rTMS and tDCS for the treatment of catatonia: A systematic review

Hansbauer, Maximilian; Wagner, Elias; Strube, Wolfgang; Röh, Astrid; Padberg, Frank; Keeser, Daniel; Falkai, Peter; Hasan, Alkomiet

doi:10.1016/j.schres.2020.05.028

Cited by 24 publications

(35 citation statements)

References 29 publications

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“…It remains to be seen whether novel interventional techniques may assist in more targeted treatments for catatonia such as repetitive transcranial magnetic stimulation (rTMS). This has already been published in several case reports (Kate 2011; Shiozawa 2013; Takamiya 2015) and represents an exciting prospect. The slow onset of efficacy means that its clinical use will likely be limited to patients unresponsive to benzodiazepines, or where ECT is either contraindicated or not available or where long-term maintenance treatment is required (Hansbauer 2020).…”

Section: Discussionmentioning

confidence: 70%

“…This has already been published in several case reports (Kate 2011; Shiozawa 2013; Takamiya 2015) and represents an exciting prospect. The slow onset of efficacy means that its clinical use will likely be limited to patients unresponsive to benzodiazepines, or where ECT is either contraindicated or not available or where long-term maintenance treatment is required (Hansbauer 2020). It may also enable a more in-depth understanding of the cortical and subcortical motor circuits that are implicated in the pathophysiology of this complex and potentially lifethreatening phenomenon.…”

Section: Immunomodulatory Therapy and Rtmsmentioning

confidence: 99%

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Are benzodiazepines effective in treating catatonia?

Carthy

2020

BJPsych advances

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SUMMARYEstablishing an evidence base for the clinical management of catatonia is made difficult by the heterogeneous nature of the condition and the limited understanding of its pathophysiology. Benzodiazepines are a mainstay of treatment. The Cochrane review discussed identified only one eligible study (17 participants with catatonia who received either lorazepam or oxazepam), which found no difference on the single outcome measure (a 50% improvement on a visual analogue scale). This commentary discusses the findings in more detail, and considers what constitutes high-quality evidence for the acute treatment of catatonia, why there is such a paucity of randomised controlled trials (RCTs) on the topic and whether RCTs are both feasible and appropriate for the condition.

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Section: Discussionmentioning

confidence: 70%

Section: Immunomodulatory Therapy and Rtmsmentioning

confidence: 99%

Are benzodiazepines effective in treating catatonia?

Carthy

2020

BJPsych advances

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“…Results were based on case reports and stimulation was applied to the DLPFC. The review concludes that both tDCS and rTMS may be beneficial in patients with catatonia that do not respond to benzodiazepines [103]. An overview of the investigated targets by means of TMS and tDCS in clinical settings can be found in Fig.…”

Section: Clinical Trialsmentioning

confidence: 99%

Using cortical non-invasive neuromodulation as a potential preventive treatment in schizophrenia - A review

2021

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Background: Evidence suggests that schizophrenia constitutes a neurodevelopmental disorder, characterized by a gradual emergence of behavioral and neurobiological abnormalities over time. Therefore, applying early interventions to prevent later manifestation of symptoms is appealing. Objective: This review focuses on the use of cortical neuromodulation in schizophrenia and its potential as a preventive treatment approach. We present clinical and preclinical findings investigating the use of neuromodulation in schizophrenia, including the current research focusing on cortical non-invasive stimulation and its possibility as a future preventive treatment. Methods: We performed a search in Medline (PubMed) in September 2020 using a combination of relevant medical subject headings (MeSH) and text words. The search included human and preclinical trials as well as existing systematic reviews and meta-analysis. There were no restrictions on language or the date of publication.Results: Neurodevelopmental animal models may be used to investigate how the disease progresses and thus which brain areas ideally should be targeted at a given time point. Here, abnormalities of the prefrontal cortex have been often identified as an early and persistent impairment in schizophrenia. Currently there is insufficient evidence to either support or refute the use of neuromodulation to the cortex in adult patients with already manifested symptoms. However, preclinical results show that early non-invasive neuromodulation to the prefrontal cortex of adolescent animals, sufficiently prevents later psychosis-relevant abnormalities in adulthood. This points to the promising potential of cortical noninvasive neuromodulation as a preventive treatment when applied early in the course of the disease. Conclusion: Preclinical translational-oriented findings indicate, that neuromodulation to cortical areas offers the possibility of targeting early neuropathology and through this diminish the progression of a later schizophrenic profile. Further studies are needed to investigate whether such early cortical stimulation may serve as a future preventive treatment in schizophrenia.

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“…Among the alternative treatments that have been investigated over the years ( 10 ), non-invasive brain stimulation techniques seem to be a promising approach despite the sparse evidence available. High frequency repetitive transcranial magnetic stimulation (rTMS) has been effective in eight published cases and failed in one case ( 11 , 12 ). The stimulation target was most frequently the left dorsolateral prefrontal cortex (DLPFC).…”

Section: Introductionmentioning

confidence: 99%

“…Thus, if tDCS applied as in Brunelin’s seminal study and in Valiengo’s study of one hundred patients can improve the negative symptoms of schizophrenia ( 13 , 18 ), it can be assumed that tDCS applied with the same frontotemporal montage could be effective in catatonia. Indeed, four cases of successful treatment by tDCS in catatonia have been published ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Transcranial Direct-Current Stimulation in Catatonia: A Review and Case Series

et al. 2022

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Catatonia is a severe neuropsychiatric syndrome, usually treated by benzodiazepines and electroconvulsive therapy. However, therapeutic alternatives are limited, which is particularly critical in situations of treatment resistance or when electroconvulsive therapy is not available. Transcranial direct-current stimulation (tDCS) is a promising non-invasive neuromodulatory technique that has shown efficacy in other psychiatric conditions. We present the largest case series of tDCS use in catatonia, consisting of eight patients in whom tDCS targeting the left dorsolateral prefrontal cortex and temporoparietal junction was employed. We used a General Linear Mixed Model to isolate the effect of tDCS from other confounding factors such as time (spontaneous evolution) or co-prescriptions. The results indicate that tDCS, in addition to symptomatic pharmacotherapies such as lorazepam, seems to effectively reduce catatonic symptoms. These results corroborate a synthesis of five previous case reports of catatonia treated by tDCS in the literature. However, the specific efficacy of tDCS in catatonia remains to be demonstrated in a randomized controlled trial. The development of therapeutic alternatives in catatonia is of paramount importance.

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rTMS and tDCS for the treatment of catatonia: A systematic review

Cited by 24 publications

References 29 publications

Are benzodiazepines effective in treating catatonia?

Are benzodiazepines effective in treating catatonia?

Using cortical non-invasive neuromodulation as a potential preventive treatment in schizophrenia - A review

Efficacy of Transcranial Direct-Current Stimulation in Catatonia: A Review and Case Series

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