High-frequency repetitive transcranial magnetic stimulation delays rapid eye movement sleep

Abstract

Repetitive transcranial magnetic stimulation (rTMS) is a promising new treatment for patients with major depression. However, the mechanisms underlying the antidepressive action of rTMS are widely unclear. Rapid eye movement (REM) sleep has been shown to play an important role in the pathophysiology of depression. In the present study we demonstrate that rTMS delays the first REM sleep epoch on average by 17 min (102.6 +/-22.5 min vs 85.7+/-18.8 min; p < 0.02) and prolongs the nonREM-REM cycle length (109.1+/-11.4 min vs 101.8+/-13.2min, p< 0.012). These rTMS-induced changes in REM sleep variables correspond to findings observed after pharmacological and electroconvulsive treatment of depression. Therefore, it is likely that the capability of rTMS to affect circadian and ultradian biological rhythms contributes to its antidepressive action.

Off-Line Learning and the Primary Motor Cortex

“…It appears unlikely that stimulation would have an effect on sleep architecture. A few studies specifically designed to examine this issue failed to find any substantial changes in sleep architecture after the application of TMS (Cohrs et al, 1998;Graf et al, 2001). Furthermore, in our study, participants in the two overnight groups spent on average 3.6 h awake before sleep.…”

Efficacy of Repetitive Transcranial Magnetic Stimulation (rTMS) in the Treatment of Affective Disorders

“…In half of the studies, rTMS over the LPFC transiently induced a decrease in self-rated happiness and an increase of sadness compared to the effects of right prefrontal cortical rTMS (Dearing et al, 1997;George et al, 1996;Pascual-Leone et al, 1996). Three more recent studies (Cohrs et al, 1998;Mosimann et al, 2000;Nedjat et al, 1998) failed to demonstrate any effects on mood in healthy volunteers.…”

“…Results from these studies are inconclusive but indicate that TMS might significantly affect neuroendocrine function (Cohrs et al, 1998;George et al, 1996;Szuba et al, 2001).…”

Advances in Neuromodulation: The Orbitofrontal-Striatal Model Of, and Deep Brain Stimulation In, Obsessive-Compulsive Disorder

“…Focal lesioning during a surgical procedures for neuropsychiatric disorders has been known as "psychosurgery". Historically, these procedures have been thought not to be discriminate in terms of neuroanatomical location or groups of patients treated [47][48][49] . Furthermore, informed consent is thought not to be properly obtained, a process which requires careful assessment of an individual's capacity to weigh the risks and benefits of an experimental medical or surgical procedure 50 .…”