Retinal tear and posterior vitreous detachment following repetitive transcranial magnetic stimulation for major depression: A case report

Marafon, Samara B; Miron, Jean‐Philippe; Juncal, Verena R.; Figueiredo, Natália; Downar, Jonathan; Blumberger, Daniel M.; Daskalakis, Zafiris J.; Muni, Rajeev H.

doi:10.1016/j.brs.2019.12.017

Cited by 8 publications

(6 citation statements)

References 9 publications

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“…Additionally, one patient reported the appearance of a spider web in her left vision after rTMS. The corresponding ophthalmologist diagnosed a vitreal floater that seemed to have existed before rTMS treatment, without any sign of retinal problems ( 44 , 45 ), indicating that the patient was able to sense a vitreal floater that was not perceived before treatment.…”

Section: Resultsmentioning

confidence: 99%

Therapeutic Effect of Repetitive Transcranial Magnetic Stimulation for Post-stroke Vascular Cognitive Impairment: A Prospective Pilot Study

Cha

Kim

et al. 2022

Front. Neurol.

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ObjectivePost-stroke cognitive impairment (PSCI) is resistant to treatment. Recent studies have widely applied repetitive transcranial magnetic stimulation (rTMS) to treat various brain dysfunctions, such as post-stroke syndromes. Nonetheless, a protocol for PSCI has not been established. Therefore, this study is aimed to evaluate the therapeutic effect of our high-frequency rTMS protocol for PSCI during the chronic phase of stroke.MethodsIn this prospective study, ten patients with PSCI were enrolled and received high-frequency rTMS on the ipsilesional dorsolateral prefrontal cortex (DLPFC) for 10 sessions (5 days per week for 2 weeks). Cognitive and affective abilities were assessed at baseline and 2 and 14 weeks after rTMS initiation. To investigate the therapeutic mechanism of rTMS, the mRNA levels of pro-inflammatory cytokines (interleukin (IL)-6, IL-1β, transforming growth factor beta [TGF-β], and tumor necrosis factor alpha [TNF-α]) in peripheral blood samples were quantified using reverse transcription polymerase chain reaction, and cognitive functional magnetic resonance imaging (fMRI) was conducted at baseline and 14 weeks in two randomly selected patients after rTMS treatment.ResultsThe scores of several cognitive evaluations, i.e., the Intelligence Quotient (IQ) of Wechsler Adult Intelligence Scale, auditory verbal learning test (AVLT), and complex figure copy test (CFT), were increased after completion of the rTMS session. After 3 months, these improvements were sustained, and scores on the Mini-Mental Status Examination and Montreal Cognitive Assessment (MoCA) were also increased (p < 0.05). While the Geriatric Depression Scale (GeDS) did not show change among all patients, those with moderate-to-severe depression showed amelioration of the score, with marginal significance. Expression of pro-inflammatory cytokines was decreased immediately after the ten treatment sessions, among which, IL-1β remained at a lower level after 3 months. Furthermore, strong correlations between the decrease in IL-6 and increments in AVLT (r = 0.928) and CFT (r = 0.886) were found immediately after the rTMS treatment (p < 0.05). Follow-up fMRI revealed significant activation in several brain regions, such as the medial frontal lobe, hippocampus, and angular area.ConclusionsHigh-frequency rTMS on the ipsilesional DLPFC may exert immediate efficacy on cognition with the anti-inflammatory response and changes in brain network in PSCI, lasting at least 3 months.

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Section: Resultsmentioning

confidence: 99%

Therapeutic Effect of Repetitive Transcranial Magnetic Stimulation for Post-stroke Vascular Cognitive Impairment: A Prospective Pilot Study

Cha

Kim

et al. 2022

Front. Neurol.

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“…Similar side effects are also reported by Marafon and colleagues (2019). They administered 25 sessions of theta-burst stimulation to bilateral DLPFC over five weeks in a 50-year-old female, which resulted in the cessation of further sessions (Marafon et al, 2020). Treatment resistance to pharmacotherapy was present in all the patients.…”

Section: Resultsmentioning

confidence: 99%

“…However, serious side effects were not reported (Cristancho et al, 2020). Interestingly, serious side effect like retinal tear with posterior vitreous detachment has been reported in a single case report (Marafon et al, 2020). Considering the low number of the population having received TBS, it demands further elaboration to ensure safety profile of this type of TMS.…”

Section: Theta-burst Stimulation (Tbs)mentioning

confidence: 99%

Transcranial Magnetic Stimulation for the treatment of late-life depression: A scoping review

Vidya¹,

Tripathi²,

Kumari³

et al. 2022

GPA

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Objective: Transcranial magnetic stimulation (TMS) is a form of neuromodulation used to treat various neuropsychiatric disorders. The clinical utility of TMS in older adults with depression is less studied. This review was conducted to compile the study findings on the efficacy and adverse effects of TMS in later-life depression to elucidate gaps in the literature and formulate recommendations. Materials and methods:A search was conducted on PubMed, Scopus and Ovid databases with search terms based on the three domains of our research questions, namely "transcranial magnetic stimulation", "depression", and "later life". All the articles published in English until June 2021 were incorporated and critically appraised after fulfilling inclusion and exclusion criteria. Results: A total of 643 articles were screened with title and abstract, and 41 were selected for full-text assessment. Finally, 26 articles were included after scrutiny and findings were tabulated. This consisted of 8 randomized controlled trials (RCTs), six open-label, one retrospective study, 4 case series and 7 case reports. Available findings in this area so far are mixed and inconclusive. Level I evidence for the use of TMS in later-life depression is lacking. Conclusion: Evidence regarding the efficacy of TMS in the treatment of depression in older adults lacks consistency in the outcomes, which warrants an urgent need for systematic review and meta-analysis of RCTs on the use of TMS in later-life depression.

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“…4 In a case published by Marafon and colleagues (2020), bilateral 50 Hz intermittent theta-burst stimulation was reported to cause retinal detachment on the 25th session. 5 On the other hand, in a case presentation by Kung and colleagues (2011), the application of inhibitory 1 Hz rTMS was reported to cause retinal detachment on the 11th session. 6 Similarly, in our case, it is considered that the relationship between inhibitory 1 Hz stimulation and retinal detachment may exist.…”

Section: Discussionmentioning

confidence: 97%

“…In a case presentation of the study conducted by Wallace and colleagues (2019), it was reported that the application of 10 Hz excitatory repetitive TMS led to retinal detachment on the 24th session 4 . In a case published by Marafon and colleagues (2020), bilateral 50 Hz intermittent theta-burst stimulation was reported to cause retinal detachment on the 25th session 5 . On the other hand, in a case presentation by Kung and colleagues (2011), the application of inhibitory 1 Hz rTMS was reported to cause retinal detachment on the 11th session 6 .…”

Section: Discussionmentioning

confidence: 99%

Retinal Tear Following Low-Frequency Repetitive Transcranial Magnetic Stimulation for Obsessive-Compulsive Disorder

Garip,

Buzkan,

Demir

2024

Clin Neuropharm

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Objectives Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive form of brain stimulation that uses magnetic pulses to stimulate specific brain regions. Retina is being investigated whether the retina, which is also known as the brain's window to the outside world, is affected by the treatment. Methods Magventure X100 device was used for the procedure. The bilateral supplementary motor area was targeted. Procedure protocol: power: 47%, repetitive rate (frequency): 1 Hz, pulses in train duration: 300, intertrain interval (waiting time): 120 seconds, number of trains: 4, total pulses: 1200. Twenty sessions of rTMS were planned for the patient. The patient was informed about the procedure, and her consent was obtained. Results The Yale-Brown Obsessive-Compulsive Disorder Scale (YBOCS) score before the first session was 31, and the Brown Assessment Beliefs Scale (BABS) score was 5. The patient's YBOCS score after the 15th session was 14, and the BABS score was 0. After the implementation of the 15th session of the patient's treatment, retinal detachment developed in the right eye, and the treatment was terminated. As a result of the eye examination of the patient, it was determined that there was 1 horseshoe rupture and 2 hole-shaped ruptures in the lower half of the left eye. Conclusions Patients at risk for retinal detachment may require specialized treatment and close monitoring to prevent the condition from worsening. It is important to consult with an ophthalmologist for patients at risk for retinal detachment before TMS application.

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Retinal tear and posterior vitreous detachment following repetitive transcranial magnetic stimulation for major depression: A case report

Cited by 8 publications

References 9 publications

Therapeutic Effect of Repetitive Transcranial Magnetic Stimulation for Post-stroke Vascular Cognitive Impairment: A Prospective Pilot Study

Therapeutic Effect of Repetitive Transcranial Magnetic Stimulation for Post-stroke Vascular Cognitive Impairment: A Prospective Pilot Study

Transcranial Magnetic Stimulation for the treatment of late-life depression: A scoping review

Retinal Tear Following Low-Frequency Repetitive Transcranial Magnetic Stimulation for Obsessive-Compulsive Disorder

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