Inter-hemispheric asymmetry of motor corticospinal excitability in major depression studied by transcranial magnetic stimulation

Lefaucheur, J.-P.; Lucas, Bart; Andraud, Fabien; Hogrel, Jean‐Yves; Bellivier, Frank; Cul, Antoine Del; Rousseva, Angela; Leboyer, Marion; Paillère-Martinot, M.L.

doi:10.1016/j.jpsychires.2007.03.001

Cited by 85 publications

(77 citation statements)

References 55 publications

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“…Furthermore, resting motor threshold in the left hemisphere in patients with major depression has been reported as higher than in the left hemisphere in healthy controls in the same study. Our study confirms the results of Lefaucheur et al [59], having found in our whole sample of depressed patients a baseline resting motor threshold in the left hemisphere higher than in the right hemisphere. But when we divide the whole sample of depressed patients in responders and in nonresponders, only in the nonresponders is the resting motor threshold in the left hemisphere higher than in the right hemisphere.…”

Section: Discussionsupporting

confidence: 93%

“…Otherwise the relation between hemispheres might be relevant. In fact, Lefaucheur et al [59] showed that in healthy controls resting motor threshold in the left hemisphere is lower than in the right hemisphere and in patients with major depression resting motor threshold in the left hemisphere is higher than in the right hemisphere. Furthermore, resting motor threshold in the left hemisphere in patients with major depression has been reported as higher than in the left hemisphere in healthy controls in the same study.…”

Section: Discussionmentioning

confidence: 99%

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Low-Frequency rTMS over Right Dorsolateral Prefrontal Cortex in the Treatment of Resistant Depression: Cognitive Improvement Is Independent from Clinical Response, Resting Motor Threshold Is Related to Clinical Response

et al. 2012

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Background: Clinical studies have shown that repetitive transcranial magnetic stimulation (rTMS) is effective in a certain percentage of treatment-resistant depression (TRD). The left dorsolateral prefrontal cortex (DLPFC) 10 Hz rTMS stimulation received FDA approval in 2008, although different rTMS protocols have also shown their effectiveness in reducing depressive symptoms. We investigated the clinical, cognitive and neurophysiologic effects of a 3 weeks’ protocol of low-frequency rTMS applied over the right DLPFC in resistant depression. Methods: Twenty-eight patients with TRD (age range 28–55) received low-frequency rTMS (1 Hz) over the right DLPFC in a 3-week open trial. Hamilton scales for depression and anxiety, Corsi block-tapping test, phonemic verbal fluency, right and left resting motor thresholds were evaluated in each subject over the trial period. Results: At the end of the trial 42.9% of the subjects were considered as responders. A significant reduction of both HAMD (p < 0.001) and HAMA (p < 0.01) total scores was observed. At the 3rd week, the performances in Corsi test (p < 0.02) and phonemic verbal fluency (p = 0.065) were improved independently from depressive symptoms variation. At the end of the rTMS protocol, a significantly decreased left hemisphere resting motor threshold was registered (p < 0.01), while right hemisphere resting motor threshold did not show significant variation. Conclusion: Low-frequency rTMS over the right DLPFC appeared effective in 42.9% of depressive resistant subjects in this sample. A significant decrease in left hemisphere resting motor threshold was observed only in responders, while a trend for improvement in cognitive function has been found and appeared independent from clinical response.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Low-Frequency rTMS over Right Dorsolateral Prefrontal Cortex in the Treatment of Resistant Depression: Cognitive Improvement Is Independent from Clinical Response, Resting Motor Threshold Is Related to Clinical Response

et al. 2012

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“…Our findings of increased RMT and decreased SICI in the left hemisphere of OCD patients with comorbid MDD but not in OCD patients without comorbid MDD are in line with previous studies that have demonstrated increased RMT and SICI deficits in patients with MDD (Lefaucheur et al, 2008;Levinson et al, 2010), and suggest a more marked GABAergic deficit in this population. The fact that OCD patients with comorbid MDD also appeared to demonstrate larger CSP deficits and excessive ICF compared with OCD patients without comorbid MDD, albeit not significantly so, further confirms this finding.…”

Section: Discussionsupporting

confidence: 92%

Evidence for Cortical Inhibitory and Excitatory Dysfunction in Obsessive Compulsive Disorder

Richter

Jesus

Hoppenbrouwers

et al. 2011

Neuropsychopharmacol

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Several lines of evidence suggest that obsessive-compulsive disorder (OCD) is associated with an inability to inhibit unwanted intrusive thoughts. The neurophysiological mechanisms mediating such inhibitory deficits include abnormalities in cortical g-aminobutyric acid (GABA) inhibitory as well as N-methyl-D-aspartate (NMDA) receptor-mediated mechanisms. Molecular evidence suggests that both these neurotransmitter systems are involved in OCD. Transcranial magnetic stimulation (TMS) represents a noninvasive technique to ascertain neurophysiological indices of inhibitory GABA and facilitatory NMDA receptor-mediated mechanisms. In this study, both mechanisms were indexed in 34 patients with OCD (23 unmedicated and 11 medicated) and compared with 34 healthy subjects. Cortical inhibitory and facilitatory neurotransmission was measured using TMS paradigms known as short-interval cortical inhibition (SICI), cortical silent period (CSP), and intracortical facilitation (ICF). Patients with OCD demonstrated significantly shortened CSP (po0.001, Cohen's d ¼ 0.91) and increased ICF (po0.009, Cohen's d ¼ 0.71) compared with healthy subjects. By contrast, there were no significant deficits in SICI. After excluding patients with OCD and comorbid major depressive disorder (MDD) from the analysis, these differences remained significant. Our findings suggest that OCD is associated with dysregulation in cortical inhibitory and facilitatory neurotransmission. Specifically, these findings suggest impairments in GABA B receptor-mediated and NMDA receptor-mediated neurotransmission. These findings are consistent with previously published genetic studies implicating GABA B , and NMDA transporter and receptor genes in OCD. It is posited that dysregulation of such mechanisms may lead to the generation and persistence of intrusive thoughts that form the basis for this disorder.

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“…They found reduced short interval cortical inhibition and cortical silent periods in patients with MDD, consistent with the hypothesis of deficient GABAergic tone in depressed patients. Similarly, Lefaucheur and colleagues 68 demonstrated that patients with MDD showed a reduced excitability of both excitatory (resting motor threshold, intracortical facilitation) and inhibitory (cortical silent period, short interval cortical inhibition) processes in the left hemisphere compared with healthy controls. More recently, Levinson and colleagues 69 examined cortical inhibition in 25 medicated individuals with treatment-resistant depression, 19 medicated euthymic partcipants, 16 unmedicated depressed patients and 25 healthy controls and found that all patients with MDD, regardless of symptom or medication state, demonstrated significant cortical silent period deficits compared with healthy participants.…”

Section: Major Depressive Disordermentioning

confidence: 86%

Inhibition of the cortex using transcranial magnetic stimulation in psychiatric populations: current and future directions

Radhu

Ravindran

Levinson

et al. 2012

J Psychiatry Neurosci

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Inter-hemispheric asymmetry of motor corticospinal excitability in major depression studied by transcranial magnetic stimulation

Cited by 85 publications

References 55 publications

Low-Frequency rTMS over Right Dorsolateral Prefrontal Cortex in the Treatment of Resistant Depression: Cognitive Improvement Is Independent from Clinical Response, Resting Motor Threshold Is Related to Clinical Response

Low-Frequency rTMS over Right Dorsolateral Prefrontal Cortex in the Treatment of Resistant Depression: Cognitive Improvement Is Independent from Clinical Response, Resting Motor Threshold Is Related to Clinical Response

Evidence for Cortical Inhibitory and Excitatory Dysfunction in Obsessive Compulsive Disorder

Inhibition of the cortex using transcranial magnetic stimulation in psychiatric populations: current and future directions

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