Neurobiological mechanisms of deep transcranial magnetic stimulation (dtms): a systematic review

Schmittwilken, Lynn; Schuchinsky, M.; Kedzior, Karina Karolina

doi:10.1016/j.brs.2017.01.123

Cited by 2 publications

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“…The non-invasive brain stimulation could be a viable alternative to pharmacotherapy in the short-term and/or could offer a longer-term relief from SUD although it may require some individualization of protocols and/or stimulation sites rather than the ‘one-size-fits-all’ approach [ 11 ]. In fact, the unique shape of the H-coil that delivers a broad cortical and presumably deeper, subcortical stimulation [ 12 , 37 ] may be particularly useful in the longer-term treatment of SUD [ 38 ]. Indeed, the current review shows that the effects of DTMS may last for up to 12 months after daily stimulation phases despite the absence of maintenance treatment.…”

Section: Discussionmentioning

confidence: 99%

Can deep transcranial magnetic stimulation (DTMS) be used to treat substance use disorders (SUD)? A systematic review

2018

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BackgroundDeep transcranial magnetic stimulation (DTMS) is a non-invasive method of stimulating widespread cortical areas and, presumably, deeper neural networks. The current study assessed the effects of DTMS in the treatment of substance use disorders (SUD) using a systematic review.MethodsElectronic literature search (PsycInfo, Medline until April 2017) identified k = 9 studies (k = 4 randomized-controlled trials, RCTs, with inactive sham and k = 5 open-label studies). DTMS was most commonly applied using high frequency/intensity (10–20 Hz/100–120% of the resting motor threshold, MT) protocols for 10–20 daily sessions in cases with alcohol, nicotine or cocaine use disorders. The outcome measures were craving and dependence (according to standardized scales) or consumption (frequency, abstinence or results of biological assays) at the end of the daily treatment phases and at the last follow-up.ResultsAcute and longer-term (6–12 months) reductions in alcohol craving were observed after 20 sessions (20 Hz, 120% MT) relative to baseline in k = 4 open-label studies with comorbid SUD and major depressive disorder (MDD). In k = 2 RCTs without MDD, alcohol consumption acutely decreased after 10–12 sessions (10–20 Hz, 100–120% MT) relative to baseline or to sham. Alcohol craving was reduced only after higher frequency/intensity DTMS (20 Hz, 120% MT) relative to sham in k = 1 RCT. Nicotine consumption was reduced and abstinence was increased after 13 sessions (10 Hz, 120% MT) and at the 6-month follow-up relative to sham in k = 1 RCT. Cocaine craving was reduced after 12 sessions (15 Hz, 100% MT) and at the 2-month follow-up relative to baseline in k = 1 open-label study while consumption was reduced after 12 sessions (10 Hz, 100% MT) relative to baseline but not to sham in k = 1 RCT.ConclusionsHigh-frequency DTMS may be effective at treating some SUD both acutely and in the longer-term. Large RCTs with inactive sham are required to determine the efficacy and the optimal stimulation parameters of DTMS for the treatment of SUD.

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Section: Discussionmentioning

confidence: 99%

Can deep transcranial magnetic stimulation (DTMS) be used to treat substance use disorders (SUD)? A systematic review

2018

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“…As in rTMS, further research is required to investigate the neurobiological mechanisms through which DTMS exerts its clinical effects (Schmittwilken et al, 2017; Ziemann, 2017). Modeling studies suggest that DTMS stimulates wider and possibly deeper, subcortical brain regions (Parazzini et al, 2017; Roth et al, 2014; Zangen et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

“…Such a broad stimulation may increase the electrical field in deeper, subcortical brain regions compared to the cortical stimulation achieved with F8-coils (Parazzini et al, 2017; Zangen et al, 2005). Although the depth of stimulation needs to be further investigated in head-to-head trials with similar stimulation protocols (Schmittwilken, Schuchinsky, & Kedzior, 2017), H1-coil provides a new alternative to the existing rTMS coils.…”

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confidence: 99%

An Update of a Meta-Analysis on the Clinical Outcomes of Deep Transcranial Magnetic Stimulation (DTMS) in Major Depressive Disorder (MDD)

Gellersen

Kedzior

2018

Zeitschrift für Psychologie

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Abstract. Deep transcranial magnetic stimulation (DTMS) is a noninvasive therapy for treatment-resistant major depressive disorder (MDD). The current study aimed to update a previous meta-analysis by investigating the acute and longer-term clinical outcomes of DTMS and their possible predictors (patient characteristics and stimulation parameters) in unipolar MDD. A systematic literature search identified 11 studies with 282 treatment-resistant, unipolar MDD patients. The clinical outcomes (depression severity, response and remission rates) were evaluated using random-effects meta-analyses. High frequency and intensity DTMS protocol with H1-coil had significant acute antidepressant outcomes and improved some cognitive functions after 20 daily sessions in unipolar MDD. Response rates tended to increase with lower severity of illness. Antidepressant effects were prolonged if maintenance DTMS was used after daily stimulation phases. DTMS consistently improves various symptom domains (antidepressant, cognitive) in treatment-resistant unipolar MDD.

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Neurobiological mechanisms of deep transcranial magnetic stimulation (dtms): a systematic review

Cited by 2 publications

References 0 publications

Can deep transcranial magnetic stimulation (DTMS) be used to treat substance use disorders (SUD)? A systematic review

Can deep transcranial magnetic stimulation (DTMS) be used to treat substance use disorders (SUD)? A systematic review

An Update of a Meta-Analysis on the Clinical Outcomes of Deep Transcranial Magnetic Stimulation (DTMS) in Major Depressive Disorder (MDD)

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