Recommandations françaises sur l’utilisation de la stimulation magnétique transcrânienne répétitive (rTMS) : règles de sécurité et indications thérapeutiques

Lefaucheur, J.-P.; Obadia, Nathalie; Poulet, Emmanuel; Devanne, H.; Haffen, Emmanuel; Londero, Alain; Crétin, Benjamin; Leroi, Anne‐Marie; Radtchenko, A.; Saba, Ghassen; Thai-Van, Hung; Litré, Claude Fabien; Vercueil, Laurent; Bouhassira, Didier; Ayache, Samar S.; Farhat, Wassim H.; Zouari, Héla; Mylius, Veit; Nicolier, Magali; Garcia-Larrea, Luis

doi:10.1016/j.neucli.2011.10.062

Cited by 108 publications

(40 citation statements)

References 412 publications

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“…It should also be noted historically that the seizure events that have been reported in TMS history have been frequently associated with secondary causes such as medications, past medical history, environmental factors, outside of the TMS alone. In fact, according to recent rTMS guidelines by Lefaucheur et al (2011), most of the reports in the literature were secondary to parameters that did not previous recommendations or concomitant use of medications that lowered the seizure threshold. However, for the sake of prudence, seizures should continue to be kept high on the differential of concerns when discussing safety.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review of Parameters of Stimulation, Clinical Trial Design Characteristics, and Motor Outcomes in Non-Invasive Brain Stimulation in Stroke

Adeyemo¹,

Simis²,

Macea³

et al. 2012

Front. Psychiatry

133

115

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Introduction/Objectives: Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation are two powerful non-invasive neuromodulatory therapies that have the potential to alter and evaluate the integrity of the corticospinal tract. Moreover, recent evidence has shown that brain stimulation might be beneficial in stroke recovery. Therefore, investigating and investing in innovative therapies that may improve neurorehabilitative stroke recovery are next steps in research and development. Participants/Materials and Methods: This article presents an up-to-date systematic review of the treatment effects of rTMS and tDCS on motor function. A literary search was conducted, utilizing search terms “stroke” and “transcranial stimulation.” Items were excluded if they failed to: (1) include stroke patients, (2) study motor outcomes, or (3) include rTMS/tDCS as treatments. Other exclusions included: (1) reviews, editorials, and letters, (2) animal or pediatric populations, (3) case reports or sample sizes ≤2 patients, and (4) primary outcomes of dysphagia, dysarthria, neglect, or swallowing. Results: Investigation of PubMed English Database prior to 01/01/2012 produced 695 applicable results. Studies were excluded based on the aforementioned criteria, resulting in 50 remaining studies. They included 1314 participants (1282 stroke patients and 32 healthy subjects) evaluated by motor function pre- and post-tDCS or rTMS. Heterogeneity among studies’ motor assessments was high and could not be accounted for by individual comparison. Pooled effect sizes for the impact of post-treatment improvement revealed consistently demonstrable improvements after tDCS and rTMS therapeutic stimulation. Most studies provided limited follow-up for long-term effects. Conclusion: It is apparent from the available studies that non-invasive stimulation may enhance motor recovery and may lead to clinically meaningful functional improvements in the stroke population. Only mild to no adverse events have been reported. Though results have been positive results, the large heterogeneity across articles precludes firm conclusions.

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Section: Discussionmentioning

confidence: 99%

Systematic Review of Parameters of Stimulation, Clinical Trial Design Characteristics, and Motor Outcomes in Non-Invasive Brain Stimulation in Stroke

Adeyemo¹,

Simis²,

Macea³

et al. 2012

Front. Psychiatry

133

115

View full text Add to dashboard Cite

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“…As an increase in FDI EMG activity during SMA conditioning could be due to spread of stimulation over M1, suggestive impending seizure [47], [48], the FDI electromyogram was therefore monitored during rTMS sessions as a precaution.…”

Section: Methodsmentioning

confidence: 99%

The Supplementary Motor Area Exerts a Tonic Excitatory Influence on Corticospinal Projections to Phrenic Motoneurons in Awake Humans

et al. 2013

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IntroductionIn humans, cortical mechanisms can interfere with autonomic breathing. Respiratory-related activation of the supplementary motor area (SMA) has been documented during voluntary breathing and in response to inspiratory constraints. The SMA could therefore participate in the increased resting state of the respiratory motor system during wake (i.e. "wakefulness drive to breathe").MethodsThe SMA was conditioned by continuous theta burst magnetic stimulation (cTBS, inhibitory) and 5 Hz conventional rTMS (5 Hz, excitatory). The ensuing effects were described in terms of the diaphragm motor evoked response (DiMEPs) to single-pulse transcranial magnetic stimulation over the motor cortex. DiMEPs were recorded at baseline, and at 3 time-points ("post1", "post2", "post3") up to 15 minutes following conditioning of the SMA.ResultscTBS reduced the amplitude of DiMEPs from 327.5±159.8 µV at baseline to 243.3±118.7 µV, 217.8±102.9 µV and 240.6±123.9 µV at post 1, post 2 and post 3, respectively (F = 6.341, p = 0.002). 5 Hz conditioning increased the amplitude of DiMEPs from 184.7±96.5 µV at baseline to 270.7±135.4 µV at post 3 (F = 4.844, p = 0.009).ConclusionsThe corticospinal pathway to the diaphragm can be modulated in both directions by conditioning the SMA. This suggests that the baseline respiratory activity of the SMA represents an equipoise from which it is possible to move in either direction. The resting corticofugal outflow from the SMA to phrenic motoneurones that this study evidences could putatively contribute to the wakefulness drive to breathe.

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“…From a safety perspective, rTMS can rarely induce accidental seizures, especially among patients with brain insult and on medications that reduce seizure threshold. However, this major side effect could be curtailed if expert guidelines are followed 53,54. Over the past 10 years, a number of meta-analyses of rTMS efficacy studies were conducted and the summary of these studies is as follows: a minimum of five to a maximum of 33 studies included; almost all included studies except one focused on depression rather than TRD; rTMS was more effective than sham rTMS; quality of studies improved successively; and rTMS designs also improved and effect size of rTMS was comparable to antidepressant drugs 55–60.…”

Section: Repetitive Transcranial Magnetic Stimulationmentioning

confidence: 99%

Neuromodulation therapies and treatment-resistant depression

Alharbi¹,

Qureshi²

2012

MDER

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BackgroundPatients with treatment-resistant depression (TRD) who showed partial response to pharmacological and psychotherapeutic interventions need a trial of neuromodulation therapies (NTs).ObjectiveThis paper aims to review evidence-based data on the use of NTs in TRD.MethodUsing keywords and combined-word strategy, multiple computer searches of PubMed, Google Scholar, Quertle(R), and Medline were conducted for retrieving relevant articles published in English-language peer-reviewed journals (2000–2012). Those papers that addressed NTs in TRD were retained for extensive review.ResultsDespite methodological challenges, a range of 30%–93% of TRD patients showed substantial improvement to one of the NTs. One hundred–percent improvement was reported in two single-case studies on deep brain stimulation. Some studies reported no benefits from transcranial direct current stimulation. NTs were reported to have good clinical efficacy, better safety margin, and benign side-effect profile. Data are limited regarding randomized clinical trials, long-term efficacy, and cost-effectiveness of these approaches. Both modified electroconvulsive therapy and magnetic seizure therapy were associated with reversible but disturbing neurocognitive adverse effects. Besides clinical utility, NTs including approaches on the horizon may unlock the biological basis underlying mood disorders including TRD.ConclusionNTs are promising in patients with TRD, as the majority of them show good clinical response measured by standardized depression scales. NTs need further technological refinements and optimization together with continuing well-designed studies that recruit larger numbers of participants with TRD.

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Recommandations françaises sur l’utilisation de la stimulation magnétique transcrânienne répétitive (rTMS) : règles de sécurité et indications thérapeutiques

Cited by 108 publications

References 412 publications

Systematic Review of Parameters of Stimulation, Clinical Trial Design Characteristics, and Motor Outcomes in Non-Invasive Brain Stimulation in Stroke

Systematic Review of Parameters of Stimulation, Clinical Trial Design Characteristics, and Motor Outcomes in Non-Invasive Brain Stimulation in Stroke

The Supplementary Motor Area Exerts a Tonic Excitatory Influence on Corticospinal Projections to Phrenic Motoneurons in Awake Humans

Neuromodulation therapies and treatment-resistant depression

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