Bilateral neuronavigated 20Hz theta burst TMS for treatment refractory depression: An open label study

Stubbeman, William F.; Zarrabi, Bijan; Bastea, Silvia; Ragland, Victoria; Khairkhah, Raya

doi:10.1016/j.brs.2018.04.012

Cited by 29 publications

(23 citation statements)

References 9 publications

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“…28 Evidence showed that bilateral neuronavigationguided 20 Hz TBS TMS targeted on BA46 (−44, 40, and 29) and its right sided homolog (44, 40, and 29) brought more than twothirds of treatment refractory depressed patients to remission. 29 Here, our findings suggested that the neuronavigationguided 10 Hz rTMS targeted on BA46 could rapidly reduce suicidal ideation and mit igate depressive symptom. Further studies are needed to system atically explore whether the neuronavigation targeted method in rTMS treatment can result in superior therapeutic efficacy for pa tients with MDD in contrast to the conventional localization tech nique, such as "5cm method" and "10-20 method.…”

Section: Discussionmentioning

confidence: 58%

Neuronavigation‐Guided rTMS for the Treatment of Depressive Patients With Suicidal Ideation: A Double‐Blind, Randomized, Sham‐Controlled Trial

Pan

Shen

Jiao

et al. 2020

Clin Pharma and Therapeutics

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During the last decade, the problem of suicide has become more serious in individuals with depression. Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for major depressive disorder (MDD). This study aims to investigate the efficacy of magnetic resonance imaging (MRI)‐based neuronavigation‐guided daily high‐dose rTMS for rapidly improving suicidal ideation in treatment‐naive patients with MDD. In the present 1‐week double‐blind study, 42 treatment‐naive patients with MDD with suicidal ideation were randomly assigned to the treatment of escitalopram oxalate tablets (10 mg/d) in combination with either active (n = 21) or sham (n = 21) rTMS. The TMS coil was positioned over a specified target location (−44, 40, and 29) in left dorsolateral prefrontal cortex based on MRI data. The severity of suicidal ideation was measured by the Beck Scale for Suicide Ideation (BSI). The 24‐item Hamilton Depression Rating Scale (HAMD‐24) and Montgomery–Åsberg Depression Rating Scale (MADRS) were utilized to assess the severity of depression. The Wisconsin Card Sorting Test, Continuous Performance Test, and Stroop Color–Word Test were adopted to assess executive function. In contrast to the sham group, the active rTMS group showed a significantly greater BSI score reduction at the third day and the seventh day (P < 0.001). Moreover, the active rTMS group showed a significantly greater HAMD (P < 0.001) and MADRS (P < 0.001) score reduction at the seventh day in comparison to the sham group. The present findings suggested that the neuronavigation‐guided high‐dose rTMS may be a novel method to rapidly reduce suicidal ideation and mitigate depressive symptoms.

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Section: Discussionmentioning

confidence: 58%

Neuronavigation‐Guided rTMS for the Treatment of Depressive Patients With Suicidal Ideation: A Double‐Blind, Randomized, Sham‐Controlled Trial

Pan

Shen

Jiao

et al. 2020

Clin Pharma and Therapeutics

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“…Among the distinct frequencies, the now-standard 10 Hz rTMS for depression therapy has been widely accepted in clinical settings. Recent evidence suggests that active 5 Hz or 20 Hz rTMS may markedly improve clinical symptoms in depressed individuals when compared with sham rTMS ( George et al, 2000 ; Luborzewski et al, 2007 ; Philip et al, 2015 ; Stubbeman et al, 2018 ; Su et al, 2005 ). However, the primary limitations of 5 Hz or 20 Hz rTMS include modest clinical sample sizes and uncertain clinical safety and treatment tolerability ( Hadley et al, 2011 ; Loo et al, 2008 ; McGirr et al, 2016 ).…”

Section: Discussionmentioning

confidence: 99%

Magnetic brain stimulation using iron oxide nanoparticle-mediated selective treatment of the left prelimbic cortex as a novel strategy to rapidly improve depressive-like symptoms in mice

Sun

Yang

et al. 2020

Zoological Research

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Magnetic brain stimulation has greatly contributed to the advancement of neuroscience. However, challenges remain in the power of penetration and precision of magnetic stimulation, especially in small animals. Here, a novel combined magnetic stimulation system (c-MSS) was established for brain stimulation in mice. The c-MSS uses a mild magnetic pulse sequence and injection of superparamagnetic iron oxide (SPIO) nanodrugs to elevate local cortical susceptibility. After imaging of the SPIO nanoparticles in the left prelimbic (PrL) cortex in mice, we determined their safety and physical characteristics. Depressive-like behavior was established in mice using a chronic unpredictable mild stress (CUMS) model. SPIO nanodrugs were then delivered precisely to the left PrL cortex using in situ injection. A 0.1 T magnetic field (adjustable frequency) was used for magnetic stimulation (5 min/session, two sessions daily). Biomarkers representing therapeutic effects were measured before and after c-MSS intervention. Results showed that c-MSS rapidly improved depressive-like symptoms in CUMS mice after stimulation with a 10 Hz field for 5 d, combined with increased brain-derived neurotrophic factor (BDNF) and inactivation of hypothalamic-pituitary-adrenal (HPA) axis function, which enhanced neuronal activity due to SPIO nanoparticle-mediated effects. The c-MSS was safe and effective, representing a novel approach in the selective stimulation of arbitrary cortical targets in small animals, playing a bioelectric role in neural circuit regulation, including antidepressant effects in CUMS mice. This expands the potential applications of magnetic stimulation and progresses brain research towards clinical application.

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“…Aus Die Forschung im Bereich der Neurostimulation ist weiterhin dynamisch; es ist zu hoffen, dass durch die neuronavigierte Identifikation von Zielarealen eine noch genauere Applikation der Magnetimpulse erfolgen wird. Zudem steht mit der theta-burst-Behandlung ein Protokoll zur Verfügung, welches eine ähnliche antidepressive Wirksamkeit bei deutlich geringerer Behandlungszeit zeigt, was insbesondere für Patientengruppen wie Schwangere vorteilhaft sein könnte, da es den Nachteil der längeren Liegezeit vermindert [32][33][34].…”

Section: Introductionunclassified

Transkranielle Magnetstimulation zur Behandlung von Depressionen bei Schwangeren

Schecklmann¹,

Langguth²,

Hebel³

2020

Nervenheilkunde

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Zusammenfassung Gegenstand und Ziel In dieser Übersichtsarbeit sollen die Wirksamkeit und Sicherheit der repetitiven transkraniellen Magnetstimulation (rTMS) für die Patientengruppe depressiv erkrankter Schwangerer evaluiert werden. Material und Methoden Es wurde eine Datenbankrecherche auf Pubmed durchgeführt, um alle relevanten Original- und Übersichtsarbeiten zu dem Thema zu identifizieren und zu analysieren Ergebnisse Zusätzlich zu einer Reihe von Fallberichten existieren 3 kontrollierte Studien zur Behandlung depressiver Schwangerer mittels rTMS. Der Datenlage nach scheint die rTMS sowohl für die schwangeren Patientinnen als auch ihre ungeborenen Kinder sicher zu sein. Es wurden keine postnatalen negativen Wirkungen auf die Kindesentwicklung berichtet. Schlussfolgerung rTMS stellt eine vielversprechende Behandlungsoption dar. Weitere Studien mit größeren Teilnehmerzahlen sind notwendig, um den Stellenwert der rTMS in einer multimodalen Depressionsbehandlung in der Schwangerschaft zu klären.

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Bilateral neuronavigated 20Hz theta burst TMS for treatment refractory depression: An open label study

Abstract: Bilateral Neuronavigated TBS-20Hz TMS brought more than two-thirds of treatment refractory depressed patients to remission. TBS-20Hz may be critical for obtaining higher remission rates. Controlled trials are warranted.

Cited by 29 publications

References 9 publications

Neuronavigation‐Guided rTMS for the Treatment of Depressive Patients With Suicidal Ideation: A Double‐Blind, Randomized, Sham‐Controlled Trial

Neuronavigation‐Guided rTMS for the Treatment of Depressive Patients With Suicidal Ideation: A Double‐Blind, Randomized, Sham‐Controlled Trial

Magnetic brain stimulation using iron oxide nanoparticle-mediated selective treatment of the left prelimbic cortex as a novel strategy to rapidly improve depressive-like symptoms in mice

Transkranielle Magnetstimulation zur Behandlung von Depressionen bei Schwangeren

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