Effects of cerebellar magnetic stimulation on chronic post-lateral medullary infarction dizziness: A proof-of-principle cohort study

Johkura, Ken; Kudo, Yoshihisa; Sugawara, Eriko; Watanabe, Kosuke; Nakamizo, Tomoki; Yamamoto, Masahiro; Amari, Kazumitsu; Koji, Takahashi; Tanaka, Osamu

doi:10.1016/j.jns.2018.07.007

Cited by 10 publications

(13 citation statements)

References 27 publications

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“…60 None reported estimating the SI based on muscles of the lower limb, as has been considered in other instances (eg, when targeting regions that are more distant from the skull than motor areas of the upper limb 107 ). Furthermore, all but 3 studies 81,82,86 stimulated participants with flat figure-of-eight coils of varying diameters. Only these used angled coil configurations.…”

Section: Discussionmentioning

confidence: 99%

“…In 1 study, the SI was increased to 90% of MT 55 because of an observed lack of efficacy at 80% of MT. More vigorous dosages were used in 5 studies 45,52,61,65,91 with 100% of the AMT and 9 other studies 33,56,69,72,73,75,77,81,84 with the RMT as a reference measure. One experiment used 70% of the RMT, 75 4 used 80%, 56,77,81,84 , 1 used 90%, 33 and 3 more used 100%.…”

Section: Simentioning

confidence: 99%

“…All but 1 study used coils configured as a figure-ofeight. This study 81 used a double-cone coil. In this architecture, series of windings are laid concentrically, gradually decreasing in diameter and adding to the depth of the structure to form a cone.…”

Section: Tms Coilmentioning

confidence: 99%

“…69,72,73 Patient withdrawals (n ¼ 6) were reported in 4 studies. 52,55,75,81 One administered cTBS and iTBS in different sessions to the lateral cerebellum of 17 patients with Parkinson disease. The SI was 70% RMT, with patient RMTs ranging from 34% to 60% (ie, Sis of 23%e42% MSO).…”

Section: Populationmentioning

confidence: 99%

“…One participant with a diagnosis of stroke withdrew after all stimulation sessions, alluding uncomfortable neck muscle contractions. 81 In addition, 1 healthy participant withdrew from a study after receiving iTBS at 100% AMT to the vermis, 52 citing nausea.…”

Section: Populationmentioning

confidence: 99%

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Safety Considerations for Cerebellar Theta Burst Stimulation

Hurtado-Puerto

Nestor

Eldaief

et al. 2020

Clinical Therapeutics

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Purpose: The cerebellum is an intricate neural structure that orchestrates various cognitive and behavioral functions. In recent years, there has been an increasing interest in neuromodulation of the cerebellum with transcranial magnetic stimulation (TMS) for therapeutic and basic science applications. Theta burst stimulation (TBS) is an efficient and powerful TMS protocol that is able to induce longerlasting effects with shorter stimulation times compared with traditional TMS. Parameters for cerebellar TBS are traditionally framed in the bounds of TBS to the cerebral cortex, even when the 2 have distinct histologic, anatomical, and functional characteristics. Tolerability limits have not been systematically explored in the literature for this specific application. Therefore, we aimed to determine the stimulation parameters that have been used for cerebellar. TBS to date and evaluate adverse events and adverse effects related to stimulation parameters.Methods: We used PubMed to perform a critical review of the literature based on a systematic review of original research studies published between September 2008 and November 2019 that reported on cerebellar TBS. We recovered information from these publications and communication with authors about the stimulation parameters used and the occurrence of adverse events.Findings: We identified 61 research articles on interventions of TBS to the cerebellum. These articles described 3176 active sessions of cerebellar TBS in 1203 individuals, including healthy participants and patients with various neurologic conditions, including 2020 Elsevier HS Journals, Inc.

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Section: Discussionmentioning

confidence: 99%

Section: Simentioning

confidence: 99%

Section: Tms Coilmentioning

confidence: 99%

Section: Populationmentioning

confidence: 99%

Section: Populationmentioning

confidence: 99%

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Safety Considerations for Cerebellar Theta Burst Stimulation

Hurtado-Puerto

Nestor

Eldaief

et al. 2020

Clinical Therapeutics

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Cerebral perfusion changes in chronic dizziness: A single-photon emission computed tomography study

et al. 2021

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Background and purpose Dizziness may persist even after the causative vestibular imbalance subsides. Although the precise mechanism of chronic dizziness is unknown, various cerebral activity changes associated with it have been reported. To understand its mechanism in the absence of the causative vestibular imbalance, we compared cerebral changes in chronic dizziness with and without persistent vestibular imbalance. Methods Between September 2014 and March 2020, we examined regional cerebral blood flow (rCBF) in 12 patients having chronic post-lateral medullary infarction dizziness with persistent brainstem vestibular imbalance and 23 patients having chronic dizziness without currently active vestibular imbalance using single-photon emission computed tomography (SPECT) with 99m Technetium-ethyl cysteinate dimer. Further, we analyzed the SPECT images using a voxel-based group comparison. Results We observed a decreased rCBF in the occipital lobe and increased rCBF in the medial and inferior parts of the temporal lobe in patients having chronic dizziness with and without active vestibular imbalance compared to healthy controls. However, only patients having chronic dizziness without active vestibular imbalance exhibited increased rCBF in the frontal lobe, including the orbitofrontal cortex. Conclusion This is the first study to highlight the difference in rCBF changes between patients having chronic dizziness with and without active vestibular imbalance. Decreased occipital lobe activity and increased medial and inferior temporal lobe activity may be related to keeping dizziness perception triggered regardless of the presence or absence of active vestibular imbalance, whereas increased frontal lobe activity may explain the dizziness background to persist after the disappearance of vestibular imbalance.

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