Slow magnetic stimulation of prefrontal cortex in depression and schizophrenia

Geller, Vadim; Grisaru, Nimrod; Abarbanel, J. M.; Lemberg, Tamara; Belmaker, Robert H.

doi:10.1016/s0278-5846(96)00161-3

Cited by 99 publications

(43 citation statements)

References 16 publications

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“…Several early case reports (14) and reports of single pulses or very slow trains of TMS applied to multiple sites (15)(16)(17) or at the vertex (18) produced encouraging initial results. In the wake of these studies, more rigorous studies were performed in which sequences of repetitive transcranial magnetic stimulation (rTMS) were applied to one brain region.…”

Section: Clinical Resultsmentioning

confidence: 98%

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Transcranial Magnetic Stimulation in the Treatment of Depression

Gershon

Dannon²,

Grunhaus³

2003

AJP

459

246

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Objective: Transcranial magnetic stimulation (TMS) is a noninvasive and easily tolerated method of altering cortical physiology. The authors evaluate evidence from the last decade supporting a possible role for TMS in the treatment of depression and explore clinical and technical considerations that might bear on treatment success. Method:The authors review English-language controlled studies of nonconvulsive TMS therapy for depression that appeared in the MEDLINE database through early 2002, as well as one study that was in press in 2002 and was published in 2003. In addition, the authors discuss studies that have examined technical, methodological, and clinical treatment parameters of TMS. Results:Most data support an antidepressant effect of high-frequency repetitive TMS administered to the left prefrontal cortex. The absence of psychosis, younger age, and certain brain physiologic markers might predict treatment success. Technical parameters possibly affecting treatment success include intensity and duration of treatment, but these suggestions require systematic testing.Conclusions: TMS shows promise as a novel antidepressant treatment. Systematic and large-scale studies are needed to identify patient populations most likely to benefit and treatment parameters most likely to produce success. In addition to its potential clinical role, TMS promises to provide insights into the pathophysiology of depression through research designs in which the ability of TMS to alter brain activity is coupled with functional neuroimaging. (Am J Psychiatry 2003; 160:835-845)In 1831, Michael Faraday discovered that electrical currents can be converted into magnetic fields and vice versa. His principle of mutual induction is the basis of transcranial magnetic stimulation (TMS). In TMS, a bank of capacitors is rapidly discharged into an electric coil to produce a magnetic field pulse (Figure 1). When the coil is placed near the head of a human or animal, the magnetic field penetrates the brain and induces an electric field in the underlying region of the cerebral cortex (4) (Figure 2). An electrical field of sufficient intensity will depolarize cortical neurons, generating action potentials. These then propagate to exert their biological effects. For example, TMS over the left motor cortex causes action potentials that propagate through the corticospinal tract, causing twitches in contralateral skeletal muscles.This new technology has been used to affect underlying brain tissue at several levels. First, TMS can alter regional activity within the cortex. Positron emission tomography (PET) has revealed changes in cortical metabolism and dose-dependent changes in regional cortical blood flow in response to TMS (5-7). Such changes are also observed at sites distant from the magnetic stimulus, showing that the effects of TMS propagate to other parts of the brain (6, 7). The connections demonstrated in this manner correspond to known neural pathways in nonhuman primates, suggesting that the propagation of TMS effects occurs by means of...

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Section: Clinical Resultsmentioning

confidence: 98%

“…Although different studies have used various frequencies, two overall types have been used: low frequency (≤1 Hz) and high frequency (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). This distinction is important because the two types of stimulation have opposite effects on brain physiology.…”

Section: Pulse Frequency-slow Versus Fast Rtmsmentioning

confidence: 99%

Transcranial Magnetic Stimulation in the Treatment of Depression

Gershon

Dannon²,

Grunhaus³

2003

AJP

459

246

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“…The first of these took a conservative approach by using only 30 single rTMS pulses applied in a single treatment session and reporting the possibility of some short-lived therapeutic effects. 17 Feinsod et al 18 subsequently reported the results of a small open study where a significant decrease in BPRS scores was found after 10 sessions of 1-Hz stimulation applied to the right PFC. The authors described this reduction as being more in nonspecific symptoms, such as anxiety and tension, rather than the core symptoms of schizophrenia.…”

Section: Early General Studiesmentioning

confidence: 99%

A Review of Repetitive Transcranial Magnetic Stimulation Use in the Treatment of Schizophrenia

Fitzgerald

Daskalakis

2008

Can J Psychiatry

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D eveloped for various investigative and potential therapeutic purposes, rTMS is a relatively new technique. Its use in experimental settings is growing rapidly 1 and its potential as a treatment is being tested in numerous neurological and psychiatric conditions. Most research and interest has focused on the potential application of rTMS in the treatment of depression. In addition, in recent years an increasing number of open and double-blind studies of rTMS were conducted in patients with schizophrenia. However, owing to the complexity of this disorder, the development of therapeutic rTMS paradigms is problematic. At least partially in response to this, most investigators have chosen to focus on the treatment of specific refractory symptoms or syndromes within the disorder. We aim to review the current status of the development of the therapeutic applications of rTMS in the treatment of schizophrenia or its symptoms. Highlights • Low-frequency rTMS applied to the temporoparietal cortical region appears to be able to modulate the severity of auditory hallucinations. • Prefrontal rTMS has promise but requires further evaluation in the treatment of negative symptoms of schizophrenia. • rTMS can be safely used in patients with schizophrenia and warrants further investigation.

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“…A paciente que teve a maior melhora foi a que apresentava a menor pontuação na escala e sem sintomas psicóticos. Chamou a atenção o fato de não haver melhora em nenhum dos sintomas psicóticos, inclusive alucinações auditivas, presentes em um dos pacientes, ao contrário do que demonstraram alguns estudos envolvendo pacientes com este sintoma 15,16 . A diminuição contínua da pontuação de todos os pacientes ao longo do estudo pode sugerir que maior núme-ro de sessões, com o prolongamento do tratamento (mais do que quatro semanas) leve a melhora mais significativa do respectivo quadro clínico.…”

Section: Discussionunclassified

O uso da estimulação magnética transcraniana de baixa frequência no tratamento da depressão no Hospital Universitário de Brasília: achados preliminares

Brasil‐Neto

Boechat-Barros

Mota-Silveira

2003

Arq. Neuro-Psiquiatr.

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RESUMO -O presente estudo relata o uso da estimulação magnética transcraniana de baixa frequência sobre o córtex pré-frontal direito em três pacientes com diagnóstico de episódio depressivo maior, de acordo com o DSM -IV. Houve melhora significativa em dois pacientes, com diminuição de mais de 50% na pontuação da escala de Hamilton -17 itens. São feitas considerações acerca de possíveis indicações e limitações do seu uso clínico, bem como sugestões ao protocolo de uso desta técnica. Também são discutidos fatores socioeconômicos relacionados a esta terapia.PALAVRAS-CHAVE: estimulação magnética transcraniana, baixa frequência, depressão.The use of slow-frequency transcranial magnetic stimulation in the treatment of depression at Brasília The use of slow-frequency transcranial magnetic stimulation in the treatment of depression at Brasília The use of slow-frequency transcranial magnetic stimulation in the treatment of depression at Brasília The use of slow-frequency transcranial magnetic stimulation in the treatment of depression at Brasília The use of slow-frequency transcranial magnetic stimulation in the treatment of depression at Brasília University Hospital: preliminary findings University Hospital: preliminary findings University Hospital: preliminary findings University Hospital: preliminary findings University Hospital: preliminary findings ABSTRACT -This paper reports the use of slow frequency transcranial magnetic stimulation of the right prefrontal cortex in three patients with a diagnosis of major depressive episode according to the DSM-IV classification. There was a significant improvement in two patients, with a decrease of over 50% in the Hamilton Scale scores-17 items. Possible indications and limitations of this therapeutic tool are discussed, as well as socio-economic aspects of this new treatment. A estimulação magnética transcraniana (EMT) foi introduzida por Barker et al. em 1985 1 , mostrandose útil para o estudo das vias motoras e o mapeamento topográfico não-invasivo do córtex motor humano 2-4 . A técnica utiliza um aparelho capaz de produzir um campo eletromagnético, usualmente da ordem de 2 tesla (40 000 vezes o campo magnético da terra e aproximadamente da mesma intensidade do campo magnético estático produzido por um aparelho de ressonância magnética), o qual é conduzido através de uma bobina que entra em contato com o couro cabeludo do indivíduo. Este campo eletromagnético atravessa o crânio estimulando uma área cortical próxima, através da indução de cargas elétricas no parênquima cerebral (indução eletro magnética -lei de Faraday). A princípio trata-se de uma forma de estimulação elétrica sem eletrodos, não havendo necessidade de craniotomia. Utilizando-se bobina em forma de oito obtêm-se resultados que se relacionam bem com aqueles produzidos pela estimulação cortical elétrica direta.Inicialmente utilizada na propedêutica com intuito de pesquisar alterações das vias motoras, a EMT passou a ser utilizada também como forma terapêu-tica em patologias como doença de Parkinson 5 e epilep...

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Slow magnetic stimulation of prefrontal cortex in depression and schizophrenia

Cited by 99 publications

References 16 publications

Transcranial Magnetic Stimulation in the Treatment of Depression

Transcranial Magnetic Stimulation in the Treatment of Depression

A Review of Repetitive Transcranial Magnetic Stimulation Use in the Treatment of Schizophrenia

O uso da estimulação magnética transcraniana de baixa frequência no tratamento da depressão no Hospital Universitário de Brasília: achados preliminares

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