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Mood Disorders
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Madeleine A. Becker, Tal E. Weinberger, Leigh J. Ocker
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive modality of treatment that delivers electrical stimuli through the scalp to modulate cortical activity and is FDA-approved for patients in the general population who have failed to respond to at least one antidepressant. TMS represents a particularly important option for the pregnant population as it does not carry pharmacologic effects and is less invasive than other neurostimulatory treatment options, such as ECT [195]. Studies of TMS used in pregnant women have demonstrated that TMS is well tolerated and effective, with most women achieving some response and approximately one third reaching remission – without adverse pregnancy or fetal outcomes. Of note, estimates of fetal exposure to electrical fields in TMS would likely be well below the threshold of potential harm [176]. Studies [2, 196] examining the effect of TMS on postpartum depression showed significant decreases in Hamilton Depression Rating Scale (HDRS) and EPDS scores [197] and low dropout [198], which supports TMS as a promising treatment in pregnant and postpartum women, but more studies are needed with larger numbers of subjects.
Psychological Rehabilitation of COVID-19
Published in Wenguang Xia, Xiaolin Huang, Rehabilitation from COVID-19, 2021
Repetitive transcranial magnetic stimulation (rTMS) is a highly safe, noninvasive neuromodulation technique. A large number of studies have shown that rTMS has a good alleviating effect on mental symptoms such as depression, anxiety, sleep disorders, and compulsions. In 2008, the US Food and Drug Administration (FDA) officially approved rTMS for the treatment of depression, especially in patients who do not respond well to medication. For example, high frequency (≥ 5 Hz) rTMS stimulation of the left dorsolateral prefrontal lobe or low frequency (1 Hz) stimulation of the right dorsolateral prefrontal lobe can relieve depressive symptoms. In addition, many studies have shown that transcranial direct current stimulation can also significantly promote psychological rehabilitation.
Therapeutic prospects and safety of transcranial magnetic stimulation in epilepsy
Published in Hans O Lüders, Deep Brain Stimulation and Epilepsy, 2020
Frithjof Tergau, Bernhard Steinhoff
In summary, rTMS, when applied according to safety criteria, appears to be relatively safe in patients with epilepsy, since a conclusive demonstration of TMS being a trigger of ictal events has only been made in very few circumstances (see above). However, not all possible side effects have been appropriately addressed so far and long-term side effects are still possible.51 High frequency rTMS studies in epilepsy should be performed only if justified by diagnostic reasons, and the patient needs to be informed about the potential risk of seizure induction.
Feasibility of performing a multi-arm clinical trial examining the novel combination of repetitive transcranial magnetic stimulation and aerobic exercise for post-stroke depression
Published in Topics in Stroke Rehabilitation, 2023
Ryan E. Ross, Catherine J. VanDerwerker, Mark S. George, Chris M. Gregory
Repetitive transcranial magnetic stimulation (rTMS) is a form of noninvasive brain stimulation therapy that utilizes an electromagnetic coil to induce brief, repetitive electrical currents in the brain. rTMS applied over the left dorsolateral prefrontal cortex is a U.S. Food and Drug Administration (FDA) approved treatment for medication-resistant depression, defined as failure of multiple trials of pharmacotherapy.10 In chronic stroke survivors with PSD, rTMS is beneficial in reducing depressive symptoms.11 A recent meta-analysis by Shen and colleagues indicates that standalone rTMS or rTMS with adjunctive treatment (treatment as usual, pharmacotherapy, acupuncture) for PSD improves scores on the Hamilton Depression Rating Scale (HDRS) by an average of 6 points compared to myriad of control conditions (sham rTMS, treatment as usual, pharmacotherapy, acupuncture).12 Less than 3% of subjects receiving rTMS or rTMS with adjunctive treatment reported side effects (headaches, gastrointestinal distress, dry mouth) and there were no reported withdrawals due to adverse events.12 These findings indicate that rTMS, either standalone or in combination with additional treatment, can reduce depressive symptoms and is well received by chronic stroke survivors.
Can a tDCS treatment enhance subjective and objective sleep among student-athletes?
Published in Journal of American College Health, 2021
Jonathan Charest, Alexandre Marois, Celyne H. Bastien
On the other hand, it appears that the indices of increased arousal predicted the lack of effect of tDCS in insomnia disorder patients.34 In particular, regional synchronization of neuronal activity43 and metabolic reductions in the prefrontal cortex40 have been identified as a fundamental feature of sleep. To date, studies on the enhancement of sleep quality through tDCS among student-athlete population have however never been performed. The tDCS literature has been concentrated around the middle-aged and elderly population, thus the knowledge in younger individuals such as student-athletes is sparse. It is noteworthy to mention that other current stimulation techniques have been explored aside tDCS. Cranial Electrotherapy Stimulation (CES) is a form of neurostimulation that delivers a small, pulsed, alternating current via electrodes on the head.44 Recently, the benefits and harms of CES have been explored on numerous conditions including chronic painful conditions, depression, anxiety and insomnia.45 Additionally, repetitive transcranial magnetic stimulation (rTMS), has also been used to explore its benefits on insomnia.46 Essentially, the rTMS device generates a pulsating electric current that passes through a coil creating an alternating magnetic field that depolarizes the underlying brain tissues.47 However, the current study solely focuses on tDCS.
Accelerated repetitive transcranial magnetic stimulation in the treatment of post-concussion symptoms due to mild traumatic brain injury: a pilot study
Published in Brain Injury, 2021
Benjamin P. Meek, Scott Hill, Mandana Modirrousta
Seizure represents an extremely rare but serious adverse side effect of rTMS. Seizures can be induced by rTMS when pulses are applied with relatively high frequencies and short interval periods between stimulation (25). Given that TBI can chronically increase neural excitability and seizure risk (38,39), TBI has typically been considered a relative contraindication for rTMS. However, this exclusion criteria may be unduly restrictive when dealing with mild head injuries, as any increased risk of epilepsy and seizures following mTBI is thought to be marginal (40–42). Nonetheless, it has been suggested that low frequency (LF) rTMS (1 Hz) may be a preferred option for the treatment of TBI (20–22) given its tendency to reduce cortical excitability compared to the general excitatory nature of high-frequency (HF) stimulation (43,44).