Opposite effects of high and low frequency rTMS on regional brain activity in depressed patients

Speer, Andrew B.; Kimbrell, Tim A.; Wassermann, Eric M.; Repella, Jennifer D.; Willis, Mark W.; Herscovitch, Peter; Post, Robert M.

doi:10.1016/s0006-3223(00)01065-9

Cited by 538 publications

(353 citation statements)

References 47 publications

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“…Several previous studies have shown that TMS over the prefrontal cortex can cause changes in activity in the hippocampus of humans (Kimbrell et al, 2002;Speer et al, 2000) and animals . Functional interaction between the two areas is well documented.…”

Section: What Might This Study Tell Us About Ltg's Mechanism Of Actiomentioning

confidence: 99%

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Interleaved Transcranial Magnetic Stimulation/Functional MRI Confirms that Lamotrigine Inhibits Cortical Excitability in Healthy Young Men

Tenebäck

Nahas

et al. 2004

Neuropsychopharmacol

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Little is known about how lamotrigine (LTG) works within brain circuits to achieve its clinical effects. We wished to determine whether the new technique of interleaved transcranial magnetic stimulation (TMS)/functional magnetic resonance imaging (fMRI) could be used to assess the effects of LTG on activated motor or prefrontal/limbic circuits. We carried out a randomized, double-blind, crossover trial involving two visits 1 week apart with TMS measures of cortical excitability and blood oxygen level-dependent TMS/fMRI. Subjects received either a single oral dose of 325 mg of LTG or placebo on each visit. In all, 10 subjects provided a complete data set that included interleaved TMS/fMRI measures and resting motor threshold (rMT) determinations under both placebo and LTG conditions. A further two subjects provided only rMT data under the two drug conditions. LTG caused a 14.979.6% (mean7SD) increase in rMT 3 h after the drug, compared with a 0.6710.9% increase 3 h after placebo (t ¼ 3.41, df ¼ 11, po0.01). fMRI scans showed that LTG diffusely inhibited cortical activation induced by TMS applied over the motor cortex. In contrast, when TMS was applied over the prefrontal cortex, LTG increased the TMS-induced activation of limbic regions, notably the orbitofrontal cortex and hippocampus. These results suggest that LTG, at clinically relevant serum concentrations, has a general inhibitory effect on cortical neuronal excitability, but may have a more complex effect on limbic circuits. Furthermore, the interleaved TMS/fMRI technique may be a useful tool for investigating regional brain effects of psychoactive compounds.

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Section: What Might This Study Tell Us About Ltg's Mechanism Of Actiomentioning

confidence: 99%

“…Inhibition of cortical excitability in healthy young men X Li et al 1999; Speer et al, 2000;Strafella et al, 2001). The present study confirmed the bilateral cortical activation following TMS over the prefrontal cortex.…”

Section: Bold Response To Tms Over the Prefrontal Cortexmentioning

confidence: 99%

Interleaved Transcranial Magnetic Stimulation/Functional MRI Confirms that Lamotrigine Inhibits Cortical Excitability in Healthy Young Men

Tenebäck

Nahas

et al. 2004

Neuropsychopharmacol

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“…25 These findings corroborate the data from a recent follow-up study of children whose mothers had A combination of the two may also be used. [37][38][39] The frequency of stimulation is related to the side of application. Studies in pregnant women with depression reported using 10-25 Hz in the left DLPFC and 1 Hz in the right DLPFC, which are very similar to the frequencies used in depression protocols in non-pregnant adults.…”

Section: Fetal Outcomesmentioning

confidence: 99%

Transcranial magnetic stimulation for treatment of major depression during pregnancy: a review

Felipe

Ferrão

2016

Trends Psychiatry Psychother.

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Introduction: Pregnancy is characterized by a high prevalence of mental disorders. Depression is the most common of these disorders and it is a risk factor for negative maternal and child development outcomes. Psychotherapy and pharmacotherapy are conventional and well-established therapeutic options, but some clients fail to respond and the safety of using some pharmacological agents during pregnancy is unclear. Some neuromodulation techniques, such as repetitive transcranial magnetic stimulation (rTMS), have been studied in depressed pregnant women. Objective: To evaluate the safety and efficacy of rTMS for major depression in pregnant women. Methods: The LILACS and PubMed databases were reviewed using the search terms depression, pregnancy and magnetic stimulation. Texts including primary data, published in Portuguese, Spanish, or English, between 1995 and2014, that evaluated depressed pregnant women and used rTMS as the intervention were selected. Papers lacking sufficient data were excluded. Twenty-two texts were initially identified; after applying the inclusion criteria, 12 were selected and analyzed. Results: The studies reviewed reported satisfactory responses to rTMS in acute depressive episodes, as measured using depressive symptom scales. Remission of symptoms was achieved in many cases. The procedure was well tolerated and there were no reports of damage/complications to unborn children. Conclusion:The data available at this time support the efficacy and tolerability of rTMS for depression in pregnant women. Controlled studies should corroborate this conclusion. This review only included studies in three languages and the resulting sample size was not large enough to conduct a meta-analysis.

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“…In a typical protocol, depressed patients are scanned with single photon emission computed tomography (SPECT) or positron emission tomography (PET) before and after rTMS applied over the left MDLFC (1-20 Hz frequency, 1-10 sessions, MDLFC defined as 5 cm anterior to the hand area of the primary motor cortex, eg Kimbrell et al, 1999;Teneback et al, 1999;Speer et al, 2000;Catafau et al, 2001;Nahas et al, 2001;Conca et al, 2002;Mottaghy et al, 2002;Nadeau et al, 2002;Shajahan et al, 2002). Following a single session of high-frequency rTMS, Shajahan et al (2002) reported that the connectivity between a number of brain circuits implicated in affect was significantly stronger.…”

Section: Introductionmentioning

confidence: 99%

“…Following a single session of high-frequency rTMS, Shajahan et al (2002) reported that the connectivity between a number of brain circuits implicated in affect was significantly stronger. Following 5-10 days of rTMS treatment applied over the left MDLFC, a number of investigators have also found changes in neural activity in the left prefrontal cortex (Speer et al, 2000;Catafau et al, 2001;Nahas et al, 2001) as well as in affectrelevant brain regions, including the anterior cingulate cortex (ACC), amygdala, and striatum (Teneback et al, 1999;Speer et al, 2000;Nahas et al, 2001;Nadeau et al, 2002). Finally, as with antidepressant drugs (eg Mayberg et al, 1997), baseline resting cerebral blood flow and cerebral glucose metabolism values in the ACC have been found to be predictive of antidepressant response to rTMS treatment Mottaghy et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Mechanisms of Action Underlying the Effect of Repetitive Transcranial Magnetic Stimulation on Mood: Behavioral and Brain Imaging Studies

Barrett

Della‐Maggiore

Chouinard

et al. 2004

Neuropsychopharmacol

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In a set of experiments, we applied 10-Hz repetitive transcranial magnetic stimulation (rTMS) over the left mid-dorsolateral frontal cortex (MDLFC) to investigate rTMS-induced changes in affective state and neural activity in healthy volunteers. In Experiment 1, we combined 10-Hz rTMS with a speech task to examine rTMS-induced changes in paralinguistic aspects of speech production, an affect-relevant behavior strongly linked to the ACC. In Experiment 2, we combined 10-Hz rTMS with positron emission tomography (PET) and used partial least squares (PLS) to identify a pattern of brain regions whose connectivity with the site of stimulation varied as a function of rTMS. The results of Experiment 1 revealed that following stimulation of the left MDLFC, subjects reported having less positive affect and vitality and displayed more monotonous speech. In Experiment 2, results revealed that 10-Hz rTMS influenced the covariation between blood flow at the site of stimulation (ie the left MDLFC) and blood flow in a number of affect-relevant brain regions including the perigenual anterior cingulate gyrus, insula, thalamus, parahippocampal gyrus, and caudate nucleus. Taken together, our results suggest that changes in affect and affect-relevant behaviour following 10-Hz rTMS applied over the left MDLFC may be related to changes in neural activity in brain regions widely implicated in affective states, including a frontocingulate circuit.

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Opposite effects of high and low frequency rTMS on regional brain activity in depressed patients

Cited by 538 publications

References 47 publications

Interleaved Transcranial Magnetic Stimulation/Functional MRI Confirms that Lamotrigine Inhibits Cortical Excitability in Healthy Young Men

Interleaved Transcranial Magnetic Stimulation/Functional MRI Confirms that Lamotrigine Inhibits Cortical Excitability in Healthy Young Men

Transcranial magnetic stimulation for treatment of major depression during pregnancy: a review

Mechanisms of Action Underlying the Effect of Repetitive Transcranial Magnetic Stimulation on Mood: Behavioral and Brain Imaging Studies

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