Sinus Tachycardia Induced by Methocarbamol and Repetitive Transcranial Magnetic Stimulation (rTMS)

Dobek, Christine E.; Dipinto, Adam A.; Kuan, Annie J; Lam, Raymond W.; Blumberger, Daniel M.; Downar, Jonathan; Daskalakis, Zafiris J.; Vila‐Rodriguez, Fidel

doi:10.1016/j.brs.2015.10.012

Cited by 6 publications

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“…24,25 This is similar for statement 14, “Manage immediate complications (e.g., Seizure) arising from rTMS” where complications may include seizures and tachycardia. 25,26 It is expected that even though these may be rare complications arising from rTMS, learners should be able to manage and triage this as these complications can be life-threatening. In addition, with statement 15 “Manage immediate side-effects (e.g., Scalp pain) arising from rTMS”, side-effects of rTMS may include headache, syncope, dizziness, facial twitching and tearing.…”

Section: Discussionmentioning

confidence: 99%

Competencies for Repetitive Transcranial Magnetic Stimulation in Postgraduate Medical Education: Expert Consensus Using a Modified Delphi Process

et al. 2023

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Background Repetitive transcranial magnetic stimulation (rTMS) is recommended in Canadian guidelines as a first-line treatment for major depressive disorder. With the shift towards competency-based medical education, it remains unclear how to determine when a resident is considered competent in applying knowledge of rTMS to patient care. Given inconsistencies between postgraduate training programmes with regards to training requirements, defining competencies will improve the standard of care in rTMS delivery. Objective The goal of this study was to develop competencies for rTMS that can be implemented into a competency-based training curriculum in postgraduate training programmes. Methods A working group drafted competencies for postgraduate psychiatry trainees. Fourteen rTMS experts from across Canada were invited to participate in the modified Delphi process. Results Ten experts participated in all three rounds of the modified Delphi process. A total of 20 items reached a consensus. There was improvement in the Cronbach's alpha over the rounds of modified Delphi process (Cronbach's alpha increased from 0.554 to 0.824) suggesting improvement in internal consistency. The intraclass correlation coefficient (ICC) increased from 0.543 to 0.805 suggesting improved interrater agreement. Conclusions This modified Delphi process resulted in expert consensus on competencies to be acquired during postgraduate medical education programmes where a learner is training to become competent as a consultant and/or practitioner in rTMS treatment. This is a field that still requires development, and it is expected that as more evidence emerges the competencies will be further refined. These results will help the development of other curricula in interventional psychiatry.

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Section: Discussionmentioning

confidence: 99%

Competencies for Repetitive Transcranial Magnetic Stimulation in Postgraduate Medical Education: Expert Consensus Using a Modified Delphi Process

et al. 2023

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“…Briefly, a MagPro X100 stimulator with a Cool-B70 fluid-cooled coil was used to deliver rTMS for all patients (Magventure, Farum, Denmark). Resting motor threshold was determined by visual inspection of right interpolicis brevis muscle contraction with the aid of the TMS Motor Threshold Assessment Tool ( Dobek et al, 2016 ). All treatments were delivered at 120% resting motor threshold ( Blumberger et al, 2018 ).…”

Section: Methodsmentioning

confidence: 99%

“…All treatments were delivered at 120% resting motor threshold ( Blumberger et al, 2018 ). Following randomization, TRD patients received either HFL stimulation or iTBS over the left DLPFC, using a Neuronavigation system (Visor 2.0, ANT Neuro, Enschede, Netherlands) and the target location specified by reverse coregistration from a stereotaxic coordinate on the standard Montreal neurological institute (MNI-152) template brain [x - 38, y + 44, z + 26] identified as optimal based on functional connectivity and clinical outcome ( Dobek et al, 2016 ).…”

Section: Methodsmentioning

confidence: 99%

Non-linear Entropy Analysis in EEG to Predict Treatment Response to Repetitive Transcranial Magnetic Stimulation in Depression

et al. 2018

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Background: Biomarkers that predict clinical outcomes in depression are essential for increasing the precision of treatments and clinical outcomes. The electroencephalogram (EEG) is a non-invasive neurophysiological test that has promise as a biomarker sensitive to treatment effects. The aim of our study was to investigate a novel non-linear index of resting state EEG activity as a predictor of clinical outcome, and compare its predictive capacity to traditional frequency-based indices.Methods: EEG was recorded from 62 patients with treatment resistant depression (TRD) and 25 healthy comparison (HC) subjects. TRD patients were treated with excitatory repetitive transcranial magnetic stimulation (rTMS) to the dorsolateral prefrontal cortex (DLPFC) for 4 to 6 weeks. EEG signals were first decomposed using the empirical mode decomposition (EMD) method into band-limited intrinsic mode functions (IMFs). Subsequently, Permutation Entropy (PE) was computed from the obtained second IMF to yield an index named PEIMF2. Receiver Operator Characteristic (ROC) curve analysis and ANOVA test were used to evaluate the efficiency of this index (PEIMF2) and were compared to frequency-band based methods.Results: Responders (RP) to rTMS exhibited an increase in the PEIMF2 index compared to non-responders (NR) at F3, FCz and FC3 sites (p < 0.01). The area under the curve (AUC) for ROC analysis was 0.8 for PEIMF2 index for the FC3 electrode. The PEIMF2 index was superior to ordinary frequency band measures.Conclusion: Our data show that the PEIMF2 index, yields superior outcome prediction performance compared to traditional frequency band indices. Our findings warrant further investigation of EEG-based biomarkers in depression; specifically entropy indices applied in band-limited EEG components. Registration in ClinicalTrials.Gov; identifiers NCT02800226 and NCT01887782.

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Ibuprofen/methocarbamol

2016

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Sinus Tachycardia Induced by Methocarbamol and Repetitive Transcranial Magnetic Stimulation (rTMS)

Cited by 6 publications

References 1 publication

Competencies for Repetitive Transcranial Magnetic Stimulation in Postgraduate Medical Education: Expert Consensus Using a Modified Delphi Process

Competencies for Repetitive Transcranial Magnetic Stimulation in Postgraduate Medical Education: Expert Consensus Using a Modified Delphi Process

Non-linear Entropy Analysis in EEG to Predict Treatment Response to Repetitive Transcranial Magnetic Stimulation in Depression

Ibuprofen/methocarbamol

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