Navegando por Palavras-chave "transcranial magnetic stimulation"
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- ItemSomente MetadadadosBiological Markers in Noninvasive Brain Stimulation Trials in Major Depressive Disorder: A Systematic Review(Lippincott Williams & Wilkins, 2014-03-01) Fidalgo, Thiago M. [UNIFESP]; Morales-Quezada, J. Leon; Muzy, Guilherme S. C.; Chiavetta, Noelle M.; Mendonca, Mariana E.; Santana, Marcus V. B.; Goncalves, Oscar F.; Brunoni, Andre R.; Fregni, Felipe; Harvard Univ; Universidade Federal de São Paulo (UNIFESP); De Montfort Univ; Santa Casa Med Sch; Univ MinhoObjectivesThe therapeutic effects of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation in patients with major depression have shown promising results; however, there is a lack of mechanistic studies using biological markers (BMs) as an outcome. Therefore, our aim was to review noninvasive brain stimulation trials in depression using BMs.MethodsThe following databases were used for our systematic review: MEDLINE, Web of Science, Cochrane, and SCIELO. We examined articles published before November 2012 that used TMS and transcranial direct current stimulation as an intervention for depression and had BM as an outcome measure. the search was limited to human studies written in English.ResultsOf 1234 potential articles, 52 articles were included. Only studies using TMS were found. Biological markers included immune and endocrine serum markers, neuroimaging techniques, and electrophysiological outcomes. in 12 articles (21.4%), end point BM measurements were not significantly associated with clinical outcomes. All studies reached significant results in the main clinical rating scales. Biological marker outcomes were used as predictors of response, to understand mechanisms of TMS, and as a surrogate of safety.ConclusionsFunctional magnetic resonance imaging, single-photon emission computed tomography, positron emission tomography, magnetic resonance spectroscopy, cortical excitability, and brain-derived neurotrophic factor consistently showed positive results. Brain-derived neurotrophic factor was the best predictor of patients' likeliness to respond. These initial results are promising; however, all studies investigating BMs are small, used heterogeneous samples, and did not take into account confounders such as age, sex, or family history. Based on our findings, we recommend further studies to validate BMs in noninvasive brain stimulation trials in MDD.
- ItemSomente MetadadadosEffects of repetitive transcranial magnetic stimulation on clinical, social, and cognitive performance in postpartum depression(Dove Medical Press Ltd, 2012-01-01) Myczkowski, Martin Luiz; Dias, Alvaro Machado [UNIFESP]; Luvisotto, Tatiana; Arnaut, Debora; Bellini, Bianca Boura; Mansur, Carlos Gustavo; Renno, Joel; Tortella, Gabriel; Ribeiro, Philip Leite; Marcolin, Marco Antonio; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)Background: This randomized, placebo-controlled, double-blind pilot study evaluated the impact of repetitive transcranial magnetic stimulation (rTMS) on clinical, cognitive, and social performance in women suffering with postpartum depression.Methods: Fourteen patients were randomized to receive 20 sessions of sham rTMS or active 5 Hz rTMS over the left dorsolateral prefrontal cortex. Psychiatric clinical scales and a neuropsychological battery were applied at baseline (pretreatment), week 4 (end of treatment), and week 6 (follow-up, posttreatment week 2).Results: the active rTMS group showed significant improvement 2 weeks after the end of rTMS treatment (week 6) in Hamilton Depression Rating Scale (P = 0.020), Global Assessment Scale (P = 0.037), Clinical Global Impression (P = 0.047), and Social Adjustment Scale-Self Report-Work at Home (P = 0.020).Conclusion: This study suggests that rTMS has the potential to improve the clinical condition in postpartum depression, while producing marginal gains in social and cognitive function.
- ItemSomente MetadadadosEstudo da excitabilidade cortical em pacientes com epilepsia mioclônica juvenil com e sem indução por praxia(Universidade Federal de São Paulo (UNIFESP), 2013-11-27) Dourado, Marcos Vidal Pires [UNIFESP]; Manzano, Gilberto Mastrocola Manzano [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)INTRODUCTION: The motor patterns of physiological tactile manipulation of objects and voluntary hand movements, defined as praxis, occur through pathways originated from the premotor cortex, primary motor cortex, parietal cortex and subcortical areas, such as the rubrospinal tract (KANDEL et al., 2000). The cognitive processing of motor behavior can induce epileptiform discharges and/or epileptic seizures in a subgroup of patients with Juvenile Myoclonic Epilepsy (JME), (GUARANHA et al., 2009). OBJECTIVE: This project aimed to study the motor and somatosensory cortical excitability in patients with JME, without praxis induction (JME-WI) and with epileptiform discharges and/or seizures induced by praxis (JME-PRX) compared with that of healthy controls. METHOD: The sample (n=36) was composed by JME-WI (n=12), JME-PRX (n=10) and control group (n=14) and was assessed by parameters of bilateral motor cortical excitability, tested by transcranial magnetic stimulation of single pulse: motor threshold, latency of motor evoked potential, central motor conduction time, contralateral and ipsilateral silent period. Bilateral somatosensory excitability was assessed by absolute values and interpeak measures of latencies and amplitudes of cortical components N20, P27, N35 and P45 tested by somatosensory evoked potentials. RESULTS: Analysis of variance (p<0.05) did not show differences with statistical significance for the study of motor excitability parameters assessed in both hemispheres, such as motor threshold [p=0.785 (D); p=0.661 (E)], motor evoked potential [p=0.644 (D); p=0.702 (E)] and central motor conduction time [p=0.776 (D); p=0.904 (E)]. The ipsilateral silent period of the left hemisphere in patients with JME-WI showed the smallest measures, when compared to control group and effect size of d=0.83, r=0.38 demonstrated a high relevance due to strong clinical significance of the coefficients in this parameter. The effect size became more evident when we compare the left hemisphere values between JME-WI group and the JME-PRX group, which presented the greatest measures of ipsilateral silent period and effect size with d=0.95, r=0.43, compared to control group. The analysis of the interpeak latency N35-P45 showed a significant difference for the variance among the three groups (p=0.020), and greatest value for this interpeak latency in patients with JME-PRX comparing with the control group (p=0.007). The analysis of variance of the amplitudes showed a difference in the mean value of the interpeak latency N27-N35 among the three groups (p=0.036), such as in the group with JME-PRX compared to the control group (p=0.013). CONCLUSIONS: The increase in the amplitude and latency of the interpeak intervals suggest greater excitability of the somatosensory cortex in patients with JME and epileptiform discharges and/or seizures induced by praxis. This findings show distinct patterns of cortical excitability between the two groups of patients.
- ItemSomente MetadadadosRandomized, proof-of-principle clinical trial of active transcranial magnetic stimulation in chronic migraine(Sage Publications Ltd, 2014-05-01) Conforto, Adriana B.; Amaro, Edson; Goncalves, Andre L.; Mercante, Juliane P. P.; Guendler, Vera Z.; Ferreira, Josione R.; Kirschner, Clara C. F. B.; Peres, Mario F. P. [UNIFESP]; Hosp Israelita Albert Einstein; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)Background High-frequency repetitive transcranial magnetic stimulation of the left dorsolateral prefrontal cortex (rTMS-DLPFC) is an effective treatment for depression. Preliminary studies indicated beneficial effects of rTMS-DLPFC on pain relief in patients treated for depression, and in patients with chronic migraine.Methods in this randomized, double-blind, parallel-group, single-center, proof-of-principle clinical trial, we tested the hypothesis that 23 sessions of active rTMS-DLPFC delivered over eight weeks would be feasible, safe and superior to sham rTMS to decrease the number of headache days in 18 patients with chronic migraine without severe depression. Per-protocol analysis was performed.Results rTMS-DLPFC applied over eight weeks was feasible and safe in patients with chronic migraine. Contrary to our primary hypothesis, the number of headache days decreased significantly more in the sham group than in the group treated with active rTMS-DLPFC at eight weeks. Average decrease in headache days was >50% in the sham group, indicating a powerful placebo response. Pain intensity improved in both groups to a similar extent.Conclusions Positive results of M1 stimulation in other studies, and the absence of significant benefits of active high-frequency rTMS of the DLPFC in the present study, point to M1 as a more promising target than the DLPFC, for larger trials of noninvasive brain stimulation in patients with chronic migraine.
- ItemSomente MetadadadosSimultaneous Low (1 Hz)- and High (10 Hz)-Frequency Bilateral Transcranial Magnetic Stimulation in a Patient With Severe Depression and Crohn Disease(Lippincott Williams & Wilkins, 2012-09-01) Rosa, Moacyr Alexandro [UNIFESP]; Andrade, Marco Aurelio [UNIFESP]; Abdo, Guilherme Lozi [UNIFESP]; Rosa, Marina Odebrecht; Universidade Federal de São Paulo (UNIFESP); IPANWe present a case report in which electroconvulsive therapy had a good effect for the treatment of depression in association with Crohn disease, but adverse effects limited its use. Repetitive transcranial magnetic stimulation was tried both in a conventional way (high frequency over the left dorsolateral prefrontal cortex) and in a bilateral sequential way (high frequency in the same region followed in the same session by low frequency on the right side). Finally, bilateral simultaneous stimulation (high frequency over the left and low frequency over the right side) was tried and resulted in a response similar to that of electroconvulsive therapy.