H-coil repetitive transcranial magnetic stimulation for treatment resistant major depressive disorder: An 18-week continuation safety and feasibility study

Harel, Eiran Vadim; Rabany, Liron; Deutsch, Lisa; Bloch, Yuval; Zangen, Abraham; Levkovitz, Yechiel

doi:10.3109/15622975.2011.639802

Cited by 80 publications

(49 citation statements)

References 25 publications

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“…There are studies targeting nonconventional brain regions such as deeper brain regions and hippocampus-related structures [36,54,59] and anterior middle frontal gyrus [28,44] associated with positive results both in terms of general depressive symptoms and neurocognitive improvements.…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, the stimulation of deeper brain regions has been associated with rapid (4 weeks of treatment) and prolonged (18 weeks of treatment) antidepressive effects [59]; the stimulation of hippocampus-related structures (e.g. amygdala) has been linked with enhanced neurogenesis and neuronal plasticity together with increased antidepressant response in patients with TRD [36], whereas the stimulation of the anterior portion of the left middle frontal gyrus has been proposed as an alternative rTMS target associated with cognitive improvements that may be assessed using Trail Making Test B [28].…”

Section: Discussionmentioning

confidence: 99%

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The Effects of Repetitive Transcranial Magnetic Stimulation on Cognitive Performance in Treatment-Resistant Depression. A Systematic Review

et al. 2015

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Background: Major depressive disorder (MDD) is a disabling illness associated with significant functional and psychosocial impairment. Although many psychopharmacological agents are currently available for its treatment, many MDD patients suffer from treatment-resistant depression (TRD). Methods: A systematic review of the current literature (Pubmed/Medline, Scopus and ScienceDirect search) has been conducted with the primary aim to investigate the role of repetitive transcranial magnetic stimulation (rTMS) in improving neurocognition in patients with TRD. Studies were included according to the following criteria: (a) being an original paper in a peer-reviewed journal and (b) having analyzed the effect of rTMS on neurocognitive functioning in TRD. Results: The combined search strategy yielded a total of 91 articles, of which, after a complete analysis, 22 fulfilled our inclusion criteria. Based on the main findings, most of the selected studies suggested the existence of a trend towards improvements in the neurocognitive profile using rTMS. Negative findings have also been reported. However, most studies were limited by their small sample size or included mixed samples, or the adopted single-blind designs potentially biased the blinding of the study design. Conclusion: rTMS is a noninvasive brain stimulation that may be considered a valuable and promising technique for cognitive enhancement in TRD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Effects of Repetitive Transcranial Magnetic Stimulation on Cognitive Performance in Treatment-Resistant Depression. A Systematic Review

et al. 2015

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“…Additionally, higher PFC stimulation frequencies are common in therapeutic studies [3,17,36,37,38,39,40,41]. Therefore, we adjusted the established subthreshold 5-Hz protocol for the MC [34,35] while stimulating the PFC, in order to ensure expected biological effects.…”

Section: Discussionmentioning

confidence: 99%

“…PFC treatment with the H-coil has been shown to be effective in the treatment of major depressive disorder [3,36,37,38,39,40,41], and BDNF has been proposed firstly as a crucial mediator of neuronal plasticity and neurogenesis and secondly as a key player in the pathology of depression [46,47]. …”

Section: Discussionmentioning

confidence: 99%

Effects of Deep Repetitive Transcranial Magnetic Stimulation on Brain-Derived Neurotrophic Factor Serum Concentration in Healthy Volunteers

Gaede

Hellweg²,

Zimmermann³

et al. 2014

Neuropsychobiology

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Objective: Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive, safe and efficacious technique for treating various neuropsychiatric disorders, but its underlying mechanisms are poorly understood. A newly developed H-coil allows the stimulation of deeper brain regions. This study is the first to investigate the effects of deep high-frequency rTMS on brain-derived neurotrophic factor (BDNF) serum concentrations in healthy volunteers. We aimed to evaluate the short-term effect of deep rTMS on BDNF serum concentrations. Methods: This was a double-blind, randomized deep high-frequency rTMS study using an H-coil on a cohort of 13 healthy volunteers (NCT01106365). The following stimulation protocols were applied: 18-Hz stimulation of the left dorsolateral prefrontal cortex (PFC), 5-Hz stimulation of the primary motor cortex (MC) and sham stimulation in random order. Blood samples were obtained before, 30 min after and 60 min after each treatment. Results: The BDNF serum concentration decreased significantly after MC and PFC stimulation, but not after sham stimulation. Furthermore, BDNF serum level changes were associated with changes in individual alertness. Conclusion: Although BDNF serum concentrations do not necessarily correlate with BDNF levels in the cerebrospinal fluid or the brain, these results indicate an acute biological effect of deep rTMS on BDNF release, and demonstrate that this change correlates with alertness.

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“…[8][9][10] But it is not clear that the focal nature of Figure-8 coils is what makes them effective at treating depression, because the H-Coil, which allows for deeper and less focal stimulation of the brain, has also proven to be effective at treating depression. 11 In neurotherapeutics, the ideal stimulation site for TMS is unknown and will likely prove to be dependent on the nature of the disease to be treated and also potentially the subject. TMS is still a relatively new technique and there is much that needs to be tested before researchers develop an understanding of what the ideal stimulation parameters are.…”

Section: Introductionmentioning

confidence: 99%

Transcranial Magnetic Stimulation-coil design with improved focality

et al. 2016

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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.

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H-coil repetitive transcranial magnetic stimulation for treatment resistant major depressive disorder: An 18-week continuation safety and feasibility study

Abstract: The results suggest that H-coil deep-TMS administered continuation treatment can help maintain an antidepressant effect for 18 weeks, following 4 weeks of acute treatment.

Cited by 80 publications

References 25 publications

The Effects of Repetitive Transcranial Magnetic Stimulation on Cognitive Performance in Treatment-Resistant Depression. A Systematic Review

The Effects of Repetitive Transcranial Magnetic Stimulation on Cognitive Performance in Treatment-Resistant Depression. A Systematic Review

Effects of Deep Repetitive Transcranial Magnetic Stimulation on Brain-Derived Neurotrophic Factor Serum Concentration in Healthy Volunteers

Transcranial Magnetic Stimulation-coil design with improved focality

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