed higher levels of knowledge. Articles were reported to be a better source for improving physician knowledge than textbooks. Having a family member or relative who was treated with rTMS positively affected psychiatrists' attitudes toward rTMS. PMID:27564426

  10. Short-term adaptations in spinal cord circuits evoked by repetitive transcranial magnetic stimulation: possible underlying mechanisms

    DEFF Research Database (Denmark)

    Perez, Monica A.; Lungholt, Bjarke K.S.; Nielsen, Jens Bo

    2005-01-01

    Repetitive transcranial magnetic stimulation (rTMS) has been shown to induce adaptations in cortical neuronal circuitries. In the present study we investigated whether rTMS, through its effect on corticospinal pathways, also produces adaptations at the spinal level, and what the neuronal mechanisms...... that the depression of the H-reflex by rTMS can be explained, at least partly, by an increased presynaptic inhibition of soleus Ia afferents. In contrast, rTMS had no effect on disynaptic reciprocal Ia inhibition from ankle dorsiflexors to plantarflexors. We conclude that a train of rTMS may modulate transmission...

  11. Impact of Repetitive Transcranial Magnetic Stimulation on Post-Stroke Dysmnesia and the Role of BDNF Val66Met SNP

    OpenAIRE

    Lu, Haitao; Zhang, Tong; Wen, Mei; Sun,Li

    2015-01-01

    Background Little is known about the effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) on dysmnesia and the impact of brain nucleotide neurotrophic factor (BDNF) Val66Met single-nucleotide polymorphism (SNP). This study investigated the impact of low-frequency rTMS on post-stroke dysmnesia and the impact of BDNF Val66Met SNP. Material/Methods Forty patients with post-stroke dysmnesia were prospectively randomized into the rTMS and sham groups. BDNF Val66Met SNP was ...

  12. Dopamine release in human striatum induced by repetitive transcranial magnetic stimulation over dorsolateral prefrontal cortex

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Sang Soo; Yoon, Eun Jin; Kim, Yu Kyeong; Lee, Won Woo; Kim, Sang Eun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2005-07-01

    Animal study suggests that prefrontal cortex plays an important Animal studies suggest that prefrontal cortex plays an important role in the modulation of dopamine (DA) release in subcortical areas. However, little is known about the relationship between DA release and prefrontal activation in human. We investigated whether repetitive transcranial magnetic stimulation (rTMS) over left dorsolateral prefrontal cortex (DLPFC) influences DA release in human striatum with SPECT measurements of striatal binding of [123I)iodobenzamide (IBZM), a DA D2 receptor radioligand that is sensitive to endogenous DA. Five healthy male volunteers (age, 25{+-}2 yr) were studied with brain [123I]IBZM SPECT under three conditions (resting, Sham stimulation, and active rTMS over left DLPFC), while receiving a bolus plus constant infusion of [123I]IBZM DLPFC was defined as a 6 cm anterior and 1cm lateral from the primary motor cortex. rTMS session consisted of three blocks, in each block, 15 trains of 2 see duration were delivered with 10 Hz stimulation frequency, 100% motor threshold, and between-train intervals of 10 sec. Striatal V3', calculated as (striatal - occipital) / occipital activity ratio, was measured under equilibrium condition, at baseline and after sham and active rTMS. Sham stimulation did not affect striatal V3'. rTMS over DLPFC induced reduction of V3' in the ipsilateral and contralateral striatum by 9.7% {+-} 1.3% and 10.6% {+-} 3.2%, respectively, compared with sham procedures (P < 0.01 and P < 0.01, respectively), indicating striatal DA release elicited by rTMS over DLPFC. V3' reduction in the ipsilateral caudate nucleus was greater than that in the contralateral caudate nucleus (9.9% {+-} 4.5% vs. 6.6% {+-} 3.1%, P < 0.05). These data demonstrate DA release in human striatum induced by rTMS over DLPFC, supporting that cortico-striatal fibers originating in prefrontal cortex are involved in local DA release.

  13. Striatal dopamine release induced by repetitive transcranial magnetic stimulation over dorsolateral prefrontal cortex: effect of aging

    Energy Technology Data Exchange (ETDEWEB)

    Bang, Seong Ae; Cho, Sang Soo; Yoon, Eun Jin; Kim, Ji Sun; Lee, Byung Chul; Kim, Yu Kyeong; Kim, Sang Eun [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2007-07-01

    We previously demonstrated dopamine (DA) release in the bilateral striatal regions following prefrontal repetitive transcranial magnetic stimulation (rTMS) in young subjects. Several lines of evidence support substantial age-related changes in human dopaminergic neurotransmission. One possible explanation is alteration of cortico striatal neural connection with aging. Therefore, we investigated how frontal activation by rTMS influences striatal DA release in the elderly with SPECT measurements of striatal binding of [123I]iodobenzamide (lBZM), a DA D2 receptor radioligand that is sensitive to endogenous DA. Five healthy elderly male subjects (age, 64 3 y) were studied with brain [123I]IBZM SPECT under three conditions (resting, sham stimulation, and active rTMS over left dorsolateral prefrontal cortex (DLPFC)), while receiving a bolus plus constant infusion of [123I]IBZM. rTMS session consisted of three blocks. In each block, 15 trains of 2 sec duration were delivered with 10 Hz stimulation frequency and 100% motor threshold. Striatal V3', calculated as (striatal - occipital)/occipital radioactivity, was measured under equilibrium condition at baseline and after sham and active rTMS. Sham stimulation did not affect striatal V3'. rTMS over left DLPFC induced no significant change in V3' in the right striatum compared with baseline condition (0.91 0.25 vs. 0.96 0.25, P = NS). Interestingly, left striatal V3' showed a significant increase after rTMS over left DLPFC compared with sham condition (1.09 0.33 vs. 0.93 0.27, P < 0.05; 17.0 11.1% increase). These results are discrepant from previous ones from young subjects, who showed frontal rTMS-induced reduction of striatal V3', indicating rTMS-induced striatal DA release. We found no significant striatal DA release induced by rTMS over DLPFC in healthy elderly subjects using in vivo binding competition techniques. These results may support an altered cortico striatal circuit in normal aging.

  14. Repetitive transcranial magnetic stimulation induces oscillatory power changes in chronic tinnitus

    Directory of Open Access Journals (Sweden)

    Martin eSchecklmann

    2015-10-01

    Full Text Available Chronic tinnitus is associated with neuroplastic changes in auditory and non-auditory cortical areas. About ten years ago, repetitive transcranial magnetic stimulation (rTMS of auditory and prefrontal cortex was introduced as potential treatment for tinnitus. The resulting changes in tinnitus loudness are interpreted in the context of rTMS induced activity changes (neuroplasticity. Here, we investigate the effect of single rTMS sessions on oscillatory power to probe the capacity of rTMS to interfere with tinnitus-specific cortical plasticity. We measured 20 patients with bilateral chronic tinnitus and 20 healthy controls comparable for age, sex, handedness, and hearing level with a 63-channel EEG system. Educational level, intelligence, depressivity and hyperacusis were controlled for by analysis of covariance. Different rTMS protocols were tested: Left and right temporal and left and right prefrontal cortices were each stimulated with 200 pulses at 1Hz and with an intensity of 60% stimulator output. Stimulation of central parietal cortex with 6-fold reduced intensity (inverted passive-cooled coil served as sham condition. Before and after each rTMS protocol five minutes of resting state EEG were recorded. The order of rTMS protocols was randomized over two sessions with one week interval in between.Analyses on electrode level showed that people with and without tinnitus differed in their response to left temporal and right frontal stimulation. In tinnitus patients left temporal rTMS decreased frontal theta and delta and increased beta2 power, whereas right frontal rTMS decreased right temporal beta3 and gamma power. No changes or increases were observed in the control group. Only non-systematic changes in tinnitus loudness were induced by single sessions of rTMS.This is the first study to show tinnitus-related alterations of neuroplasticity that were specific to stimulation site and oscillatory frequency. The observed effects can be interpreted

  15. A Randomised Controlled Trial of Neuronavigated Repetitive Transcranial Magnetic Stimulation (rTMS in Anorexia Nervosa.

    Directory of Open Access Journals (Sweden)

    Jessica McClelland

    Full Text Available Anorexia nervosa (AN is associated with morbid fear of fatness, extreme food restriction and altered self-regulation. Neuroimaging data implicate fronto-striatal circuitry, including the dorsolateral prefrontal cortex (DLPFC.In this double-blind parallel group study, we investigated the effects of one session of sham-controlled high-frequency repetitive transcranial magnetic stimulation (rTMS to the left DLPFC (l-DLPFC in 60 individuals with AN. A food exposure task was administered before and after the procedure to elicit AN-related symptoms.The primary outcome measure was 'core AN symptoms', a variable which combined several subjective AN-related experiences. The effects of rTMS on other measures of psychopathology (e.g. mood, temporal discounting (TD; intertemporal choice behaviour and on salivary cortisol concentrations were also investigated. Safety, tolerability and acceptability were assessed.Fourty-nine participants completed the study. Whilst there were no interaction effects of rTMS on core AN symptoms, there was a trend for group differences (p = 0.056: after controlling for pre-rTMS scores, individuals who received real rTMS had reduced symptoms post-rTMS and at 24-hour follow-up, relative to those who received sham stimulation. Other psychopathology was not altered differentially following real/sham rTMS. In relation to TD, there was an interaction trend (p = 0.060: real versus sham rTMS resulted in reduced rates of TD (more reflective choice behaviour. Salivary cortisol concentrations were unchanged by stimulation. rTMS was safe, well-tolerated and was considered an acceptable intervention.This study provides modest evidence that rTMS to the l-DLPFC transiently reduces core symptoms of AN and encourages prudent decision making. Importantly, individuals with AN considered rTMS to be a viable treatment option. These findings require replication in multiple-session studies to evaluate therapeutic efficacy

  16. [Treatment of vascular Parkinson's syndrome after stroke by ultralow frequency and high frequency repetitive transcranial magnetic stimulation].

    Science.gov (United States)

    Xie, Renming; Li, Yanru; Lei, Da

    2015-04-01

    To determine effect and safety of ultra-low frequency and high frequency repetitive transcranial magnetic stimulation on treating vascular Parkinson's syndrome (VPS) after stroke. The 0.1 Hz low frequency (n=21) and 5 Hz high frequency (n=21) rTMS were used to treat patients with VPS, and the false stimulation servered as a control group (n=18). The UPDRS score and Parkinson's Disease Questionnaire (PDQ) were chosen to evaluate the curative effect on PD. The patients were given anti-PD drugs continuously during the treatment. UPDRS scores as well as I, II, and III scores after the treatment were significantly decreased in both the ultra-low frequency group and the high frequency group compared with those before the treatment (all Pfrequency and the high frequency group at the same time point before and after the treatment (P>0.05). There was no significant difference in UPDRS scores between before and after the treatment in the control group (P>0.05), but PDQ scores were significantly decreased at the third month after the treatment compared with those of before and after treatment (Pfrequency and high frequency repetitive transcranial magnetic stimulation can safely improve the clinical symptoms and life quality of patients with VPS.

  17. Preliminary guidelines for safe and effective use of repetitive transcranial magnetic stimulation in moderate to severe traumatic brain injury.

    Science.gov (United States)

    Nielson, Dylan M; McKnight, Curtis A; Patel, Riddhi N; Kalnin, Andrew J; Mysiw, Walter J

    2015-04-01

    Transcranial magnetic stimulation has generated extensive interest within the traumatic brain injury (TBI) rehabilitation community, but little work has been done with repetitive protocols, which can produce prolonged changes in behavior. This is partly because of concerns about the safety of repetitive transcranial magnetic stimulation (rTMS) in subjects with TBI, particularly the risk of seizures. These risks can be minimized by careful selection of the rTMS protocol and exclusion criteria. In this article, we identify guidelines for safe use of rTMS in subjects with TBI based on a review of the literature and illustrate their application with a case study. Our subject is a 48-year-old man who sustained a severe TBI 5 years prior to beginning rTMS for the treatment of post-TBI depression. After a 4-week baseline period, we administered daily sessions of low-frequency stimulation to the right dorsolateral prefrontal cortex for 6 weeks. After stimulation, we performed monthly assessments for 3 months. The Hamilton Depression Rating Scale (HAMD) was our primary outcome measure. The stimulation was well tolerated and the patient reported no side effects. After 6 weeks of stimulation, the patient's depression was slightly improved, and these improvements continued through follow-up. At the end of follow-up, the patient's HAMD score was 49% of the average baseline score.

  18. Mapping of cortical language function by functional magnetic resonance imaging and repetitive navigated transcranial magnetic stimulation in 40 healthy subjects.

    Science.gov (United States)

    Sollmann, Nico; Ille, Sebastian; Boeckh-Behrens, Tobias; Ringel, Florian; Meyer, Bernhard; Krieg, Sandro M

    2016-07-01

    Functional magnetic resonance imaging (fMRI) is considered to be the standard method regarding non-invasive language mapping. However, repetitive navigated transcranial magnetic stimulation (rTMS) gains increasing importance with respect to that purpose. However, comparisons between both methods are sparse. We performed fMRI and rTMS language mapping of the left hemisphere in 40 healthy, right-handed subjects in combination with the tasks that are most commonly used in the neurosurgical context (fMRI: word-generation = WGEN task; rTMS: object-naming = ON task). Different rTMS error rate thresholds (ERTs) were calculated, and Cohen's kappa coefficient and the cortical parcellation system (CPS) were used for systematic comparison of the two techniques. Overall, mean kappa coefficients were low, revealing no distinct agreement. We found the highest agreement for both techniques when using the 2-out-of-3 rule (CPS region defined as language positive in terms of rTMS if at least 2 out of 3 stimulations led to a naming error). However, kappa for this threshold was only 0.24 (kappa of <0, 0.01-0.20, 0.21-0.40, 0.41-0.60, 0.61-0.80 and 0.81-0.99 indicate less than chance, slight, fair, moderate, substantial and almost perfect agreement, respectively). Because of the inherent differences in the underlying physiology of fMRI and rTMS, the different tasks used and the impossibility of verifying the results via direct cortical stimulation (DCS) in the population of healthy volunteers, one must exercise caution in drawing conclusions about the relative usefulness of each technique for language mapping. Nevertheless, this study yields valuable insights into these two mapping techniques for the most common language tasks currently used in neurosurgical practice.

  19. Inhibitory repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex modulates early affective processing.

    Science.gov (United States)

    Zwanzger, Peter; Steinberg, Christian; Rehbein, Maimu Alissa; Bröckelmann, Ann-Kathrin; Dobel, Christian; Zavorotnyy, Maxim; Domschke, Katharina; Junghöfer, Markus

    2014-11-01

    The dorsolateral prefrontal cortex (dlPFC) has often been suggested as a key modulator of emotional stimulus appraisal and regulation. Therefore, in clinical trials, it is one of the most frequently targeted regions for non-invasive brain stimulation such as repetitive transcranial magnetic stimulation (rTMS). In spite of various encouraging reports that demonstrate beneficial effects of rTMS in anxiety disorders, psychophysiological studies exploring the underlying neural mechanisms are sparse. Here we investigated how inhibitory rTMS influences early affective processing when applied over the right dlPFC. Before and after rTMS or sham stimulation, subjects viewed faces with fearful or neutral expressions while whole-head magnetoencephalography (MEG) was recorded. Due to the disrupted functioning of the right dlPFC, visual processing in bilateral parietal, temporal, and occipital areas was amplified starting at around 90 ms after stimulus onset. Moreover, increased fear-specific activation was found in the right TPJ area in a time-interval between 110 and 170 ms. These neurophysiological effects were reflected in slowed reaction times for fearful, but not for neutral faces in a facial expression identification task while there was no such effect on a gender discrimination control task. Our study confirms the specific and important role of the dlPFC in regulation of early emotional attention and encourages future clinical research to use minimal invasive methods such as transcranial magnetic (TMS) or direct current stimulation (tDCS). Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Transcranial direct current stimulation (tDCS) priming of 1Hz repetitive transcranial magnetic stimulation (rTMS) modulates experimental pain thresholds.

    Science.gov (United States)

    Moloney, Tonya M; Witney, Alice G

    2013-02-08

    Transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) of primary motor cortex (M1) modulate cortical excitability. Both techniques have been demonstrated to modulate chronic pain and experimental pain thresholds, but with inconsistent effects. Preconditioning M1 with weak tDCS (1mA) standardizes the effects of subsequent stimulation via rTMS on levels of cortical excitability. Here we examine whether 1Hz rTMS, primed with tDCS, could effectively standardize the modulation of pain thresholds. Thermal pain thresholds were determined using quantitative sensory testing (QST) of the palmar thenar of both hands in 12 healthy males pre and post tDCS - 1Hz rTMS over the hand area of the left M1. Cathodal tDCS preconditioning of 1Hz rTMS successfully reversed the normal suppressive effect of low frequency rTMS and effectively modulated cold and heat pain thresholds. Conversely, anodal tDCS - 1Hz rTMS led to a decrease in cold pain thresholds. Therefore, this study supports that preconditioning M1 using cathodal tDCS before subsequent stimulation via 1Hz rTMS facilitates the production of analgesia.

  1. The use of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) to relieve pain.

    Science.gov (United States)

    Lefaucheur, Jean-Pascal; Antal, Andrea; Ahdab, Rechdi; Ciampi de Andrade, Daniel; Fregni, Felipe; Khedr, Eman M; Nitsche, Michael; Paulus, Walter

    2008-10-01

    Chronic pain resulting from injury of the peripheral or central nervous system may be associated with a significant dysfunction of extensive neural networks. Noninvasive stimulation techniques, such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) may be suitable to treat chronic pain as they can act on these networks by modulating neural activities not only in the stimulated area, but also in remote regions that are interconnected to the site of stimulation. Motor cortex was the first cortical target that was proved to be efficacious in chronic pain treatment. At present, significant analgesic effects were also shown to occur after the stimulation of other cortical targets (including prefrontal and parietal areas) in acute provoked pain, chronic neuropathic pain, fibromyalgia, or visceral pain. Therapeutic applications of rTMS in pain syndromes are limited by the short duration of the induced effects, but prolonged pain relief can be obtained by repeating rTMS sessions every day for several weeks. Recent tDCS studies also showed some effects on various types of chronic pain. We review the evidence to date of these two techniques of noninvasive brain stimulation for the treatment of pain.

  2. Priming does not enhance the efficacy of 1 Hertz repetitive transcranial magnetic stimulation for the treatment of auditory verbal hallucinations : Results of a randomized controlled study

    NARCIS (Netherlands)

    Slotema, Christina Wilhelmina; Blom, Jan Dirk; de Weijer, Antoin Dave; Hoek, Hans Wijbrand; Sommer, Iris Else

    2012-01-01

    Background Low-frequency repetitive transcranial magnetic stimulation (rTMS) applied to the left temporoparietal area (TP) has been investigated as a treatment method for auditory verbal hallucinations (AVH) yielding inconsistent results. In vitro studies have indicated that the effects of low-frequ

  3. Meta-analysis of repetitive transcranial magnetic stimulation in the treatment of auditory verbal hallucinations : Update and effects after one month

    NARCIS (Netherlands)

    Slotema, C. W.; Aleman, A.; Daskalakis, Z. J.; Sommer, I. E.

    2012-01-01

    Objective: Several meta-analyses considering repetitive transcranial magnetic stimulation (rTMS) for auditory verbal hallucinations (AVH) have been performed with moderate to high mean weighted effect sizes. Since then several negative findings were reported in relatively large samples. The aim of t

  4. Short and Long Term Effects of Left and Bilateral Repetitive Transcranial Magnetic Stimulation in Schizophrenia Patients with Auditory Verbal Hallucinations : A Randomized Controlled Trial

    NARCIS (Netherlands)

    Bais, Leonie; Vercammen, Ans; Stewart, Roy; van Es, Frank; Visser, Bert; Aleman, Andre; Knegtering, Henderikus

    2014-01-01

    Background: Repetitive transcranial magnetic stimulation of the left temporo-parietal junction area has been studied as a treatment option for auditory verbal hallucinations. Although the right temporo-parietal junction area has also shown involvement in the genesis of auditory verbal hallucinations

  5. Efficacy of bilateral repetitive transcranial magnetic stimulation for negative symptoms of schizophrenia : results of a multicenter double-blind randomized controlled trial

    NARCIS (Netherlands)

    Dlabac-de Lange, J. J.; Bais, L.; van Es, F. D.; Visser, B. G. J.; Reinink, E.; Bakker, B.; van den Heuvel, E. R.; Aleman, A.; Knegtering, H.

    2015-01-01

    Background. Few studies have investigated the efficacy of repetitive transcranial magnetic stimulation (rTMS) treatment for negative symptoms of schizophrenia, reporting inconsistent results. We aimed to investigate whether 10 Hz stimulation of the bilateral dorsolateral prefrontal cortex during 3 w

  6. Preliminary Evidence of the Effects of High-frequency Repetitive Transcranial Magnetic Stimulation (rTMS) on Swallowing Functions in Post-Stroke Individuals with Chronic Dysphagia

    Science.gov (United States)

    Cheng, Ivy K. Y.; Chan, Karen M. K.; Wong, C. S.; Cheung, Raymond T. F.

    2015-01-01

    Background: There is growing evidence of potential benefits of repetitive transcranial magnetic stimulation (rTMS) in the rehabilitation of dysphagia. However, the site and frequency of stimulation for optimal effects are not clear. Aims: The aim of this pilot study is to investigate the short-term effects of high-frequency 5 Hz rTMS applied to…

  7. Low-Frequency Repetitive Transcranial Magnetic Stimulation and Intensive Occupational Therapy for Poststroke Patients with Upper Limb Hemiparesis: Preliminary Study of a 15-Day Protocol

    Science.gov (United States)

    Kakuda, Wataru; Abo, Masahiro; Kobayashi, Kazushige; Momosaki, Ryo; Yokoi, Aki; Fukuda, Akiko; Ishikawa, Atsushi; Ito, Hiroshi; Tominaga, Ayumi

    2010-01-01

    The purpose of the study was to determine the safety and feasibility of a 15-day protocol of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with intensive occupational therapy (OT) on motor function and spasticity in hemiparetic upper limbs in poststroke patients. Fifteen poststroke patients (age at study entry 55 [plus…

  8. Preliminary Evidence of the Effects of High-frequency Repetitive Transcranial Magnetic Stimulation (rTMS) on Swallowing Functions in Post-Stroke Individuals with Chronic Dysphagia

    Science.gov (United States)

    Cheng, Ivy K. Y.; Chan, Karen M. K.; Wong, C. S.; Cheung, Raymond T. F.

    2015-01-01

    Background: There is growing evidence of potential benefits of repetitive transcranial magnetic stimulation (rTMS) in the rehabilitation of dysphagia. However, the site and frequency of stimulation for optimal effects are not clear. Aims: The aim of this pilot study is to investigate the short-term effects of high-frequency 5 Hz rTMS applied to…

  9. Short and Long Term Effects of Left and Bilateral Repetitive Transcranial Magnetic Stimulation in Schizophrenia Patients with Auditory Verbal Hallucinations : A Randomized Controlled Trial

    NARCIS (Netherlands)

    Bais, Leonie; Vercammen, Ans; Stewart, Roy; van Es, Frank; Visser, Bert; Aleman, Andre; Knegtering, Henderikus

    2014-01-01

    Background: Repetitive transcranial magnetic stimulation of the left temporo-parietal junction area has been studied as a treatment option for auditory verbal hallucinations. Although the right temporo-parietal junction area has also shown involvement in the genesis of auditory verbal

  10. A neuronal network model for simulating the effects of repetitive transcranial magnetic stimulation on local field potential power spectra.

    Directory of Open Access Journals (Sweden)

    Alina Bey

    Full Text Available Repetitive transcranial magnetic stimulation (rTMS holds promise as a non-invasive therapy for the treatment of neurological disorders such as depression, schizophrenia, tinnitus, and epilepsy. Complex interdependencies between stimulus duration, frequency and intensity obscure the exact effects of rTMS stimulation on neural activity in the cortex, making evaluation of and comparison between rTMS studies difficult. To explain the influence of rTMS on neural activity (e.g. in the motor cortex, we use a neuronal network model. The results demonstrate that the model adequately explains experimentally observed short term effects of rTMS on the band power in common frequency bands used in electroencephalography (EEG. We show that the equivalent local field potential (eLFP band power depends on stimulation intensity rather than on stimulation frequency. Additionally, our model resolves contradictions in experiments.

  11. Repetitive Transcranial Magnetic Stimulation (rTMS) to Treat Social Anxiety Disorder: Case Reports and a Review of the Literature

    Science.gov (United States)

    Paes, Flávia; Baczynski, Tathiana; Novaes, Felipe; Marinho, Tamires; Arias-Carrión, Oscar; Budde, Henning; Sack, Alexander T.; Huston, Joseph P.; Almada, Leonardo Ferreira; Carta, Mauro; Silva, Adriana Cardoso; Nardi, Antonio E.; Machado, Sergio

    2013-01-01

    Objectives: Social anxiety disorder (SAD) is a common and debilitating anxiety disorders. However, few studies had been dedicated to the neurobiology underlying SAD until the last decade. Rates of non-responders to standard methods of treatment remain unsatisfactorily high of approximately 25%, including SAD. Advances in our understanding of SAD could lead to new treatment strategies. A potential non invasive therapeutic option is repetitive transcranial magnetic stimulation (rTMS). Thus, we reported two cases of SAD treated with rTMS Methods: The bibliographical search used Pubmed/Medline, ISI Web of Knowledge and Scielo databases. The terms chosen for the search were: anxiety disorders, neuroimaging, repetitive transcranial magnetic stimulation. Results: In most of the studies conducted on anxiety disorders, except SAD, the right prefrontal cortex (PFC), more specifically dorsolateral PFC was stimulated, with marked results when applying high-rTMS compared with studies stimulating the opposite side. However, according to the “valence hypothesis”, anxiety disorders might be characterized by an interhemispheric imbalance associated with increased right-hemispheric activity. With regard to the two cases treated with rTMS, we found a decrease in BDI, BAI and LSAS scores from baseline to follow-up. Conclusion: We hypothesize that the application of low-rTMS over the right medial PFC (mPFC; the main structure involved in SAD circuitry) combined with high-rTMS over the left mPFC, for at least 4 weeks on consecutive weekdays, may induce a balance in brain activity, opening an attractive therapeutic option for the treatment of SAD. PMID:24278088

  12. Functional cortical reorganization after low-frequency repetitive transcranial magnetic stimulation plus intensive occupational therapy for upper limb hemiparesis: evaluation by functional magnetic resonance imaging in poststroke patients.

    Science.gov (United States)

    Yamada, Naoki; Kakuda, Wataru; Senoo, Atsushi; Kondo, Takahiro; Mitani, Sugao; Shimizu, Masato; Abo, Masahiro

    2013-08-01

    Low-frequency repetitive transcranial magnetic stimulation of the nonlesional hemisphere combined with occupational therapy significantly improves motor function of the affected upper limb in poststroke hemiparetic patients, but the recovery mechanism remains unclear. To investigate the recovery mechanism using functional magnetic resonance imaging. Forty-seven poststroke hemiparetic patients were hospitalized to receive 12 sessions of 40-min low-frequency repetitive transcranial magnetic stimulation over the nonlesional hemisphere and daily occupational therapy for 15 days. Motor function was evaluated with the Fugl-Meyer Assessment and Wolf Motor Function Test. The functional magnetic resonance imaging with motor tasks was performed at admission and discharge. The laterality index of activated voxel number in Brodmann areas 4 and 6 on functional magnetic resonance imaging was calculated (laterality index range of -1 to +1). Patients were divided into two groups based on functional magnetic resonance imaging findings before the intervention: group 1: patients who showed bilateral activation (n = 27); group 2: patients with unilateral activation (n = 20). Treatment resulted in improvement in Fugl-Meyer Assessment and Wolf Motor Function Test in the two groups (P functional magnetic resonance imaging indicated that our proposed treatment can induce functional cortical reorganization, leading to motor functional recovery of the affected upper limb. Especially, it seems that neural activation in the lesional hemisphere plays an important role in such recovery in poststroke hemiparetic patients. © 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization.

  13. Effects of repetitive transcranial magnetic stimulation on non-veridical decision making.

    Science.gov (United States)

    Tulviste, Jaan; Goldberg, Elkhonon; Podell, Kenneth; Bachmann, Talis

    2016-01-01

    We test the emerging hypothesis that prefrontal cortical mechanisms involved in non-veridical decision making do not overlap with those of veridical decision making. Healthy female subjects performed an experimental task assessing free choice, agent-centered decision making (The Cognitive Bias Task) and a veridical control task related to visuospatial working memory (the Moving Spot Task). Transcranial magnetic stimulation (TMS) was applied to the left and right dorsolateral prefrontal cortex (DLPFC) using 1 Hz and 10 Hz (intermittent) rTMS and sham protocols. Both 1 Hz and 10 Hz stimulation of the DLPFC triggered a shift towards a more context-independent, internal representations driven non-veridical selection bias. A significantly reduced preference for choosing objects based on similarity was detected, following both 1 Hz and 10 Hz treatment of the right as well as 1 Hz rTMS of the left DLPFC. 1 Hz rTMS treatment of the right DLPFC also triggered a significant improvement in visuospatial working memory performance on the veridical task. The effects induced by prefrontal TMS mimicked those of posterior lesions, suggesting that prefrontal stimulation influenced neuronal activity in remote cortical regions interconnected with the stimulation site via longitudinal fasciculi.

  14. Repetitive transcranial magnetic stimulation for stroke rehabilitation-potential therapy or misplaced hope?

    Science.gov (United States)

    Bates, Kristyn Alissa; Rodger, Jennifer

    2015-01-01

    Repeated sessions of transcranial magnetic stimulation (rTMS) are capable of changing and modulating neural activity beyond the period of stimulation. Because many neurological disorders are thought to involve abnormal or dysfunctional neuronal activity, it is hypothesised that the therapeutic action of rTMS may occur through modulating and reversing abnormal activity and facilitating neuroplasticity.Numerous clinical studies have investigated the safety and efficacy of rTMS treatment for a wide variety of conditions including depression, anxiety disorders including obsessive compulsive disorder, Parkinson's disease, stroke, tinnitus, affective disorders, schizophrenia and chronic pain. Despite some promising results, rTMS is not currently widely used to assist in recovery from neurotrama. In this review, we argue that the therapeutic promise of rTMS is limited because the mechanisms of action of rTMS are not completely understood and therefore it is difficult to determine which treatment protocols are appropriate for specific neurological conditions. We use the application of rTMS in motor functional recovery from cerebral ischemic stroke to illustrate the difficulties in interpreting and assessing the therapeutic potential of rTMS for neurotrauma in terms of the presumed mechanisms of action of rTMS. Future directions for research will also be discussed.

  15. Effects of Repetitive Transcranial Magnetic Stimulation on Behavioral Recovery during Early Stage of Traumatic Brain Injury in Rats.

    Science.gov (United States)

    Yoon, Kyung Jae; Lee, Yong-Taek; Chung, Pil-Wook; Lee, Yun Kyung; Kim, Dae Yul; Chun, Min Ho

    2015-10-01

    Repetitive transcranial magnetic stimulation (rTMS) is a promising technique that modulates neural networks. However, there were few studies evaluating the effects of rTMS in traumatic brain injury (TBI). Herein, we assessed the effectiveness of rTMS on behavioral recovery and metabolic changes using brain magnetic resonance spectroscopy (MRS) in a rat model of TBI. We also evaluated the safety of rTMS by measuring brain swelling with brain magnetic resonance imaging (MRI). Twenty male Sprague-Dawley rats underwent lateral fluid percussion and were randomly assigned to the sham (n=10) or the rTMS (n=10) group. rTMS was applied on the fourth day after TBI and consisted of 10 daily sessions for 2 weeks with 10 Hz frequency (total pulses=3,000). Although the rTMS group showed an anti-apoptotic effect around the peri-lesional area, functional improvements were not significantly different between the two groups. Additionally, rTMS did not modulate brain metabolites in MRS, nor was there any change of brain lesion or edema after magnetic stimulation. These data suggest that rTMS did not have beneficial effects on motor recovery during early stages of TBI, although an anti-apoptosis was observed in the peri-lesional area.

  16. Bilateral Repetitive Transcranial Magnetic Stimulation Combined with Intensive Swallowing Rehabilitation for Chronic Stroke Dysphagia: A Case Series Study

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    Momosaki, Ryo; Abo, Masahiro; Kakuda, Wataru

    2014-01-01

    The purpose of this study was to clarify the safety and feasibility of a 6-day protocol of bilateral repetitive transcranial magnetic stimulation (rTMS) combined with intensive swallowing rehabilitation for chronic poststroke dysphagia. In-hospital treatment was provided to 4 poststroke patients (age at treatment: 56–80 years; interval between onset of stroke and treatment: 24–37 months) with dysphagia. Over 6 consecutive days, each patient received 10 sessions of rTMS at 3 Hz applied to the pharyngeal motor cortex bilaterally, followed by 20 min of intensive swallowing rehabilitation exercise. The swallowing function was evaluated by the Penetration Aspiration Scale (PAS), Modified Mann Assessment of Swallowing Ability (MMASA), Functional Oral Intake Scale (FOIS), laryngeal elevation delay time (LEDT) and Repetitive Saliva-Swallowing Test (RSST) on admission and at discharge. All patients completed the 6-day treatment protocol and none showed any adverse reactions throughout the treatment. The combination treatment improved laryngeal elevation delay time in all patients. Our proposed protocol of rTMS plus swallowing rehabilitation exercise seems to be safe and feasible for chronic stroke dysphagia, although its efficacy needs to be confirmed in a large number of patients. PMID:24803904

  17. Bilateral Repetitive Transcranial Magnetic Stimulation Combined with Intensive Swallowing Rehabilitation for Chronic Stroke Dysphagia: A Case Series Study

    Directory of Open Access Journals (Sweden)

    Ryo Momosaki

    2014-03-01

    Full Text Available The purpose of this study was to clarify the safety and feasibility of a 6-day protocol of bilateral repetitive transcranial magnetic stimulation (rTMS combined with intensive swallowing rehabilitation for chronic poststroke dysphagia. In-hospital treatment was provided to 4 poststroke patients (age at treatment: 56-80 years; interval between onset of stroke and treatment: 24-37 months with dysphagia. Over 6 consecutive days, each patient received 10 sessions of rTMS at 3 Hz applied to the pharyngeal motor cortex bilaterally, followed by 20 min of intensive swallowing rehabilitation exercise. The swallowing function was evaluated by the Penetration Aspiration Scale (PAS, Modified Mann Assessment of Swallowing Ability (MMASA, Functional Oral Intake Scale (FOIS, laryngeal elevation delay time (LEDT and Repetitive Saliva-Swallowing Test (RSST on admission and at discharge. All patients completed the 6-day treatment protocol and none showed any adverse reactions throughout the treatment. The combination treatment improved laryngeal elevation delay time in all patients. Our proposed protocol of rTMS plus swallowing rehabilitation exercise seems to be safe and feasible for chronic stroke dysphagia, although its efficacy needs to be confirmed in a large number of patients.

  18. Ventrolateral prefrontal cortex repetitive transcranial magnetic stimulation in the treatment of depersonalization disorder: A consecutive case series.

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    Jay, Emma-Louise; Nestler, Steffen; Sierra, Mauricio; McClelland, Jessica; Kekic, Maria; David, Anthony S

    2016-06-30

    Case reports and an open trial have reported promising responses to repetitive transcranial magnetic stimulation (rTMS) to prefrontal and temporo-parietal sites in patients with depersonalization disorder (DPD). We recently showed that a single session of rTMS to the ventrolateral prefrontal cortex (VLPFC) was associated with a reduction in symptoms and increase in physiological arousal. Seven patients with medication-resistant DSM-IV DPD received up to 20 sessions of right-sided rTMS to the VLPFC for 10 weeks. Stimulation was guided using neuronavigation software based on participants' individual structural MRIs, and delivered at 110% of resting motor threshold. A session consisted of 1Hz repetitive TMS for 15min. The primary outcome measure was reduction in depersonalization symptoms on the Cambridge Depersonalization Scale (CDS). Secondary outcomes included scores on the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). 20 sessions of rTMS treatment to right VLPFC significantly reduced scores on the CDS by on average 44% (range 2-83.5%). Two patients could be classified as "full responders", four as "partial" and one a non-responder. Response usually occurred within the first 6 sessions. There were no significant adverse events. A randomized controlled clinical trial of VLPFC rTMS for DPD is warranted.

  19. Test-retest assessment of cortical activation induced by repetitive transcranial magnetic stimulation with brain atlas-guided optical topography

    Science.gov (United States)

    Tian, Fenghua; Kozel, F. Andrew; Yennu, Amarnath; Croarkin, Paul E.; McClintock, Shawn M.; Mapes, Kimberly S.; Husain, Mustafa M.; Liu, Hanli

    2012-11-01

    Repetitive transcranial magnetic stimulation (rTMS) is a technology that stimulates neurons with rapidly changing magnetic pulses with demonstrated therapeutic applications for various neuropsychiatric disorders. Functional near-infrared spectroscopy (fNIRS) is a suitable tool to assess rTMS-evoked brain responses without interference from the magnetic or electric fields generated by the TMS coil. We have previously reported a channel-wise study of combined rTMS/fNIRS on the motor and prefrontal cortices, showing a robust decrease of oxygenated hemoglobin concentration (Δ[HbO2]) at the sites of 1-Hz rTMS and the contralateral brain regions. However, the reliability of this putative clinical tool is unknown. In this study, we develop a rapid optical topography approach to spatially characterize the rTMS-evoked hemodynamic responses on a standard brain atlas. A hemispherical approximation of the brain is employed to convert the three-dimensional topography on the complex brain surface to a two-dimensional topography in the spherical coordinate system. The test-retest reliability of the combined rTMS/fNIRS is assessed using repeated measurements performed two to three days apart. The results demonstrate that the Δ[HbO2] amplitudes have moderate-to-high reliability at the group level; and the spatial patterns of the topographic images have high reproducibility in size and a moderate degree of overlap at the individual level.

  20. Predictors of response to repetitive transcranial magnetic stimulation (rTMS) in the treatment of major depressive disorder.

    Science.gov (United States)

    Beuzon, G; Timour, Q; Saoud, M

    2017-02-01

    Repetitive transcranial magnetic stimulation (rTMS), based on the principle of electromagnetic induction, consists of applying series of magnetic impulses to the cerebral cortex so as to modulate neurone activity in a target zone. This technique, still experimental, could prove promising in the field of psychiatry, in particular for the treatment of major depressive disorder. It is important for the clinician to be able to assess the response potential of a given patient to rTMS, and this among other things requires relevant predictive factors to be available. This review of the literature aims to determine and analyse reported predictive factors for therapeutic response to rTMS treatment in major depressive disorder. Different parameters are studied, in particular age, the severity of the depressive episode, psychological dimensions, genetic factors, cerebral blood flows via cerebral imagery, and neuronavigation. The factors found to be associated with better therapeutic response were young age, low level of severity of the depressive episode, motor threshold intensity over 100%, more than 1000 stimulations per session, more than 10 days treatment, L/L genotype on the 5-HTTLPR transporter gene, C/C homozygosity on the promotor regions of the 5-HT1A receptor gene, Val/Val homozygosity on the BDNF gene, cordance analyses by EEG, and finally the accurate localisation provided by neuronavigation. The authors conclude that investigations in larger patient samples are required in the future, and that the work already achieved should provide lines of approach for the coming experimental studies.

  1. Impact of Repetitive Transcranial Magnetic Stimulation (rTMS) on Brain Functional Marker of Auditory Hallucinations in Schizophrenia Patients

    Science.gov (United States)

    Maïza, Olivier; Hervé, Pierre-Yve; Etard, Olivier; Razafimandimby, Annick; Montagne-Larmurier, Aurélie; Dollfus, Sonia

    2013-01-01

    Several cross-sectional functional Magnetic Resonance Imaging (fMRI) studies reported a negative correlation between auditory verbal hallucination (AVH) severity and amplitude of the activations during language tasks. The present study assessed the time course of this correlation and its possible structural underpinnings by combining structural, functional MRI and repetitive Transcranial Magnetic Stimulation (rTMS). Methods: Nine schizophrenia patients with AVH (evaluated with the Auditory Hallucination Rating scale; AHRS) and nine healthy participants underwent two sessions of an fMRI speech listening paradigm. Meanwhile, patients received high frequency (20 Hz) rTMS. Results: Before rTMS, activations were negatively correlated with AHRS in a left posterior superior temporal sulcus (pSTS) cluster, considered henceforward as a functional region of interest (fROI). After rTMS, activations in this fROI no longer correlated with AHRS. This decoupling was explained by a significant decrease of AHRS scores after rTMS that contrasted with a relative stability of cerebral activations. A voxel-based-morphometry analysis evidenced a cluster of the left pSTS where grey matter volume negatively correlated with AHRS before rTMS and positively correlated with activations in the fROI at both sessions. Conclusion: rTMS decreases the severity of AVH leading to modify the functional correlate of AVH underlain by grey matter abnormalities. PMID:24961421

  2. Long-term effects of repetitive transcranial magnetic stimulation (rTMS) in patients with chronic tinnitus.

    Science.gov (United States)

    Kleinjung, Tobias; Eichhammer, Peter; Langguth, Berthold; Jacob, Peter; Marienhagen, Joerg; Hajak, Goeran; Wolf, Stephan R; Strutz, Juergen

    2005-04-01

    The pathophysiologic mechanisms of idiopathic tinnitus remain unclear. Recent studies demonstrated focal brain activation in the auditory cortex of patients with chronic tinnitus. Low-frequency repetitive transcranial magnetic stimulation (rTMS) is able to reduce cortical hyperexcitability. Fusing of the individual PET-scan with the structural MRI-scan (T1, MPRAGE) allowed us to identify exactly the area of increased metabolic activity in the auditory cortex of patients with chronic tinnitus. With the use of a neuronavigational system, this target area was exactly stimulated by the figure 8-shaped magnetic coil. In a prospective study, rTMS (110% motor threshold; 1 Hz; 2000 stimuli/day over 5 days) was performed using a placebo controlled cross-over design. Patients were blinded regarding the stimulus condition. For the sham stimulation a specific sham-coil system was used. Fourteen patients were followed for 6 months. Treatment outcome was assessed with a specific tinnitus questionnaire (Goebel and Hiller). Tertiary referral medical center. Increased metabolic activation in the auditory cortex was verified in all patients. After 5 days of verum rTMS, a highly significant improvement of the tinnitus score was found whereas the sham treatment did not show any significant changes. The treatment outcome after 6 months still demonstrated significant reduction of tinnitus score. These preliminary results demonstrate that neuronavigated rTMS offers new possibilities in the understanding and treatment of chronic tinnitus.

  3. Impact of Repetitive Transcranial Magnetic Stimulation (rTMS on Brain Functional Marker of Auditory Hallucinations in Schizophrenia Patients

    Directory of Open Access Journals (Sweden)

    Sonia Dollfus

    2013-04-01

    Full Text Available Several cross-sectional functional Magnetic Resonance Imaging (fMRI studies reported a negative correlation between auditory verbal hallucination (AVH severity and amplitude of the activations during language tasks. The present study assessed the time course of this correlation and its possible structural underpinnings by combining structural, functional MRI and repetitive Transcranial Magnetic Stimulation (rTMS. Methods: Nine schizophrenia patients with AVH (evaluated with the Auditory Hallucination Rating scale; AHRS and nine healthy participants underwent two sessions of an fMRI speech listening paradigm. Meanwhile, patients received high frequency (20 Hz rTMS. Results: Before rTMS, activations were negatively correlated with AHRS in a left posterior superior temporal sulcus (pSTS cluster, considered henceforward as a functional region of interest (fROI. After rTMS, activations in this fROI no longer correlated with AHRS. This decoupling was explained by a significant decrease of AHRS scores after rTMS that contrasted with a relative stability of cerebral activations. A voxel-based-morphometry analysis evidenced a cluster of the left pSTS where grey matter volume negatively correlated with AHRS before rTMS and positively correlated with activations in the fROI at both sessions. Conclusion: rTMS decreases the severity of AVH leading to modify the functional correlate of AVH underlain by grey matter abnormalities.

  4. Blood flow and oxygenation changes due to low-frequency repetitive transcranial magnetic stimulation of the cerebral cortex

    Science.gov (United States)

    Mesquita, Rickson C.; Faseyitan, Olufunsho K.; Turkeltaub, Peter E.; Buckley, Erin M.; Thomas, Amy; Kim, Meeri N.; Durduran, Turgut; Greenberg, Joel H.; Detre, John A.; Yodh, Arjun G.; Hamilton, Roy H.

    2013-06-01

    Transcranial magnetic stimulation (TMS) modulates processing in the human brain and is therefore of interest as a treatment modality for neurologic conditions. During TMS administration, an electric current passing through a coil on the scalp creates a rapidly varying magnetic field that induces currents in the cerebral cortex. The effects of low-frequency (1 Hz), repetitive TMS (rTMS) on motor cortex cerebral blood flow (CBF) and tissue oxygenation in seven healthy adults, during/after 20 min stimulation, is reported. Noninvasive optical methods are employed: diffuse correlation spectroscopy (DCS) for blood flow and diffuse optical spectroscopy (DOS) for hemoglobin concentrations. A significant increase in median CBF (33%) on the side ipsilateral to stimulation was observed during rTMS and persisted after discontinuation. The measured hemodynamic parameter variations enabled computation of relative changes in cerebral metabolic rate of oxygen consumption during rTMS, which increased significantly (28%) in the stimulated hemisphere. By contrast, hemodynamic changes from baseline were not observed contralateral to rTMS administration (all parameters, p>0.29). In total, these findings provide new information about hemodynamic/metabolic responses to low-frequency rTMS and, importantly, demonstrate the feasibility of DCS/DOS for noninvasive monitoring of TMS-induced physiologic effects.

  5. Repetitive Transcranial Magnetic Stimulation (rTMS) in the Management of Alcohol Dependence and other Substance Abuse Disorders – Emerging Data and Clinical Relevance

    Science.gov (United States)

    Sousa, Avinash De

    2013-01-01

    Repetitive transcranial magnetic stimulation (rTMS) has been used widely in various psychiatric disorders like depression and schizophrenia. There have been some reports of its usefulness in alcohol dependence and substance use disorders. The present paper reviews the studies done using rTMS in substance use disorders including alcohol and nicotine dependence. Various studies done have been reviewed including the proposed mechanisms of action are outlined with the future research needs and need for further clinical data PMID:25337357

  6. Effects of Repetitive Transcranial Magnetic Stimulation in the Rehabilitation of Communication and Deglutition Disorders: Systematic Review of Randomized Controlled Trials.

    Science.gov (United States)

    Gadenz, Camila Dalbosco; Moreira, Tais de Campos; Capobianco, Dirce Maria; Cassol, Mauriceia

    2015-01-01

    To systematically review randomized controlled trials that evaluate the effects of repetitive transcranial magnetic stimulation (rTMS) on rehabilitation aspects related to communication and swallowing functions. A search was conducted on PubMed, Clinical Trials, Cochrane Library, and ASHA electronic databases. Studies were judged according to the eligibility criteria and analyzed by 2 independent and blinded researchers. We analyzed 9 studies: 4 about aphasia, 3 about dysphagia, 1 about dysarthria in Parkinson's disease and 1 about linguistic deficits in Alzheimer's disease. All aphasia studies used low-frequency rTMS to stimulate Broca's homologous area. High-frequency rTMS was applied over the pharyngoesophageal cortex from the left and/or right hemisphere in the dysphagia studies and over the left dorsolateral prefrontal cortex in the Parkinson's and Alzheimer's studies. Two aphasia and all dysphagia studies showed a significant improvement of the disorder, compared to the sham group. The other 2 studies related to aphasia found a benefit restricted to subgroups with a severe case or injury on the anterior portion of the language cortical area, respectively, whereas the Alzheimer's study demonstrated positive effects specific to auditory comprehension. There were no changes for vocal function in the Parkinson's study. The benefits of the technique and its applicability in neurogenic disorders related to communication and deglutition are still uncertain. Therefore, other randomized controlled trials are needed to clarify the optimal stimulation protocol for each disorder studied and its real effects. © 2015 S. Karger AG, Basel.

  7. Modulation of the Left Prefrontal Cortex with High Frequency Repetitive Transcranial Magnetic Stimulation Facilitates Gait in Multiple Sclerosis

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    Amer M. Burhan

    2015-01-01

    Full Text Available Multiple Sclerosis (MS is a chronic central nervous system (CNS demyelinating disease. Gait abnormalities are common and disabling in patients with MS with limited treatment options available. Emerging evidence suggests a role of prefrontal attention networks in modulating gait. High-frequency repetitive transcranial magnetic stimulation (rTMS is known to enhance cortical excitability in stimulated cortex and its correlates. We investigated the effect of high-frequency left prefrontal rTMS on gait parameters in a 51-year-old Caucasian male with chronic relapsing/remitting MS with residual disabling attention and gait symptoms. Patient received 6 Hz, rTMS at 90% motor threshold using figure of eight coil centered on F3 location (using 10-20 electroencephalography (EEG lead localization system. GAITRite gait analysis system was used to collect objective gait measures before and after one session and in another occasion three consecutive daily sessions of rTMS. Two-tailed within subject repeated measure t-test showed significant enhancement in ambulation time, gait velocity, and cadence after three consecutive daily sessions of rTMS. Modulating left prefrontal cortex excitability using rTMS resulted in significant change in gait parameters after three sessions. To our knowledge, this is the first report that demonstrates the effect of rTMS applied to the prefrontal cortex on gait in MS patients.

  8. Analgesic effect of repetitive transcranial magnetic stimulation (rTMS) in patients with chronic low back pain.

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    Ambriz-Tututi, Mónica; Alvarado-Reynoso, Beatriz; Drucker-Colín, René

    2016-08-22

    The objective of the present study was to assess the benefits of 1-week repetitive transcranial magnetic stimulation (rTMS) in patients with chronic low back pain (LBP). The visual analogue scale (VAS), Short Form McGill pain questionnaire (SF-MPQ), and Short Form 36 Health Survey were used to evaluate the effect of this treatment. Eighty-two patients diagnosed with LBP were divided randomly into three groups: rTMS-treated group, sham group, and physical therapy-treated group. We observed a significant reduction in VAS and SF-MPQ scores in the rTMS-treated group, but not in the sham group. Moreover, patients who received rTMS had a lower mean pain score than patients treated with physical therapy. Our study suggests that rTMS produces safe, significant, and long-term relief in patients with LBP without evident side effects. This study shows for the first time that long-term repeated sessions of rTMS decrease pain perception of LBP. Bioelectromagnetics. © 2016 Wiley Periodicals, Inc.

  9. Involvement of the superior temporal cortex and the occipital cortex in spatial hearing: evidence from repetitive transcranial magnetic stimulation.

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    Lewald, Jörg; Meister, Ingo G; Weidemann, Jürgen; Töpper, Rudolf

    2004-06-01

    The processing of auditory spatial information in cortical areas of the human brain outside of the primary auditory cortex remains poorly understood. Here we investigated the role of the superior temporal gyrus (STG) and the occipital cortex (OC) in spatial hearing using repetitive transcranial magnetic stimulation (rTMS). The right STG is known to be of crucial importance for visual spatial awareness, and has been suggested to be involved in auditory spatial perception. We found that rTMS of the right STG induced a systematic error in the perception of interaural time differences (a primary cue for sound localization in the azimuthal plane). This is in accordance with the recent view, based on both neurophysiological data obtained in monkeys and human neuroimaging studies, that information on sound location is processed within a dorsolateral "where" stream including the caudal STG. A similar, but opposite, auditory shift was obtained after rTMS of secondary visual areas of the right OC. Processing of auditory information in the OC has previously been shown to exist only in blind persons. Thus, the latter finding provides the first evidence of an involvement of the visual cortex in spatial hearing in sighted human subjects, and suggests a close interconnection of the neural representation of auditory and visual space. Because rTMS induced systematic shifts in auditory lateralization, but not a general deterioration, we propose that rTMS of STG or OC specifically affected neuronal circuits transforming auditory spatial coordinates in order to maintain alignment with vision.

  10. Benefit of Multiple Sessions of Perilesional Repetitive Transcranial Magnetic Stimulation for an Effective Rehabilitation of Visuo-Spatial Function

    Science.gov (United States)

    Afifi, Linda; Rushmore, R. Jarrett; Valero-Cabré, Antoni

    2012-01-01

    Non-invasive neurostimulation techniques have been used alone or in conjunction with rehabilitation therapy to treat the neurological sequelae of brain damage with rather variable therapeutic outcomes. One potential factor limiting a consistent success for such techniques may be the few sessions carried out in patients, despite reports that their accrual may play a key role in alleviating neurological deficits long-term. In this study, we tested the effects of seventy consecutive sessions of perilesional high frequency (10 Hz) repetitive transcranial magnetic stimulation (rTMS) in the treatment of chronic neglect deficits in a well-established feline model of visuo-spatial neglect. Under identical rTMS parameters and visuo-spatial testing regimes, half of the subjects improved in visuo-spatial orienting performance. The other half experienced either none or extremely moderate ameliorations in the neglected hemispace and displayed transient patterns of maladaptive visuo-spatial behavior. Detailed analyses suggest that lesion location and extent did not account for the behavioral differences observed between these two groups of animals. We conclude that multi-session perilesional rTMS regimes have the potential to induce functional ameliorations following focal chronic brain injury, and that behavioral performance prior to the onset of the rTMS treatment is the factor that best predicts positive outcomes for non-invasive neurostimulation treatments in visuo-spatial neglect. PMID:23167832

  11. Benefit of multiple sessions of perilesional repetitive transcranial magnetic stimulation for an effective rehabilitation of visuospatial function.

    Science.gov (United States)

    Afifi, Linda; Jarrett Rushmore, R; Valero-Cabré, Antoni

    2013-02-01

    Noninvasive neurostimulation techniques have been used alone or in conjunction with rehabilitation therapy to treat the neurological sequelae of brain damage with rather variable therapeutic outcomes. One potential factor limiting a consistent success for such techniques may be the limited number of sessions carried out in patients, despite reports that their accrual may play a key role in alleviating neurological deficits long-term. In this study, we tested the effects of seventy consecutive sessions of perilesional high-frequency (10 Hz) repetitive transcranial magnetic stimulation (rTMS) in the treatment of chronic neglect deficits in a well-established feline model of visuospatial neglect. Under identical rTMS parameters and visuospatial testing regimes, half of the subjects improved in visuospatial orienting performance. The other half experienced either none or extremely moderate ameliorations in the neglected hemispace and displayed transient patterns of maladaptive visuospatial behavior. Detailed analyses suggest that lesion location and extent did not account for the behavioral differences observed between these two groups of animals. We conclude that multi-session perilesional rTMS regimes have the potential to induce functional ameliorations following focal chronic brain injury, and that behavioral performance prior to the onset of the rTMS treatment is the factor that best predicts positive outcomes for noninvasive neurostimulation treatments in visuospatial neglect.

  12. The study of clinical value of repetitive transcranial magnetic stimulation combined with dutoxetine for patients with generalized anxiety disorder

    Institute of Scientific and Technical Information of China (English)

    Ji-Dong Ren

    2016-01-01

    Objective:To analyze the clinical value of repetitive transcranial magnetic stimulation (RTMS) combined with dutoxetine for patients with generalized anxiety disorder (GAD).Methods:A total of 180 cases of patients with GAD were randomly divided into two groups (the control group and the observation group) with 90 cases each group. Patients in control group were treated with dutoxetine, while those in observation group were treated by dutoxetine combined with RTMS. The Hamilton anxiety scale and the clinical global impression scale were used to evaluate the efficacy of both groups before and after treatment, then the characteristics of mismatch negativity and P300 were detected by using brain evoked potential, and meanwhile, plasma cortisol, brain derived neurotrophic factor and homocysteine levels were detected and compared too.Results:Analysis of variance of repeated measure data showed that the main effect of time, main effect between groups and interaction effect of Hamilton anxiety scale and the clinical global impression scale scores, MMN incubation period, MMN amplitude, target N2 incubation period, target P3 incubation period, P2 non-target amplitude, levels of plasma cortisol, brain derived neurotrophic factor and homocysteine of both groups were statistically significant (P < 0.05).Conclusions:The treatment of RTMS combined with dutoxetine for patients with GAD has a faster and better curative effect, which is worthy of clinical promotion.

  13. Can neurophysiologic measures serve as biomarkers for the efficacy of repetitive transcranial magnetic stimulation treatment of major depressive disorder?

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    Kobayashi, Brian; Cook, Ian A; Hunter, Aimee M; Minzenberg, Michael J; Krantz, David E; Leuchter, Andrew F

    2017-03-31

    Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for Major Depressive Disorder (MDD). There are clinical data that support the efficacy of many different approaches to rTMS treatment, and it remains unclear what combination of stimulation parameters is optimal to relieve depressive symptoms. Because of the costs and complexity of studies that would be necessary to explore and compare the large number of combinations of rTMS treatment parameters, it would be useful to establish reliable surrogate biomarkers of treatment efficacy that could be used to compare different approaches to treatment. This study reviews the evidence that neurophysiologic measures of cortical excitability could be used as biomarkers for screening different rTMS treatment paradigms. It examines evidence that: (1) changes in excitability are related to the mechanism of action of rTMS; (2) rTMS has consistent effects on measures of excitability that could constitute reliable biomarkers; and (3) changes in excitability are related to the outcomes of rTMS treatment of MDD. An increasing body of evidence indicates that these neurophysiologic measures have the potential to serve as reliable biomarkers for screening different approaches to rTMS treatment of MDD.

  14. Food cravings and the effects of left prefrontal repetitive transcranial magnetic stimulation using an improved sham condition

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    Kelly eBarth

    2011-03-01

    Full Text Available This study examined whether a single session of repetitive transcranial magnetic stimulation (rTMS of the left prefrontal cortex would inhibit food cravings in healthy women who endorsed frequent food cravings. Ten participants viewed images of food and completed ratings for food cravings before and after receiving either real or sham rTMS over the left prefrontal cortex (10Hz, 100% rMT, 10 seconds-on, 20 seconds-off for 15 minutes; 3000 pulses. Sham TMS was matched with real TMS with respect to perceived painfulness of the stimulation. Each participant received both real and sham rTMS in random order and were blind to the condition in a within-subject cross-over design. With an improved sham control condition, prefrontal rTMS inhibited food cravings no better than sham rTMS. The mild pain from the real and sham rTMS may distract or inhibit food craving, and the decreased craving may not be caused by the effect of rTMS itself. Further studies are needed to elucidate whether rTMS has any true effects on food craving and whether painful stimuli inhibit food or other cravings. A sham condition which matches the painfulness is important to understand the true effects of TMS on behaviors and diseases.

  15. Cortical excitability in patients with focal epilepsy: a study with high frequency repetitive transcranial magnetic stimulation (rTMS

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    Maria Gabriele

    2008-12-01

    Full Text Available Epileptogenesis involves an increase in excitatory synaptic strength in the brain in a manner similar to synaptic potentiation. In the present study we investigated the mechanisms of short-term synaptic potentiation in patients with focal epilepsy by using 5 Hz repetitive transcranial magnetic stimulation (rTMS, a non invasive neurophysiological technique able to investigate the mechanisms of synaptic plasticity in humans. Ten patients with focal idiopathic cortical epilepsy were studied. 5 Hz-rTMS (10 stimuli-trains, 120% of motor threshold, RMT was delivered over the first dorsal interosseus (FDI motor area of both (affected and unaffected hemispheres. Changes in the motor evoked potential (MEP size in the FDI muscle during the trains and the RMT were measured and compared between the hemispheres. 5 Hz-rTMS was also delivered in a group of healthy subjects over both hemispheres. 5 Hz-rTMS in patients elicited a reduced MEP facilitation compared to normal subjects. The reduced MEP amplitude was more evident in the affected hemisphere than in the unaffected hemisphere. RMT in the affected hemisphere was higher than in the unaffected hemisphere and in healthy subjects. Our findings showing a decreased response to 5 Hz-rTMS over the affected hemisphere, differently from the expected results suggest a reduced cortical excitability in epileptic patients. We hypothesize an altered balance between excitatory and inhibitory circuits in epileptic patients under chronic therapy.

  16. Abnormal plasticity of the sensorimotor cortex to slow repetitive transcranial magnetic stimulation in patients with writer's cramp.

    Science.gov (United States)

    Bäumer, Tobias; Demiralay, Cüneyt; Hidding, Ute; Bikmullina, Rosalia; Helmich, Rick C; Wunderlich, Silke; Rothwell, John; Liepert, Joachim; Siebner, Hartwig R; Münchau, Alexander

    2007-01-01

    Previous studies demonstrated functional abnormalities in the somatosensory system, including a distorted functional organization of the somatosensory cortex (S1) in patients with writer's cramp. We tested the hypothesis that these functional alterations render S1 of these patients more susceptible to the "inhibitory" effects of subthreshold 1 Hz repetitive transcranial magnetic stimulation (rTMS) given to S1. Seven patients with writer's cramp and eight healthy subjects were studied. Patients also received rTMS to the motor cortex hand area (M1). As an outcome measure, short-latency afferent inhibition (SAI) was tested. SAI was studied in the relaxed first dorsal interosseous muscle using conditioning electrical stimulation of the index finger and TMS pulses over the contralateral M1. Baseline SAI did not differ between groups. S1 but not M1 rTMS reduced SAI in patients. rTMS had no effects on SAI in healthy subjects. Because SAI is mediated predominantly at a cortical level in the sensorimotor cortex, we conclude that there is an abnormal responsiveness of this area to 1 Hz rTMS in writer's cramp, which may represent a trait toward maladaptive plasticity in the sensorimotor system in these patients.

  17. The continuous Wagon wheel illusion and the 'when' pathway of the right parietal lobe: a repetitive transcranial magnetic stimulation study.

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    Rufin VanRullen

    Full Text Available A continuous periodic motion stimulus can sometimes be perceived moving in the wrong direction. These illusory reversals have been taken as evidence that part of the motion perception system samples its inputs as a series of discrete snapshots -although other explanations of the phenomenon have been proposed, that rely on the spurious activation of low-level motion detectors in early visual areas. We have hypothesized that the right inferior parietal lobe ('when' pathway plays a critical role in timing perceptual events relative to one another, and thus we examined the role of the right parietal lobe in the generation of this "continuous Wagon Wheel Illusion" (c-WWI. Consistent with our hypothesis, we found that the illusion was effectively weakened following disruption of right, but not left, parietal regions by low frequency repetitive transcranial magnetic stimulation (1 Hz, 10 min. These results were independent of whether the motion stimulus was shown in the left or the right visual field. Thus, the c-WWI appears to depend on higher-order attentional mechanisms that are supported by the 'when' pathway of the right parietal lobe.

  18. Bihemispheric repetitive transcranial magnetic stimulation combined with intensive occupational therapy for upper limb hemiparesis after stroke: a preliminary study.

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    Yamada, Naoki; Kakuda, Wataru; Kondo, Takahiro; Shimizu, Masato; Mitani, Sugao; Abo, Masahiro

    2013-12-01

    We investigated the safety, feasibility, and efficacy of the combination of bihemispheric repetitive transcranial magnetic stimulation (rTMS) and intensive occupational therapy (OT) for upper limb hemiparesis in poststroke patients. The study participants were eight poststroke patients with upper limb hemiparesis (age at intervention: 62.8±4.9 years, time after stroke: 84.3±87.2 months, mean±SD). During 15 days of hospitalization, each patient received 10 sessions of 40-min bihemispheric rTMS and 240-min intensive OT (120-min one-to-one training and 120-min self-training). One session of bihemispheric rTMS comprised the application of both 1 and 10 Hz rTMS (2000 stimuli for each hemisphere). The Fugl-Meyer Assessment, Wolf Motor Function Test, and the Modified Ashworth Scale were administered on the day of admission and at discharge. All patients completed the treatment without any adverse effects. Motor function of the affected upper limb improved significantly, on the basis of changes in Fugl-Meyer Assessment and Wolf Motor Function Test (Ptherapy for poststroke hemiparetic patients, and improved motor function of the hemiparetic upper limb in poststroke patients. The findings provide a new avenue for the treatment of patients with poststroke hemiparesis.

  19. The effect of computer-assisted cognitive rehabilitation and repetitive transcranial magnetic stimulation on cognitive function for stroke patients.

    Science.gov (United States)

    Park, In-Seok; Yoon, Jung-Gyu

    2015-03-01

    [Purpose] This study investigated the effects of computer-assisted cognitive rehabilitation (CACR) and repetitive transcranial magnetic stimulation (rTMS) on cognitive function in patients with stroke. [Subjects and Methods] We enrolled 20 patients and divided them into CACR and rTMS groups. CACR and rTMS were performed thrice a week for 4 weeks. Cognitive function was measured with the Korean Mini-Mental State Examination (K-MMSE) and Lowenstein Occupational Therapy Cognitive Assessment-Geriatric (LOTCA-G) before and after treatment. The independent samples t-test was performed to test the homogeneity of K-MMSE and LOTCA-G before treatment and compare the differences in cognitive improvement between the CACR and rTMS groups. A paired samples t-test was used to compare cognitive function before and after treatment. [Results] Cognitive function of both the groups significantly improved after the intervention based on the K-MMSE and LOTCA-G scores. While the LOTCA-G score improved significantly more in the CACR group than in the rTMS group, no significant difference was seen in the K-MMSE scores. [Conclusion] We showed that CACR is more effective than rTMS in improving cognitive function after stroke.

  20. Repetitive transcranial magnetic stimulation induced slow wave activity modification: A possible role in disorder of consciousness differential diagnosis?

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    Pisani, Laura Rosa; Naro, Antonino; Leo, Antonino; Aricò, Irene; Pisani, Francesco; Silvestri, Rosalia; Bramanti, Placido; Calabrò, Rocco Salvatore

    2015-12-15

    Slow wave activity (SWA) generation depends on cortico-thalamo-cortical loops that are disrupted in patients with chronic Disorders of Consciousness (DOC), including the Unresponsive Wakefulness Syndrome (UWS) and the Minimally Conscious State (MCS). We hypothesized that the modulation of SWA by means of a repetitive transcranial magnetic stimulation (rTMS) could reveal residual patterns of connectivity, thus supporting the DOC clinical differential diagnosis. We enrolled 10 DOC individuals who underwent a 24hh polysomnography followed by a real or sham 5Hz-rTMS over left primary motor area, and a second polysomnographic recording. A preserved sleep-wake cycle, a standard temporal progression of sleep stages, and a SWA perturbation were found in all of the MCS patients and in none of the UWS individuals, only following the real-rTMS. In conclusion, our combined approach may improve the differential diagnosis between MCS patients, who show a partial preservation of cortical plasticity, and UWS individuals, who lack such properties.

  1. Repetitive Transcranial Magnetic Stimulation (rTMS) Modulates Event-Related Potential (ERP) Indices of Attention in Autism

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    Casanova, Manuel F.; Baruth, Joshua M.; El-Baz, Ayman; Tasman, Allan; Sears, Lonnie; Sokhadze, Estate

    2014-01-01

    Individuals with autism spectrum disorder (ASD) have previously been shown to have significantly augmented and prolonged event-related potentials (ERP) to irrelevant visual stimuli compared to controls at both early and later stages (e.g., N200, P300) of visual processing and evidence of an overall lack of stimulus discrimination. Abnormally large and indiscriminative cortical responses to sensory stimuli may reflect cortical inhibitory deficits and a disruption in the excitation/inhibition ratio. Low-frequency (≤1HZ) repetitive transcranial magnetic stimulation (rTMS) has been shown to increase inhibition of stimulated cortex by the activation of inhibitory circuits. It was our prediction that after 12 sessions of low-frequency rTMS applied bilaterally to the dorsolateral prefrontal cortices in individuals with ASD there would be a significant improvement in ERP indices of selective attention evoked at later (i.e., 200–600 ms) stages of attentional processing as well as an improvement in motor response error rate. We assessed 25 participants with ASD in a task of selective attention using illusory figures before and after 12 sessions of rTMS in a controlled design where a waiting-list group of 20 children with ASD performed the same task twice. We found a significant improvement in both N200 and P300 components as a result of rTMS as well as a significant reduction in response errors. We also found significant reductions in both repetitive behavior and irritability according to clinical behavioral questionnaires as a result of rTMS. We propose that rTMS has the potential to become an important therapeutic tool in ASD research and treatment. PMID:24683490

  2. Effects of repetitive facilitative exercise with neuromuscular electrical stimulation, vibratory stimulation and repetitive transcranial magnetic stimulation of the hemiplegic hand in chronic stroke patients.

    Science.gov (United States)

    Etoh, Seiji; Noma, Tomokazu; Takiyoshi, Yuko; Arima, Michiko; Ohama, Rintaro; Yokoyama, Katsuya; Hokazono, Akihiko; Amano, Yumeko; Shimodozono, Megumi; Kawahira, Kazumi

    2016-11-01

    Repetitive facilitative exercise (RFE) is a developed approach to the rehabilitation of hemiplegia. RFE can be integrated with neuromuscular electrical stimulation (NMES), direct application of vibratory stimulation (DAVS) and repetitive transcranial magnetic stimulation (rTMS). The aims of the present study were to retrospectively compare the effects of RFE and NMES, DAVS with those of RFE and rTMS, and to determine the maximal effect of the combination of RFE with NMES, DAVS, rTMS and pharmacological treatments in stroke patients. Thirty-three stroke patients were enrolled and divided into three groups: 15 who received RFE with rTMS (4 min) (TMS4 alone), 9 who received RFE with NMES, DAVS (NMES, DAVS alone) and 9 who received RFE with NMES, DAVS and rTMS (10 min) (rTMS10 + NMES, DAVS). The subjects performed the Fugl-Meyer Assessment (FMA) and Action Research Arm Test (ARAT) before and after the 2-week session. The 18 patients in the NMES, DAVS alone and rTMS10 + NMES, DAVS group underwent the intervention for 4 weeks. There were no significant differences in the increases in the FMA, ARAT scores in the three groups. The FMA or ARAT scores in the NMES, DAVS alone and the rTMS10 + NMES, DAVS group were increased significantly. The FMA and ARAT scores were significantly improved after 4 weeks in the NMES, DAVS alone group. RFE with NMES, DAVS may be more effective than RFE with rTMS for the recovery of upper-limb function. Patients who received RFE with NMES, DAVS and pharmacological treatments showed significant functional recovery.

  3. 重复经颅磁刺激治疗卒中后失语%Repetitive transcranial magnetic stimulation for the treatment of poststroke aphasia

    Institute of Scientific and Technical Information of China (English)

    李艳红; 张国忠; 李娜; 王艳萍

    2014-01-01

    失语是一种常见的卒中并发症.经颅磁刺激是一种无创性脑部刺激方法.一些病例研究和随机对照试验证实了重复经颅磁刺激治疗卒中后失语的有效性,但其具体机制尚不完全清楚.%Aphasia is a common complication of stroke.Transcranial magnetic stimulation is a noninvasive brain stimulation approach.Some case studies and randomized controlled trials have confirmed the effectiveness of repetitive transcranial magnetic stimulation for the treatment of poststroke aphasia,but its specific mechanism remains unclear.

  4. Repetitive transcranial magnetic stimulation (rTMS) improves behavioral and biochemical deficits in levodopa-induced dyskinetic rats model.

    Science.gov (United States)

    Ba, Maowen; Kong, Min; Guan, Lina; Yi, Maoli; Zhang, Hongli

    2016-09-13

    Fluctuations of dopamine levels and upregulations of NR2B tyrosine phosphorylation in the striatum have been connected with levodopa (L-dopa)-induced dyskinesia (LID) in Parkinson's disease (PD). Repetitive transcranial magnetic stimulation (rTMS) is one of the noninvasive and potential method treating dyskinesia. Yet, the effect of rTMS on the above key pathological events remains unclear. In this study, we gave L-dopa treatment intraperitoneally for 22 days to 6-hydroxydopamine-lesioned PD rats to prepare LID rats model, and subsequently applied rTMS daily for 3 weeks to LID rats model. The effect of rTMS on abnormal involuntary movements (AIMs) was assessed. After ending the experiments, we further determined tyrosine hydroxylase (TH)-positive dopaminergic neurons number by immunohistochemistry, dopamine levels by HPLC, glial cell line-derived neurotrophic factor (GDNF) levels by ELISA, NR2B tyrosine phosphorylation and interactions of NR2B with Fyn by immunoblotting and immunoprecipitation. The results demonstrated that rTMS obviously attenuated AIMs scores, reduced the loss of nigral dopaminergic neurons and the fluctuations of striatal dopamine levels. Meanwhile, rTMS significantly increased the expression of GDNF, which couldrestore the damage of dopaminergic neurons. Additionally, rTMS also reduced the levels of the NR2B tyrosine phosphorylation andits interactions with Fyn in the lesioned striatum of LID rats model. Thus, these data indicate that rTMS can provide benefit for the therapy of LID by improving the key biochemical deficits related to dyskinesia.

  5. Repetitive transcranial magnetic stimulation regulates L-type Ca(2+) channel activity inhibited by early sevoflurane exposure.

    Science.gov (United States)

    Liu, Yang; Yang, Huiyun; Tang, Xiaohong; Bai, Wenwen; Wang, Guolin; Tian, Xin

    2016-09-01

    Sevoflurane might be harmful to the developing brain. Therefore, it is essential to reverse sevoflurane-induced brain injury. This study aimed to determine whether low-frequency repetitive transcranial magnetic stimulation (rTMS) can regulate L-type Ca(2+) channel activity, which is inhibited by early sevoflurane exposure. Rats were randomly divided into three groups: control, sevoflurane, and rTMS groups. A Whole-cell patch clamp technique was applied to record L-type Ca(2+) channel currents. The I-V curve, steady-state activation and inactivation curves were studied in rats of each group at different ages (1 week, 2 weeks, 3 weeks, 4 weeks and 5 weeks old). In the control group, L-type Ca(2+) channel current density significantly increased from week 2 to week 3. Compared with the control group, L-type Ca(2+) channel currents of rats in the sevoflurane group were significantly inhibited from week 1 to week 3. Activation curves of L-type Ca(2+) channel shifted significantly towards depolarization at week 1 and week 2. Moreover, steady-state inactivation curves shifted towards hyperpolarization from week 1 to week 3. Compared with the sevoflurane group, rTMS significantly increased L-type Ca(2+) channel currents at week 2 and week 3. Activation curves of L-type Ca(2+) channel significantly shifted towards hyperpolarization at week 2. Meanwhile, steady-state inactivation curves significantly shifted towards depolarization at week 2. The period between week 2 and week 3 is critical for the development of L-type Ca(2+) channels. Early sevoflurane exposure inhibits L-type Ca(2+) channel activity and rTMS can regulate L-type Ca(2+) channel activity inhibited by sevoflurane. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Results on the spatial resolution of repetitive transcranial magnetic stimulation for cortical language mapping during object naming in healthy subjects.

    Science.gov (United States)

    Sollmann, Nico; Hauck, Theresa; Tussis, Lorena; Ille, Sebastian; Maurer, Stefanie; Boeckh-Behrens, Tobias; Ringel, Florian; Meyer, Bernhard; Krieg, Sandro M

    2016-10-24

    The spatial resolution of repetitive navigated transcranial magnetic stimulation (rTMS) for language mapping is largely unknown. Thus, to determine a minimum spatial resolution of rTMS for language mapping, we evaluated the mapping sessions derived from 19 healthy volunteers for cortical hotspots of no-response errors. Then, the distances between hotspots (stimulation points with a high error rate) and adjacent mapping points (stimulation points with low error rates) were evaluated. Mean distance values of 13.8 ± 6.4 mm (from hotspots to ventral points, range 0.7-30.7 mm), 10.8 ± 4.8 mm (from hotspots to dorsal points, range 2.0-26.5 mm), 16.6 ± 4.8 mm (from hotspots to apical points, range 0.9-27.5 mm), and 13.8 ± 4.3 mm (from hotspots to caudal points, range 2.0-24.2 mm) were measured. According to the results, the minimum spatial resolution of rTMS should principally allow for the identification of a particular gyrus, and according to the literature, it is in good accordance with the spatial resolution of direct cortical stimulation (DCS). Since measurement was performed between hotspots and adjacent mapping points and not on a finer-grained basis, we only refer to a minimum spatial resolution. Furthermore, refinement of our results within the scope of a prospective study combining rTMS and DCS for resolution measurement during language mapping should be the next step.

  7. Cumulative sessions of repetitive transcranial magnetic stimulation (rTMS) build up facilitation to subsequent TMS-mediated behavioural disruptions.

    Science.gov (United States)

    Valero-Cabré, Antoni; Pascual-Leone, Alvaro; Rushmore, Richard J

    2008-02-01

    A single session of repetitive transcranial magnetic stimulation (rTMS) can induce behavioural effects that outlast the duration of the stimulation train itself (off-line effects). Series of rTMS sessions on consecutive days are being used for therapeutic applications in a variety of disorders and are assumed to lead to the build-up of cumulative effects. However, no studies have carefully assessed this notion. In the present study we applied 30 daily sessions of 1 Hz rTMS (continuous train of 20 min) to repeatedly modulate activity in the posterior parietal cortex and associated neural systems in two intact cats. We assessed the effect on visuospatial orientation before and after each stimulation session. Cumulative sessions of rTMS progressively induced visuospatial neglect-like 'after-effects' of greater magnitude (from 5-10% to 40-50% error levels) and increasing spatial extent (from 90-75 degrees to 45-30 degrees eccentricity locations), affecting the visual hemifield contralateral to the stimulated hemisphere. Nonetheless, 60 min after each TMS session, visual detection-localization abilities repeatedly returned to baseline levels. Furthermore, no lasting behavioural effect could be demonstrated at any time across the study, when subjects were tested 1 or 24 h post-rTMS. We conclude that the past history of periodically cumulative rTMS sessions builds up a lasting 'memory', resulting in increased facilitation to subsequent TMS-induced disruptions. Such a phenomenon allows a behavioural effect of progressively higher magnitude, but equal duration, in response to individual TMS interventions.

  8. Modulation of N400 in chronic non-fluent aphasia using low frequency Repetitive Transcranial Magnetic Stimulation (rTMS).

    Science.gov (United States)

    Barwood, Caroline H S; Murdoch, Bruce E; Whelan, Brooke-Mai; Lloyd, David; Riek, Stephan; O'Sullivan, John D; Coulthard, Alan; Wong, Andrew

    2011-03-01

    Low frequency Repetitive Transcranial Magnetic Stimulation (rTMS) has previously been applied to language homologues in non-fluent populations of persons with aphasia yielding significant improvements in behavioral language function up to 43 months post stimulation. The present study aimed to investigate the electrophysiological correlates associated with the application of rTMS through measurement of the semantic based N400 Event-related brain potentials (ERP) component. Low frequency (1 Hz) rTMS was applied to the anterior portion of the homologue to Broca's area (pars triangularis), for 20 min per day for 10 days, using a stereotactic neuronavigational system. Twelve non-fluent persons with aphasia, 2-6 years post stroke were stimulated. Six participants were randomly assigned to receive real stimulation and six participants were randomly assigned to receive a blind sham control condition. ERP measures were recorded at baseline, 1 week and 2 months subsequent to stimulation. The findings demonstrate treatment related changes observed in the stimulation group when compared to the placebo control group at 2 months post stimulation indicating neuromodulation of N400 as a result of rTMS. No treatment related changes were identified in the stimulation group, when compared to the sham group from baseline to 1 week post stimulation. The electrophysiological results represent the capacity of rTMS to modulate neural language networks and measures of lexical-semantic function in participants with non-fluent aphasia and suggest that time may be an important factor in brain reorganization subsequent to rTMS.

  9. The Role of Right Inferior Parietal Cortex in Auditory Spatial Attention: A Repetitive Transcranial Magnetic Stimulation Study.

    Directory of Open Access Journals (Sweden)

    Debra S Karhson

    Full Text Available Behavioral studies support the concept of an auditory spatial attention gradient by demonstrating that attentional benefits progressively diminish as distance increases from an attended location. Damage to the right inferior parietal cortex can induce a rightward attention bias, which implicates this region in the construction of attention gradients. This study used event-related potentials (ERPs to define attention-related gradients before and after repetitive transcranial magnetic stimulation (rTMS to the right inferior parietal cortex. Subjects (n = 16 listened to noise bursts at five azimuth locations (left to right: -90°, -45°, 0° midline, +45°, +90° and responded to stimuli at one target location (-90°, +90°, separate blocks. ERPs as a function of non-target location were examined before (baseline and after 0.9 Hz rTMS. Results showed that ERP attention gradients were observed in three time windows (frontal 230-340, parietal 400-460, frontal 550-750 ms. Significant transient rTMS effects were seen in the first and third windows. The first window had a voltage decrease at the farthest location when attending to either the left or right side. The third window had on overall increase in positivity, but only when attending to the left side. These findings suggest that rTMS induced a small contraction in spatial attention gradients within the first time window. The asymmetric effect of attended location on gradients in the third time window may relate to neglect of the left hemispace after right parietal injury. Together, these results highlight the role of the right inferior parietal cortex in modulating frontal lobe attention network activity.

  10. Therapeutic impact of repetitive transcranial magnetic stimulation (rTMS) on tinnitus: a systematic review and meta-analysis.

    Science.gov (United States)

    Soleimani, Robabeh; Jalali, Mir Mohammad; Hasandokht, Tolou

    2016-07-01

    In this study, we conducted a systematic literature review and meta-analysis on the effect of repetitive transcranial magnetic stimulation (rTMS) compared with sham in chronic tinnitus patients. We searched databases, from their onset up to August 2014, for randomized controlled trials (RCT) in English that assessed the effectiveness of rTMS for chronic tinnitus. RCTs were selected according to inclusion/exclusion criteria before data were extracted. For the meta-analysis weighted mean differences (and standard deviations) of Tinnitus Questionnaire (TQ) and Tinnitus Handicap Inventory (THI) scores were determined. Therapeutic success was defined as difference of at least 7 points in the THI score between baseline and the follow-up assessment after treatment. The odds ratio (OR) for this variable was assessed. Results from 15 RCTs were analyzed. The mean difference for TQ score at 1 week after intervention was 3.42. For THI, the data of mean difference score in two groups, 1 and 6 month after intervention, was 6.71 and 12.89, respectively. The all comparisons indicated a significant medium to large effect size in follow-up which is in favor of the rTMS. The pooled OR of therapeutic success of the studies which used THI at 1 month after intervention was 15.75. These data underscore the clinical effect of rTMS in the treatment of tinnitus. However, there is high variability of studies design and reported outcomes. Replication of data in multicenter trials with a large number of patients and long-term follow-up is needed before further conclusions can be drawn.

  11. Cognitive and anatomical underpinnings of the conceptual knowledge for common objects and familiar people: a repetitive transcranial magnetic stimulation study.

    Directory of Open Access Journals (Sweden)

    Fabio Campanella

    Full Text Available Several studies have addressed the issue of how knowledge of common objects is organized in the brain, whereas the cognitive and anatomical underpinnings of familiar people knowledge have been less explored. Here we applied repetitive transcranial magnetic stimulation (rTMS over the left and right temporal poles before asking healthy individuals to perform a speeded word-to-picture matching task using familiar people and common objects as stimuli. We manipulated two widely used semantic variables, namely the semantic distance and the familiarity of stimuli, to assess whether the semantic organization of familiar people knowledge is similar to that of common objects. For both objects and faces we reliably found semantic distance and familiarity effects, with less accurate and slower responses for stimulus pairs that were more closely related and less familiar. However, the effects of semantic variables differed across categories, with semantic distance effects larger for objects and familiarity effects larger for faces, suggesting that objects and faces might share a partially comparable organization of their semantic representations. The application of rTMS to the left temporal pole modulated, for both categories, semantic distance, but not familiarity effects, revealing that accessing object and face concepts might rely on overlapping processes within left anterior temporal regions. Crucially, rTMS of the left temporal pole affected only the recognition of pairs of stimuli that could be discriminated at specific levels of categorization (e.g., two kitchen tools or two famous persons, with no effect for discriminations at either superordinate or individual levels. Conversely, rTMS of the right temporal pole induced an overall slowing of reaction times that positively correlated with the visual similarity of the stimuli, suggesting a more perceptual rather than semantic role of the right anterior temporal regions. Results are discussed in the

  12. A proof-of-concept study on the combination of repetitive transcranial magnetic stimulation and relaxation techniques in chronic tinnitus.

    Science.gov (United States)

    Kreuzer, Peter M; Poeppl, Timm B; Bulla, Jan; Schlee, Winfried; Lehner, Astrid; Langguth, Berthold; Schecklmann, Martin

    2016-10-01

    Interference of ongoing neuronal activity and brain stimulation motivated this study to combine repetitive transcranial magnetic stimulation (rTMS) and relaxation techniques in tinnitus patients. Forty-two patients were enrolled in this one-arm proof-of-concept study to receive ten sessions of rTMS applied to the left dorsolateral prefrontal cortex and temporo-parietal cortex. During stimulation, patients listened to five different kinds of relaxation audios. Variables of interest were tinnitus questionnaires, tinnitus numeric rating scales, depressivity, and quality of life. Results were compared to results of historical control groups having received the same rTMS protocol (active control) and sham treatment (placebo) without relaxation techniques. Thirty-eight patients completed the treatment, drop-out rates and adverse events were low. Responder rates (reduction in tinnitus questionnaire (TQ) score ≥5 points 10 weeks after treatment) were 44.7 % in the study, 27.8 % in the active control group, and 21.7 % in the placebo group, differing between groups on a near significant level. For the tinnitus handicap inventory (THI), the main effect of group was not significant. However, linear mixed model analyses showed that the relaxation/rTMS group differed significantly from the active control group showing steeper negative THI trend for the relaxation/rTMS group indicating better amelioration over the course of the trial. Deepness of relaxation during rTMS and selection of active relaxation vs. passive listening to music predicted larger TQ. All remaining secondary outcomes turned out non-significant. This combined treatment proved to be a safe, feasible and promising approach to enhance rTMS treatment effects in chronic tinnitus.

  13. Cognitive and anatomical underpinnings of the conceptual knowledge for common objects and familiar people: a repetitive transcranial magnetic stimulation study.

    Science.gov (United States)

    Campanella, Fabio; Fabbro, Franco; Urgesi, Cosimo

    2013-01-01

    Several studies have addressed the issue of how knowledge of common objects is organized in the brain, whereas the cognitive and anatomical underpinnings of familiar people knowledge have been less explored. Here we applied repetitive transcranial magnetic stimulation (rTMS) over the left and right temporal poles before asking healthy individuals to perform a speeded word-to-picture matching task using familiar people and common objects as stimuli. We manipulated two widely used semantic variables, namely the semantic distance and the familiarity of stimuli, to assess whether the semantic organization of familiar people knowledge is similar to that of common objects. For both objects and faces we reliably found semantic distance and familiarity effects, with less accurate and slower responses for stimulus pairs that were more closely related and less familiar. However, the effects of semantic variables differed across categories, with semantic distance effects larger for objects and familiarity effects larger for faces, suggesting that objects and faces might share a partially comparable organization of their semantic representations. The application of rTMS to the left temporal pole modulated, for both categories, semantic distance, but not familiarity effects, revealing that accessing object and face concepts might rely on overlapping processes within left anterior temporal regions. Crucially, rTMS of the left temporal pole affected only the recognition of pairs of stimuli that could be discriminated at specific levels of categorization (e.g., two kitchen tools or two famous persons), with no effect for discriminations at either superordinate or individual levels. Conversely, rTMS of the right temporal pole induced an overall slowing of reaction times that positively correlated with the visual similarity of the stimuli, suggesting a more perceptual rather than semantic role of the right anterior temporal regions. Results are discussed in the light of current

  14. Evoking visual neglect-like deficits in healthy volunteers - an investigation by repetitive navigated transcranial magnetic stimulation.

    Science.gov (United States)

    Giglhuber, Katrin; Maurer, Stefanie; Zimmer, Claus; Meyer, Bernhard; Krieg, Sandro M

    2016-01-18

    In clinical practice, repetitive navigated transcranial magnetic stimulation (rTMS) is of particular interest for non-invasive mapping of cortical language areas. Yet, rTMS studies try to detect further cortical functions. Damage to the underlying network of visuospatial attention function can result in visual neglect-a severe neurological deficit and influencing factor for a significantly reduced functional outcome. This investigation aims to evaluate the use of rTMS for evoking visual neglect in healthy volunteers and the potential of specifically locating cortical areas that can be assigned for the function of visuospatial attention. Ten healthy, right-handed subjects underwent rTMS visual neglect mapping. Repetitive trains of 5 Hz and 10 pulses were applied to 52 pre-defined cortical spots on each hemisphere; each cortical spot was stimulated 10 times. Visuospatial attention was tested time-locked to rTMS pulses by a landmark task. Task pictures were displayed tachistoscopically for 50 ms. The subjects' performance was analyzed by video, and errors were referenced to cortical spots. We observed visual neglect-like deficits during the stimulation of both hemispheres. Errors were categorized into leftward, rightward, and no response errors. Rightward errors occurred significantly more often during stimulation of the right hemisphere than during stimulation of the left hemisphere (mean rightward error rate (ER) 1.6 ± 1.3 % vs. 1.0 ± 1.0 %, p = 0.0141). Within the left hemisphere, we observed predominantly leftward errors rather than rightward errors (mean leftward ER 2.0 ± 1.3 % vs. rightward ER 1.0 ± 1.0 %; p = 0.0005). Visual neglect can be elicited non-invasively by rTMS, and cortical areas eloquent for visuospatial attention can be detected. Yet, the correlation of this approach with clinical findings has to be shown in upcoming steps.

  15. Repetitive transcranial magnetic stimulation (rTMS) influences spatial cognition and modulates hippocampal structural synaptic plasticity in aging mice.

    Science.gov (United States)

    Ma, Jun; Zhang, Zhanchi; Kang, Lin; Geng, Dandan; Wang, Yanyong; Wang, Mingwei; Cui, Huixian

    2014-10-01

    Normal aging is characteristic with the gradual decline in cognitive function associated with the progressive reduction of structural and functional plasticity in the hippocampus. Repetitive transcranial magnetic stimulation (rTMS) has developed into a novel neurological and psychiatric tool that can be used to investigate the neurobiology of cognitive function. Recent studies have demonstrated that low-frequency rTMS (≤1Hz) affects synaptic plasticity in rats with vascular dementia (VaD), and it ameliorates the spatial cognitive ability in mice with Aβ1-42-mediated memory deficits, but there are little concerns about the effects of rTMS on normal aging related cognition and synaptic plasticity changes. Thus, the current study investigated the effects of rTMS on spatial memory behavior, neuron and synapse morphology in the hippocampus, and synaptic protein markers and brain-derived neurotrophic factor (BDNF)/tropomyosin-related kinase B (TrkB) in normal aging mice, to illustrate the mechanisms of rTMS in regulating cognitive capacity. Relative to adult animals, aging caused hippocampal-dependent cognitive impairment, simultaneously inhibited the activation of the BDNF-TrkB signaling pathway, reduced the transcription and expression of synaptic protein markers: synaptophysin (SYN), growth associated protein 43 (GAP43) and post-synaptic density protein 95 (PSD95), as well as decreased synapse density and PSD (post-synaptic density) thickness. Interestingly, rTMS with low intensity (110% average resting motor threshold intensity, 1Hz, LIMS) triggered the activation of BDNF and TrkB, upregulated the level of synaptic protein markers, and increased synapse density and thickened PSD, and further reversed the spatial cognition dysfunction in aging mice. Conversely, high-intensity magnetic stimulation (150% average resting motor threshold intensity, 1Hz, HIMS) appeared to be detrimental, inducing thinning of PSDs, disordered synaptic structure, and a large number of

  16. Safety and tolerability of repetitive transcranial magnetic stimulation in patients with epilepsy: a review of the literature.

    Science.gov (United States)

    Bae, Erica Hyunji; Schrader, Lara M; Machii, Katsuyuki; Alonso-Alonso, Miguel; Riviello, James J; Pascual-Leone, Alvaro; Rotenberg, Alexander

    2007-06-01

    Repetitive transcranial magnetic stimulation (rTMS) is emerging as a new therapeutic tool in epilepsy, where it can be used to suppress seizures or treat comorbid conditions such as mood disorder. However, as rTMS carries a risk of inducing seizures among other adverse events, its safety and tolerability in the population with epilepsy warrant distinct consideration, as this group is especially seizure-prone. Accordingly, we performed a review of the literature to estimate the risk of seizures and other adverse events associated with rTMS in patients with epilepsy. We performed an English-language literature search, and reviewed all studies published from January 1990 to February 2007 in which patients with epilepsy were treated with rTMS, and complemented the literature search with personal correspondence with authors when necessary. We identified 30 publications that described patients with epilepsy who underwent rTMS, and noted total number of relevant subjects, medication usage, incidence of adverse events, and rTMS parameters including stimulus frequency, number of stimuli, train duration, intertrain interval, coil type, and stimulation sites. The data were analyzed for adverse events related to rTMS. Crude per-subject risk, as well as per-subject mean risk weighted by sample size and risk per 1000 stimuli weighted by number of stimuli in each study, were computed for seizures and for other adverse events. Adverse events or lack thereof was reported in 26 studies (n=280 subjects). Adverse events attributed to rTMS were generally mild and occurred in 17.1% of subjects. Headache was most common, occurring in 9.6%. The most serious adverse event was seizure during treatment, which occurred in four patients (1.4% crude per-subject risk). All but one case were the patients' typical seizures with respect to duration and semiology, and were associated with low-frequency rTMS. A single case of an atypical seizure appearing to arise from the region of stimulation

  17. Management of Chronic Tinnitus and Insomnia with Repetitive Transcranial Magnetic Stimulation and Cognitive Behavioral Therapy – a Combined Approach

    Directory of Open Access Journals (Sweden)

    Kneginja Richter

    2017-04-01

    Full Text Available It has been estimated that up to 80% of people will experience symptoms of tinnitus over the courses of their lives, with rates of comorbid sleeping problems ranging from 50 to 77%. Because of a potential connection between tinnitus and sleep disorders as well as high rates of comorbid psychiatric disorders, interdisciplinary approaches to treatment seem to be the most efficient option. In this study, we present the case of a 53-year-old male patient, who started to experience symptoms of tinnitus at the age of 49, most likely caused by work-related stress. Over the course of his illness, the patient developed comorbid insomnia. He consulted us for treatment of both conditions and we developed a treatment plan with ten sessions of repetitive transcranial magnetic stimulation (rTMS followed by 10 sessions of cognitive behavioral therapy (CBT. We used the Tinnitus Fragebogen (TF to assess the severity of the tinnitus, the Beck Depression Inventory (BDI-II for depressive symptoms, and the WHO Well-being Index (WHO-5 for subjective well-being. Improvements could be achieved with regard to both diagnoses and the patient went from severe (48 to clinically negligible (12 TF scores, from minimal (BDI-II score 10 to no (0 depressive symptoms, and from just above critical (WHO-5 percentile 52 to above average (84 well-being. The combination of technological and psychological approaches to treat tinnitus and insomnia thus proved successful in this case. One may therefore conclude that rTMS may be considered an effective first therapeutic step for tinnitus treatment prior to CBT. To our knowledge this is the first published case in which rTMS and CBT were combined for tinnitus therapy. The approach proved successful since it led to a considerable increase in well-being and everyday functioning. To gauge the effect on a more general level, large-scale studies are still needed to cancel out potential placebo effects. Likewise, the importance of the order of

  18. Protective effects of repetitive transcranial magnetic stimulation in a rat model of transient cerebral ischaemia: a microPET study

    Energy Technology Data Exchange (ETDEWEB)

    Gao, Feng [Second Affiliated Hospital of Zhejiang University School of Medicine, Department of Nuclear Medicine, Hangzhou, Zhejiang (China); Second Affiliated Hospital of Zhejiang University School of Medicine, Department of Neurology, Hangzhou, Zhejiang (China); Zhejiang University Medical PET Center, Hangzhou, Zhejiang (China); Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, Zhejiang (China); Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, Zhejiang (China); Wang, Shuang; Guo, Yi; Lou, Min; Wu, Jimin; Ding, Meiping [Second Affiliated Hospital of Zhejiang University School of Medicine, Department of Neurology, Hangzhou, Zhejiang (China); Wang, Jing; Zhang, Hong [Second Affiliated Hospital of Zhejiang University School of Medicine, Department of Nuclear Medicine, Hangzhou, Zhejiang (China); Zhejiang University Medical PET Center, Hangzhou, Zhejiang (China); Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, Zhejiang (China); Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, Zhejiang (China); Tian, Mei [The University of Texas M.D. Anderson Cancer Center, Department of Experimental Diagnostic Imaging, Houston, TX (United States)

    2010-05-15

    Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive method to excite neurons in the brain. However, the underlying mechanism of its therapeutic effects in stroke remains unclear. The aim of this study was to investigate the neuroprotective effect of high-frequency rTMS in a rat model of transient cerebral ischaemia using positron emission tomography (PET). Sprague-Dawley rats (n=30) were anaesthetized with chloral hydrate and subjected to 90 min of intraluminal middle cerebral artery occlusion (MCAO) with subsequent reperfusion in three groups: control (n=10), rTMS (n=10), or sham-rTMS groups (n=10). In the rTMS group, rTMS was given 1 h after ischaemia and every 24 h for 7 days after MCAO. In all three groups, small-animal PET (microPET) imaging with {sup 18}F-FDG was used to evaluate brain glucose metabolism. Apoptotic molecules were measured in the infarct margin using immunohistochemical staining. The neurological scores of the rats in the rTMS group were higher than in those of the control group over the whole 7-day observation period. The total, cortical and striatal infarct volumes were significantly less in the rTMS group than in the control group, as measured by 2,3,5-triphenyltetrazolium chloride staining. {sup 18}F-FDG microPET images showed significantly higher standardized uptake values in the cortex and striatum in the rTMS group than in the control group in the affected hemisphere. The number of cells positive for caspase-3 was significantly lower in the rTMS group than in the control group, while the Bcl-2/Bax ratio was significantly higher in the rTMS group than in the control group. rTMS therapy increased glucose metabolism and inhibited apoptosis in the ischaemic hemisphere. {sup 18}F-FDG PET could be used to monitor rTMS therapy in transient cerebral ischaemia in animal studies and in future clinical trials. (orig.)

  19. Utilizing repetitive transcranial magnetic stimulation to improve language function in stroke patients with chronic non-fluent aphasia.

    Science.gov (United States)

    Garcia, Gabriella; Norise, Catherine; Faseyitan, Olufunsho; Naeser, Margaret A; Hamilton, Roy H

    2013-07-02

    Transcranial magnetic stimulation (TMS) has been shown to significantly improve language function in patients with non-fluent aphasia(1). In this experiment, we demonstrate the administration of low-frequency repetitive TMS (rTMS) to an optimal stimulation site in the right hemisphere in patients with chronic non-fluent aphasia. A battery of standardized language measures is administered in order to assess baseline performance. Patients are subsequently randomized to either receive real rTMS or initial sham stimulation. Patients in the real stimulation undergo a site-finding phase, comprised of a series of six rTMS sessions administered over five days; stimulation is delivered to a different site in the right frontal lobe during each of these sessions. Each site-finding session consists of 600 pulses of 1 Hz rTMS, preceded and followed by a picture-naming task. By comparing the degree of transient change in naming ability elicited by stimulation of candidate sites, we are able to locate the area of optimal response for each individual patient. We then administer rTMS to this site during the treatment phase. During treatment, patients undergo a total of ten days of stimulation over the span of two weeks; each session is comprised of 20 min of 1 Hz rTMS delivered at 90% resting motor threshold. Stimulation is paired with an fMRI-naming task on the first and last days of treatment. After the treatment phase is complete, the language battery obtained at baseline is repeated two and six months following stimulation in order to identify rTMS-induced changes in performance. The fMRI-naming task is also repeated two and six months following treatment. Patients who are randomized to the sham arm of the study undergo sham site-finding, sham treatment, fMRI-naming studies, and repeat language testing two months after completing sham treatment. Sham patients then cross over into the real stimulation arm, completing real site-finding, real treatment, fMRI, and two- and six

  20. [French guidelines on the use of repetitive transcranial magnetic stimulation (rTMS): safety and therapeutic indications].

    Science.gov (United States)

    Lefaucheur, J-P; André-Obadia, N; Poulet, E; Devanne, H; Haffen, E; Londero, A; Cretin, B; Leroi, A-M; Radtchenko, A; Saba, G; Thai-Van, H; Litré, C-F; Vercueil, L; Bouhassira, D; Ayache, S-S; Farhat, W-H; Zouari, H-G; Mylius, V; Nicolier, M; Garcia-Larrea, L

    2011-12-01

    During the past decade, a large amount of work on transcranial magnetic stimulation (TMS) has been performed, including the development of new paradigms of stimulation, the integration of imaging data, and the coupling of TMS techniques with electroencephalography or neuroimaging. These accumulating data being difficult to synthesize, several French scientific societies commissioned a group of experts to conduct a comprehensive review of the literature on TMS. This text contains all the consensual findings of the expert group on the mechanisms of action, safety rules and indications of TMS, including repetitive TMS (rTMS). TMS sessions have been conducted in thousands of healthy subjects or patients with various neurological or psychiatric diseases, allowing a better assessment of risks associated with this technique. The number of reported side effects is extremely low, the most serious complication being the occurrence of seizures. In most reported seizures, the stimulation parameters did not follow the previously published recommendations (Wassermann, 1998) [430] and rTMS was associated to medication that could lower the seizure threshold. Recommendations on the safe use of TMS / rTMS were recently updated (Rossi et al., 2009) [348], establishing new limits for stimulation parameters and fixing the contraindications. The recommendations we propose regarding safety are largely based on this previous report with some modifications. By contrast, the issue of therapeutic indications of rTMS has never been addressed before, the present work being the first attempt of a synthesis and expert consensus on this topic. The use of TMS/rTMS is discussed in the context of chronic pain, movement disorders, stroke, epilepsy, tinnitus and psychiatric disorders. There is already a sufficient level of evidence of published data to retain a therapeutic indication of rTMS in clinical practice (grade A) in chronic neuropathic pain, major depressive episodes, and auditory

  1. Acoustic evaluation of short-term effects of repetitive transcranial magnetic stimulation on motor aspects of speech in Parkinson's disease.

    Science.gov (United States)

    Eliasova, I; Mekyska, J; Kostalova, M; Marecek, R; Smekal, Z; Rektorova, I

    2013-04-01

    Hypokinetic dysarthria in Parkinson's disease (PD) can be characterized by monotony of pitch and loudness, reduced stress, variable rate, imprecise consonants, and a breathy and harsh voice. Using acoustic analysis, we studied the effects of high-frequency repetitive transcranial magnetic stimulation (rTMS) applied over the primary orofacial sensorimotor area (SM1) and the left dorsolateral prefrontal cortex (DLPFC) on motor aspects of voiced speech in PD. Twelve non-depressed and non-demented men with PD (mean age 64.58 ± 8.04 years, mean PD duration 10.75 ± 7.48 years) and 21 healthy age-matched men (a control group, mean age 64 ± 8.55 years) participated in the speech study. The PD patients underwent two sessions of 10 Hz rTMS over the dominant hemisphere with 2,250 stimuli/day in a random order: (1) over the SM1; (2) over the left DLPFC in the "on" motor state. Speech examination comprised the perceptual rating of global speech performance and an acoustic analysis based upon a standardized speech task. The Mann-Whitney U test was used to compare acoustic speech variables between controls and PD patients. The Wilcoxon test was used to compare data prior to and after each stimulation in the PD group. rTMS applied over the left SM1 was associated with a significant increase in harmonic-to-noise ratio and net speech rate in the sentence tasks. With respect to the vowel task results, increased median values and range of Teager-Kaiser energy operator, increased vowel space area, and significant jitter decrease were observed after the left SM1 stimulation. rTMS over the left DLPFC did not induce any significant effects. The positive results of acoustic analysis were not reflected in a subjective rating of speech performance quality as assessed by a speech therapist. Our pilot results indicate that one session of rTMS applied over the SM1 may lead to measurable improvement in voice quality and intensity and an increase in speech rate and tongue movements

  2. Should We Expand the Toolbox of Psychiatric Treatment Methods to Include Repetitive Transcranial Magnetic Stimulation (rTMS)? A Meta-Analysis of the Efficacy of rTMS in Psychiatric Disorders

    NARCIS (Netherlands)

    Slotema, Christina W.; Blom, Jan Dirk; Hoek, Hans W.; Sommer, Iris E. C.

    2010-01-01

    Objective: Repetitive transcranial magnetic stimulation (rTMS) is a safe treatment method with few side effects However, efficacy for various psychiatric disorders is currently not clear Data sources: A literature search was performed from 1966 through October 2008 using PubMed, Ovid Medline, Embase

  3. Successful Treatment of Phantom Limb Pain by 1 Hz Repetitive Transcranial Magnetic Stimulation Over Affected Supplementary Motor Complex: A Case Report

    Science.gov (United States)

    Lee, Jong-Hoo; Byun, Jeong-Hyun; Choe, Yu-Ri; Lim, Seung-Kyu; Lee, Ka-Young

    2015-01-01

    A 37-year-old man with a right transfemoral amputation suffered from severe phantom limb pain (PLP). After targeting the affected supplementary motor complex (SMC) or primary motor cortex (PMC) using a neuro-navigation system with 800 stimuli of 1 Hz repetitive transcranial magnetic stimulation (rTMS) at 85% of resting motor threshold, the 1 Hz rTMS over SMC dramatically reduced his visual analog scale (VAS) of PLP from 7 to 0. However, the 1 Hz rTMS over PMC failed to reduce pain. To our knowledge, this is the first case report of a successfully treated severe PLP with a low frequency rTMS over SMC in affected hemisphere. PMID:26361601

  4. QEEG Theta Cordance in the Prediction of Treatment Outcome to Prefrontal Repetitive Transcranial Magnetic Stimulation or Venlafaxine ER in Patients With Major Depressive Disorder.

    Science.gov (United States)

    Bares, Martin; Brunovsky, Martin; Novak, Tomas; Kopecek, Miloslav; Stopkova, Pavla; Sos, Peter; Höschl, Cyril

    2015-04-01

    The aims of this double-blind study were to assess and compare the efficacy of quantitative electroencephalographic (QEEG) prefrontal theta band cordance in the prediction of response to 4-week, right, prefrontal, 1-Hz repetitive transcranial magnetic stimulation (rTMS) or venlafaxine ER in patients with major depressive disorder (MDD). Prefrontal QEEG cordance values of 50 inpatients (25 subjects in each group) completing 4 weeks of the study were obtained at baseline and after 1 week of treatment. Depressive symptoms were assessed using Montgomery-Åsberg Depression Rating Scale (MADRS) at baseline and at week 1 and 4. Treatment response was defined as a ≥50% reduction in baseline MADRS total score. All responders (n = 9) and 6 of 16 nonresponders in the rTMS group had reduced cordance at week 1 (P treatment, with comparable predictive efficacy for both therapeutic interventions. © EEG and Clinical Neuroscience Society (ECNS) 2014.

  5. Repetitive transcranial magnetic stimulation inhibits Sirt1/MAO-A signaling in the prefrontal cortex in a rat model of depression and cortex-derived astrocytes.

    Science.gov (United States)

    Peng, Zheng-Wu; Xue, Fen; Zhou, Cui-Hong; Zhang, Rui-Guo; Wang, Ying; Liu, Ling; Sang, Han-Fei; Wang, Hua-Ning; Tan, Qing-Rong

    2017-09-25

    Repetitive transcranial magnetic stimulation (rTMS) is a useful monotherapy for depression or adjunctive therapy for resistant depression. However, the anti-depressive effects of different parameters and the underlying mechanisms remain unclear. Here, we aimed to assess the effect of rTMS with different parameters (1/5/10 Hz, 0.84/1.26 T) on the depressive-like behaviors, 5-hydroxytryptamine (5-HT), 5-HIAA (5-hydroxyindoleacetic acid) and DA and NE levels, and monoamine oxidase A (MAO-A) activity in chronic unpredictable stress-treated rats, along with the expression of sirtuin 1 (Sirt1) and MAO-A in the prefrontal cortex (PFC) and cortex-derived astrocytes from new-born rats. Moreover, the depressive-like behaviors were monitored following the transcranial injection of the Sirt1 inhibitor EX527 (1 mM) daily for 1 week. We found that rTMS treatment (5/10 Hz, 0.84/1.26 T) ameliorated depressive-like behaviors, increased 5-HT, DA and NE levels, decreased the 5-HIAA level and Sirt1 and MAO-A expression, and reduced MAO-A activity in the PFC. The depressive-like behaviors were also ameliorated after the transcranial injection of EX527. Importantly, rTMS (5/10 Hz, 0.84/1.26 T) inhibited Sirt1 and MAO-A expressions in astrocytes and Sirt1 knockdown with short hairpin RNA decreased MAO-A expression in astrocytes. These results suggest that the inhibition of Sirt1/MAO-A expression in astrocytes in the PFC may contribute to the different anti-depressive effects of rTMS with different parameters, and may also provide a novel insight into the mechanisms underlying major depressive disorder.

  6. The efficacy of cerebellar vermal deep high frequency (theta range) repetitive transcranial magnetic stimulation (rTMS) in schizophrenia: A randomized rater blind-sham controlled study.

    Science.gov (United States)

    Garg, Shobit; Sinha, Vinod Kumar; Tikka, Sai Krishna; Mishra, Preeti; Goyal, Nishant

    2016-09-30

    Repetitive transcranial magnetic stimulation (rTMS) is a promising therapeutic for schizophrenia. Treatment effects of rTMS have been variable across different symptom clusters, with negative symptoms showing better response, followed by auditory hallucinations. Cerebellum, especially vermis and its abnormalities (both structural and functional) have been implicated in cognitive, affective and positive symptoms of schizophrenia. rTMS to this alternate site has been suggested as a novel target for treating patients with this disorder. Hypothesizing cerebellar vermal magnetic stimulation as an adjunct to treat schizophrenia psychopathology, we conducted a double blind randomized sham controlled rTMS study. In this study, forty patients were randomly allocated (using block randomization method) to active high frequency (theta patterned) rTMS (n=20) and sham (n=20) groups. They received 10 sessions over 2 weeks. The Positive and Negative Syndrome Scale (PANSS) and Calgary Depression Scale for Schizophrenia (CDSS) scores were assessed at baseline, after last session and at 4 weeks (2 weeks post-rTMS). We found a significantly greater improvement in the group receiving active rTMS sessions, compared to the sham group on negative symptoms, and depressive symptoms. We conclude that cerebellar stimulation can be used as an effective adjunct to treat negative and affective symptoms.

  7. Shaped magnetic field pulses by multi-coil repetitive transcranial magnetic stimulation (rTMS) differentially modulate anterior cingulate cortex responses and pain in volunteers and fibromyalgia patients

    Science.gov (United States)

    2013-01-01

    Background Repetitive transcranial magnetic stimulation (rTMS) has shown promise in the alleviation of acute and chronic pain by altering the activity of cortical areas involved in pain sensation. However, current single-coil rTMS technology only allows for effects in surface cortical structures. The ability to affect activity in certain deep brain structures may however, allow for a better efficacy, safety, and tolerability. This study used PET imaging to determine whether a novel multi-coil rTMS would allow for preferential targeting of the dorsal anterior cingulate cortex (dACC), an area always activated with pain, and to provide preliminary evidence as to whether this targeted approach would allow for efficacious, safe, and tolerable analgesia both in a volunteer/acute pain model as well as in fibromyalgia chronic pain patients. Methods Part 1: Different coil configurations were tested in a placebo-controlled crossover design in volunteers (N = 16). Tonic pain was induced using a capsaicin/thermal pain model and functional brain imaging was performed by means of H215O positron emission tomography – computed tomography (PET/CT) scans. Differences in NRS pain ratings between TMS and sham treatment (NRSTMS-NRSplacebo) which were recorded each minute during the 10 minute PET scans. Part 2: 16 fibromyalgia patients were subjected to 20 multi-coil rTMS treatments over 4 weeks and effects on standard pain scales (Brief Pain Inventory, item 5, i.e. average pain NRS over the last 24 hours) were recorded. Results A single 30 minute session using one of 3 tested rTMS coil configurations operated at 1 Hz consistently produced robust reduction (mean 70% on NRS scale) in evoked pain in volunteers. In fibromyalgia patients, the 20 rTMS sessions also produced a significant pain inhibition (43% reduction in NRS pain over last 24 hours), but only when operated at 10 Hz. This degree of pain control was maintained for at least 4 weeks after the final session

  8. A comparison of the effects of repetitive transcranial magnetic stimulation (rTMS) by number of stimulation sessions on hemispatial neglect in chronic stroke patients.

    Science.gov (United States)

    Kim, Yong Kyun; Jung, Jae Hwan; Shin, Sung Hun

    2015-01-01

    We investigated the effect of repetitive transcranial magnetic stimulation (rTMS) applied either during one session of stimulation, or by ten sessions of low-frequency stimulation over the left parietal cortex, on hemispatial neglect in stroke patients. We enrolled 34 subjects that had experienced a stroke. All subjects received 1,200 real rTMS over the left parietal cortex at an intensity of 90% of motor thresholds with 1 Hz. Subjects were divided into two groups. One group of subjects (n = 19) received real rTMS over the left parietal cortex in a single session of stimulation, and the other group (n = 15), underwent a total of ten sessions of daily stimulations for 2 weeks. Letter cancelation test, line bisection test, and Ota's task were administered to compare the effects of different rTMS protocols, before and after rTMS. The results showed no difference in baseline value between the single session group and the ten sessions group. Total ten sessions of low-frequency rTMS over the left parietal cortex, compared with the single session of rTMS, significantly improved hemispatial neglect in letter cancelation, line bisection, and Ota's task (P rTMS can be used in treatment by rTMS for patients suffering from hemispatial neglect after stroke.

  9. Repetitive transcranial magnetic stimulation (rTMS) for the treatment of depression in Parkinson disease: a meta-analysis of randomized controlled clinical trials.

    Science.gov (United States)

    Xie, Cheng-Long; Chen, Jie; Wang, Xiao-Dan; Pan, Jia-Lin; Zhou, Yi; Lin, Shi-Yi; Xue, Xiao-Dong; Wang, Wen-Wen

    2015-10-01

    The objective of this meta-analysis was to evaluate the effects of repetitive transcranial magnetic stimulation (rTMS) for the treatment of depression in patients with Parkinson disease in order to arrive at qualitative and quantitative conclusions about the efficacy of rTMS. We included randomized controlled trials examining the effects of rTMS compared with sham-rTMS or selective serotonin re-uptake inhibitors (SSRIs). The quality of included studies was strictly evaluated. Data analyses were performed using the RevMan5.1 software. Eight studies including 312 patients met all inclusion criteria. The results showed that rTMS could evidently improve the HRSD score compared with sham-rTMS (p rTMS and SSRIs groups in terms of HRSD and BDI score (p = 0.65; p = 0.75, respectively). Furthermore, patients who received rTMS could evidently show improvement on the unified Parkinson's disease rating scale (UPDRS), ADL score, and UPDRS motor score compared with sham-rTMS or SSRIs (p rTMS evidenced that the efficacy of low-frequency rTMS was superior to sham-rTMS (p rTMS has the same antidepressant efficacy as SSRIs (p = 0.94). The current meta-analysis provided evidence that rTMS was superior to sham-rTMS and had similar antidepressant efficacy as SSRIs, and may have the additional advantage of some improvement in motor function.

  10. Benefits of Repetitive Transcranial Magnetic Stimulation (rTMS) for Spastic Subjects: Clinical, Functional, and Biomechanical Parameters for Lower Limb and Walking in Five Hemiparetic Patients

    Science.gov (United States)

    Gross, Raphael; Leboeuf, Fabien; Desal, Hubert; Hamel, Olivier; Nguyen, Jean Paul; Pérot, Chantal; Buffenoir, Kévin

    2014-01-01

    Introduction. Spasticity is a disabling symptom resulting from reorganization of spinal reflexes no longer inhibited by supraspinal control. Several studies have demonstrated interest in repetitive transcranial magnetic stimulation in spastic patients. We conducted a prospective, randomized, double-blind crossover study on five spastic hemiparetic patients to determine whether this type of stimulation of the premotor cortex can provide a clinical benefit. Material and Methods. Two stimulation frequencies (1 Hz and 10 Hz) were tested versus placebo. Patients were assessed clinically, by quantitative analysis of walking and measurement of neuromechanical parameters (H and T reflexes, musculoarticular stiffness of the ankle). Results. No change was observed after placebo and 10 Hz protocols. Clinical parameters were not significantly modified after 1 Hz stimulation, apart from a tendency towards improved recruitment of antagonist muscles on the Fügl-Meyer scale. Only cadence and recurvatum were significantly modified on quantitative analysis of walking. Neuromechanical parameters were modified with significant decreases in Hmax⁡ /Mmax⁡ and T/Mmax⁡ ratios and stiffness indices 9 days or 31 days after initiation of TMS. Conclusion. This preliminary study supports the efficacy of low-frequency TMS to reduce reflex excitability and stiffness of ankle plantar flexors, while clinical signs of spasticity were not significantly modified. PMID:24883390

  11. Mechanism of functional recovery after repetitive transcranial magnetic stimulation (rTMS) in the subacute cerebral ischemic rat model: neural plasticity or anti-apoptosis?

    Science.gov (United States)

    Yoon, Kyung Jae; Lee, Yong-Taek; Han, Tai Ryoon

    2011-10-01

    Repetitive transcranial magnetic stimulation (rTMS) has been studied increasingly in recent years to determine whether it has a therapeutic benefit on recovery after stroke. However, the underlying mechanisms of rTMS in stroke recovery remain unclear. Here, we evaluated the effect of rTMS on functional recovery and its underlying mechanism by assessing proteins associated with neural plasticity and anti-apoptosis in the peri-lesional area using a subacute cerebral ischemic rat model. Twenty cerebral ischemic rats were randomly assigned to the rTMS or the sham group at post-op day 4. A total of 3,500 impulses with 10 Hz frequency were applied to ipsilesional cortex over a 2-week period. Functional outcome was measured before (post-op day 4) and after rTMS (post-op day 18). The rTMS group showed more functional improvement on the beam balance test and had stronger Bcl-2 and weaker Bax expression on immunohistochemistry compared with the sham group. The expression of NMDA and MAP-2 showed no significant difference between the two groups. These results suggest that rTMS in subacute cerebral ischemia has a therapeutic effect on functional recovery and is associated with an anti-apoptotic mechanism in the peri-ischemic area rather than with neural plasticity.

  12. Self-harm and suicidal acts: a suitable case for treatment of impulsivity-driven behaviour with repetitive transcranial magnetic stimulation (rTMS)

    Science.gov (United States)

    Shergill, Sukhwinder S.; David, Anthony S.; Fonagy, Peter; Zaman, Rashid; Downar, Jonathan; Eliott, Emma; Bhui, Kamaldeep

    2015-01-01

    Summary Suicidal thinking, self-harm and suicidal acts are common, although determining their precise prevalence is complex. Epidemiological work has identified a number of associated demographic and clinical factors, though, with the exception of past acts of self-harm, these are non-specific and weak future predictors. There is a critical need shift focus from managing ‘suicidality-by-proxy’ through general mental health treatments, to better understand the neuropsychology and neurophysiology of such behaviour to guide targeted interventions. The model of the cognitive control of emotion (MCCE) offers such a paradigm, with an underlying pan-diagnostic pathophysiology of a hypoactive prefrontal cortex failing to suitably inhibit an overactive threat-responding limbic system. The result is a phenotype – from any number of causative gene–environment interactions – primed to impulsively self-harm. We argue that such neural dysconnectivity is open to potential therapeutic modification from repetitive transcranial magnetic stimulation (rTMS). The current evidence base for this is undoubtedly extremely limited, but the societal and clinical burden self-harm and suicide pose warrants such investigation. Declaration of interest K.B. is the Editor of BJPsych Open, but had no editorial involvement in the review or decision process regarding this paper. Copyright and usage © The Royal College of Psychiatrists 2015. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence. PMID:27703728

  13. High-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) Improves Functional Recovery by Enhancing Neurogenesis and Activating BDNF/TrkB Signaling in Ischemic Rats.

    Science.gov (United States)

    Luo, Jing; Zheng, Haiqing; Zhang, Liying; Zhang, Qingjie; Li, Lili; Pei, Zhong; Hu, Xiquan

    2017-02-20

    Repetitive transcranial magnetic stimulation (rTMS) has rapidly become an attractive therapeutic approach for stroke. However, the mechanisms underlying this remain elusive. This study aimed to investigate whether high-frequency rTMS improves functional recovery mediated by enhanced neurogenesis and activation of brain-derived neurotrophic factor (BDNF)/tropomyosin-related kinase B (TrkB) pathway and to compare the effect of conventional 20 Hz rTMS and intermittent theta burst stimulation (iTBS) on ischemic rats. Rats after rTMS were sacrificed seven and 14 days after middle cerebral artery occlusion (MCAO), following evaluation of neurological function. Neurogenesis was measured using specific markers: Ki67, Nestin, doublecortin (DCX), NeuN and glial fibrillary acidic protein (GFAP), and the expression levels of BDNF were visualized by Western blotting and RT-PCR analysis. Both high-frequency rTMS methods significantly improved neurological function and reduced infarct volume. Moreover, 20 Hz rTMS and iTBS significantly promoted neurogenesis, shown by an increase of Ki67/DCX, Ki67/Nestin, and Ki67/NeuN-positive cells in the peri-infarct striatum. These beneficial effects were accompanied by elevated protein levels of BDNF and phosphorylated-TrkB. In conclusion, high-frequency rTMS improves functional recovery possibly by enhancing neurogenesis and activating BDNF/TrkB signaling pathway and conventional 20 Hz rTMS is better than iTBS at enhancing neurogenesis in ischemic rats.

  14. High-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS Improves Functional Recovery by Enhancing Neurogenesis and Activating BDNF/TrkB Signaling in Ischemic Rats

    Directory of Open Access Journals (Sweden)

    Jing Luo

    2017-02-01

    Full Text Available Repetitive transcranial magnetic stimulation (rTMS has rapidly become an attractive therapeutic approach for stroke. However, the mechanisms underlying this remain elusive. This study aimed to investigate whether high-frequency rTMS improves functional recovery mediated by enhanced neurogenesis and activation of brain-derived neurotrophic factor (BDNF/tropomyosin-related kinase B (TrkB pathway and to compare the effect of conventional 20 Hz rTMS and intermittent theta burst stimulation (iTBS on ischemic rats. Rats after rTMS were sacrificed seven and 14 days after middle cerebral artery occlusion (MCAO, following evaluation of neurological function. Neurogenesis was measured using specific markers: Ki67, Nestin, doublecortin (DCX, NeuN and glial fibrillary acidic protein (GFAP, and the expression levels of BDNF were visualized by Western blotting and RT-PCR analysis. Both high-frequency rTMS methods significantly improved neurological function and reduced infarct volume. Moreover, 20 Hz rTMS and iTBS significantly promoted neurogenesis, shown by an increase of Ki67/DCX, Ki67/Nestin, and Ki67/NeuN-positive cells in the peri-infarct striatum. These beneficial effects were accompanied by elevated protein levels of BDNF and phosphorylated-TrkB. In conclusion, high-frequency rTMS improves functional recovery possibly by enhancing neurogenesis and activating BDNF/TrkB signaling pathway and conventional 20 Hz rTMS is better than iTBS at enhancing neurogenesis in ischemic rats.

  15. Bilateral repetitive transcranial magnetic stimulation for treatment-resistant depression: a systematic review and meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Y.Q. Zhang

    2015-03-01

    Full Text Available There has been concern regarding the use of controversial paradigms for repetitive transcranial magnetic stimulation (rTMS to manage treatment-resistant depression (TRD. This meta-analysis assessed the efficacy of bilateral rTMS compared with unilateral and sham rTMS in patients with TRD. PubMed, Embase, CENTRAL, PsycINFO, Web of Science, EAGLE and NTIS databases were searched to identify relevant studies, and randomized controlled trials (RCTs on bilateral rTMS for TRD patients were included. The response was defined as the primary outcome, and remission was the secondary outcome. Ten RCTs that included 634 patients met the eligibility criteria. The risk ratio (RRs of both the primary and secondary outcomes of bilateral rTMS showed non-significant increases compared to unilateral rTMS (RR=1.01, P=0.93; odds ratio [OR]=0.77, P=0.22. Notably, the RR of the primary bilateral rTMS outcome was significantly increased compared to that for sham rTMS (RR=3.43, P=0.0004. The results of our analysis demonstrated that bilateral rTMS was significantly more effective than sham rTMS but not unilateral rTMS in patients with TRD. Thus, bilateral rTMS may not be a useful paradigm for patients with TRD.

  16. Unanticipated rapid remission of refractory bulimia nervosa, during high-dose repetitive transcranial magnetic stimulation of the dorsomedial prefrontal cortex: a case report

    Directory of Open Access Journals (Sweden)

    Jonathan eDownar

    2012-04-01

    Full Text Available A woman with severe, refractory bulimia nervosa underwent treatment for comorbid depression using repetitive transcranial magnetic stimulation (rTMS of the dorsomedial prefrontal cortex (DMPFC using a novel technique. Unexpectedly, she showed a rapid, dramatic remission from bulimia nervosa. For 5 months pre-treatment, she had reported two 5-hour binge-purge episodes per day. After rTMS session 2 the episodes stopped entirely for 1 week; after session 10 there were no further recurrences. Depression scores improved more gradually to remission at session 10. Full remission from depression and binge-eating/purging episodes was sustained more than 2 months after treatment completion. In neuroimaging studies, the DMPFC is important in impulse control, and is underactive in bulimia nervosa. DMPFC-rTMS may have enhanced the patient’s ability to deploy previously acquired strategies to avoid binge-eating and purging via a reduction in her impulsivity. A larger sham-controlled trial of DMPFC-rTMS for binge-eating and purging behavior may be warranted.

  17. The Role of the Right Dorsolateral Prefrontal Cortex in Phasic Alertness: Evidence from a Contingent Negative Variation and Repetitive Transcranial Magnetic Stimulation Study

    Directory of Open Access Journals (Sweden)

    Daniela Mannarelli

    2015-01-01

    Full Text Available Phasic alertness represents the ability to increase response readiness to a target following an external warning stimulus. Specific networks in the frontal and parietal regions appear to be involved in the alert state. In this study, we examined the role of the right dorsolateral prefrontal cortex (DLPFC during the attentional processing of a stimulus using a cued double-choice reaction time task. The evaluation of these processes was conducted by means of Event-Related Potentials (ERPs, in particular by using the Contingent Negative Variation (CNV, and repetitive 1-Hz Transcranial Magnetic Stimulation (rTMS. Transient virtual inhibition of the right DLPFC induced by real 1-Hz rTMS stimulation led to a significant decrease in total CNV and W1-CNV areas if compared with the basal and post-sham rTMS conditions. Reaction times (RTs did not decrease after inhibitory rTMS, but they did improve after sham stimulation. These results suggest that the right DLPFC plays a crucial role in the genesis and maintenance of the alerting state and learning processes.

  18. Safety of primed repetitive transcranial magnetic stimulation and modified constraint-induced movement therapy in a randomized controlled trial in pediatric hemiparesis.

    Science.gov (United States)

    Gillick, Bernadette T; Krach, Linda E; Feyma, Tim; Rich, Tonya L; Moberg, Kelli; Menk, Jeremiah; Cassidy, Jessica; Kimberley, Teresa; Carey, James R

    2015-04-01

    To investigate the safety of combining a 6-Hz primed low-frequency repetitive transcranial magnetic stimulation (rTMS) intervention in the contralesional hemisphere with a modified constraint-induced movement therapy (mCIMT) program in children with congenital hemiparesis. Phase 1 randomized, double-blinded, placebo-controlled pretest/posttest trial. University academic facility and pediatric specialty hospital. Subjects (N = 19; age range, 8-17 y) with congenital hemiparesis caused by ischemic stroke or periventricular leukomalacia. No subject withdrew because of adverse events. All subjects included completed the study. Subjects were randomized to 1 of 2 groups: either real rTMS plus mCIMT (n = 10) or sham rTMS plus mCIMT (n = 9). Adverse events, physician assessment, ipsilateral hand function, stereognosis, cognitive function, subject report of symptoms assessment, and subject questionnaire. No major adverse events occurred. Minor adverse events were found in both groups. The most common events were headaches (real: 50%, sham: 89%; P = .14) and cast irritation (real: 30%, sham: 44%; P = .65). No differences between groups in secondary cognitive and unaffected hand motor measures were found. Primed rTMS can be used safely with mCIMT in congenital hemiparesis. We provide new information on the use of rTMS in combination with mCIMT in children. These findings could be useful in research and future clinical applications in advancing function in congenital hemiparesis. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. Effect of low frequency repetitive transcranial magnetic stimulation on kindling-induced changes in electrophysiological properties of rat CA1 pyramidal neurons.

    Science.gov (United States)

    Moradi Chameh, Homeira; Janahmadi, Mahyar; Semnanian, Saeed; Shojaei, Amir; Mirnajafi-Zadeh, Javad

    2015-05-01

    In this study, the effect of repetitive transcranial magnetic stimulation (rTMS) on the kindling induced changes in electrophysiological firing properties of hippocampal CA1 pyramidal neurons was investigated. Male Wistar rats were kindled by daily electrical stimulation of the basolateral amygdala in a semi-rapid manner (12 stimulations/day) until they achieved stage-5 seizure. One group (kindled+rTMS (KrTMS)) of animals received rTMS (240 pulses at 1 Hz) at 5 min after termination of daily kindling stimulations. Twenty-four hours following the last kindling stimulation electrophysiological properties of hippocampal CA1 pyramidal neurons were investigated using a whole-cell patch clamp technique, under current clamp condition. Amygdala kindling significantly decreased the adaptation index, post-afterhyperpolarization, rheobase current, utilization time, and delay to the first rebound spike. It also caused an increase in the voltage sag, number of rebound spikes and number of evoked action potential. Results of the present study revealed that application of rTMS following kindling stimulations had antiepileptogenic effects. In addition, application of rTMS prevented hyperexcitability of CA1 pyramidal neurons induced by kindling and conserved the normal neuronal firing.

  20. High-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) Improves Functional Recovery by Enhancing Neurogenesis and Activating BDNF/TrkB Signaling in Ischemic Rats

    Science.gov (United States)

    Luo, Jing; Zheng, Haiqing; Zhang, Liying; Zhang, Qingjie; Li, Lili; Pei, Zhong; Hu, Xiquan

    2017-01-01

    Repetitive transcranial magnetic stimulation (rTMS) has rapidly become an attractive therapeutic approach for stroke. However, the mechanisms underlying this remain elusive. This study aimed to investigate whether high-frequency rTMS improves functional recovery mediated by enhanced neurogenesis and activation of brain-derived neurotrophic factor (BDNF)/tropomyosin-related kinase B (TrkB) pathway and to compare the effect of conventional 20 Hz rTMS and intermittent theta burst stimulation (iTBS) on ischemic rats. Rats after rTMS were sacrificed seven and 14 days after middle cerebral artery occlusion (MCAO), following evaluation of neurological function. Neurogenesis was measured using specific markers: Ki67, Nestin, doublecortin (DCX), NeuN and glial fibrillary acidic protein (GFAP), and the expression levels of BDNF were visualized by Western blotting and RT-PCR analysis. Both high-frequency rTMS methods significantly improved neurological function and reduced infarct volume. Moreover, 20 Hz rTMS and iTBS significantly promoted neurogenesis, shown by an increase of Ki67/DCX, Ki67/Nestin, and Ki67/NeuN-positive cells in the peri-infarct striatum. These beneficial effects were accompanied by elevated protein levels of BDNF and phosphorylated-TrkB. In conclusion, high-frequency rTMS improves functional recovery possibly by enhancing neurogenesis and activating BDNF/TrkB signaling pathway and conventional 20 Hz rTMS is better than iTBS at enhancing neurogenesis in ischemic rats. PMID:28230741

  1. The clinical utility of repetitive transcranial magnetic stimulation in reducing the risks of transitioning from acute to chronic pain in traumatically injured patients.

    Science.gov (United States)

    Jodoin, Marianne; Rouleau, Dominique; Larson-Dupuis, Camille; Gosselin, Nadia; De Beaumont, Louis

    2017-07-08

    Pain is a multifaceted condition and a major ongoing challenge for healthcare professionals having to treat patients in whom pain put them at risk of developing other conditions. Significant efforts have been invested in both clinical and research settings in an attempt to demystify the mechanisms at stake and develop optimal treatments as well as to reduce individual and societal costs. It is now universally accepted that neuroinflammation and central sensitization are two key underlying factors causing pain chronification as they result from maladaptive central nervous system plasticity. Recent research has shown that the mechanisms of action of repetitive transcranial magnetic stimulation (rTMS) make it a particularly promising avenue in treating various pain conditions. This review will first discuss the contribution of neuroinflammation and central sensitization in the transition from acute to chronic pain in traumatically injured patients. A detailed discussion on how rTMS may allow the restoration from maladaptive plasticity in addition to breaking down the chain of events leading to pain chronification will follow. Lastly, this review will provide a theoretical framework of what might constitute optimal rTMS modalities in dealing with pain symptoms in traumatically injured patients based on an integrated perspective of the physiopathological mechanisms underlying pain. Copyright © 2017. Published by Elsevier Inc.

  2. Effect of single-session repetitive transcranial magnetic stimulation applied over the hand versus leg motor area on pain after spinal cord injury.

    Science.gov (United States)

    Jetté, Fanny; Côté, Isabelle; Meziane, Hadj Boumediene; Mercier, Catherine

    2013-09-01

    Neuropathic pain often follows spinal cord injury (SCI). To compare the effect of repetitive transcranial magnetic stimulation (rTMS) applied over different motor cortex targets (hand vs leg area) versus sham stimulation on neuropathic pain and local neurophysiological changes in patients with SCI. A total of 16 patients with complete or incomplete motor SCI and chronic neuropathic pain participated in a double-blind, cross-over randomized study. Three single sessions of sham or active rTMS (10 Hz, total of 2000 stimuli) were applied in random order over the hand or leg area with a minimal 2-week interval. THE MAIN OUTCOME MEASURES: were the numeric rating scale for pain sensation and parameters derived from motor mapping of the first dorsal interosseous muscle, including maximal amplitude of evoked response as well as map area, volume, and location. rTMS applied to either the hand or the leg area, but not sham stimulation, induced a significant but equivalent reduction in pain for the first 48 hours postintervention (P stimulation of the hand area (P = .04) but not for the other conditions. rTMS applied over the hand or leg motor cortex decreased neuropathic pain regardless of any change in cortical excitability, suggesting that the analgesic effect is not associated with local changes at the motor cortex level itself.

  3. Benefits of Repetitive Transcranial Magnetic Stimulation (rTMS for Spastic Subjects: Clinical, Functional, and Biomechanical Parameters for Lower Limb and Walking in Five Hemiparetic Patients

    Directory of Open Access Journals (Sweden)

    Luc Terreaux

    2014-01-01

    Full Text Available Introduction. Spasticity is a disabling symptom resulting from reorganization of spinal reflexes no longer inhibited by supraspinal control. Several studies have demonstrated interest in repetitive transcranial magnetic stimulation in spastic patients. We conducted a prospective, randomized, double-blind crossover study on five spastic hemiparetic patients to determine whether this type of stimulation of the premotor cortex can provide a clinical benefit. Material and Methods. Two stimulation frequencies (1 Hz and 10 Hz were tested versus placebo. Patients were assessed clinically, by quantitative analysis of walking and measurement of neuromechanical parameters (H and T reflexes, musculoarticular stiffness of the ankle. Results. No change was observed after placebo and 10 Hz protocols. Clinical parameters were not significantly modified after 1 Hz stimulation, apart from a tendency towards improved recruitment of antagonist muscles on the Fügl-Meyer scale. Only cadence and recurvatum were significantly modified on quantitative analysis of walking. Neuromechanical parameters were modified with significant decreases in Hmax⁡ /Mmax⁡ and T/Mmax⁡ ratios and stiffness indices 9 days or 31 days after initiation of TMS. Conclusion. This preliminary study supports the efficacy of low-frequency TMS to reduce reflex excitability and stiffness of ankle plantar flexors, while clinical signs of spasticity were not significantly modified.

  4. Does a combined intervention program of repetitive transcranial magnetic stimulation and intensive occupational therapy affect cognitive function in patients with post-stroke upper limb hemiparesis?

    Science.gov (United States)

    Hara, Takatoshi; Abo, Masahiro; Kakita, Kiyohito; Masuda, Takeshi; Yamazaki, Ryunosuke

    2016-12-01

    Low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) to the contralesional hemisphere and intensive occupational therapy (iOT) have been shown to contribute to a significant improvement in upper limb hemiparesis in patients with chronic stroke. However, the effect of the combined intervention program of LF-rTMS and iOT on cognitive function is unknown. We retrospectively investigated whether the combined treatment influence patient's Trail-Making Test part B (TMT-B) performance, which is a group of easy and inexpensive neuropsychological tests that evaluate several cognitive functions. Twenty-five patients received 11 sessions of LF-rTMS to the contralesional hemisphere and 2 sessions of iOT per day over 15 successive days. Patients with right- and left-sided hemiparesis demonstrated significant improvements in upper limb motor function following the combined intervention program. Only patients with right-sided hemiparesis exhibited improved TMT-B performance following the combined intervention program, and there was a significant negative correlation between Fugl-Meyer Assessment scale total score change and TMT-B performance. The results indicate the possibility that LF-rTMS to the contralesional hemisphere combined with iOT improves the upper limb motor function and cognitive function of patients with right-sided hemiparesis. However, further studies are necessary to elucidate the mechanism of improved cognitive function.

  5. Does Therapeutic Repetitive Transcranial Magnetic Stimulation Cause Cognitive Enhancing Effects in Patients with Neuropsychiatric Conditions? A Systematic Review and Meta-Analysis of Randomised Controlled Trials.

    Science.gov (United States)

    Martin, Donel M; McClintock, Shawn M; Forster, Jane; Loo, Colleen K

    2016-09-01

    Repetitive transcranial magnetic stimulation (rTMS) is increasingly used as a therapeutic intervention for neuropsychiatric illnesses and has demonstrated efficacy for treatment of major depression. However, an unresolved question is whether a course of rTMS treatment results in effects on cognitive functioning. In this systematic review and meta-analysis we aimed to quantitatively determine whether a course of rTMS has cognitive enhancing effects. We examined cognitive outcomes from randomised, sham-controlled studies conducted in patients with neuropsychiatric conditions where rTMS was administered to the dorsolateral prefrontal cortex (DLPFC) across repeated sessions, searched from PubMed/MEDLINE and other databases up until October 2015. Thirty studies met our inclusion criteria. Cognitive outcomes were pooled and examined across the following domains: Global cognitive function, executive function, attention, working memory, processing speed, visual memory, verbal memory and visuospatial ability. Active rTMS treatment was unassociated with generalised gains across the majority of domains of cognitive functioning examined. Secondary analyses revealed a moderate sized positive effect for improved working memory in a small number of studies in patients with schizophrenia (k = 3, g = 0.507, 95 % CI = [0.183-0.831], p cognitive enhancing effects.

  6. Repetitive transcranial magnetic stimulation enhances spatial learning and synaptic plasticity via the VEGF and BDNF-NMDAR pathways in a rat model of vascular dementia.

    Science.gov (United States)

    Zhang, N; Xing, M; Wang, Y; Tao, H; Cheng, Y

    2015-12-17

    This study aimed to evaluate the effects of repetitive transcranial magnetic stimulation (rTMS) on learning and memory in a rat model of vascular dementia (VaD) and to analyze the associated mechanisms. Bilateral carotid artery occlusion (2-VO) was used to establish a rat model of VaD. High-frequency (5Hz) rTMS was performed on rats for four weeks. Spatial learning and memory abilities were evaluated using the Morris water maze (MWM), and synaptic plasticity in the hippocampus was assessed via long-term potentiation (LTP). Hippocampal expression of vascular endothelial growth factor (VEGF), brain-derived neurotrophic factor (BDNF) and three subunits of the N-methyl-D-aspartic acid receptor (NMDAR), NR1, NR2A and NR2B, was analyzed by Western blotting. Compared with the VaD group, escape latency was decreased (PCA3-CA1 synapses was enhanced by rTMS (PBDNF, NR1 and NR2B expression was decreased in the VaD group and increased by rTMS (PBDNF and NMDARs. In addition, NR2B may be more important than NR2A for LTP induction in the hippocampus during rTMS treatment of VaD.

  7. Effect of the stimulus frequency and pulse number of repetitive transcranial magnetic stimulation on the inter-reversal time of perceptual reversal on the right superior parietal lobule

    Science.gov (United States)

    Nojima, Kazuhisa; Ge, Sheng; Katayama, Yoshinori; Ueno, Shoogo; Iramina, Keiji

    2010-05-01

    The aim of this study is to investigate the effect of the stimulus frequency and pulses number of repetitive transcranial magnetic stimulation (rTMS) on the inter-reversal time (IRT) of perceptual reversal on the right superior parietal lobule (SPL). The spinning wheel illusion was used as the ambiguous figures stimulation in this study. To investigate the rTMS effect over the right SPL during perceptual reversal, 0.25 Hz 60 pulse, 1 Hz 60 pulse, 0.5 Hz 120 pulse, 1 Hz 120 pulse, and 1 Hz 240 pulse biphasic rTMS at 90% of resting motor threshold was applied over the right SPL and the right posterior temporal lobe (PTL), respectively. As a control, a no TMS was also conducted. It was found that rTMS on 0.25 Hz 60 pulse and 1 Hz 60 pulse applied over the right SPL caused shorter IRT. In contrast, it was found that rTMS on 1 Hz 240-pulse applied over the right SPL caused longer IRT. On the other hand, there is no significant difference between IRTs when the rTMS on 0.5 Hz 120 pulse and 1 Hz 120 pulse were applied over the right SPL. Therefore, the applying of rTMS over the right SPL suggests that the IRT of perceptual reversal is effected by the rTMS conditions such as the stimulus frequency and the number of pulses.

  8. Effect of inter-train interval on the induction of repetition suppression of motor-evoked potentials using transcranial magnetic stimulation.

    Science.gov (United States)

    Pitkänen, Minna; Kallioniemi, Elisa; Julkunen, Petro

    2017-01-01

    Repetition suppression (RS) is evident as a weakened response to repeated stimuli after the initial response. RS has been demonstrated in motor-evoked potentials (MEPs) induced with transcranial magnetic stimulation (TMS). Here, we investigated the effect of inter-train interval (ITI) on the induction of RS of MEPs with the attempt to optimize the investigative protocols. Trains of TMS pulses, targeted to the primary motor cortex by neuronavigation, were applied at a stimulation intensity of 120% of the resting motor threshold. The stimulus trains included either four or twenty pulses with an inter-stimulus interval (ISI) of 1 s. The ITI was here defined as the interval between the last pulse in a train and the first pulse in the next train; the ITIs used here were 1, 3, 4, 6, 7, 12, and 17 s. RS was observed with all ITIs except with the ITI of 1 s, in which the ITI was equal to ISI. RS was more pronounced with longer ITIs. Shorter ITIs may not allow sufficient time for a return to baseline. RS may reflect a startle-like response to the first pulse of a train followed by habituation. Longer ITIs may allow more recovery time and in turn demonstrate greater RS. Our results indicate that RS can be studied with confidence at relatively short ITIs of 6 s and above.

  9. Repetitive Transcranial Magnetic Stimulation Changes Cerebral Oxygenation on the Left Dorsolateral Prefrontal Cortex in Bulimia Nervosa: A Near-Infrared Spectroscopy Pilot Study.

    Science.gov (United States)

    Sutoh, Chihiro; Koga, Yasuko; Kimura, Hiroshi; Kanahara, Nobuhisa; Numata, Noriko; Hirano, Yoshiyuki; Matsuzawa, Daisuke; Iyo, Masaomi; Nakazato, Michiko; Shimizu, Eiji

    2016-01-01

    Previous studies showed that food craving in eating disorders can be weakened with high-frequency repetitive transcranial magnetic stimulation (rTMS) on the left dorsolateral prefrontal cortex (DLPFC). The aims of this study were to assess cerebral oxygenation change induced with rTMS and to assess the short-term impact of rTMS on food craving and other bulimic symptoms in patients with bulimia nervosa (BN). Eight women diagnosed with BN according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria participated in this study. We measured haemoglobin concentration changes in the DLPFC with near-infrared spectroscopy during cognitive tasks measuring self-regulatory control in response to food photo stimuli, both at baseline and after a single session of rTMS. Subjective ratings for food cravings demonstrated significant reduction. A significant decrease in cerebral oxygenation of the left DLPFC was also observed after a single session of rTMS. Measurement with NIRS after rTMS intervention may be applicable for discussing the mechanisms underlying rTMS modulation in patients with BN. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

  10. Effects of repetitive transcranial magnetic stimulation of the unaffected hemisphere leg motor area in patients with subacute stroke and substantial leg impairment: A pilot study.

    Science.gov (United States)

    Lin, Yen-Nung; Hu, Chaur-Jong; Chi, Ju-yang; Lin, Li-Fong; Yen, Tze-Hsun; Lin, Yen-Kuang; Liou, Tsan-Hon

    2015-04-01

    To evaluate the effects of repetitive transcranial magnetic stimulation (rTMS) on mobility among patients with substantial leg impairment after subacute stroke. Double-blinded, stratified, randomized trial involving a sham control group. Patients who developed unilateral hemiplegia after first-ever subacute stroke and underwent inpatient stroke rehabilitation. The 15-day intervention programme used in the present study included the application of rTMS (1 Hz, 15 min) over the leg motor area of the unaffected hemisphere, followed by 45 min physical therapy. Overall, 32 participants were randomly assigned to receive either real rTMS or sham stimulation. Clinical assessments, including the Postural Assessment Scale for Stroke Patients (PASS), balance subscale of the Performance Oriented Mobility Assessment (POMA-b), Fugl-Meyer Assessment, Barthel Index (BI), and Timed Up and Go test, were performed immediately before and after the intervention. Both groups demonstrated significant improvements in all the test results over time. At the post-test assessment, the patients in the real rTMS group demonstrated greater improvements in the PASS, POMA, and BI scores than did the patients in the sham rTMS group. In addition, a significantly higher number of patients in the real rTMS group regained mobility at the post-test assessment compared with the corresponding number of patients in the sham rTMS group. Application of 1-Hz rTMS may improve mobility among patients with substantial leg impairment after subacute stroke.

  11. Combination Treatment of Low-Frequency Repetitive Transcranial Magnetic Stimulation and Intensive Occupational Therapy for Ataxic Hemiparesis due to Thalamic Hemorrhage

    Directory of Open Access Journals (Sweden)

    Naoki Urushidani

    2017-07-01

    Full Text Available Background: Both low-frequency repetitive transcranial magnetic stimulation (LF-rTMS and intensive occupational therapy (OT are clinically beneficial for post-stroke patients with upper-limb hemiparesis. However, the usefulness of LF-rTMS and intensive OT for ataxic hemiparesis (AH is unknown. Methods: The study subjects included 7 patients with AH. All patients had ataxia and mild hemiparesis without a sensory disturbance that was due to thalamic hemorrhage. Each patient was scheduled to receive 20-min rTMS at 1 Hz at the contralesional cerebral hemisphere followed by 120-min intensive OT, daily for 21 sessions. The primary outcome was the motor function of the affected upper limb that was evaluated by using the Fugl-Meyer Assessment (FMA. In addition, the International Cooperative Ataxia Rating Scale (ICARS score was determined to assess the severity of ataxia. Results: All patients completed the protocol without any adverse effects. The FMA score significantly increased after treatment. Notably, the ICARS score also significantly decreased. Conclusions: Our proposed combination treatment is a safe and feasible neurorehabilitative intervention for patients with AH due to thalamic hemorrhage. Our results demonstrate the possibility that rTMS in combination with intensive OT could improve motor function and alleviated ataxia in patients with AH.

  12. The use of repetitive transcranial magnetic stimulation for modulating craving and addictive behaviours: a critical literature review of efficacy, technical and methodological considerations.

    Science.gov (United States)

    Grall-Bronnec, M; Sauvaget, A

    2014-11-01

    Repetitive transcranial magnetic stimulation (rTMS) is a potential therapeutic intervention for the treatment of addiction. This critical review aims to summarise the recent developments with respect to the efficacy of rTMS for all types of addiction and related disorders (including eating disorders), and concentrates on the associated methodological and technical issues. The bibliographic search consisted of a computerised screening of the Medline and ScienceDirect databases up to December 2013. Criteria for inclusion were the target problem was an addiction, a related disorder, or craving; the intervention was performed using rTMS; and the study was a clinical trial. Of the potential 638 articles, 18 met the criteria for inclusion. Most of these (11 of the 18) supported the efficacy of rTMS, especially in the short term. In most cases, the main assessment criterion was the measurement of craving using a Visual Analogue Scale. The results are discussed with respect to the study limitations and, in particular, the many methodological and technical discrepancies that were identified. Key recommendations are provided.

  13. Can repetitive transcranial magnetic stimulation increase muscle strength in functional neurological paresis? A proof-of-principle study

    NARCIS (Netherlands)

    Broersma, M; Koops, E A; Vroomen, Patrick; Van der Hoeven, J H; Aleman, A; Leenders, K L; Maurits, N M; van Beilen, M

    2015-01-01

    BACKGROUND AND PURPOSE: Therapeutic options are limited in functional neurological paresis disorder. Earlier intervention studies did not control for a placebo effect, hampering assessment of effectivity. A proof-of-principle investigation was conducted into the therapeutic potential of repetitive t

  14. Effects of low-frequency repetitive transcranial magnetic stimulation and neuromuscular electrical stimulation on upper extremity motor recovery in the early period after stroke: a preliminary study.

    Science.gov (United States)

    Tosun, Aliye; Türe, Sabiha; Askin, Ayhan; Yardimci, Engin Ugur; Demirdal, Secil Umit; Kurt Incesu, Tülay; Tosun, Ozgur; Kocyigit, Hikmet; Akhan, Galip; Gelal, Fazıl Mustafa

    2017-07-01

    To assess the efficacy of inhibitory repetitive transcranial magnetic stimulation (rTMS) and neuromuscular electrical stimulation (NMES) on upper extremity motor function in patients with acute/subacute ischemic stroke. Twenty-five ischemic acute/subacute stroke subjects were enrolled in this randomized controlled trial. Experimental group 1 received low frequency (LF) rTMS to the primary motor cortex of the unaffected side + physical therapy (PT) including activities to improve strength, flexibility, transfers, posture, balance, coordination, and activities of daily living, mainly focusing on upper limb movements; experimental group 2 received the same protocol combined with NMES to hand extensor muscles; and the control group received only PT. Functional magnetic resonance imaging (fMRI) scan was used to evaluate the activation or inhibition of the affected and unaffected primary motor cortex. No adverse effect was reported. Most of the clinical outcome scores improved significantly in all groups, however no statistically significant difference was found between groups due to the small sample sizes. The highest percent improvement scores were observed in TMS + NMES group (varying between 48 and 99.3%) and the lowest scores in control group (varying between 13.1 and 28.1%). Hand motor recovery was significant in both experimental groups while it did not change in control group. Some motor cortex excitability changes were also observed in fMRI. LF-rTMS with or without NMES seems to facilitate the motor recovery in the paretic hand of patients with acute/subacute ischemic stroke. TMS or the combination of TMS + NMES may be a promising additional therapy in upper limb motor training. Further studies with larger numbers of patients are needed to establish their effectiveness in upper limb motor rehabilitation of stroke.

  15. Transcranial Magnetic Stimulation for Schizophrenia

    National Research Council Canada - National Science Library

    Dougall, Nadine; Maayan, Nicola; Soares-Weiser, Karla; McDermott, Lisa M; McIntosh, Andrew

    2015-01-01

    .... One proposed alternative to drug treatments is transcranial magnetic stimulation (TMS). To date, many research trials to assess effectiveness of TMS for people with symptoms of schizophrenia have been conducted worldwide...

  16. Effect of Low-Frequency Repetitive Transcranial Magnetic Stimulation on Naming Abilities in Early-Stroke Aphasic Patients: A Prospective, Randomized, Double-Blind Sham-Controlled Study

    Directory of Open Access Journals (Sweden)

    Konrad Waldowski

    2012-01-01

    Full Text Available Background and Purpose. Functional brain imaging studies with aphasia patients have shown increased cortical activation in the right hemisphere language homologues, which hypothetically may represent a maladaptive strategy that interferes with aphasia recovery. The aim of this study was to investigate whether low-frequency repetitive transcranial magnetic stimulation (rTMS over the Broca’s homologues in combination with speech/language therapy improves naming in early-stroke aphasia patients. Methods. 26 right-handed aphasic patients in the early stage (up to 12 weeks of a first-ever left hemisphere ischemic stroke were randomized to receive speech and language therapy combined with real or sham rTMS. Prior to each 45-minute therapeutic session (15 sessions, 5 days a week, 30 minutes of 1-Hz rTMS was applied. Outcome measures were obtained at baseline, immediately after 3 weeks of experimental treatment and 15 weeks; posttreatment using the Computerized Picture Naming Test. Results. Although both groups significantly improved their naming abilities after treatment, no significant differences were noted between the rTMS and sham stimulation groups. The additional analyses have revealed that the rTMS subgroup with a lesion including the anterior part of language area showed greater improvement primarily in naming reaction time 15 weeks after completion of the therapeutic treatment. Improvement was also demonstrated in functional communication abilities. Conclusions. Inhibitory rTMS of the unaffected right inferior frontal gyrus area in combination with speech and language therapy cannot be assumed as an effective method for all poststroke aphasia patients. The treatment seems to be beneficial for patients with frontal language area damage, mostly in the distant time after finishing rTMS procedure.

  17. Repetitive transcranial magnetic stimulation improves open field locomotor recovery after low but not high thoracic spinal cord compression-injury in adult rats.

    Science.gov (United States)

    Poirrier, Anne-Lise; Nyssen, Yves; Scholtes, Felix; Multon, Sylvie; Rinkin, Charline; Weber, Géraldine; Bouhy, Delphine; Brook, Gary; Franzen, Rachelle; Schoenen, Jean

    2004-01-15

    Electromagnetic fields are able to promote axonal regeneration in vitro and in vivo. Repetitive transcranial magnetic stimulation (rTMS) is used routinely in neuropsychiatric conditions and as an atraumatic method to activate descending motor pathways. After spinal cord injury, these pathways are disconnected from the spinal locomotor generator, resulting in most of the functional deficit. We have applied daily 10 Hz rTMS for 8 weeks immediately after an incomplete high (T4-5; n = 5) or low (T10-11; n = 6) thoracic closed spinal cord compression-injury in adult rats, using 6 high- and 6 low-lesioned non-stimulated animals as controls. Functional recovery of hindlimbs was assessed using the BBB locomotor rating scale. In the control group, the BBB score was significantly better from the 7th week post-injury in animals lesioned at T4-5 compared to those lesioned at T10-11. rTMS significantly improved locomotor recovery in T10-11-injured rats, but not in rats with a high thoracic injury. In rTMS-treated rats, there was significant positive correlation between final BBB score and grey matter density of serotonergic fibres in the spinal segment just caudal to the lesion. We propose that low thoracic lesions produce a greater functional deficit because they interfere with the locomotor centre and that rTMS is beneficial in such lesions because it activates this central pattern generator, presumably via descending serotonin pathways. The benefits of rTMS shown here suggest strongly that this non-invasive intervention strategy merits consideration for clinical trials in human paraplegics with low spinal cord lesions.

  18. Different frequency repetitive transcranial magnetic stimulation (rTMS) for posttraumatic stress disorder (PTSD): A systematic review and meta-analysis.

    Science.gov (United States)

    Yan, Tingting; Xie, Qinglian; Zheng, Zhong; Zou, Ke; Wang, Lijuan

    2017-06-01

    Posttraumatic stress disorder (PTSD) is a psychiatric disorder. Repetitive transcranial magnetic stimulation (rTMS) has been found to be effective for treating PTSD, but whether different frequencies have different effects remains controversial. We conducted this systematic review and meta-analysis to address this question. We searched the literature for studies written in English or Chinese in 9 electronic databases from the databases' inception to August 1, 2016. Additional articles were identified from the reference lists of identified studies and from personal reference collections. Eighteen articles were included, and 11 were suitable for the meta-analysis (Combined sample size was 377 (217 in active rTMS groups, 160 in sham-controlled groups)). Low-frequency (LF) rTMS resulted in a significant reduction in the PTSD total score and the depression score (1. PTSD total score: pooled SMD, 0.92; CI, 0.11-1.72; 2. Depression: pooled SMD, 0.54; CI, 0.08-1.00). High-frequency (HF) rTMS showed the following results: 1. PTSD total score: pooled SMD, 3.24; CI, 2.24-4.25; 2. re-experiencing: pooled SMD, -1.77; CI, -2.49-(-1.04); 3. Avoidance: pooled SMD, -1.57; CI, -2.50-(-0.84); 4. hyperarousal: pooled SMD, -1.32; CI, -2.17-(-0.47); 5. depression: pooled SMD, 1.92; CI, 0.80-3.03; and 6. Anxiety: pooled SMD, 2.67; CI, 1.82-3.52. Therefore, both HF and LF rTMS can alleviate PTSD symptoms. Although the evidence is extremely limited, LF rTMS can reduce overall PTSD and depression symptoms. HF rTMS can improve the main and related symptoms of PTSD. However, additional research is needed to substantiate these findings.

  19. Comparison of the effects of high- and low-frequency repetitive transcranial magnetic stimulation on upper limb hemiparesis in the early phase of stroke.

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    Sasaki, Nobuyuki; Mizutani, Saneyuki; Kakuda, Wataru; Abo, Masahiro

    2013-05-01

    Recently, high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) and low-frequency rTMS (LF-rTMS) are reported to improve motor function significantly in chronic hemiparetic stroke patients. However, few studies have investigated the safety and efficacy of these rTMS modalities introduced during the early phase of stroke. The purpose of this study was to clarify the rTMS modality that is more beneficial for upper limb hemiparesis in the early phase of stroke using a randomized controlled trial. Twenty-nine patients with a hemispheric stroke lesion in the early phase of stroke were examined. Patients were randomly assigned into 3 groups: the HF-rTMS group (10 Hz rTMS to the lesional hemisphere [n = 9]), the LF-rTMS group (1 Hz rTMS to the nonlesional hemisphere [n = 11]), and the sham stimulation group [n = 9]). Patients received sessions for 5 consecutive days. Grip strength and tapping frequency were assessed before and after the intervention. Motor improvement of the affected upper limb after intervention was compared among the 3 groups. All patients completed the 5-day protocol. Both the HF-rTMS and LF-rTMS groups had significant increases in both grip strength and tapping frequency. Comparison of the extent of improvement showed a more significant increase in grip strength and tapping frequency in the HF-rTMS group compared to the sham stimulation group (each P stimulation group. HF-rTMS applied to the lesional hemisphere in the early phase of stroke was more beneficial for motor improvement of the affected upper limb than LF-rTMS. Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  20. Right secondary somatosensory cortex-a promising novel target for the treatment of drug-resistant neuropathic orofacial pain with repetitive transcranial magnetic stimulation.

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    Lindholm, Pauliina; Lamusuo, Salla; Taiminen, Tero; Pesonen, Ullamari; Lahti, Ari; Virtanen, Arja; Forssell, Heli; Hietala, Jarmo; Hagelberg, Nora; Pertovaara, Antti; Parkkola, Riitta; Jääskeläinen, Satu

    2015-07-01

    High-frequency repetitive transcranial magnetic stimulation (rTMS) of the motor cortex has analgesic effect; however, the efficacy of other cortical targets and the mode of action remain unclear. We examined the effects of rTMS in neuropathic orofacial pain, and compared 2 cortical targets against placebo. Furthermore, as dopaminergic mechanisms modulate pain responses, we assessed the influence of the functional DRD2 gene polymorphism (957C>T) and the catechol-O-methyltransferase (COMT) Val158Met polymorphism on the analgesic effect of rTMS. Sixteen patients with chronic drug-resistant neuropathic orofacial pain participated in this randomized, placebo-controlled, crossover study. Navigated high-frequency rTMS was given to the sensorimotor (S1/M1) and the right secondary somatosensory (S2) cortices. All subjects were genotyped for the DRD2 957C>T and COMT Val158Met polymorphisms. Pain, mood, and quality of life were monitored throughout the study. The numerical rating scale pain scores were significantly lower after the S2 stimulation than after the S1/M1 (P = 0.0071) or the sham (P = 0.0187) stimulations. The Brief Pain Inventory scores were also lower 3 to 5 days after the S2 stimulation than those at pretreatment baseline (P = 0.0127 for the intensity of pain and P = 0.0074 for the interference of pain) or after the S1/M1 (P = 0.001 and P = 0.0001) and sham (P = 0.0491 and P = 0.0359) stimulations. No correlations were found between the genetic polymorphisms and the analgesic effect in the present small clinical sample. The right S2 cortex is a promising new target for the treatment of neuropathic orofacial pain with high-frequency rTMS.

  1. Primed low-frequency repetitive transcranial magnetic stimulation and constraint-induced movement therapy in pediatric hemiparesis: a randomized controlled trial.

    Science.gov (United States)

    Gillick, Bernadette T; Krach, Linda E; Feyma, Tim; Rich, Tonya L; Moberg, Kelli; Thomas, William; Cassidy, Jessica M; Menk, Jeremiah; Carey, James R

    2014-01-01

    The aim of this study was to determine the feasibility and efficacy of five treatments of 6 Hz primed, low-frequency, repetitive transcranial magnetic stimulation (rTMS) combined with constraint-induced movement therapy (CIMT) to promote recovery of the paretic hand in children with congenital hemiparesis. Nineteen children with congenital hemiparesis aged between 8 and 17 years (10 males, nine females; mean age 10 years 10 months, SD 2 years 10 months; Manual Ability Classification Scale levels I-III) underwent five sessions of either real rTMS (n=10) or sham rTMS (n=9) alternated daily with CIMT. CIMT consisted of 13 days of continuous long-arm casting with five skin-check sessions. Each child received a total of 10 hours of one-to-one therapy. The primary outcome measure was the Assisting Hand Assessment (AHA) and the secondary outcome variables were the Canadian Occupational Performance Measure (COPM) and stereognosis. A Wilcoxon signed-rank sum test was used to analyze differences between pre- and post-test scores within the groups. Analysis of covariance was used to compute mean differences between groups adjusting for baseline. Fisher's exact test was used to compare individual change in AHA raw scores with the smallest detectable difference (SDD) of 4 points. All participants receiving treatment finished the study. Improvement in AHA differed significantly between groups (p=0.007). No significant differences in the secondary outcome measures were found. Eight out of 10 participants in the rTMS/CIMT group showed improvement greater than the SDD, but only two out of nine in the sham rTMS/CIMT group showed such improvement (p=0.023). No serious adverse events occurred. Primed, low-frequency rTMS combined with CIMT appears to be safe, feasible, and efficacious in pediatric hemiparesis. Larger clinical trials are now indicated. © 2013 Mac Keith Press.

  2. Role of Brain-Derived Neurotrophic Factor in Beneficial Effects of Repetitive Transcranial Magnetic Stimulation for Upper Limb Hemiparesis after Stroke.

    Science.gov (United States)

    Niimi, Masachika; Hashimoto, Kenji; Kakuda, Wataru; Miyano, Satoshi; Momosaki, Ryo; Ishima, Tamaki; Abo, Masahiro

    2016-01-01

    Repetitive transcranial magnetic stimulation (rTMS) can improve upper limb hemiparesis after stroke but the mechanism underlying its efficacy remains elusive. rTMS seems to alter brain-derived neurotrophic factor (BDNF) and such effect is influenced by BDNF gene polymorphism. To investigate the molecular effects of rTMS on serum levels of BDNF, its precursor proBDNF and matrix metalloproteinase-9 (MMP-9) in poststroke patients with upper limb hemiparesis. Poststroke patients with upper limb hemiparesis were studied. Sixty-two patients underwent rehabilitation plus rTMS combination therapy and 33 patients underwent rehabilitation monotherapy without rTMS for 14 days at our hospital. One Hz rTMS was applied over the motor representation of the first dorsal interosseous muscle on the non-lesional hemisphere. Fugl-Meyer Assessment and Wolf Motor Function (WMFT) were used to evaluate motor function on the affected upper limb before and after intervention. Blood samples were collected for analysis of BDNF polymorphism and measurement of BDNF, proBDNF and MMP-9 levels. Two-week combination therapy increased BDNF and MMP-9 serum levels, but not serum proBDNF. Serum BDNF and MMP-9 levels did not correlate with motor function improvement, though baseline serum proBDNF levels correlated negatively and significantly with improvement in WMFT (ρ = -0.422, p = 0.002). The outcome of rTMS therapy was not altered by BDNF gene polymorphism. The combination therapy of rehabilitation plus low-frequency rTMS seems to improve motor function in the affected limb, by activating BDNF processing. BDNF and its precursor proBDNF could be potentially suitable biomarkers for poststroke motor recovery.

  3. Can temporal repetitive transcranial magnetic stimulation be enhanced by targeting affective components of tinnitus with frontal rTMS? a randomized controlled pilot trial

    Directory of Open Access Journals (Sweden)

    Peter Michael Kreuzer

    2011-11-01

    Full Text Available Objectives: Low-frequency repetitive transcranial magnetic stimulation (rTMS of the temporal cortex has been investigated as a new treatment tool for chronic tinnitus during the last years and has shown moderate efficacy. However, there is growing evidence that tinnitus is not a pathology of a specific brain region, but rather the result of network dysfunction involving both auditory and non-auditory brain regions. In functional imaging studies the right dorsolateral prefrontal cortex has been identified as an important hub in tinnitus related networks and has been shown to particularly reflect the affective components of tinnitus. Based on these findings we aimed to investigate whether the effects of left low frequency rTMS can be enhanced by antecedent right prefrontal low-frequency rTMS. Study Design: Fifty-six patients were randomized to receive either low-frequency left temporal rTMS or a combination of low-frequency right prefrontal followed by low-frequency left temporal rTMS. The change of the tinnitus questionnaire (TQ score was the primary outcome, secondary outcome parameters included the Tinnitus Handicap Inventory, numeric rating scales and the Beck Depression Inventory. The study is registered in clinicaltrials.gov (NCT01261949.Results: Directly after therapy there was a significant improvement of the TQ-score in both groups. Comparison of both groups revealed a trend towards more pronounced effects for the combined group (effect size: Cohen’s d=0.176, but this effect did not reach significance. A persistent trend towards better efficacy was also observed in all other outcome criteria. Conclusion: Additional stimulation of the right prefrontal cortex seems to be a promising strategy for enhancing TMS effects over the temporal cortex. These results further support the involvement of the right DLPFC in the pathophysiology of tinnitus. The small effect size might be due to the study design comparing the protocol to an active control

  4. Effects of high-frequency repetitive transcranial magnetic stimulation (rTMS) on spontaneously hypertensive rats, an animal model of attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Kim, Jungyun; Park, Heamen; Yu, Seong-Lan; Jee, Sungju; Cheon, Keun-Ah; Song, Dong Ho; Kim, Seung Jun; Im, Woo-Young; Kang, Jaeku

    2016-10-01

    The current treatment of choice for attention deficit hyperactivity disorder (ADHD) is pharmacotherapy. A search for new treatment options is underway, however, as the wide application of drugs to the general population of patients with ADHD is limited by side effects and the variance of pharmacokinetic effects of the drugs in each patient. In the present study, we applied repetitive transcranial magnetic stimulation (rTMS), a non-invasive treatment used in a number of other psychiatric disorders, to spontaneously hypertensive rats (SHRs), an animal model of ADHD, in order to assess the efficacy of the treatment in modifying behavioural symptoms as well as levels of dopamine, noradrenaline, serotonin, and brain-derived neurotrophic factor (BDNF). A total of fifteen sessions of high-frequency rTMS treatment were administered. Behavioural symptoms were observed using open field, Y-maze, and elevated plus-maze tests. Upon completion of the experiments, rats were sacrificed, and the neurochemical changes in brain tissue were analysed using high performance liquid chromatography and Western blotting. The SHRs treated with rTMS tended to exhibit less locomotor activity in the open field test over the course of treatment, but there was no improvement in inattention as measured by the Y-maze test. Furthermore, BDNF concentration increased and noradrenaline concentration decreased in the prefrontal cortex of SHRs treated with rTMS. The results of the present preclinical study indicate that rTMS may constitute a new modality of treatment for patients with ADHD, through further evaluation of specific treatment parameters as well as safety and efficacy in humans are required.

  5. Role of Brain-Derived Neurotrophic Factor in Beneficial Effects of Repetitive Transcranial Magnetic Stimulation for Upper Limb Hemiparesis after Stroke.

    Directory of Open Access Journals (Sweden)

    Masachika Niimi

    Full Text Available Repetitive transcranial magnetic stimulation (rTMS can improve upper limb hemiparesis after stroke but the mechanism underlying its efficacy remains elusive. rTMS seems to alter brain-derived neurotrophic factor (BDNF and such effect is influenced by BDNF gene polymorphism.To investigate the molecular effects of rTMS on serum levels of BDNF, its precursor proBDNF and matrix metalloproteinase-9 (MMP-9 in poststroke patients with upper limb hemiparesis.Poststroke patients with upper limb hemiparesis were studied. Sixty-two patients underwent rehabilitation plus rTMS combination therapy and 33 patients underwent rehabilitation monotherapy without rTMS for 14 days at our hospital. One Hz rTMS was applied over the motor representation of the first dorsal interosseous muscle on the non-lesional hemisphere. Fugl-Meyer Assessment and Wolf Motor Function (WMFT were used to evaluate motor function on the affected upper limb before and after intervention. Blood samples were collected for analysis of BDNF polymorphism and measurement of BDNF, proBDNF and MMP-9 levels.Two-week combination therapy increased BDNF and MMP-9 serum levels, but not serum proBDNF. Serum BDNF and MMP-9 levels did not correlate with motor function improvement, though baseline serum proBDNF levels correlated negatively and significantly with improvement in WMFT (ρ = -0.422, p = 0.002. The outcome of rTMS therapy was not altered by BDNF gene polymorphism.The combination therapy of rehabilitation plus low-frequency rTMS seems to improve motor function in the affected limb, by activating BDNF processing. BDNF and its precursor proBDNF could be potentially suitable biomarkers for poststroke motor recovery.

  6. Effectiveness and acceptability of accelerated repetitive transcranial magnetic stimulation (rTMS) for treatment-resistant major depressive disorder: an open label trial.

    Science.gov (United States)

    McGirr, Alexander; Van den Eynde, Frederique; Tovar-Perdomo, Santiago; Fleck, Marcelo P A; Berlim, Marcelo T

    2015-03-01

    Major depressive disorder (MDD) is a significant cause of worldwide disability and treatment resistance is common. High-frequency repetitive transcranial magnetic stimulation (HF-rTMS) has emerged as a treatment for MDD, and while efficacious, the daily commitment for typical 4-6 weeks of treatment poses a significant challenge. We aimed to determine the effectiveness and acceptability of an accelerated rTMS protocol for MDD. In this naturalistic trial, 27 patients with moderate to severe chronic and treatment-resistant MDD were treated with twice-daily HF-rTMS (10 Hz) applied over the left dorsolateral prefrontal cortex for 2 consecutive weeks (60,000 pulses). The primary outcomes were rates of clinical remission and response (16-item Quick Inventory of Depressive Symptomatology post-treatment score ≤ 6, and ≥ 50% reduction, respectively). Secondary outcomes were self-reported anxious symptoms, depressive symptoms and quality of life, and dropout rates as a proxy for acceptability. Ten (37.0%) patients met criteria for clinical remission and 15 (55.6%) were classified as responders, with comparable outcomes for both moderate and severe MDD. Clinician-rated improvements in depressive symptoms were paralleled in self-reported depressive and anxious symptoms, as well as quality of life. No patient discontinued treatment. This study is limited by short treatment duration that might be lengthened with corresponding improvements in effectiveness, limited duration of follow-up, small sample size, and an open-label design requiring randomized controlled replication. An accelerated protocol involving twice-daily sessions of HF-rTMS over the left DLPFC for 2 weeks was effective in treatment-resistant MDD, and had excellent acceptability. Additional research is required to optimize accelerated rTMS treatment protocols and determine efficacy using sham-controlled trials. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Short and long term effects of left and bilateral repetitive transcranial magnetic stimulation in schizophrenia patients with auditory verbal hallucinations: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Leonie Bais

    Full Text Available BACKGROUND: Repetitive transcranial magnetic stimulation of the left temporo-parietal junction area has been studied as a treatment option for auditory verbal hallucinations. Although the right temporo-parietal junction area has also shown involvement in the genesis of auditory verbal hallucinations, no studies have used bilateral stimulation. Moreover, little is known about durability effects. We studied the short and long term effects of 1 Hz treatment of the left temporo-parietal junction area in schizophrenia patients with persistent auditory verbal hallucinations, compared to sham stimulation, and added an extra treatment arm of bilateral TPJ area stimulation. METHODS: In this randomized controlled trial, 51 patients diagnosed with schizophrenia and persistent auditory verbal hallucinations were randomly allocated to treatment of the left or bilateral temporo-parietal junction area or sham treatment. Patients were treated for six days, twice daily for 20 minutes. Short term efficacy was measured with the Positive and Negative Syndrome Scale (PANSS, the Auditory Hallucinations Rating Scale (AHRS, and the Positive and Negative Affect Scale (PANAS. We included follow-up measures with the AHRS and PANAS at four weeks and three months. RESULTS: The interaction between time and treatment for Hallucination item P3 of the PANSS showed a trend for significance, caused by a small reduction of scores in the left group. Although self-reported hallucination scores, as measured with the AHRS and PANAS, decreased significantly during the trial period, there were no differences between the three treatment groups. CONCLUSION: We did not find convincing evidence for the efficacy of left-sided rTMS, compared to sham rTMS. Moreover, bilateral rTMS was not superior over left rTMS or sham in improving AVH. Optimizing treatment parameters may result in stronger evidence for the efficacy of rTMS treatment of AVH. Moreover, future research should consider

  8. Repetitive transcranial magnetic stimulation of the primary motor cortex in the treatment of motor signs in Parkinson's disease: A quantitative review of the literature.

    Science.gov (United States)

    Zanjani, Anosha; Zakzanis, Konstantine K; Daskalakis, Zafiris J; Chen, Robert

    2015-05-01

    Parkinson's disease (PD) is a progressive disorder characterized by the emergence of motor deficits. In light of the voluminous and conflicting findings in the literature, the aim of the present quantitative review was to examine the effects of repetitive transcranial magnetic stimulation (rTMS) targeting the primary motor cortex (M1) in the treatment of motor signs in PD. Studies meeting inclusion criteria were analyzed using meta-analytic techniques and the Unified Parkinson's Disease Rating Scale (UPDRS) sections II and III were used as outcome measures. In order to determine the treatment effects of rTMS, the UPDRS II and III scores obtained at baseline, same day, to 1 day post rTMS treatment (short-term follow-up) and 1-month post stimulation (long-term follow-up) were compared between the active and sham rTMS groups. Additionally, the placebo effect was evaluated as the changes in UPDRS III scores in the sham rTMS groups. A placebo effect was not demonstrated, because sham rTMS did not improve motor signs as measured by UPDRS III. Compared with sham rTMS, active rTMS targeting the M1 significantly improved UPDRS III scores at the short-term follow-up (Cohen's d of 0.27, UPDRS III score improvement of 3.8 points). When the long-term follow-up UPDRS III scores were compared with baseline scores, the standardized effect size between active and sham rTMS did not reach significance. However, this translated into a significant nonstandardized 6.3-point improvement on the UPDRS III. No significant improvement in the UPDRS II was found. rTMS over the M1 may improve motor signs. Further studies are needed to provide a definite conclusion.

  9. Effects of low-frequency repetitive transcranial magnetic stimulation combined with intensive speech therapy on cerebral blood flow in post-stroke aphasia.

    Science.gov (United States)

    Hara, Takatoshi; Abo, Masahiro; Kobayashi, Kentaro; Watanabe, Motoi; Kakuda, Wataru; Senoo, Atushi

    2015-10-01

    We provided an intervention to chronic post-stroke aphasic patients using low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) guided by a functional magnetic resonance imaging (fMRI) evaluation of language laterality, combined with intensive speech therapy (ST). We performed a single photon emission-computed tomography (SPECT) scan pre- and post-intervention and investigated the relationship between cerebral blood flow (CBF) and language function. Fifty right-handed chronic post-stroke aphasic patients were enrolled in the study. During their 11-day hospital admission, the patients received a 40-min session of 1-Hz LF-rTMS on the left or right hemisphere, according to language localization identified by the fMRI evaluation, and intensive ST daily for 10 days, except for Sunday. A SPECT scan and language evaluation by the Standard Language Test of Aphasia (SLTA) were performed at the time of admission and at 3 months following discharge. We calculated laterality indices (LIs) of regional CBF (rCBF) in 13 language-related Brodmann area (BA) regions of interest. In patients who received LF-rTMS to the intact right hemisphere (RH-LF-rTMS), the improvement in the total SLTA score was significantly correlated with the pre- and post-intervention change of LI (ΔLI) in BA44. In patients who received LF-rTMS to the lesional left hemisphere (LH-LF-rTMS), this association was not observed. Analyses of the SLTA subscales and rCBF ΔLI demonstrated that in the RH-LF-rTMS group, the SLTA Speaking subscale scores were significantly correlated with ΔLIs in BA11, 20, and 21, and the SLTA Writing subscale scores were significantly correlated with ΔLIs in BA6 and 39. Conversely, in the LH-LF-rTMS group, the SLTA Speaking subscale scores were correlated with ΔLI in BA10, and the SLTA Reading subscale scores were significantly correlated with ΔLIs in BA13, 20, 22, and 44. Our results suggest the possibility that fMRI-guided LF-rTMS combined with intensive ST may

  10. Challenges in comparing the acute cognitive outcomes of high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) vs. electroconvulsive therapy (ECT) in major depression: A systematic review.

    Science.gov (United States)

    Kedzior, Karina Karolina; Schuchinsky, Maria; Gerkensmeier, Imke; Loo, Colleen

    2017-03-02

    The present study aimed to systematically compare the cognitive outcomes of high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) and electroconvulsive therapy (ECT) in head-to-head studies with major depression (MDD) patients. A systematic literature search identified six studies with 219 MDD patients that were too heterogeneous to reliably detect meaningful differences in acute cognitive outcomes after ECT vs. HF-rTMS. Cognitive effects of brain stimulation vary depending on the timeframe and methods of assessment, stimulation parameters, and maintenance treatment. Thus, acute and longer-term differences in cognitive outcomes both need to be investigated at precisely defined timeframes and with similar instruments assessing comparable functions.

  11. The effects of repetitive transcranial magnetic stimulation in obese females with binge eating disorder: a protocol for a double-blinded, randomized, sham-controlled trial.

    Science.gov (United States)

    Maranhão, Mara Fernandes; Estella, Nara Mendes; Cury, Maria Elisa Gisbert; Amigo, Veruska Lastoria; Picasso, Clarissa Mollinero; Berberian, Arthur; Campbell, Iain; Schmidt, Ulrike; Claudino, Angélica Medeiros

    2015-08-12

    Binge eating disorder is a new category in DSM-5 and highly associated with higher body mass index. The neural mechanisms that underlie binge eating are of great interest in order to improve treatment interventions. Brain mechanisms underlying drug and food craving are suggested to be similar: for example, both are reported to be associated with increased neural activity in the orbitofrontal and anterior cingulate cortex, and a diminished regulatory influence from lateral prefrontal circuits. Several studies have begun to assess the potential benefits of brain stimulation in reducing craving and addictive behaviors. Data from a study of a one-off session of transcranial magnetic stimulation in healthy women identified as strong cravers and of individuals with bulimic-type eating disorders, reported a reduction in food craving and binge eating episodes. This provides support for a more extensive investigation of the potential therapeutic benefits of transcranial magnetic stimulation. Lastly, brain imaging studies and a dimensional approach, will improve understanding of the neural correlates of the disorders and of the mode of action of transcranial magnetic stimulation. Sixty eligible obese females, with binge eating disorder, will be randomly allocated to receive 20 sessions of transcranial magnetic stimulation intervention (n = 30) or the sham transcranial magnetic stimulation intervention (n = 30) scattered 3 days/week. Thirty eligible controls will complete the baseline assessment. The primary outcome (number of binge eating episodes) will be assed at each treatment sessions, and 8 weeks after intervention completion (follow-up). It is hypothesized that mean weekly binge-eating episodes will be reduced in the intervention group, compared to the sham group, and that the effect will be maintained at follow-up. Despite the severity associated with Binge Eating Disorder, there are limited treatment options. This study is an important step in the development of more

  12. Efficacy and safety of the Chinese herbal medicine shuganjieyu with and without adjunctive repetitive transcranial magnetic stimulation (rTMS) for geriatric depression: a randomized controlled trial

    Science.gov (United States)

    XIE, Minmin; JIANG, Wenhai; YANG, Haibo

    2015-01-01

    Background Pharmacological treatment of geriatric depression is often ineffective because patients cannot tolerate adequate doses of antidepressant medications. Aim Examine the efficacy and safety of shuganjieyu – the first Chinese herbal medicine approved for the treatment of depression by China’s drug regulatory agency -- with and without adjunctive treatment with repetitive transcranial magnetic stimulation (rTMS) in the treatment of geriatric depression. Methods Sixty-five inpatients 60 or older who met ICD-10 criteria for depression were randomly assigned to an experimental group (shuganjieyu + rTMS) (n=36) or a control group (shuganjieyu + sham rTMS)(n=29). All participants received 4 capsules of shuganjieyu daily for 6 weeks. rTMS (or sham rTMS) was administered 20 minutes daily, five days a week for 4 weeks. Blinded raters used the Hamilton Rating Scale for Depression (HAMD-17) and the Treatment Emergent Symptom Scale to assess clinical efficacy and safety at baseline and 1, 2, 4, and 6 weeks after starting treatment. Over the six-week trial, there was only one dropout from the experimental group and two dropouts from the control group. Results None of the patients had serious side effects, but 40% in the experimental group and 50% in the control group experienced minor side effects that all resolved spontaneously. Both groups showed substantial stepwise improvement in depressive symptoms over the 6 weeks. Repeated measures ANOVA found no differences between the two groups. After 6 weeks, 97% of the experimental group had experienced a 25% or greater drop in the level of depression, but only 20% had experience a 50% or greater drop in the level of depression; the corresponding values in the control group were 96% and 19%. There were some minor, non-significant differences in the onset of the treatment effect between the different types of depressive symptoms, but by the second week of treatment all five HAMD-17 subscale scores had improved significantly

  13. The Effects of Different Repetitive Transcranial Magnetic Stimulation (rTMS) Protocols on Cortical Gene Expression in a Rat Model of Cerebral Ischemic-Reperfusion Injury.

    Science.gov (United States)

    Ljubisavljevic, Milos R; Javid, Asma; Oommen, Joji; Parekh, Khatija; Nagelkerke, Nico; Shehab, Safa; Adrian, Thomas E

    2015-01-01

    Although repetitive Transcranial Magnetic Stimulation (rTMS) in treatment of stroke in humans has been explored over the past decade the data remain controversial in terms of optimal stimulation parameters and the mechanisms of rTMS long-term effects. This study aimed to explore the potential of different rTMS protocols to induce changes in gene expression in rat cortices after acute ischemic-reperfusion brain injury. The stroke was induced by middle cerebral artery occlusion (MCAO) with subsequent reperfusion. Changes in the expression of 96 genes were examined using low-density expression arrays after MCAO alone and after MCAO combined with 1Hz, 5Hz, continuous (cTBS) and intermittent (iTBS) theta-burst rTMS. rTMS over the lesioned hemisphere was given for two weeks (with a 2-day pause) in a single daily session and a total of 2400 pulses. MCAO alone induced significant upregulation in the expression of 44 genes and downregulation in 10. Two weeks of iTBS induced significant increase in the expression of 52 genes. There were no downregulated genes. 1Hz and 5Hz had no significant effects on gene expression, while cTBS effects were negligible. Upregulated genes included those involved in angiogenesis, inflammation, injury response and cellular repair, structural remodeling, neuroprotection, neurotransmission and neuronal plasticity. The results show that long-term rTMS in acute ischemic-reperfusion brain injury induces complex changes in gene expression that span multiple pathways, which generally promote the recovery. They also demonstrate that induced changes primarily depend on the rTMS frequency (1Hz and 5Hz vs. iTBS) and pattern (cTBS vs. iTBS). The results further underlines the premise that one of the benefits of rTMS application in stroke may be to prime the brain, enhancing its potential to cope with the injury and to rewire. This could further augment its potential to favorably respond to rehabilitation, and to restore some of the loss functions.

  14. Effects of Electroconvulsive Therapy and Repetitive Transcranial Magnetic Stimulation on Serum Brain-Derived Neurotrophic Factor Levels in Patients with Depression

    Science.gov (United States)

    Gedge, Laura; Beaudoin, Ashley; Lazowski, Lauren; du Toit, Regina; Jokic, Ruzica; Milev, Roumen

    2012-01-01

    Objective: Brain-derived neurotrophic factor (BDNF) levels are decreased in individuals with depression and increase following antidepressant treatment. The objective of this study is to compare pre- and post-treatment serum BDNF levels in patients with drug-resistant major depressive disorder (MDD) who received either electroconvulsive therapy (ECT) or repetitive transcranial magnetic stimulation (rTMS). It is hypothesized that non-pharmacological treatments also increase serum BDNF levels. Methods: This was a prospective, single-blind study comparing pre- and post-treatment serum BDNF levels of 29 patients with drug-resistant MDD who received ECT or rTMS treatment. Serum BDNF levels were measured 1 week prior to and 1 week after treatment using the sandwich ELISA technique. Depression severity was measured 1 week before and 1 week after treatment using the Hamilton Depression Rating Scale. Two-sided normal distribution paired t-test analysis was used to compare pre- and post-treatment BDNF concentration and illness severity. Bivariate correlations using Pearson’s coefficient assessed the relationship between post-treatment BDNF levels and post-treatment depression severity. Results: There was no significant difference in serum BDNF levels before and after ECT, although concentrations tended to increase from a baseline mean of 9.95–12.29 ng/ml after treatment (p = 0.137). Treatment with rTMS did not significantly alter BDNF concentrations (p = 0.282). Depression severity significantly decreased following both ECT (p = 0.003) and rTMS (p < 0.001). Post-treatment BDNF concentration was not significantly correlated with post-treatment depression severity in patients who received either ECT (r = −0.133, p = 0.697) or rTMS (r = 0.374, p = 0.126). It is important to note that these results are based on the small number of patients included in this study. Conclusion: This study suggests that ECT and rTMS may not exert their

  15. Effects of electroconvulsive therapy and repetitive transcranial magnetic stimulation on serum brain-derived neurotrophic factor levels in patients with depression

    Directory of Open Access Journals (Sweden)

    Laura eGedge

    2012-02-01

    Full Text Available Objective: Brain-derived neurotrophic factor (BDNF levels are decreased in individuals with depression and increase following antidepressant treatment. The objective of this study is to compare pre- and post-treatment serum BDNF levels in patients with drug-resistant major depressive disorder (MDD who received either electroconvulsive therapy (ECT or repetitive transcranial magnetic stimulation (rTMS. It is hypothesized that non-pharmacological treatments also increase serum BDNF levels.Methods: This was a prospective, single-blind study comparing pre- and post-treatment serum BDNF levels of twenty-nine patients with drug-resistant MDD who received ECT or rTMS treatment. Serum BDNF levels were measured one week prior to and one week after treatment using the sandwich ELISA technique. Depression severity was measured one week before and one week after treatment using the Hamilton Depression Rating Scale. Two-sided normal distribution paired t-test analysis was used to compare pre- and post-treatment BDNF concentration and illness severity. Bivariate correlations using Pearson's coefficient assessed the relationship between post-treatment BDNF levels and post-treatment depression severity.Results: There was no significant difference in serum BDNF levels before and after ECT, although concentrations tended to increase from a baseline mean of 9.95 ng/ml to 12.29 ng/ml after treatment (p= 0.137. Treatment with rTMS did not significantly alter BDNF concentrations (p= 0.282. Depression severity significantly decreased following both ECT (p= 0.003 and rTMS (p< 0.001. Post-treatment BDNF concentration was not significantly correlated with post-treatment depression severity in patients who received either ECT (r= -0.133, p= 0.697 or rTMS (r= 0.374, p= 0.126.Conclusion: This study suggests that ECT and rTMS may not exert their clinical effects by altering serum BDNF levels. Serum BDNF concentration may not be a biomarker of ECT or rTMS treatment response.

  16. Effect of low-frequency repetitive transcranial magnetic stimulation combining task-oriented training on upper limb motor function recovery after stroke

    Directory of Open Access Journals (Sweden)

    Hong-bin WANG

    2017-07-01

    Full Text Available Objective To investigate the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS combined with task-oriented training on the recovery of upper limb motor function of stroke patients. Methods A total of 42 patients with hemiplegia after stroke were randomly divided into control group (N = 20 and treatment group (N = 22. Control group received routine rehabilitation training and task-oriented training, and treatment group received low-frequency (1 Hz rTMS over the contralesional cortex addition to routine rehabilitation and task-oriented training. Fugl-Meyer Assessment Scale for Upper Extremity (FMA-UE and Wolf Motor Function Test (WMFT were used to evaluate upper limb motor function of all patients before treatment, after 4-week treatment and 3 months after treatment. The latency and central motor conduction time (CMCT of motor-evoked potential (MEP in the contralesional cortex were recorded and analyzed. Results Compared with control group, FMA-UE score (P = 0.006 and WMFT score (P = 0.024 were significantly increased in treatment group. There was significant difference in FMA-AUE score (P = 0.000 and WMFT score (P = 0.000 at different time points. Compared with before treatment, FMA-UE score (P = 0.000, for all and WMFT score (P = 0.000, for all of patients in both groups were all significantly increased after 4-week treatment and 3 months after treatment. Besides, FMA-UE score (P = 0.000, for all and WMFT score (P = 0.000, for all 3 months after treatment were higher than those after 4-week treatment. There was no statistically significant difference between 2 groups on the latency (P = 0.979 and CMCT (P = 0.807 of MEP before and after treatment, and so was the difference on the latency (P = 0.085 and CMCT (P = 0.507 of MEP in the contralesional cortex at different time points (before treatment, after 4-week treatment and 3 months after treatment. Conclusions Low-frequency rTMS over the contralesional cortex combined

  17. The Effects of Different Repetitive Transcranial Magnetic Stimulation (rTMS Protocols on Cortical Gene Expression in a Rat Model of Cerebral Ischemic-Reperfusion Injury.

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    Milos R Ljubisavljevic

    Full Text Available Although repetitive Transcranial Magnetic Stimulation (rTMS in treatment of stroke in humans has been explored over the past decade the data remain controversial in terms of optimal stimulation parameters and the mechanisms of rTMS long-term effects. This study aimed to explore the potential of different rTMS protocols to induce changes in gene expression in rat cortices after acute ischemic-reperfusion brain injury. The stroke was induced by middle cerebral artery occlusion (MCAO with subsequent reperfusion. Changes in the expression of 96 genes were examined using low-density expression arrays after MCAO alone and after MCAO combined with 1Hz, 5Hz, continuous (cTBS and intermittent (iTBS theta-burst rTMS. rTMS over the lesioned hemisphere was given for two weeks (with a 2-day pause in a single daily session and a total of 2400 pulses. MCAO alone induced significant upregulation in the expression of 44 genes and downregulation in 10. Two weeks of iTBS induced significant increase in the expression of 52 genes. There were no downregulated genes. 1Hz and 5Hz had no significant effects on gene expression, while cTBS effects were negligible. Upregulated genes included those involved in angiogenesis, inflammation, injury response and cellular repair, structural remodeling, neuroprotection, neurotransmission and neuronal plasticity. The results show that long-term rTMS in acute ischemic-reperfusion brain injury induces complex changes in gene expression that span multiple pathways, which generally promote the recovery. They also demonstrate that induced changes primarily depend on the rTMS frequency (1Hz and 5Hz vs. iTBS and pattern (cTBS vs. iTBS. The results further underlines the premise that one of the benefits of rTMS application in stroke may be to prime the brain, enhancing its potential to cope with the injury and to rewire. This could further augment its potential to favorably respond to rehabilitation, and to restore some of the loss

  18. The positive effects of high-frequency right dorsolateral prefrontal cortex repetitive transcranial magnetic stimulation on memory, correlated with increases in brain metabolites detected by proton magnetic resonance spectroscopy in recently detoxified alcohol-dependent patients

    Directory of Open Access Journals (Sweden)

    Qiao J

    2016-09-01

    Full Text Available Jun Qiao,1,2 Guixing Jin,1,2 Licun Lei,3 Lan Wang,1,2 Yaqiang Du,3 Xueyi Wang1,2 1Institute of Mental Health, The First Hospital of Hebei Medical University, 2Brain Ageing and Cognitive Neuroscience Laboratory, Hebei Medical University, 3Department of Radiology, The First Hospital of Hebei Medical University, Hebei, People’s Republic of China Objective: To explore the effect of right dorsolateral prefrontal cortex (DLPFC repetitive transcranial magnetic stimulation (rTMS on memory, and its correlation with levels of hippocampal brain metabolites detected by proton magnetic resonance spectroscopy (1H-MRS in recently detoxified alcohol-dependent patients. Materials and methods: In this randomized, double-blind sham-controlled trial, alcohol-dependent patients were enrolled and randomized into two groups: the experimental group (rTMS, 10 Hz, on right DLPFC, 20 sessions and the control group (sham stimulation. Memory function was assessed using Hopkins Verbal Learning Test-Revised (HVLT-R and Brief Visuospatial Memory Test-Revised (BVMT-R before and after treatment. 1H-MRS was used to detect the levels of N-acetyl aspartic acid (NAA, choline (Cho, and creatine (Cr in bilateral hippocampi before and after treatment. Results: Thirty-eight patients (18 in the experimental group and 20 in the control group were included in the analyses. The experimental group showed significantly greater changes in HVLT-R, BVMT-R, NAA/Cr, and Cho/Cr after rTMS from baseline than the control group. The percentage change in BVMT-R and HVLT-R correlated with the percentage change in NAA/Cr and Cho/Cr in the right brain. Conclusion: High-frequency right DLPFC rTMS was associated with improvement in memory dysfunction, which is correlated with levels of hippocampal brain metabolites detected by 1H-MRS in recently detoxified alcohol-dependent patients. Keywords: alcohol dependence, memory, repetitive transcranial magnetic stimulation, MR spectroscopy

  19. Repetitive transcranial magnetic stimulation (rTMS) combined with cognitive training is a safe and effective modality for the treatment of Alzheimer's disease: clinical experience.

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    Rabey, Jose Martin; Dobronevsky, Evgenia

    2016-12-01

    Alzheimer's disease (AD) is the most common type of dementia among the elderly. Common treatments available and non-pharmacological interventions have their limitations, and new therapeutic approaches are critically needed. Transcranial magnetic stimulation (TMS) is a non-invasive technique that generates an electric current-inducing modulation in cortical excitability. The previous clinical trials showed that combinations of rTMS and cognitive training (rTMS-COG), as provided by the NeuroAD medical device system, offer a novel, safe, and effective method improving mild-to-moderate AD patients. In this article, we present our experience with rTMS-COG treatment, in clinical settings, of 30 mild-to-moderate AD patients that received rTMS-COG commercial treatments in two clinics for 1-h daily sessions, 5 days per week, for 6 weeks (30 sessions). Five patients returned for a second treatment. ADAS-Cog and MMSE scores were measured pre- and post-treatments. The main analyses were conducted on patients who received 1 treatment (n = 30). Data received from the five returning patients were analyzed separately. The effect of rTMS-COG treatment was statistically significant regarding both ADAS-Cog (-2.4 point improvement, PV <0.001) and MMSE (+1.7 points improvement, PV <0.001) scores. About 80 % of patients gained some cognitive improvement following NeuroAD treatment, with more than 60 % improving by more than two points, for a minimum of 9 months. The Neuronix NeuroAD System was shown to be a safe and effective non-invasive modality for cognitive improvement of Alzheimer patients, with measurable outcomes lasting, in some of them, for up to 1 year, following completion of the 6-week daily intervention course (a carryover effect).

  20. Nonconventional interventions for chronic post-traumatic stress disorder: Ketamine, repetitive trans-cranial magnetic stimulation (rTMS), and alternative approaches.

    Science.gov (United States)

    Pradhan, Basant; Kluewer D'Amico, Jessica; Makani, Ramkrishna; Parikh, Tapan

    2016-01-01

    It is alarming that only 59% of those who have post-traumatic stress disorder (PTSD) respond to selective serotonin reuptake inhibitors. Many existing treatments, both pharmacological and nonpharmacological, do not directly target trauma memories that lay at the core of the PTSD pathogenesis. Notable exceptions are medications like ketamine and propranolol and trauma-focused psychotherapies like eye-movement desensitization and reprocessing therapy (developed by Shapiro) and Trauma Interventions using Mindfulness Based Extinction and Reconsolidation (TIMBER) for trauma memories (developed by Pradhan). Although the antidepressant effects of ketamine are no longer news, ketamine's effects on treatment refractory PTSD (TR-PTSD) is a recent concept. As TR-PTSD has a marked public health burden and significant limitations in terms of treatment interventions, a thorough assessment of current strategies is required. Research to bring clarity to the underlying pathophysiology and neurobiology of TR-PTSD delineating the chemical, structural, and circuitry abnormalities will take time. In the interim, in the absence of a 1-size-fits-all therapeutic approach, pragmatically parallel lines of research can be pursued using the pharmacological and nonpharmacological treatments that have a strong theoretical rationale for efficacy. This article aims to review the current literature on interventions for PTSD, most notably ketamine, trans-cranial magnetic stimulation treatment, yoga and mindfulness interventions, and TIMBER. We present an outline for their future use, alone as well as in combination, with a hope of providing additional insights as well as advocating for developing more effective therapeutic intervention for this treatment-resistant and debilitating condition.

  1. 重复经颅磁刺激器电容充电技术发展现状%Current progress of capacitor charging techniques for repetitive transcranial magnetic stimulation

    Institute of Scientific and Technical Information of China (English)

    雷发胜; 赵晓昕; 张广浩; 霍小林

    2016-01-01

    经颅磁刺激( TMS)是一种非侵入式、无创无痛的神经检测和治疗技术。其中,重复经颅磁刺激( rTMS)具有调节病变区皮质兴奋性等复杂机制,在神经性疾病治疗研究方面具有巨大潜在价值,已经成为当今的研究热点。电容器充电技术是重复经颅磁刺激的核心技术,直接影响rTMS的性能,研制高效和可靠的电容充电电源成为rTMS技术发展的迫切需求。目前比较成熟的电容器充电技术中,高频开关变换器充电方式较其他方式具有明显的优势,随着电力电子器件的发展已成为当今的主流。本文首先详细介绍了两种高频变换器拓扑结构:PWM变换器和谐振变换器,随后从效率、充电速度、体积等几方面阐述了可用于rTMS系统的电容器充电电源技术的最新研究进展,最后指明了rTMS电源技术未来的发展方向。%Transcranial magnetic stimulation ( TMS ) is a non⁃invasive neural detection and treatment technique without causing the subject discomfort. Repetitive transcranial magnetic stimulation ( rTMS) which has some com⁃plex regulatory mechanisms, such as regulating excitability of cortical areas, has great potential value in therapy re⁃search for neurological diseases, and it has become a current research hotspot. The capacitor charging technology is the core of repetitive transcranial magnetic stimulation, directly impacting on the performance of rTMS. Developing highly efficient and reliable capacitor charging power supply ( CCPS) becomes urgent requirements for the advance⁃ment of rTMS techniques. With the mushroom growth of power electronic devices, compared with the other two kinds of techniques, high frequency switching converter has become current mainstream. Firstly two topologies of high frequency converter, PWM converter and resonant convertor, are introduced in detail, and then the latest re⁃search progress of capacitor charging power supply

  2. Repetitive transcranial magnetic stimulation increases the corticospinal inhibition and the brain-derived neurotrophic factor in chronic myofascial pain syndrome: an explanatory double-blinded, randomized, sham-controlled trial.

    Science.gov (United States)

    Dall'Agnol, Letizzia; Medeiros, Liciane Fernandes; Torres, Iraci L S; Deitos, Alicia; Brietzke, Aline; Laste, Gabriela; de Souza, Andressa; Vieira, Júlia Lima; Fregni, Felipe; Caumo, Wolnei

    2014-08-01

    Chronic myofascial pain syndrome has been related to defective descending inhibitory systems. Twenty-four females aged 19 to 65 years with chronic myofascial pain syndrome were randomized to receive 10 sessions of repetitive transcranial magnetic stimulation (rTMS) (n = 12) at 10 Hz or a sham intervention (n = 12). We tested if pain (quantitative sensory testing), descending inhibitory systems (conditioned pain modulation [quantitative sensory testing + conditioned pain modulation]), cortical excitability (TMS parameters), and the brain-derived neurotrophic factor (BDNF) would be modified. There was a significant interaction (time vs group) regarding the main outcomes of the pain scores as indexed by the visual analog scale on pain (analysis of variance, P myofascial pain syndrome were mediated by top-down regulation mechanisms, enhancing the corticospinal inhibitory system possibly via BDNF secretion modulation. High-frequency rTMS analgesic effects were mediated by top-down regulation mechanisms enhancing the corticospinal inhibitory, and this effect involved an increase in BDNF secretion. Copyright © 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.

  3. Advance of Repetitive Transcranial Magnetic Stimulation for Aphasia after Stroke (review)%重复经颅磁刺激治疗在脑卒中后失语症中的应用进展

    Institute of Scientific and Technical Information of China (English)

    胡雪艳; 江晓峰; 张通

    2015-01-01

    Aphasia is common after stroke, and seriously influences the family and social communication of the patients. As a safe and noninvasive therapy, repetitive transcranial magnetic stimulation (rTMS) is used to induce or enhance neural plasticity, including promoting the recovery of aphasia after stroke. This paper reviewed mechanism of speech recovery and the application of rTMS for aphasia after stroke.%失语症是脑卒中后常见的并发症,对患者的工作、家庭和社会交往能力影响巨大。重复经颅磁刺激治疗(rTMS)是用于诱导或增强神经可塑性的一种安全无创的方法,有助于脑卒中后失语症的恢复。本文从言语恢复的机制、rTMS治疗在脑卒中后失语症恢复中的应用进行综述。

  4. Action-blindsight in healthy subjects after transcranial magnetic stimulation

    DEFF Research Database (Denmark)

    Christensen, Mark Schram; Kristiansen, Lasse; Rowe, James B.

    2008-01-01

    Clinical cases of blindsight have shown that visually guided movements can be accomplished without conscious visual perception. Here, we show that blindsight can be induced in healthy subjects by using transcranial magnetic stimulation over the visual cortex. Transcranial magnetic stimulation...

  5. Transcranial Magnetic Stimulation Studies in Alzheimer's Disease

    Directory of Open Access Journals (Sweden)

    Andrea Guerra

    2011-01-01

    Full Text Available Although motor deficits affect patients with Alzheimer's disease (AD only at later stages, recent studies demonstrated that primary motor cortex is precociously affected by neuronal degeneration. It is conceivable that neuronal loss is compensated by reorganization of the neural circuitries, thereby maintaining motor performances in daily living. Effectively several transcranial magnetic stimulation (TMS studies have demonstrated that cortical excitability is enhanced in AD and primary motor cortex presents functional reorganization. Although the best hypothesis for the pathogenesis of AD remains the degeneration of cholinergic neurons in specific regions of the basal forebrain, the application of specific TMS protocols pointed out a role of other neurotransmitters. The present paper provides a perspective of the TMS techniques used to study neurophysiological aspects of AD showing also that, based on different patterns of cortical excitability, TMS may be useful in discriminating between physiological and pathological brain aging at least at the group level. Moreover repetitive TMS might become useful in the rehabilitation of AD patients. Finally integrated approaches utilizing TMS together with others neuro-physiological techniques, such as high-density EEG, and structural and functional imaging as well as biological markers are proposed as promising tool for large-scale, low-cost, and noninvasive evaluation of at-risk populations.

  6. New therapeutic perspectives in neurorehabilitation: transcranial magnetic stimulation

    Directory of Open Access Journals (Sweden)

    STANESCU Ioana

    2014-05-01

    Full Text Available Transcranial magnetic stimulation (TMS is a non-invasive tool for the electrical stimulation of neural tissue, including the cerebral cortex, and is an excellent method to study brain physiology. Trains of stimuli (repetitive TMS can modify excitability of the cerebral cortex at the stimulated site and also at remote areas along anatomo-functional connexions. Repetitive TMS is used to modulate cortical excitability in a frequency-dependent manner, for a period of time that outlasts the duration of stimulation, inducing plastic changes in the brain. Repetitive TMS may become an additional tool for early rehabilitation and might be useful for promoting cortical plasticity in neurologic patients. Its utility have been demonstrated by many clinical studies in various disabling conditions, as stroke, Parkinson disease, multiple sclerosis, spinal cord injuries, and many more, where rTMS opens a new field of therapeutic possibilities.

  7. The Impact of Accelerated Right Prefrontal High-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) on Cue-Reactivity: An fMRI Study on Craving in Recently Detoxified Alcohol-Dependent Patients.

    Science.gov (United States)

    Herremans, Sarah C; Van Schuerbeek, Peter; De Raedt, Rudi; Matthys, Frieda; Buyl, Ronald; De Mey, Johan; Baeken, Chris

    2015-01-01

    In alcohol-dependent patients craving is a difficult-to-treat phenomenon. It has been suggested that high-frequency (HF) repetitive transcranial magnetic stimulation (rTMS) may have beneficial effects. However, exactly how this application exerts its effect on the underlying craving neurocircuit is currently unclear. In an effort to induce alcohol craving and to maximize detection of HF-rTMS effects to cue-induced alcohol craving, patients were exposed to a block and event-related alcohol cue-reactivity paradigm while being scanned with fMRI. Hence, we assessed the effect of right dorsolateral prefrontal cortex (DLPFC) stimulation on cue-induced and general alcohol craving, and the related craving neurocircuit. Twenty-six recently detoxified alcohol-dependent patients were included. First, we evaluated the impact of one sham-controlled stimulation session. Second, we examined the effect of accelerated right DLPFC HF-rTMS treatment: here patients received 15 sessions in an open label accelerated design, spread over 4 consecutive days. General craving significantly decreased after 15 active HF-rTMS sessions. However, cue-induced alcohol craving was not altered. Our brain imaging results did not show that the cue-exposure affected the underlying craving neurocircuit after both one and fifteen active HF-rTMS sessions. Yet, brain activation changes after one and 15 HF-rTMS sessions, respectively, were observed in regions associated with the extended reward system and the default mode network, but only during the presentation of the event-related paradigm. Our findings indicate that accelerated HF-rTMS applied to the right DLPFC does not manifestly affect the craving neurocircuit during an alcohol-related cue-exposure, but instead it may influence the attentional network.

  8. Repetitive transcranial magnetic stimulation (rTMS) augmentation of selective serotonin reuptake inhibitors (SSRIs) for SSRI-resistant obsessive-compulsive disorder (OCD): a meta-analysis of randomized controlled trials

    Science.gov (United States)

    Ma, Zhong-Rui; Shi, Li-Jun

    2014-01-01

    Background and objective: Randomized controlled trials (RCTs) on repetitive transcranial magnetic stimulation (rTMS) as augmentation of selective serotonin reuptake inhibitors (SSRIs) for SSRI-resistant obsessive-compulsive disorder (OCD) have yielded conflicting results. Therefore, this meta-analysis was conducted to assess the efficacy of this strategy for SSRI-resistant OCD. Methods: Scientific and medical databases, including international databases (PubMed, MEDLINE, EMBASE, CCTR, Web of Science, PsycINFO), two Chinese databases (CBM-disc, CNKI), and relevant websites dated up to July 2014, were searched for RCTs on this strategy for treating OCD. Mantel-Haenszel random-effects model was used. Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score, response rates and drop-out rates were evaluated. Results: Data were obtained from nine RCTs consisting of 290 subjects. Active rTMS was an effective augmentation strategy in treating SSRI-resistant OCD with a pooled WMD of 3.89 (95% CI = [1.27, 6.50]) for reducing Y-BOCS score and a pooled odds ratio (OR) of 2.65 (95% CI = [1.36, 5.17] for response rates. No significant differences in drop-out rates were found. No publication bias was detected. Conclusion: The pooled examination demonstrated that this strategy seems to be efficacious and acceptable for treating SSRI-resistant OCD. As the number of RCTs included here was limited, further large-scale multi-center RCTs are required to validate our conclusions. PMID:25663986

  9. 重复经颅磁刺激辅助治疗精神分裂症的双盲对照研究%Repetitive transcranial magnetic stimulation for the treatment of schizophrenia:a double-blind study

    Institute of Scientific and Technical Information of China (English)

    王丹逢; 郭建雄; 刘恩益; 张春平; 卢想云

    2015-01-01

    目的:探讨重复经颅磁刺激治疗( rTMS)对精神分裂症阳性症状及阴性症状的效果。方法采用随机数字表法将64例符合《精神障碍诊断与统计手册(第4版)》( DSM-IV)诊断标准的精神分裂症患者分为研究组(真刺激)和对照组(伪刺激)各32例,在原有抗精神病药物剂量保持不变基础上,分别予2周10次的1Hz左侧颞顶叶rTMS真性刺激和假性刺激治疗。治疗开始前和治疗结束后均采用阳性和阴性症状量表( PANSS)评定临床疗效。结果两组在治疗后阳性症状评分、阴性症状评分、一般精神病理学评分、PANSS 总评分差异无统计学差异(P>0.05);治疗后研究组的幻觉性行为(P3)的减分率与对照组相比,差异有统计学差异(P0. 05). However,we do found that the hallucinatory behavior(P3)of the study group was significantly lower than it in the control group(P<0. 05). Conclusion Repeti-tive transcranial magnetic stimulation can improve the hallucinatory behavior(P3)of schizophrenia.

  10. Low frequency (1-Hz), right prefrontal repetitive transcranial magnetic stimulation (rTMS) compared with venlafaxine ER in the treatment of resistant depression: a double-blind, single-centre, randomized study.

    Science.gov (United States)

    Bares, Martin; Kopecek, Miloslav; Novak, Tomas; Stopkova, Pavla; Sos, Peter; Kozeny, Jiri; Brunovsky, Martin; Höschl, Cyril

    2009-11-01

    Previous studies have shown effectiveness of repetitive transcranial magnetic stimulation (rTMS) in the treatment of depression. This double-blind study compared efficacy of l Hz rTMS over the right prefrontal dorsolateral cortex with venlafaxine ER in the treatment of resistant depression. A total of 60 inpatients with depressive disorder (DSM-IV criteria), who previously did not respond to at least one antidepressant treatment, were randomly assigned to 1 Hz rTMS with placebo and venlafaxine ER with sham rTMS for 4 weeks. The primary outcome measure was score change in the Montgomery-Asberg Depression Rating Scale (MADRS). We also used Clinical Global Impression (CGI) and Beck Depressive. Inventory-Short Form (BDI-SF). The response was defined as a >or=50% reduction of MADRS score. There were no significant differences between treatment groups in MADRS (p=0.38), BDI-SF (p=0.56) and CGI (p=0.17) scores from baseline to endpoint. Response rates for rTMS (33%) and venlafaxine (39%) as well as remission (MADRS score

  11. A single-subject study to evaluate ‎the inhibitory repetitive transcranialmagnetic stimulation combined ‎with traditional dysphagia‎ therapy in patients with‎ post-stroke dysphagia

    Directory of Open Access Journals (Sweden)

    Leila Ghelichi

    2016-08-01

    Full Text Available Background: Post-stroke dysphagia is common and is associated with the development of pneumonia. To investigate the effects of repetitive transcranial magnetic stimulation (rTMS combined with traditional dysphagia therapy (TDT on swallowing function in patients with post-stroke dysphagia.Methods: In this single-subject study, four patients with dysphagia post-stroke included. The patients received the rTMS applied to the intact cerebral hemisphere at 1 Hz with train of 1200 for 5 consecutive days combined with TDT 3 days per week for 6 weeks. The main outcome measure was the Mann Assessment of Swallowing Ability (MASA. Measurements were taken before, after the end of 5th, 10th, 15th treatment sessions, and after the end of the treatment (18th session.Results: The MASA scores improved in all patients following treatment. The maximum and minimum change in level between the baseline phase and treatment phase was +84 and +36. The greatest percentage improvement was observed after 5th treatment sessions ranging between 11 and 35%. The treatment trend was upward shown by the directions of the slopes indicated by positive values (+9.1-+20.7. The dysphagia was resolved after 10th treatment session in all participants. The aspiration resolved in two participants after the 5th treatment session and resolved in another 2 participants after the 10th treatment session.Conclusion: The combination therapy of rTMS plus TDT improved swallowing function in patients with post-stroke dysphagia. Further research with a larger sample size is recommended.

  12. Posture-cognitive dual-tasking: A relevant marker of depression-related psychomotor retardation. An illustration of the positive impact of repetitive transcranial magnetic stimulation in patients with major depressive disorder.

    Science.gov (United States)

    Deschamps, Thibault; Sauvaget, Anne; Pichot, Anne; Valrivière, Pierre; Maroulidès, Maxime; Bois, Aurore; Bulteau, Samuel; Thomas-Ollivier, Véronique

    2016-12-01

    This study examined whether postural control variables, particularly the center-of-pressure (COP) velocity-based parameters, could be a relevant hallmark of depression-related psychomotor retardation (PMR). We first aimed at investigating the interplay between the PMR scores and the COP performance in patients with major depressive disorder (MDD), as compared to age-matched healthy controls; secondly, we focused on the impact of a repetitive transcranial magnetic stimulation (rTMS) treatment on depression, PMR scores and postural performance. 16 MDD patients, and a control group of 16 healthy adults, were asked to maintain quiet standing balance during two trials with or without vision, and while backward counting (dual task). All the position and velocity-based COP variables were computed. Before and after the rTMS session (n eligible MDD = 10), we assessed the depression level with the Montgomery-Asberg Depression Rating Scale (MADRS), the PMR scores with the French Retardation Rating Scale for Depression (ERD), and postural performance. Before the treatment, significant positive partial correlations were found between the pre-ERD scores and the velocity-based COP variables, especially in the dual-task conditions (p < 0.05). In contrast, there was no significant correlation between the post-ERD scores and any postural parameter after the treatment. The MADRS and ERD scores showed a significant decrease between before and after the rTMS intervention. For the first time, the findings clearly validated the view that the assessment of postural performance - easy to envisage in clinical settings-constitutes a reliable and objective marker of PMR in MDD patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. 重复经颅磁刺激对冰毒成瘾患者认知功能的影响%Repetitive Transcranial Magnetic Stimulation Effects on Cognitive Function in Patients with Methamphetamine Addiction

    Institute of Scientific and Technical Information of China (English)

    徐进; 周利洪

    2013-01-01

    目的:评价重复经颅磁刺激rTMS对冰毒成瘾患者认知功能的影响。方法90例冰毒成瘾患者接受10Hz rTMS治疗20次,治疗前后应用韦氏记忆量表(WMS--RS)、心理旋转试验(MR)、威斯康星卡片分类测验(WCST)进行评定。结果 WMS--RS、中大部分测验项目在治疗前后都有统计学意义,MR在治疗前后有显著统计学意义,WCST错误应答(RE)有显著下降,非持续性错误(NRPE)也有显著下降。结论 rTMS可以改善冰毒成瘾患者的认知功能。%Objective Evaluation of Repetitive Transcranial Magnetic Stimulation (rTMS )ef ects on cognitive function in patients with methamphetamine addiction. Methods 90 methamphetamine addiction patients accept 10 Hz rTMS treatment for 20 times,Before and after treatment using wechsler memory scale (WMS-RS), mental rotation test (MR), Wisconsin card sorting test (WCST) were assessed. Results Most of the WMS- RS test item before and after treatment was statistical y significant,MR significant statistical significance before and after therapy,WCST RE has dropped significantly,NRPE has dropped significantly. Conclusion rTMS can improve cognitive function in patients with methamphetamine addiction.

  14. Application of Repetitive Transcranial Magnetic Stimulation for Neuropathic Pain (review)%重复经颅磁刺激治疗神经病理性疼痛研究进展

    Institute of Scientific and Technical Information of China (English)

    韩晓阁; 杨晓秋

    2016-01-01

    Repetitive transcranial magnetic stimulation (rTMS) may release neuropathic pain (NeP) by changing the excitability of cor-tex, improving the cerebral blood flow, regulating the expression of neurotransmitter, fitting the plasticity, reducing the overexpression of neuronal nitric oxide synthase and overaction of astrocyte, etc. It is used for management of post-herpetic neuralgia, thalamic pain after stroke, NeP after spinal cord injury, phantom limb pain, atypical facial pain post operation of trigeminal nerve, etc. The outcome is associat-ed with the location, frequency, pulses, intensity of stimulation, as well as the shape of the stimulator, etc.%重复经颅磁刺激通过改变大脑皮质的兴奋性,改善脑血流和代谢,调节神经递质表达,改变神经系统可塑性,降低背根神经节内过度表达的神经元型一氧化氮合酶、抑制星形胶质细胞活性等途径,发挥治疗神经病理性疼痛的作用,目前已用于带状疱疹后神经痛、脑卒中后丘脑痛、脊髓损伤后神经痛、幻肢痛、三叉神经术后非典型面痛等的治疗中,疗效与刺激部位、频率、脉冲数、刺激器形状、刺激强度等因素有关。

  15. Rapid Modulation of Distributed Brain Activity by Transcranial Magnetic Stimulation of Human Motor Cortex

    OpenAIRE

    Lucy Lee; Hartwig Siebner; Sven Bestmann

    2006-01-01

    This paper reviews the effects of single and repetitive transcranial magnetic stimuli (rTMS) delivered to one cortical area and measured across distributed brain regions using electrophysiological measures (e.g. motor thresholds, motor evoked potentials, paired-pulse stimulation), functional neuroimaging (including EEG, PET and fMRI) and behavioural measures. Discussion is restricted to changes in excitability in the primary motor cortex and behaviour during motor tasks following transcranial...

  16. Transcranial magnetic stimulation intensities in cognitive paradigms.

    Directory of Open Access Journals (Sweden)

    Jakob A Kaminski

    Full Text Available BACKGROUND: Transcranial magnetic stimulation (TMS has become an important experimental tool for exploring the brain's functional anatomy. As TMS interferes with neural activity, the hypothetical function of the stimulated area can thus be tested. One unresolved methodological issue in TMS experiments is the question of how to adequately calibrate stimulation intensities. The motor threshold (MT is often taken as a reference for individually adapted stimulation intensities in TMS experiments, even if they do not involve the motor system. The aim of the present study was to evaluate whether it is reasonable to adjust stimulation intensities in each subject to the individual MT if prefrontal regions are stimulated prior to the performance of a cognitive paradigm. METHODS AND FINDINGS: Repetitive TMS (rTMS was applied prior to a working memory task, either at the 'fixed' intensity of 40% maximum stimulator output (MSO, or individually adapted at 90% of the subject's MT. Stimulation was applied to a target region in the left posterior middle frontal gyrus (pMFG, as indicated by a functional magnetic resonance imaging (fMRI localizer acquired beforehand, or to a control site (vertex. Results show that MT predicted the effect size after stimulating subjects with the fixed intensity (i.e., subjects with a low MT showed a greater behavioral effect. Nevertheless, the individual adaptation of intensities did not lead to stable effects. CONCLUSION: Therefore, we suggest assessing MT and account for it as a measure for general cortical TMS susceptibility, even if TMS is applied outside the motor domain.

  17. [Fundamentals and Clinical Applications of Transcranial Magnetic Stimulation in Neuropsychiatry].

    Science.gov (United States)

    Malavera, Mayra; Silva, Federico; García, Ronald; Rueda, Ligia; Carrillo, Sandra

    2014-03-01

    Transcranial Magnetic Stimulation (TMS) is a non-invasive method for stimulation of brain that is based on the ability of a generated magnetic field to penetrate skull and brain meninges, inducing an electric current in the brain tissues that produces neuronal depolarization. TMS can be applied as single pulse of stimulation, pairs of stimuli separated by variable intervals to the same or different brain areas, or as trains of repetitive stimuli at various frequencies. Its mechanism of action is currently unknown. Repetitive TMS can modify the excitability of the cerebral cortex, and has been postulated as a diagnostic and therapeutic tool in the area of neuropsychiatry. The aim of this article is to review the knowledge of the TMS as regards its basic principles, pathophysiological mechanism, and its usefulness in clinical practice. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  18. Transcranial magnetic stimulation and the human brain

    Science.gov (United States)

    Hallett, Mark

    2000-07-01

    Transcranial magnetic stimulation (TMS) is rapidly developing as a powerful, non-invasive tool for studying the human brain. A pulsed magnetic field creates current flow in the brain and can temporarily excite or inhibit specific areas. TMS of motor cortex can produce a muscle twitch or block movement; TMS of occipital cortex can produce visual phosphenes or scotomas. TMS can also alter the functioning of the brain beyond the time of stimulation, offering potential for therapy.

  19. More female patients and fewer stimuli per session are associated with the short-term antidepressant properties of repetitive transcranial magnetic stimulation (rTMS): a meta-analysis of 54 sham-controlled studies published between 1997–2013

    Science.gov (United States)

    Kedzior, Karina Karolina; Azorina, Valeriya; Reitz, Sarah Kim

    2014-01-01

    Background Repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex (DLPFC) appears to have short-term antidepressant properties. The aim of the current study was to update our previous meta-analysis and to investigate factors associated with the antidepressant properties of rTMS. Method Following a systematic literature search conducted in Medline and PsycInfo, N=14 sham-controlled, parallel design studies (published after 2008 to August 2013) that had utilized rTMS of the DLPFC in major depression were included in the current meta-analysis. The sensitivity and moderator analyses also included data from N=40 studies (published in 1997–2008) from our previous meta-analysis. The effect size (Cohen’s d) in each study was the standardized difference in mean depression scores (on Hamilton Depression Rating Scale, Beck Depression Inventory, Montgomery Åsberg Depression Rating Scale) from baseline to final (after last session) in rTMS compared to sham groups. Results According to a random-effects model with inverse-variance weights, depression scores were significantly reduced after rTMS compared to sham in studies published from 2008–2013 based on N=659 patients (overall mean weighted d=−0.42, 95% confidence interval: −0.66, −0.18, P=0.001). Combining studies from our past and current meta-analyses (published in 1997–2013; N=54) revealed that depression was significantly reduced after left-fast (>1 Hz), right-slow (≤1 Hz), and bilateral (or sequential) rTMS of DLPFC compared to sham. Significant antidepressant properties of rTMS were observed in studies with patients who were treatment resistant, unipolar (or bipolar), non-psychotic, medication-free (or started on antidepressants concurrently with rTMS). According to univariate meta-regressions, depression scores were significantly lower in studies with more female patients and fewer stimuli per session. There was little evidence that publication bias occurred in the

  20. Clinical outcomes and neural correlates of 20 sessions of repetitive transcranial magnetic stimulation in severe and enduring anorexia nervosa (the TIARA study): study protocol for a randomised controlled feasibility trial.

    Science.gov (United States)

    Bartholdy, Savani; McClelland, Jessica; Kekic, Maria; O'Daly, Owen G; Campbell, Iain C; Werthmann, Jessica; Rennalls, Samantha J; Rubia, Katya; David, Anthony S; Glennon, Danielle; Kern, Nikola; Schmidt, Ulrike

    2015-12-03

    Anorexia nervosa (AN) is a serious mental disorder with multiple comorbidities and complications. In those with a severe and enduring form of the illness (SEED-AN), treatment responsivity is poor and the evidence base limited. Thus, there is a need for novel treatment strategies. This paper describes the theoretical background and protocol of a feasibility randomised controlled trial (RCT) of real versus sham (placebo) therapeutic repetitive transcranial magnetic stimulation (rTMS) in SEED-AN. The aim of this trial is to obtain information that will guide decision making and protocol development in relation to a future large-scale RCT of rTMS in this group of patients, and also to assess the preliminary efficacy and neural correlates of rTMS treatment. Forty-four adults from the community with a DSM-5 diagnosis of AN, an illness duration>3 years and a previous course of unsuccessful treatment will be randomly allocated to receive 20 sessions of either real or sham rTMS, in a parallel group design. As this is a feasibility study, no primary outcome has been defined and a broad range of outcome variables will be examined. These include weight/body mass index (BMI), eating disorder psychopathology, other psychopathology (for example, depression, anxiety), quality of life, neuropsychological processes (such as self-regulation, attentional bias and food choice behaviour), neuroimaging measures (that is, changes in brain structure or function), tolerability and acceptability of rTMS, and additional service utilisation. The feasibility of conducting a large-scale RCT of rTMS and the appropriateness of rTMS as a treatment for SEED-AN will be evaluated through: assessment of recruitment and retention rates, acceptability of random allocation, blinding success (allocation concealment), completion of treatment sessions and research assessments (baseline, post-treatment and follow-up assessments). The acceptability and tolerability of the treatment will be assessed via semi

  1. Review of the Efficacy of Transcranial Magnetic Stimulation for Auditory Verbal Hallucinations

    NARCIS (Netherlands)

    Slotema, Christina W.; Blom, Jan; van Lutterveld, Remko; Hoek, Hans W.; Sommer, Iris E. C.

    2014-01-01

    With an increase of the number of studies exploring repetitive transcranial magnetic stimulation (rTMS) for the treatment of auditory verbal hallucinations (AVH), an update is provided on the efficacy of different paradigms. A literature search was performed from 1966 through April 2013. Twenty-five

  2. Study of synergistic effect of 1 Hz repetitive transcranial magnetic stimulation on medication - resistant schizophrenia%低频重复经颅磁刺激对难治性精神分裂症的增效作用

    Institute of Scientific and Technical Information of China (English)

    王雪; 罗炯; 李晓虹; 任艳萍

    2016-01-01

    目的:评价低频重复经颅磁刺激(rTMS)对难治性精神分裂症的疗效和认知功能的影响及其安全性。方法将52例幻听症状突出的难治性精神分裂症患者随机分为真刺激组和伪刺激组,刺激频率为1Hz,部位为背外侧前额叶皮质。在基线期、2周(治疗10次)、6周(治疗20次)和治疗结束后1个月采用阳性和阴性症状量表(PANSS)、幻听量表(AHRS)、临床总体印象量表(CGIS)评价精神症状,采用可反复测查的成套神经心理状态评估工具( RBANS)评价认知功能,采用副反应量表(TESS)评定不良反应。结果 rTMS 治疗10次、20次及随访1个月时,真刺激组和伪刺激组相比,PANSS 幻觉、CGI 评分、AHRS 频率及 RBANS 总评分比较差异均有统计学意义(P ﹤0.05或0.01);rTMS 治疗20次及随访1个月时,AHRS 总评分、影响、痛苦、RBANS 视觉广度、言语功能及注意力评分差异有统计学意义(P ﹤0.05或0.01);随访1个月时,PANSS 阳性症状、一般病理症状评分、RBANS 即刻记忆评分差异有统计学意义(P ﹤0.05或0.01)。rTMS 治疗后未发现明显不良反应。结论低频 rTMS 可改善精神分裂症的幻听、阳性症状和认知功能且安全性好。%Objective To evaluate the efficacy and safety of 1Hz repetitive transcranial magnetic stimulation(rTMS)on audi-tory hallucination and cognitive impairment of schizophrenia. Methods Fifty - two patients who had medication - resistant auditory hallucination were randomized to either active rTMS applied to the dorsolateral prefrontal cortex(n = 26)or sham rTMS(n = 26). The outcome measures included Positive and Negative Syndrome Scale(PANSS),Auditory Hallucinations Rating Scale(AHRS),Clinical Global Impression Scale(CGIS),Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)and Treatment Emer-gent Symptom Scale(TESS)at baseline,treatment for 2 weeks,6 weeks and

  3. 重复经颅磁刺激联合帕罗西汀治疗重性抑郁障碍%Repetitive transcranial magnetic stimulation in combination with paroxetine for major depressive disorder

    Institute of Scientific and Technical Information of China (English)

    房萌; 任艳萍; 刘辉; 周方; 王刚

    2014-01-01

    Objective To investigate the efficacy of repetitive transcranial magnetic stimulation( rTMS) in combination with paroxetine for major depressive disorder. Methods In a 6-week, randomized, double-blind, sham-controlled trial, 48 patients with major depressive disorder were randomly assigned to receive real or sham rTMS for 2 weeks. During the 6 weeks, paroxetine was used at a fixed dose of 20 mg per day for all participants. Seven sites were set to conduct assessment of efficacy and adverse events in this study. ResultsThe Montgomery-Asberg Depression Rating(MADRS), the 17-item Hamilton Depression Rating Scale(HAMD-17) and Hamilton Anxiety Rating Scale( HAMA) scores significantly decreased from baseline to the endpoint in both groups. No meaningful difference was observed between the two groups in general clinical effect. The mean time-to-onset was earlier by 3 days in Real group, but the difference was not significant. In the Real group, the scores of HAMD anxiety/somatic symptom factor significantly decreased on day10, 14 and 28; the scores of HAMA significantly decreased on day 10. The incidence of adverse events in both groups had no significant difference. Conclusion The combination of rTMS and paroxetine was effective and safe in treatment of MDD. The tendency of fast onset of effect was observed in the comprehensive intervention, which probably is beneficial to the patients with anxiety and somatic symptoms.%目的探讨重复经颅磁刺激( repetitive transcranial magnetic stimulation,rTMS)联合帕罗西汀对重性抑郁障碍( major depressive disorder,MDD)的疗效。方法本研究是一项为期6周的随机、双盲、伪刺激对照临床试验。48例MDD患者采用数字表法随机分为2组接受rTMS真(real)或伪(sham)刺激治疗2周,基线起同时合并固定剂量的帕罗西汀(20 mg/d),rTMS治疗结束后随访至6周末,随访期间帕罗西汀治疗剂量保持不变。设置7个访视点进行疗效评定和不良事件记录。结

  4. Investigative effects of low frequency repetitive transcranial magnetic stimulation combined with drugs on obstinate auditory hallucinations and cognitive function in patients with schizophrenia%低频重复经颅刺激联合药物干预对精神分裂症患者顽固性幻听和认知功能的影响效果探析

    Institute of Scientific and Technical Information of China (English)

    马继东; 潘赞; 田洪伟; 王朝

    2015-01-01

    Objective To explore the clinical value of low frequency repetitive transcranial magnetic stimulation in improving obstinate auditory hallucinations and cognitive function in patients with schizophrenia. Methods According to visiting order number, 128 patients with schizophrenia were divided into control group and observation group.The observation group was treated by low frequency repetitive transcranial magnetic stimulation combined with risperidone, the control group was treated with risperidone.Before and after treatment, the patients were evaluated, by auditory hallucinations rating scale( AHRS) and assessment of verbal fluency and trail making were performed in patients.Results There was no significant difference in AHRS scores, VFT scores and trail making between the two groups before treatment (P>0.05).After treatment, the AHRS scores in the observation group were lower than that in the control group, the VFT scores in the observation group were higher than that in the control group, with statistical significance between two groups (P0.05).治疗后,观察组AHRS评分低于对照组,VFT评分则升高明显,差异具统计学意义( P<0.05). 结论 低频重复经颅刺激联合药物干预可较好的改善精神分裂症患者顽固性幻听,以及语言方面的认知功能.

  5. 重复经颅磁刺激治疗妊娠期及产后抑郁症的临床疗效%Effects of repetitive transcranial magnetic stimulation on depression during pregnancy and postpartum depression

    Institute of Scientific and Technical Information of China (English)

    李恩泽; 李倩琴; 薛湘; 洪军

    2014-01-01

    Objective To explore the therapeutic efficacy of repetitive transcranial magnetic stimulation (rT-MS) on depression during pregnancy and postpartum depression .Methods The evaluation method of cochrane col-laboration system was used to make a system review of 3 articles about rTMS treatment in depression during preg-nancy and postpartum depression .Results Scores of Hamilton Depression Rating Scale for Depression (HDRS)-17 , Edinburgh postnatal depression scale (EPDS) ,clinical global impressions-severity scale (CGI-S) ,clinical global im-pressions-life quality scale (CGI-3 ) ,Self adjusting social scale (SAS )-self report (SR )-overall social performance (OSP) ,Beck Depression Inventory (BDI) ,inventory of depressive symptoms-self report (IDS-SR) ,SAS-SR-work of home (WH) in patients before treatment were statistically different with scores after treatment (P<0 .05) ,including the combination of HDRS-17 ,EPDS and CGI-SC (P<0 .05) .Conclusion rTMS could be an effective treatment for depression during pregnancy and postpartum depression .%目的:探讨重复经颅磁刺激(rTMS)治疗妊娠期及产后抑郁症的疗效。方法采用Cochrane协作网的系统评价方法,对纳入的3篇有关rTMS治疗妊娠期及产后抑郁症的文章进行研究。结果患者治疗前后汉密尔抑郁评分量表-17项(HDRS-17)、爱丁堡产后抑郁量表(EPDS)、临床总体印象-严重度评分量表(CGI-S)、临床总体印象-生活质量评分量表(CGI-3)、社会自我调整量表-自我报告-整体社会绩效(SAS-SR-OSP)、Beck抑郁自评问卷(BDI)、抑郁症状自我报告详细目录(IDS-SR)、社会自我调整量表-自我报告-家庭工作(SAS-SR-WH)评分比较,差异有统计学意义(P<0.05),其中 HDRS-17、EPDS、CGI-S是合并量的分析(提示3个研究结果合并后的 HDRS-17、EPDS、CGI-S治疗前后评分比较,差异有统计学意义(P<0.05)。结论 rTMS能有效治疗妊娠期及产后抑郁症。

  6. A control study of repetitive transcranial magnetic stimulation for memory disorders due to MECT%重复经颅磁刺激治疗 MECT 所致记忆障碍对照研究

    Institute of Scientific and Technical Information of China (English)

    郭昕; 王跃升; 龚毅

    2015-01-01

    Objective To explore the efficacy of repetitive transcranial magnetic stimulation (rTMS) for memory disorders due to modified electroconvulsive therapy (MECT) .Methods Fifty‐two schizophrenics who developed memory disorders in 2 weeks after MECT were randomly assigned to two groups ,rTMSs given to research group and pseudo‐rTMSs to control group for 4 weeks .Memory function rehabilitations were assessed with the Wechsler Memory Scale (WMS) .Results Since the 1st day treatment each dimension score of the WMS of both groups heightened continuously (P<0.05 or 0.01) , those at the ends of the 1st and 2nd week did more significantly in research than control group (P<0.05 or 0 .01);full recovery rate of memory function was significantly higher in research than control group at the end of the 2nd week (69.2% vs 15.4% ,χ2 =15.44 , P<0.01) .Conclusion The rTMS has an evident effect on memory disorders due to M ECT in schizophrenics .%目的:探讨重复经颅磁刺激治疗无抽搐电休克所致记忆障碍的疗效。方法将52例经无抽搐电休克治疗2周后出现记忆障碍的精神分裂症患者随机分为两组,研究组予以重复经颅磁刺激治疗,对照组予以假性重复经颅磁刺激治疗,观察4周。采用韦氏记忆量表评估患者记忆功能恢复状况。结果治疗后两组韦氏记忆量表各维度评分均较治疗第1d呈持续性升高( P<0.05或0.01),治疗第1周、2周末研究组各维度评分较对照组升高更显著( P<0.05或0.01);治疗第2周末研究组记忆功能完全恢复率69.2%,对照组为15.4%,研究组显著高于对照组(χ2=15.44,P<0.01)。结论重复经颅磁刺激治疗精神分裂症患者行无抽搐电休克治疗后所致的记忆障碍效果显著。

  7. 低频重复经颅磁刺激在帕金森病康复治疗中的应用价值%The application of low frequency repetitive transcranial magnetic stimulation in rehabilitation of Parkinson's disease patients

    Institute of Scientific and Technical Information of China (English)

    吴卓华; 崔立谦; 许启锋; 林杰; 刘磊; 吴宜娟; 谭红愉; 李少明; 邵明

    2013-01-01

    Objective To explore the application value of low frequency repetitive transcranial magnetic stimulation (rTMS) in Parkinson's disease (PD) patients and electrophysiological research.Methods Fifty-six PD patients treated in the Department of Neurology of our hospital from September 2010 to September 2012 were randomly divided into 2 groups,group A (N =28) and group B (N =28).Patients in group A were given conventional drug treatment and rehabilitation training,while patients in group B were given low frequency rTMS on the basis of conventional drug treatment and rehabilitation training.After 3 weeks,the scores of Unified Parkinson's Disease Rating Scale (UPDRS),resting threshold (RT),cortical latent period,nerve root latent period,central motor conduction time (CMCT) and the incidence of adverse reactions were compared between 2 groups.Results After intervention,the emotion,ability of daily living and motor function of patients in group B was obviously improved,and the scores of UPDRS in group B were significantly lower than that in group A (P < 0.05,for all).The RT,cortical latent period and CMCT in group B were longer than that in group A (P < 0.05,for all).The incidence of adverse reactions of 2 groups was not obviously different (P > 0.05).Conclusion The effect of low frequency rTMS in the treatment for PD is evident,safe and reliable,and with less adverse reaction.It can be used as a noninvasive physical treatment measure for PD.%目的 探讨低频重复经颅磁刺激在帕金森病康复治疗中的应用价值及电生理学研究方法.方法 选择56例符合纳入条件的帕金森病患者,随机分为常规药物治疗和康复训练组(A组)及常规治疗辅助低频重复经颅磁刺激治疗组(B组),连续治疗3周后评价两组患者统一帕金森病评价量表(UPDRS)评分、静息阈值、皮质潜伏期、神经根潜伏期、中枢运动传导时间和不良反应发生率.结果 与A组相比,低频重复经颅磁刺激治疗后B

  8. Field modeling for transcranial magnetic stimulation

    DEFF Research Database (Denmark)

    Thielscher, Axel; Antunes, Andre; Saturnino, Guilherme B

    2015-01-01

    Electric field calculations based on numerical methods and increasingly realistic head models are more and more used in research on Transcranial Magnetic Stimulation (TMS). However, they are still far from being established as standard tools for the planning and analysis in practical applications...... of TMS. Here, we start by delineating three main challenges that need to be addressed to unravel their full potential. This comprises (i) identifying and dealing with the model uncertainties, (ii) establishing a clear link between the induced fields and the physiological stimulation effects, and (iii...

  9. Clinical Applications of Transcranial Magnetic Stimulation in Pediatric Neurology.

    Science.gov (United States)

    Narayana, Shalini; Papanicolaou, Andrew C; McGregor, Amy; Boop, Frederick A; Wheless, James W

    2015-08-01

    Noninvasive brain stimulation is now an accepted technique that is used as a diagnostic aid and in the treatment of neuropsychiatric disorders in adults, and is being increasingly used in children. In this review, we will discuss the basic principles and safety of one noninvasive brain stimulation method, transcranial magnetic stimulation. Improvements in the spatial accuracy of transcranial magnetic stimulation are described in the context of image-guided transcranial magnetic stimulation. The article describes and provides examples of the current clinical applications of transcranial magnetic stimulation in children as an aid in the diagnosis and treatment of neuropsychiatric disorders and discusses future potential applications. Transcranial magnetic stimulation is a noninvasive tool that is safe for use in children and adolescents for functional mapping and treatment, and for many children it aids in the preoperative evaluation and the risk-benefit decision making.

  10. Effect of low frequency repetitive transcranial magnetic stimulation on dysfunction and depressive symptoms of parkinson disease patients%低频重复经颅磁刺激对帕金森病患者功能障碍及抑郁症状的影响

    Institute of Scientific and Technical Information of China (English)

    唐雪琴; 邓景贵; 宋涛; 刘佳; 张长杰; 吴亚岑; 桂一莎

    2015-01-01

    Objective To discuss the clinical effect of transcranial magnetic stimulation in treatment of dysfunction and depression of parkinson disease patients. Methods A totao of 50 cases of parkinson patients were randomly divided into the observation group and the control group, each group 25 cases, the control group was given conventional medicine and rehabilitation training, the observation group was given low frequency repetitive transcranial magnetic stimulation based on the control group. Results After 1 months of treatment, UPDRS Ⅰ, UPDRS II, UPDRS III, UP-DRS total scores in the observation group were lower than that in the control group, there was statistical significance (P0.05), but HAMD score in the observation group was lower than that in the control group, there was statis-tical significance (P0.05),但观察组的HAMD评分低于对照组,差异有统计学意义(P<0.05)。结论低频重复经颅磁刺激可作为一项无创性物理治疗帕金森病的措施。

  11. Research progress of diagnostic transcranial magnetic stimulation

    Directory of Open Access Journals (Sweden)

    Bei HUANG

    2017-07-01

    Full Text Available Transcranial magnetic stimulation (TMS is a non-invasive and painless neuroelectrophysiological examination technology. TMS-motor evoked potential (TMS-MEP is widely used to assess motor cortex excitability and conduction of descending corticobulbar tract and corticospinal tract. Recently, deeper understanding on principles of magnetic stimulation and diversification of stimulation coil and pattern has greatly expanded the application of TMS in clinical diagnosis. Moreover, MEP operation procedures are becoming more scientific and standardized. This paper reviews the progress of conventional diagnostic TMS pattern, several special stimulation patterns and the combined application of TMS, electroencephalograpy (EEG and fMRI. DOI: 10.3969/j.issn.1672-6731.2017.04.011

  12. The Clinical Effect of Low Frequency Repetitive Transcranial Magnetic Stimulation combined with Cognitive Behavioral Therapy in the Treatment of Adolescent Depression%经颅磁刺激联合认知行为疗法治疗青少年抑郁症的临床效果

    Institute of Scientific and Technical Information of China (English)

    王静; 杜红兴

    2016-01-01

    Objective:To study the efficacy of low frequency repetitive transcranial magnetic stimulation combined with cognitive behavioral therapy in the treatment of adolescent depression.Method:135 patients were selected in our hospital from January 2010 to December 2015,they were randomly divided into three groups,45 cases in each group.A group was given only antidepressant sertraline treatment,B group based on the sertraline treatment combined with repetitive transcranial magnetic stimulation treatment,C group based on the use of sertraline treatment combined with repetitive transcranial magnetic stimulation and cognitive behavioral therapy. Result:After treatment 4 weeks,the efficacy in group C was significantly better than that in group A and B (P<0.05),scores of HAMD changed from (28.16±3.95) scores to (17.92±9.86) scores,lower than that in group A and B.Scores of TSCS and PSP in group C were higher than that in other groups.Conclusion:Low frequency repetitive transcranial magnetic stimulation combined with cognitive behavior therapy provide an effective and well-tolerant treatment for depression.%目的:研究探讨重复低频经颅磁刺激联合认知行为疗法治疗青少年抑郁症的临床效果。方法:将2010年1月-2015年12月于本院精神科门诊就诊的患者共135例随机分为A、B、C三组,每组45例,其中A组仅用抗抑郁药物舍曲林治疗,B组在使用舍曲林治疗的基础上联合重复低频经颅磁刺激治疗,C组在使用舍曲林治疗的基础上联合重复低频经颅磁刺激和认知行为疗法。结果:治疗4周后,C组的治疗效果明显优于A、B两组(P<0.05)。C组的HAMD评分从(28.16±3.95)分降至(17.92±9.86)分,显著低于A、B两组,TSCS评分和PSP评分均高于A、B两组。结论:重复低频经颅磁刺激联合认知行为疗法是治疗抑郁症的安全有效的方法。

  13. 24例舍曲林合并重复经颅磁刺激治疗难治性强迫症患者临床观察%Clinical Observation on 24 Cases of Sertraline Combined With Repetitive Transcranial Magnetic Stimulation in the Treatment of Patients With Refractory Obsessive Compulsive Disorder

    Institute of Scientific and Technical Information of China (English)

    赵永明

    2016-01-01

    Objective To evaluate the clinical efficacy of sertraline combined with repetitive transcranial magnetic stimulation in the treatment of patients with refractory obsessive compulsive disorder.Methods Patients with refractory obsessive compulsive disorder in our hospital were selected as the research object and randomly divided into observation group and control group,24 cases in each group,to compare the curative effect of two groups before and after treatment.Results After treatment,the Y-BOCS score of observation group was significantly lower than that before treatment,the factorial scores of WHOQOL-100 rating scale of observation group were significantly better than that of control group,the difference was statisticaly significant,P<0.05.Conclusion Application of sertraline combined with repetitive transcranial magnetic stimulation in the treatment of patients with refractory obsessive compulsive disorder (OCD) has the obviously curative effect and good safety.%目的:探讨舍曲林合并重复经颅磁刺激治疗难治性强迫症的临床疗效。方法选择我院收治的难治性强迫症患者作为研究对象,随机分组为观察组和对照组各24例,比较两组患者治疗前后的效果。结果观察组Y-BOCS评分低于治疗前,观察组治疗后WHOQOL-100评量表的各项指标评分优于对照组,差异具有统计学意义,P<0.05。结论采用舍曲林合并重复经颅磁刺激治疗难治性强迫症具有明显的疗效和良好的安全性。

  14. Effect of Repetitive Transcranial Magnetic Stimulation on Patients With Mild Cognitive Impairment After Cerebral Infarction%重复经颅磁刺激对脑梗死后轻度认知功能障碍患者的影响

    Institute of Scientific and Technical Information of China (English)

    黄旭玲

    2015-01-01

    ObjectiveTo study the effect of repetitive transcranial magnetic stimulation on the cognitive function of patients with mild cognitive impairment after cerebral infarction.Methods 40 patients with mild cognitive impairment after cerebral infarction in our hospital from January 2013 to January 2015 were randomly selected,and the patients were treated with transcranial magnetic stimulation for 4 courses. The changes of cognitive function were compared before and after treatment. Results Compared with before treatment,the latency of P300 in patients was shorter(P<0.05),amplitude was increased(P<0.05),MoCA scale scores were improved,the total score of MoCA score and delayed memory improved significantly(P<0.05).Conclusion In patients with mild cognitive impairment after cerebral infarction,repetitive transcranial magnetic stimulation can improve the patients'cognitive function and improve the memory.%目的:研究脑梗死后轻度认知功能障碍患者进行重复经颅磁刺激治疗的效果。方法随机选取2013年1月~2015年1月入住我院脑梗死后轻度认知功能障碍患者40例,对所选患者进行重复经颅磁刺激治疗,治疗4个疗程后,对比治疗前后患者认知功能的变化。结果与治疗前相比,患者P300的潜伏期缩短(P<0.05)、波幅增高(P<0.05)、MoCA量表的各项评分均有所改善,MoCA量表评分总分和延迟记忆改善(P<0.05)。结论对于脑梗死后轻度认知功能障碍患者,重复经颅磁刺激可以改善患者认知功能,提高患者的记忆力。

  15. Clinical efficacy of different frequency repetitive transcranial magnetic stimulation for tardive dyskinesia%不同频率重复经颅磁刺激治疗迟发性运动障碍的疗效研究

    Institute of Scientific and Technical Information of China (English)

    张保华; 谭云龙; 王志仁; 张五芳; 杨甫德; 卞清涛; 韩笑乐; 江述荣; 杨贵刚

    2014-01-01

    目的 探讨不同频率重复经颅磁刺激(rTMS)治疗迟发性运动障碍(TD)的疗效.方法 长期服用抗精神病药所致迟发性运动障碍的精神分裂症患者,随机给予1 Hz(低频)和10 Hz(高频)的rTMS治疗4周,每周治疗5d.中间休息2周.分别在治疗前和治疗后进行异常不自主运动评定量表(AIMS)和锥体外系副反应量表(RESES)评定,评分变化作为疗效和副反应评价指标.结果 低频组经rTMS治疗后只有上肢的不自主运动改善[治疗前(2.6±1.0)分,治疗后(1.8±1.1)分],差异有统计学意义(P<0.05).高频组经rTMS治疗后多个量表分下降,其中上肢[治疗前(1.9±1.2)分,治疗后(0.8±0.9)分]、唇及口周[治疗前(1.0±0.8)分,治疗后(0.3±0.5)分]和舌[治疗前(2.6±0.9)分,治疗后(1.7±0.9)分]及总量表分[治疗前(7.7±3.0)分,治疗后(4.2±1.7)分]评分治疗前后差异有统计学意义(P< 0.05或<0.01).另外,两组间在下肢和总量表分减分率方面差异有统计学意义(P<0.05).结论 rTMS治疗TD有效,且高频(10 Hz)组治疗TD效果好.%Objective To investigate the effect of different frequency of repetitive transcranial magnetic stimulation (rTMS)on tardive dyskinesia (TD).Methods Schizophrenia combined with antipsychotic-induced TD were screened.All patients were planed to receive 1Hz or 10Hz rTMS for 4 weeks in which two weeks' break was inserted at end of 2nd weekend.The curative effect and side effects were assessed by abnormal involuntary movement scale(AIMS) and rating scale for extrapyramidal side effects(RSESE) respectively at before and after treatment.Results In the 1Hz group,only Involuntary movements of the upper extremities were improved after rTMS treatment (before treatment 2.6± 1.0,after treatment 1.8 ± 1.1),the difference was statistically significant (P<0.05).But in 10Hz group,upper extremities (before treatment 1.9 ± 1.2,0.8 ± 0.9 after treatment),mouth (before treatment 1.0±0.8,after treatment 0.3±0

  16. Transcranial magnetic stimulation (TMS) inhibits cortical dendrites.

    Science.gov (United States)

    Murphy, Sean C; Palmer, Lucy M; Nyffeler, Thomas; Müri, René M; Larkum, Matthew E

    2016-03-18

    One of the leading approaches to non-invasively treat a variety of brain disorders is transcranial magnetic stimulation (TMS). However, despite its clinical prevalence, very little is known about the action of TMS at the cellular level let alone what effect it might have at the subcellular level (e.g. dendrites). Here, we examine the effect of single-pulse TMS on dendritic activity in layer 5 pyramidal neurons of the somatosensory cortex using an optical fiber imaging approach. We find that TMS causes GABAB-mediated inhibition of sensory-evoked dendritic Ca(2+) activity. We conclude that TMS directly activates fibers within the upper cortical layers that leads to the activation of dendrite-targeting inhibitory neurons which in turn suppress dendritic Ca(2+) activity. This result implies a specificity of TMS at the dendritic level that could in principle be exploited for investigating these structures non-invasively.

  17. Transcranial magnetic stimulation in the treatment of substance addiction

    National Research Council Canada - National Science Library

    Gorelick, David A; Zangen, Abraham; George, Mark S

    2014-01-01

    Transcranial magnetic stimulation (TMS) is a noninvasive method of brain stimulation used to treat a variety of neuropsychiatric disorders, but is still in the early stages of study as addiction treatment...

  18. Numerical dosimetry of transcranial magnetic stimulation coils

    Science.gov (United States)

    Crowther, Lawrence; Hadimani, Ravi; Jiles, David

    2014-03-01

    Transcranial magnetic stimulation (TMS) is a non-invasive neuromodulation technique capable of stimulating neurons by means of electromagnetic induction. TMS can be used to map brain function and shows promise for the diagnosis and treatment of neurological and psychiatric disorders. Calculation of fields induced in the brain are necessary to accurately identify stimulated neural tissue during TMS. This allows the development of novel TMS coil designs capable of stimulating deeper brain regions and increasing the localization of stimulation that can be achieved. We have performed numerical calculations of magnetic and electric field with high-resolution anatomically realistic human head models to find these stimulated brain regions for a variety of proposed TMS coil designs. The realistic head models contain heterogeneous tissue structures and electrical conductivities, yielding superior results to those obtained from the simplified homogeneous head models that are commonly employed. The attenuation of electric field as a function of depth in the brain and the localization of stimulating field have been methodically investigated. In addition to providing a quantitative comparison of different TMS coil designs the variation of induced field between subjects has been investigated. We also show the differences in induced fields between adult, adolescent and child head models to preemptively identify potential safety issues in the application of pediatric TMS.

  19. The effect of low frequency repetitive transcranial magnetic stimulation on Parkinson's plus syndrome%低频重复经颅磁刺激治疗帕金森叠加综合征疗效初探

    Institute of Scientific and Technical Information of China (English)

    王铭维; 顾平; 李艳敏; 马晓伟; 郭记宏; 孙海民; 孟莉

    2009-01-01

    Objective To study the effects of repeated transcranial magnetic stimulation(rTMS)on Parkinson's plus syndrome(PPS).Methods Fifteen in-patients with PPS were studied between 2005 and 2008.The patients received 1 Hz rTMS at an intensity 30%over the threshold.The rTMS was applied on the hand representive area of the bilateral first motor cortex,50 stimulations on each side,5 arrays,for 5 min,once daily for 15 d.Hamilton's depression scale(HAMD),Hamilton's anxiety scale(HAMA),the unified Parkinson's disease rating scale(UPDRS,which can be subdivided into UPDRS Ⅰ,UPDRS Ⅱ and UPDRS Ⅲ),an activities of daily living scale(ADL),the mini-mental state examination(MMSE)and motor evoked potential(MEP)were assessed before and immediately after 15 d of rTMS treatment. Results Average HAMD,HAMA,UPDRS,UPDRS Ⅱ and UPDRS Ⅲ scores all decreased,and ADL scores increased significantly after treatment,while UPDRSⅠand MMSE scores were unchanged before and after treatment.No significant changes in resting motor threshold or central motor conduction time of the MEP were observed after rTMS treatment. Conclusion Clinical symptoms of PPS patients improved after rTMS treatment and side effects were few.Depression,anxiety,motor function and ability in the activities of daily living improved greatly.Repeated transcranial magnetic stimulation is a potential treatment for PPS patients.There may be no correlation between the effective mechanism of rTMS and cortex excitation.%目的 探讨低频重复经颅磁刺激(rTMS)治疗帕会森叠加综合征的疗效.方法 选择2005至2008年入住我院的15例帕金森叠加综合征(PPS)患者,行低频rTMS,刺激强度为阈上30%,频率为1 Hz,刺激部位为双侧的第一运动皮质手代表区,每侧50个刺激,分为5个序列,每天1次,每次5 min,治疗15 d;治疗前、后采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、统一帕金森病评定量表(UPDRS)、日常生活活动能力量表(ADL)、简易

  20. Transcranial magnetic stimulation of the cerebellum.

    Science.gov (United States)

    Minks, Eduard; Kopickova, Marie; Marecek, Radek; Streitova, Hana; Bares, Martin

    2010-06-01

    The cerebellum is a very complex structure with many motor/non-motor functions and direct and indirect connections with almost the entire central nervous system. Transcranial magnetic stimulation (TMS) is a non-invasive electrophysiological method for studying, diagnosing, and treating disorders of the nervous system. The aim of the present review is to summarise the research and potential clinical uses of cerebellar TMS. PubMed literature search using the key words "cerebellum TMS". TMS of the cerebellum is used in two types of protocols. The first type involves the separate stimulation of the cerebellum while tracking its clinical or electrophysiological influence on motor and non-motor functions. The second involves stimulation of the cerebellum as a conditioning stimulus before stimulating the motor cortex, to monitor the electrophysiological impact of cerebellar stimulation on the motor cortex. Most studies are performed on small groups of healthy volunteers; isolated studies are performed on patients with neurological disorders (spinocerebellar ataxia, migraine, dystonia, Miller Fisher syndrome). It has been shown that cerebellar TMS is able to influence motor systems, memory, and perception of time, and there is evidence of its electrophysiological effects in the frontal cortex. Published studies suggest that cerebellar TMS is currently only important in research. There is not yet any clear or reliable evidence of the therapeutic effects of cerebellar TMS. However, its use as a treatment method can be anticipated.

  1. Transcranial magnetic stimulation after spinal cord injury.

    Science.gov (United States)

    Awad, Basem I; Carmody, Margaret A; Zhang, Xiaoming; Lin, Vernon W; Steinmetz, Michael P

    2015-02-01

    To review the basic principles and techniques of transcranial magnetic stimulation (TMS) and provide information and evidence regarding its applications in spinal cord injury clinical rehabilitation. A review of the available current and historical literature regarding TMS was conducted, and a discussion of its potential use in spinal cord injury rehabilitation is presented. TMS provides reliable information about the functional integrity and conduction properties of the corticospinal tracts and motor control in the diagnostic and prognostic assessment of various neurological disorders. It allows one to follow the evolution of motor control and to evaluate the effects of different therapeutic procedures. Motor-evoked potentials can be useful in follow-up evaluation of motor function during treatment and rehabilitation, specifically in patients with spinal cord injury and stroke. Although studies regarding somatomotor functional recovery after spinal cord injury have shown promise, more trials are required to provide strong and substantial evidence. TMS is a promising noninvasive tool for the treatment of spasticity, neuropathic pain, and somatomotor deficit after spinal cord injury. Further investigation is needed to demonstrate whether different protocols and applications of stimulation, as well as alternative cortical sites of stimulation, may induce more pronounced and beneficial clinical effects. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. 重复经颅磁刺激治疗卒中后抑郁疗效的脑功能磁共振评价%Effect of repetitive transcranial magnetic stimulation in the treatment of post-stroke depression and evaluation of the effect by magnetic resonance spectroscopy and diffusion tensor imaging

    Institute of Scientific and Technical Information of China (English)

    谭向红; 兰丽梅; 黄惠君

    2015-01-01

    目的:探讨磁共振波谱成像(MRS)及扩散张量成像(DTI)用于评价重复经颅磁刺激治疗卒中后抑郁疗效的价值。方法将40例脑卒中后抑郁患者根据随机数表法分为观察组和对照组各20例,另选择20例作为健康志愿者。对照组应用文拉法辛治疗,150 mg/d,缓释片顿服。观察组给予文拉法辛合并重复经颅磁刺激(rTMS)治疗。比较两组患者治疗前后的汉密尔顿抑郁量表(HAMD)评分、MRS、DTI指标的变化及其与健康志愿者的差异。结果(1)治疗后,两组患者的HAMD评分均明显降低,且观察组患者改善更显著,差异均具有统计学意义(P<0.05);(2)治疗前,两组患者的额叶、颞叶及基底节区各向异性分数(FA)值均明显低于健康志愿者,差异均具有统计学意义(P<0.05)。治疗后10 d,观察组额叶及颞叶FA值明显升高,与治疗前及对照组比较差异均具有统计学意义(P<0.05);(3)治疗前,两组额叶、颞叶及基底节区NAA/(Cho+Cr)、NAA/Cr值均明显低于健康志愿者,Cho/Cr显著高于健康志愿者,差异均具有统计学意义(P<0.05)。治疗后10 d,观察组额叶及颞叶NAA/(Cho+Cr)、NAA/Cr值明显升高,Cho/Cr明显降低,与治疗前及对照组比较差异均具有统计学意义( P<0.05)。结论重复经颅磁刺激治疗卒中后抑郁疗效可靠,应用MRS及DTI可以对其进行评价。%Objective To investigate the value of magnetic resonance spectroscopy (MRS) and diffusion ten-sor imaging (DTI) for evaluating the effect of repetitive transcranial magnetic stimulation in the treatment of post-stroke depression. Methods Forty patients with post-stroke depression were randomly divided into observation group (20 cases) and control group (20 cases). Twenty healthy volunteers were selected as healthy control group. The control group was treated with Vin Rafa Sin treatment (150 mg/d) and sustained-release tablets orally. The observation group was

  3. The effects of repetitive transcranial magnetic stimulation combined with abdominal muscle electrical stimulation on the pulmonary ventilation of patients with cervical spinal cord injury%重复功能性磁刺激联合腹直肌电刺激对颈髓损伤患者肺通气功能的影响

    Institute of Scientific and Technical Information of China (English)

    李宁; 袁华; 牟翔; 杜起; 毛利; 惠楠

    2013-01-01

    Objective To observe the effects of repetitive transcranial magnetic stimulation (rTMS) combined with abdominal muscle electrical stimulation on the pulmonary ventilation of patients with cervical spinal cord injury.Methods Twenty-five patients with cervical spinal cord injury were randomized into an experimental group (n =13) and a control group (n =12).The control group was given comprehensive rehabilitation treatment,including upper limb movements,standing training and training of respiratory function,while the experimental group was given repetitive transcranial magnetic stimulation and abdominal muscle electrical stimulation in addition to the comprehensive rehabilitation treatment.The patients' maximum lung capacity (VC),forced expiratory volume for 1 second (FEV1),peak expiratory flow rate (PEF) and tidal volume (VT) were measured at the outset and after 3 months of treatment.Results The lung function indexes increased in both groups after treatment,but each index improved significantly more in the experimental group,on average,than in the control group.Conclusion As a supplement to routine respiratory function training,repetitive transcranial magnetic stimulation combined with abdominal intermediate frequency electrical stimulation can improve the pulmonary ventilation function of patients with middle and lower cervical spinal cord injury.%目的 观察重复功能性磁刺激(rFMS)联合腹直肌电刺激对中、低位颈髓损伤(CSCI)患者肺通气功能的影响.方法 共选取25例中、低位CSCI患者,采用随机数字表法将其分为治疗组及对照组.对照组给予上肢主动运动、站立训练、呼吸功能训练等综合康复治疗,治疗组在此基础上辅以rFMS及腹直肌中频电刺激.分别于治疗前、治疗3个月后对2组患者肺功能[包括最大肺活量(VC)、1秒钟用力呼气量(FEV1)、呼气峰值流速(PEF)及潮气量(VT)等指标]进行评定.结果 2组患者分别经3个

  4. Effect of low-frequency repetitive transcranial magnetic stimulation promotes recovery of cognitive function and functional independence in patients with traumatic brain injury%低频重复经颅磁刺激对脑外伤患者认知功能和功能独立的影响

    Institute of Scientific and Technical Information of China (English)

    黄居科; 麦荣康; 陈尚杰

    2009-01-01

    Objective To observe the effect of low-frequency repetitive transcranial magnetic stimulation in improving the memory function and quality of life of patients with traumatic brain injury. Methods Sixty patients with brain injury were randomly divided into the treatmem group and control group. The patients in the control group received conventional treatments (including medications, acupuncture and exercise training), and those in the treatment group were given additional low-frequency repetitive transcranial magnetic stimulation treatment. Scores of the Rivermead Behavioral Memory Test (RBMT) and Functional independence Measure (FIM) were recorded before and after the treatments and compared between the two groups. Results The patients in both of the groups showed significant improvements in RBMT and FIM scores after the treatments (P<0.05). The improvements in RBMT and FIM scores after the treatments differed significantly between the two groups (P<0.05). Conclusion Low-frequency repetitive transcranial magnetic stimulation can significantly improve the cognitive function and functional independence of patients with traumatic brain injury.%目的 观察低频重复经颅磁刺激改善脑外伤患者的认知功能和功能独立的作用.方法 将60例脑损伤患者按随机数字表法分为治疗组和对照组(各30例),均给予常规治疗.治疗组在此基础上应用低频重复经颅磁刺激治疗,连续治疗5 d为1个疗程,疗程之间间隔2d,连续4个疗程.观察两组患者治疗前后Rivermead行为记忆评分(RBMT)和功能独立性评分(FIM).结果 两组患者治疗后RBMT评分(治疗组:17.72±5.69,对照组:16.86±4.82)和FIM评分(治疗组:75.19±16.55,对照组:59.86±15.27)均较治疗前(治疗组:13.97±4.37,对照组:14.25±4.51;治疗组:43.21±12.62,对照组:45.79±13.97)有明显改善,比较差异有统计学意义(P<0.05);两组治疗前后RBMT评分差值(3.68±2.06 vs 2.71±1.17)和FIM评分差值(31.86±10.89 vs 18.71

  5. POSSIBLE MECHANISMS UNDERLYING THE THERAPEUTIC EFFECTS OF TRANSCRANIAL MAGNETIC STIMULATION

    Directory of Open Access Journals (Sweden)

    Alexander eChervyakov

    2015-06-01

    Full Text Available Transcranial magnetic stimulation (TMS is an effective method used to diagnose and treat many neurological disorders. Although repetitive TMS (rTMS has been used to treat a variety of serious pathological conditions including stroke, depression, Parkinson's disease, epilepsy, pain, and migraines, the pathophysiological mechanisms underlying the effects of long-term TMS remain unclear. In the present review, the effects of rTMS on neurotransmitters and synaptic plasticity are described, including the classic interpretations of TMS effects on synaptic plasticity via long-term potentiation (LTP and long-term depression (LTD. We also discuss the effects of rTMS on the genetic apparatus of neurons, glial cells and the prevention of neuronal death. The neurotrophic effects of rTMS on dendritic growth and sprouting and neurotrophic factors are described, including change in brain-derived neurotrophic factor (BDNF concentration under the influence of rTMS. Also, non-classical effects of TMS related to biophysical effects of magnetic fields are described, including the quantum effects, the magnetic spin effects, genetic magnetoreception, the macromolecular effects of TMS, and the electromagnetic theory of consciousness. Finally, we discuss possible interpretations of TMS effects according to dynamical systems theory. Evidence suggests that a rTMS-induced magnetic field should be considered a separate physical factor that can be impactful at the subatomic level and that rTMS is capable of significantly altering the reactivity of molecules (radicals. It is thought that these factors underlie the therapeutic benefits of therapy with TMS. Future research on these mechanisms will be instrumental to the development of more powerful and reliable TMS treatment protocols.

  6. Transcranial magnetic stimulation (TMS) in stroke: Ready for clinical practice?

    Science.gov (United States)

    Smith, Marie-Claire; Stinear, Cathy M

    2016-09-01

    The use of transcranial magnetic stimulation (TMS) in stroke research has increased dramatically over the last decade with two emerging and potentially useful functions identified. Firstly, the use of single pulse TMS as a tool for predicting recovery of motor function after stroke, and secondly, the use of repetitive TMS (rTMS) as a treatment adjunct aimed at modifying the excitability of the motor cortex in preparation for rehabilitation. This review discusses recent advances in the use of TMS in both prediction and treatment after stroke. Prediction of recovery after stroke is a complex process and the use of TMS alone is not sufficient to provide accurate prediction for an individual after stroke. However, when applied in conjunction with other tools such as clinical assessment and MRI, accuracy of prediction using TMS is increased. rTMS temporarily modulates cortical excitability after stroke. Very few rTMS studies are completed in the acute or sub-acute stages after stroke and the translation of altered cortical excitability into gains in motor function are modest, with little evidence of long term effects. Although gains have been made in both of these areas, further investigation is needed before these techniques can be applied in routine clinical care.

  7. Psychogenic paralysis and recovery after motor cortex transcranial magnetic stimulation.

    Science.gov (United States)

    Chastan, Nathalie; Parain, Dominique

    2010-07-30

    Psychogenic paralysis presents a real treatment challenge. Despite psychotherapy, physiotherapy, antidepressants, acupuncture, or hypnosis, the outcome is not always satisfactory with persistent symptoms after long-term follow-up. We conducted a retrospective study to assess clinical features and to propose an alternative treatment based on repetitive transcranial magnetic stimulation (rTMS). Seventy patients (44 F/26 M, mean age: 24.7 +/- 16.6 years) experienced paraparesis (57%), monoparesis (37%), tetraparesis (3%), or hemiparesis (3%). A precipitating event was observed in 42 patients, primarily as a psychosocial event or a physical injury. An average of 30 stimuli over the motor cortex contralateral to the corresponding paralysis was delivered at low frequency with a circular coil. The rTMS was effective in 89% of cases, with a significantly better outcome for acute rather than chronic symptoms. In conclusion, motor cortex rTMS seem to be very effective in patients with psychogenic paralysis and could be considered a useful therapeutic option.

  8. Estimulación magnética transcraneal Transcranial magnetic stimulation

    Directory of Open Access Journals (Sweden)

    M.A. Ibiricu

    2009-01-01

    Full Text Available La estimulación magnética transcraneal en un método no invasivo para estimular eléctricamente el córtex cerebral y poder valorar la excitabilidad del córtex motor y del tracto corticoespinal. Puede aplicarse mediante pulsos únicos, pares de estímulos separados por intervalos de tiempo variables sobre la misma región o diferente, o mediante trenes de estímulos a frecuencias variables. Estímulos únicos pueden despolarizar neuronas y producir efectos medibles. Trenes de estímulos pueden modificar la excitabilidad cortical de la zona estimulada y de áreas remotas relacionadas a través de conexiones anatómicas funcionales. La estimulación magnética transcraneal puede dar pistas en la fisiopatología de los circuitos neuronales que subyacen en enfermedades neurológicas y psiquiátricas, pero se necesitan más estudios para establecer el papel de la estimulación magnética transcraneal en la clínica neurológica.Transcranial magnetic stimulation is a non-invasive tool for the electrical stimulation of the cerebral cortex, and for evaluation of the excitability of the motor cortex and pathways. Transcranial magnetic stimulation can be applied as single pulses of stimulation, pairs of stimuli separated by variable intervals to the same or different brain areas, or as trains of repetitive stimuli at various frequencies. Single stimuli can depolarise neurons and evoke measurable effects. Series of stimuli (repetitive transcranial magnetic stimulation can modify the excitability of the cerebral cortex at the stimulated site and also at remote areas along functional anatomical connections. TMS might provide novel insights into the pathophysiology of the neural circuitry underlying neurological and psychiatric disorders, but more work is needed to establish the role of transcranial magnetic stimulation in clinical neurology.

  9. Combining functional magnetic resonance imaging with transcranial electrical stimulation

    Directory of Open Access Journals (Sweden)

    Catarina eSaiote

    2013-08-01

    Full Text Available Transcranial electrical stimulation (tES is a neuromodulatory method with promising potential for basic research and as a therapeutic tool. The most explored type of tES is transcranial direct current stimulation (tDCS, but also transcranial alternating current stimulation (tACS and transcranial random noise stimulation (tRNS have been shown to affect cortical excitability, behavioral performance and brain activity. Although providing indirect measure of brain activity, functional magnetic resonance imaging (fMRI can tell us more about the global effects of stimulation in the whole brain and what is more, on how it modulates functional interactions between brain regions, complementing what is known from electrophysiological methods such as measurement of motor evoked potentials. With this review, we aim to present the studies that have combined these techniques, the current approaches and discuss the results obtained so far.

  10. 重复经颅磁刺激对不完全性脊髓损伤患者运动和步行功能的疗效%Effect of Repetitive Transcranial Magnetic Stimulation on Motor and Ambulation Function for Incomplete Spinal Cord Injury

    Institute of Scientific and Technical Information of China (English)

    潘钰; 郄淑燕; 刘畅; 甄巧霞; 刘晓磊; 丁永红; 杨等; 邰志红

    2013-01-01

    Objective To assess the effect of repetitive transcranial magnetic stimulation (rTMS) on motor and ambulatory function in incomplete spinal cord injury (SCI) patients. Methods 18 incomplete SCI patients (AIS D) were randomized to treatment group (n=10) and control group (n=8). The treatment group received rTMS while the control group received sham stimulation for 2 weeks. All the patients re-ceived routine rehabilitation. They were assessed with Lower Extremity Motor Score (LEMS), 10 m Walking Test for Walking Speed, modi-fied Ashworth scale (MAS), Walking Index for SCI Scale II(WISCI II), and Spinal Cord Independence Measure (SCIM) before and after treatment, and followed up for 2 weeks after treatment. Results The treatment group significantly improved in LEMS, walking speed, and SCIM after treatment and during follow up (P0.05)。结论 rTMS可进一步改善不完全性脊髓损伤患者的下肢运动功能。

  11. 低频重复经颅磁刺激治疗半侧空间忽略的临床研究%Effect of Low Frequency Repetitive Transcranial Magnetic Stimulation on Unilateral Spatial Neglect

    Institute of Scientific and Technical Information of China (English)

    何静杰; 刘丽旭; 公维军; 杨宇琦; 毕晓辉; 崔丽华; 杨凌雨; 山磊; 胡雪艳

    2011-01-01

    Objective To explore the effect of low frequency repetitive transranial magnetic stimulation (Rtms) on unilateral spatial neglect (USN). Methods 40 stroke patients with USN were divided into treatment group (n=20) and control group (n=20). Patients in the treatment group were treated with low frequency Rtms for 2 weeks. The USN degree of these groups were evaluated before and after the treatment. Results There was no significant difference of USN degree between these groups before the treatment (.P>0.05); Compared with the control group, the treatment group improved significantly after the treatment (P0.05). Conclusion USN induced by stroke could be improved obviously through low frequency Rtms.%目的 探讨低频重复经颅磁刺激治疗半侧空间忽略症的临床疗效。方法 将40例脑卒中所致半侧空间忽略症患者分为治疗组及对照组各20例,并对治疗组进行为期2周的低频重复经颅磁刺激治疗。在治疗前后,采用半侧卒间忽略评估量表分别对两组患者进行评定。结果 治疗前,两组患者半侧空间忽略程度无显著性差异(P>0.05);治疗后,治疗组半侧卒间忽略程度较对照组改善(P<0.05);治疗后,治疗组中重度异常率较治疗前明显降低(P<0.05),对照组无显著性差异(P>0.05)。结论 通过低频重复经颅磁刺激治疗,脑卒中所致半侧空间忽略程度明显改善。

  12. Severity of depression predicts remission rates using transcranial magnetic stimulation

    Directory of Open Access Journals (Sweden)

    Geoffrey eGrammer

    2015-09-01

    Full Text Available Background: Multiple factors likely impact response and remission rates in the treatment of depression with repetitive transcranial magnetic stimulation (rTMS. Notably the role of symptom severity in outcomes with rTMS is poorly understood.Objective/Hypothesis: This study investigated the predictors of achieving remission in patients suffering from depression who receive ≥3 rTMS treatments per week. Methods: Available data on 41 patients treated at Walter Reed National Military Medical Center from 2009 to 2014 were included for analysis. Patients received a range of pulse sequences from 3,000 to 5,000 with left sided or bilateral coil placement. Primary outcome measures were total score on the Patient Health Questionnaire (PHQ-9 or the Quick Inventory of Depressive Symptomatology—Self Rated (QIDS-SR. Remission was defined as a total score less than five, and response was defined as a 50% decrease in the total score on both outcome metrics. Outcomes in patients diagnosed as suffering from mild or moderate depression were compared to those suffering from severe depression. Results: Of the 41 patients receiving treatment, 16 reached remission by the end of treatment. Remission rate was associated with the initial severity of depression, with patients with mild or moderate depression reaching remission at a significantly higher rate than those with severe depression. Total number of rTMS sessions or length of treatment were not predictors of remission. Conclusion: Patients with a baseline level of depression characterized as mild or moderate had significantly better outcomes following rTMS compared to patients with severe depression.

  13. Fundamentals of Transcranial Electric and Magnetic Stimulation Dose: Definition, Selection, and Reporting Practices

    Science.gov (United States)

    Peterchev, Angel V.; Wagner, Timothy A.; Miranda, Pedro C.; Nitsche, Michael A.; Paulus, Walter; Lisanby, Sarah H.; Pascual-Leone, Alvaro; Bikson, Marom

    2011-01-01

    The growing use of transcranial electric and magnetic (EM) brain stimulation in basic research and in clinical applications necessitates a clear understanding of what constitutes the dose of EM stimulation and how it should be reported. The biological effects of EM stimulation are mediated through an electromagnetic field injected (via electric stimulation) or induced (via magnetic stimulation) in the body. Therefore, transcranial EM stimulation dose ought to be defined by all parameters of the stimulation device that affect the electromagnetic field generated in the body, including the stimulation electrode or coil configuration parameters: shape, size, position, and electrical properties, as well as the electrode or coil current (or voltage) waveform parameters: pulse shape, amplitude, width, polarity, and repetition frequency; duration of and interval between bursts or trains of pulses; total number of pulses; and interval between stimulation sessions and total number of sessions. Knowledge of the electromagnetic field generated in the body may not be sufficient but is necessary to understand the biological effects of EM stimulation. We believe that reporting of EM stimulation dose should be guided by the principle of reproducibility: sufficient information about the stimulation parameters should be provided so that the dose can be replicated. This paper provides fundamental definition and principles for reporting of dose that encompass any transcranial EM brain stimulation protocol. PMID:22305345

  14. Effects of repetitive transcranial magnetic stimulation on serum leptin level in patients with non-dementia vascular cognitive dysfunction%重复经颅磁刺激对非痴呆型血管性认知功能障碍患者血清瘦素水平的影响

    Institute of Scientific and Technical Information of China (English)

    王莉; 张燕; 余巨明

    2016-01-01

    提高患者的认知功能,且最佳磁刺激频率为3 Hz。%Objective To investigate the effects of repetitive transcranial magnetic stimulation on the level of serum leptin in patients with non -dementia vascular cognitive dysfunction .Methods A total of 80 patients who were diag-nosed with non-dementia vascular cognitive dysfunction in our hospital from June 2012 to June 2015 were enrolled in the current study .These patients were randomly divided into four groups ( n=20 ):a control group , a high frequency group , a medium frequency group , and a low frequency group .The control group was given routine therapy , while patients in the other groups underwent repetitive transcranial magnetic stimulation in addition to routine therapy .The stimulation fre-quency was 0.5 Hz for the low frequency group , 3 Hz for the medium frequency group , and 5 Hz for the high frequency group.Before and after treatment , all patients underwent proton magnetic resonance spectroscopy and P 300 event evoked potential detection .Meanwhile , the levels of serum leptin , endothelin-1 ( ET-1 ) , vascular endothelial growth factor ( VEGF) , and nerve growth factor ( NGF) were detected .These patients were scored according to mini -mental state ex-amination ( MMSE) scale, and cognitive function impairment scale .Adverse reactions were recorded .Results Com-pared with the control , the other three groups presented obviously shorter P 300 latency but markedly enhanced MRS spec-trum (P0.05).More adverse reactions were recorded in the high frequency group than the other three groups (P0.05).Conclusion Repetitive transcranial magnetic stimulation can remarkably enhance the level of serum leptin in patients with non -dementia vascular cognitive dysfunction to improve their cognitive function .The opti-mal frequency of magnetic stimulation is 3Hz.

  15. Transcranial magnetic stimulation: Improved coil design for deep brain investigation

    Science.gov (United States)

    Crowther, L. J.; Marketos, P.; Williams, P. I.; Melikhov, Y.; Jiles, D. C.; Starzewski, J. H.

    2011-04-01

    This paper reports on a design for a coil for transcranial magnetic stimulation. The design shows potential for improving the penetration depth of the magnetic field, allowing stimulation of subcortical structures within the brain. The magnetic and induced electric fields in the human head have been calculated with finite element electromagnetic modeling software and compared with empirical measurements. Results show that the coil design used gives improved penetration depth, but also indicates the likelihood of stimulation of additional tissue resulting from the spatial distribution of the magnetic field.

  16. 高频重复经颅磁刺激治疗精神分裂症难治性阴性症状的随机双盲对照试验%Effects of high frequency repetitive transcranial magnetic stimulation on refractory negative symptom of schizophrenia: A double blind, randomized controlled trial

    Institute of Scientific and Technical Information of China (English)

    任艳萍; 周东丰; 蔡焯基; 黄青; 卢芩; 陈琦

    2011-01-01

    目的:探讨双背侧前额叶高频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)治疗精神分裂症难治性阴性症状的疗效和安全性,并观察不良反应.方法:本研究为双盲随机对照临床试验.研究对象来源于2002年11月1日至2003年12月31日期间就诊于北京大学第六医院和北京安定医院的门诊和住院患者,符合美国精神疾病诊断与统计手册第4版(Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition,DSM.IV)中精神分裂症诊断标准.23例以难治性阴性症状为主的精神分裂症患者随机分为rTMS治疗组(n=12)和对照组(n=11),分别给予10次20Hz rTMS真刺激和伪刺激治疗,治疗期间维持原有抗精神病药种类及剂量不变.采用阳性和阴性症状量表(Positive and Negative Syndrome Scale,PANSS)评估临床症状,采用治疗中需处理的不良反应症状量表(Treatment Emergent Symptom scale,TESS)及其他检查评估不良反应.结果:23例患者均完成治疗.治疗组有效率高于对照组(34%vs.17%,P<0.05).未观察到明显不良反应.结论:抗精神病药合并20 Hz双背侧前额叶重复经颅磁刺激治疗精神分裂症难治性阴性症状有效、安全.%Objective: To examine the therapeutic effects of dual dorsolateral prefrontal repetitive transcranial magnetic stimulation ( rTMS ) on refractory negative symptom experienced by patients with schizophrenia. Methods: A double-blind, randomized controlled study was conducted. Totally 23 schizophrenic patients met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for schizophrenia were recruited. Subjects were grouped into active treatment subgroup and sham subgroup randomly. Clinical symptom was measured with the Positive and Negative Symptom Scale (PANSS) . Side effects were valuated with the Treatment Emergent Symptom Scale (TESS). Results: Totally 23 subjects completed the trial. The treatment efficiency of

  17. 重复经颅磁刺激(rTMS)治疗慢性主观性耳鸣的短期疗效分析%The Short-term Effect Analysis of Repetitive Transcranial Magnetic Stimulation (rTMS) in Chronic Tinnitus

    Institute of Scientific and Technical Information of China (English)

    杨海弟; 郑亿庆; 区永康; 黄夏茵

    2015-01-01

    Objective Evaluate the therapeutic effect of 1-Hz repetitive transcranial magnetic stimulation (rTMS) on tinnitus. Methods 46 chronic tinnitus patients were treated with repetitive transcranial magnetic stimulation for two weeks and the therapeutic effects were assessed afterward. Results rTMS treatment could improve tinnitus obviously. The overall effec⁃tive rate is 63.1%in subjective tinnitus, The effective rate is higher in decompensated tinnitus(THI≥40) than compensatory tinnitus (THI<40) (77%vs 45%;P<0.001), The THI score of tinnitus patients before and after treatment were r 51.8 ± 23.5 and 37 ± 18.8;espectively (t=5.94, p<0.001), VAS were 6.3 ± 2.4 and 4.9 ± 1.8;(t=5.27, p<0.01.) The difference of the changes of THI between decompensated tinnitus and compensated tinnitus group after rTMS treatment was 19.4 ± 8.5 (df=42, T=4.95, P<0.001). Conclusions rTMS could improve tinnitus, especially for decompensated tinnitus patients.%目的:采取1Hz低频重复经颅磁刺激(rTMS)治疗慢性主观性耳鸣并评价其治疗效果。方法对慢性主观性耳鸣患者46例行1Hz低频rTMS连续治疗2周,治疗前后分别行耳鸣残疾量表评分(THI)评分及主观疗效评估。结果 rTMS对耳鸣治疗有明显效果,对主观耳鸣症状总体有效率为63.1%,其中失代偿性耳鸣(THI≥40)的有效率明显高于代偿性耳鸣(THI<40)(77%vs 45%;P<0.001),耳鸣患者治疗前后THI为(51.8±23.5 vs 37.0±18.8;t=5.94,p<0.001), VAS为(6.3±2.4 vs 4.9±1.8;t=5.27,p<0.01),治疗前后有统计学差异。失代偿组与代偿组耳鸣rTMS治疗后THI变化存在显著差异,两组差值为19.4±8.5(df=42,T=4.95,P<0.001)。结论 rTMS治疗耳鸣有效,可明显降低THI得分,改善耳鸣症状,特别在失代偿性耳鸣效果更明显。

  18. Use of transcranial magnetic stimulation in the treatment of selected movement disorders

    Directory of Open Access Journals (Sweden)

    Brown KE

    2014-12-01

    Full Text Available Katlyn E Brown,1 Jason L Neva,2 Noah MH Ledwell,1 Lara A Boyd1,2 1Graduate Program in Rehabilitation Science, 2Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada Abstract: Transcranial magnetic stimulation (TMS is a valuable technique for assessing the underlying neurophysiology associated with various neuropathologies, and is a unique tool for establishing potential neural mechanisms responsible for disease progression. Recently, repetitive TMS (rTMS has been advanced as a potential therapeutic technique to treat selected neurologic disorders. In healthy individuals, rTMS can induce changes in cortical excitability. Therefore, targeting specific cortical areas affected by movement disorders theoretically may alter symptomology. This review discusses the evidence for the efficacy of rTMS in Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis, and multiple sclerosis. It is hoped that gaining a more thorough understanding of the timing and parameters of rTMS in individuals with neurodegenerative disorders may advance both clinical care and research into the most effective uses of this technology. Keywords: repetitive transcranial magnetic stimulation, selected movement disorders, treatment

  19. THE EFFECTS OF REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION APPLIED TO DIFFERENT CORTICAL TARGETS ON FIBROMYALGIA SYNDROME%重复经颅磁刺激在纤维肌痛综合征治疗中的靶点选择及疗效分析

    Institute of Scientific and Technical Information of China (English)

    张希; 陶蔚; 胡永生; 朱宏伟; 肖东升; 李勇杰

    2016-01-01

    目的:探讨重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)在纤维肌痛综合征(fibromyalgia syndrome,FMS)治疗中的应用价值及靶点选择.方法:首先对18例入组患者进行为期2周伪刺激,随后将患者随机分为2组,分别选取左侧运动区(M1)皮层及左侧额前背外侧区皮层(dorsal lateral prefrontal cortex,DLPFC)为刺激靶点进行高频(10 Hz) rTMS治疗,采用FMS症状相关的多种量表评估,比较rTMS作用于不同靶点对FMS症状的治疗作用,并进行随访.结果:高频(10Hz) rTMS刺激L-M1与L-DLPFC靶点两周,均可缓解FMS疼痛症状.在疼痛视觉模拟评分(Visual Analogue Scale/Score,VAS)、痛点计数、纤维肌痛量表(Fibromyalgia Impact Questionnaire,FIQ)评价中,L-M1靶点治疗效果优于L-DLPFC靶点.对焦虑情绪的缓解作用,刺激L-DLPFC靶点效果优于L-M1靶点.结论:高频(l0Hz) rTMS刺激L-M1靶点可以显著缓解FMS患者疼痛症状,提高生活质量.伴随严重焦虑、抑郁症状的FMS患者,可以选择高频rTMS刺激L-DLPFC靶点治疗.

  20. Efficacy and adverse reactions of repetitive transcranial magnetic stimulation on general anxiety disorder: a meta-analysis%重复经颅磁刺激治疗广泛性焦虑障碍的疗效及不良反应的meta分析

    Institute of Scientific and Technical Information of China (English)

    李丽君; 胡卫疆; 高雅坤; 陈琦; 王春雪; 张宁

    2016-01-01

    背景 重复经颅磁刺激(rTMS)已经逐步被应用于治疗广泛性焦虑障碍(GAD),作为一种新型的治疗手段,本文系统评价了rTMS治疗GAD患者的疗效及不良反应.方法 计算机检索Pubmed、Cochrane library、OVID、CNKI、VIP数据库所有关于rTMS治疗GAD患者的随机对照试验(RCT),对符合纳入标准的文献使用ReVMan 5.3软件对文献数据进行Meta分析.结果 共纳入10个RCT研究进行meta分析,共计732人,根据研究内容(rTMS治疗结束后疗效随访观察和rTMS治疗疗效)的不同对患者进行亚组分析,结果显示:rTMS在治疗结束后的短期随访研究中显示疗效优于对照组(WMD =-5.02,95% CI =-6.84~-3.20,P<0.01);rTMS 干预治疗能早期改善GAD患者的焦虑症状,低频、高频rTMS干预结果分别为WMD=-1.34,95% CI =-1 97~-0.71(P<0.01)、WMD =-2.65,95% CI =-3.51-1.79(P<0.01).干预组较对照组不良反应较少(WMD=-7.04,95% CI =-11.64~-2.43,P<0.01).结论 rTMS干预治疗GAD患者治疗结束时及短期期随访疗效较好,rTMS干预治疗后起效快,干预组不良反应较少见.%Objective Repetitive transcranial magnetic stimulation (rTMS) has gradually been used in the treatment of generalized anxiety disorder (GAD).The efficacy and adverse reactions of repetitive transcranial magnetic stimulation on general anxiety disorder are assessed in the review.Methods Searched databases such as Pubmed,Cochrane library,OVID,CNKI,VIP by computer,and researched published randomized controlled trials (RCTs) focused on repetitive transcranial magnetic stimulation on general anxiety disorder.Meta-analysis was conducted by RevMan 5.3 software.Results A total of 10 RCTs were included,involving 732 general anxiety disorder patients.The were divided into two subgroups,one group is effect observation,the other group is the improvement of curative effect in the treatment process.The effectiveness of intervention of rTMS follow up is better than that of the

  1. Cortical silent period following transcranial magnetic stimulation in epileptic patients.

    Science.gov (United States)

    Ertaş, N K; Gül, G; Altunhalka, A; Kirbas, D

    2000-09-01

    Cortical silent period (SP) following transcranial magnetic stimulation is mainly due to cortical inhibitory mechanisms. SP may have a value for detecting inhibitory mechanisms in epileptic patients with or without treatment. The aim of this study was to evaluate the effect of both the epilepsy and the antiepileptic medication on these inhibitory mechanisms. The subgroups studied consisted of (a) normal subjects, (b) unmedicated epileptic patients, (c) epileptic patients with uncontrolled seizures under medication, (d) epileptic patients with controlled seizures under medication. SP following transcranial magnetic stimulation was measured in all subjects. The SP values from shortest to the longest were in the following order: 1) normal subjects; 2) epileptic patients with controlled seizures under medication; 3) unmedicated epileptic patients; 4) epileptic patients with uncontrolled seizures under medication. Our findings probably indicate the enhanced interictal inhibitory mechanisms in epilepsy which is resistant to antiepileptic medication.

  2. Transcranial static magnetic field stimulation of the human motor cortex.

    Science.gov (United States)

    Oliviero, Antonio; Mordillo-Mateos, Laura; Arias, Pablo; Panyavin, Ivan; Foffani, Guglielmo; Aguilar, Juan

    2011-10-15

    The aim of the present study was to investigate in healthy humans the possibility of a non-invasive modulation of motor cortex excitability by the application of static magnetic fields through the scalp. Static magnetic fields were obtained by using cylindrical NdFeB magnets. We performed four sets of experiments. In Experiment 1, we recorded motor potentials evoked by single-pulse transcranial magnetic stimulation (TMS) of the motor cortex before and after 10 min of transcranial static magnetic field stimulation (tSMS) in conscious subjects. We observed an average reduction of motor cortex excitability of up to 25%, as revealed by TMS, which lasted for several minutes after the end of tSMS, and was dose dependent (intensity of the magnetic field) but not polarity dependent. In Experiment 2, we confirmed the reduction of motor cortex excitability induced by tSMS using a double-blind sham-controlled design. In Experiment 3, we investigated the duration of tSMS that was necessary to modulate motor cortex excitability. We found that 10 min of tSMS (compared to 1 min and 5 min) were necessary to induce significant effects. In Experiment 4, we used transcranial electric stimulation (TES) to establish that the tSMS-induced reduction of motor cortex excitability was not due to corticospinal axon and/or spinal excitability, but specifically involved intracortical networks. These results suggest that tSMS using small static magnets may be a promising tool to modulate cerebral excitability in a non-invasive, painless, and reversible way.

  3. Measurement of motor evoked potentials following repetitive magnetic motor cortex stimulation during isoflurane or propofol anaesthesia.

    Science.gov (United States)

    Rohde, V; Krombach, G A; Baumert, J H; Kreitschmann-Andermahr, I; Weinzierl, M; Gilsbach, J M

    2003-10-01

    Isoflurane and propofol reduce the recordability of compound muscle action potentials (CMAP) following single transcranial magnetic stimulation of the motor cortex (sTCMS). Repetition of the magnetic stimulus (repetitive transcranial magnetic stimulation, rTCMS) might allow the inhibition caused by anaesthesia with isoflurane or propofol to be overcome. We applied rTCMS (four stimuli; inter-stimulus intervals of 3, 4, 5 ms (333, 250, 200 Hz), output 2.5 Tesla) in 27 patients and recorded CMAP from the hypothenar and anterior tibial muscle. Anaesthesia was maintained with fentanyl 0.5-1 microg kg(-1) x h(-1) and either isoflurane 1.2% (10 patients) or propofol 5 mg kg(-1) x h(-1) with nitrous oxide 60% in oxygen (17 patients). No CMAP were detected during isoflurane anaesthesia. During propofol anaesthesia 333 Hz, four-pulse magnetic stimulation evoked CMAP in the hypothenar muscle in 75%, and in the anterior tibial muscle in 65% of the patients. Less response was obtained with 250 and 200 Hz stimulation. In most patients, rTCMS can overcome suppression of CMAP during propofol/nitrous oxide anaesthesia, but not during isoflurane anaesthesia. A train of four magnetic stimuli at a frequency of 333 Hz is most effective in evoking potentials from the upper and lower limb muscles. The authors conclude that rTCMS can be used for evaluation of the descending motor pathways during anaesthesia.

  4. Unraveling the cellular and molecular mechanisms of repetitive magnetic stimulation

    Directory of Open Access Journals (Sweden)

    Florian eMüller-Dahlhaus

    2013-12-01

    Full Text Available Despite numerous clinical studies, which have investigated the therapeutic potential of repetitive transcranial magnetic stimulation (rTMS in various brain diseases, our knowledge of the cellular and molecular mechanisms underlying rTMS-based therapies remains limited. Thus, a deeper understanding of rTMS-induced neural plasticity is required to optimize current treatment protocols. Studies in small animals or appropriate in vitro preparations (including models of brain diseases provide highly useful experimental approaches in this context. State-of-the-art electrophysiological and live-cell imaging techniques that are well established in basic neuroscience can help answering some of the major questions in the field, such as (i which neural structures are activated during TMS, (ii how does rTMS induce Hebbian plasticity, and (iii are other forms of plasticity (e.g., metaplasticity, structural plasticity induced by rTMS? We argue that data gained from these studies will support the development of more effective and specific applications of rTMS in clinical practice.

  5. A measure of acoustic noise generated from transcranial magnetic stimulation coils.

    Science.gov (United States)

    Dhamne, Sameer C; Kothare, Raveena S; Yu, Camilla; Hsieh, Tsung-Hsun; Anastasio, Elana M; Oberman, Lindsay; Pascual-Leone, Alvaro; Rotenberg, Alexander

    2014-01-01

    The intensity of sound emanating from the discharge of magnetic coils used in repetitive transcranial magnetic stimulation (rTMS) can potentially cause acoustic trauma. Per Occupational Safety and Health Administration (OSHA) standards for safety of noise exposure, hearing protection is recommended beyond restricted levels of noise and time limits. We measured the sound pressure levels (SPLs) from four rTMS coils with the goal of assessing if the acoustic artifact levels are of sufficient amplitude to warrant protection from acoustic trauma per OSHA standards. We studied the SPLs at two frequencies (5 and 10 Hz), three machine outputs (MO) (60, 80 and 100%), and two distances from the coil (5 and 10 cm). We found that the SPLs were louder at closer proximity from the coil and directly dependent on the MO. We also found that in all studied conditions, SPLs were lower than the OSHA permissible thresholds for short (8 h) exposure.

  6. Transcranial Magnetic Stimulation for the treatment of tinnitus: Effects on cortical excitability

    Directory of Open Access Journals (Sweden)

    Hajak Göran

    2007-07-01

    Full Text Available Abstract Background Low frequency repetitive transcranial magnetic stimulation (rTMS has been proposed as an innovative treatment for chronic tinnitus. The aim of the present study was to elucidate the underlying mechanism and to evaluate the relationship between clinical outcome and changes in cortical excitability. We investigated ten patients with chronic tinnitus who participated in a sham-controlled crossover treatment trial. Magnetic-resonance-imaging and positron-emission-tomography guided 1 Hz rTMS were performed over the auditory cortex on 5 consecutive days. Active and sham treatments were separated by one week. Parameters of cortical excitability (motor thresholds, intracortical inhibition, intracortical facilitation, cortical silent period were measured serially before and after rTMS treatment by using single- and paired-pulse transcranial magnetic stimulation. Clinical improvement was assessed with a standardized tinnitus-questionnaire. Results We noted a significant interaction between treatment response and changes in motor cortex excitability during active rTMS. Specifically, clinical improvement was associated with an increase in intracortical inhibition, intracortical facilitation and a prolongation of the cortical silent period. These results indicate that intraindividual changes in cortical excitability may serve as a correlate of response to rTMS treatment. Conclusion The observed alterations of cortical excitability suggest that low frequency rTMS may evoke long-term-depression like effects resulting in an improvement of subcortical inhibitory function.

  7. Transcranial magnetic stimulation of the brain: guidelines for pain treatment research.

    Science.gov (United States)

    Klein, Max M; Treister, Roi; Raij, Tommi; Pascual-Leone, Alvaro; Park, Lawrence; Nurmikko, Turo; Lenz, Fred; Lefaucheur, Jean-Pascal; Lang, Magdalena; Hallett, Mark; Fox, Michael; Cudkowicz, Merit; Costello, Ann; Carr, Daniel B; Ayache, Samar S; Oaklander, Anne Louise

    2015-09-01

    Recognizing that electrically stimulating the motor cortex could relieve chronic pain sparked development of noninvasive technologies. In transcranial magnetic stimulation (TMS), electromagnetic coils held against the scalp influence underlying cortical firing. Multiday repetitive transcranial magnetic stimulation (rTMS) can induce long-lasting, potentially therapeutic brain plasticity. Nearby ferromagnetic or electronic implants are contraindications. Adverse effects are minimal, primarily headaches. Single provoked seizures are very rare. Transcranial magnetic stimulation devices are marketed for depression and migraine in the United States and for various indications elsewhere. Although multiple studies report that high-frequency rTMS of the motor cortex reduces neuropathic pain, their quality has been insufficient to support Food and Drug Administration application. Harvard's Radcliffe Institute therefore sponsored a workshop to solicit advice from experts in TMS, pain research, and clinical trials. They recommended that researchers standardize and document all TMS parameters and improve strategies for sham and double blinding. Subjects should have common well-characterized pain conditions amenable to motor cortex rTMS and studies should be adequately powered. They recommended standardized assessment tools (eg, NIH's PROMIS) plus validated condition-specific instruments and consensus-recommended metrics (eg, IMMPACT). Outcomes should include pain intensity and qualities, patient and clinician impression of change, and proportions achieving 30% and 50% pain relief. Secondary outcomes could include function, mood, sleep, and/or quality of life. Minimum required elements include sample sources, sizes, and demographics, recruitment methods, inclusion and exclusion criteria, baseline and posttreatment means and SD, adverse effects, safety concerns, discontinuations, and medication-usage records. Outcomes should be monitored for at least 3 months after initiation

  8. Effect of Repetitive Transcranial Magnetic Stimulation on Intelligent Development in Children with Cerebral Palsy with Epilepsy%重复经颅磁刺激对脑性瘫痪并发癫痫患儿智力发育的影响

    Institute of Scientific and Technical Information of China (English)

    王迎红; 马丙祥

    2014-01-01

    Objective To explore the effect of repetitive transcranial magnetic stimulation (rTMS) on intelligence development in chil-dren with cerebral palsy with epilepsy. Methods 156 children with cerebral palsy with epilepsy were randomly divided into control group (n=70) and treatment group (n=86). The control group received comprehensive rehabilitation combined with traditional Chinese and western medicine. The treatment group received rTMS in addition. Both groups were evaluated with the development quotient (DQ) of Gesell Devel-opment Schedules and Mental Developmental Index (MDI) of Children's Development Center of China (CDCC) intelligence test before, and 2 and 4 months after treatment. Results The DQ and MDI improved more in the treatment group than in the control group (P<0.001). Con-clusion rTMS can improve the intelligent development in children with cerebral palsy with epilepsy.%目的:探讨重复经颅磁刺激(rTMS)对脑瘫并发癫痫患儿智力的影响。方法脑瘫并发癫痫患儿156例,采用随机数字表法分为对照组(n=70)和治疗组(n=86)。对照组采用中西医结合综合康复,治疗组在对照组基础上加用rTMS。2个月和4个月后,分别用Gesell发育量表适应性发育商(DQ)及婴幼儿智能发育检查量表智力发育指数(MDI)进行评估。结果两组患儿DQ和MDI两次评分治疗组均显著高于对照组(P<0.001)。结论 rTMS能促进脑瘫并发癫痫患儿的智力发育。

  9. 低频重复经颅磁刺激对脑卒中后记忆及认知功能的影响%Effect of Low-frequency Repetitive Transcranial Magnetic Stimulation on Memory and Cognition Impairment af-ter Stroke

    Institute of Scientific and Technical Information of China (English)

    芦海涛; 孙莉; 郭华珍; 张通

    2015-01-01

    目的:观察低频重复经颅磁刺激(rTMS)刺激右侧前额叶背外侧皮层对脑卒中患者认知及记忆功能的影响。方法脑卒中后记忆功能障碍患者40例,随机分为磁刺激组(n=19)和假刺激组(n=21),分别接受真假1 Hz rTMS治疗。所有患者在治疗前、治疗结束后和治疗结束2个月后分别用蒙特利尔认知评估量表(MoCA)中文版、洛文斯顿作业疗法认知评估(LOTCA)及行为记忆量表(RBMT)进行测评。结果两组在治疗后及治疗结束2个月时,MoCA、LOTCA及RBMT评分均有显著升高(P<0.001),磁刺激组改善程度明显优于假刺激组(P<0.01)。结论低频rTMS可以改善脑卒中后认知及记忆功能障碍。%Objective To investigate the effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) on post-stroke dis-function of cognition and memory by stimulating right dorsolateral prefrontal cortex. Methods 40 patients were randomized into the rTMS (n=19) and sham (n=21) groups. The function of cognition and memory were measured before treatment, after treatment and 2 months post-treatment with Montreal Cognitive Assessment (MoCA), Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and Riv-ermead Behaviour Memory Test (RBMT). Results All scores improved in both groups after treatment and 2 months post-treatment (P<0.001), and improved more in the rTMS group than in the sham group (P<0.01). Conclusion Low-frequency rTMS may improve the func-tion of memory and cognition after stoke.

  10. Effects of Repetitive Transcranial Magnetic Stimulation on Cognitive Ability in Patients with Mild Cognitive Im-pairment after Ischemic Stroke%重复经颅磁刺激对脑梗死后轻度认知功能障碍的影响及安全性研究

    Institute of Scientific and Technical Information of China (English)

    李亚梅; 徐丽; 杨艳; 田金艳; 余茜

    2015-01-01

    目的:探讨重复经颅磁刺激(rTMS)对脑梗死患者轻度认知障碍的影响及安全性。方法45例脑梗死后具有认知功能损害但未达痴呆诊断标准的患者,随机分为对照组(n=22)和观察组(n=23)。两组均予常规药物治疗和认知训练,观察组加以rTMS治疗(刺激左侧前额叶背外侧皮质,5 Hz,80%运动阈值),疗程4周。结果治疗后两组蒙特利尔认知评估量表(MoCA)评分、事件相关电位P300的潜伏期和波幅均较治疗前显著改善(P<0.001),且观察组优于对照组(P<0.05)。观察组治疗后MoCA得分与P300潜伏期呈高度负相关(r=-0.851, P<0.05)。治疗过程中未见明显不良反应。结论 rTMS可能对脑梗死患者的轻度认知功能障碍有改善作用,且相对安全。%Objective To explore the effects of repetitive transcranial magnetic stimulation (rTMS) on cognitive ability of patients after ischemic stroke. Methods 45 patients with mild cognitive impairment (MCI) after ischemic stroke were randomly assigned into control group (n=22) and observation group (n=23). Both groups received routine drugs and cognitive training. The observation group received rT-MS over the left dorsolateral prefrontal cortex (DLPFC) (5 Hz, 80%motor threshold) in addition for 4 weeks. Results The score of Montre-al Cognitive Assessment (MoCA), P300 latencies and amplitudes improved after treatment in both groups (P<0.001), and were better in the observation group than in the control group (P<0.05). The MoCA score was negatively related with P300 latency (r=-0.851, P<0.05). There was no severe adverse effect during the treatment. Conclusion rTMS could improve the cognitive ability of patients with MCI after stroke, with little side effect.

  11. Transcranial magnetic stimulation and BDNF plasma levels in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Angelucci, Francesco; Oliviero, Antonio; Pilato, Fabio; Saturno, Eleonora; Dileone, Michele; Versace, Viviana; Musumeci, Gabriella; Batocchi, Anna P; Tonali, Pietro A; Di Lazzaro, Vincenzo

    2004-03-22

    Low- and high-frequency repetitive transcranial magnetic stimulation (rTMS) of the motor cortex results in lasting changes of excitatory neurotransmission. We investigated the effects of suprathreshold 1 Hz rTMS on brain derived neurotrophic factor (BDNF) plasma levels in 10 healthy subjects and effects of either 1 Hz or 20 Hz rTMS in four amyotrophic lateral sclerosis (ALS) patients. BDNF levels were progressively decreased by 1 Hz rTMS in healthy subjects; there was no effect of 1 Hz rTMS on BDNF plasma levels in ALS patients, an effect probably due to the loss of motor cortex pyramidal cells. High frequency rTMS determined a transitory decrease in BDNF plasma levels. Cumulatively these findings suggest that rTMS might influence the BDNF production by interfering with neuronal activity.

  12. The role of pulse shape in motor cortex transcranial magnetic stimulation using full-sine stimuli

    DEFF Research Database (Denmark)

    Delvendahl, Igor; Gattinger, Norbert; Berger, Thomas;

    2014-01-01

    excitation. Preferential excitation of neuronal target cells in the posterior-anterior segment or targeting of different neuronal structures by the two half-segments can explain this result. Thus, our findings help understanding the mechanisms of neural stimulation by full-sine TMS.......A full-sine (biphasic) pulse waveform is most commonly used for repetitive transcranial magnetic stimulation (TMS), but little is known about how variations in duration or amplitude of distinct pulse segments influence the effectiveness of a single TMS pulse to elicit a corticomotor response. Using......) compared monophasic, half-sine, and full-sine pulses, (ii) applied two-segment pulses consisting of two identical half-sines, and (iii) manipulated amplitude, duration, and current direction of the first or second full-sine pulse half-segments. RMT was significantly higher using half-sine or monophasic...

  13. The effect of repetitive transcranial magnetic stimulation on behaviors and hippocampal GR protein ex-pression in depression model rats%重复经颅磁刺激对抑郁模型大鼠行为学及海马区糖皮质激素受体表达的影响

    Institute of Scientific and Technical Information of China (English)

    任慧聪; 谷世娜; 赵琳; 李文强; 张朝辉

    2016-01-01

    Objective To explore the effect of repetitive transcranial magnetic stimulation (rTMS) on behaviors and hippocampal glucocorticoid receptor (GR) protein expression in chronic stress depression model rats and the possible antidepressant mechanism of rTMS. Method Seventy-five male Sprague-Dawley rats were randomly divided into the blank control group (n=15) and the stress-induced group (n=60). Singly housing and chronic unpredictable mild stress (CUMS) were used to induce the depression model in stress-induced group. Forty-five CUMS rats were selected and ran⁃domly divided into rTMS group (receiving 10 Hz rTMS intervention for 3 weeks), sham group (receiving pseudo rTMS treatments for 3 weeks) and depression group (with no further treatment). Body weight measurements and performance in the sucrose consumption and forced swimming test (FST) were evaluated before modeling, after modeling and after inter⁃vention. The GR protein and GR mRNA expression level in the hippocampus were examined after intervention. Results Compared with control group, the body weight growth rate and the sugar water preference were significantly lower in stress-induced group (P0.05), were higher than those in sham group and depression group (P<0.01). The immobility times of FST in rTMS group and control group were shorter than sham group and depression group (P<0.01). Compared with rTMS group and control group, GR and GR mRNA expression levels in the hippocampus were significantly reduced in sham group and depression group (P<0.01). Conclusion rTMS can improve depression behavior of CUMS rats, which may be associated with upregulation of GR expression in the hippocampus.%目的:观察重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)对慢性应激抑郁模型大鼠的抗抑郁作用及对海马区糖皮质激素受体(glucocorticoid receptor,GR)表达的影响,探讨rTMS抗抑郁作用的可能机制。方法75只健康成年雄性

  14. Estimulação magnética transcraniana de repetição associada a antidepressivo: início e intensidade da resposta antidepressiva Repetitive transcranial magnetic stimulation associated with antidepressant: start and intensive of the antidrepressant answer

    Directory of Open Access Journals (Sweden)

    Demetrio Ortega Rumi

    2004-01-01

    Full Text Available OBJETIVOS: Avaliar diferentes estudos que analisam o grau de eficácia da resposta antidepressiva entre a associação de estimulação magnética transcraniana de repetição (EMTr com antidepressivos em pacientes deprimidos graves. MÉTODOS: Os autores revisaram vários estudos em que a EMTr foi usada concomitantemente a antidepressivos em pacientes deprimidos graves. Adicionalmente, relatou-se um estudo feito no Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Estudo duplo-cego, randomizado, unicêntrico, placebo-controlado com 46 pacientes atendendo aos critérios diagnósticos da DSM-IV para episódio depressivo severo. Os pacientes estavam em uso de amitriptilina. RESULTADOS: De forma geral, a maioria dos estudos mostra que a EMTr apresenta boa eficácia antidepressiva quando associada a antidepressivos. Há grande diversidade de parâmetros técnicos utilizados, tipos de bobina, diferentes técnicas de placebo e uso de diferentes antidepressivos. O estudo realizado no Instituto de Psiquiatria mostrou que o emprego da EMTr de alta freqüência aumentou a resposta antidepressiva à amitriptilina e diminuiu o tempo para o início da resposta antidepressiva em relação ao grupo placebo. CONCLUSÕES: EMTr é um método novo, promissor e com grande potencial para o tratamento da depressão. Apesar disso, observa-se que não há ainda uniformidade no emprego dos parâmetros técnicos, nem tampouco das técnicas de placebo. O estudo realizado no Instituto de Psiquiatria do HC- FMUSP mostrou grandes taxas de resposta e remissão em relação ao grupo com estimulação sham e amitriptilna.OBJECTIVE: Transcranial magnetic stimulation has been developed as a noninvasive method to stimulate the cortex, and the treatment of depression is one of its potential therapeutic applications. This report makes a review about add-on trials (hf-rTMS plus antidepressants discuss whether rTMS does

  15. A comparative study of repetitive Transcranial Magnetic Stimulation (rTMS) to improve anxiety symptoms and psychological craving of patients with methamphetamine dependence%重复经颅磁刺激改善甲基苯丙胺依赖者焦虑及心理渴求症状的对照研究

    Institute of Scientific and Technical Information of China (English)

    朱纬国; 刘书奎; 刘增训

    2015-01-01

    目的:探讨重复经颅磁刺激( rTMS)对甲基苯丙胺依赖者焦虑及心理渴求症状的疗效。方法将112例甲基苯丙胺依赖患者随机分为研究组和对照组,研究组接受系统的rTMS治疗,对照组接受类似rTMS 的假性刺激治疗,共8周。在基线及治疗后第1、2、4、6、8周末应用焦虑自评量表( SAS)和视觉模拟标尺( VAS)评定患者的焦虑症状和心理渴求状况。结果治疗后第1、2、4、6、8周末,研究组SAS评分及VAS评分较基线评分均降低(P<0.05),对照组治疗后第4、6、8周末SAS、VAS评分较基线时降低(P<0.05),研究组治疗后第1、2、4、6、8周末SAS评分及VAS评分均低于对照组(P<0.05)。结论 rTMS可显著改善甲基苯丙胺依赖患者的焦虑症状与心理渴求状况,安全性高。%Objective To explore the effects of repetitive Transcranial Magnetic Stimulation ( rTMS ) to improve anxiety symptoms and psychological craving of patients with methamphetamine dependence.Method A total of 112 patients with methamphetamine dependence were randomly divided into study group with rTMS and control group without rTMS for treatment of 8 weeks.They were assessed with Self-rating Anxiety Scale(SAS)and Visual Analogue Scale(VAS) on baseline, the 1st, 2nd, 4th, 6th and 8th weekend of treatment.Result On the 1st, 2nd, 4th, 6th and 8th weekend of treatment, the scores of SAS and VAS in study group were significantly lower than those on baseline (P<0.05), and were significantly lower than those in control group (P<0.05).On the 4th 6th and 8th weekend of treatment,the scores of SAS and VAS in control group were significantly lower than those on baseline ( P <0.05 ) .Conclusion It is effective and safe for rTMS to improve anxiety symptoms and psychological craving of patients with methamphetamine dependence.

  16. 重复经颅磁刺激对轻度认知功能障碍患者认知功能的影响%Effects of repetitive transcranial magnetic stimulation on cognitive function in patients with mild cognitive impairmen

    Institute of Scientific and Technical Information of China (English)

    章礼勇; 袁良津; 王玉

    2014-01-01

    目的:探讨重复经颅磁刺激( rTMS)对轻度认知功能障碍( MCI)患者认知功能的影响。方法50例MCI患者随机分为rTMS治疗组( rTMS组)和吡啦西坦治疗组(对照组),每组25例。 rTMS组患者rTMS治疗的刺激点位于双侧前额区,每天1次,连续治疗6d为1个疗程,两个疗程间隔3周,共治疗4个疗程。对照组患者给予吡啦西坦0.8 g,3次/d,连续服用16周。分别于治疗前、后进行事件相关电位P300和蒙特利尔认知评估(MoCA)量表检查。结果 rTMS组患者治疗后与治疗前比较,P300潜伏期明显缩短、波幅明显增高, MoCA量表总分和延迟记忆得分明显增高(P<0.05~0.01);与对照组比较,差异亦均有统计学意义(均P<0.05)。而对照组患者治疗前、后P300潜伏期、波幅及MoCA量表总分和各分项得分之间的差异均无统计学意义。结论 rTMS治疗能改善MCI患者的记忆和认知功能,可在一定程度上延缓痴呆的发生。%Objective To explore the effects of repetitive transcranial magnetic stimulation ( rTMS ) on cognitive function in patients with mild cognitive impairmen ( MCI).Methods Fifty patients with MCI were randomly divided into rTMS treatment group ( rTMS group ) and piracetam treatment group ( control group ) , 25 patients in each group .The stimulated point of rTMS treatment were in the bilateral prefrontal area , for one time a day, continuous treatment for 6 d as a courses in rTMS group patients .Two courses of treatment was interval of 3 weeks, a total of 4 courses.The patients of control group were treated with piracetam 0.8 g, 3 times a day, for taking 16 weeks.Before and after treatment, the event-related potentials P300 and Montreal Cognitive Assessment (MoCA) scale examination were taken in two group respectively .Results Compared with before treatment , the P300 latency significant was significantly shortened and amplitude increased , scores of

  17. 氨磺必利联合重复经颅磁刺激治疗首发精神分裂症的随机对照研究%Clinical controlled study on amisulpride combined with repetitive transcranial magnetic stimulation in the treatment of first - episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    焦金; 金毅琼; 马素杰; 成艳红

    2015-01-01

    Objective To investigate the clinical efficacy of amisulpride combined with Repetitive Transcranial Magnetic Stimu-lation(rTMS)for patients with first - episode schizophrenia. Methods Using random number table,88 patients of first - episode schizophrenia were randomly assigned to study group(44 cases)and control group(44 cases),the study group was treated with amisulpride combined with rTMS,and the control group was treated with amisulpride. The efficacy were assessed by Positive and Nega-tive Syndrome Scale(PANSS)before and after treatment for 2,4,6,8 weeks,and the adverse reactions were evaluated with Treatment Emergent Symptom Scale(TESS). Results After 8 weeks treatment,the scores of PANSS in both groups decreased significantly com-pared to the baseline(P 0. 05). The scores of negative symptom in study group decreased signifi-cantly compared to the control group,and there was statistically significant difference(P 0. 05). Conclusion Amisulpride combined with rTMS is as effective as amisulpride for the treatment of positive symptoms of first - episode schizophrenia patients,but it is more effec-tive than amisulpride in the treatment of the negative symptoms.%目的:探讨氨磺必利合并重复经颅磁刺激(rTMS)治疗精神分裂症的效果。方法采用随机数字表法将符合《国际疾病分类(第10版)》(ICD -10)精神分裂症诊断标准的88例首发精神分裂症患者分为研究组和对照组各44例,研究组采用氨磺必利联合重复经颅磁刺激(rTMS)治疗,对照组单用氨磺必利治疗,采用阳性与阴性症状量表(PANSS)于治疗前及治疗后第2、4、6、8周评定疗效,采用副反应量表(TESS)评定不良反应。结果经8周治疗,两组 PANSS 总评分均较治疗前低(P 均0.05)。但研究组阴性症状评分减分与对照组比较,差异有统计学意义(P 0.05)。结论氨磺必利合并 rTMS 对首发精神分裂症阳性症状的疗效与单用氨磺

  18. The effect of repetitive transcranial magnetic stimulation on the changes of depressive like behaviors in chronic unpredictable mild stress model rats and its possible mechanism%重复经颅磁刺激对抑郁模型大鼠行为的改善作用及机制

    Institute of Scientific and Technical Information of China (English)

    刘高华; 陈冠婕; 陈怡环; 杨帆; 张瑞国; 彭正午; 谭庆荣

    2013-01-01

    Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on the depressive like behaviors and expression of brain derived neurotrophic factor (BDNF),IL-1β and NF-κB of hippocampal in chronic unpredictable mild stress (CUMS) rats.Methods Thirty-two adult male rats were randomly divided into four groups (n =8):Control group,Control + rTMS group,CUMS group and CUMS + rTMS group.The sucrose preference test,forced swim test and open field test were used to evaluate depressive like behaviors for each groups.In addition,the expression of BDNF,NF-κB and IL-1 β in hippocampal were detected by western blot and ELISA after behavioral test,respectively.Results 1.The effects of rTMS on depressive like behaviors of CUMS rats:in the sucrose preference test,the sucrose preference rate of CUMS rats (0.67 ± 0.06) was significantly lower than Control group (0.91 ± 0.04),which was higher in the CUMS + rTMS group (0.83 ±0.08).In the forced swim test,the immobility time of CUMS group ((26.88 ± 11.33) s) was longer than Control group ((15.22 ± 6.75) s) and CUMS + rTMS group ((18.41 ± 6.95) s).In the open field test,both the total distance travelled and number of central area entry times of CUMS group((849.165 ± 769.01) cm,(7.42 ± 5.68))were significantly shorter ((6224.81 ± 1403.2) cm) and smaller (22.86 ± 3.72) than Control group,and those of the CUMS + rTMS were longer ((4105.57 ± 1516.92)cm) and larger (21.25 ± 3.45).All the behavioral results were statistically significant (P< 0.05).And of all the aforementioned behavioral parameters,there were no significant differences between Control group and Control + rTMS group(P>0.05).2.The effects of rTMS on the hippocampal expressions of BDNF,NF-κB and IL-1β in CUMS rats:compared with Control group,the hippocampal expression of BDNF in CUMS rats was significantly decreased,while the expressions of NF-κB and IL-1β in the hippocampus were significantly increased (P< 0.05).Compared

  19. Comparison of Coil Designs for Transcranial Magnetic Stimulation on Mice

    Science.gov (United States)

    Rastogi, Priyam; Hadimani, Ravi; Jiles, David

    2015-03-01

    Transcranial magnetic stimulation (TMS) is a non-invasive treatment for neurological disorders using time varying magnetic field. The electric field generated by the time varying magnetic field is used to depolarize the brain neurons which can lead to measurable effects. TMS provides a surgical free method for the treatment of neurological brain disorders like depression, post-traumatic stress disorder, traumatic brain injury and Parkinson's disease. Before using TMS on human subjects, it is appropriate that its effects are verified on animals such as mice. The magnetic field intensity and stimulated region of the brain can be controlled by the shape, position and current in the coils. There are few reports on the designs of the coils for mice. In this paper, different types of coils are developed and compared using an anatomically realistic mouse model derived from MRI images. Parameters such as focality, depth of the stimulation, electric field strength on the scalp and in the deep brain regions, are taken into account. These parameters will help researchers to determine the most suitable coil design according to their need. This should result in improvements in treatment of specific disorders. Carver Charitable Trust.

  20. Is the human mirror neuron system plastic? Evidence from a transcranial magnetic stimulation study.

    Science.gov (United States)

    Mehta, Urvakhsh Meherwan; Waghmare, Avinash V; Thirthalli, Jagadisha; Venkatasubramanian, Ganesan; Gangadhar, Bangalore N

    2015-10-01

    Virtual lesions in the mirror neuron network using inhibitory low-frequency (1Hz) transcranial magnetic stimulation (TMS) have been employed to understand its spatio-functional properties. However, no studies have examined the influence of neuro-enhancement by using excitatory high-frequency (20Hz) repetitive transcranial magnetic stimulation (HF-rTMS) on these networks. We used three forms of TMS stimulation (HF-rTMS, single and paired pulse) to investigate whether the mirror neuron system facilitates the motor system during goal-directed action observation relative to inanimate motion (motor resonance), a marker of putative mirror neuron activity. 31 healthy individuals were randomized to receive single-sessions of true or sham HF-rTMS delivered to the left inferior frontal gyrus - a component of the human mirror system. Motor resonance was assessed before and after HF-rTMS using three TMS cortical reactivity paradigms: (a) 120% of resting motor threshold (RMT), (b) stimulus intensity set to evoke motor evoked potential of 1-millivolt amplitude (SI1mV) and (c) a short latency paired pulse paradigm. Two-way RMANOVA showed a significant group (true versus sham) X occasion (pre- and post-HF-rTMS motor resonance) interaction effect for SI1mV [F(df)=6.26 (1, 29), p=0.018] and 120% RMT stimuli [F(df)=7.01 (1, 29), p=0.013] indicating greater enhancement of motor resonance in the true HF-rTMS group than the sham-group. This suggests that HF-rTMS could adaptively modulate properties of the mirror neuron system. This neuro-enhancement effect is a preliminary step that can open translational avenues for novel brain stimulation therapeutics targeting social-cognition deficits in schizophrenia and autism. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. 强制性诱导语言治疗联合低频重复经颅磁刺激对非流畅性失语的疗效%Effectiveness of constraint induced language therapy combined with low frequency repetitive transcranial magnetic stim-ulation for non-fluent aphasia

    Institute of Scientific and Technical Information of China (English)

    周秋敏; 丛芳; 沈滢; 殷稚飞; 张文通; 叶芊; 陈文莉; 单春雷

    2014-01-01

    目的:观察强制性诱导语言治疗(CILT)联合低频重复经颅磁刺激(rTMS)对非流畅性失语的语言功能和交流能力的影响。方法:40例失语症患者随机分为4组各10例,分别采用常规治疗(常规组)、常规治疗+CIL T (CILT组)、常规治疗+1Hz rTMS(rTMS组)及常规治疗+CILT+1Hz rTMS(联合组)治疗10d ,治疗前后进行西方失语症成套测验(WAB)的自发言语、听理解、复述及命名前4项及日常生活交流活动检查(CADL )评定语言功能和交流能力。结果:治疗10d后,联合组WAB各项功能评分及CADL评分均较治疗前、CILT 组及常规组明显提高(P<0.05),联合组WAB评分自发言语、听理解和命名3项及CADL评分均较rTMS组明显提高(P<0.05), WAB评分复述项联合组与rTMS组组间比较差异无统计学意义;rTMS组WAB各项功能评分及CADL评分均较治疗前及常规组提高更明显(P<0.05);CILT组WAB评分自发言语、听理解和命名3项及CADL评分均较治疗前及常规组明显提高(P<0.05);常规组WAB评分仅自发言语较治疗前有提高(P<0.05),CADL评分治疗前后比较差异无统计学意义。结论:强制性诱导疗法和低频重复性经颅磁刺激对非流畅型失语疗效优于常规治疗,两者联合运用疗效更优。%Objective:To observe the effects of constraint induced language therapy(CILT) combined with low fre-quency repetitive transcranial magnetic stimulation(rTMS) on language functions and communication skills of non-fluent aphasia patients .Methods:Forty patients were randomly assigned to four groups accepting conventional thera-py(conventional group) ,conventional therapy + CILT (CILT group) ,conventional therapy + 1 Hz rTMS (rTMS group) ,and conventional therapy+CILT+1 Hz rTMS(combined group) for 10 days ,respectively .Before and after therapy ,the language functions were evaluated with the

  2. Enhancement of Phonological Memory Following Transcranial Magnetic Stimulation (TMS

    Directory of Open Access Journals (Sweden)

    Matthew P. Kirschen

    2006-01-01

    Full Text Available Phonologically similar items (mell, rell, gell are more difficult to remember than dissimilar items (shen, floy, stap, likely because of mutual interference of the items in the phonological store. Low-frequency transcranial magnetic stimulation (TMS, guided by functional magnetic resonance imaging (fMRI was used to disrupt this phonological confusion by stimulation of the left inferior parietal (LIP lobule. Subjects received TMS or placebo stimulation while remembering sets of phonologically similar or dissimilar pseudo-words. Consistent with behavioral performance of patients with neurological damage, memory for phonologically similar, but not dissimilar, items was enhanced following TMS relative to placebo stimulation. Stimulation of a control region of the brain did not produce any changes in memory performance. These results provide new insights into how the brain processes verbal information by establishing the necessity of the inferior parietal region for optimal phonological storage. A mechanism is proposed for how TMS reduces phonological confusion and leads to facilitation of phonological memory.

  3. Transcranial Magnetic Stimulation-coil design with improved focality

    Science.gov (United States)

    Rastogi, P.; Lee, E. G.; Hadimani, R. L.; Jiles, D. C.

    2017-05-01

    Transcranial Magnetic Stimulation (TMS) is a technique for neuromodulation that can be used as a non-invasive therapy for various neurological disorders. In TMS, a time varying magnetic field generated from an electromagnetic coil placed on the scalp is used to induce an electric field inside the brain. TMS coil geometry plays an important role in determining the focality and depth of penetration of the induced electric field responsible for stimulation. Clinicians and basic scientists are interested in stimulating a localized area of the brain, while minimizing the stimulation of surrounding neural networks. In this paper, a novel coil has been proposed, namely Quadruple Butterfly Coil (QBC) with an improved focality over the commercial Figure-8 coil. Finite element simulations were conducted with both the QBC and the conventional Figure-8 coil. The two coil's stimulation profiles were assessed with 50 anatomically realistic MRI derived head models. The coils were positioned on the vertex and the scalp over the dorsolateral prefrontal cortex to stimulate the brain. Computer modeling of the coils has been done to determine the parameters of interest-volume of stimulation, maximum electric field, location of maximum electric field and area of stimulation across all 50 head models for both coils.

  4. Electromagnetic characteristics of eccentric figure-eight coils for transcranial magnetic stimulation: A numerical study

    Science.gov (United States)

    Kato, Takuya; Sekino, Masaki; Matsuzaki, Taiga; Nishikawa, Atsushi; Saitoh, Youichi; Ohsaki, Hiroyuki

    2012-04-01

    Repetitive transcranial magnetic stimulation (rTMS) is effective for treatment of several neurological and psychiatric diseases. We proposed an eccentric figure-eight coil, which induces strong eddy currents in the target brain tissue. In this study, numerical analyses were carried out to obtain magnetic field distribution of the eccentric figure-eight coil and eddy current in the brain. The analyses were performed with various coil design parameters, such as the outer and inner diameters and number of turns, to investigate the influence of these parameters on the coil characteristics. Increases in the inner diameter, outer diameter, and number of turns caused increases in the maximum eddy current densities. Coil inductance, working voltage, and heat generation also became higher with the increases in these design parameters. In order to develop a compact stimulator system for use at home, we need to obtain strong eddy current density, keeping the working voltage as low as possible. Our results show that it is effective to enlarge the outer diameter.

  5. Ataxic hemiparesis: neurophysiological analysis by cerebellar transcranial magnetic stimulation.

    Science.gov (United States)

    Kikuchi, Saeko; Mochizuki, Hitoshi; Moriya, Arata; Nakatani-Enomoto, Setsu; Nakamura, Koichiro; Hanajima, Ritsuko; Ugawa, Yoshikazu

    2012-03-01

    The aim of this study was to investigate physiological mechanisms underlying ataxia in patients with ataxic hemiparesis. Subjects were three patients with ataxic hemiparesis, whose responsible lesion was located at the posterior limb of internal capsule (case 1), thalamus (case 2), or pre- and post-central gyri (case 3). Paired-pulse transcranial magnetic stimulation (TMS) technique was used to evaluate connectivity between the cerebellum and contralateral motor cortex. The conditioning cerebellar stimulus was given over the cerebellum and the test stimulus over the primary motor cortex. We studied how the conditioning stimulus modulated motor evoked potentials (MEPs) to the cortical test stimulus. In non-ataxic limbs, the cerebellar stimulus normally suppressed cortical MEPs. In ataxic limbs, the cerebellar inhibition was not elicited in patients with a lesion at the posterior limb of internal capsule (case 1) or thalamus (case 2). In contrast, normal cerebellar inhibition was elicited in the ataxic limb in a patient with a lesion at sensori-motor cortex (case 3). Lesions at the internal capsule and thalamus involved the cerebello-thalamo-cortical pathways and reduced the cerebellar suppression effect. On the other hand, a lesion at the pre- and post-central gyri should affect cortico-pontine pathway but not involve the cerebello-thalamo-cortical pathways. This lack of cerebello-talamo-cortical pathway involvement may explain normal suppression in this patient. The cerebellar TMS method can differentiate cerebellar efferent ataxic hemiparesis from cerebellar afferent ataxic hemiparesis.

  6. Improved transcranial magnetic stimulation coil design with realistic head modeling

    Science.gov (United States)

    Crowther, Lawrence; Hadimani, Ravi; Jiles, David

    2013-03-01

    We are investigating Transcranial magnetic stimulation (TMS) as a noninvasive technique based on electromagnetic induction which causes stimulation of the neurons in the brain. TMS can be used as a pain-free alternative to conventional electroconvulsive therapy (ECT) which is still widely implemented for treatment of major depression. Development of improved TMS coils capable of stimulating subcortical regions could also allow TMS to replace invasive deep brain stimulation (DBS) which requires surgical implantation of electrodes in the brain. Our new designs allow new applications of the technique to be established for a variety of diagnostic and therapeutic applications of psychiatric disorders and neurological diseases. Calculation of the fields generated inside the head is vital for the use of this method for treatment. In prior work we have implemented a realistic head model, incorporating inhomogeneous tissue structures and electrical conductivities, allowing the site of neuronal activation to be accurately calculated. We will show how we utilize this model in the development of novel TMS coil designs to improve the depth of penetration and localization of stimulation produced by stimulator coils.

  7. Modulating functional and dysfunctional mentalizing by transcranial magnetic stimulation

    Directory of Open Access Journals (Sweden)

    Tobias eSchuwerk

    2014-11-01

    Full Text Available Mentalizing, the ability to attribute mental states to others and oneself, is a cognitive function with high relevance for social interactions. Recent neuroscientific research has increasingly contributed to attempts to decompose this complex social cognitive function into constituting neurocognitive building blocks. Additionally, clinical research that focuses on social cognition to find links between impaired social functioning and neurophysiological deviations has accumulated evidence that mentalizing is affected in most psychiatric disorders. Recently, both lines of research have started to employ transcranial magnetic stimulation: the first to modulate mentalizing in order to specify its neurocognitive components, the latter to treat impaired mentalizing in clinical conditions. This review integrates findings of these two different approaches to draw a more detailed picture of the neurocognitive basis of mentalizing and its deviations in psychiatric disorders. Moreover, we evaluate the effectiveness of hitherto employed stimulation techniques and protocols, paradigms and outcome measures. Based on this overview we highlight new directions for future research on the neurocognitive basis of functional and dysfunctional social cognition.

  8. Transcranial magnetic stimulation and amyotrophic lateral sclerosis: pathophysiological insights.

    Science.gov (United States)

    Vucic, Steve; Ziemann, Ulf; Eisen, Andrew; Hallett, Mark; Kiernan, Matthew C

    2013-10-01

    Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disorder of the motor neurons in the motor cortex, brainstem and spinal cord. A combination of upper and lower motor neuron dysfunction comprises the clinical ALS phenotype. Although the ALS phenotype was first observed by Charcot over 100 years ago, the site of ALS onset and the pathophysiological mechanisms underlying the development of motor neuron degeneration remain to be elucidated. Transcranial magnetic stimulation (TMS) enables non-invasive assessment of the functional integrity of the motor cortex and its corticomotoneuronal projections. To date, TMS studies have established motor cortical and corticospinal dysfunction in ALS, with cortical hyperexcitability being an early feature in sporadic forms of ALS and preceding the clinical onset of familial ALS. Taken together, a central origin of ALS is supported by TMS studies, with an anterograde transsynaptic mechanism implicated in ALS pathogenesis. Of further relevance, TMS techniques reliably distinguish ALS from mimic disorders, despite a compatible peripheral disease burden, thereby suggesting a potential diagnostic utility of TMS in ALS. This review will focus on the mechanisms underlying the generation of TMS measures used in assessment of cortical excitability, the contribution of TMS in enhancing the understanding of ALS pathophysiology and the potential diagnostic utility of TMS techniques in ALS.

  9. Relative suppression of magical thinking: a transcranial magnetic stimulation study.

    Science.gov (United States)

    Bell, Vaughan; Reddy, Venu; Halligan, Peter; Kirov, George; Ellis, Hadyn

    2007-05-01

    The tendency to perceive meaning in noise (apophenia) has been linked to "magical thinking" (MT), a distinctive form of thinking associated with a range of normal cognitive styles, anomalous perceptual experiences and frank psychosis. Important aspects of MT include the propensity to imbue meaning or causality to events that might otherwise be considered coincidental. Structures in the lateral temporal lobes have been hypothesised to be involved in both the clinical and nonclinical aspects of MT. Accordingly, in this study we used single-pulse transcranial magnetic stimulation (TMS) to stimulate either the left or right lateral temporal areas, or the vertex, of 12 healthy participants (balanced for similar levels of MT, delusional ideation and temporal lobe disturbance) while they were required to indicate if they had "detected" pictures, claimed to be present by the experimenters, in visual noise. Relative to the vertex, TMS inhibition of the left lateral temporal area produced significant reduced tendency to report meaningful information, suggesting that left lateral temporal activation may be more important in MT and therefore producing and supporting anomalous beliefs and experiences. The effect cannot simply be explained by TMS induced cognitive slowing as reaction times were not affected.

  10. Transcranial Magnetic Stimulation Reveals Intrinsic Perceptual and Attentional Rhythms

    Science.gov (United States)

    Dugué, Laura; VanRullen, Rufin

    2017-01-01

    Oscillatory brain activity has functional relevance for perceptual and cognitive processes, as proven by numerous electrophysiology studies accumulating over the years. However, only within the past two decades have researchers been able to study the causal role of such oscillations using transcranial magnetic stimulation (TMS) technology. Two complementary approaches exist. A majority of research employs rhythmic TMS (rTMS) to entrain oscillatory activity and investigate its effect on targeted brain functions. On the other hand, single pulses of TMS (spTMS) that can be delivered with a high spatio-temporal resolution, can be used to precisely probe the state of the system. In this mini-review, we concentrate on this second approach. We argue that, with no a priori hypothesis on the oscillatory frequency of the targeted cortical regions, spTMS can help establish causal links between spontaneous oscillatory activity and perceptual and cognitive functions. Notably, this approach helped to demonstrate that the occipital cortex is periodically involved during specific attentional tasks at the theta (~5 Hz) frequency. We propose that this frequency reflects periodic inter-areal communication for attentional exploration and selection. In the future, clever combination of non-invasive recording and stimulation with well-controlled psychophysics protocols will allow us to further our understanding of the role of brain oscillations for human brain functions.

  11. The role of cutaneous inputs during magnetic transcranial stimulation.

    Science.gov (United States)

    Rossini, P M; Tecchio, F; Sabato, A; Finazzi-Agrò, A; Pasqualetti, P; Rossi, S

    1996-10-01

    Latency and amplitude characteristics of motor evoked potentials (MEPs) from abductor digiti minimi (ADM) and first dorsal interosseus (FDI) muscles were evaluated in 7 healthy volunteers via magnetic transcranial stimulation of the hemiscalp overlying contralateral motor areas. MEPs in complete relaxation and during contraction were recorded in two different experimental conditions: before and following anesthesia of median (sensory + motor) and radial (sensory) nerve fibers at wrist. This procedure induced a complete loss of skin sensation from dorsal and palmar aspects of the hand area "enveloping" the FDI muscle. On the other hand, the skin overlying the ADM muscle, as well as the strength of ulnar nerve supplied muscles were spared. This selective sensory deprivation lead to the following short-term changes: the physiological latency "jump" toward shorter values in contracted MEPs vs. relaxation was partially lost in the FDI (3.0 +/- 1.4 ms in basal condition, 1.8 +/- 1.1 ms after anesthesia, P = 0.028), while it was still clearly evident in the ADM (3.7 +/- 0.9 ms and 3.3 +/- 1.0 ms, respectively). Moreover, minor amplitude changes of MEPs during active contraction in the two muscles were detected: MEPs recorded from the FDI muscle were less potentiated during voluntary contraction than those recorded from the ADM muscle. The role of the cutaneous input in governing latency/amplitude characteristics of MEPs is discussed.

  12. Enhancement of human cognitive performance using transcranial magnetic stimulation (TMS).

    Science.gov (United States)

    Luber, Bruce; Lisanby, Sarah H

    2014-01-15

    Here we review the usefulness of transcranial magnetic stimulation (TMS) in modulating cortical networks in ways that might produce performance enhancements in healthy human subjects. To date over sixty studies have reported significant improvements in speed and accuracy in a variety of tasks involving perceptual, motor, and executive processing. Two basic categories of enhancement mechanisms are suggested by this literature: direct modulation of a cortical region or network that leads to more efficient processing, and addition-by-subtraction, which is disruption of processing which competes or distracts from task performance. Potential applications of TMS cognitive enhancement, including research into cortical function, rehabilitation therapy in neurological and psychiatric illness, and accelerated skill acquisition in healthy individuals are discussed, as are methods of optimizing the magnitude and duration of TMS-induced performance enhancement, such as improvement of targeting through further integration of brain imaging with TMS. One technique, combining multiple sessions of TMS with concurrent TMS/task performance to induce Hebbian-like learning, appears to be promising for prolonging enhancement effects. While further refinements in the application of TMS to cognitive enhancement can still be made, and questions remain regarding the mechanisms underlying the observed effects, this appears to be a fruitful area of investigation that may shed light on the basic mechanisms of cognitive function and their therapeutic modulation.

  13. Electronically switchable sham transcranial magnetic stimulation (TMS system.

    Directory of Open Access Journals (Sweden)

    Fumiko Hoeft

    Full Text Available Transcranial magnetic stimulation (TMS is increasingly being used to demonstrate the causal links between brain and behavior in humans. Further, extensive clinical trials are being conducted to investigate the therapeutic role of TMS in disorders such as depression. Because TMS causes strong peripheral effects such as auditory clicks and muscle twitches, experimental artifacts such as subject bias and placebo effect are clear concerns. Several sham TMS methods have been developed, but none of the techniques allows one to intermix real and sham TMS on a trial-by-trial basis in a double-blind manner. We have developed an attachment that allows fast, automated switching between Standard TMS and two types of control TMS (Sham and Reverse without movement of the coil or reconfiguration of the setup. We validate the setup by performing mathematical modeling, search-coil and physiological measurements. To see if the stimulus conditions can be blinded, we conduct perceptual discrimination and sensory perception studies. We verify that the physical properties of the stimulus are appropriate, and that successive stimuli do not contaminate each other. We find that the threshold for motor activation is significantly higher for Reversed than for Standard stimulation, and that Sham stimulation entirely fails to activate muscle potentials. Subjects and experimenters perform poorly at discriminating between Sham and Standard TMS with a figure-of-eight coil, and between Reverse and Standard TMS with a circular coil. Our results raise the possibility of utilizing this technique for a wide range of applications.

  14. 不同频率重复经颅磁刺激对脑梗死患者上肢功能的影响%Effect of repetitive transcranial magnetic stimulation with different frequencies for upper limb function in patients with cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    沈滢; 单春雷; 殷稚飞; 孟殿怀; 侯红; 戴文骏; 励建安

    2012-01-01

    目的:比较不同频率的重复经颅磁刺激(rTMS)对脑梗死患者上肢功能的影响.方法:将30例患者随机分为0.5Hz组、1Hz组和2Hz组,常规药物治疗和康复训练基础上对健侧大脑皮质M1区进行不同频率(0.5Hz、1Hz、2Hz)的rTMS治疗,持续治疗20d,于治疗前、治疗第10天及第20天时对各组患者进行疗效评定,采用上肢Fugl-Meyer评分法、上肢运动力指数(MI)、偏瘫上肢功能测试(香港版)对患者上肢功能进行评定,同时检测各组患侧脑区运动诱发电位(MEP)皮质潜伏期及中枢运动传导时间(CMCT).结果:①上肢功能变化:治疗后3组上肢功能均明显提高,治疗10d时,0.5Hz组上肢MI评分明显高于2Hz组(P<0.05),1Hz组与其他两组组间差异无显著性意义(P>0.05);治疗20d时,0.5Hz组各项评分均优于2Hz组(P<0.05),1Hz组上肢MI评分优于2Hz组(P<0.05),0.5Hz组与1Hz组组间差异不具有显著性意义(P>0.05).②神经电生理学变化:治疗后3组MEP皮质潜伏期及CMCT均较治疗前明显缩短,治疗10d时,0.5Hz组CMCT明显短于2Hz组(P<0.05); 1Hz组与其他两组组间差异无显著性意义(P>0.05);治疗20d时,0.5Hz组MEP皮质潜伏期明显短于2Hz组(P<0.05),CMCT明显短于1Hz组和2Hz组(P<0.05); 1Hz组CMCT较2Hz组缩短明显(P<0.05).结论:0.5Hz或1Hz的重复经颅磁刺激作用于脑梗死患者健侧半球均可明显提高患侧脑区运动皮质的兴奋性,促进患侧上肢功能的恢复,且0.5Hz的刺激频率对提高患侧运动皮质的兴奋性最有效.%Objective:To compare the effect of repetitive transcranial magnetic stimulation (rTMS) with different frequencies for upper limb function in patients with cerebral infarction. Method: Thirty patients were randomly assigned to three groups receiving 0.5Hz, lHz, and 2Hz rTMS on M1 area of the unaffected hemisphere for 20d, respectively. In the same period, all patients were also treated with conventional medical treatment and

  15. The effect of low frequency repetitive transcranial magnetic stimulation on acute cerebral infarction patients movement function recovery%低频重复经颅磁刺激对急性脑梗死患者运动功能恢复的影响

    Institute of Scientific and Technical Information of China (English)

    宁耀超; 孙辉

    2013-01-01

    目的 探讨低频重复经颅磁刺激(rTMS)对急性脑梗死患者运动功能恢复的影响,以期能为低频rTMS治疗急性脑梗死的深入研究及临床应用提供一定参考依据.方法 选取60例急性脑梗死伴单侧肢体运动功能障碍患者,按随机数字表法分为低频rTMS组与对照组,每组30例,两组均给予常规药物治疗及康复训练,低频rTMS组在以上治疗基础上加用低频rTMS治疗10d,观察两组患者治疗前、治疗后10d、治疗后40d时美国国立卫生院神经功能缺损评分(NIHSS)、Fugl-Meyer运动量表(FMA)评分及Barthel指数(BI)评分变化.结果 低频rTMS组治疗前NIHSS、BI评分和FMA评分分别为(16.44±3.29)、(36.69±5.97)、(31.06±7.43)分,对照组分别为(16.38±4.01)、(35.98±6.41)、(30.87±8.56)分,两组比较差异无统计学意义(P>0.05).低频rTMS组治疗后10d NIHSS评分、BI评分和FMA评分分别为(8.13±2.18)、(56.04±5.21)、(48.42±7.73)分,对照组分别为(11.23±1.97)、(50.12±4.88)、(42.12±8.61)分;低频rTMS组治疗后40d NIHSS、BI评分和FMA评分分别为(3.11±0.53)、(73.29±5.34)、(61.63±8.36)分,对照组分别为(5.62±0.98)、(63.96±4.46)、(52.45±7.61)分.两组治疗后10、40d NIHSS均较治疗前明显下降,BI及FMA评分均较治疗前明显升高,差异有统计学意义(P<0.05);低频rTMS组治疗后10、40d NIHSS、BI评分和FMA评分与对照组比较差异均有统计学意义(P<0.05).结论 低频rTMS对急性脑梗死患者运动功能恢复有明显的促进作用.%Objective To investigate low frequency repetitive transcranial magnetic stimulation (rTMS) on acute cerebral infarction (ACI) patients movement function recovery,in order to provide certain reference basis about the further research on low frequency rTMS treatment ACI and clinical application.Methods Sixty patients of ACI with unilateral limb movement function disorder were divided into low frequency rTMS group and control group by table of

  16. A study about influence of slow repetitive transcranial magnetic stimulation on the level of serum prolactin in chronic schizophrenics.%低频重复经颅磁刺激对慢性精神分裂症患者血清催乳素水平的影响

    Institute of Scientific and Technical Information of China (English)

    高志勤; 余海鹰; 金梅; 孙剑; 杨春; 丁松柏; 赵斌; 邱旭萍; 钟爱芳

    2011-01-01

    目的 探讨低频重复经颅磁刺激(rTMS)治疗抗精神病药所致高催乳素血症的疗效及安全性.方法 将61例利培酮所致高催乳素血症的住院军人慢性精神分裂症患者随机分为两组,在原有利培酮剂量稳定不变的基础上,分别予以10 d的1Hz低频删S刺激(31例)及假rTMS刺激(30例).于刺激前、后对两组分别进行血清催乳素(PRL)测定及阳性和阴性症状量表(PANss)、17项汉密尔顿抑郁量表(HAMD-17)评定,同时观察高催乳素血症临床症状的变化情况,并于1个月后对研究组的血清PRL水平进行复测.结果 (1)研究组rTMS刺激后PRL水平[(27.9±7.1)μg/L]较治疗前[(101.5±41.2)μg/L]下降,差异有统计学意义(P<0.01);对照组治疗后PRL水平[(111.4±44.5)μg/L]与治疗前[(106.6±41.9)μg/L]比较,差异无统计学意义(P>0.05);研究组疗效明显优于对照组(F=22.3,P<0.01);研究组治疗1个月后复测PRL[(96.7±38.3)μg/L],已恢复至治疗前水平(P>0.05).(2)研究组男性乳房女性化消失(8/14),自发泌乳消失(11/17),月经恢复(4/7),对照组则均无改善.(3)与治疗前比较,治疗后研究组及对照组PANSS及HAMD-17评分变化均无统计学意义(均P>0.05).两组不良反应均较轻,除头痛研究组多于对照组外,其余不良反应发生率两组相近.结论 短期低频rTMS治疗可使慢性精神分裂症患者服用抗精神病药所致高催乳素血症的症状减轻,且安全性较好,但需进一步的rTMS维持治疗以巩固疗效.%Objective To explore the efficacy and tolerability of slow repetitive Transcranial Magnetic Stimulation (rTMS) in the treatment of hyperprolactinemia caused by antipsychotic.Methods A total of 61 chronic schizophrenic patients with hyperprolactinemia caused by risperidone were randomized into study group (31 cases) treated with active rTMS plus former dosage of risperidone and control group (31 cases) treated with sham rTMS plus former dosage of risperidone

  17. The effects of repetitive transcranial magnetic stimulation on the cognitive ability in patients with mild cognitive impairment after ischemic stroke%重复经颅磁刺激对脑梗死后轻度认知功能障碍的影响

    Institute of Scientific and Technical Information of China (English)

    李亚梅; 徐丽; 杨艳; 田金艳; 余茜

    2015-01-01

    目的 观察重复经颅磁刺激(rTMS)对脑梗死后轻度认知障碍患者认知功能的影响.方法 选取脑梗死后认知功能损害但未达痴呆诊断标准的患者45例,按随机数字表法分为观察组(32例)和对照组(30例),2组均给予常规药物治疗和认知功能训练,观察组在此基础上增加rTMS治疗(刺激左侧前额叶背外侧皮质,5 Hz,80%运动阈值).2组患者均于治疗前和治疗4周后(治疗后)进行神经心理评分和听觉事件相关电位检测.结果 治疗后,2组患者的蒙特利尔认知评估表(MoCA)评分较组内治疗前均显著升高,差异有统计学意义(P<0.05),且治疗组治疗后的MoCA评分亦显著高于对照组治疗后,差异有统计学意义(p<0.05).治疗后,2组患者的P300潜伏期均较组内治疗前缩短,波幅均较组内治疗前升高(p<0.05),且观察组治疗后的潜伏期和波幅分别为(355.67±16.43) ms和(8.69±1.65) μV,与对照组治疗后的(372.76±23.35) ms和(7.03±3.04)μV比较,差异均有统计学意义(P<0.05).结论 rTMS可显著改善脑梗死后轻度认知功能障碍患者的认知功能,且相对安全.%Objective To explore the effects of repetitive transcranial magnetic stimulation (rTMS) on cognitive ability in patients suffering from mild cognitive impairment (MCI) after ischemic stroke.Methods Forty five ischemic stroke survivors with MCI but not meeting the criterion for diagnosis as dementia were recruited, and were randomly assigned into an rTMS group (32 patients) and a control group (30 patients) according to a random number table.Both groups received the routine drug therapy of medicine and cognitive function training, and the rTMS group was additionally given rTMS over the left dorsolateral prefrontal cortex at 5 Hz and 80% motor threshold.The treatments lasted for 4 weeks.The Montreal Cognitive Assessment (MoCA) and auditory event related potential (ERP) were tested for both group before and after the treatment

  18. 低频重复经颅磁刺激治疗对卒中后抑郁患者认知和日常生活能力的影响%Effects of Low-frequency Repetitive Transcranial Magnetic Stimulation on Cognitive Function and Daily Life Ability in Patients with Post Stroke Depression

    Institute of Scientific and Technical Information of China (English)

    李克娇

    2015-01-01

    Objective: To explore the effects of low-frequency repetitive transcranial magnetic stimulation (r-TMS) on cognitive function and daily life ability of patients with post stroke depression (PSD). Methods: One-hundred and twenty-eight patients with PSD and mild cognitive impairment were enrolled and randomly divided into control group and r-TMS group with 64 cases in each group. Foundation treatment such as nerve nutrition, dilate blood ves-sels, early limb function rehabilitation, psychological counseling and antidepressant treatment were implemented in the control group. Cases in r-TMS group were treated with low-frequency r-TMS on the basis of foundation treat-ment for 8 weeks. The degree of depression were evaluated by using Hamilton depression scale (HAMD)-17; the cognitive function were evaluated by using mini-mental state examination (MMSE), and daily life ability were eval-uated by using Barthel index (BI) before and 4 and 8 weeks after treatment in two groups. Results: There were no difference in HAMD and MMSE scores and BI between two the groups (P>0.05) before treatment. After treatment, both groups showed lower HAMD scores as well as higher MMSE scores and BI than those before treatment (P<0.05). The scores of HAMD, MMSE and BI were improved more significantly in r-TMS group than those in control group (P<0.05 or 0.01). No serious adverse event was found in r-TMS group. Conclusion: Low-frequency r-TMS is an effective and safe therapy for patients with PSD, which can relieve depression and improve the cognitive func-tion and daily life ability.%目的:探讨低频重复经颅磁刺激(rTMS)治疗对卒中后抑郁(PSD)患者认知和日常生活能力的影响。方法:PSD 伴轻度认知障碍患者128例随机分为对照组和 r-TMS 组,各64例。对照组给予常规药物治疗及早期肢体功能康复、心理疏导和抗抑郁治疗;r-TMS 组在对照组治疗基础上加用低频 r-TMS 治疗。疗程均为8周。

  19. The effect of repetitive transcranial magnetic stimulation on neuropathic pain and nNOS in dorsal root ganglia in a rat model%低频和高频重复经颅磁刺激对大鼠神经病理性疼痛及背根神经节内nNOS的影响

    Institute of Scientific and Technical Information of China (English)

    郭铁成; 许惊飞

    2014-01-01

    Objective In order to explore the mechanism of repetitive transcranial magnetic stimulation rTMS) on neuropathic pain,we observed the effect of different frequencies of rTMS on neuropathic pain and the expression of neuronal nitric oxide synthase (nNOS) in the dorsal root ganglion (DRG).Methods A total of 28 male Sprague-Dawley rats were used and divided into a control group,in which sham-operation was performed,and an experimental group which was further divided into a sham-rTMS group,a 1 Hz group and a 20 Hz group after successful neuropathic pain model was established by operation to ligate the left sciatic nerves,with 7 rats in each group.Three days after the operation,rTMS was applied to the primary motor cortex (M1) contralateral to the pain once dai ly for 10 consecutive days.The pain behavior and nNOS expression in the DRG were measured before and after 10 days of rTMS intervention.Results All the neuropathic pain model rats demonstrated pain-related behaviors 3 days postoperation,the mechanical pain thresholds were significantly lower than those in the control group (P < 0.05).After rTMS treatment,the mechanical hyperalgsia was significantly relieved in 20 Hz group but not 1 Hz group as demonstrated by a comparison with the sham-rTMS group (P < 0.05).The expression of nNOS in DRG ipsilateral to the neuropathic pain was significantly increased in sham-rTMS group and 1 Hz group (P < 0.05) when compared with the control group.Meanwhile,it was shown that expression of nNOS was down-regulated in 20 Hz group but not 1 Hz group (P < 0.05).The degree of pain relief in 20 Hz group was negatively correlated with the expression of nNOS in DRG (P <0.05).Conclusions Neuropathic pain induced by peripheral nerve injury is associated with elevated expression of nNOS in the DRG.High-frequency rTMS can relieve neuropathic pain through down-regulating the overexpression of nNOS in the DRG,but the low-frequency rTMS has no such effect.%目的 观察不同频率的

  20. Effects of high frequency repetitive transcranial magnetic stimulation on emotional disorders and P300 of patients with Parkinson's disease%高频重复经颅磁刺激对帕金森病患者情绪障碍及P300电位的影响

    Institute of Scientific and Technical Information of China (English)

    郑秀琴; 于苏文; 陈升东; 蒋建波

    2013-01-01

    研究背景以往研究显示高频重复经颅磁刺激可以明显改善帕金森病患者运动功能,但帕金森病晚期非运动性症状给患者带来更为严重的影响,因此研究高频重复经颅磁刺激治疗帕金森病患者情绪和认知功能障碍等非运动性症状的临床疗效具有重要意义.方法共纳入65例诊断明确的帕金森病患者,根据统一帕金森病评价量表(UPDRS)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)和P300波,评价高频重复经颅磁刺激对患者精神行为和情绪、日常生活活动能力及运动功能的改善作用.结果与治疗前相比,帕金森病患者UPDRS总评分(t=10.872,P=0.000)和UPDRSⅠ(t=4.538,P:0.023)、UPDRS Ⅱ(t=8.846,P=0.012)、UPDRS Ⅲ(t=9.114,P=0.000)评分降低.患者焦虑和抑郁发生率由治疗前的52.46%(32/61)降至29.51%(18/61),认知功能障碍发生率由治疗前的42.62%(26/61)降至32.79%(20/61),HAMA(t=3.692,P=0.000)和HAMD(t=4.241,P=0.000)评分显著降低,但幻觉发生率由治疗前的18.03%(11/61)升至29.51%(18161).P300波潜伏期(t=5.924,P=0.000)和波幅(t=8.512,P=0.000)与治疗前比较,差异均有统计学意义.结论高频重复经颅磁刺激能够减轻帕金森病患者焦虑和抑郁状态,改善其认知功能.%Background Previous studies revealed that repetitive transcranial magnetic stimulation (rTMS) can obviously improve the motor function of Parkinson's disease (PD) patients. Since the non-motor symptoms of late stage PD can induce worse impacts on patients, it is important to investigate the clinical effects of high frequency rTMS on non- motor symptoms including emotional and cognitive disorders of PD patients. Methods Sixty - five patients with PD received rTMS therapy. Unified Parkinson's Disease Rating Scale (UPDRS), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and P300 before and after treatment were recorded to assess the effect of rTMS on patient's emotions, abilities of

  1. Methods of high current magnetic field generator for transcranial magnetic stimulation application

    Science.gov (United States)

    Bouda, N. R.; Pritchard, J.; Weber, R. J.; Mina, M.

    2015-05-01

    This paper describes the design procedures and underlying concepts of a novel High Current Magnetic Field Generator (HCMFG) with adjustable pulse width for transcranial magnetic stimulation applications. This is achieved by utilizing two different switching devices, the MOSFET and insulated gate bipolar transistor (IGBT). Results indicate that currents as high as ±1200 A can be generated with inputs of +/-20 V. Special attention to tradeoffs between field generators utilizing IGBT circuits (HCMFG1) and MOSFET circuits (HCMFG2) was considered. The theory of operation, design, experimental results, and electronic setup are presented and analyzed.

  2. Methods of high current magnetic field generator for transcranial magnetic stimulation application

    Energy Technology Data Exchange (ETDEWEB)

    Bouda, N. R., E-mail: nybouda@iastate.edu; Pritchard, J.; Weber, R. J.; Mina, M. [Department of Electrical and Computer engineering, Iowa State University, Ames, Iowa 50011 (United States)

    2015-05-07

    This paper describes the design procedures and underlying concepts of a novel High Current Magnetic Field Generator (HCMFG) with adjustable pulse width for transcranial magnetic stimulation applications. This is achieved by utilizing two different switching devices, the MOSFET and insulated gate bipolar transistor (IGBT). Results indicate that currents as high as ±1200 A can be generated with inputs of +/−20 V. Special attention to tradeoffs between field generators utilizing IGBT circuits (HCMFG{sub 1}) and MOSFET circuits (HCMFG{sub 2}) was considered. The theory of operation, design, experimental results, and electronic setup are presented and analyzed.

  3. 3-dimensional modeling of transcranial magnetic stimulation: Design and application

    Science.gov (United States)

    Salinas, Felipe Santiago

    Over the past three decades, transcranial magnetic stimulation (TMS) has emerged as an effective tool for many research, diagnostic and therapeutic applications in humans. TMS delivers highly localized brain stimulations via non-invasive externally applied magnetic fields. This non-invasive, painless technique provides researchers and clinicians a unique tool capable of stimulating both the central and peripheral nervous systems. However, a complete analysis of the macroscopic electric fields produced by TMS has not yet been performed. In this dissertation, we present a thorough examination of the total electric field induced by TMS in air and a realistic head model with clinically relevant coil poses. In the first chapter, a detailed account of TMS coil wiring geometry was shown to provide significant improvements in the accuracy of primary E-field calculations. Three-dimensional models which accounted for the TMS coil's wire width, height, shape and number of turns clearly improved the fit of calculated-to-measured E-fields near the coil body. Detailed primary E-field models were accurate up to the surface of the coil body (within 0.5% of measured values) whereas simple models were often inadequate (up to 32% different from measured). In the second chapter, we addressed the importance of the secondary E-field created by surface charge accumulation during TMS using the boundary element method (BEM). 3-D models were developed using simple head geometries in order to test the model and compare it with measured values. The effects of tissue geometry, size and conductivity were also investigated. Finally, a realistic head model was used to assess the effect of multiple surfaces on the total E-field. We found that secondary E-fields have the greatest impact at areas in close proximity to each tissue layer. Throughout the head, the secondary E-field magnitudes were predominantly between 25% and 45% of the primary E-fields magnitude. The direction of the secondary E

  4. Transcranial magnetic stimulation disrupts the perception and embodiment of facial expressions.

    Science.gov (United States)

    Pitcher, David; Garrido, Lúcia; Walsh, Vincent; Duchaine, Bradley C

    2008-09-03

    Theories of embodied cognition propose that recognizing facial expressions requires visual processing followed by simulation of the somatovisceral responses associated with the perceived expression. To test this proposal, we targeted the right occipital face area (rOFA) and the face region of right somatosensory cortex (rSC) with repetitive transcranial magnetic stimulation (rTMS) while participants discriminated facial expressions. rTMS selectively impaired discrimination of facial expressions at both sites but had no effect on a matched face identity task. Site specificity within the rSC was demonstrated by targeting rTMS at the face and finger regions while participants performed the expression discrimination task. rTMS targeted at the face region impaired task performance relative to rTMS targeted at the finger region. To establish the temporal course of visual and somatosensory contributions to expression processing, double-pulse TMS was delivered at different times to rOFA and rSC during expression discrimination. Accuracy dropped when pulses were delivered at 60-100 ms at rOFA and at 100-140 and 130-170 ms at rSC. These sequential impairments at rOFA and rSC support embodied accounts of expression recognition as well as hierarchical models of face processing. The results also demonstrate that nonvisual cortical areas contribute during early stages of expression processing.

  5. Neural dissociation of automatic and controlled temporal preparation by transcranial magnetic stimulation.

    Science.gov (United States)

    Correa, Angel; Cona, Giorgia; Arbula, Sandra; Vallesi, Antonino; Bisiacchi, Patrizia

    2014-12-01

    Recent neuropsychological evidence suggested a role for the right prefrontal cortex in temporal orienting of attention guided by symbolic cues, and the left prefrontal cortex in preparation guided by rhythms. We tested this hypothesis by comparing the effects of 1-Hz repetitive transcranial magnetic stimulation (TMS) over prefrontal regions on the performances of two temporal preparation tasks, one using symbolic cues (short vs. long lines) and the other using regular rhythms (fast vs. slow pace) to indicate when (early vs. late) a target would be most likely to appear. Stimulation site was either the left dorsolateral prefrontal cortex (DLPFC), right DLPFC, or sham condition. The results showed that frontal TMS produced differential effects as a function of type of cuing. In symbolic cuing, TMS on either left or right frontal sites (vs. sham) increased temporal orienting effects by reducing reaction times in valid trials. In rhythmic cuing, however, frontal TMS did not influence performance. This dissociation between two forms of temporal preparation suggests a specific role for the DLPFC in the ability of temporal orienting, but not in preparation guided by rhythms.

  6. Transcranial Magnetic Stimulation to Address Mild Cognitive Impairment in the Elderly: A Randomized Controlled Study

    Science.gov (United States)

    Drumond Marra, Hellen Livia; Myczkowski, Martin Luiz; Maia Memória, Cláudia; Arnaut, Débora; Leite Ribeiro, Philip; Sardinha Mansur, Carlos Gustavo; Lancelote Alberto, Rodrigo; Boura Bellini, Bianca; Alves Fernandes da Silva, Adriano; Tortella, Gabriel; Ciampi de Andrade, Daniel; Teixeira, Manoel Jacobsen; Forlenza, Orestes Vicente; Marcolin, Marco Antonio

    2015-01-01

    Transcranial magnetic stimulation (TMS) is a noninvasive brain stimulation technique with potential to improve memory. Mild cognitive impairment (MCI), which still lacks a specific therapy, is a clinical syndrome associated with increased risk of dementia. This study aims to assess the effects of high-frequency repetitive TMS (HF rTMS) on everyday memory of the elderly with MCI. We conducted a double-blinded randomized sham-controlled trial using rTMS over the left dorsolateral prefrontal cortex (DLPFC). Thirty-four elderly outpatients meeting Petersen's MCI criteria were randomly assigned to receive 10 sessions of either active TMS or sham, 10 Hz rTMS at 110% of motor threshold, 2,000 pulses per session. Neuropsychological assessment at baseline, after the last session (10th) and at one-month follow-up, was applied. ANOVA on the primary efficacy measure, the Rivermead Behavioural Memory Test, revealed a significant group-by-time interaction (p = 0.05), favoring the active group. The improvement was kept after one month. Other neuropsychological tests were heterogeneous. rTMS at 10 Hz enhanced everyday memory in elderly with MCI after 10 sessions. These findings suggest that rTMS might be effective as a therapy for MCI and probably a tool to delay deterioration. PMID:26160997

  7. Transcranial Magnetic Stimulation to Address Mild Cognitive Impairment in the Elderly: A Randomized Controlled Study

    Directory of Open Access Journals (Sweden)

    Hellen Livia Drumond Marra

    2015-01-01

    Full Text Available Transcranial magnetic stimulation (TMS is a noninvasive brain stimulation technique with potential to improve memory. Mild cognitive impairment (MCI, which still lacks a specific therapy, is a clinical syndrome associated with increased risk of dementia. This study aims to assess the effects of high-frequency repetitive TMS (HF rTMS on everyday memory of the elderly with MCI. We conducted a double-blinded randomized sham-controlled trial using rTMS over the left dorsolateral prefrontal cortex (DLPFC. Thirty-four elderly outpatients meeting Petersen’s MCI criteria were randomly assigned to receive 10 sessions of either active TMS or sham, 10 Hz rTMS at 110% of motor threshold, 2,000 pulses per session. Neuropsychological assessment at baseline, after the last session (10th and at one-month follow-up, was applied. ANOVA on the primary efficacy measure, the Rivermead Behavioural Memory Test, revealed a significant group-by-time interaction p=0.05, favoring the active group. The improvement was kept after one month. Other neuropsychological tests were heterogeneous. rTMS at 10 Hz enhanced everyday memory in elderly with MCI after 10 sessions. These findings suggest that rTMS might be effective as a therapy for MCI and probably a tool to delay deterioration.

  8. Induced Effects of Transcranial Magnetic Stimulation on the Autonomic Nervous System and the Cardiac Rhythm

    Directory of Open Access Journals (Sweden)

    Mercedes Cabrerizo

    2014-01-01

    Full Text Available Several standard protocols based on repetitive transcranial magnetic stimulation (rTMS have been employed for treatment of a variety of neurological disorders. Despite their advantages in patients that are retractable to medication, there is a lack of knowledge about the effects of rTMS on the autonomic nervous system that controls the cardiovascular system. Current understanding suggests that the shape of the so-called QRS complex together with the size of the different segments and intervals between the PQRST deflections of the heart could predict the nature of the different arrhythmias and ailments affecting the heart. This preliminary study involving 10 normal subjects from 20 to 30 years of age demonstrated that rTMS can induce changes in the heart rhythm. The autonomic activity that controls the cardiac rhythm was indeed altered by an rTMS session targeting the motor cortex using intensity below the subject’s motor threshold and lasting no more than 5 minutes. The rTMS activation resulted in a reduction of the RR intervals (cardioacceleration in most cases. Most of these cases also showed significant changes in the Poincare plot descriptor SD2 (long-term variability, the area under the low frequency (LF power spectrum density curve, and the low frequency to high frequency (LF/HF ratio. The RR intervals changed significantly in specific instants of time during rTMS activation showing either heart rate acceleration or heart rate deceleration.

  9. Transcranial magnetic stimulation of degenerating brain: a comparison of normal aging, Alzheimer's, Parkinson's and Huntington's disease.

    Science.gov (United States)

    Ljubisavljevic, M R; Ismail, F Y; Filipovic, S

    2013-07-01

    Although the brain's ability to change constantly in response to external and internal inputs is now well recognized the mechanisms behind it in normal aging and neurodegeneration are less well understood. To gain a better understanding, transcranial magnetic stimulation (TMS) has been used extensively to characterize non-invasively the cortical neurophysiology of the aging and degenerating brain. Furthermore, there has been a surge of studies examining whether repetitive TMS (rTMS) can be used to improve functional deficits in various conditions including normal aging, Alzheimer's and Parkinson's disease. The results of these studies in normal aging and neurodegeneration have emerged reasonably coherent in delineating the main pathology in spite of considerable technical limitations, omnipresent methodological variability, and extraordinary patient heterogeneity. Nevertheless, comparing and integrating what is known about TMS measurements of cortical excitability and plasticity in disorders that predominantly affect cortical brain structures with disorders that predominantly affect subcortical brain structures may provide better understanding of normal and abnormal brain aging fostering new. The present review provides a TMS perspective of changes in cortical neurophysiology and neurochemistry in normal aging and neurodegeneration by integrating what is revealed in individual TMS measurements of cortical excitability and plasticity in physiological aging, Alzheimer's, Parkinson's, and Huntington's, disease. The paper also reflects on current developments in utilizing TMS as a physiologic biomarker to discriminate physiologic aging from neurodegeneration and its potential as a method of therapeutic intervention.

  10. Alteration of Duration Mismatch Negativity Induced by Transcranial Magnetic Stimulation Over the Left Parietal Lobe.

    Science.gov (United States)

    Oshima, Hirokazu; Shiga, Tetsuya; Niwa, Shin-Ichi; Enomoto, Hiroyuki; Ugawa, Yoshikazu; Yabe, Hirooki

    2017-01-01

    Mismatch negativity (MMN) is generated by a comparison between an incoming sound and the memory trace of preceding sounds stored in sensory memory without any attention to the sound. N100 (N1) is associated with the afferent response to sound onset and reflects early analysis of stimulus characteristics. MMN generators are present in the temporal and frontal lobe, and N1 generators are present in the temporal lobe. The parietal lobe is involved in MMN generation elicited by a change in duration. The anatomical network connecting these areas, lateralization, and the effect of the side of ear stimulation on MMN remain unknown. Thus, we studied the effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) over the left parietal lobe on MMN and N1 in 10 healthy subjects. Low-frequency rTMS over the left parietal lobe decreased the amplitude of MMN following right ear sound stimulation, but the amplitude was unaffected with left ear sound stimulation. We observed no significant changes in the amplitude of N1 or the latency of MMN or N1. These results suggest that low-frequency rTMS over the left parietal lobe modulates the detection of early auditory changes in duration in healthy subjects. Stimulation that is contralateral to the side of the ear experiencing sound may affect the generation of duration MMN more than ipsilateral stimulation. © EEG and Clinical Neuroscience Society (ECNS) 2016.

  11. Continuous theta burst transcranial magnetic stimulation affects brain functional connectivity.

    Science.gov (United States)

    Dan Cao; Yingjie Li; Ling Wei; Yingying Tang

    2016-08-01

    Prefrontal cortex (PFC) plays an important role in the emotional processing as well as in the functional brain network. Hyperactivity in the right dorsolateral prefrontal cortex (DLPFC) would be found in anxious participants. However, it is still unclear what the role of PFC played in a resting functional network. Continuous theta burst transcranial magnetic stimulation (cTBS) is an effective tool to create virtual lesions on brain regions. In this paper, we applied cTBS over right prefrontal area, and investigated the effects of cTBS on the brain activity for functional connectivity by the method of graph theory. We recorded 64-channels EEG on thirteen healthy participants in the resting condition and emotional tasks before and after 40 s of cTBS. This work focused on the effect of cTBS on cortical activities in the resting condition by calculating the coherence between EEG channels and building functional networks before and after cTBS in the delta, theta, alpha and beta bands. Results revealed that 1) The functional connectivity after cTBS was significantly increased compared with that before cTBS in delta, theta, alpha and beta bands in the resting condition; 2) The efficiency-cost reached the maximum before and after cTBS both with the cost about 0.3 in the bands above, which meant that the information transmission of functional brain network with this cost was highly efficient; 3) the clustering coefficient and path length after cTBS was significantly increased in delta, theta and beta bands. In conclusion, cTBS over PFC indeed enhanced the functional connectivity in the resting condition. In addition, the information transmission in the resting brain network was highly efficient with the cost about 0.3.

  12. Motor cortex hyperexcitability to transcranial magnetic stimulation in Alzheimer's disease.

    Science.gov (United States)

    Di Lazzaro, V; Oliviero, A; Pilato, F; Saturno, E; Dileone, M; Marra, C; Daniele, A; Ghirlanda, S; Gainotti, G; Tonali, P A

    2004-04-01

    Recent transcranial magnetic stimulation (TMS) studies demonstrate that motor cortex excitability is increased in Alzheimer's disease (AD) and that intracortical inhibitory phenomena are impaired. The aim of the present study was to determine whether hyperexcitability is due to the impairment of intracortical inhibitory circuits or to an independent abnormality of excitatory circuits. We assessed the excitability of the motor cortex with TMS in 28 patients with AD using several TMS paradigms and compared the data of cortical excitability (evaluated by measuring resting motor threshold) with the amount of motor cortex disinhibition as evaluated using the test for motor cortex cholinergic inhibition (short latency afferent inhibition) and GABAergic inhibition (short latency intracortical inhibition). The data in AD patients were also compared with that from 12 age matched healthy individuals. The mean resting motor threshold was significantly lower in AD patients than in controls. The amount of short latency afferent inhibition was significantly smaller in AD patients than in normal controls. There was also a tendency for AD patients to have less pronounced short latency intracortical inhibition than controls, but this difference was not significant. There was no correlation between resting motor threshold and measures of either short latency afferent or intracortical inhibition (r = -0.19 and 0.18 respectively, NS). In 14 AD patients the electrophysiological study was repeated after a single oral dose of the cholinesterase inhibitor rivastigmine. Resting motor threshold was not significantly modified by the administration of rivastigmine. In contrast, short latency afferent inhibition from the median nerve was significantly increased by the administration of rivastigmine. The change in threshold did not seem to correlate with dysfunction of inhibitory intracortical cholinergic and GABAergic circuits, nor with the central cholinergic activity. We propose that the

  13. Analysis of the effect of repeated-pulse transcranial magnetic stimulation at the Guangming point on electroencephalograms

    Institute of Scientific and Technical Information of China (English)

    Xin Zhang; Lingdi Fu; Yuehua Geng; Xiang Zhai; Yanhua Liu

    2014-01-01

    Here, we administered repeated-pulse transcranial magnetic stimulation to healthy people at the left Guangming (GB37) and a mock point, and calculated the sample entropy of electroencephalo-gram signals using nonlinear dynamics. Additionally, we compared electroencephalogram sample entropy of signals in response to visual stimulation before, during, and after repeated-pulse tran-scranial magnetic stimulation at the Guangming. Results showed that electroencephalogram sample entropy at left (F3) and right (FP2) frontal electrodes were significantly different depending on where the magnetic stimulation was administered. Additionally, compared with the mock point, electroencephalogram sample entropy was higher after stimulating the Guangming point. When visual stimulation at Guangming was given before repeated-pulse transcranial magnetic stimula-tion, signiifcant differences in sample entropy were found at ifve electrodes (C3, Cz, C4, P3, T8) in parietal cortex, the central gyrus, and the right temporal region compared with when it was given after repeated-pulse transcranial magnetic stimulation, indicating that repeated-pulse transcranial magnetic stimulation at Guangming can affect visual function. Analysis of electroencephalogram revealed that when visual stimulation preceded repeated pulse transcranial magnetic stimulation, sample entropy values were higher at the C3, C4, and P3 electrodes and lower at the Cz and T8 electrodes than visual stimulation followed preceded repeated pulse transcranial magnetic stimula-tion. The ifndings indicate that repeated-pulse transcranial magnetic stimulation at the Guangming evokes different patterns of electroencephalogram signals than repeated-pulse transcranial mag-netic stimulation at other nearby points on the body surface, and that repeated-pulse transcranial magnetic stimulation at the Guangming is associated with changes in the complexity of visually evoked electroencephalogram signals in parietal regions, central gyrus

  14. Low-frequency transcranial magnetic stimulation is beneifcial for enhancing synaptic plasticity in the aging brain

    Institute of Scientific and Technical Information of China (English)

    Zhan-chi Zhang; Feng Luan; Chun-yan Xie; Dan-dan Geng; Yan-yong Wang; Jun Ma

    2015-01-01

    In the aging brain, cognitive function gradually declines and causes a progressive reduction in the structural and functional plasticity of the hippocampus. Transcranial magnetic stimulation is an emerging and novel neurological and psychiatric tool used to investigate the neurobiology of cognitive function. Recent studies have demonstrated that low-frequency transcranial magnetic stimulation (≤1 Hz) ameliorates synaptic plasticity and spatial cognitive deifcits in learning-im-paired mice. However, the mechanisms by which this treatment improves these deifcits during normal aging are still unknown. Therefore, the current study investigated the effects of tran-scranial magnetic stimulation on the brain-derived neurotrophic factor signal pathway, synaptic protein markers, and spatial memory behavior in the hippocampus of normal aged mice. The study also investigated the downstream regulator, Fyn kinase, and the downstream effectors, syn-aptophysin and growth-associated protein 43 (both synaptic markers), to determine the possible mechanisms by which transcranial magnetic stimulation regulates cognitive capacity. Transcra-nial magnetic stimulation with low intensity (110%average resting motor threshold intensity, 1 Hz) increased mRNA and protein levels of brain-derived neurotrophic factor, tropomyosin receptor kinase B, and Fyn in the hippocampus of aged mice. The treatment also upregulated the mRNA and protein expression of synaptophysin and growth-associated protein 43 in the hippo-campus of these mice. In conclusion, brain-derived neurotrophic factor signaling may play an important role in sustaining and regulating structural synaptic plasticity induced by transcranial magnetic stimulation in the hippocampus of aging mice, and Fyn may be critical during this reg-ulation. These responses may change the structural plasticity of the aging hippocampus, thereby improving cognitive function.

  15. Low-frequency transcranial magnetic stimulation is beneficial for enhancing synaptic plasticity in the aging brain

    Directory of Open Access Journals (Sweden)

    Zhan-chi Zhang

    2015-01-01

    Full Text Available In the aging brain, cognitive function gradually declines and causes a progressive reduction in the structural and functional plasticity of the hippocampus. Transcranial magnetic stimulation is an emerging and novel neurological and psychiatric tool used to investigate the neurobiology of cognitive function. Recent studies have demonstrated that low-frequency transcranial magnetic stimulation (≤1 Hz ameliorates synaptic plasticity and spatial cognitive deficits in learning-impaired mice. However, the mechanisms by which this treatment improves these deficits during normal aging are still unknown. Therefore, the current study investigated the effects of transcranial magnetic stimulation on the brain-derived neurotrophic factor signal pathway, synaptic protein markers, and spatial memory behavior in the hippocampus of normal aged mice. The study also investigated the downstream regulator, Fyn kinase, and the downstream effectors, synaptophysin and growth-associated protein 43 (both synaptic markers, to determine the possible mechanisms by which transcranial magnetic stimulation regulates cognitive capacity. Transcranial magnetic stimulation with low intensity (110% average resting motor threshold intensity, 1 Hz increased mRNA and protein levels of brain-derived neurotrophic factor, tropomyosin receptor kinase B, and Fyn in the hippocampus of aged mice. The treatment also upregulated the mRNA and protein expression of synaptophysin and growth-associated protein 43 in the hippocampus of these mice. In conclusion, brain-derived neurotrophic factor signaling may play an important role in sustaining and regulating structural synaptic plasticity induced by transcranial magnetic stimulation in the hippocampus of aging mice, and Fyn may be critical during this regulation. These responses may change the structural plasticity of the aging hippocampus, thereby improving cognitive function.

  16. Meta-analysis of transcranial magnetic stimulation to treat post-stroke dysfunction

    Institute of Scientific and Technical Information of China (English)

    Yang Tian; Lianguo Kang; Hongying Wang; Zhenyi Liu

    2011-01-01

    OBJECTIVE: To evaluate the effects of transcranial magnetic stimulation (TMS) on post-stroke dysfunction.DATA SOURCES: A computer-based online search of the VIP and PubMed databases was performed to identify TMS studies published between January 1989 and December 2010 using the Key Words "transcranial magnetic stimulation, stroke" in Chinese and English.A total of 61 articles were collected.STUDY SELECTION: Repetitive articles were excluded.Articles published recently in the authoritative journals of the same domain were selected.The full-text of selected articles was searched.A total of seven articles were randomized controlled experiments regarding the application of TMS in the treatment of post-stroke dysfunction.The methodology quality of included articles was evaluated according to standards of Cochrane Reviewer's Handbook system and analyzed using RevMand4.2 software.MAIN OUTCOME MEASURES: Therapeutic effects and difference evaluation indices were represented by odds ratios, weighted mean difference (WMD) and 95% confidence interval (CI).Potential publication bias was described using a funnel plot.RESULTS: A total of seven randomized, controlled studies were included involving 281 patients.Following TMS treatment, meta-analysis results revealed that scores in the Mini-Mental State Examination were higher in the TMS group compared with the control group [WMD = 3.96, 95% CI (2.44, 5.49), P = 0.08]; scores in the Hamilton Rating Scale for Depression were significantly lower in the TMS group compared with the control group [WMD = -6.21, 95% CI (-7.55, -4.87), P = 0.92]; scores in National Institutes of Health Stroke Scale were lower following TMS treatment compared with the control group [WMD = -0.89, 95% CI (-1.98, 0.19), P = 0.04].Performance of patients undergoing TMS treatment was better than the controls in the line bisection test [WMD = -0.78, 95% CI (-1.43, -0.12), P = 0.005] and line cancellation test [WMD = -0.47, 95% CI (-0.78, -0.15), P < 0.000 01

  17. Coming unbound: disrupting automatic integration of synesthetic color and graphemes by transcranial magnetic stimulation of the right parietal lobe.

    Science.gov (United States)

    Esterman, Michael; Verstynen, Timothy; Ivry, Richard B; Robertson, Lynn C

    2006-09-01

    In some individuals, a visually presented letter or number automatically evokes the perception of a specific color, an experience known as color-grapheme synesthesia. It has been suggested that parietal binding mechanisms play a role in the phenomenon. We used a noninvasive stimulation technique, transcranial magnetic stimulation (TMS), to determine whether the posterior parietal lobe is critical for the integration of color and shape in color-grapheme synesthesia, as it appears to be for normal color-shape binding. Using a color-naming task with colored letters that were either congruent or incongruent with the synesthetic photism, we demonstrate that inhibition of the right posterior parietal lobe with repetitive TMS transiently attenuates synesthetic binding. These findings suggest that synesthesia (the induction of color from shape) relies on similar mechanisms as found in normal perception (where the perception of color is induced by wavelength).

  18. Transcranial radiograph and magnetic resonance imaging in the evaluation of osseous changes of the temporomandibular joint

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Soo Beom; Koh, Kwang Joon [School of Dentistry, Chonbuk National University, Chonju (Korea, Republic of)

    2002-06-15

    To evaluate the diagnostic accuracy of transcranial radiographs and magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) in the assessment of osseous changes of the condylar head and articular eminence. Osseous changes of the TMJ were evaluated in forty-three patients. Osseous changes of the condylar head and articular eminence were observed in 41 joints and 64 joints, respectively on transcranial radiographs, and 48 joints and 59 joints, respectively on MRI. The flattening, sclerosis, erosion, and osteophyte formation of the condylar heads were observed in 36.6%, 43.9%, 12.2%, and 7.3%, respectively on transcranial radiographs compared with 35.4%, 20.8%, 37.5%, and 6.3%, respectively on MRI. While, the flattening, sclerosis, and erosion of the articular eminences were observed in 26.6%, 67.2%, and 6.2%, respectively on transcranial radiographs compared with 32.2%, 59.3%, and 8.5%, respectively on MRI. There were no statistical differences between transcranial radiographs and MRI scans in the detection of osseous changes of the TMJ. However, MRI scans were superior to the transcranial radiographs in the detection of erosion of the condylar head (p<0.01).

  19. Computational analysis of transcranial magnetic stimulation in the presence of deep brain stimulation probes

    Science.gov (United States)

    Syeda, F.; Holloway, K.; El-Gendy, A. A.; Hadimani, R. L.

    2017-05-01

    Transcranial Magnetic Stimulation is an emerging non-invasive treatment for depression, Parkinson's disease, and a variety of other neurological disorders. Many Parkinson's patients receive the treatment known as Deep Brain Stimulation, but often require additional therapy for speech and swallowing impairment. Transcranial Magnetic Stimulation has been explored as a possible treatment by stimulating the mouth motor area of the brain. We have calculated induced electric field, magnetic field, and temperature distributions in the brain using finite element analysis and anatomically realistic heterogeneous head models fitted with Deep Brain Stimulation leads. A Figure of 8 coil, current of 5000 A, and frequency of 2.5 kHz are used as simulation parameters. Results suggest that Deep Brain Stimulation leads cause surrounding tissues to experience slightly increased E-field (Δ Emax =30 V/m), but not exceeding the nominal values induced in brain tissue by Transcranial Magnetic Stimulation without leads (215 V/m). The maximum temperature in the brain tissues surrounding leads did not change significantly from the normal human body temperature of 37 °C. Therefore, we ascertain that Transcranial Magnetic Stimulation in the mouth motor area may stimulate brain tissue surrounding Deep Brain Stimulation leads, but will not cause tissue damage.

  20. Cathodal Transcranial Direct Current Stimulation of the Right Wernicke's Area Improves Comprehension in Subacute Stroke Patients

    Science.gov (United States)

    You, Dae Sang; Kim, Dae-Yul; Chun, Min Ho; Jung, Seung Eun; Park, Sung Jong

    2011-01-01

    Previous studies have shown the appearance of right-sided language-related brain activity in right-handed patients after a stroke. Non-invasive brain stimulation such as transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) have been shown to modulate excitability in the brain. Moreover, rTMS and…

  1. Transcranial magnetic stimulation-induced 'visual echoes' are generated in early visual cortex

    NARCIS (Netherlands)

    Jolij, J.; Lamme, V.A.F.

    2010-01-01

    Transcranial magnetic stimulation (TMS) of the early visual areas can trigger perception of a flash of light, a so-called phosphene. Here we show that a very brief presentation of a stimulus can modulate features of a subsequent TMS-induced phosphene, to a level that participants mistake phosphenes

  2. The influence of sulcus width on simulated electric fields induced by transcranial magnetic stimulation

    NARCIS (Netherlands)

    Janssen, A.M.; Rampersad, S.M.; Lucka, F.; Lanfer, B.; Lew, S.; Aydin, U.; Wolters, C.H.; Stegeman, D.F.; Oostendorp, T.F.

    2013-01-01

    Volume conduction models can help in acquiring knowledge about the distribution of the electric field induced by transcranial magnetic stimulation. One aspect of a detailed model is an accurate description of the cortical surface geometry. Since its estimation is difficult, it is important to know h

  3. A standardized motor threshold estimation procedure for transcranial magnetic stimulation research

    NARCIS (Netherlands)

    Schutter, D.J.L.G.; Honk, E.J. van

    2006-01-01

    Objectives: To introduce and to test a simple standardized motor threshold (MT) estimation procedure for transcranial magnetic stimulation (TMS) research. Methods: A 5-step MT estimation procedure was introduced, and interestimator reliability was tested by comparing MTs as determined by an experien

  4. Transcranial magnetic stimulation-induced 'visual echoes' are generated in early visual cortex

    NARCIS (Netherlands)

    Jolij, J.; Lamme, V.A.F.

    2010-01-01

    Transcranial magnetic stimulation (TMS) of the early visual areas can trigger perception of a flash of light, a so-called phosphene. Here we show that a very brief presentation of a stimulus can modulate features of a subsequent TMS-induced phosphene, to a level that participants mistake phosphenes

  5. Paired associative stimulation targeting the tibialis anterior muscle using either mono or biphasic transcranial magnetic stimulation

    DEFF Research Database (Denmark)

    Mrachacz-Kersting, Natalie; Stevenson, Andrew James Thomas

    2017-01-01

    Paired associative stimulation (PAS) protocols induce plastic changes within the motor cortex. The objectives of this study were to investigate PAS effects targeting the tibialis anterior (TA) muscle using a biphasic transcranial magnetic stimulation (TMS) pulse form and, to determine whether...

  6. Functional Assessment of Corticospinal Conduction with Transcranial Magnetic Stimulation: Basic Principles

    DEFF Research Database (Denmark)

    Groppa, S.; Peller, M.; Siebner, Hartwig R.

    2010-01-01

    Here we review how transcranial magnetic stimulation (TMS) is used in clinical practice to examine the functional integrity of the fast conducting fibres of the human corticomotor path ways. We first summarise the technical and physiological principles of TMS that are relevant to its clinical use...

  7. Motor pathway excitability in ATP13A2 mutation carriers: a transcranial magnetic stimulation study.

    NARCIS (Netherlands)

    Zittel, S.; Kroeger, J.; Vegt, J.P.M. van der; Siebner, H.R.; Bruggemann, N.; Ramirez, A.; Behrens, M.I.; Gerloff, C.; Baumer, T.; Klein, C.; Munchau, A.

    2012-01-01

    OBJECTIVE: To describe excitability of motor pathways in Kufor-Rakeb syndrome (PARK9), an autosomal recessive nigro-striatal-pallidal-pyramidal neurodegeneration caused by a mutation in the ATP13A2 gene, using transcranial magnetic stimulation (TMS). METHODS: Five members of a Chilean family with an

  8. How Reproducible Are Transcranial Magnetic Stimulation-Induced MEPs in Subacute Stroke?

    NARCIS (Netherlands)

    Hoonhorst, Maurits H. W. J.; Kollen, Boudewijn J.; van den Berg, Peter S. P.; Emmelot, Cornelis H.; Kwakkel, Gert

    2014-01-01

    Purpose: Motor evoked potentials (MEPs) and total motor conduction time (TMCT) induced by transcranial magnetic stimulation (TMS) are used to make assumptions about the prognosis of motor outcome after stroke. Understanding the different sources of variability is fundamental to the concept of reliab

  9. Repetitive magnetic stimulation of human-derived neuron-like cells activates cAMP-CREB pathway.

    Science.gov (United States)

    Hellmann, Julian; Jüttner, Rene; Roth, Clarisse; Bajbouj, Malek; Kirste, Imke; Heuser, Isabella; Gertz, Karen; Endres, Matthias; Kronenberg, Golo

    2012-02-01

    Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neurostimulatory technique widely used in research, diagnostics, and neuro-psychiatric therapy. Despite its growing popularity, basic molecular mechanisms underlying the clinical effects of rTMS have remained largely under-researched. Here, we present a human-derived neuronal cell culture system responsive to rTMS effects. SH-SY5Y neuroblastoma cells were differentiated by retinoic acid treatment for 10 days, resulting in a neuronal phenotype characterized by upregulation of neuronal marker proteins and generation of an action potential in response to depolarizing current step injection. Repetitive magnetic stimulation of these cells resulted in increased intracellular cAMP levels and increased phosphorylation of transcription factor CREB. Pretreatment with ketamine (1 μM) potentiated, while pretreatment with lithium (2 mM) attenuated this cellular response to repetitive magnetic stimulation. In conclusion, we introduce here a novel in vitro system responding to rTMS at the level of second messenger signaling. The use of human-derived cells with neuron-like properties will prove useful for further studies on the cellular effects of rTMS.

  10. Non-invasive mapping of bilateral motor speech areas using navigated transcranial magnetic stimulation and functional magnetic resonance imaging.

    Science.gov (United States)

    Könönen, Mervi; Tamsi, Niko; Säisänen, Laura; Kemppainen, Samuli; Määttä, Sara; Julkunen, Petro; Jutila, Leena; Äikiä, Marja; Kälviäinen, Reetta; Niskanen, Eini; Vanninen, Ritva; Karjalainen, Pasi; Mervaala, Esa

    2015-06-15

    Navigated transcranial magnetic stimulation (nTMS) is a modern precise method to activate and study cortical functions noninvasively. We hypothesized that a combination of nTMS and functional magnetic resonance imaging (fMRI) could clarify the localization of functional areas involved with motor control and production of speech. Navigated repetitive TMS (rTMS) with short bursts was used to map speech areas on both hemispheres by inducing speech disruption during number recitation tasks in healthy volunteers. Two experienced video reviewers, blinded to the stimulated area, graded each trial offline according to possible speech disruption. The locations of speech disrupting nTMS trials were overlaid with fMRI activations of word generation task. Speech disruptions were produced on both hemispheres by nTMS, though there were more disruptive stimulation sites on the left hemisphere. Grade of the disruptions varied from subjective sensation to mild objectively recognizable disruption up to total speech arrest. The distribution of locations in which speech disruptions could be elicited varied among individuals. On the left hemisphere the locations of disturbing rTMS bursts with reviewers' verification followed the areas of fMRI activation. Similar pattern was not observed on the right hemisphere. The reviewer-verified speech disruptions induced by nTMS provided clinically relevant information, and fMRI might explain further the function of the cortical area. nTMS and fMRI complement each other, and their combination should be advocated when assessing individual localization of speech network. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Interaction of transcranial magnetic stimulation and electrical transmastoid stimulation in human subjects

    DEFF Research Database (Denmark)

    Taylor, Janet L; Petersen, Nicolas Caesar; Butler, Jane E

    2002-01-01

    Transcranial magnetic stimulation activates corticospinal neurones directly and transsynaptically and hence, activates motoneurones and results in a response in the muscle. Transmastoid stimulation results in a similar muscle response through activation of axons in the spinal cord. This study...... was designed to determine whether the two stimuli activate the same descending axons. Responses to transcranial magnetic stimuli paired with electrical transmastoid stimuli were examined in biceps brachii in human subjects. Twelve interstimulus intervals (ISIs) from -6 ms (magnet before transmastoid) to 5 ms......-wave, facilitation still occurred at ISIs of -6 and -5 ms and depression of the paired response at ISIs of 0, 1, 4 and 5 ms. The interaction of the response to transmastoid stimulation with the multiple descending volleys elicited by magnetic stimulation of the cortex is complex. However, depression of the response...

  12. Non-invasive Mapping of Face Processing by Navigated Transcranial Magnetic Stimulation

    Science.gov (United States)

    Maurer, Stefanie; Giglhuber, Katrin; Sollmann, Nico; Kelm, Anna; Ille, Sebastian; Hauck, Theresa; Tanigawa, Noriko; Ringel, Florian; Boeckh-Behrens, Tobias; Meyer, Bernhard; Krieg, Sandro M.

    2017-01-01

    Background: Besides motor and language function, tumor resections within the frontal and parietal lobe have also been reported to cause neuropsychological impairment like prosopagnosia. Objective: Since non-navigated transcranial magnetic stimulation (TMS) has previously been used to map neuropsychological cortical function, this study aims to evaluate the feasibility and spatial discrimination of repetitive navigated TMS (rTMS) mapping for detection of face processing impairment in healthy volunteers. The study was also designed to establish this examination for preoperative mapping in brain tumor patients. Methods: Twenty healthy and purely right-handed volunteers (11 female, 9 male) underwent rTMS mapping for cortical face processing function using 5 Hz/10 pulses. Both hemispheres were investigated randomly with an interval of 2 weeks between mapping sessions. Fifty-two predetermined cortical spots of the whole hemispheres were mapped after baseline measurement. The task consisted of 80 portraits of popular persons, which had to be named while rTMS was applied. Results: In 80% of all subjects rTMS elicited naming errors in the right middle middle frontal gyrus (mMFG). Concerning anomia errors, the highest error rate (35%) was achieved in the bilateral triangular inferior frontal gyrus (trIFG). With regard to similarly or wrongly named persons, we observed 10% error rates mainly in the bilateral frontal lobes. Conclusion: It seems feasible to map the cortical face processing function and to generate face processing impairment via rTMS. The observed localizations are well in accordance with the contemporary literature, and the mapping did not interfere with rTMS-induced language impairment. The clinical usefulness of preoperative mapping has to be evaluated subsequently. PMID:28167906

  13. Functional MRI of the immediate impact of transcranial magnetic stimulation on cortical and subcortical motor circuits.

    Science.gov (United States)

    Bestmann, Sven; Baudewig, Jürgen; Siebner, Hartwig R; Rothwell, John C; Frahm, Jens

    2004-04-01

    Recent studies indicate that the cortical effects of transcranial magnetic stimulation (TMS) may not be localized to the site of stimulation, but spread to other distant areas. Using echo-planar imaging with blood-oxygenation-level-dependent (BOLD) contrast at 3 Tesla, we measured MRI signal changes in cortical and subcortical motor regions during high-frequency (3.125 Hz) repetitive TMS (rTMS) of the left sensorimotor cortex (M1/S1) at intensities above and below the active motor threshold in healthy humans. The supra- and subthreshold nature of the TMS pulses was confirmed by simultaneous electromyographic monitoring of a hand muscle. Suprathreshold rTMS activated a network of primary and secondary cortical motor regions including M1/S1, supplementary motor area, dorsal premotor cortex, cingulate motor area, the putamen and thalamus. Subthreshold rTMS elicited no MRI-detectable activity in the stimulated M1/S1, but otherwise led to a similar activation pattern as obtained for suprathreshold stimulation though at reduced intensity. In addition, we observed activations within the auditory system, including the transverse and superior temporal gyrus, inferior colliculus and medial geniculate nucleus. The present findings support the notion that re-afferent feedback from evoked movements represents the dominant input to the motor system via M1 during suprathreshold stimulation. The BOLD MRI changes in motor areas distant from the site of subthreshold stimulation are likely to originate from altered synaptic transmissions due to induced excitability changes in M1/S1. They reflect the capability of rTMS to target both local and remote brain regions as tightly connected constituents of a cortical and subcortical network.

  14. The role of pulse shape in motor cortex transcranial magnetic stimulation using full-sine stimuli.

    Directory of Open Access Journals (Sweden)

    Igor Delvendahl

    Full Text Available A full-sine (biphasic pulse waveform is most commonly used for repetitive transcranial magnetic stimulation (TMS, but little is known about how variations in duration or amplitude of distinct pulse segments influence the effectiveness of a single TMS pulse to elicit a corticomotor response. Using a novel TMS device, we systematically varied the configuration of full-sine pulses to assess the impact of configuration changes on resting motor threshold (RMT as measure of stimulation effectiveness with single-pulse TMS of the non-dominant motor hand area (M1. In young healthy volunteers, we (i compared monophasic, half-sine, and full-sine pulses, (ii applied two-segment pulses consisting of two identical half-sines, and (iii manipulated amplitude, duration, and current direction of the first or second full-sine pulse half-segments. RMT was significantly higher using half-sine or monophasic pulses compared with full-sine. Pulses combining two half-sines of identical polarity and duration were also characterized by higher RMT than full-sine stimuli resulting. For full-sine stimuli, decreasing the amplitude of the half-segment inducing posterior-anterior oriented current in M1 resulted in considerably higher RMT, whereas varying the amplitude of the half-segment inducing anterior-posterior current had a smaller effect. These findings provide direct experimental evidence that the pulse segment inducing a posterior-anterior directed current in M1 contributes most to corticospinal pathway excitation. Preferential excitation of neuronal target cells in the posterior-anterior segment or targeting of different neuronal structures by the two half-segments can explain this result. Thus, our findings help understanding the mechanisms of neural stimulation by full-sine TMS.

  15. A neurophysiological insight into the potential link between transcranial magnetic stimulation, thalamocortical dysrhythmia and neuropsychiatric disorders.

    Science.gov (United States)

    Fuggetta, Giorgio; Noh, Nor Azila

    2013-07-01

    Altered neural oscillations and their abnormal synchronization are crucial factors in the pathophysiology of several neuropsychiatric disorders. There is increasing evidence that the perturbation with an abnormal increase of spontaneous thalamocortical neural oscillations lead to a phenomenon termed Thalamocortical dysrhythmia (TCD) which underlies the symptomatology of a variety of neurological and psychiatric disorders including Parkinson's disease, schizophrenia, epilepsy, neuropathic pain, tinnitus, major depression and obsessive-compulsive disorder. In addition, repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neurophysiological tool that has been shown to both induce a modulation of neural oscillations and alleviate a wide range of human neuropsychiatric pathologies. However, little is known about the precise electrophysiological mechanisms behind the therapeutic effect of rTMS and its potential to improve abnormal oscillations across diverse neuropsychiatric disorders. Here we show, using combined rTMS and surface electroencephalography (EEG), a short lasting frequency-dependent rTMS after-effect on thalamocortical rhythmic interplay of low-frequency oscillations in healthy humans at rest. In particular, high-frequency rTMS (10 Hz) induces a transient synchronised activity for delta (δ) and theta (θ) rhythms thus mimicking the pathological TCD-like oscillations. In contrast, rTMS 1 and 5 Hz have the opposite outcome of de-synchronising low-frequency brain rhythms. These results lead to a new neurophysiological insight of basic mechanisms underlying neurological and psychiatric disorders and a probable electrophysiological mechanism underlying the therapeutic effects of rTMS. Thus, we propose the use of rTMS and EEG as a platform to test possible treatments of TCD phenotypes by restoring proper neural oscillations across various neuropsychiatric disorders. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

  16. Experimental therapy of epilepsy with transcranial magnetic stimulation: lack of additional benefit with prolonged treatment

    Directory of Open Access Journals (Sweden)

    Brasil-Neto Joaquim P.

    2004-01-01

    Full Text Available OBJECTIVE: To investigate the effect of three months of low-frequency repetitive transcranial magnetic stimulation (rTMS treatment in intractable epilepsy. METHODS: Five patients (four males, one female; ages 6 to 50 years, were enrolled in the study; their epilepsy could not be controlled by medical treatment and surgery was not indicated. rTMS was performed twice a week for three months; patients kept records of seizure frequency for an equal period of time before, during, and after rTMS sessions. rTMS was delivered to the vertex with a round coil, at an intensity 5 % below motor threshold. During rTMS sessions, 100 stimuli (five series of 20 stimuli, with one-minute intervals between series were delivered at a frequency of 0.3 Hz. RESULTS: Mean daily number of seizures (MDNS decreased in three patients and increased in two during rTMS- one of these was treated for only one month; the best result was achieved in a patient with focal cortical dysplasia (reduction of 43.09 % in MDNS. In the whole patient group, there was a significant (p<0.01 decrease in MDNS of 22.8 %. CONCLUSION: Although prolonged rTMS treatment is safe and moderately decreases MDNS in a group of patients with intractable epilepsy, individual patient responses were mostly subtle and clinical relevance of this method is probably low. Our data suggest, however, that patients with focal cortical lesions may indeed benefit from this novel treatment. Further studies should concentrate on that patient subgroup.

  17. Transcranial magnetic stimulation to understand pathophysiology and as potential treatment for neurodegenerative diseases.

    Science.gov (United States)

    Ni, Zhen; Chen, Robert

    2015-01-01

    Common neurodegenerative diseases include Parkinson's disease (PD), Alzheimer's disease (AD), amyotrophic lateral sclerosis (ALS) and Huntington's disease (HD). Transcranial magnetic stimulation (TMS) is a noninvasive and painless method to stimulate the human brain. Single- and paired-pulse TMS paradigms are powerful ways to study the pathophysiological mechanisms of neurodegenerative diseases. Motor evoked potential studied with single-pulse TMS is increased in PD, AD and ALS, but is decreased in HD. Changes in motor cortical excitability in neurodegenerative diseases may be related to functional deficits in cortical circuits or to compensatory mechanisms. Reduction or even absence of short interval intracortical inhibition induced by paired-pulse TMS is common in neurodegenerative diseases, suggesting that there are functional impairments of inhibitory cortical circuits. Decreased short latency afferent inhibition in AD, PD and HD may be related to the cortical cholinergic deficits in these conditions. Cortical plasticity tested by paired associative stimulation or theta burst stimulation is impaired in PD, AD and HD. Repetitive TMS (rTMS) refers to the application of trains of regularly repeating TMS pulses. High-frequency facilitatory rTMS may improve motor symptoms in PD patients whereas low-frequency inhibitory stimulation is a potential treatment for levodopa induced dyskinesia. rTMS delivered both to the left and right dorsolateral prefrontal cortex improves memory in AD patients. Supplementary motor cortical stimulation in low frequency may be useful for HD patients. However, the effects of treatment with multiple sessions of rTMS for neurodegenerative diseases need to be tested in large, sham-controlled studies in the future before they can be adopted for routine clinical practice.

  18. The contribution of transcranial magnetic stimulation in the functional evaluation of microcircuits in human motor cortex.

    Science.gov (United States)

    Di Lazzaro, Vincenzo; Ziemann, Ulf

    2013-01-01

    Although transcranial magnetic stimulation (TMS) activates a number of different neuron types in the cortex, the final output elicited in corticospinal neurones is surprisingly stereotyped. A single TMS pulse evokes a series of descending corticospinal volleys that are separated from each other by about 1.5 ms (i.e., ~670 Hz). This evoked descending corticospinal activity can be directly recorded by an epidural electrode placed over the high cervical cord. The earliest wave is thought to originate from the direct activation of the axons of fast-conducting pyramidal tract neurones (PTN) and is therefore termed "D" wave. The later waves are thought to originate from indirect, trans-synaptic activation of PTNs and are termed "I" waves. The anatomical and computational characteristics of a canonical microcircuit model of cerebral cortex composed of layer II and III and layer V excitatory pyramidal cells, inhibitory interneurons, and cortico-cortical and thalamo-cortical inputs can account for the main characteristics of the corticospinal activity evoked by TMS including its regular and rhythmic nature, the stimulus intensity-dependence and its pharmacological modulation. In this review we summarize present knowledge of the physiological basis of the effects of TMS of the human motor cortex describing possible interactions between TMS and simple canonical microcircuits of neocortex. According to the canonical model, a TMS pulse induces strong depolarization of the excitatory cells in the superficial layers of the circuit. This leads to highly synchronized recruitment of clusters of excitatory neurons, including layer V PTNs, and of inhibitory interneurons producing a high frequency (~670 Hz) repetitive discharge of the corticospinal axons. The role of the inhibitory circuits is crucial to entrain the firing of the excitatory networks to produce a high-frequency discharge and to control the number and magnitude of evoked excitatory discharge in layer V PTNs. In summary

  19. Volitional muscle activity paired with transcranial magnetic stimulation increases corticospinal excitability

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    Matthew A Edwardson

    2015-01-01

    Full Text Available Studies of activity-dependent stimulation in non-human primates suggest that pairing each instance of volitional muscle activity with immediate intracortical stimulation causes long-term-potentiation-like effects. This technique holds promise for clinical rehabilitation, yet few investigators have tested activity-dependent stimulation in human subjects. In addition, no one has studied activity-dependent stimulation on the cortical representation for two separate target muscles in human subjects. We hypothesized that 40 min of transcranial magnetic stimulation (TMS triggered from ballistic muscle activity at a mean repetition rate of 1 Hz would cause greater increases in corticospinal excitability than TMS-cued muscle activity, and that these changes would be specific to the muscle of study. Ten healthy human subjects participated in 4 separate sessions in this crossover study: (1 visually cued volitional activation of the abductor pollicis brevis (APB muscle triggering TMS (APB-Triggered TMS, (2 volitional activation of APB in response to TMS delivered from a recording of the prior APB-Triggered TMS session (TMS-Cued APB, (3 visually cued volitional activation of the extensor digitorum (ED triggering TMS (ED-Triggered TMS, and (4 volitional activation of ED in response to TMS delivered from a recording of the prior ED-Triggered TMS session (TMS-Cued ED. Contrary to our hypothesis, we discovered evidence of increased corticospinal excitability for all conditions as measured by change in area of the motor evoked potential. We conclude that single TMS pulses paired either before or after muscle activity may increase corticospinal excitability and that further studies are needed to clarify the optimal time window for inducing neural plasticity with activity-dependent stimulation. These findings will inform the design of future activity-dependent stimulation protocols for clinical rehabilitation.

  20. Regional cerebral blood flow changes associated with transcranial magnetic stimulation in refractory depressed patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, C. H.; Chung, Y. A.; Chae, J. H.; Oh, J. H.; Kim, S. H.; Sohn, H. S.; Chung, S. K. [The Catholic University of Korea, Seoul (Korea, Republic of)

    2005-07-01

    Imaging studies by repetitive transcranial magnetic stimulation (rTMS) demonstrates biological activities of the brain. The aim of this study was to investigate the patterns of regional cerebral blood flow (rCBF) after a series of therapeutic rTMS sessions. Nine patients with refractory depression who had not been responsive to appropriate pharmacotherapy over 1 year were randomly assigned to daily 1 Hz right-sided rTMS or 20 Hz left-sided rTMS sessions for over 3 weeks. Baseline and 3-week post-rTMS treatment SPECT images were obtained 40 minutes after intravenous injection of approximately 740925 MBq of Tc-99m ECD using a multi-detector scanner (ECAM plus; Siemens, Erlangen, Germany) equipped with a low-energy, fan-beam collimator. All patients showed a good clinical outcome. Statistically significant common increase in rCBF patterns was found in the fusiform gyrus of left temporal lobe, left hippocampus, left superior parietal lobule, superior frontal gyrus of right frontal lobe, right lateral globus pallidus and cingulated gyrus of both limbic lobes. And in the fusiform gyrus of left occipital lobe and middle frontal gyrus of right frontal lobe decreased uptake was seen compared to controls. Low-frequency rTMS on the right prefrontal cortex and high-frequency rTMS on the left prefrontal cortex for 3 weeks as an add-on regimen have increased activity in specific brain regions in patients with treatment refractory depression. Therapeutic TMS seems to influence distinct cortical regions, as well as different pathways, affecting rCBF in a homogeneous manner that is probably region dependent and illness related.

  1. Calculating the induced electromagnetic fields in real human head by deep transcranial magnetic stimulation.

    Science.gov (United States)

    Lu, Mai; Ueno, Shoogo

    2013-01-01

    Stimulation of deeper brain structures by transcranial magnetic stimulation (TMS) may be beneficial in the treatment of several neurological and psychiatric disorders. This paper presents numerical simulation of deep transcranial magnetic stimulation (dTMS) by considering double cone, H-and Halo coils. Three-dimensional distributions of the induced fields i.e. magnetic flux density, current density and electric fields in realistic head model by dTMS coils were calculated by impedance method and the results were compared with that of figure-of-eight coil. It was found that double cone and H-coils have significantly deep field penetration at the expense of induced higher and wider spread electrical fields in superficial cortical regions. The Halo coil working with a circular coil carrying currents in opposite directions provides a flexible way to stimulate deep brain structures with much lower stimulation in superficial brain tissues.

  2. Using transcranial magnetic stimulation of the undamaged brain to identify lesion sites that predict language outcome after stroke.

    Science.gov (United States)

    Lorca-Puls, Diego L; Gajardo-Vidal, Andrea; Seghier, Mohamed L; Leff, Alexander P; Sethi, Varun; Prejawa, Susan; Hope, Thomas M H; Devlin, Joseph T; Price, Cathy J

    2017-06-01

    Transcranial magnetic stimulation focused on either the left anterior supramarginal gyrus or opercular part of the left inferior frontal gyrus has been reported to transiently impair the ability to perform phonological more than semantic tasks. Here we tested whether phonological processing abilities were also impaired following lesions to these regions in right-handed, English speaking adults, who were investigated at least 1 year after a left-hemisphere stroke. When our regions of interest were limited to 0.5 cm3 of grey matter centred around sites that had been identified with transcranial magnetic stimulation-based functional localization, phonological impairments were observed in 74% (40/54) of patients with damage to the regions and 21% (21/100) of patients sparing these regions. This classification accuracy was better than that observed when using regions of interest centred on activation sites in previous functional magnetic resonance imaging studies of phonological processing, or transcranial magnetic stimulation sites that did not use functional localization. New regions of interest were generated by redefining the borders of each of the transcranial magnetic stimulation sites to include areas that were consistently damaged in the patients with phonological impairments. This increased the incidence of phonological impairments in the presence of damage to 85% (46/54) and also reduced the incidence of phonological impairments in the absence of damage to 15% (15/100). The difference in phonological processing abilities between those with and without damage to these 'transcranial magnetic stimulation-guided' regions remained highly significant even after controlling for the effect of lesion size. The classification accuracy of the transcranial magnetic stimulation-guided regions was validated in a second sample of 108 patients and found to be better than that for (i) functional magnetic resonance imaging-guided regions; (ii) a region identified from an

  3. Study of intracranial pressure in human brain during transcranial magnetic stimulation.

    Science.gov (United States)

    Honrath, Marc; Sabouni, Abas

    2015-01-01

    This paper presents the results of cranial force in human brain due to electromagnetic pulse during transcranial magnetic stimulation. To model the force in a realistic brain, we used three dimensional magnetic resonance image of the 26 years old female subject. Simulation results show that during TMS procedure, there is a small force generated within the cranial tissue layers along with a torque value in different layers of brain tissues. The force depends on the magnitude of the magnetic field generated by the TMS coil.

  4. Inter-individual variability in optimal current direction for transcranial magnetic stimulation of the motor cortex

    DEFF Research Database (Denmark)

    Balslev, Daniela; Braet, Wouter; McAllister, Craig

    2007-01-01

    We evaluated inter-individual variability in optimal current direction for biphasic transcranial magnetic stimulation (TMS) of the motor cortex. Motor threshold for first dorsal interosseus was detected visually at eight coil orientations in 45 degrees increments. Each participant (n=13) completed...... two experimental sessions. One participant with low test-retest correlation (Pearson's rvisual detection of motor threshold was compared to EMG detection; motor thresholds were very similar and highly correlated (0.94-0.99). Similar with previous studies...

  5. Studying the Effects of Transcranial Direct-Current Stimulation in Stroke Recovery Using Magnetic Resonance Imaging

    OpenAIRE

    Stagg, Charlotte J; Johansen-Berg, Heidi

    2013-01-01

    Transcranial direct-current stimulation (tDCS) is showing increasing promise as an adjunct therapy in stroke rehabilitation. However questions still remain concerning its mechanisms of action, which currently limit its potential. Magnetic resonance (MR) techniques are increasingly being applied to understand the neural effects of tDCS. Here, we review the MR evidence supporting the use of tDCS to aid recovery after stroke and discuss the important open questions that remain.

  6. The involvement of primary motor cortex in mental rotation revealed by transcranial magnetic stimulation

    OpenAIRE

    Eisenegger, Christoph; Herwig, Uwe; Jäncke, Lutz

    2007-01-01

    We used single-pulse transcranial magnetic stimulation of the left primary hand motor cortex and motor evoked potentials of the contralateral right abductor pollicis brevis to probe motor cortex excitability during a standard mental rotation task. Based on previous findings we tested the following hypotheses. (i) Is the hand motor cortex activated more strongly during mental rotation than during reading aloud or reading silently? The latter tasks have been shown to increase motor cortex excit...

  7. Studying The Effects Of Transcranial Direct Current Stimulation In Stroke Recovery Using Magnetic Resonance Imaging

    Directory of Open Access Journals (Sweden)

    Charlotte J Stagg

    2013-12-01

    Full Text Available Transcranial direct current stimulation (tDCS is showing increasing promise as an adjunct therapy in stroke rehabilitation. However questions still remain concerning its mechanisms of action, which currently limit its potential. Magnetic Resonance (MR techniques are increasingly being applied to understand the neural effects of tDCS. Here, we review the MR evidence supporting the use of tDCS to aid recovery after stroke and discuss the important open questions that remain.

  8. Using Transcranial Magnetic Stimulation to Evaluate the Motor Pathways After an Intraoperative Spinal Cord Injury and to Predict the Recovery of Intraoperative Transcranial Electrical Motor Evoked Potentials: A Case Report.

    Science.gov (United States)

    Grover, Helen J; Thornton, Rachel; Lutchman, Lennel N; Blake, Julian C

    2016-06-01

    The authors report a case of unilateral loss of intraoperative transcranial electrical motor evoked potentials (TES MEP) associated with a spinal cord injury during scoliosis correction and the subsequent use of extraoperative transcranial magnetic stimulation to monitor the recovery of spinal cord function. The authors demonstrate the absence of TES MEPs and absent transcranial magnetic stimulation responses in the immediate postoperative period, and document the partial recovery of transcranial magnetic stimulation responses, which corresponded to partial recovery of TES MEPs. Intraoperative TES MEPs were enhanced using spatial facilitation technique, which enabled the patient to undergo further surgery to stabilize the spine and correct her scoliosis. This case report supports evidence of the use of extraoperative transcranial magnetic stimulation to predict the presence of intraoperative TES responses and demonstrates the usefulness of spatial facilitation to monitor TES MEPs in a patient with a preexisting spinal cord injury.

  9. Effect of anatomical variability in brain on transcranial magnetic stimulation treatment

    Science.gov (United States)

    Syeda, F.; Magsood, H.; Lee, E. G.; El-Gendy, A. A.; Jiles, D. C.; Hadimani, R. L.

    2017-05-01

    Transcranial Magnetic Stimulation is a non-invasive clinical therapy used to treat depression and migraine, and shows further promise as treatment for Parkinson's disease, Alzheimer's disease, and other neurological disorders. However, it is yet unclear as to how anatomical differences may affect stimulation from this treatment. We use finite element analysis to model and analyze the results of Transcranial Magnetic Stimulation in various head models. A number of heterogeneous head models have been developed using MRI data of real patients, including healthy individuals as well as patients of Parkinson's disease. Simulations of Transcranial Magnetic Stimulation performed on 22 anatomically different models highlight the differences in induced stimulation. A standard Figure of 8 coil is used with frequency 2.5 kHz, placed 5 mm above the head. We compare cortical stimulation, volume of brain tissue stimulated, specificity, and maximum E-field induced in the brain for models ranging from ages 20 to 60. Results show that stimulation varies drastically between patients of the same age and health status depending upon brain-scalp distance, which is not necessarily a linear progression with age.

  10. Remediation of sleep-deprivation-induced working memory impairment with fMRI-guided transcranial magnetic stimulation.

    Science.gov (United States)

    Luber, B; Stanford, A D; Bulow, P; Nguyen, T; Rakitin, B C; Habeck, C; Basner, R; Stern, Y; Lisanby, S H

    2008-09-01

    Repetitive transcranial magnetic stimulation (rTMS) was applied to test the role of selected cortical regions in remediating sleep-deprivation-induced deficits in visual working memory (WM) performance. Three rTMS targets were chosen using a functional magnetic resonance imaging (fMRI)-identified network associated with sleep-deprivation-induced WM performance impairment: 2 regions from the network (upper left middle occipital gyrus and midline parietal cortex) and 1 nonnetwork region (lower left middle occipital gyrus). Fifteen participants underwent total sleep deprivation for 48 h. rTMS was applied at 5 Hz during a WM task in a within-subject sham-controlled design. The rTMS to the upper-middle occipital site resulted in a reduction of the sleep-induced reaction time deficit without a corresponding decrease in accuracy, whereas stimulation at the other sites did not. Each subject had undergone fMRI scanning while performing the task both pre- and postsleep deprivation, and the degree to which each individual activated the fMRI network was measured. The degree of performance enhancement with upper-middle occipital rTMS correlated with the degree to which each individual failed to sustain network activation. No effects were found in a subset of participants who performed the same rTMS procedure after recovering from sleep deprivation, suggesting that the performance enhancements seen following sleep deprivation were state dependent.

  11. The Relationship Between Brain Oscillatory Activity and Therapeutic Effectiveness of Transcranial Magnetic Stimulation in the Treatment of Major Depressive Disorder

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    Andrew Francis Leuchter

    2013-02-01

    Full Text Available Major Depressive Disorder (MDD is marked by disturbances in brain functional connectivity. This connectivity is modulated by rhythmic oscillations of brain electrical activity, which enable coordinated functions across brain regions. Oscillatory activity plays a central role in regulating thinking and memory, mood, cerebral blood flow, and neurotransmitter levels, and restoration of normal oscillatory patterns is associated with effective treatment of MDD. Repetitive Transcranial Magnetic Stimulation (rTMS is a robust treatment for MDD, but the mechanism of action (MOA of its benefits for mood disorders remains incompletely understood. Benefits of rTMS have been tied to enhanced neuroplasticity in specific brain pathways. We summarize here the evidence that rTMS entrains and resets thalamocortical oscillators, normalizes regulation and facilitates reemergence of intrinsic cerebral rhythms, and through this mechanism restores normal brain function. This entrainment and resetting may be a critical step in engendering neuroplastic changes and the antidepressant effects of rTMS. It may be possible to modify the method of rTMS administration to enhance this mechanism of action and achieve better antidepressant effectiveness. We propose that rTMS can be administered: 1 synchronized to a patient’s individual alpha rhythm (IAF, or synchronized rTMS (sTMS; 2 as a low magnetic field strength sinusoidal wave form; and, 3 broadly to multiple brain areas simultaneously. We present here the theory and evidence indicating that these modifications could enhance the therapeutic effectiveness of rTMS for the treatment of MDD.

  12. Adjunctive treatment with transcranial magnetic stimulation in treatment resistant depression: a randomized, double-blind, sham-controlled study

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    Qiang LIU

    2011-02-01

    Full Text Available Background: High-frequency repetitive transcranial magnetic stimulation (rTMS to the left prefrontal cortex is a promising antidepressant treatment but the appropriate duration of treatment andits effect on cognitive symptoms in treatment resistant patients is uncertain.Hypotheis: Patients with treatment resistant depression on standard antidepressant medication who receive four weeks of adjunctive treatment with high-frequency rTMS to the left prefrontal cortex will have better clinical outcomes and better cognitive functioning than those who receive sham rTMS treatments.Methods: Thirty patients with treatment resistant depression (defined as failure to respond to two or more antidepressants of different classes administered for at least 6 weeks at or above two-thirds of the recommended maximum dose receiving selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors wererandomly assigned to receive adjundive treatment with either real rTMS (n=15 or sham rTMS (n=15 5 times a week for 4 conseculive weeks. Blinded pre-post evaluations were conducted using the 17-item Hamilton Depression Rating Scale (HAMD, the Montgomery-Asberg Depression Rating Scale (MADRS, the severity of illness measure from the Clinical Global Impression Rating scale(CGI-S, the Wechsler Adult Intelligence ScaIe (WAIS, the Wechsler Memory Scale (WMS, and the Wisconsjn Card Sorting Test(WC5T.Results:14 subjects from each group completed the study. There was no significant difference in the HAMD total scores between the two groups after 2 weeks of treatment but after 4 weeks of treatment the mean percentage drop in the HAMD total score was significantly greater in the real rTMS group (49%, SD=19% than in the sham rTMS group(29%, SD=25%, with a mean difference of 20% [95%CI=3%-37%;t26=2.42; P=0.023]. At 4 weeks the mean (SD reduction in the MADRS total score was also greater in the real rTMS group [47%(23% vs 16%(40

  13. Risk of seizures in transcranial magnetic stimulation: a clinical review to inform consent process focused on bupropion

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    Dobek CE

    2015-11-01

    Full Text Available Christine E Dobek,1 Daniel M Blumberger,2 Jonathan Downar,3 Zafiris J Daskalakis,2 Fidel Vila-Rodriguez11Department of Psychiatry, Faculty of Medicine, Non-Invasive Neurostimulation Therapies (NINET Laboratory, University of British Columbia, Vancouver, BC, 2Department of Psychiatry, Centre for Addiction and Mental Health, 3Department of Psychiatry, University Health Network, University of Toronto, Toronto, ON, CanadaObjective: When considering repetitive transcranial magnetic stimulation (rTMS for major depressive disorder, clinicians often face a lack of detailed information on potential interactions between rTMS and pharmacotherapy. This is particularly relevant to patients receiving bupropion, a commonly prescribed antidepressant with lower risk of sexual side effects or weight increase, which has been associated with increased risk of seizure in particular populations. Our aim was to systematically review the information on seizures occurred with rTMS to identify the potential risk factors with attention to concurrent medications, particularly bupropion.Data sources: We conducted a systematic review through the databases PubMed, PsycINFO, and EMBASE between 1980 and June 2015. Additional articles were found using reference lists of relevant articles. Reporting of data follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.Study selection: Two reviewers independently screened articles reporting the occurrence of seizures during rTMS. Articles reporting seizures in epilepsy during rTMS were excluded. A total of 25 rTMS-induced seizures were included in the final review.Data extraction: Data were systematically extracted, and the authors of the applicable studies were contacted when appropriate to provide more detail about the seizure incidents.Results: Twenty-five seizures were identified. Potential risk factors emerged such as sleep deprivation, polypharmacy, and neurological insult. High-frequency-rTMS was

  14. Transcranial stimulability of phosphenes by long lightning electromagnetic pulses

    CERN Document Server

    Peer, J

    2010-01-01

    The electromagnetic pulses of rare long (order of seconds) repetitive lightning discharges near strike point (order of 100m) are analyzed and compared to magnetic fields applied in standard clinical transcranial magnetic stimulation (TMS) practice. It is shown that the time-varying lightning magnetic fields and locally induced potentials are in the same order of magnitude and frequency as those established in TMS experiments to study stimulated perception phenomena, like magnetophosphenes. Lightning electromagnetic pulse induced transcranial magnetic stimulation of phosphenes in the visual cortex is concluded to be a plausible interpretation of a large class of reports on luminous perceptions during thunderstorms.

  15. Transcranial stimulability of phosphenes by long lightning electromagnetic pulses

    Energy Technology Data Exchange (ETDEWEB)

    Peer, J. [Institut fuer Ionenphysik und Angewandte Physik, Universitaet Innsbruck, A-6020 Innsbruck (Austria); Kendl, A., E-mail: alexander.kendl@uibk.ac.a [Institut fuer Ionenphysik und Angewandte Physik, Universitaet Innsbruck, A-6020 Innsbruck (Austria)

    2010-06-28

    The electromagnetic pulses of rare long (order of seconds) repetitive lightning discharges near strike point (order of 100 m) are analyzed and compared to magnetic fields applied in standard clinical transcranial magnetic stimulation (TMS) practice. It is shown that the time-varying lightning magnetic fields and locally induced electric fields are in the same order of magnitude and frequency as those established in TMS experiments to study stimulated perception phenomena, like magnetophosphenes. Lightning electromagnetic pulse induced transcranial magnetic stimulation of phosphenes in the visual cortex is concluded to be a plausible interpretation of a large class of reports on luminous perceptions during thunderstorms.

  16. Theta, alpha and beta burst transcranial magnetic stimulation: brain modulation in tinnitus

    Directory of Open Access Journals (Sweden)

    Dirk De Ridder, Elsa van der Loo, Karolien Van der Kelen, Tomas Menovsky, Paul van de Heyning, Aage Moller

    2007-01-01

    Full Text Available Introduction: Some forms of tinnitus are considered to be auditory phantom phenomena related to reorganization and hyperactivity of the auditory central nervous system. Repetitive transcranial magnetic stimulation (rTMS is a non-invasive tool capable of modulating human brain activity, using single pulse or burst stimuli. Burst rTMS has only been performed in the theta range, and has not been used clinically. The authors analyze whether burst TMS at theta (5 Hz, alpha (10 Hz and beta (20 Hz frequencies can temporarily suppress narrow band noise/white noise tinnitus, which has been demonstrated to be intractable to tonic stimulation. Methods: rTMS is performed both in tonic and burst mode in 46 patients contralateral to the tinnitus side, at 5, 10 and 20 Hz. Fourteen placebo negative rTMS responders are further analyzed. Results: In 5 patients, maximal tinnitus suppression is obtained with theta, in 2 with alpha and in 7 with beta burst stimulation. Burst rTMS suppresses narrow band/white tinnitus much better than tonic rTMS t(13=6.4, p<.000. Women experience greater suppression of their tinnitus with burst stimulation than men, t(12=2.9, p<.05. Furthermore left sided tinnitus is perceived as more distressing on the TQ than right sided tinnitus, t(12=3.2, p<.01. The lower the tinnitus pitch the more effectively rTMS suppresses tinnitus(r=-0.65, p<0.05. Discussion: Burst rTMS can be used clinically, not only theta burst, but also alpha and beta burst. Burst rTMS is capable of suppressing narrow band/white noise tinnitus very much better than tonic rTMS. This could be due the simple fact that burst neuromodulation is more powerful than tonic neuromodulation or to a differential effect of burst and tonic stimulation on the lemniscal and extralemniscal auditory system. In some patients only alpha or beta burst rTMS is capable of suppressing tinnitus, and theta burst not. Therefore in future rTMS studies it could be worthwhile not to limit burst

  17. Corticospinal excitability measurements using transcranial magnetic stimulation are valid with intramuscular electromyography

    Science.gov (United States)

    2017-01-01

    Objectives Muscular targets that are deep or inaccessible to surface electromyography (sEMG) require intrinsic recording using fine-wire electromyography (fEMG). It is unknown if fEMG validly record cortically evoked muscle responses compared to sEMG. The purpose of this investigation was to establish the validity and agreement of fEMG compared to sEMG to quantify typical transcranial magnetic stimulation (TMS) measures pre and post repetitive TMS (rTMS). The hypotheses were that fEMG would demonstrate excellent validity and agreement compared with sEMG. Materials and methods In ten healthy volunteers, paired pulse and cortical silent period (CSP) TMS measures were collected before and after 1200 pulses of 1Hz rTMS to the motor cortex. Data were simultaneously recorded with sEMG and fEMG in the first dorsal interosseous. Concurrent validity (r and rho) and agreement (Tukey mean-difference) were calculated. Results fEMG quantified corticospinal excitability with good to excellent validity compared to sEMG data at both pretest (r = 0.77–0.97) and posttest (r = 0.83–0.92). Pairwise comparisons indicated no difference between sEMG and fEMG for all outcomes; however, Tukey mean-difference plots display increased variance and questionable agreement for paired pulse outcomes. CSP displayed the highest estimates of validity and agreement. Paired pulse MEP responses recorded with fEMG displayed reduced validity, agreement and less sensitivity to changes in MEP amplitude compared to sEMG. Change scores following rTMS were not significantly different between sEMG and fEMG. Conclusion fEMG electrodes are a valid means to measure CSP and paired pulse MEP responses. CSP displays the highest validity estimates, while caution is warranted when assessing paired pulse responses with fEMG. Corticospinal excitability and neuromodulatory aftereffects from rTMS may be assessed using fEMG. PMID:28231250

  18. Bilateral Transcranial Magnetic Stimulation of the Prefrontal Cortex reduces cocaine intake: a pilot study.

    Directory of Open Access Journals (Sweden)

    Corinna Bolloni

    2016-08-01

    Full Text Available Background: Chronic cocaine consumption is associated to a decrease in mesolimbic dopamine transmission that maintains drug intake. Transcranial Magnetic Stimulation (TMS is gaining reliability a useful therapeutic tool in drug addiction since it can modulate cortico-limbic activity resulting in reduction of drug craving. Aims: In the present study we investigated the therapeutic effect of bilateral TMS of prefrontal cortex (PFC in reducing cocaine intake, in a sample of treatment-seeking patients with current cocaine use disorder (DSM-V. Methods: 10 cocaine addicts (DSM-V were randomly assigned to the active or sham stimulation protocol in a double-blind experimental design. Twelve repetitive TMS (rTMS sessions were administered 3 times a week for 4 weeks at 100% of motor threshold, over bilateral PFC. Cocaine intake (ng/mg was assessed by hair analysis at baseline (before treatment, T0, after one month (end of treatment, T1, 3 (T2 and 6 (T3 months later. All subjects received psychological support weekly. Results: The two-way ANOVA for repeated measures did not show a significant effect of the interaction between time and treatment (F4,32= 0.35; p=.87. Despite that result indicated no difference in the effect of the two conditions (active vs sham along time, a decreasing trend in cocaine consumption in active TMS group (F3,23=3.42; p=.04 vs sham (F3,15=1.88; p=.20 was observed when we performed exploratory analysis with time as factor . Indeed, Post-hoc comparisons showed a significant reduction in the amount of cocaine detected from the onset to three months later (T0-T2; p=.02 and to the end of treatment (T0-T3; p=.01 in addicts from the active group. Conclusions: Bilateral rTMS of PFC at 10 Hz did not show a significant effect on cocaine intake compared to sham. However, a long-term reduction in cocaine intake in active TMS treated patients was observed when we considered the time as factor. Further studies are required to confirm these

  19. Contactless Remote Induction of Shear Waves in Soft Tissues Using a Transcranial Magnetic Stimulation Device

    CERN Document Server

    Grasland-Mongrain, Pol; Tang, An; Catheline, Stefan; Cloutier, Guy

    2016-01-01

    This study presents the first observation of shear wave induced remotely within soft tissues. It was performed through the combination of a transcranial magnetic stimulation device and a permanent magnet. A physical model based on Maxwell and Navier equations was developed. Experiments were performed on a cryogel phantom and a chicken breast sample. Using an ultrafast ultrasound scanner, shear waves of respective amplitude of 5 and 0.5 micrometers were observed. Experimental and numerical results were in good agreement. This study constitutes the framework of an alternative shear wave elastography method.

  20. Repetitive magnetic stimulation induces plasticity of excitatory postsynapses on proximal dendrites of cultured mouse CA1 pyramidal neurons.

    Science.gov (United States)

    Lenz, Maximilian; Platschek, Steffen; Priesemann, Viola; Becker, Denise; Willems, Laurent M; Ziemann, Ulf; Deller, Thomas; Müller-Dahlhaus, Florian; Jedlicka, Peter; Vlachos, Andreas

    2015-11-01

    Repetitive transcranial magnetic stimulation (rTMS) of the human brain can lead to long-lasting changes in cortical excitability. However, the cellular and molecular mechanisms which underlie rTMS-induced plasticity remain incompletely understood. Here, we used repetitive magnetic stimulation (rMS) of mouse entorhino-hippocampal slice cultures to study rMS-induced plasticity of excitatory postsynapses. By employing whole-cell patch-clamp recordings of CA1 pyramidal neurons, local electrical stimulations, immunostainings for the glutamate receptor subunit GluA1 and compartmental modeling, we found evidence for a preferential potentiation of excitatory synapses on proximal dendrites of CA1 neurons (2-4 h after stimulation). This rMS-induced synaptic potentiation required the activation of voltage-gated sodium channels, L-type voltage-gated calcium channels and N-methyl-D-aspartate-receptors. In view of these findings we propose a cellular model for the preferential strengthening of excitatory synapses on proximal dendrites following rMS in vitro, which is based on a cooperative effect of synaptic glutamatergic transmission and postsynaptic depolarization.

  1. Transcranial Magnetic Stimulation: An Automated Procedure to Obtain Coil-specific Models for Field Calculations

    DEFF Research Database (Denmark)

    Madsen, Kristoffer Hougaard; Ewald, Lars; Siebner, Hartwig R.

    2015-01-01

    Background: Field calculations for transcranial magnetic stimulation (TMS) are increasingly implemented online in neuronavigation systems and in more realistic offline approaches based on finite-element methods. They are often based on simplified and/or non-validated models of the magnetic vector...... potential of the TMS coils. Objective: To develop an approach to reconstruct the magnetic vector potential based on automated measurements. Methods: We implemented a setup that simultaneously measures the three components of the magnetic field with high spatial resolution. This is complemented by a novel...... approach to determine the magnetic vector potential via volume integration of the measured field. Results: The integration approach reproduces the vector potential with very good accuracy. The vector potential distribution of a standard figure-of-eight shaped coil determined with our setup corresponds well...

  2. Neglect-like visual exploration behaviour after theta burst transcranial magnetic stimulation of the right posterior parietal cortex.

    Science.gov (United States)

    Nyffeler, Thomas; Cazzoli, Dario; Wurtz, Pascal; Lüthi, Mathias; von Wartburg, Roman; Chaves, Silvia; Déruaz, Anouk; Hess, Christian W; Müri, René M

    2008-04-01

    The right posterior parietal cortex (PPC) is critically involved in visual exploration behaviour, and damage to this area may lead to neglect of the left hemispace. We investigated whether neglect-like visual exploration behaviour could be induced in healthy subjects using theta burst repetitive transcranial magnetic stimulation (rTMS). To this end, one continuous train of theta burst rTMS was applied over the right PPC in 12 healthy subjects prior to a visual exploration task where colour photographs of real-life scenes were presented on a computer screen. In a control experiment, stimulation was also applied over the vertex. Eye movements were measured, and the distribution of visual fixations in the left and right halves of the screen was analysed. In comparison to the performance of 28 control subjects without stimulation, theta burst rTMS over the right PPC, but not the vertex, significantly decreased cumulative fixation duration in the left screen-half and significantly increased cumulative fixation duration in the right screen-half for a time period of 30 min. These results suggest that theta burst rTMS is a reliable method of inducing transient neglect-like visual exploration behaviour.

  3. The perceived position of moving objects: transcranial magnetic stimulation of area MT+ reduces the flash-lag effect.

    Science.gov (United States)

    Maus, Gerrit W; Ward, Jamie; Nijhawan, Romi; Whitney, David

    2013-01-01

    How does the visual system assign the perceived position of a moving object? This question is surprisingly complex, since sluggish responses of photoreceptors and transmission delays along the visual pathway mean that visual cortex does not have immediate information about a moving object's position. In the flash-lag effect (FLE), a moving object is perceived ahead of an aligned flash. Psychophysical work on this illusion has inspired models for visual localization of moving objects. However, little is known about the underlying neural mechanisms. Here, we investigated the role of neural activity in areas MT+ and V1/V2 in localizing moving objects. Using short trains of repetitive Transcranial Magnetic Stimulation (TMS) or single pulses at different time points, we measured the influence of TMS on the perceived location of a moving object. We found that TMS delivered to MT+ significantly reduced the FLE; single pulse timings revealed a broad temporal tuning with maximum effect for TMS pulses, 200 ms after the flash. Stimulation of V1/V2 did not significantly influence perceived position. Our results demonstrate that area MT+ contributes to the perceptual localization of moving objects and is involved in the integration of position information over a long time window.

  4. Involvement of the human dorsal premotor cortex in unimanual motor control: an interference approach using transcranial magnetic stimulation.

    Science.gov (United States)

    Cincotta, Massimo; Borgheresi, Alessandra; Balestrieri, Fabrizio; Giovannelli, Fabio; Rossi, Simone; Ragazzoni, Aldo; Zaccara, Gaetano; Ziemann, Ulf

    2004-09-02

    Unilateral movements are enabled through a distributed network of motor cortical areas but the relative contribution from the parts of this network is largely unknown. Failure of this network potentially results in mirror activation of the primary motor cortex (M1) ipsilateral to the intended movement. Here we tested the role of the right dorsal premotor cortex (dPMC) in 11 healthy subjects by disrupting its activity with 20 Hz repetitive transcranial magnetic stimulation (rTMS) whilst the subjects exerted a unilateral contraction of the left first dorsal interosseous (FDI). We found that disruption of right dPMC enhanced mirror activation of the ipsilateral left M1, as probed by motor evoked potential (MEP) amplitude to the right FDI. This was not the case with sham rTMS, when rTMS was directed to the right M1, or with rTMS of the right dPMC but without contraction of the left FDI. Findings suggest that activity in the dPMC contributes to the suppression of mirror movements during intended unilateral movements.

  5. Combined use of transcranial magnetic stimulation and metal electrode implants: a theoretical assessment of safety considerations

    Science.gov (United States)

    Golestanirad, Laleh; Rouhani, Hossein; Elahi, Behzad; Shahim, Kamal; Chen, Robert; Mosig, Juan R.; Pollo, Claudio; Graham, Simon J.

    2012-12-01

    This paper provides a theoretical assessment of the safety considerations encountered in the simultaneous use of transcranial magnetic stimulation (TMS) and neurological interventions involving implanted metallic electrodes, such as electrocorticography. Metal implants are subject to magnetic forces due to fast alternating magnetic fields produced by the TMS coil. The question of whether the mechanical movement of the implants leads to irreversible damage of brain tissue is addressed by an electromagnetic simulation which quantifies the magnitude of imposed magnetic forces. The assessment is followed by a careful mechanical analysis determining the maximum tolerable force which does not cause irreversible tissue damage. Results of this investigation provide useful information on the range of TMS stimulator output powers which can be safely used in patients having metallic implants. It is shown that conventional TMS applications can be considered safe when applied on patients with typical electrode implants as the induced stress in the brain tissue remains well below the limit of tissue damage.

  6. Effects of repetitive transcranial magnetic stimulation on post-stroke depression, sleep quality and activities of daily living%重复经颅磁刺激对脑卒中后抑郁患者抑郁情绪、睡眠障碍及日常生活活动能力的影响

    Institute of Scientific and Technical Information of China (English)

    何予工; 李鹏

    2015-01-01

    目的 探讨重复经颅磁刺激(rTMS)对脑卒中后抑郁(PSD)患者抑郁情绪、睡眠障碍及日常生活活动(ADL)能力的影响.方法 选取PSD患者90例,按随机数字表法将其分为对照组、治疗组和联合治疗组,每组30例.3组患者均给予基础治疗及综合康复训练,对照组在此基础上给予艾司西酞普兰治疗,治疗组给予rTMS治疗,联合治疗组在对照组基础上辅以rTMS治疗,疗程8周.治疗前及治疗8周后(治疗后),采用汉密尔顿抑郁量表(HAMD)、匹斯堡睡眠质量指数量表(PSQI)、中国脑卒中量表(CSS)及改良Barthel指数(MBI)对患者的抑郁情绪、睡眠质量、神经功能缺损情况及ADL能力进行评定.结果 治疗前,3组患者HAMD、CSS、PSQI、MBI评分之间比较.差异无统计学意义(P>0.05).治疗8周后(治疗后),3组患者HAMD评分、PSQI评分、CSS评分均较治疗前明显下降(P<0.05),MBI评分较治疗前明显增高(P<0.05).与对照组治疗后比较,治疗组及联合治疗组治疗后HAMD、CSS、PSQI、MBI评分均无显著变化,差异无统计学意义(P>0.05).与联合治疗组治疗后比较,治疗组治疗后HAMD[(9.76±4.59)分]、CSS[(7.65±2.35)分]、PSQI[(16.13 ±4.12)分]、MBI评分[(52.6l±9.26)分]无显著变化,差异无统计学意义(P>0.05).结论 rTMS可显著改善PSD患者的抑郁症状、睡眠障碍及神经功能缺损状况,有效提高其ADL能力.%Objective To explore the effects of repetitive transcraninal magnetic stimulation (rTMS) on depression,sleep disorder and activities of daily life (ADL) in post-stroke depression (PSD) patients.Methods A total of 90 PSD patients were divided into a control group,a treatment group and a combined treatment group according to a random number table,30 cases in each group.All patients were given basic treatment and comprehensive rehabilitation training.Moreover,the control group was additionally received escitalopram treatment,the treatment group r

  7. Immediate Effects of Repetitive Magnetic Stimulation on Single Cortical Pyramidal Neurons

    Science.gov (United States)

    Banerjee, Jineta; Sorrell, Mary E.; Celnik, Pablo A.; Pelled, Galit

    2017-01-01

    Repetitive Transcranial Magnetic Stimulation (rTMS) has been successfully used as a non-invasive therapeutic intervention for several neurological disorders in the clinic as well as an investigative tool for basic neuroscience. rTMS has been shown to induce long-term changes in neuronal circuits in vivo. Such long-term effects of rTMS have been investigated using behavioral, imaging, electrophysiological, and molecular approaches, but there is limited understanding of the immediate effects of TMS on neurons. We investigated the immediate effects of high frequency (20 Hz) rTMS on the activity of cortical neurons in an effort to understand the underlying cellular mechanisms activated by rTMS. We used whole-cell patch-clamp recordings in acute rat brain slices and calcium imaging of cultured primary neurons to examine changes in neuronal activity and intracellular calcium respectively. Our results indicate that each TMS pulse caused an immediate and transient activation of voltage gated sodium channels (9.6 ± 1.8 nA at -45 mV, p value rTMS stimulation induced action potentials in a subpopulation of neurons, and significantly increased the steady state current of the neurons at near threshold voltages (at -45 mV: before TMS: I = 130 ± 17 pA, during TMS: I = 215 ± 23 pA, p value = 0.001). rTMS stimulation also led to a delayed increase in intracellular calcium (153.88 ± 61.94% increase from baseline). These results show that rTMS has an immediate and cumulative effect on neuronal activity and intracellular calcium levels, and suggest that rTMS may enhance neuronal responses when combined with an additional motor, sensory or cognitive stimulus. Thus, these results could be translated to optimize rTMS protocols for clinical as well as basic science applications. PMID:28114421

  8. Paired associative stimulation targeting the tibialis anterior muscle using either mono or biphasic transcranial magnetic stimulation

    DEFF Research Database (Denmark)

    Mrachacz-Kersting, Natalie; Stevenson, Andrew James Thomas

    2017-01-01

    a reduced intensity of this pulse would lead to significant changes as has been reported for hand muscles using a monophasic TMS pulse. Three interventions were investigated: (1) suprathreshold PAbi-PAS (n = 11); (2) suprathreshold PAmono-PAS (n = 11) where PAS was applied using a biphasic or monophasic......Paired associative stimulation (PAS) protocols induce plastic changes within the motor cortex. The objectives of this study were to investigate PAS effects targeting the tibialis anterior (TA) muscle using a biphasic transcranial magnetic stimulation (TMS) pulse form and, to determine whether...

  9. Motor cortical representation in two different strength training modalities revealed by transcranial magnetic stimulation

    DEFF Research Database (Denmark)

    Jørgensen, Rune Refsgaard; Osuna-Florentz, Patrick; Stevenson, Andrew James Thomas

    2017-01-01

    were recruited and divided into two groups based on their training experience (explosive and non-explosive resistance trained). The participants had a minimum of two years of experience with either weightlifting (snatch and clean and jerk) or conventional resistance training. Transcranial magnetic...... stimulation was used for mapping motor cortical representations (MAP) of VL and BF in an active state (~5-10% of a squat). The stimulation intensity used was slightly above active motor threshold (~105%). Results The MAP area for VL was significantly larger for the explosively trained than for the resistance...

  10. 高频重复经颅磁刺激对脑梗死大鼠缺血半暗带超微结构及脑源性神经营养因子表达的影响%Effects of high-frequency repetitive transcranial magnetic stimulation on the ultrastructure of an ischemic brain penumbra and the expression of brain-derived neurotrophic factors in rats

    Institute of Scientific and Technical Information of China (English)

    黄杰; 马玉娟; 方征宇; 种玉飞; 随燕芳; 尤春景

    2011-01-01

    Objective To investigate the effects of high-frequency repetitive transcranial magnetic stimulation (rTMS) at different intensities on the ultrastructure of an ischemic brain penumbra and the expression of brainderived neurotrophic factor (BDNF) using rats with permanent middle cerebral artery occlusion (MCAO).Methods Forty-two rats were randomly divided into a blank control group,an MCAO model control group,a sham stimulation control group and an rTMS group.The rTMS group was divided further into 3 subgroups:an 80% of motor threshold (MT) subgroup,a 100% of MT subgroup and a 120% of MT subgroup.The cerebral infarction model was established by right MCAO.rTMS treatment was given 24 hours after the MCAO model was successfully established.The rTMS group and sham stimulation control group were given 20 Hz rTMS with the planned intensities.The MCAO model control group was not given any stimulation.After 14 days of treatment,transmission electron microscopy,immunohistochemical and Western blotting ( WB ) methods were used to investigate the ultrastructure of the ischemic penumbra and the expression of BDNF.Results Damage reflected in the ultrastructure in the 3 rTMS subgroups was less than in the model control group and the sham stimulation control group.Expression of BDNF protein increased significantly in 100% of the MT group and blank control group rats as compared with that in the sham stimulation control group,while the blank control group and the 3 rTMS subgroups had no statistically significant difference in comparison with the MCAO model control group.The expression of BDNF protein had no statistically significant difference between any of the groups.Conclusion 20 Hz rTMS might,especially at 100% of the MT,promote the recovery of the ultrastructure of neural tissues in the ischemic penumbra after acute cerebral infarction and enhance the expression of BDNF in the ipsilesional hemisphere.This may be one of the important mechanisms of r

  11. 低频重复经颅磁刺激治疗难治性癫(癎)大鼠模型及对脑源性神经营养因子和神经肽Y表达的影响%The effects of low frequency repetitive transcranial magnetic stimulation on the rat model of refractory epilepsy and expression of brain-derived neurotrophic factor and neuropeptide Y

    Institute of Scientific and Technical Information of China (English)

    张丽娜; 武士京; 陶华英; 张秀娜

    2011-01-01

    Objective To investigate the effects of low frequency repetitive transcranial magnetic stimulation (rTMS) on electroencephalogram (EEG) and expression of brain - derived neurotrophic factor (BDNF) and neuropeptide Y (NPY) in hippocampus of rats with refractory epilepsy (RE), and to explore the possible mechanisms of the therapeutic effect of rTMS on RE.Methods Fifty-four adult male Wistar rats were equally randomized into RE rTMS (rTMS), RE sham-rTMS (srTMS) and normal saline control (NS) groups.RE model was induced by injecting of kainic acid (KA) into the CA3 area of left hippocampus with a stereotaxic apparatus, while NS group was injected by NS.The rats in rTMS group were treated for 10 d (stimulation was given in 5 d and discontinued for 2 d, the whole course was 2 weeks).The expression of BDNF and NPY in hippocampus of rats at 3 weeks after operation were collected for EEG signal analysis before and after rTMS treatment, and compared the spike numbers by using the software running on Matlab 7.0 in different groups.The expression of BDNF and NPY in hippocampus of rats were detected by immunohistochemical technique before and 3 weeks after rTMS treatment.Results After rTMS, the amount of EEG sharp waves was reduced significantly (before rTMS, amount of EEG sharp waves, T3: 16.16 ± 1.17, T4: 14.94 ± 0.98; after rTMS, amount of EEG sharp waves, T3: 9.09 ± 0.67, T4: 8.93 ± 0.91; P = 0.000, for all), and the expression of BDNF, tyrosine protein kinase B (TrkB) and NPY in hippocampus of the rats with RE reduced significantly after low frequency rTMS (before rTMS, BDNF IOD: 49 571.40 ± 2344.02, TrkB IOD: 2946.77 ± 1142.79, NPY IOD: 33 823.05 ±843.45; after rTMS, BDNF IOD: 29 602.07±1932.82, TrkB IOD: 18 104.34 ± 934.58, NPY IOD: 15 037.14 ± 772.95; P = 0.000, for all).Number of active cell decreased significantly (P = 0.000).Conclusion rTMS can reduce epileptiform discharge and down regulate the expression of BDNF, TrkB and NPY, and thus provides

  12. Effects of Low-frequency Repetitive Transcranial Magnetic Stimulation on Expressions of Hippocampus CA3 Region Annexin A7 in Rats after Pilocarpine-induced Seizures%低频重复经颅磁刺激的抗(癎)作用及其对癫(癎)大鼠海马CA3区膜连蛋白A7表达的影响

    Institute of Scientific and Technical Information of China (English)

    余琴; 王莉; 余巨明; 贾朝均

    2012-01-01

    目的:观察低频重复经颅磁刺激(rTMS)对大鼠(癎)性发作行为及海马CA3区膜连蛋白A7表达的影响.方法:取85只健康雄性SD大鼠,按预处理方式将其分成rTMS组(rTMS刺激+毛果芸香碱致(癎))、对照组(假刺激+毛果芸香碱致(癎))及生理盐水对照组(假刺激+生理盐水).各组大鼠经相应处理后,rTMS组和对照组(各n=30)大鼠制作氯化锂-毛果芸香碱癫(癎)持续状态(SE)模型;生理盐水对照组(n=25)则腹腔注射生理盐水.观察各组大鼠行为表现及SE潜伏期,应用免疫组化法观察膜连蛋白A7表达的动态变化(6h、24h、1周、3周、6周).结果:①rTMS组SE潜伏期为(41.37±5.45)min,与对照组(23.86±4.42)min比较明显延长(P<0.01);②海马CA3区膜连蛋白A7阳性细胞数在各时间点均为对照组最多,rTMS组次之,生理盐水对照组最少(均P<0.05).但是膜连蛋白A7的表达随时间变化的趋势rTMS组与对照组明显不同.结论:低频rTMS有一定抗(癎)作用;低频rTMS可影响大鼠海马CA3区膜连蛋白A7表达并呈现独特的动态变化特点.%Aim: To observe the effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) on rat behavior and the expressions of hippocampus CA3 region annexin A7 in rats after pilocarpine-induced seizures, and explore the possible anti-epileptic mechanisms of rTMS. Methods: 85 healthy male SD rats were randomly divided into rTMS group (rTMS+pilocarpine), control group (sham stimulation+ pilocarpine), and NS control group (sham stimulation+normal saline), with 30 rats in each of rTMS group and control group, and 25 rats in NS control group. After consecutive corresponding stimulation for 2 weeks respectively, the status epilepticus rat models were established in rTMS group and control group, their behavior were observed and the latent time to status epilepticus was measured. The rats in all groups were killed in different time (6 h, 24 h, 1 week, 3 weeks, 6 weeks

  13. The electric field induced by transcranial magnetic stimulation: A comparison between analytic and fem solutions

    Directory of Open Access Journals (Sweden)

    Porzig Konstantin

    2014-01-01

    Full Text Available The induced electric field profiles in a homogeneous isotropic sphere, were calculated and compared between an analytic and a finite-element method in the framework of transcranial magnetic stimulation (TMS. This model can also be applied for concentric spheres in the framework of magnetic induction tomography (MIT, non destructive testing (NDT or to calculate the lead field in magnetoencephalography (MEG. The calculations were performed using Eaton’s method as well as the finite-element program Comsol Multiphysics 4.2a (COMSOL Inc., Burlington, USA. A circular- and a figure-of-8 coil were used to operate as the sources of excitation. In our study the spherical volume conductor represents the human head consisting of grey matter. In order to quantify the differences between both methods an intense parameter study was performed. A comparison between both methods show a higher conformity than reported in previous studies. Regarding Eaton’s method, the influence of the maximum order of approximation L and the number of elements per winding K was investigated. The maximum relative difference was approximately 0.3% for L = 20 and K > 16. Furthermore the relative efficiency of the algorithm was calculated to save computational time. With the presented results it is possible to use Eaton’s method efficiently to compute the induced electric field profiles very quickly for example while searching for specific coil arrangements around the humans head, as in the case of deep brain transcranial magnetic stimulation (dTMS.

  14. Application of Transcranial Magnetic Stimulation to Time Perception%经颅磁刺激在时间认知研究中的应用

    Institute of Scientific and Technical Information of China (English)

    任维聪; 张志杰; 王铭维

    2012-01-01

    经颅磁刺激(TMS)可以暂时性地改变特定大脑区域的神经活动以研究该脑区在时间认知中的作用.高频TMS通常增加皮质兴奋性,用高频TMS刺激右侧背外侧前额皮质可以影响秒范围的时距知觉,刺激小脑可以影响毫秒范围的时距知觉.经颅磁刺激可以作为探讨时间认知神经机制的有效工具,并可以作为脑损伤病人改善时间认知能力的有效治疗手段.%Transcranial magnetic stimulation(TMS), which can temporarily change the neural activity of a definite brain area, has been used to explore the role of the brain regions in time perception. Generally, high-frequency TMS produces increasing excitability of the cortical network. High-frequency repetitive TMS, when applied to the right dorsolateral pre-frontal cortex (DLPFC), can affect the perception of second range intervals; while repetitive TMS of cerebellum can affect the perception of millisecond time processing. Repetitive TMS should be an effective tool in neural mechanism of time perception and plays an important role in neuiorehabilitation.

  15. Low-frequency transcranial magnetic stimulation over left dorsal premotor cortex improves the dynamic control of visuospatially cued actions

    Science.gov (United States)

    Ward, Nick S.; Bestmann, Sven; Hartwigsen, Gesa; Weiss, Michael M.; Christensen, Lars O.D.; Frackowiak, Richard S.J.; Rothwell, John C.; Siebner, Hartwig R.

    2013-01-01

    Left rostral dorsal premotor cortex (rPMd) and supramarginal gyrus (SMG) have been implicated in the dynamic control of actions. In 12 right-handed healthy individuals we applied 30 minutes of low-frequency (1Hz) repetitive transcranial magnetic stimulation (rTMS) over left rPMd to investigate the involvement of left rPMd and SMG in the rapid adjustment of actions guided by visuospatial cues. After rTMS, subjects underwent functional magnetic resonance imaging while making spatially congruent button presses with right or left index finger in response to a left- or right-sided target. Subjects were asked to covertly prepare motor responses as indicated by a directional cue presented one second before the target. On 20% of trials the cue was invalid requiring subjects to re-adjust their motor plan according to the target location. Compared to sham rTMS, real rTMS increased the number of correct responses in invalidly cued trials. After real rTMS, task-related activity of the stimulated left rPMd showed increased task-related coupling with activity in ipsilateral SMG and adjacent anterior intraparietal area (AIP). Individuals who showed a stronger increase in left-hemispheric premotor-parietal connectivity also made fewer errors on invalidly cued trials after rTMS. The results suggest that rTMS over left rPMd improved the ability to dynamically adjust visuospatial response mapping by strengthening left-hemispheric connectivity between rPMd and the SMG-AIP region. These results support the notion that left rPMd and SMG-AIP contribute towards dynamic control of actions, and demonstrate that low-frequency rTMS can enhance functional coupling between task-relevant brain regions and improve some aspects of motor performance. PMID:20610756

  16. Voluntary activation of human knee extensors measured using transcranial magnetic stimulation.

    Science.gov (United States)

    Goodall, S; Romer, L M; Ross, E Z

    2009-09-01

    The aim of this study was to determine the applicability and reliability of a transcranial magnetic stimulation twitch interpolation technique for measuring voluntary activation of a lower limb muscle group. Cortical voluntary activation of the knee extensors was determined in nine healthy men on two separate visits by measuring superimposed twitch torques evoked by transcranial magnetic stimulation during isometric knee extensions of varying intensity. Superimposed twitch amplitude decreased linearly with increasing voluntary torque between 50 and 100% of mean maximal torque, allowing estimation of resting twitch amplitude and subsequent calculation of voluntary activation. There were no systematic differences for maximal voluntary activation within day (mean +/- s.d. 90.9 +/- 6.2 versus 90.7 +/- 5.9%; P = 0.98) or between days (90.8 +/- 6.0 versus 91.2 +/- 5.7%; P = 0.92). Systematic bias and random error components of the 95% limits of agreement were 0.23 and 9.3% within day versus 0.38 and 7.5% between days. Voluntary activation was also determined immediately after a 2 min maximal voluntary isometric contraction; in four of these subjects, voluntary activation was determined 30 min after the sustained contraction. Immediately after the sustained isometric contraction, maximal voluntary activation was reduced from 91.2 +/- 5.7 to 74.2 +/- 12.0% (P knee extensors.

  17. Spontaneously Fluctuating Motor Cortex Excitability in Alternating Hemiplegia of Childhood: A Transcranial Magnetic Stimulation Study

    Science.gov (United States)

    Stern, William M.; Desikan, Mahalekshmi; Hoad, Damon; Jaffer, Fatima; Strigaro, Gionata; Sander, Josemir W.; Rothwell, John C.; Sisodiya, Sanjay M.

    2016-01-01

    Background Alternating hemiplegia of childhood is a very rare and serious neurodevelopmental syndrome; its genetic basis has recently been established. Its characteristic features include typically-unprovoked episodes of hemiplegia and other transient or more persistent neurological abnormalities. Methods We used transcranial magnetic stimulation to assess the effect of the condition on motor cortex neurophysiology both during and between attacks of hemiplegia. Nine people with alternating hemiplegia of childhood were recruited; eight were successfully tested using transcranial magnetic stimulation to study motor cortex excitability, using single and paired pulse paradigms. For comparison, data from ten people with epilepsy but not alternating hemiplegia, and ten healthy controls, were used. Results One person with alternating hemiplegia tested during the onset of a hemiplegic attack showed progressively diminishing motor cortex excitability until no response could be evoked; a second person tested during a prolonged bilateral hemiplegic attack showed unusually low excitability. Three people tested between attacks showed asymptomatic variation in cortical excitability, not seen in controls. Paired pulse paradigms, which probe intracortical inhibitory and excitatory circuits, gave results similar to controls. Conclusions We report symptomatic and asymptomatic fluctuations in motor cortex excitability in people with alternating hemiplegia of childhood, not seen in controls. We propose that such fluctuations underlie hemiplegic attacks, and speculate that the asymptomatic fluctuation we detected may be useful as a biomarker for disease activity. PMID:26999520

  18. [Design and field calculation of coil array for transcranial magnetic stimulation (TMS) based on genetic algorithm].

    Science.gov (United States)

    Liu, Jicheng; Huang, Kama; Guo, Lanting; Zhang, Hong; Hu, Yayi

    2005-04-01

    It is the intent of this paper to locate the activation point in Transcranial Magnetic Stimulation (TMS) efficiently. The schemes of coil array in torus shape is presented to get the electromagnetic field distribution with ideal focusing capability. Then an improved adaptive genetic algorithm (AGA) is applied to the optimization of both value and phase of the current infused in each coil. Based on the calculated results of the optimized current configurations, ideal focusing capability is drawn as contour lines and 3-D mesh charts of magnitude of both magnetic and electric field within the calculation area. It is shown that the coil array has good capability to establish focused shape of electromagnetic distribution. In addition, it is also demonstrated that the coil array has the capability to focus on two or more targets simultaneously.

  19. Effect of the different winding methods of coil on electromagnetic field during transcranial magnetic stimulation.

    Science.gov (United States)

    Yang, Shuo; Xu, Guizhi; Wang, Lei; Zhang, Xiu

    2008-01-01

    Transcranial magnetic stimulation (TMS) is a powerful, non-invasive tool for investigating functions in the brain. The target inside the head is stimulated with eddy currents induced in the tissues by the time-varying magnetic field. TMS has been used in several applications in medical and clinical research which include brain mapping, treatment of mood disorder and schizophrenia, treatment of epilepsy, treatment of chronic pain and so on. The stimulation effect can be affected by the stimulation intensity. For coils with the same shape, different winding methods make the coil have different stimulation intensity. In this paper, three different methods for winding circular coils are discussed. The electromagnetic fields induced by the three different circular coils were analyzed. The results show that the circular coil with the pancake coil winding has the strongest stimulation intensity.

  20. New perspectives in transcranial magnetic stimulation: epilepsy, consciousness and the perturbational approach.

    Science.gov (United States)

    Manganotti, Paolo; Del Felice, Alessandra

    2013-01-01

    Transcranial magnetic stimulation (TMS) evolved from a simple method to stimulate the motor cortex to an invaluable tool for multiple diagnostic, research, and therapeutic applications. A further development of this noninvasive brain stimulation technique is concomitant electroencephalographic (EEG) recording during TMS. The theoretical underpinnings and the technological innovation of TMS-EEG co-registration have opened new ways to study brain excitability in neurological conditions previously investigated with conventional EEG alone. A further advance in TMS research applications is the perturbational approach: magnetic pulses can interfere not only with dynamic, often pathological rhythms in epilepsy or altered consciousness states, but also modulate physiological states such as sleep and sleep deprivation. So applied, TMS-EEG co-registration can reveal different neurophysiological and behavioral patterns in the awake state, sleep or sleep deprivation. In this review, we discuss the use of TMS and TMS-EEG co-registration in epilepsy, a still rather limited although promising area of study.

  1. How does transcranial magnetic stimulation modify neuronal activity in the brain? Implications for studies of cognition

    DEFF Research Database (Denmark)

    Siebner, Hartwig R; Hartwigsen, Gesa; Kassuba, Tanja

    2009-01-01

    Transcranial magnetic stimulation (TMS) uses a magnetic field to "carry" a short lasting electrical current pulse into the brain where it stimulates neurones, particularly in superficial regions of cerebral cortex. TMS can interfere with cognitive functions in two ways. A high intensity TMS pulse...... in the human brain. This transient neurodisruption has been termed a "virtual lesion". Smaller intensities of stimulation produce less activity; in such cases, cognitive operations can probably continue but are disrupted because of the added noisy input from the TMS pulse. It is usually argued that if a TMS...... pulse affects performance, then the area stimulated must provide an essential contribution to behaviour being studied. However, there is one exception to this: the pulse could be applied to an area that is not involved in the task but which has projections to the critical site. Activation of outputs...

  2. A study of transcranial magnetic stimulation in older (>3 years patients of malnutrition.

    Directory of Open Access Journals (Sweden)

    Karak B

    1999-07-01

    Full Text Available Transcranial magnetic stimulation was performed in 40 subjects. Twenty patients in the age group of 3 to 8 years and having different grades of malnutrition were included in the ′study group′ whereas 20 normal children having no complaints comprised the ′control group′. The coil of the magnetic stimulator was applied tangentially over the vertex to stimulate the cortex. The motor evoked potential (MEP was obtained using root stimulation by applying the coil at the cervical and lumbosacral spines. Recordings were made from the abductor pollicis brevis (APB and extensor digitorum brevis (EDB muscles of both sides. Cortical threshold, latency and amplitude of motor evoked potential and central conduction time were recorded. Malnourished children showed significantly increased cortical threshold, prolonged cortical latency and central conduction time and reduction in amplitude of MEP. Observed delay in central motor conduction in malnourished children suggests asymptomatic involvement of corticospinal pathways.

  3. Transcranial alternating current stimulation: a review of the underlying mechanisms and modulation of cognitive processes

    OpenAIRE

    Herrmann, Christoph S; Rach, Stefan; Neuling, Toralf; Strüber, Daniel

    2013-01-01

    Brain oscillations of different frequencies have been associated with a variety of cognitive functions. Convincing evidence supporting those associations has been provided by studies using intracranial stimulation, pharmacological interventions and lesion studies. The emergence of novel non-invasive brain stimulation techniques like repetitive transcranial magnetic stimulation (rTMS) and transcranial alternating current stimulation (tACS) now allows to modulate brain oscillations directly. Pa...

  4. Cortical Inhibition in Attention Deficit Hyperactivity Disorder: New Insights from the Electroencephalographic Response to Transcranial Magnetic Stimulation

    Science.gov (United States)

    Bruckmann, Sarah; Hauk, Daniela; Roessner, Veit; Resch, Franz; Freitag, Christine M.; Kammer, Thomas; Ziemann, Ulf; Rothenberger, Aribert; Weisbrod, Matthias; Bender, Stephan

    2012-01-01

    Attention deficit hyperactivity disorder is one of the most frequent neuropsychiatric disorders in childhood. Transcranial magnetic stimulation studies based on muscle responses (motor-evoked potentials) suggested that reduced motor inhibition contributes to hyperactivity, a core symptom of the disease. Here we employed the N100 component of the…

  5. Changes in 5-HT1A and NMDA binding sites by a single rapid transcranial magnetic stimulation procedure in rats

    NARCIS (Netherlands)

    Kole, MHP; Fuchs, E; Ziemann, U; Paulus, W; Ebert, U

    1999-01-01

    The effects of a single rapid-rate transcranial magnetic stimulation (rTMS) exposure on neurotransmitter binding sites in the rat brain 24 h after the stimulation were examined. Quantification by in vitro-autoradiography showed no differences for H-3-paroxetine binding (5-HT uptake sites) between rT

  6. A Preliminary Transcranial Magnetic Stimulation Study of Cortical Inhibition and Excitability in High-Functioning Autism and Asperger Disorder

    Science.gov (United States)

    Enticott, Peter G.; Rinehart, Nicole J.; Tonge, Bruce J.; Bradshaw, John L.; Fitzgerald, Paul B.

    2010-01-01

    Aim: Controversy surrounds the distinction between high-functioning autism (HFA) and Asperger disorder, but motor abnormalities are associated features of both conditions. This study examined motor cortical inhibition and excitability in HFA and Asperger disorder using transcranial magnetic stimulation (TMS). Method: Participants were diagnosed by…

  7. Figure-ground segregation requires two distinct periods of activity in V1: A transcranial magnetic stimulation study.

    NARCIS (Netherlands)

    Heinen, K.; Jolij, J.; Lamme, V.A.F.

    2005-01-01

    Discriminating objects from their surroundings by the visual system is known as figure-ground segregation. This process entails two different subprocesses: boundary detection and subsequent surface segregation or 'filling in'. In this study, we used transcranial magnetic stimulation to test the

  8. The number of full-sine cycles per pulse influences the efficacy of multicycle transcranial magnetic stimulation

    DEFF Research Database (Denmark)

    Pechmann, Astrid; Delvendahl, Igor; Bergmann, Til O

    2012-01-01

    Previous studies have shown that the efficacy of transcranial magnetic stimulation (TMS) to excite corticospinal neurons depends on pulse waveform. OBJECTIVE/HYPOTHESES: In this study, we examined whether the effectiveness of polyphasic TMS can be increased by using a pulse profile that consists ...... of multiple sine cycles....

  9. EEG-guided transcranial magnetic stimulation reveals rapid shifts in motor cortical excitability during the human sleep slow oscillation

    DEFF Research Database (Denmark)

    Bergmann, Til O; Mölle, Matthias; Schmidt, Marlit A

    2012-01-01

    Evoked cortical responses do not follow a rigid input-output function but are dynamically shaped by intrinsic neural properties at the time of stimulation. Recent research has emphasized the role of oscillatory activity in determining cortical excitability. Here we employed EEG-guided transcranial...... magnetic stimulation (TMS) during non-rapid eye movement sleep to examine whether the spontaneous...

  10. Cortical Inhibition in Attention Deficit Hyperactivity Disorder: New Insights from the Electroencephalographic Response to Transcranial Magnetic Stimulation

    Science.gov (United States)

    Bruckmann, Sarah; Hauk, Daniela; Roessner, Veit; Resch, Franz; Freitag, Christine M.; Kammer, Thomas; Ziemann, Ulf; Rothenberger, Aribert; Weisbrod, Matthias; Bender, Stephan

    2012-01-01

    Attention deficit hyperactivity disorder is one of the most frequent neuropsychiatric disorders in childhood. Transcranial magnetic stimulation studies based on muscle responses (motor-evoked potentials) suggested that reduced motor inhibition contributes to hyperactivity, a core symptom of the disease. Here we employed the N100 component of the…

  11. A Preliminary Transcranial Magnetic Stimulation Study of Cortical Inhibition and Excitability in High-Functioning Autism and Asperger Disorder

    Science.gov (United States)

    Enticott, Peter G.; Rinehart, Nicole J.; Tonge, Bruce J.; Bradshaw, John L.; Fitzgerald, Paul B.

    2010-01-01

    Aim: Controversy surrounds the distinction between high-functioning autism (HFA) and Asperger disorder, but motor abnormalities are associated features of both conditions. This study examined motor cortical inhibition and excitability in HFA and Asperger disorder using transcranial magnetic stimulation (TMS). Method: Participants were diagnosed by…

  12. An endocrine perspective on the role of steroid hormones in the antidepressant treatment efficacy of transcranial magnetic stimulation

    NARCIS (Netherlands)

    Schutter, D.J.L.G.; Honk, E.J. van

    2010-01-01

    Evidence from recent meta-analyses indicates that transcranial magnetic stimulation (TMS) is moderately effective in the treatment of major depressive disorder (MDD). Individual differences in the susceptibility to TMS are suggested to underlie a significant portion of the variability in antidepress

  13. Repetitive Transcranial Direct Current Stimulation Induced Excitability Changes of Primary Visual Cortex and Visual Learning Effects-A Pilot Study.

    Science.gov (United States)

    Sczesny-Kaiser, Matthias; Beckhaus, Katharina; Dinse, Hubert R; Schwenkreis, Peter; Tegenthoff, Martin; Höffken, Oliver

    2016-01-01

    Studies on noninvasive motor cortex stimulation and motor learning demonstrated cortical excitability as a marker for a learning effect. Transcranial direct current stimulation (tDCS) is a non-invasive tool to modulate cortical excitability. It is as yet unknown how tDCS-induced excitability changes and perceptual learning in visual cortex correlate. Our study aimed to examine the influence of tDCS on visual perceptual learning in healthy humans. Additionally, we measured excitability in primary visual cortex (V1). We hypothesized that anodal tDCS would improve and cathodal tDCS would have minor or no effects on visual learning. Anodal, cathodal or sham tDCS were applied over V1 in a randomized, double-blinded design over four consecutive days (n = 30). During 20 min of tDCS, subjects had to learn a visual orientation-discrimination task (ODT). Excitability parameters were measured by analyzing paired-stimulation behavior of visual-evoked potentials (ps-VEP) and by measuring phosphene thresholds (PTs) before and after the stimulation period of 4 days. Compared with sham-tDCS, anodal tDCS led to an improvement of visual discrimination learning (p visual perceptual learning and increased cortical excitability. tDCS is a promising tool to alter V1 excitability and, hence, perceptual visual learning.

  14. Repetitive peripheral magnetic neurostimulation of multifidus muscles combined with motor training influences spine motor control and chronic low back pain.

    Science.gov (United States)

    Massé-Alarie, Hugo; Beaulieu, Louis-David; Preuss, Richard; Schneider, Cyril

    2017-03-01

    The study tested whether combining repetitive peripheral magnetic stimulation (RPMS) and motor training of the superficial multifidus muscle (MF) better improved the corticomotor control of spine than training alone in chronic low back pain (CLBP). Twenty-one participants with CLBP were randomly allocated to [RPMS+training] and [Sham+training] groups for three sessions (S1-S3) over a week where MF was stimulated before training (volitional contraction). Training was also home-practiced twice a day. Changes were tested at S1 and S3 for anticipatory postural adjustments (APAs) of MF and semi-tendinosus (ST), MF EMG activation, cortical motor plasticity (transcranial magnetic stimulation) and pain/disability. The RPMS group showed immediate decrease of pain at S1, then improvement of MF activation, ST APA, M1 facilitation, and pain/disability at S3. Changes were larger when brain excitability was lower at baseline. Disability index remained improved one month later. Combining RPMS with training of MF in CLBP impacted motor planning, MF and lumbopelvic spine motor control and pain/disability one week after the onset of protocol. Brain plasticity might have favoured motor learning and improved daily lumbopelvic spine control without pain generation. Clinically, RPMS impacted the function by improving the gains beyond those reached by training alone in CLBP. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  15. Neuroprotective effect of repetitive magnetic stimulation on primarily cultured hippocampus neurons in rats%重复性磁刺激对原代培养大鼠海马神经元的保护作用

    Institute of Scientific and Technical Information of China (English)

    魏莉; 林宏; 李柱一; 刘煜

    2005-01-01

    BACKGROUND: Much has been studied on the neuroprotective effect of repetitive transcranial magnetic stimulation.OBJECTIVE: To observe the effects of repetitive transcranial magnetic stimulation on the morphology and vitality of rat hippocampus neurons in vitro in order to verify its protective effect on neurons.DESIGN: A completely randomized controlled experiment with animals as subjects.SETTING: Institute of neuroscience of a military medical university of Chinese PLA.MATERIALS: The experiment was conducted at the Institute of Neuroscience, Fourth Military Medical University of Chinese PLA, from April to June 2004. Primary cultured hippocampus neurons of neonatal SD rats were used in the experiment. The cells were randomly assigned to control group,repetitive transcranial magnetic stimulation group, H2O2 group and repetitive transcranial magnetic stimulation-H2O2 group, each group having 10 wells.METHODS: Hippocampus neurons of the rats were cultured by common culture method. Repetitive transcranial magnetic stimulation group and repetitive transcranial magnetic stimulation-H2O2 group were treated with 1 Hz 100 mT repetitive magnetic stimulation for 1 000 times 48 hours after being seeded, whereas the control group and H2O2 group were left untreated. H2O2group and repetitive transcranial magnetic stimulation-H2O2 group were incubated with 100 μmol/L H2O2 56 hours after being seeded. Seventy-two hours after being seeded, the cellular morphology of repetitive transcranial magnetic stimulation group and control group was observed under an inverted phase contrast microscope. Cell vitality was assayed with 3-(4, 5)-dimethythioazol-2-yl-2, 5-diphenyl-tetrazoliumbromide method (MTT).MAIN OUTCOME MEASURES: The morphology and viability of the neurons in repetitive transcranial magnetic stimulation group and control group.RESULTS: Seventy-two hours after being seeded, the cellular morphology of repetitive transcranial magnetic stimulation group and control group was

  16. Cortical mapping with navigated transcranial magnetic stimulation in low-grade glioma surgery

    Directory of Open Access Journals (Sweden)

    Paiva WS

    2012-05-01

    Full Text Available Wellingson S Paiva1, Erich T Fonoff1, Marco A Marcolin2, Hector N Cabrera1, Manoel J Teixeira11Division of Functional Neurosurgery, Hospital das Clinicas, 2TMS Laboratory of the Psychiatry Institute, Hospital das Clinicas, University of São Paulo School of Medicine, São Paulo, BrazilAbstract: Transcranial magnetic stimulation (TMS is a promising method for both investigation and therapeutic treatment of psychiatric and neurologic disorders and, more recently, for brain mapping. This study describes the application of navigated TMS for motor cortex mapping in patients with a brain tumor located close to the precentral gyrus.Materials and methods: In this prospective study, six patients with low-grade gliomas in or near the precentral gyrus underwent TMS, and their motor responses were correlated to locations in the cortex around the lesion, generating a functional map overlaid on three-dimensional magnetic resonance imaging (MRI scans of the brain. To determine the accuracy of this new method, we compared TMS mapping with the gold standard mapping with direct cortical electrical stimulation in surgery. The same navigation system and TMS-generated map were used during the surgical resection procedure.Results: The motor cortex could be clearly mapped using both methods. The locations corresponding to the hand and forearm, found during intraoperative mapping, showed a close spatial relationship to the homotopic areas identified by TMS mapping. The mean distance between TMS and direct cortical electrical stimulation (DES was 4.16 ± 1.02 mm (range: 2.56–5.27 mm.Conclusion: Preoperative mapping of the motor cortex with navigated TMS prior to brain tumor resection is a useful presurgical planning tool with good accuracy.Keywords: transcranial magnetic stimulation, cortical mapping, brain tumor, motor cortex

  17. Repetitive magnetic stimulation promotes neural stem cells proliferation by upregulating MiR-106b in vitro.

    Science.gov (United States)

    Liu, Hua; Han, Xiao-hua; Chen, Hong; Zheng, Cai-xia; Yang, Yi; Huang, Xiao-lin

    2015-10-01

    Neural stem cells (NSCs) proliferation can be influenced by repetitive transcranial magnetic stimulation (rTMS) in vivo via microRNA-106b-25 cluster, but the underlying mechanisms are poorly understood. This study investigated the involvement of microRNA-106b-25 cluster in the proliferation of NSCs after repetitive magnetic stimulation (rMS) in vitro. NSCs were stimulated by rMS (200/400/600/800/1000 pulses per day, with 10 Hz frequency and 50% maximum machine output) over a 3-day period. NSCs proliferation was detected by using ki-67 and EdU staining. Ki-67, p21, p57, cyclinD1, cyclinE, cyclinA, cdk2, cdk4 proteins and miR-106b, miR-93, miR-25 mRNAs were detected by Western blotting and qRT-PCR, respectively. The results showed that rMS could promote NSCs proliferation in a dose-dependent manner. The proportions of ki-67+ and Edu+ cells in 1000 pulses group were 20.65% and 4.00%, respectively, significantly higher than those in control group (9.25%, 2.05%). The expression levels of miR-106b and miR-93 were significantly upregulated in 600-1000 pulses groups compared with control group (Pp21 protein were decreased significantly in 800/1000 pulses groups, and those of cyclinD1, cyclinA, cyclinE, cdk2 and cdk4 were obviously increased after rMS as compared with control group (Pp21/cdks/cyclins pathway was involved in the process.

  18. Control of proliferation rate of N27 dopaminergic neurons using Transcranial Magnetic Stimulation orientation

    Science.gov (United States)

    Meng, Yiwen; Hadimani, Ravi; Anantharam, Vellareddy; Kanthasamy, Anumantha; Jiles, David

    2015-03-01

    Transcranial magnetic stimulation (TMS) has been used to investigate possible treatments for a variety of neurological disorders. However, the effect that magnetic fields have on neurons has not been well documented in the literature. We have investigated the effect of different orientation of magnetic field generated by TMS coils with a monophasic stimulator on the proliferation rate of N27 neuronal cells cultured in flasks and multi-well plates. The proliferation rate of neurons would increase by exposed horizontally adherent N27 cells to a magnetic field pointing upward through the neuronal proliferation layer compared with the control group. On the other hand, proliferation rate would decrease in cells exposed to a magnetic field pointing downward through the neuronal growth layer compared with the control group. We confirmed results obtained from the Trypan-blue and automatic cell counting methods with those from the CyQuant and MTS cell viability assays. Our findings could have important implications for the preclinical development of TMS treatments of neurological disorders and represents a new method to control the proliferation rate of neuronal cells.

  19. Differential effects of motor cortical excitability and plasticity in young and old individuals: a Transcranial Magnetic Stimulation (TMS study

    Directory of Open Access Journals (Sweden)

    Shahid eBashir

    2014-06-01

    Full Text Available Aging is associated with changes in the motor system that, over time, can lead to functional impairments and contribute negatively to the ability to recover after brain damage. Unfortunately, there are still many questions surrounding the physiological mechanisms underlying these impairments. We examined cortico-spinal excitability and plasticity in a young cohort (age range: 19-31 and an elderly cohort (age range: 47-73 of healthy right-handed individuals using navigated transcranial magnetic stimulation (nTMS. Subjects were evaluated with a combination of physiological (motor evoked potentials (MEPs, motor threshold (MT, intracortical inhibition (ICI, intracortical facilitation (ICF, and silent period (SP and behavioral (reaction time (RT, pinch force, 9 hole peg task (HPT measures at baseline and following one session of low-frequency (1 Hz navigated repetitive TMS (rTMS to the right (non-dominant hemisphere.In the young cohort, the inhibitory effect of 1 Hz rTMS was significantly in the right hemisphere and a significant facilitatory effect was noted in the unstimulated hemisphere. Conversely, in the elderly cohort, we report only a trend toward a facilitatory effect in the unstimulated hemisphere, suggesting reduced cortical plasticity and interhemispheric commuinication. To this effect, we show that significant differences in hemispheric cortico-spinal excitability were present in the elderly cohort at baseline, with significantly reduced cortico-spinal excitability in the right hemisphere as compared to the left hemisphere. A correlation analysis revealed no significant relationship between cortical thickness of the selected region of interest and MEPs in either young or old subjects prior to and following rTMS. When combined with our preliminary results, further research into this topic could lead to the development of neurophysiological markers pertinent to the diagnosis, prognosis, and treatment of neurological

  20. Differences in motor evoked potentials induced in rats by transcranial magnetic stimulation under two separate anesthetics: implications for plasticity studies

    Directory of Open Access Journals (Sweden)

    Matthew Sykes

    2016-10-01

    Full Text Available Repetitive transcranial magnetic stimulation (rTMS is primarily used in humans to change the state of corticospinal excitability. To assess the efficacy of different rTMS stimulation protocols, motor evoked potentials (MEPs are used as a readout due to their non-invasive nature. Stimulation of the motor cortex produces a response in a targeted muscle, and the amplitude of this twitch provides an indirect measure of the current state of the cortex. When applied to the motor cortex, rTMS can alter MEP amplitude, however results are variable between participants and across studies. In addition, the mechanisms underlying any change and its locus are poorly understood. In order to better understand these effects, MEPs have been investigated in vivo in animal models, primarily in rats. One major difference in protocols between rats and humans is the use of general anesthesia in animal experiments. Anesthetics are known to affect plasticity-like mechanisms and so may contaminate the effects of an rTMS protocol. In the present study, we explored the effect of anesthetic on MEP amplitude, recorded before and after intermittent theta burst stimulation (iTBS, a patterned rTMS protocol with reported facilitatory effects. MEPs were assessed in the brachioradialis muscle of the upper forelimb under two anesthetics: a xylazine/zoletil combination and urethane. We found MEPs could be induced under both anesthetics, with no differences in the resting motor threshold or the average baseline amplitudes. However, MEPs were highly variable between animals under both anesthetics, with the xylazine/zoletil combination showing higher variability and most prominently a rise in amplitude across the baseline recording period. Interestingly, application of iTBS did not facilitate MEP amplitude under either anesthetic condition. Although it is important to underpin human application of TMS with mechanistic examination of effects in animals, caution must be taken when

  1. Transcranial magnetic stimulation:potential treatment for co-occurring alcohol, traumatic brain injury and posttraumatic stress disorders

    Institute of Scientific and Technical Information of China (English)

    Amy AHerrold; Sandra LKletzel; Brett CHarton; R.Andrew Chambers; Neil Jordan; Teresa Louise-Bender Pape

    2014-01-01

    Alcohol use disorder (AUD), mild traumatic brain injury (mTBI), and posttraumatic stress dis-order (PTSD) commonly co-occur (AUD + mTBI + PTSD). These conditions have overlapping symptoms which are, in part, relfective of overlapping neuropathology. These conditions become problematic because their co-occurrence can exacerbate symptoms. Therefore, treatments must be developed that are inclusive to all three conditions. Repetitive transcranial magnetic stimu-lation (rTMS) is non-invasive and may be an ideal treatment for co-occurring AUD + mTBI +PTSD. There is accumulating evidence on rTMS as a treatment for people with AUD, mTBI, and PTSD each alone. However, there are no published studies to date on rTMS as a treatment for co-occurring AUD + mTBI + PTSD. This review article advances the knowledge base for rTMS as a treatment for AUD + mTBI + PTSD. This review provides background information about these co-occurring conditions as well as rTMS. The existing literature on rTMS as a treatment for people with AUD, TBI, and PTSD each alone is reviewed. Finally, neurobiological ifndings in support of a theoretical model are discussed to inform TMS as a treatment for co-occurring AUD + mTBI + PTSD. The peer-reviewed literature was identiifed by targeted literature searches using PubMed and supplemented by cross-referencing the bibliographies of relevant review arti-cles. The existing evidence on rTMS as a treatment for these conditions in isolation, coupled with the overlapping neuropathology and symptomology of these conditions, suggests that rTMS may be well suited for the treatment of these conditions together.

  2. Descending motor pathways and cortical physiology after spinal cord injury assessed by transcranial magnetic stimulation: a systematic review.

    Science.gov (United States)

    Nardone, Raffaele; Höller, Yvonne; Brigo, Francesco; Orioli, Andrea; Tezzon, Frediano; Schwenker, Kerstin; Christova, Monica; Golaszewski, Stefan; Trinka, Eugen

    2015-09-04

    We performed here a systematic review of the studies using transcranial magnetic stimulation (TMS) as a research and clinical tool in patients with spinal cord injury (SCI). Motor evoked potentials (MEPs) elicited by TMS represent a highly accurate diagnostic test that can supplement clinical examination and neuroimaging findings in the assessment of SCI functional level. MEPs allows to monitor the changes in motor function and evaluate the effects of the different therapeutic approaches. Moreover, TMS represents a useful non-invasive approach for studying cortical physiology, and may be helpful in elucidating the pathophysiological mechanisms of brain reorganization after SCI. Measures of motor cortex reactivity, e.g., the short interval intracortical inhibition and the cortical silent period, seem to point to an increased cortical excitability. However, the results of TMS studies are sometimes contradictory or divergent, and should be replicated in a larger sample of subjects. Understanding the functional changes at brain level and defining their effects on clinical outcome is of crucial importance for development of evidence-based rehabilitation therapy. TMS techniques may help in identifying neurophysiological biomarkers that can reliably assess the extent of neural damage, elucidate the mechanisms of neural repair, predict clinical outcome, and identify therapeutic targets. Some researchers have begun to therapeutically use repetitive TMS (rTMS) in patients with SCI. Initial studies revealed that rTMS can induce acute and short duration beneficial effects especially on spasticity and neuropathic pain, but the evidence is to date still very preliminary and well-designed clinical trials are warranted. This article is part of a Special Issue entitled SI: Spinal cord injury. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. Does a single session of theta-burst transcranial magnetic stimulation of inferior temporal cortex affect tinnitus perception?

    Directory of Open Access Journals (Sweden)

    Moser Tobias

    2009-05-01

    Full Text Available Abstract Background Cortical excitability changes as well as imbalances in excitatory and inhibitory circuits play a distinct pathophysiological role in chronic tinnitus. Repetitive transcranial magnetic stimulation (rTMS over the temporoparietal cortex was recently introduced to modulate tinnitus perception. In the current study, the effect of theta-burst stimulation (TBS, a novel rTMS paradigm was investigated in chronic tinnitus. Twenty patients with chronic tinnitus completed the study. Tinnitus severity and loudness were monitored using a tinnitus questionnaire (TQ and a visual analogue scale (VAS before each session. Patients received 600 pulses of continuous TBS (cTBS, intermittent TBS (iTBS and intermediate TBS (imTBS over left inferior temporal cortex with an intensity of 80% of the individual active or resting motor threshold. Changes in subjective tinnitus perception were measured with a numerical rating scale (NRS. Results TBS applied to inferior temporal cortex appeared to be safe. Although half of the patients reported a slight attenuation of tinnitus perception, group analysis resulted in no significant difference when comparing the three specific types of TBS. Converting the NRS into the VAS allowed us to compare the time-course of aftereffects. Only cTBS resulted in a significant short-lasting improvement of the symptoms. In addition there was no significant difference when comparing the responder and non-responder groups regarding their anamnestic and audiological data. The TQ score correlated significantly with the VAS, lower loudness indicating less tinnitus distress. Conclusion TBS does not offer a promising outcome for patients with tinnitus in the presented study.

  4. Intensity-dependent effects of repetitive anodal transcranial direct current stimulation on learning and memory in a rat model of Alzheimer's disease.

    Science.gov (United States)

    Yu, Xuehong; Li, Yiyan; Wen, Huizhong; Zhang, Yinghui; Tian, Xuelong

    2015-09-01

    Single-session anodal transcranial direct current stimulation (tDCS) can improve the learning-memory function of patients with Alzheimer's disease (AD). After-effects of tDCS can be more significant if the stimulation is repeated regularly in a period. Here the behavioral and the histologic effects of the repetitive anodal tDCS on a rat model of AD were investigated. Sprague-Dawley rats were divided into 6 groups, the sham group, the β-amyloid (Aβ) group, the Aβ+20μA tDCS group, the Aβ+60μA tDCS group, the Aβ+100μA tDCS group and the Aβ+200μA tDCS group. Bilateral hippocampus of the rats in the Aβ group and the Aβ+tDCS groups were lesioned by Aβ1-40 to produce AD models. One day after drug injection, repetitive anodal tDCS (10 sessions in two weeks, 20min per session) was applied to the frontal cortex of the rats in the tDCS groups, while sham stimulation was applied to the Aβ group and the sham group. The spatial learning and memory capability of the rats were tested by Morris water maze. Bielschowsky's silver staining, Nissl's staining, choline acetyltransferase (ChAT) and glial-fibrillary-acidic protein (GFAP) immunohistochemistry of the hippocampus were conducted for histologic analysis. Results show in the Morris water maze task, rats in the Aβ+100μA and the Aβ+200μA tDCS groups had shorter escape latency and larger number of crossings on the platform. Significant histologic differences were observed in the Aβ+100μA and the Aβ+200μA tDCS groups compared to the Aβ group. The behavioral and the histological experiments indicate that the proposed repetitive anodal tDCS treatment can protect spatial learning and memory dysfunction of Aβ1-40-lesioned AD rats.

  5. A Novel Transcranial Magnetic Stimulator Inducing Near Rectangular Pulses with Controllable Pulse Width (cTMS)

    Science.gov (United States)

    Jalinous, Reza; Lisanby, Sarah H.

    2013-01-01

    A novel transcranial magnetic stimulation (TMS) device with controllable pulse width (PW) and near rectangular pulse shape (cTMS) is described. The cTMS device uses an insulated gate bipolar transistor (IGBT) with appropriate snubbers to switch coil currents up to 7 kA, enabling PW control from 5 μs to over 100 μs. The near-rectangular induced electric field pulses use 22–34% less energy and generate 67–72% less coil heating compared to matched conventional cosine pulses. CTMS is used to stimulate rhesus monkey motor cortex in vivo with PWs of 20 to 100 μs, demonstrating the expected decrease of threshold pulse amplitude with increasing PW. The technological solutions used in the cTMS prototype can expand functionality, and reduce power consumption and coil heating in TMS, enhancing its research and therapeutic applications. PMID:18232369

  6. Effects of transcranial magnetic stimulation during voluntary and non-voluntary stepping movements in humans.

    Science.gov (United States)

    Solopova, I A; Selionov, V A; Kazennikov, O V; Ivanenko, Y P

    2014-09-05

    Here, we compared motor evoked potentials (MEP) in response to transcranial magnetic stimulation of the motor cortex and the H-reflex during voluntary and vibration-induced air-stepping movements in humans. Both the MEPs (in mm biceps femoris, rectus femoris and tibialis anterior) and H-reflex (in m soleus) were significantly smaller during vibration-induced cyclic leg movements at matched amplitudes of angular motion and muscle activity. These findings highlight differences between voluntary and non-voluntary activation of the spinal pattern generator circuitry in humans, presumably due to an extra facilitatory effect of voluntary control/triggering of stepping on spinal motoneurons and interneurons. The results support the idea of active engagement of supraspinal motor areas in developing central pattern generator-modulating therapies. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. An Ethics Perspective on Transcranial Magnetic Stimulation (TMS and Human Neuromodulation

    Directory of Open Access Journals (Sweden)

    Judy Illes

    2006-01-01

    Full Text Available This paper concerns the ethics of human neuromodulation using transcranial magnetic stimulation (TMS. We examine the challenges of modulating the brain with TMS through the research ethics lens and in clinical medicine for treating frank pathology, primarily in psychiatric diseases. We also consider contemporary issues raised in the neuroethics literature about managing unexpected findings, and relate these to TMS and to other frontier neurotechnology that is becoming openly available in the public domain. We argue that safety and informed consent are of paramount importance for TMS, but that personal values and sociocultural factors must also be considered when examining the promise of this technology and applications that ought to be highlighted for extra precautions.

  8. Detailed 3D models of the induced electric field of transcranial magnetic stimulation coils

    Energy Technology Data Exchange (ETDEWEB)

    Salinas, F S; Lancaster, J L; Fox, P T [Research Imaging Center, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229 (United States)

    2007-05-21

    Previous models neglected contributions from current elements spanning the full geometric extent of wires in transcranial magnetic stimulation (TMS) coils. A detailed account of TMS coil wiring geometry is shown to provide significant improvements in the accuracy of electric field (E-field) models. Modeling E-field dependence based on the TMS coil's wire width, height, shape and number of turns clearly improved the fit of calculated-to-measured E-fields near the coil body. Detailed E-field models were accurate up to the surface of the coil body (within 0.5% of measured) where simple models were often inadequate (up to 32% different from measured)

  9. Suppression of EMG activity by transcranial magnetic stimulation in human subjects during walking

    DEFF Research Database (Denmark)

    Petersen, Nicolas Caesar; Butler, Jane E; Marchand-Pauvert, Veronique

    2001-01-01

    1. The involvement of the motor cortex during human walking was evaluated using transcranial magnetic stimulation (TMS) of the motor cortex at a variety of intensities. Recordings of EMG activity in tibialis anterior (TA) and soleus muscles during walking were rectified and averaged. 2. TMS of low...... intensity (below threshold for a motor-evoked potential, MEP) produced a suppression of ongoing EMG activity during walking. The average latency for this suppression was 40.0 +/- 1.0 ms. At slightly higher intensities of stimulation there was a facilitation of the EMG activity with an average latency of 29.......5 +/- 1.0 ms. As the intensity of the stimulation was increased the facilitation increased in size and eventually a MEP was clear in individual sweeps. 3. In three subjects TMS was replaced by electrical stimulation over the motor cortex. Just below MEP threshold there was a clear facilitation at short...

  10. Dorsolateral prefrontal cortex, working memory and episodic memory processes: insight through transcranial magnetic stimulation techniques

    Institute of Scientific and Technical Information of China (English)

    Michela Balconi

    2013-01-01

    The ability to recall and recognize facts we experienced in the past is based on a complex mechanism in which several cerebral regions are implicated.Neuroimaging and lesion studies agree in identifying the frontal lobe as a crucial structure for memory processes,and in particular for working memory and episodic memory and their relationships.Furthermore,with the introduction of transcranial magnetic stimulation (TMS) a new way was proposed to investigate the relationships between brain correlates,memory functions and behavior.The aim of this review is to present the main findings that have emerged from experiments which used the TMS technique for memory analysis.They mainly focused on the role of the dorsolateral prefrontal cortex in memory process.Furthermore,we present state-of-the-art evidence supporting a possible use of TMS in the clinic.Specifically we focus on the treatment of memory deficits in depression and anxiety disorders.

  11. Transcranial magnetic stimulation reveals complex cognitive control representations in the rostral frontal cortex.

    Science.gov (United States)

    Bahlmann, J; Beckmann, I; Kuhlemann, I; Schweikard, A; Münte, T F