rTMS in resistant mixed states: An exploratory study

Pallanti, Stefano; Grassi, Giacomo; Antonini, Sarah; Quercioli, Leonardo; Salvadori, Emilia; Hollander, Eric

doi:10.1016/j.jad.2013.12.024

Cited by 22 publications

(29 citation statements)

References 47 publications

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“…Li and colleagues evaluated TMS as a maintenance treatment in patients (n = 7) who had been successfully treated with TMS for their depression in a previously described study (Nahas et al, 2003). At post-treatment, the responder rate for depressive symptoms (as assessed via the HAM-D (Hamilton, 1960)) was 46%, of which 29% met criteria for full remission, and the responder rate for manic symptoms (as assessed via the YMRS (Young et al, 1978)) was 15% with all meeting criteria for full remission (Pallanti et al, 2014). Among the study patients, three continued with TMS for the full year and did not re-enter an acute depressive episode during that period (Li, Nahas, Anderson, Kozel, & George, 2004).…”

Section: Tms In Other Illness Stagesmentioning

confidence: 99%

“…TMS for mania has been the focus of fewer clinical trials and yielded more inconsistent findings with only one randomized, controlled trial suggesting the benefit of rTMS over a sham treatment (Praharaj et al, 2009). Open-label studies of TMS for bipolar mixed states (Pallanti et al, 2014) and for maintenance care (Li et al, 2004) have also delivered promising findings. Open-label studies of TMS for bipolar mixed states (Pallanti et al, 2014) and for maintenance care (Li et al, 2004) have also delivered promising findings.…”

Section: Tms In Other Illness Stagesmentioning

confidence: 99%

“…All patients also received a mood stabilizer as part of the study (e.g., valproate). At post-treatment, the responder rate for depressive symptoms (as assessed via the HAM-D (Hamilton, 1960)) was 46%, of which 29% met criteria for full remission, and the responder rate for manic symptoms (as assessed via the YMRS (Young et al, 1978)) was 15% with all meeting criteria for full remission (Pallanti et al, 2014).…”

Section: Tms In Other Illness Stagesmentioning

confidence: 99%

“…Of note, despite the disparate study outcomes, nearly all the studies of TMS for mania targeted similar right prefrontal cortical regions. Open-label studies of TMS for bipolar mixed states (Pallanti et al, 2014) and for maintenance care (Li et al, 2004) have also delivered promising findings.…”

Section: Tms In Other Illness Stagesmentioning

confidence: 99%

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Clinical applications of transcranial magnetic stimulation in bipolar disorder

Gold

Ornelas²,

Cirillo³

et al. 2019

Brain and Behavior

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Background Many patients with bipolar disorder (BD) fail to experience benefit following traditional pharmacotherapy, necessitating alternative treatment options that will enable such patients to achieve remission. Transcranial magnetic stimulation (TMS) is a relatively new, noninvasive neuromodulation technique that involves the application of magnetic pulses on hyperactive or hypoactive cortical brain areas. We evaluated the existing literature on TMS as a treatment for BD across varied mood states. Methods We searched PubMed up to October 2018 for original data articles published in English that evaluated outcomes in a bipolar sample across depressive, manic, mixed, and maintenance phases of BD. Results Clinical trials of TMS for BD particularly suggest the potential of repetitive TMS for reducing depressive symptoms. Studies of TMS for mania have yielded more mixed findings. Few studies have evaluated TMS in other phases of the bipolar illness. TMS is generally associated with mild side effects though, in a few studies, it has been shown to contribute to a manic switch in previously depressed bipolar patients. Conclusions Transcranial magnetic stimulation is a promising approach for treating patients with BD who have failed to respond to pharmacological or psychosocial treatment. Future research should more clearly elucidate which TMS protocols may be most effective for a given bipolar patient.

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Section: Tms In Other Illness Stagesmentioning

confidence: 99%

Section: Tms In Other Illness Stagesmentioning

confidence: 99%

Section: Tms In Other Illness Stagesmentioning

confidence: 99%

Section: Tms In Other Illness Stagesmentioning

confidence: 99%

See 2 more Smart Citations

Clinical applications of transcranial magnetic stimulation in bipolar disorder

Gold

Ornelas²,

Cirillo³

et al. 2019

Brain and Behavior

View full text Add to dashboard Cite

show abstract

“…This is especially clinically relevant since low-frequency TMS carries a lower risk of seizure compared with high-frequency TMS. Some studies have attempted to extend the success in unipolar depression to bipolar depression, although more work is needed to establish efficacy and safety in bipolar disorder (63)(64)(65).…”

Section: Transcranial Magnetic Stimulation Tms In Major Depressive DImentioning

confidence: 99%

Recent Developments in Noninvasive Neuromodulation for Mood and Anxiety Disorders

Rakesh

Lisanby

2015

Curr Behav Neurosci Rep

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Noninvasive neuromodulation refers to a family of device-based interventions that apply electrical or magnetic fields, either at convulsive or subconvulsive levels, to the brain through the intact skull to modulate neural function. This is a rapidly evolving field, with new research emerging regarding the various roles that these devices can play both in studying the neural mechanisms underlying mood and anxiety disorders, and in treating pharmacoresistant conditions either on their own or in combination with other therapies. Each neuromodulation modality has its pros and cons and should be carefully chosen after weighing the risks and benefits. This manuscript reviews some of the most exciting developments in this field over the past year and emphasizes themes that are emerging as being important for these tools to fulfill their potential to transform how we study and treat mood and anxiety disorders. Key among these themes is the concept of how we understand the "dose" of the stimulation, and how exogenously applied fields interact with endogenous brain activity. Refining the concept of dose will ultimately be important in allowing clinicians and researchers to apply the procedure with precision to engage the targeted network to achieve the desired effects in each individual. The large parameter space defining dose of neuromodulation makes interpreting the literature on safety and efficacy challenging and highlights the need for clear and accurate reporting of the spatial, temporal, and contextual features of dosage to make the emerging literature base as informative as possible. Ultimately, the impact of noninvasive neuromodulation devices is potentially transformational given their utility in providing mechanistic insight into the circuitbased and oscillatory origins of mood and anxiety disorders, as well as providing therapeutic interventions rationally designed to target disease-related processes.

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