High-frequency repetitive transcranial magnetic stimulation (rTMS) improves neurocognitive function in bipolar disorder

Lin-de, Yang; Zhao, Dong; Kong, Lanlan; Sun, Yaqi; Wang, Zi-Yang; Gao, Yuanyuan; Li, Na; Lü, Lin; Shi, Le; Wang, Xueyi; Wang, Yumei

doi:10.1016/j.jad.2018.12.102

Cited by 43 publications

(47 citation statements)

References 52 publications

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“…ECT was reported to produce an improvement in neurocognitive function similar to that of algorithm-based pharmacological treatment [ 127 ]. A recent study reported that ten consecutive days of high-frequency active rTMS improved aspects of neurocognition without an effect on mood symptoms [ 128 ].…”

Section: Treatment Of the Neurocognitive Deficitmentioning

confidence: 99%

Neurocognitive impairment and evidence-based treatment options in Bipolar disorder

Fountoulakis

2020

Ann Gen Psychiatry

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Background The current paper briefly summarizes the literature on the neurocognitive deficit and its treatment in BD patients. Methods The material was chosen on the basis of previous systematic reviews the author has taken part in. Results The data so far suggest that the deficit is qualitatively similar but quantitatively milder in comparison to schizophrenia, it is present already since the first episode, is weakly related to mood symptoms and somewhat stronger to psychotic symptoms, it probably determines much of the disability and treatment is problematic. This deficit is also present during periods of euthymia. The possible adverse effect of psychotropic medication is rather small if any at all and is confounded by the specific clinical symptoms, for which medication is used for their treatment. This is especially true concerning antipsychotics and psychotic symptoms. The origin and the etiopathogenesis of the core neurocognitive impairment remain elusive. The presence of a neurodegenerative and of a neurodevelopmental component has both data in favor and against and they are both the focus of debate. Conclusions Treatment of the neurocognitive deficit and restoration of functioning is problematic. The data are limited and treatment options are few and with a weak overall effect. Pharmacological treatments, ECT and rTMS present some hard data, while the literature is inconclusive concerning psychotherapeutic interventions.

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Section: Treatment Of the Neurocognitive Deficitmentioning

confidence: 99%

Neurocognitive impairment and evidence-based treatment options in Bipolar disorder

Fountoulakis

2020

Ann Gen Psychiatry

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“…23 Our data also agreed with studies where patients who were in a treatment against heroin addiction and who underwent a 10 Hz stimulation protocol for six weeks reported a significant improvement in sleep quality. 24 While melatonin was more effective in improving sleep quality, statistical analyzes did not show that one treatment was more effective than the other. These results could be explained because melatonin has the natural function of regulating sleep cycles, increasing the REM sleep cycle and decreasing sleep latency.…”

Section: Discussionmentioning

confidence: 99%

“…The anxiety inventory has a score of 0 to 100 and the classification of minimum anxiety (0-4), limit (5-10), light (11)(12)(13)(14)(15)(16)(17)(18)(19)(20), moderate (21)(22)(23)(24)(25)(26)(27)(28)(29)(30), severe (41-50) and extreme (51-100). The inventory of depression has a score of 0 to 100 and is classified in the categories of non-deprecated (0-5), normal but unhappy (6-10), minimal depression (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25), moderate depression (26-50), severe depression (51-75) and extreme depression (76-100). 21 Melatonin: 10 mg sublingual melatonin tablets from the Eurovital nutraceuticals brand were used.…”

Section: Materials/equipmentmentioning

confidence: 99%

The effectiveness of exogenous melatonin versus transcranial magnetic stimulation on the quality of sleep, memory and mood of young adult people

Javier¹,

Arturo²,

Raquel³

et al. 2019

PPIJ

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Melatonin is a neurohormone that is secreted in the brain and which is associated with the sleep cycle, its clinical uses have been focused on sleep disorders, as well as on the improvement of cognitive performance and people's mood. Likewise, Transcranial Magnetic Stimulation (TMS) has been used in the same areas. The objective of this research was to analyze for two weeks, in young adults with an average age of 24 (the minimum age was 18 and the maximum was 32), which of the two treatments was more effective in inducing improvements in sleep quality, memory and mood. Four groups were formed, the placebo group (n=28), the sham group (n=28), the melatonin group (n=25) and the TMS group (n=16). All groups had a pre-test evaluation of sleep quality, memory, depression and anxiety. The experimental phase lasted 2 weeks and consisted of placebo exposure, sham stimulation, melatonin consumption (10 mg) and TMS (128 Hz). After this period, the post-test evaluation was carried out. The results showed that both treatments were equally effective in improving sleep quality, although TMS was more effective in improving memory and anxiety symptoms. It is inferred that both treatments are effective, although the question arises about their long-term use and the maintenance of the improvements.

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“…Yang et al have conducted the largest (published) bipolar depression rTMS trial to date. 65 This RCT recruited BD patients who had at least 3 months of clinical remission before randomisation. The main outcome measures were cognitive functioning, as measured via the MATRICS Consensus Cognitive Battery (MCCB), and clinical symptoms (e.g.…”

Section: Rcts Comparing Active Treatmentsmentioning

confidence: 99%

“…However, Yang et al were the only study to employ a false coil sham, but using the same procedure, possibly representing the optimal sham design. 65 For the bipolar mania studies there was two RCTs and only one reported that rTMS was superior to sham, 71 suggesting that high-frequency rTMS may be effective at reducing manic symptoms; however, further RCTs, with larger samples, are needed before firm conclusions can be drawn. In terms of the sham conditions adopted, both studies utilised a sham that tilted the coil at an angle (e.g.…”

Section: Effectiveness Of Rtms To Treat Bdmentioning

confidence: 99%

Repetitive transcranial magnetic stimulation in the treatment of bipolar disorder

Hett

Marwaha

2020

Therapeutic Advances in Psychopharmacology

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Bipolar disorder (BD) is a debilitating mood disorder marked by manic, hypomanic and/or mixed or depressive episodes. It affects approximately 1–2% of the population and is linked to high rates of suicide, functional impairment and poorer quality of life. Presently, treatment options for BD are limited. There is a strong evidence base for pharmacological (e.g., lithium) and psychological (e.g., psychoeducation) treatments; however, both of these pose challenges for treatment outcomes (e.g., non-response, side-effects, limited access). Repetitive transcranial magnetic stimulation (rTMS), a non-invasive brain stimulation technique, is a recommended treatment for unipolar depression, but it is unclear whether rTMS is an effective, safe and well tolerated treatment in people with BD. This article reviews the extant literature on the use of rTMS to treat BD across different mood states. We found 34 studies in total ( N = 611 patients), with most assessing bipolar depression ( n = 26), versus bipolar mania ( n = 5), mixed state bipolar ( n = 2) or those not in a current affective episode ( n = 1). Across all studies, there appears to be a detectable signal of efficacy for rTMS treatment, as most studies report that rTMS treatment reduced bipolar symptoms. Importantly, within the randomised controlled trial (RCT) study designs, most reported that rTMS was not superior to sham in the treatment of bipolar depression. However, these RCTs are based on small samples ( NBD ⩽ 52). Reported side effects of rTMS in BD include headache, dizziness and sleep problems. Ten studies ( N = 14 patients) reported cases of affective switching; however, no clear pattern of potential risk factors for affective switching emerged. Future adequately powered, sham-controlled trials are needed to establish the ideal rTMS treatment parameters to help better determine the efficacy of rTMS for the treatment of BD.

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High-frequency repetitive transcranial magnetic stimulation (rTMS) improves neurocognitive function in bipolar disorder

Cited by 43 publications

References 52 publications

Neurocognitive impairment and evidence-based treatment options in Bipolar disorder

Neurocognitive impairment and evidence-based treatment options in Bipolar disorder

The effectiveness of exogenous melatonin versus transcranial magnetic stimulation on the quality of sleep, memory and mood of young adult people

Repetitive transcranial magnetic stimulation in the treatment of bipolar disorder

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