Personalized TMS: role of RNA genotyping

Abstract

Purpose Noninvasive brain stimulation (NIBS) such a transcranial magnetic stimulation, intermittent theta burst stimulation, transcranial direct current stimulation and electroconvulsive therapy have emerged as an efficacious and well-tolerated therapy for treatment-resistant psychiatric disorders. While novel NIBS techniques are an exciting addition to the current repertoire of neuropsychiatric therapies, their success is somewhat limited by the wide range of treatment responses seen among treated patients. Design/methodology/approach In this study, the authors will review the studies on relevant genetic polymorphisms and discuss the role of RNA genotyping in personalizing NIBS. Findings Genome studies have revealed several genetic polymorphisms that may contribute for the heterogeneity of treatment response to NIBS where the presence of certain single nucleotide polymorphisms (SNPs) are associated with responders versus nonresponders. Originality/value Historically, mental illnesses have been arguably some of the most challenging disorders to study and to treat because of the degree of biological variability across affected individuals, the role of genetic and epigenetic modifications, the diversity of clinical symptomatology and presentations and the interplay with environmental factors. In lieu of these challenges, there has been a push for personalized medicine in psychiatry that aims to optimize treatment response based on one’s unique characteristics.

A single- and paired-pulse TMS-EEG investigation of the N100 and long interval cortical inhibition in autism spectrum disorder

“…When considering the application of TMS in the field of ASD, these factors are of particular importance as age (90), biological sex (91,92), and genetics (93,94) are all known to contribute to the vast heterogeneity of this condition. Notably, some of the genes known to affect the response to non-invasive brain stimulation, including TMS (95), are also implicated in ASD (96,97). More work in this domain is imperative.…”

Understanding the Regulation of Transcription in Mental Illness

“…Choosing patients more likely to respond to one selective serotonin reuptake inhibitor (SSRI) vs. another, based on polymorphisms in liver enzymes, can lead to considerable progress [11]. Similarly, choosing patients more likely to respond to specific protocols of transcranial magnetic stimulation (TMS) vs. cognitive behavioral therapy (CBT) can also lead to significant progress [12,13]. However, genome-wide association studies (GWAS) conducted to search for polymorphisms for explaining psychiatric diagnoses have disappointed many as the effect size is often small, and positive findings explain the effects in only a small proportion of the patients with the disease [14,15].…”

“…Moreover, a recent increase in the cases of mental illness has motivated investigators and clinicians to search for novel and efficacious treatments [1][2][3]. Innovation in genetic sequencing and personalized medicine is promising [12]. Another promising technique is the use of single-cell transcriptomics combined with systems biology to understand the pathophysiology underlying these diseases [21].…”