Low-frequency rTMS inhibits the anti-depressive effect of ECT. A pilot study

2020 ◽  
Vol 32 (6) ◽  
pp. 328-338
Author(s):  
Poul Erik Buchholtz ◽  
Mahmoud Ashkanian ◽  
Simon Hjerrild ◽  
Line Kirstine Hauptmann ◽  
Torben Albert Devantier ◽  
...  
Keyword(s):  
Placebo Group ◽  
Pilot Study ◽  
Major Depression ◽  
Negative Impact ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Low Frequency ◽  
Double Blind Study ◽  
Depressant Effect ◽  
Significant Difference ◽  
Low Frequency Rtms

AbstractObjective:Low-frequency repetitive transcranial magnetic stimulation (rTMS) of the prefrontal cortex has been shown to have a statistically and clinically significant anti-depressant effect. The present pilot study was carried out to investigate if right prefrontal low-frequency rTMS as an add-on to electroconvulsive therapy (ECT) accelerates the anti-depressant effect and reduces cognitive side effects.Methods:In this randomised, controlled, double-blind study, thirty-five patients with major depression were allocated to ECT+placebo or ECT+low-frequency right prefrontal rTMS. The severity of depression was evaluated during the course using the Hamilton scale for depression (the 17-item as well as the 6-item scale) and the major depression inventory (MDI). Furthermore, neuropsychological assessment of cognitive function was carried out.Results:The study revealed no significant difference between the two groups for any of the outcomes, but with a visible trend to lower scores for MDI after treatment in the placebo group. The negative impact of ECT on neurocognitive functions was short-lived, and scores on logical memory were significantly improved compared to baseline 4 weeks after last treatment. The ECT-rTMS group revealed generally less impairment of cognitive functions than the ECT-placebo group.Conclusion:The addition of low-frequency rTMS as an add-on to ECT treatment did not result in an accelerated response. On the contrary, the results suggest that low-frequency rTMS could inhibit the anti-depressant effect of ECT.

Effects of smoking status and MADRS retardation factor on response to low frequency repetitive transcranial magnetic stimulation for depression

2016 ◽  
Vol 38 ◽  
pp. 40-44 ◽  
Author(s):  
E. Poulet ◽  
F. Galvao ◽  
E. Haffen ◽  
D. Szekely ◽  
C. Brault ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Clinical Outcome ◽  
Magnetic Stimulation ◽  
Rating Scale ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Smoking Status ◽  
Low Frequency ◽  
Retardation Factor ◽  
Significant Difference ◽  
Low Frequency Rtms

AbstractBackgroundDespite growing evidence supporting the clinical interest of repetitive transcranial magnetic stimulation (rTMS) in treatment-resistant depression (TRD), little is known regarding the effects of clinical and sociodemographic factors on the clinical outcome in patients.MethodsWe retrospectively investigated the effects of clinical (using the 3-factor model of the Montgomery-Åsberg depression rating scale [MADRS] encompassing dysphoria, retardation and vegetative symptoms) and sociodemographic characteristics of participants on clinical outcome in a sample of 54 TRD patients receiving low frequency rTMS (1 Hz, 360 pulses) applied over the right dorsolateral prefrontal cortex combined with sham venlafaxine.ResultsResponders (n= 29) displayed lower retardation baseline scores (13.6 ± 2.9) than non-responders (15.6 ± 2.9;n= 25;P= 0.02). We also observed a significant difference between the numbers of ex-smokers in responders and non-responders groups; all ex-smokers (n= 8) were responders to rTMS (P= 0.005).ConclusionLow MADRS retardation factor and ex-smoker status is highly prevalent in responders to low frequency rTMS. Further studies are needed to investigate the predictive value of these factors.

Neurocognitive Effects of Repetitive Transcranial Magnetic Stimulation in Patients with Cerebrovascular Disease Without Dementia

2008 ◽  
Vol 22 (1) ◽  
pp. 14-19 ◽  
Author(s):  
S. Sedlackova ◽  
I. Rektorova ◽  
Z. Fanfrdlova ◽  
I. Rektor
Keyword(s):  
Pilot Study ◽  
High Frequency ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Low Frequency ◽  
Specific Effect ◽  
Frameless Stereotaxy ◽  
Stimulation Site ◽  
Positive Effects ◽  
Vascular Type ◽  
Low Frequency Rtms

Aims: The results of our pilot study suggested that one session of high frequency rTMS applied over the left dorsolateral prefrontal cortex (DLPFC) might induce measurable positive effects on executive functioning in patients with mild cognitive impairment of the vascular type without dementia (MCI-V). The aims of the current study were to replicate the results of our pilot study using a frameless stereotaxy as opposed to the standard and routinely used procedure. We also studied the effects of low frequency rTMS. Patients and method: Seven patients with MCI-V participated in a randomized, controlled, blind study with a crossover design. Each patient received 10 Hz and 1 Hz stimulation over the left DLPFC (an active stimulation site) or the motor cortex (MC; a control stimulation site). Frameless stereotaxy was used to target the DLPFC. The order of sites and frequencies was randomized. A short battery of neuropsychological tests was performed to evaluate executive function, working memory, and psychomotor speed. Results: One session of both high and low frequency rTMS was well tolerated and safe in terms of the cognitive after-effects in patients with MCI-V. We did not observe any significant frequency dependent or stimulation site-dependent cognitive effects of rTMS. Conclusion: We found neither positive nor negative significant effect of either low or high frequency rTMS applied over the DLPFC or the MC, while a mild positive site-specific effect of 10 Hz rTMS was observed in our pilot study on the Stroop interference results. These results suggested that MCI-V is a heterogeneous and poorly defined entity and, thus, rTMS might be useful in a subpopulation of this group of patients.

scholarly journals Repetitive Transcranial Magnetic Stimulation for Tinnitus Treatment in Vestibular Schwannoma: A Pilot Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Maria Teresa Leao ◽  
Kathrin Machetanz ◽  
Joey Sandritter ◽  
Marina Liebsch ◽  
Andreas Stengel ◽  
...  
Keyword(s):  
Pilot Study ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Low Frequency ◽  
Acute Effect ◽  
Term Effect ◽  
Long Term Effect ◽  
The Right ◽  
Low Frequency Rtms ◽  
Present Pilot Study

Background: Vestibular schwannomas (VS) are brain tumors affecting the vestibulocochlear nerve. Thus, VS patients suffer from tinnitus (TN). While the pathophysiology is mainly unclear, there is an increasing interest in repetitive transcranial magnetic stimulation (rTMS) for TN treatment. However, the results have been divergent. In addition to the methodological aspects, the heterogeneity of the patients might affect the outcome. Yet, there is no study evaluating rTMS exclusively in VS-associated tinnitus. Thus, the present pilot study evaluates low-frequency rTMS to the right dorsolateral pre-frontal cortex (DLPFC) in a VS-associated tinnitus.Methods: This prospective pilot study enrolled nine patients with a monoaural VS-associated tinnitus ipsilateral to the tumor. Patients were treated with a 10-day rTMS regime (1 Hz, 100% RMT, 1,200 pulses, right DLPFC). The primary endpoint of the study was the reduction of TN distress (according to the Tinnitus Handicap Inventory, THI). The secondary endpoint was a reduction of TN intensity (according to the Tinnitus Matching Test, TMT) and the evaluation of factors predicting tinnitus outcome (i.e., hearing impairment, TN duration, type of tinnitus).Results: No complications or side effects occurred. There was one drop-out due to a non-responsiveness of the complaint. There was a significant acute effect of rTMS on the THI and TMT. However, there was no significant long-term effect after 4 weeks. While the THI failed to detect any clinically relevant acute effect of rTMS in 56% of the patients, TMT revealed a reduction of TN intensity for more than 20 in 89% and for more than 50 in 56% of the patients. Notably, the acute effect of rTMS was influenced by the TN type and duration. In general, patients with a tonal TN and shorter TN duration showed a better response to the rTMS therapy.Conclusion: The present pilot study is the first one to exclusively evaluate the effect of low-frequency rTMS to the right DLPFC in a VS-associated tinnitus. Our results prove the feasibility and the efficacy of rTMS in this patient cohort. There is a significant acute but a limited long-term effect. In addition, there is evidence that patients with a tonal tinnitus and shorter tinnitus duration might have the strongest benefit. A larger, randomized controlled study is necessary to prove these initial findings.

Combined cognitive and motor training improves the outcome in the early phase after stroke and prevents a decline of executive functions: A pilot study

2020 ◽  
pp. 1-12
Author(s):  
Mareike Eschweiler ◽  
Lara Bohr ◽  
Josef Kessler ◽  
Gereon R. Fink ◽  
Elke Kalbe ◽  
...  
Keyword(s):  
Working Memory ◽  
Pilot Study ◽  
Cognitive Flexibility ◽  
Negative Impact ◽  
Low Frequency ◽  
Control Group ◽  
Motor Training ◽  
Set Shifting ◽  
Stroke Patients ◽  
Motor Functioning

BACKGROUND: The negative impact of cognitive dysfunction on motor rehabilitation as a relearning-process is well known in stroke patients. However, evidence for combined cognitive and motor training (CMT) is lacking. OBJECTIVE: To evaluate the effects of combined CMT in early stroke rehabilitation. METHODS: In a controlled pilot study, 29 moderately affected stroke patients with low-level motor performance and cognitive impairment received motor therapy plus either cognitive (experimental group, EG) or low-frequency ergometer training (control group, CG) for eight days. RESULTS: Both groups improved their motor functioning significantly. After training, between-group comparison revealed significant differences for cognitive flexibility and trends for set-shifting, working memory, and reaction control in favor of the EG. Within-group effects showed improvement across all cognitive domains in the EG, which correlated with gains in bed-mobility, while the CG showed no significant improvement in cognition. Rather, a trend towards reaction control decline was observed, which correlated with less functional progression and recovery. Furthermore, a decline in cognitive flexibility, set-shifting, and working memory was descriptively observed. CONCLUSIONS: Combined CMT may enhance cognition and motor relearning early after stroke and is superior to single motor training. Further studies are needed to replicate these results and investigate long-term benefits.

scholarly journals Blinding integrity in randomized sham-controlled trials of repetitive transcranial magnetic stimulation for major depression: a systematic review and meta-analysis

2013 ◽  
Vol 16 (5) ◽  
pp. 1173-1181 ◽  
Author(s):  
Marcelo T. Berlim ◽  
Hannah J. Broadbent ◽  
Frederique Van den Eynde
Keyword(s):  
Systematic Review ◽  
Transcranial Magnetic Stimulation ◽  
Major Depression ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Treatment Allocation ◽  
Significant Difference

Abstract Repetitive transcranial magnetic stimulation (rTMS) is a safe and effective treatment for major depression (MD). However, the perceived lack of a suitable sham rTMS condition might have compromised the success of blinding procedures in clinical trials. Thus, we conducted a systematic review and meta-analysis of randomized, double-blind and sham-controlled trials (RCTs) on high frequency (HF-), low frequency (LF-) and bilateral rTMS for MD. We searched the literature from January 1995 to July 2012 using Medline, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials and Scopus. The main outcome measure was participants' ability to correctly guess their treatment allocation at study end. We used a random-effects model and risk difference (RD). Overall, data were obtained from seven and two RCTs on HF- and bilateral rTMS, respectively. No RCT on LF-rTMS reporting on blinding success was found. HF- and bilateral rTMS trials enrolled 396 and 93 depressed subjects and offered an average of approximately 13 sessions. At study end, 52 and 59% of subjects receiving HF-rTMS and sham rTMS were able to correctly guess their treatment allocation, a non-significant difference (RD = −0.04; z = −0.51; p = 0.61). Furthermore, 63.3 and 57.5% of subjects receiving bilateral and sham rTMS were able to correctly guess their treatment allocation, also a non-significant difference (RD = 0.05; z = 0.49; p = 0.62). In addition, the use of angulation and sham coil in HF-rTMS trials produced similar results. In summary, existing sham rTMS interventions appear to result in acceptable levels of blinding regarding treatment allocation.

Pyridoxine is not effective for the prevention of hand foot syndrome (HFS) associated with capecitabine therapy: Results of a randomized double-blind placebo-controlled study

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 9007-9007 ◽  
Author(s):  
S. Lee ◽  
S. Lee ◽  
Y. Chun ◽  
M. Kim ◽  
H. Chang ◽  
...  
Keyword(s):  
Placebo Group ◽  
Chemotherapy Regimen ◽  
Controlled Study ◽  
Double Blind Study ◽  
Double Blind ◽  
Significant Difference ◽  
Hand Foot Syndrome ◽  
Version 2.0 ◽  
The Mean ◽  
To Receive

9007 Introduction: Although pyridoxine has been used empirically for the prevention of HFS associated with capecitabine, its efficacy has not been proven yet. We performed a prospective randomized double-blind study to determine whether pyridoxine can prevent the development of HFS when given concurrently with capecitabine. Method: Chemotherapy-naive patients (pts) with gastrointestinal tract cancers who were going to have capecitabine-containing chemotherapy were randomized to receive either oral pyridoxine (200 mg/day) or placebo daily during chemotherapy after stratified by chemotherapy regimen: 1) capecitabine alone, 2) capecitabine and cisplatin, or 3) docetaxel, capecitabine, and cisplatin. The patients were observed until grade 2 or 3 HFS (by NCI CTC version 2.0) developed or capecitabine containing chemotherapy ended. When grade 2 or 3 HFS developed in pts in placebo group, the pts were randomized again to receive either pyridoxine or placebo for next cycle of chemotherapy in order to determine whether pyridoxine could improve the HFS. Result: From Jun 2004 to Oct 2005, total 389 pts were entered onto the study. But, 29 pts (15 in placebo group and 14 in pyridoxine group) were excluded from the study because of ineligibility or pts’ refusal. Pts’ characteristics were well balanced between the 2 groups. Grade 2 or 3 HFS developed in 55 of 180 (30.6%) pts in placebo group and in 57 of 180 (31.7%) pts in pyridoxine group. (p=0.788) The median cycles of chemotherapy to grade 2 or 3 HFS was 3 in both groups. The mean cumulative dose of capecitabine until occurrence of grade 2 or 3 HFS was not different statistically between the two groups. (221,157.5 mg/m2 vs. 259,808.5 mg/m2, p=0.788). Total 44 of 55 pts in placebo group who had grade 2 or 3 HFS were randomized to receive either placebo or pyridoxine at next cycle. There was no significant difference between the two groups in the proportion of pts with improvement of HFS (43% vs 48%, p=0.94). Conclusion: These results indicated that pyridoxine is not effective for the prevention of HFS associated with capecitabine therapy. No significant financial relationships to disclose.

Sign in / Sign up

Export Citation Format

Share Document