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Transcranial Magnetic Stimulation (transcranial + magnetic_stimulation)
Kinds of Transcranial Magnetic Stimulation Terms modified by Transcranial Magnetic Stimulation Selected AbstractsDaily Sessions of Transcranial Magnetic Stimulation to the Left Prefrontal Cortex Gradually Reduce Cocaine CravingTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 4 2008Ernestina Politi MD No abstract is available for this article. [source] In Reference to Maintenance Repetitive Transcranial Magnetic Stimulation can Inhibit the Return of TinnitusTHE LARYNGOSCOPE, Issue 12 2008Berthold Langguth MD No abstract is available for this article. [source] In Reference to Maintenance Repetitive Transcranial Magnetic Stimulation can Inhibit the Return of TinnitusTHE LARYNGOSCOPE, Issue 12 2008Mark Stephen Mennemeier PhD No abstract is available for this article. [source] Transcranial magnetic stimulation in child psychiatry: disturbed motor system excitability in hypermotoric syndromesDEVELOPMENTAL SCIENCE, Issue 3 2002Gunther H. Moll Normal development and dysfunctions of motor system excitability can be investigated in vivo by means of single- and paired-pulse transcranial magnetic stimulation (TMS). While different TMS-parameters show different developmental time courses between 8 and 16 years of age, distinct dysfunctional patterns of motor system excitability can be demonstrated in child psychiatric disorders with hypermotoric behavior: in tic disorder, a shortened cortical silent period can be stated providing evidence for deficient inhibitory mechanisms within the sensorimotor loop, probably primarily at the level of the basal ganglia. In attention deficit hyperactivity disorder (ADHD), a decreased intracortical inhibition indicates deficient inhibitory mechanisms within the motor cortex (but enhancement of intracortical inhibition after oral intake of 10 mg methylphenidate). In children with comorbid ADHD and tic disorder, the findings of a reduced intracortical inhibition as well as a shortened cortical silent period provide evidence for additive effects at the level of motor system excitability. Thus, TMS allows us to obtain substantial insight into both the normal development and the neurobiological basis of hypermotoric syndromes in child psychiatry. [source] Transcranial magnetic stimulation of the human frontal eye field facilitates visual awarenessEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 11 2003Marie-Hélène Grosbras Abstract What are the brain mechanisms allowing a stimulus to enter our awareness? Some theories suggest that this process engages resources overlapping with those required for action control, but experimental support for these ideas is still required. Here, we investigated whether the human frontal eye field (FEF), an area known to control eye movements, is involved in visual awareness. Volunteers participated in a backward masking task in which they were able to detect a target in a small proportion of trials. We observed that a single pulse of transcranial magnetic stimulation applied over the FEF shortly before the target's onset facilitated visual sensitivity; subjects were able to detect an otherwise subliminal object. These results show that modulating the neuronal activity of the FEF can enhance visual detection, thereby yielding new insights into the neural basis of visual awareness. [source] Transcranial magnetic stimulation: Potential treatment for tinnitus?PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 2 2006SAXBY PRIDMORE md Abstract, Tinnitus is a common and often severely disabling disorder for which there is no satisfactory treatment. Transcranial magnetic stimulation (TMS) is a new, non-invasive method of modifying the excitability of the cerebral cortex, which has proven effective in auditory hallucinations and other disorders. Some early studies have been published in which TMS has been trialed in the treatment of tinnitus. The aim of the present paper was to examine the literature and consider the potential for TMS as a therapy in tinnitus. A thorough search of the tinnitus and TMS literature was conducted, and all available relevant material was examined. Discussions were held with leaders in both fields. Tinnitus is common and there are no effective treatments. It is frequently associated with deafness, and may be the result of a pathological plastic process, secondary to loss of innervation of the outer hair cells of the cochlea. Neuroimaging studies demonstrate increase blood flow to the primary and secondary auditory cortices, particularly on the left side. Transcranial magnetic stimulation is a non-invasive method of perturbing and inducing change in the cerebral cortex. It uses electromagnetic principles and has been successfully employed in the treatment of other conditions associated with increased activity of the cerebral cortex. A small number of studies have suggested that TMS may be effective in the treatment of tinnitus. There is a good theoretical basis and early research evidence suggesting that TMS may have treatment potential in tinnitus. Further, larger studies are necessary. [source] Transcranial magnetic stimulation for the deficit syndrome of schizophrenia: A pilot investigationPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 3 2005PERMINDER SACHDEV md, franzcp Abstract, In an open study, four subjects with a stable deficit syndrome of schizophrenia received high frequency repetitive transcranial magnetic stimulation (15 Hz at 90% of motor threshold, 1800 pulses each session, daily for 20 sessions over 4 weeks) over the left dorsolateral prefrontal cortex. Subjects showed a significant reduction in negative symptoms and improvement in function, with no change in positive symptoms. This improvement was maintained at the 1 month follow up. Repetitive transcranial magnetic stimulation as a treatment of the deficit syndrome of schizophrenia is feasible, safe and may be beneficial. A systematic study in randomized control trials would be appropriate. [source] Excitability of human motor cortex inputs prior to graspTHE JOURNAL OF PHYSIOLOGY, Issue 1 2007Gita Prabhu Transcranial magnetic stimulation (TMS) was used to investigate corticospinal excitability during the preparation period preceding visually guided self-paced grasping. Previously we have shown that while subjects prepare to grasp a visible object, paired-pulse TMS at a specific interval facilitates motor-evoked potentials (MEPs) in hand muscles in a manner that varies with the role of the muscle in shaping the hand for the upcoming grasp. This anticipatory modulation may reflect transmission of inputs to human primary motor cortex (M1) for visuomotor guidance of hand shape. Conversely, single-pulse TMS is known to suppress MEPs during movement preparation. Here we investigate the time course of single- and paired-pulse MEP modulation. TMS was delivered over M1, at different time intervals after visual presentation of either a handle or a disc to healthy subjects. Participants were instructed to view the object, and later to grasp it when given a cue. During grasp there was a specific pattern of hand muscle activity according to the object grasped. MEPs were evoked in these muscles by TMS delivered prior to grasp. Paired-pulse MEPs were facilitated, whilst single-pulse MEPs were suppressed. The pattern of facilitation matched the object-specific pattern of muscle activity for TMS pulses delivered 150 ms or more after object presentation. However, this effect was not present when TMS was delivered immediately after object presentation, or if the delivery of TMS was given separately from the cue to perform the grasp action. These results suggest that object-related information for preparation of appropriate hand shapes reaches M1 only immediately preceding execution of the grasp. [source] Developmental plasticity connects visual cortex to motoneurons after strokeANNALS OF NEUROLOGY, Issue 1 2010Anna Basu BM We report motor cortical function in the left occipital cortex of a subject who suffered a left middle cerebral artery stroke early in development. Transcranial magnetic stimulation of the left occipital cortex evoked contraction of right hand muscles. Electroencephalogram recorded over the left occipital cortex showed: 1) coherence with electromyogram from a right hand muscle; 2) a typical sensorimotor Mu rhythm at rest that was suppressed during contraction of right hand muscles. This is the first evidence that cortical plasticity extends beyond reshaping of primary sensory cortical fields to respecification of the cortical origin of subcortically projecting pathways. ANN NEUROL 2010;67:132,136 [source] Cortical disinhibition in diabetic patients with neuropathic painACTA NEUROLOGICA SCANDINAVICA, Issue 6 2009N. Turgut Objectives,,, Motor cortex disinhibition has a role in the mechanism of neuropathic pain. The duration of the cortical silent period (CSP) is used as a measure of excitability in cortical inhibitory circuits. We investigated cortical disinhibition in diabetic patients with and without neuropathic pain. Materials and methods,,, We studied diabetic patients with (n = 20) and without (n = 50) neuropathic pain, and control subjects (n = 30). Transcranial magnetic stimulation (TMS) was performed on the right hemisphere at rest, and surface electromyography was recorded from the left first dorsal interosseous muscle for evaluation of motor evoked potential (MEP) latency and amplitude. CSP was recorded from the left FDI, and TMS was then delivered while the subject was performing a voluntary contraction. Results,,, We showed a low resting motor threshold, a short CSP duration, and a low CSP duration/MEP amplitude ratio in patients with neuropathic pain (P < 0.0001, P < 0.0001, P < 0.0001). Conclusions,,, Our findings demonstrate that diabetic patients with neuropathic pain have a cortical disinhibition. [source] Transcranial magnetic stimulation for the deficit syndrome of schizophreniaACTA NEUROPSYCHIATRICA, Issue 1 2007Perminder S. Sachdev No abstract is available for this article. [source] Changes in presumed motor cortical activity during fatiguing muscle contraction in humansACTA PHYSIOLOGICA, Issue 3 2010T. Seifert Abstract Aim:, Changes in sensory information from active muscles accompany fatiguing exercise and the force-generating capacity deteriorates. The central motor commands therefore must adjust depending on the task performed. Muscle potentials evoked by transcranial magnetic stimulation (TMS) change during the course of fatiguing muscle activity, which demonstrates activity changes in cortical or spinal networks during fatiguing exercise. Here, we investigate cortical mechanisms that are actively involved in driving the contracting muscles. Methods:, During a sustained submaximal contraction (30% of maximal voluntary contraction) of the elbow flexor muscles we applied TMS over the motor cortex. At an intensity below motor threshold, TMS reduced the ongoing muscle activity in biceps brachii. This reduction appears as a suppression at short latency of the stimulus-triggered average of rectified electromyographic (EMG) activity. The magnitude of the suppression was evaluated relative to the mean EMG activity during the 50 ms prior to the cortical stimulus. Results:, During the first 2 min of the fatiguing muscle contraction the suppression was 10 ± 0.9% of the ongoing EMG activity. At 2 min prior to task failure the suppression had reached 16 ± 2.1%. In control experiments without fatigue we did not find a similar increase in suppression with increasing levels of ongoing EMG activity. Conclusion:, Using a form of TMS which reduces cortical output to motor neurones (and disfacilitates them), this study suggests that neuromuscular fatigue increases this disfacilitatory effect. This finding is consistent with an increase in the excitability of inhibitory circuits controlling corticospinal output. [source] Probing the corticospinal link between the motor cortex and motoneurones: some neglected aspects of human motor cortical functionACTA PHYSIOLOGICA, Issue 4 2010N. C. Petersen Abstract This review considers the operation of the corticospinal system in primates. There is a relatively widespread cortical area containing corticospinal outputs to a single muscle and thus a motoneurone pool receives corticospinal input from a wide region of the cortex. In addition, corticospinal cells themselves have divergent intraspinal branches which innervate more than one motoneuronal pool but the synergistic couplings involving the many hand muscles are likely to be more diverse than can be accommodated simply by fixed patterns of corticospinal divergence. Many studies using transcranial magnetic stimulation of the human motor cortex have highlighted the capacity of the cortex to modify its apparent excitability in response to altered afferent inputs, training and various pathologies. Studies using cortical stimulation at ,very low' intensities which elicit only short-latency suppression of the discharge of motor units have revealed that the rapidly conducting corticospinal axons (stimulated at higher intensities) drive motoneurones in normal voluntary contractions. There are also major non-linearities generated at a spinal level in the relation between corticospinal output and the output from the motoneurone pool. For example, recent studies have revealed that the efficacy of the human corticospinal connection with motoneurones undergoes activity-dependent changes which influence the size of voluntary contractions. Hence, corticospinal drives must be sculpted continuously to compensate for the changing functional efficacy of the descending systems which activate the motoneurones. This highlights the need for proprioceptive monitoring of movements to ensure their accurate execution. [source] The effect of strength training on the force of twitches evoked by corticospinal stimulation in humansACTA PHYSIOLOGICA, Issue 2 2009T. J. Carroll Abstract Aim:, Although there is considerable evidence that strength training causes adaptations in the central nervous system, many details remain unclear. Here we studied neuromuscular responses to strength training of the wrist by recording electromyographic and twitch responses to transcranial magnetic stimulation (TMS) and cervicomedullary stimulation of the corticospinal tract. Methods:, Seventeen participants performed 4 weeks (12 sessions) of strength training for the radial deviator (RD) muscles of the wrist (n = 8) or control training without external load (n = 9). TMS recruitment curves were constructed from stimuli at five to eight intensities ranging between 15% below resting motor threshold and maximal stimulator output, both at rest and during isometric wrist extension (EXT) and RD at 10% and 50% of maximal voluntary contraction (MVC). Responses to weak TMS and cervicomedullary stimulation (set to produce a response of 10% maximal M wave amplitude during 10% MVC EXT contraction) were also compared at contraction strengths ranging from 10% to 75% MVC. Results:, Isometric strength increased following strength training (10.7% for the RD MVC, 8.8% for the EXT MVC), but not control training. Strength training also significantly increased the amplitude of TMS- and cervicomedullary-evoked twitches during low-force contractions. Increases in the force-generating capacity of the wrist extensor muscles are unlikely to account for this finding because training did not affect the amplitude of twitches elicited by supra-maximal nerve stimulation. Conclusion:, The data suggest that strength training induces adaptations that increase the net gain of corticospinal-motor neuronal projections to the trained muscles. [source] An enhanced level of motor cortical excitability during the control of human standingACTA PHYSIOLOGICA, Issue 3 2009C. D. Tokuno Abstract Aim:, The study examined the role of the motor cortex in the control of human standing. Methods:, Subjects (n = 15) stood quietly with or without body support. The supported standing condition enabled subjects to stand with a reduced amount of postural sway. Peripheral electrical stimulation, transcranial magnetic stimulation (TMS) or transcranial electrical stimulation (TES) was applied to elicit a soleus (SOL) H-reflex, or motor-evoked potentials (MEPs) in the SOL and the tibialis anterior (TA). Trials were grouped based on the standing condition (i.e. supported vs. normal) as well as sway direction (i.e. forward and backward) while subjects were standing normally. Results:, During normal when compared to supported standing, the SOL H-reflex was depressed (,11 ± 4%), while the TMS-evoked MEPs from the SOL and TA were facilitated (35 ± 11% for the SOL, 51 ± 15% for the TA). TES-evoked SOL and TA MEPs were, however, not different between the normal and supported standing conditions. The data based on sway direction indicated that the SOL H-reflex, as well as the SOL TMS- and TES-evoked MEPs were all greater during forward when compared to backward sway. In contrast, the TMS- and TES-evoked MEPs from the TA were smaller when swaying forward as compared to backward. Conclusions:, The results indicated the presence of an enhanced cortical excitability because of the need to control for postural sway during normal standing. The increased cortical excitability was, however, unlikely to be involved in an on-going control of postural sway, suggesting that postural sway is controlled at the spinal and/or subcortical levels. [source] Risk factors for relapse after remission with repetitive transcranial magnetic stimulation for the treatment of depressionDEPRESSION AND ANXIETY, Issue 7 2009Roni B. Cohen M.D. Abstract Background: Several studies have shown that repetitive transcranial magnetic stimulation (rTMS) treatment is associated with a significant antidepressant effect that can last for several months. Methods: To investigate the mean remission time and the predictors associated with its duration; we performed a large retrospective, naturalistic study with 204 patients who underwent treatment with rTMS. During the periods from 2000 to 2006, we identified and collected the data on 204 patients who underwent rTMS treatment for major depression and who remitted their depression (defined as Hamilton Depression Rating Scores less or equal to 7). Patients were followed up to 6 months after this therapy. Results: Event-free remission with the end point defined as relapse (Hamilton Depression Rating Scores higher than 8) was 75.3% (73.7) at 2 months, 60.0% (74.5) at 3 months, 42.7% (74.8) at 4 months, and 22.6% (74.5) at 6 months. According to a multivariate analysis, only the age and number of sessions were independent predictors of outcome. Although depression severity and use of tricyclics also showed a significant relationship with remission duration, the model including these variables was not adequate to explain our data. Conclusions: The results of this study suggest that young age and additional rTMS sessions are associated with a ong duration of rTMS effects and therefore future trials investigating the effects of maintenance rTMS treatment need to explore further the implication of these factors for depression remission. Depression and Anxiety, 2009. © 2009 Wiley-Liss, Inc. [source] Patients with a major depressive episode responding to treatment with repetitive transcranial magnetic stimulation (rTMS) are resistant to the effects of rapid tryptophan depletionDEPRESSION AND ANXIETY, Issue 8 2007John P. O'Reardon M.D. Abstract Repetitive transcranial magnetic stimulation (rTMS) appears to be efficacious in the treatment of major depression based on the results of controlled studies, but little is known about its antidepressant mechanism of action. Mood sensitivity following rapid tryptophan depletion (RTD) has been demonstrated in depressed patients responding to SSRI antidepressants and phototherapy, but not in responders to electroconvulsive therapy (ECT). We sought to study the effects of RTD in patients with major depression responding to a course of treatment with rTMS. Twelve subjects treated successfully with rTMS monotherapy underwent both RTD and sham depletion in a double-blind crossover design. Depressive symptoms were assessed using both a modified Hamilton Depression Rating Scale (HDRS) and Beck Depression Inventory (BDI). The differential change in depression scores across the procedures was compared. No significant difference in mood symptoms was noted between RTD and the sham-depletion procedure on either continuous measures of depression, or in the proportions of subjects that met predefined criteria for a significant degree of mood worsening. Responders to rTMS are resistant to the mood perturbing effects of RTD. This suggests that rTMS does not depend on the central availability of serotonin to exert antidepressant effects in major depression. Depression Anxiety 24:537,544, 2007. © 2006 Wiley-Liss, Inc. [source] Has repetitive transcranial magnetic stimulation (rTMS) treatment for depression improved?ACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2007A systematic review, meta-analysis comparing the recent vs. the earlier rTMS studies Objective:, To investigate whether the recent repetitive transcranial magnetic stimulation (rTMS) studies on depression using new parameters of stimulation have shown improved clinical results. Method:, We performed a systematic review and a meta-analysis of the rTMS studies on depression published in the past 12 months comparing these results with an earlier meta-analysis that analyzed the results of the initial rTMS studies on depression. Results:, Using our inclusion criteria, we selected the meta-analysis of Martin [Br J Psychiatry (2003) Vol. 182, 480,491] that included 13 studies (324 patients) and five studies for the recent meta-analysis (274 patients). The pooled effect size (standardized mean difference between pretreatment vs. post-treatment) from the random effects model was ,0.76 (95% confidence interval, CI, ,1.01 to ,0.51). This result was significantly larger than that of the earlier meta-analysis (,0.35, 95% CI ,0.66 to ,0.04). Conclusion:, Our findings suggest that recent rTMS clinical trials have shown larger antidepressant effects when compared with the earlier studies. [source] Development of the corticospinal system and hand motor function: central conduction times and motor performance testsDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 4 2000U M Fietzek Maturation of the corticospinal (CS) tract and hand motor function provide paradigms for central nervous system development. In this study, involving 112 participants (aged from 0.2 to 30 years), we evaluated central motor conduction times (CMCT) obtained with transcranial magnetic stimulation (TMS) during preinnervation conditions of facilitation and relaxation. Auditory reaction time, velocity of a ballistic movement of the arm, finger tapping, diadochokinesis, and fine motor visuomanual tracking were also examined. The maturation profiles for every parameter were calculated. CMCTs for the different preinnervation conditions reached adult values at different times and this could be explained by maturation of excitability at the cortical and spinal level. A stable phase for CMCTs and reaction time was reached during childhood. Parameters which measured motor speed and skill indicated that the development of these continued into adulthood. The maturation of the fast CS tract seems to be completed before the acquisition of the related motor performance has been accomplished. In conclusion, we could demonstrate that data from several neurophysiological methods can be combined and used to study the maturation of the function of the nervous system. This approach could allow appraisal of pathological conditions that show parallels with omissions or lack of developmental progress. [source] Transcranial magnetic stimulation in child psychiatry: disturbed motor system excitability in hypermotoric syndromesDEVELOPMENTAL SCIENCE, Issue 3 2002Gunther H. Moll Normal development and dysfunctions of motor system excitability can be investigated in vivo by means of single- and paired-pulse transcranial magnetic stimulation (TMS). While different TMS-parameters show different developmental time courses between 8 and 16 years of age, distinct dysfunctional patterns of motor system excitability can be demonstrated in child psychiatric disorders with hypermotoric behavior: in tic disorder, a shortened cortical silent period can be stated providing evidence for deficient inhibitory mechanisms within the sensorimotor loop, probably primarily at the level of the basal ganglia. In attention deficit hyperactivity disorder (ADHD), a decreased intracortical inhibition indicates deficient inhibitory mechanisms within the motor cortex (but enhancement of intracortical inhibition after oral intake of 10 mg methylphenidate). In children with comorbid ADHD and tic disorder, the findings of a reduced intracortical inhibition as well as a shortened cortical silent period provide evidence for additive effects at the level of motor system excitability. Thus, TMS allows us to obtain substantial insight into both the normal development and the neurobiological basis of hypermotoric syndromes in child psychiatry. [source] Magnetic motor threshold and response to TMS in major depressive disorderACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2002O. T. Dolberg Dolberg OT, Dannon PN, Schreiber S, Grunhaus L. Magnetic motor threshold and response to TMS in major depressive disorder. Acta Psychiatr Scand 2002: 106: 220,223. © Blackwell Munksgaard 2002. Objective:,The aim of this study was to examine motor threshold (MT) during treatment with transcranial magnetic stimulation (TMS). Method:,The TMS was administered to 46 patients with depression and 13 controls. TMS was performed at 90% power of measured MT. The stimulation frequency was 10 Hz for 6 s, for 20 trains, with 30 s inter-train intervals. The trial included 20 sessions. Patients and controls were assessed on various outcome measures. Results:,The MT values were comparable between patients and controls. Neither demographic nor clinical variables were factors in determining MT. MT was not shown to have any predictive value regarding outcome of treatment. Conclusion:,In this study, MT at baseline or changes in MT during the treatment period were not able to discriminate between patients and controls and were not found to have any predictive value with regard to treatment outcome. [source] The application of transcranial magnetic stimulation in psychiatry and neurosciences researchACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2002P. B. Fitzgerald Objective:,Over recent years transcranial magnetic stimulation (TMS) has become widely applied in the study of neuropsychiatric disorders. The aim of this article is to review the application of TMS as an investigative tool and as a potential therapeutic modality in psychiatric disorders. Method:,A comprehensive literature review. Results:,When applied as an investigative tool, TMS provides innovative ways to directly study the excitability of the cortex, cortical regional connectivity, the plasticity of brain responses and cognitive functioning in illness and disease states. A number of studies suggest the potential of treatment with TMS in disease states, especially in patients with depression, although difficulties exist with the interpretation of the published literature. Conclusion:,TMS has a considerable role in neuropsychiatric research. It appears to have considerable potential as a therapeutic tool in depression, and perhaps a role in several other disorders, although widespread application requires larger trials and establishment of sustained response. [source] Role of neurophysiology in the clinical practice of primary pediatric headachesDRUG DEVELOPMENT RESEARCH, Issue 7 2007V. Raieli Abstract The role of electrophysiological studies in pediatric headaches is controversial. In childhood headaches, neurophysiological examinations are of interest for potential clinical use because they are noninvasive and are scarcely influenced by environmental factors or drug use. Electrophysiological studies in childhood headache principally explored the role of electroencephalographic (EEG) evaluations in migraine, while less evidence has been reported about other neurophysiological techniques, such as evoked potentials, event-related potentials, and, less often, transcranial magnetic stimulation. In this brief review, we point out our attention to the aid of neurophysiological methods in the clinical diagnosis of pediatric headaches. Although many examinations are actually of little value in the clinical setting, they may have a potential role in some clinical subgroups or in monitoring and evaluating the effects of pharmacological treatment. Drug Dev Res 68:389,396, 2007. © 2008 Wiley-Liss, Inc. [source] Efficacy of repetitive transcranial magnetic stimulation in alcohol dependence: a sham-controlled studyADDICTION, Issue 1 2010Biswa R. Mishra ABSTRACT Objective To study the anticraving efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) of the right dorsolateral pre-frontal cortex (DLPFC) in patients with alcohol dependence. Methods We performed a prospective, single-blind, sham-controlled study involving 45 patients with alcohol dependence syndrome (according to ICD-10 DCR), with Clinical Institute of Withdrawal Assessment in Alcohol Withdrawal (CIWA-Ar) scores ,10. Patients were allocated to active and sham rTMS in a 2 : 1 ratio, such that 30 patients received active and 15 patients sham rTMS to the right DLPFC (10 Hz frequency, 4.9 seconds per train, inter-train interval of 30 seconds, 20 trains per session, total 10 sessions). The Alcohol Craving Questionnaire (ACQ-NOW) was administered to measure the severity of alcohol craving at baseline, after the last rTMS session and after 1 month of the last rTMS session. Results Two-way repeated-measures analysis of variance (ANOVA) showed significant reduction in the post-rTMS ACQ-NOW total score and factor scores in the group allocated active rTMS compared to the sham stimulation. The effect size for treatment with time interaction was moderate (,2 = 0.401). Conclusions Right dorsolateral pre-frontal high-frequency rTMS was found to have significant anticraving effects in alcohol dependence. The results highlight the potential of rTMS which, combined with other anticraving drugs, can act as an effective strategy in reducing craving and subsequent relapse in alcohol dependence. [source] Repeated high-frequency transcranial magnetic stimulation over the dorsolateral prefrontal cortex reduces cigarette craving and consumptionADDICTION, Issue 4 2009Revital Amiaz ABSTRACT Aims To evaluate the effect of repeated high-frequency transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC), combined with either smoking or neutral cues, on cigarette consumption, dependence and craving. Design Participants were divided randomly to real and sham stimulation groups. Each group was subdivided randomly into two subgroups presented with either smoking-related or neutral pictures just before the daily TMS intervention. Ten daily rTMS sessions were applied every week-day and then a maintenance phase was conducted in which rTMS sessions were less frequent. Setting Single-site, out-patient, randomized, double-blind, sham-controlled. Participants Forty-eight chronic smokers who smoked at least 20 cigarettes per day and were motivated to quit smoking. Healthy males and females were recruited from the general population using advertisements in newspapers and on internet websites. Intervention Ten daily rTMS sessions were administered using a standard figure-8 coil over the DLPFC. Stimulation included 20 trains/day at 100% of motor threshold. Each train consisted of 50 pulses at 10 Hz with an inter-train interval of 15 seconds. Measurements Cigarette consumption was evaluated objectively by measuring cotinine levels in urine samples and subjectively by participants' self-reports. Dependence and craving were evaluated by standard questionnaires. Findings Ten daily rTMS sessions over the DLPFC reduced cigarette consumption and nicotine dependence. Furthermore, treatment blocked the craving induced by daily presentation of smoking-related pictures. However, these effects tended to dissipate over time. Conclusions Multiple high-frequency rTMS of the DLPFC can attenuate nicotine craving. [source] rTMS Reveals Premotor Cortex Dysfunction in Frontal Lobe EpilepsyEPILEPSIA, Issue 2 2007Wolfgang N. Löscher Summary:,Purpose: Studies of motor cortex excitability provided evidence that focal epilepsies may alter the excitability of cortical areas distant from the epileptogenic zone. In order to explore this hypothesis we studied the functional connectivity between premotor and motor cortex in seven patients with frontal lobe epilepsy and seizure onset zone outside the premotor or motor cortex. Methods: Low-frequency subthreshold repetitive transcranial magnetic stimulation was applied to the premotor cortex and its impact on motor cortex excitability was measured by the amplitude of motor-evoked potentials in response to direct suprathreshold stimulation of the motor cortex. Results: Stimulation of the premotor cortex of the non-epileptogenic hemisphere resulted in a progressive and significant inhibition of the motor cortex as evidenced by a reduction of motor evoked potential amplitude. On the other hand, stimulation of the premotor cortex of the epileptogenic hemisphere failed to inhibit the motor cortex. The reduced inhibition of the motor cortex by remote areas was additionally supported by the significantly shorter cortical silent periods obtained after stimulation of the motor cortex of the epileptogenic hemisphere. Conclusion: These results show that the functional connectivity between premotor and motor cortex or motor cortex interneuronal excitability is impaired in the epileptogenic hemisphere in frontal lobe epilepsy while it is normal in the nonepileptogenic hemisphere. [source] Slow Repetitive TMS for Drug-resistant Epilepsy: Clinical and EEG Findings of a Placebo-controlled TrialEPILEPSIA, Issue 2 2007Roberto Cantello Summary:,Purpose: To assess the effectiveness of slow repetitive transcranial magnetic stimulation (rTMS) as an adjunctive treatment for drug-resistant epilepsy. Methods: Forty-three patients with drug-resistant epilepsy from eight Italian Centers underwent a randomized, double-blind, sham-controlled, crossover study on the clinical and EEG effects of slow rTMS. The stimulus frequency was 0.3 Hz. One thousand stimuli per day were given at the resting motor threshold intensity for 5 consecutive days, with a round coil at the vertex. Results:"Active" rTMS was no better than placebo for seizure reduction. However, it decreased interictal EEG epileptiform abnormalities significantly (p < 0.05) in one-third of the patients, which supports a detectable biologic effect. No correlation linked the rTMS effects on seizure frequency to syndrome or anatomic classification, seizure type, EEG changes, or resting motor threshold (an index of motor cortex excitability). Conclusions: Although the antiepileptic action was not significant (p > 0.05), the individual EEG reactivity to "active" rTMS may be encouraging for the development of more-powerful, noninvasive neuromodulatory strategies. [source] Pregabalin Exerts Oppositional Effects on Different Inhibitory Circuits in Human Motor Cortex: A Double-blind, Placebo-controlled Transcranial Magnetic Stimulation StudyEPILEPSIA, Issue 5 2006Nicolas Lang Summary:,Purpose: To explore acute effects of pregabalin (PGB) on human motor cortex excitability with transcranial magnetic stimulation (TMS). Methods: PGB, 600 mg/day, was orally administered in 19 healthy subjects twice daily in a randomized, double-blind, placebo-controlled crossover design. Several measures of motor cortex excitability were tested with single- and paired-pulse TMS. Results: Mean short-interval intracortical inhibition (SICI) was reduced after PGB (74 ± 7% of unconditioned response) compared with placebo (60 ± 6% of unconditioned response). In contrast, mean long-interval intracortical inhibition (LICI) was increased by PGB (26 ± 4% of unconditioned response) compared with placebo (45 ± 8% of unconditioned response), and mean cortical silent period (CSP) showed an increase from 139 ± 8 ms or 145 ± 8 ms after placebo to 162 ± 7 ms or 161 ± 10 ms after PGB. Motor thresholds, intracortical facilitation, and corticospinal excitability were unaffected. Conclusions: The observed excitability changes with oppositional effects on SICI and LICI or CSP suggest ,-aminobutyric acid (GABA)B -receptor activation. They are markedly distinct from those induced by gabapentin, although both PGB and gabapentin are thought to mediate their function by binding to the ,(2)-, subunit of voltage-gated calcium channels. Conversely, the TMS profile of PGB shows striking similarities with the pattern evoked by the GABA-reuptake inhibitor tiagabine. [source] CLINICAL STUDY: Abnormalities in cortical and transcallosal inhibitory mechanisms in subjects at high risk for alcohol dependence: a TMS studyADDICTION BIOLOGY, Issue 3-4 2008Kesavan Muralidharan ABSTRACT Central nervous system (CNS) hyperexcitability and a resulting state of behavioral undercontrol are thought to underlie the vulnerability to early-onset alcohol dependence (AD). The aim of this study was to explore the differences in the functioning of cortical inhibitory systems, utilizing transcranial magnetic stimulation (TMS), in subjects at high risk (HR) and low risk (LR) for AD and to examine the relationship between CNS inhibition and behavioral undercontrol. Right-handed HR (n = 15) and LR (n = 15) subjects, matched for age, gender, height, weight and education, were assessed for psychopathology and family history of alcoholism using the Semi-Structured Assessment for the Genetics of Alcoholism and the Family Interview for Genetic Studies. Following single-pulse TMS, an electromyogram recorded from the right opponens pollicis muscle was used to measure the silent periods at different stimulus intensities. HR subjects had significantly shorter contralateral and ipsilateral (iSP) silent periods and a relatively higher prevalence of ,absent' iSP. They had significantly higher mean externalizing symptoms scores (ESS) than LR subjects, and there was a significant negative correlation between iSP duration and ESS. These preliminary findings suggest that HR subjects have relative impairments in corticocortical and transcallosal inhibitory mechanisms. The consequent state of CNS hyperexcitability may be etiologically linked to the excess of externalizing behaviors observed in this population, which is thought to be a predisposition to a higher risk of developing early-onset alcoholism. [source] Repetitive transcranial magnetic stimulation improve tinnitus in normal hearing patients: a double-blind controlled, clinical and neuroimaging outcome studyEUROPEAN JOURNAL OF NEUROLOGY, Issue 1 2010R. A. Marcondes Background and purpose:, Tinnitus is a frequent disorder which is very difficult to treat and there is compelling evidence that tinnitus is associated with functional alterations in the central nervous system. Targeted modulation of tinnitus-related cortical activity has been proposed as a promising new treatment approach. We aimed to investigate both immediate and long-term effects of low frequency (1 Hz) repetitive transcranial magnetic stimulation (rTMS) in patients with tinnitus and normal hearing. Methods:, Using a parallel design, 20 patients were randomized to receive either active or placebo stimulation over the left temporoparietal cortex for five consecutive days. Treatment results were assessed by using the Tinnitus Handicap Inventory. Ethyl cysteinate dimmer-single photon emission computed tomography (SPECT) imaging was performed before and 14 days after rTMS. Results:, After active rTMS there was significant improvement of the tinnitus score as compared to sham rTMS for up to 6 months after stimulation. SPECT measurements demonstrated a reduction of metabolic activity in the inferior left temporal lobe after active rTMS. Conclusion:, These results support the potential of rTMS as a new therapeutic tool for the treatment of chronic tinnitus, by demonstrating a significant reduction of tinnitus complaints over a period of at least 6 months and significant reduction of neural activity in the inferior temporal cortex, despite the stimulation applied on the superior temporal cortex. [source] | ||||||||||||||||||||||||||||