Transcranial Electrical Stimulation and Behavioral Change: The Intermediary Influence of the Brain

Harty, Siobhán; Sella, Francesco; Kadosh, Roi Cohen

doi:10.3389/fnhum.2017.00112

Cited by 8 publications

(7 citation statements)

References 22 publications

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“…Future rTMS research should focus on the inter-individual variability of effects [35], and promote the establishment of personalized rTMS treatment: tailoring rTMS to individualized targets and predictors based on structural or functional connectivity [36,37 ▪ ]; and adjusting rTMS protocols to distinct brain states guided by individual neurophysiological markers or using closed-loop protocols [38 ▪ ,39]. Furthermore, cognitive indices could be leveraged for several purposes: baseline cognitive performance can predict response to rTMS [40] and therefore – based on machine learning approaches – could be used as a relatively straightforward method for prediction; cognitive changes can provide insights on rTMS mechanisms of action, for instance, by exploring whether they mediate depression improvement [41].…”

Section: Personalized and Stratified Treatment As An Avenue To Precismentioning

confidence: 99%

Repetitive transcranial magnetic stimulation treatment for depressive disorders

Baeken

Brem

Arns

et al. 2019

Current Opinion in Psychiatry

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Purpose of review After three decades of clinical research on repetitive transcranial magnetic stimulation (rTMS), major depressive disorder (MDD) has proven to be the primary field of application. MDD poses a major challenge for health systems worldwide, emphasizing the need for improving clinical efficacy of existing rTMS applications and promoting the development of novel evidence-based rTMS treatment approaches. Recent findings Several promising new avenues have been proposed: novel stimulation patterns, targets, and coils; combinatory treatments and maintenance; and personalization and stratification of rTMS parameters, and treatment of subpopulations. Summary This opinion review summarizes current knowledge in the field and addresses the future direction of rTMS treatment in MDD, facilitating the establishment of this clinical intervention method as a standard treatment option and continuing to improve response and remission rates, and take the necessary steps to personalize rTMS-based treatment approaches.

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Section: Personalized and Stratified Treatment As An Avenue To Precismentioning

confidence: 99%

Repetitive transcranial magnetic stimulation treatment for depressive disorders

Baeken

Brem

Arns

et al. 2019

Current Opinion in Psychiatry

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“…However, there have been increasing concerns about reported variability in response patterns across individuals. Although there is abundant evidence of physiological factors influencing interindividual variability (Harty, Sella, & Cohen Kadosh, 2017; Li, Uehara, & Hanakawa, 2015), remarkably little work has been explicitly directed at identifying baseline markers that could identify individuals who are more likely to be sensitive to NIBS. Recent investigations have highlighted how off-line electroencephalography (EEG) recordings acquired prior to NIBS interventions could be particularly viable in this regard (see Thut et al, 2017).…”

mentioning

confidence: 99%

Suboptimal Engagement of High-Level Cortical Regions Predicts Random-Noise-Related Gains in Sustained Attention

Harty

Kadosh

2019

Psychol Sci

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Interindividual variability in outcomes across individuals poses great challenges for the application of noninvasive brain stimulation in psychological research. Here, we examined how the effects of high-frequency transcranial random-noise stimulation (tRNS) on sustained attention varied as a function of a well-studied electrocortical marker: spontaneous theta:beta ratio. Seventy-two participants received sham, 1-mA, and 2-mA tRNS in a double-blind, crossover manner while they performed a sustained-attention task. Receiving 1-mA tRNS was associated with improved sustained attention, whereas the effect of 2-mA tRNS was similar to the effect of sham tRNS. Furthermore, individuals’ baseline theta:beta ratio moderated the effects of 1-mA tRNS and provided explanatory power beyond baseline behavioral performance. The tRNS-related effects on sustained attention were also accompanied by reductions in theta:beta ratio. These findings impart novel insights into mechanisms underlying tRNS effects and emphasize how designing studies that link variability in cognitive outcomes to variability in neurophysiology can improve inferential power in neurocognitive research.

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“…179 Moreover, evaluating cognitive changes can provide mechanistic insights into the antidepressant mechanisms of action of NIN -e.g., by exploring whether they moderate and/or mediate depression improvement -and into NIN-induced changes in specific brain structures. 180 In this case, cognitive changes have been operationalized as fundamental mechanisms of action, but also as more translational processes, such as self-referential thoughts and emotions (e.g., negative affect, rumination, regret, cognitive bias). To date, most of this research is being performed in healthy volunteers, but the transition to clinical samples -also based on the idea of functional targeting of similar functional and neuroanatomical circuits using multimodal interventions -is slowly moving forward.…”

Section: Convulsive Modalitiesmentioning

confidence: 99%

Precision non-implantable neuromodulation therapies: a perspective for the depressed brain

Borrione

Bellini

Razza

et al. 2020

Braz. J. Psychiatry

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Current first-line treatments for major depressive disorder (MDD) include pharmacotherapy and cognitive-behavioral therapy. However, one-third of depressed patients do not achieve remission after multiple medication trials, and psychotherapy can be costly and time-consuming. Although nonimplantable neuromodulation (NIN) techniques such as transcranial magnetic stimulation, transcranial direct current stimulation, electroconvulsive therapy, and magnetic seizure therapy are gaining momentum for treating MDD, the efficacy of non-convulsive techniques is still modest, whereas use of convulsive modalities is limited by their cognitive side effects. In this context, we propose that NIN techniques could benefit from a precision-oriented approach. In this review, we discuss the challenges and opportunities in implementing such a framework, focusing on enhancing NIN effects via a combination of individualized cognitive interventions, using closed-loop approaches, identifying multimodal biomarkers, using computer electric field modeling to guide targeting and quantify dosage, and using machine learning algorithms to integrate data collected at multiple biological levels and identify clinical responders. Though promising, this framework is currently limited, as previous studies have employed small samples and did not sufficiently explore pathophysiological mechanisms Brazilian Psychiatric Association 0 0 0 0 0 0 0 0 -0 0 0 2 -7 3 1 6 -1 1 8 5 associated with NIN response and side effects. Moreover, cost-effectiveness analyses have not been performed. Nevertheless, further advancements in clinical trials of NIN could shift the field toward a more ''precision-oriented'' practice. DisclosureZ-DD is listed as inventor on patents/patent applications related to brain stimulation technology, assigned to Columbia University and NEVA Electromagnetics, not licensed, and with no remuneration. Although he is an employee of the U.S. government, the views expressed Braz J Psychiatry. 2020;00 (00) Precision NIN for depression

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Transcranial Electrical Stimulation and Behavioral Change: The Intermediary Influence of the Brain

Cited by 8 publications

References 22 publications

Repetitive transcranial magnetic stimulation treatment for depressive disorders

Repetitive transcranial magnetic stimulation treatment for depressive disorders

Suboptimal Engagement of High-Level Cortical Regions Predicts Random-Noise-Related Gains in Sustained Attention

Precision non-implantable neuromodulation therapies: a perspective for the depressed brain

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