Preliminary evidence for a beneficial effect of low-frequency, repetitive transcranial magnetic stimulation in patients with major depression and schizophrenia

Feinsod, Moshé; Kreinin, B.; Chistyakov, Andrei V.; Klein, Ehud

doi:10.1002/(sici)1520-6394(1998)7:2<65::aid-da2>3.0.co;2-4

Cited by 119 publications

(36 citation statements)

References 11 publications

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“…Most studies have reported clinical success when applying excitatory stimuli to the left prefrontal cortex of depressed patients (19, 21, 22, 26-29, 33, 34, 36-39). A few have reported success when applying inhibitory stimuli to the opposite side (3,23,34). Speer et al (54) and Kimbrell et al (52) compared the effects of excitatory and inhibitory stimulation to the left prefrontal cortex with two interesting results.…”

Section: Pulse Frequency-slow Versus Fast Rtmsmentioning

confidence: 99%

Transcranial Magnetic Stimulation in the Treatment of Depression

Gershon

Dannon²,

Grunhaus³

2003

AJP

450

246

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Objective: Transcranial magnetic stimulation (TMS) is a noninvasive and easily tolerated method of altering cortical physiology. The authors evaluate evidence from the last decade supporting a possible role for TMS in the treatment of depression and explore clinical and technical considerations that might bear on treatment success. Method:The authors review English-language controlled studies of nonconvulsive TMS therapy for depression that appeared in the MEDLINE database through early 2002, as well as one study that was in press in 2002 and was published in 2003. In addition, the authors discuss studies that have examined technical, methodological, and clinical treatment parameters of TMS. Results:Most data support an antidepressant effect of high-frequency repetitive TMS administered to the left prefrontal cortex. The absence of psychosis, younger age, and certain brain physiologic markers might predict treatment success. Technical parameters possibly affecting treatment success include intensity and duration of treatment, but these suggestions require systematic testing.Conclusions: TMS shows promise as a novel antidepressant treatment. Systematic and large-scale studies are needed to identify patient populations most likely to benefit and treatment parameters most likely to produce success. In addition to its potential clinical role, TMS promises to provide insights into the pathophysiology of depression through research designs in which the ability of TMS to alter brain activity is coupled with functional neuroimaging. (Am J Psychiatry 2003; 160:835-845)In 1831, Michael Faraday discovered that electrical currents can be converted into magnetic fields and vice versa. His principle of mutual induction is the basis of transcranial magnetic stimulation (TMS). In TMS, a bank of capacitors is rapidly discharged into an electric coil to produce a magnetic field pulse (Figure 1). When the coil is placed near the head of a human or animal, the magnetic field penetrates the brain and induces an electric field in the underlying region of the cerebral cortex (4) (Figure 2). An electrical field of sufficient intensity will depolarize cortical neurons, generating action potentials. These then propagate to exert their biological effects. For example, TMS over the left motor cortex causes action potentials that propagate through the corticospinal tract, causing twitches in contralateral skeletal muscles.This new technology has been used to affect underlying brain tissue at several levels. First, TMS can alter regional activity within the cortex. Positron emission tomography (PET) has revealed changes in cortical metabolism and dose-dependent changes in regional cortical blood flow in response to TMS (5-7). Such changes are also observed at sites distant from the magnetic stimulus, showing that the effects of TMS propagate to other parts of the brain (6, 7). The connections demonstrated in this manner correspond to known neural pathways in nonhuman primates, suggesting that the propagation of TMS effects occurs by means of...

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Section: Pulse Frequency-slow Versus Fast Rtmsmentioning

confidence: 99%

Transcranial Magnetic Stimulation in the Treatment of Depression

Gershon

Dannon²,

Grunhaus³

2003

AJP

450

246

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“…The first of these took a conservative approach by using only 30 single rTMS pulses applied in a single treatment session and reporting the possibility of some short-lived therapeutic effects. 17 Feinsod et al 18 subsequently reported the results of a small open study where a significant decrease in BPRS scores was found after 10 sessions of 1-Hz stimulation applied to the right PFC. The authors described this reduction as being more in nonspecific symptoms, such as anxiety and tension, rather than the core symptoms of schizophrenia.…”

Section: Early General Studiesmentioning

confidence: 99%

“…Several studies have begun to use MRI-and fMRI-based techniques to potentially improve response to rTMS used for hallucination treatment. In the first of these, 18 12 patients received 1-week blocks of stimulation applied to either the superior temporal gyrus, Broca's area, or a control position in the occipital cortex. In one-half of these, positioning was based on fMRI activation and in the other one-half, on a structural MRI scan.…”

Section: Treatment Of Auditory Hallucinationsmentioning

confidence: 99%

A Review of Repetitive Transcranial Magnetic Stimulation Use in the Treatment of Schizophrenia

Fitzgerald

Daskalakis

2008

Can J Psychiatry

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D eveloped for various investigative and potential therapeutic purposes, rTMS is a relatively new technique. Its use in experimental settings is growing rapidly 1 and its potential as a treatment is being tested in numerous neurological and psychiatric conditions. Most research and interest has focused on the potential application of rTMS in the treatment of depression. In addition, in recent years an increasing number of open and double-blind studies of rTMS were conducted in patients with schizophrenia. However, owing to the complexity of this disorder, the development of therapeutic rTMS paradigms is problematic. At least partially in response to this, most investigators have chosen to focus on the treatment of specific refractory symptoms or syndromes within the disorder. We aim to review the current status of the development of the therapeutic applications of rTMS in the treatment of schizophrenia or its symptoms. Highlights • Low-frequency rTMS applied to the temporoparietal cortical region appears to be able to modulate the severity of auditory hallucinations. • Prefrontal rTMS has promise but requires further evaluation in the treatment of negative symptoms of schizophrenia. • rTMS can be safely used in patients with schizophrenia and warrants further investigation.

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“…TMS has been useful in the study of a growing list of neurologic and psychiatric disorders, including movement disorders [44][45][46][47], epilepsy [11,48,49], schizophrenia [50][51][52], and anxiety disorders [53][54][55][56][57]. As an interventional probe in neuropsychiatric disorders, rTMS has the potential o taking functional imaging one step further by elucidating causal relationships.…”

Section: Clinical Applicationsmentioning

confidence: 99%

Improvement of depression following transcranial magnetic stimulation

George

Nahas

Kozel

et al. 1999

Curr Psychiatry Rep

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Psychiatry as a field was transformed by the discovery and introduction of electroconvulsive therapy (ECT) as a treatment in the early part of this century. ECT demonstrated that depression was a disease of the brain and that it could be treated with a direct brain intervention. Psychiatry's evolution continued in 1958 with the discovery of the antidepressant activity of the monoamine oxidase inhibitors. Interestingly, although the area of neuropsychopharmacology has continued to advance, the realm of physical somatic interventions in psychiatry has lagged behind. With perhaps the exception of light therapy, there were no advances in somatic interventions in psychiatry. However, in 1985, Barker et al. developed a brief high intensity electromagnet capable of depolarizing cortical neurons, called transcranial magnetic stimulation (TMS). There has been much interest in the past 10 years in whether TMS might have antidepressant actions, similar to ECT but without causing a seizure and with no apparent cognitive side effects. This review examines the basic principles underlying TMS, and describes how TMS differs from electrical stimulation and the other uses of magnets.

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Preliminary evidence for a beneficial effect of low-frequency, repetitive transcranial magnetic stimulation in patients with major depression and schizophrenia

Cited by 119 publications

References 11 publications

Transcranial Magnetic Stimulation in the Treatment of Depression

Transcranial Magnetic Stimulation in the Treatment of Depression

A Review of Repetitive Transcranial Magnetic Stimulation Use in the Treatment of Schizophrenia

Improvement of depression following transcranial magnetic stimulation

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