Effect of low-frequency repetitive transcranial magnetic stimulation on sleep pattern and quality of life in patients with focal epilepsy

Sánchez-Escandón, Óscar; Arana-Lechuga, Yoaly; Terán-Pérez, Guadalupe; Ruiz-Chow, Ángel; González-Robles, Rosa Obdulia; Shkurovich-Bialik, Paul; Collado-Corona, Miguel Ángel; Velázquez‐Moctezuma, Javier

doi:10.1016/j.sleep.2015.11.022

Cited by 17 publications

(9 citation statements)

References 20 publications

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“…Moreover, we observed a significant change of accompanying symptoms to addictive behaviors, including sleep disturbances, depression, anxiety, and negative-affect symptoms, as demonstrated by the improvement of PSQI, BDI-II, SAS, and SCL-90-R scores during the treatment period. Several findings already support a beneficial effect of rTMS for primary sleep disorders and for sleep disturbances comorbid with other neuropsychiatric disorders [55,56,57,58]. To our knowledge, this is one of the first studies reporting a beneficial effect on accompanying symptoms to addictive behaviors and, thus, the results have to be interpreted cautiously.…”

Section: Discussionmentioning

confidence: 73%

Clinical Improvements in Comorbid Gambling/Cocaine Use Disorder (GD/CUD) Patients Undergoing Repetitive Transcranial Magnetic Stimulation (rTMS)

Cardullo¹,

Pérez²,

Marconi³

et al. 2019

JCM

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(1) Background: Pathological gambling behaviors may coexist with cocaine use disorder (CUD), underlying common pathogenic mechanisms. Repetitive transcranial magnetic stimulation (rTMS) has shown promise as a therapeutic intervention for CUD. In this case series, we evaluated the clinical effects of rTMS protocol stimulating the left dorsolateral prefrontal cortex (DLPFC) on the pattern of gambling and cocaine use. (2) Methods: Gambling severity, craving for cocaine, sleep, and other negative affect symptoms were recorded in seven patients with a diagnosis of gambling disorder (South Oaks Gambling Screen (SOGS) >5), in comorbidity with CUD, using the following scales: Gambling-Symptom Assessment Scale (G-SAS), Cocaine Craving Questionnaire (CCQ), Beck Depression Inventory-II (BDI-II), Self-rating Anxiety Scale (SAS), and Symptoms checklist-90 (SCL-90). The measures were assessed before the rTMS treatment and after 5, 30, and 60 days of treatment. Patterns of gambling and cocaine use were assessed by self-report and regular urine screens. (3) Results: Gambling severity at baseline ranged from mild to severe (mean ± Standard Error of the Mean (SEM), G-SAS score baseline: 24.42 ± 2.79). G-SAS scores significantly improved after treatment (G-SAS score Day 60: 2.66 ± 1.08). Compared to baseline, consistent improvements were significantly seen in craving for cocaine and in negative-affect symptoms. (4) Conclusions: The present findings provide unprecedent insights into the potential role of rTMS as a therapeutic intervention for reducing both gambling and cocaine use in patients with a dual diagnosis.

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Section: Discussionmentioning

confidence: 73%

Clinical Improvements in Comorbid Gambling/Cocaine Use Disorder (GD/CUD) Patients Undergoing Repetitive Transcranial Magnetic Stimulation (rTMS)

Cardullo¹,

Pérez²,

Marconi³

et al. 2019

JCM

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“…Other studies examined rTMS's effect on different conditions such as epilepsy or MDD. In one epilepsy study, patients were administered LF rTMS in areas where their epileptic activity was highest, and sleep improvements were found by questionnaires and PSG parameters (Sánchez-Escandón et al 2016). A different study focusing on rTMS in MDD and using PSQI and actigraphy had mixed findings.…”

Section: Sleep Measurement Outcomesmentioning

confidence: 99%

“…Sleep disorders are common in the general population (Ohayon 2011) and in patients suffering from MDD (Ohayon 2011;Murphy and Peterson 2015). Several studies have reported that rTMS for various conditions improved sleep quality by subjective measures (van Dijk et al 2009;Sánchez-Escandón et al 2016), even in those who experienced no improvement with the actual mood disorder (Sonmez et al 2020); hence, it has recently been suggested that rTMS could have an intrinsic positive effect on sleep outside of its application in MDD (Sonmez et al 2020). Neuroimaging studies have found that patients with chronic primary insomnia often exhibit cortical hyperexcitability (Van Der Werf et al 2010;Lanza et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Transcranial magnetic stimulation therapeutic applications on sleep and insomnia: a review

Oroz

Kung

Croarkin

et al. 2021

Sleep Science Practice

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Repetitive transcranial magnetic stimulation (rTMS) is a neuromodulatory technique approved by the US Food and Drug Administration for use in treatment-resistant major depressive disorder. It works by generating localized magnetic fields that create depolarizing electrical currents in neurons a few centimeters below the scalp. This localized effect is believed to stimulate neural plasticity, activate compensatory processes, and influence cortical excitability. Additionally, rTMS has been used in a variety of clinical trials for neurological and psychiatric conditions such as anxiety, post-traumatic stress disorder and epilepsy. Beneficial effects in sleep parameters have been documented in these trials, as well as in major depressive disorder, and have led to an interest in using rTMS in the field of sleep medicine for specific disorders such as insomnia, hypersomnia, and restless legs syndrome. It is unknown whether rTMS has intrinsically beneficial properties when applied to primary sleep disorders, or if it only acts on sleep through mood disorders. This narrative review sought to examine available literature regarding the application of rTMS for sleep disorder to identify knowledge gaps and inform future study design. The literature in this area remains scarce, with few randomized clinical trials on rTMS and insomnia. Available studies have found mixed results, with some studies reporting subjective sleep improvement while objective improvement is less consistent. Due to the heterogeneity of results and the variations in rTMS protocols, no definitive conclusions have been reached, signaling the need for further research.

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“…Compelling evidence already supports a beneficial effect of rTMS for primary sleep disorders [28], and for sleep disturbances comorbid with other neuropsychiatric disorders, such as obsessive and compulsive disorder [57], focal epilepsy [58], depression [59], and heroin and methamphetamine addiction [29]. Both high and lowfrequency rTMS can modulate total sleep and total wake times, sleep latency, sleep efficiency, and other aspects of sleep architecture [28,59,60].…”

Section: Discussionmentioning

confidence: 99%

Sleep quality improves during treatment with repetitive transcranial magnetic stimulation (rTMS) in patients with cocaine use disorder: a retrospective observational study

et al. 2020

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Background: Sleep disturbance is a prominent and common complaint in people with cocaine use disorder (CUD), either during intake or withdrawal. Repetitive transcranial magnetic stimulation (rTMS) has shown promise as a treatment for CUD. Thus, we evaluated the relationship between self-perceived sleep quality and cocaine use pattern variables in outpatients with CUD undergoing an rTMS protocol targeted at the left dorsolateral prefrontal cortex. Methods: This is a retrospective observational study including 87 patients diagnosed with CUD according to the DSM-5 criteria. Scores in Pittsburgh Sleep Quality Index (PSQI), Cocaine Craving Questionnaire (CCQ), Beck Depression Inventory-II (BDI-II), Self-rating Anxiety Scale (SAS), and Symptoms checklist 90-Revised (outcome used: Global Severity Index, GSI) were recorded at baseline, and after 5, 30, 60, and 90 days of rTMS treatment. Cocaine use was assessed by self-report and regular urine screens. Results: Sleep disturbances (PSQI scores > 5) were common in patients at baseline (mean ± SD; PSQI score baseline: 9.24 ± 3.89; PSQI > 5 in 88.5% of patients). PSQI scores significantly improved after rTMS treatment (PSQI score Day 90: 6.12 ± 3.32). Significant and consistent improvements were also seen in craving and in negative-affect symptoms compared to baseline. Considering the lack of a control group, in order to help the conceptualization of the outcomes, we compared the results to a wait-list group (n = 10). No significant improvements were observed in the wait-list group in any of the outcome measures. Conclusions: The present findings support the therapeutic role of rTMS interventions for reducing cocaine use and accompanying symptoms such as sleep disturbance and negative-affect symptoms. Trial registration: ClinicalTrials.gov.NCT03733821.

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Effect of low-frequency repetitive transcranial magnetic stimulation on sleep pattern and quality of life in patients with focal epilepsy

Cited by 17 publications

References 20 publications

Clinical Improvements in Comorbid Gambling/Cocaine Use Disorder (GD/CUD) Patients Undergoing Repetitive Transcranial Magnetic Stimulation (rTMS)

Clinical Improvements in Comorbid Gambling/Cocaine Use Disorder (GD/CUD) Patients Undergoing Repetitive Transcranial Magnetic Stimulation (rTMS)

Transcranial magnetic stimulation therapeutic applications on sleep and insomnia: a review

Sleep quality improves during treatment with repetitive transcranial magnetic stimulation (rTMS) in patients with cocaine use disorder: a retrospective observational study

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