Safety and Efficacy of Adjunctive Θ Burst Repetitive Transcranial Magnetic Stimulation to Right Inferior Parietal Lobule in Schizophrenia Patients With First-Rank Symptoms

Tikka, Sai Krishna; Nizamie, S. Haque; Babu, G.M. Venkatesh; Aggarwal, Nidhi; Das, Archana Kumari; Goyal, Nishant

doi:10.1097/yct.0000000000000343

Cited by 16 publications

(12 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this study, there was no significant efficacy of active cTBS over sham, despite a significant clinical amelioration of auditory hallucinations in both groups. More recently, a study by Tikka et al81 recruited 20 patients and examined the same paradigm as Koops et al80 but targeting the right inferior parietal lobe; the results led to the same conclusion of a lack of superiority of active cTBS over sham.…”

Section: Introductionmentioning

confidence: 87%

<p>Auditory verbal hallucinations in schizophrenia: current perspectives in brain stimulation treatments</p>

Nathou

Dollfus

2019

NDT

View full text Add to dashboard Cite

Purpose This review reports the current perspectives of brain stimulation techniques in the treatment of auditory verbal hallucinations (AVH) in schizophrenia. Methods A systematic search of the literature in the PubMed database revealed that the most studied techniques are noninvasive techniques (NIBS), including electroconvulsive therapy (ECT), transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS). Results The results showed that ECT could have great clinical efficacy but is currently underused in practice perhaps due to the costs associated with its limited implementation and potential associated risks. tDCS is still poorly studied and does not demonstrate sufficiently homogeneous or conclusive results yet to prove its efficacy in the treatment of AVH. However, its safe and simple implementation allows us to recommend it to patients who are refractory to other stimulation techniques. Finally, rTMS seems to be the most efficacious NIBS to offer patients with persistent AVH as an add-on therapeutic strategy. Its implementation has a non negligible cost but can be performed by a single practitioner. Great evolution in these techniques with technological progress, robotics and computer science are currently being tested and will undoubtedly improve the clinical efficacy of these procedures, particularly towards more personalized treatments such as individual rTMS targets and intensities. There are also new techniques for deep brain stimulation based on focused ultrasound that could provide much insight into the treatment of AVH in schizophrenia. Conclusion This review suggests that add-on brain stimulation treatments could play a key role among the therapeutic strategies for auditory hallucinations reduction in schizophrenia.

show abstract

Section: Introductionmentioning

confidence: 87%

<p>Auditory verbal hallucinations in schizophrenia: current perspectives in brain stimulation treatments</p>

Nathou

Dollfus

2019

NDT

View full text Add to dashboard Cite

show abstract

“…In this study, the severity of depression was measured using HAM-D 12 and Beck Depression Inventory (BDI) 19 . Concomitant anxiety symptoms were assessed by Hamilton Anxiety Rating Scale (HAM-A) 20 .…”

Section: Methodsmentioning

confidence: 99%

“…Intensive cTBS was chosen as the "inhibitory protocol" citing its more robust inhibitory actions on the cortical excitability than the other low-frequency rTMS. 12 An ensuing objective of our study was to find out the cTBS effects on concomitant anxiety, sexual function, and quality of life in acute-phase bipolar depression subjects as compared with placebo.…”

mentioning

confidence: 99%

“…With this background, we aimed to study the safety and efficacy of inhibitory rTMS to rDLPFC in acute-phase bipolar depression subjects on a randomized rater blinded placebo control design. Intensive cTBS was chosen as the “inhibitory protocol” citing its more robust inhibitory actions on the cortical excitability than the other low-frequency rTMS 12 . An ensuing objective of our study was to find out the cTBS effects on concomitant anxiety, sexual function, and quality of life in acute-phase bipolar depression subjects as compared with placebo.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Safety and Efficacy of Continuous Theta Burst “Intensive” Stimulation in Acute-Phase Bipolar Depression

Mallik¹,

Mishra²,

Garg³

et al. 2022

J ECT

Self Cite

View full text Add to dashboard Cite

ObjectivesRepetitive transcranial magnetic stimulation efficacy in unipolar depression is known, but its efficacy in acute-phase bipolar depression is at best modest. Citing differential right dorsolateral prefrontal cortex hyperconnectivity implicated in BD, we aimed to study the effect of novel continuous theta burst stimulation (cTBS) targeting right dorsolateral prefrontal cortex in a randomized rater blinded placebo control design.Material and MethodsNineteen patients aged 18 to 59 years (baseline Hamilton Depression Rating Scale [HAM-D] 17 severity score >18) were randomly allocated to active cTBS (n = 11) and sham cTBS (n = 9) groups using block randomization method. They received 15 cTBS sessions (burst of 3 pulses delivered at 50 Hz, repeated every 200 ms at 5 Hz, 600 pulses per session), 3 sessions per day (total of 1800 pulses) for 5 days in a week at 80% resting motor threshold. The HAM-D, Beck Depression Inventory, Hamilton Anxiety Rating Scale, World Health Organization's abbreviated quality of life assessment, and Changes in Sexual Functioning Questionnaire were assessed at baseline, after the last session, and at 2 weeks after repetitive transcranial magnetic stimulation. Intention-to-treat analysis was conducted and missing values (2 patients) were replaced using the last observation carried forward method.ResultsOn repeated measures analysis of variance, a significant within-group time effect (from pretreatment to 2 weeks after TBS) for HAM-D (F = 15.091, P < 0.001), Beck Depression Inventory (F = 22.376, P < 0.001), Hamilton Anxiety Rating Scale (F = 18.290, P < 0.001), Changes in Sexual Functioning Questionnaire (F = 9.281, P = 0.001), and World Health Organization's abbreviated quality of life assessment (F = 24.008, P < 0.001). The integrity of the blind assessed by the guess matrix was good. When significant between group*time effect was compared, none of the variables retained statistical significance. No major adverse effects were reported, and none of the patients discontinued the trial because of adverse effects.ConclusionsOur trial concludes that although safe and well tolerated, the therapeutic efficacy of intensive intermittent TBS in acute-phase bipolar depression is inconclusive. Choice of lower total number to sessions and smaller intersession interval along with small sample size limit the study findings.

show abstract

“…21 Previous studies have indicated that the theta burst stimulation (TBS), a highfrequency rTMS, is a safe procedure with minor adverse effects. 22,23 A more recent and efficient form of TBS is intermittent theta burst stimulation (iTBS), which has shown faster and longer-lasting poststimulation effects. 24 Notably, iTBS can create long-term effects by inducing long-term forms of synaptic plasticity, which are longterm potentiation and long-term depression.…”

mentioning

confidence: 99%

The Therapeutic Role of Intermittent Theta Burst Stimulation in Schizophrenia

Salabat,

Pourebrahimi,

Mayeli

et al. 2024

J ECT

View full text Add to dashboard Cite

Schizophrenia affects approximately 1% of the population worldwide. Multifactorial reasons, ranging from drug resistance to adverse effects of medications, have necessitated exploring further therapeutic options. Intermittent theta burst stimulation (iTBS) is a novel high-frequency form of transcranial magnetic stimulation, a safe procedure with minor adverse effects with faster and longer-lasting poststimulation effects with a potential role in treating symptoms; however, the exact target brain regions and symptoms are still controversial. Therefore, we aimed to systematically investigate the current literature regarding the therapeutic utilities of iTBS using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Twelve studies were included among which 9 found iTBS effective to some degree. These studies targeted the dorsolateral prefrontal cortex and the midline cerebellum. We performed a random-effects meta-analysis on studies that compared the effects of iTBS on schizophrenia symptoms measured by the Positive and Negative Syndrome Scale (PANSS) to sham treatment. Our results showed no significant difference between iTBS and sham in PANSS positive and negative scores, but a trend-level difference in PANSS general scores (k = 6, P = 0.07), and a significant difference in PANSS total scores (k = 6, P = 0.03). Analysis of the studies targeting the dorsolateral prefrontal cortex showed improvement in PANSS negative scores (k = 5, standardized mean difference = −0.83, P = 0.049), but not in PANSS positive scores. Moderators (intensity, pulse, quality, sessions) did not affect the results. However, considering the small number of studies included in this meta-analysis, future works are required to further explore the effects of these factors and also find optimum target regions for positive symptoms.

show abstract

Safety and Efficacy of Adjunctive Θ Burst Repetitive Transcranial Magnetic Stimulation to Right Inferior Parietal Lobule in Schizophrenia Patients With First-Rank Symptoms

Cited by 16 publications

References 41 publications

<p>Auditory verbal hallucinations in schizophrenia: current perspectives in brain stimulation treatments</p>

<p>Auditory verbal hallucinations in schizophrenia: current perspectives in brain stimulation treatments</p>

Safety and Efficacy of Continuous Theta Burst “Intensive” Stimulation in Acute-Phase Bipolar Depression

The Therapeutic Role of Intermittent Theta Burst Stimulation in Schizophrenia

Contact Info

Product

Resources

About