Augmentative Repetitive Transcranial Magnetic Stimulation (rTMS) in the Acute Treatment of Poor Responder Depressed Patients: A Comparison Study Between High and Low Frequency Stimulation

Dell’Osso, Bernardo; Oldani, Lucio; Camuri, G.; Dobrea, Cristina; Cremaschi, Laura; Benatti, Beatrice; Arici, C.; Grancini, Benedetta; Altamura, Alfredo Carlo

doi:10.1016/j.eurpsy.2014.12.001

Cited by 38 publications

(28 citation statements)

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“…These findings suggest that rTMS-induced modulation of dopaminergic networks may influence motor performance. The use of rTMS has highlighted the dysfunctional circuitry in depression, and rTMS may correct this abnormality and may alleviate depressive symptoms (Dell'Osso et al, 2015). Not all reports, however, have found patients with depression to be responsive to rTMS, In fact, in a double-blind controlled trial, rTMS was not significantly superior to sham rTMS for treatment-resistant depressed patients (Boutros et al, 2002).…”

Section: Tms-petmentioning

confidence: 99%

Contribution of transcranial magnetic stimulation to assessment of brain connectivity and networks

Hallett

Iorio

Rossini

et al. 2017

Clinical Neurophysiology

128

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The goal of this review is to show how transcranial magnetic stimulation (TMS) techniques can make a contribution to the study of brain networks. Brain networks are fundamental in understanding how the brain operates. Effects on remote areas can be directly observed or identified after a period of stimulation, and each section of this review will discuss one method. EEG analyzed following TMS is called TMS-evoked potentials (TEPs). A conditioning TMS can influence the effect of a test TMS given over the motor cortex. A disynaptic connection can be tested also by assessing the effect of a pre-conditioning stimulus on the conditioning-test pair. Basal ganglia-cortical relationships can be assessed using electrodes placed in the process of deep brain stimulation therapy. Cerebellar-cortical relationships can be determined using TMS over the cerebellum. Remote effects of TMS on the brain can be found as well using neuroimaging, including both positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). The methods complement each other since they give different views of brain networks, and it is often valuable to use more than one technique to achieve converging evidence. The final product of this type of work is to show how information is processed and transmitted in the brain.

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Section: Tms-petmentioning

confidence: 99%

Contribution of transcranial magnetic stimulation to assessment of brain connectivity and networks

Hallett

Iorio

Rossini

et al. 2017

Clinical Neurophysiology

128

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“…Yet, this caveat is not so much a limitation as a reflection on these studies' capacity to reflect "real-world" bipolar patients who may be interested in pursuing TMS treatment. Most notably, in three bipolar depression studies, patients experienced a switch into a manic episode either during or shortly after treatment (Dell'Osso et al, 2015;Dolberg, Schreiber, & Grunhaus, 2001) and, in one study, a patient with bipolar depression experienced transient hypomania after three weeks of left-sided, high-frequency rTMS (Hu et al, 2016). The most common mild side effects among the studies of TMS for bipolar depression were headaches and insomnia with other side effects including local pain at the site of administration, fatigue, memory difficulties, and dizziness (Dell'Osso et al, 2009Tamas et al, 2007;Tavares et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…Post-treatment, patients demonstrated significant improvements in symptoms of depression (as assessed via the HAM-D (Hamilton, 1960) and CGI) with no significant group differences in treatment efficacy or tolerability (Dell'Osso et al, 2015). Post-treatment, patients demonstrated significant improvements in symptoms of depression (as assessed via the HAM-D (Hamilton, 1960) and CGI) with no significant group differences in treatment efficacy or tolerability (Dell'Osso et al, 2015).…”

Section: Scores)mentioning

confidence: 98%

Clinical applications of transcranial magnetic stimulation in bipolar disorder

Gold

Ornelas²,

Cirillo³

et al. 2019

Brain and Behavior

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Background Many patients with bipolar disorder (BD) fail to experience benefit following traditional pharmacotherapy, necessitating alternative treatment options that will enable such patients to achieve remission. Transcranial magnetic stimulation (TMS) is a relatively new, noninvasive neuromodulation technique that involves the application of magnetic pulses on hyperactive or hypoactive cortical brain areas. We evaluated the existing literature on TMS as a treatment for BD across varied mood states. Methods We searched PubMed up to October 2018 for original data articles published in English that evaluated outcomes in a bipolar sample across depressive, manic, mixed, and maintenance phases of BD. Results Clinical trials of TMS for BD particularly suggest the potential of repetitive TMS for reducing depressive symptoms. Studies of TMS for mania have yielded more mixed findings. Few studies have evaluated TMS in other phases of the bipolar illness. TMS is generally associated with mild side effects though, in a few studies, it has been shown to contribute to a manic switch in previously depressed bipolar patients. Conclusions Transcranial magnetic stimulation is a promising approach for treating patients with BD who have failed to respond to pharmacological or psychosocial treatment. Future research should more clearly elucidate which TMS protocols may be most effective for a given bipolar patient.

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“…Limited literature compared those two protocols head-to-head. One study compared HF-TMS and LF-TMS in treatmentresistant unipolar and bipolar depression (62). No significant difference was reported between groups; however, the study was under-dosed and under-powered (N=33) in its three-arm design.…”

Section: Transcranial Magnetic Stimulation Tms In Major Depressive DImentioning

confidence: 99%

“…Available evidence supports efficacy of two TMS protocols in moderate MDD when given daily for 4 to 6 weeks using a figure 8 coil: (1) high-frequency TMS (HF-TMS) over the left dorsolateral prefrontal cortex (DLPFC), 3000 pulses per session (7,8), and (2) low-frequency TMS (LF-TMS) over the right DLPFC, more than 1200 pulses per session (7,62). Limited literature compared those two protocols head-to-head.…”

Section: Transcranial Magnetic Stimulation Tms In Major Depressive DImentioning

confidence: 99%

Recent Developments in Noninvasive Neuromodulation for Mood and Anxiety Disorders

Rakesh

Lisanby

2015

Curr Behav Neurosci Rep

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Noninvasive neuromodulation refers to a family of device-based interventions that apply electrical or magnetic fields, either at convulsive or subconvulsive levels, to the brain through the intact skull to modulate neural function. This is a rapidly evolving field, with new research emerging regarding the various roles that these devices can play both in studying the neural mechanisms underlying mood and anxiety disorders, and in treating pharmacoresistant conditions either on their own or in combination with other therapies. Each neuromodulation modality has its pros and cons and should be carefully chosen after weighing the risks and benefits. This manuscript reviews some of the most exciting developments in this field over the past year and emphasizes themes that are emerging as being important for these tools to fulfill their potential to transform how we study and treat mood and anxiety disorders. Key among these themes is the concept of how we understand the "dose" of the stimulation, and how exogenously applied fields interact with endogenous brain activity. Refining the concept of dose will ultimately be important in allowing clinicians and researchers to apply the procedure with precision to engage the targeted network to achieve the desired effects in each individual. The large parameter space defining dose of neuromodulation makes interpreting the literature on safety and efficacy challenging and highlights the need for clear and accurate reporting of the spatial, temporal, and contextual features of dosage to make the emerging literature base as informative as possible. Ultimately, the impact of noninvasive neuromodulation devices is potentially transformational given their utility in providing mechanistic insight into the circuitbased and oscillatory origins of mood and anxiety disorders, as well as providing therapeutic interventions rationally designed to target disease-related processes.

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Augmentative Repetitive Transcranial Magnetic Stimulation (rTMS) in the Acute Treatment of Poor Responder Depressed Patients: A Comparison Study Between High and Low Frequency Stimulation

Abstract: Augmentative rTMS appeared to be effective and well tolerated for the acute treatment of unipolar and bipolar depression with features of poor drug response/treatment resistance, showing a comparable effectiveness profile between protocols of high and low frequency stimulation.

Cited by 38 publications

References 50 publications

Contribution of transcranial magnetic stimulation to assessment of brain connectivity and networks

Contribution of transcranial magnetic stimulation to assessment of brain connectivity and networks

Clinical applications of transcranial magnetic stimulation in bipolar disorder

Recent Developments in Noninvasive Neuromodulation for Mood and Anxiety Disorders

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