Transcranial Magnetic and Direct Current Stimulation in the Treatment of Depression: Basic Mechanisms and Challenges of Two Commonly Used Brain Stimulation Methods in Interventional Psychiatry

Singh, Aditya; Erwin-Grabner, Tracy; Goya-Maldonado, Roberto; Antal, Andrea

doi:10.1159/000502149

Cited by 17 publications

(15 citation statements)

References 129 publications

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“…Over 25 years ago, a population of individuals with bipolar disorder, reported mood improvements following a magnetic resonance spectroscopic imaging procedure (22). Since then, numerous studies have sought to investigate the ability of magnetic stimulation on neuromodulation (23)(24)(25)(26). LFMS is of interest as a non-invasive neuromodulation therapy, which has been shown to rapidly improve mood in patients diagnosed with depression (27).…”

Section: Low-field Magnetic Stimulation Improved Cuprizone-induced Depression-like Symptoms and Demyelination In Female Micementioning

confidence: 99%

Low‑field magnetic stimulation improved cuprizone‑induced depression‑like symptoms and demyelination in female mice

et al. 2022

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Depression is a common and disabling comorbidity of multiple sclerosis (MS), with currently no clear guidelines for treatment. Low-field magnetic stimulation (LFMS), a novel non-invasive neuromodulation intervention, has been previously demonstrated to rapidly alleviate mood disorders. The aim of the present study was to investigate the effects of LFMS on depression-like behaviors and demyelination in a well-established mouse model of MS. C57BL/6 female mice were fed a 0.2% cuprizone (CPZ) diet for 3 or 6 weeks to induce acute demyelination. During this time, the mice were treated with either sham or LFMS for 20 min/day, 5 days/week. After 3 or 6 weeks of treatment, behavior was assessed with the open field task, Y-maze and the forced swim test. The prefrontal cortex and hippocampus were then collected to perform immunohistochemistry and western blot analysis to verify myelination status. The CPZ diet did not cause significant locomotor deficits; however, working memory, measured using the Y maze, depression-like behavior and adaptive learning, assayed using the forced swim test, were significantly impaired in these animals. LFMS treatment demonstrated a significant antidepressant-like effect and markedly attenuated the CPZ-induced demyelination in the prefrontal cortex after 3-and 6-weeks of treatment, as observed by changes in myelin basic protein immunostaining and western blot analysis. Therefore, the results of the present study indicated that LFMS may be a promising therapy for demyelinating diseases due to the improvement of depressive symptoms via regulation of myelination in cortical areas.

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Section: Low-field Magnetic Stimulation Improved Cuprizone-induced Depression-like Symptoms and Demyelination In Female Micementioning

confidence: 99%

Low‑field magnetic stimulation improved cuprizone‑induced depression‑like symptoms and demyelination in female mice

et al. 2022

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“…Until now, the efficacy of NIBS is unclear and some have questioned whether these techniques have any effect on the brain at all (Vöröslakos et al, 2018 ). Skepticism is increased by lack of clear theories and evidence on working mechanisms of both interventions, which hampers smart applications (Chase, Boudewyn, Carter, & Phillips, 2020 ; Singh, Erwin-Grabner, Goya-Maldonado, & Antal, 2019 ) Nevertheless, many studies have applied NIBS techniques in an attempt to improve cognitive function in different diagnostic groups. Although some studies showed promising findings, the results of studies on the effect of NIBS on cognition remain inconsistent and the field would benefit from an overarching systematic overview of findings so far.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of non-invasive brain stimulation on cognitive functioning in brain disorders: a meta-analysis

et al. 2020

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Background Cognition is commonly affected in brain disorders. Non-invasive brain stimulation (NIBS) may have procognitive effects, with high tolerability. This meta-analysis evaluates the efficacy of transcranial magnetic stimulation (TMS) and transcranial Direct Current Stimulation (tDCS) in improving cognition, in schizophrenia, depression, dementia, Parkinson's disease, stroke, traumatic brain injury, and multiple sclerosis. Methods A PRISMA systematic search was conducted for randomized controlled trials. Hedges' g was used to quantify effect sizes (ES) for changes in cognition after TMS/tDCS v. sham. As different cognitive functions may have unequal susceptibility to TMS/tDCS, we separately evaluated the effects on: attention/vigilance, working memory, executive functioning, processing speed, verbal fluency, verbal learning, and social cognition. Results We included 82 studies (n = 2784). For working memory, both TMS (ES = 0.17, p = 0.015) and tDCS (ES = 0.17, p = 0.021) showed small but significant effects. Age positively moderated the effect of TMS. TDCS was superior to sham for attention/vigilance (ES = 0.20, p = 0.020). These significant effects did not differ across the type of brain disorder. Results were not significant for the other five cognitive domains. Conclusions Our results revealed that both TMS and tDCS elicit a small trans-diagnostic effect on working memory, tDCS also improved attention/vigilance across diagnoses. Effects on the other domains were not significant. Observed ES were small, yet even slight cognitive improvements may facilitate daily functioning. While NIBS can be a well-tolerated treatment, its effects appear domain specific and should be applied only for realistic indications (i.e. to induce a small improvement in working memory or attention).

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“…Given the ability of rTMS and tDCS of causing long-lasting suppression of neuronal spiking/excitability via LTD-like effects, these techniques could represent safe and useful tools to modulate neuronal firing and thus, hopefully, limit glioma mitosis and invasiveness. In support of this, it has already been shown that both high-frequency rTMS (600 pulses over 30 min daily) and low-frequency rTMS (1800 pulses over 30 min daily at 1 Hz) protocols applied to the left or right dorsolateral prefrontal cortex for drug-resistant depression are able to induce long-lasting changes in local cortical activity, connectivity, perfusion, and even affect structural brain properties [ 34 , 35 ]. Given the focality of TMS electric fields (E-field, 1-2 cm 3 ), rTMS could be applied to several locations surrounding a small cortical lesion, consequently targeting a relatively limited bordering neuronal population; alternatively, a local or distant single area could be targeted based on significant communication with the HGG cells detected via neuroimaging modalities such as functional MRI-based connectivity.…”

Section: Local Therapymentioning

confidence: 96%

Personalised, image-guided, noninvasive brain stimulation in gliomas: Rationale, challenges and opportunities

et al. 2021

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Malignant brain tumours are among the most aggressive human cancers, and despite intensive effort s made over the last decades, patients' survival has scarcely improved. Recently, high-grade gliomas (HGG) have been found to be electrically integrated with healthy brain tissue, a communication that facilitates tumour mitosis and invasion. This link to neuronal activity has provided new insights into HGG pathophysiology and opened prospects for therapeutic interventions based on electrical modulation of neural and synaptic activity in the proximity of tumour cells, which could potentially slow tumour growth. Noninvasive brain stimulation (NiBS), a group of techniques used in research and clinical settings to safely modulate brain activity and plasticity via electromagnetic or electrical stimulation, represents an appealing class of interventions to characterise and target the electrical properties of tumour-neuron interactions. Beyond neuronal activity, NiBS may also modulate function of a range of substrates and dynamics that locally interacts with HGG (e.g., vascular architecture, perfusion and blood-brain barrier permeability). Here we discuss emerging applications of NiBS in patients with brain tumours, covering potential mechanisms of action at both cellular, regional, network and whole-brain levels, also offering a conceptual roadmap for future research to prolong survival or promote wellbeing via personalised NiBS interventions.

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Transcranial Magnetic and Direct Current Stimulation in the Treatment of Depression: Basic Mechanisms and Challenges of Two Commonly Used Brain Stimulation Methods in Interventional Psychiatry

Cited by 17 publications

References 129 publications

Low‑field magnetic stimulation improved cuprizone‑induced depression‑like symptoms and demyelination in female mice

Low‑field magnetic stimulation improved cuprizone‑induced depression‑like symptoms and demyelination in female mice

Efficacy of non-invasive brain stimulation on cognitive functioning in brain disorders: a meta-analysis

Personalised, image-guided, noninvasive brain stimulation in gliomas: Rationale, challenges and opportunities

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