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Cheng JL, Tan C, Liu HY, Han DM, Liu ZC. Past, present, and future of deep transcranial magnetic stimulation: A review in psychiatric and neurological disorders. World J Psychiatry 2023; 13:607-619. [PMID: 37771645 PMCID: PMC10523198 DOI: 10.5498/wjp.v13.i9.607] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/25/2023] [Accepted: 08/01/2023] [Indexed: 09/15/2023] Open
Abstract
Deep transcranial magnetic stimulation (DTMS) is a new non-invasive neuromodulation technique based on repetitive transcranial magnetic stimulation tech-nology. The new H-coil has significant advantages in the treatment and mechanism research of psychiatric and neurological disorders. This is due to its deep stimulation site and wide range of action. This paper reviews the clinical progress of DTMS in psychiatric and neurological disorders such as Parkinson's disease, Alzheimer's disease, post-stroke motor dysfunction, aphasia, and other neurological disorders, as well as anxiety, depression, and schizophrenia.
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Affiliation(s)
- Jin-Ling Cheng
- Department of Rehabilitation Medicine, Shaoguan First People’s Hospital, Shaoguan 512000, Guangdong Province, China
| | - Cheng Tan
- Department of Rehabilitation Medicine, Shaoguan First People’s Hospital, Shaoguan 512000, Guangdong Province, China
| | - Hui-Yu Liu
- Department of Infectious Diseases, Yuebei Second People’s Hospital, Shaoguan 512026, Guangdong Province, China
| | - Dong-Miao Han
- Department of Rehabilitation Therapy Teaching and Research, Gannan Healthcare Vocational College, Ganzhou 341000, Jiangxi Province, China
| | - Zi-Cai Liu
- Department of Rehabilitation Medicine, Shaoguan First People’s Hospital, Shaoguan 512000, Guangdong Province, China
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Leocani L, Dalla Costa G, Coppi E, Santangelo R, Pisa M, Ferrari L, Bernasconi MP, Falautano M, Zangen A, Magnani G, Comi G. Repetitive Transcranial Magnetic Stimulation With H-Coil in Alzheimer's Disease: A Double-Blind, Placebo-Controlled Pilot Study. Front Neurol 2021; 11:614351. [PMID: 33679572 PMCID: PMC7930223 DOI: 10.3389/fneur.2020.614351] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/16/2020] [Indexed: 12/14/2022] Open
Abstract
Focal repetitive transcranial magnetic stimulation (rTMS) has been applied to improve cognition in Alzheimer's disease (AD) with conflicting results. We applied rTMS in AD in a pilot placebo-controlled study using the H2-coil. H-coils are suitable for targeting wider neuronal structures compared with standard focal coils, in particular the H2-coil stimulates simultaneously the frontal-parietal-temporal lobes bilaterally. Thirty patients (mean age 70.9 year, SD 8.1; mean MMSE score 16.9, SD 5.5) were randomized to sham or real 10 Hz rTMS stimulation with the H2-coil. Each patient underwent 3 sessions/week for 4 weeks, followed by 4 weeks with maintenance treatment (1 session/week). Primary outcome was improvement of ADAS-cog at 4 and 8 weeks compared with baseline. A trend toward an improved ADAS-cog score over time was observed for patients undergoing real rTMS, with actively treated patients experiencing a mean decrease of −1.01 points at the ADAS-Cog scale score per time point (95% CIs −0.02 to −3.13, p < 0.04). This trend was no longer evident 2 months after the end of treatment. Real rTMS showed no significant effect on MMSE and BDI changes over time. These preliminary findings suggest that rTMS with H-coil is feasible and safe in patients with probable AD and might provide beneficial, even though transient, effects on cognition. This study prompts larger studies in the early stages of AD, combining rTMS and cognitive rehabilitation. Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT04562506.
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Affiliation(s)
- Letizia Leocani
- Experimental Neurophysiology Unit, Institute of Experimental Neurology - INSPE, Hospital San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Gloria Dalla Costa
- Experimental Neurophysiology Unit, Institute of Experimental Neurology - INSPE, Hospital San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Elisabetta Coppi
- Experimental Neurophysiology Unit, Institute of Experimental Neurology - INSPE, Hospital San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Roberto Santangelo
- Experimental Neurophysiology Unit, Institute of Experimental Neurology - INSPE, Hospital San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Marco Pisa
- Experimental Neurophysiology Unit, Institute of Experimental Neurology - INSPE, Hospital San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Laura Ferrari
- Experimental Neurophysiology Unit, Institute of Experimental Neurology - INSPE, Hospital San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | | | - Monica Falautano
- Neuropsychology and Clinical Psychology Service, Hospital San Raffaele, Milan, Italy
| | - Abraham Zangen
- Neuroscience Laboratory, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Giuseppe Magnani
- Memory Disorders Unit, Institute of Experimental Neurology-INSPE, Hospital San Raffaele, Milan, Italy
| | - Giancarlo Comi
- University Vita-Salute San Raffaele, Milan, Italy.,Institute of Experimental Neurology-INSPE, Hospital San Raffaele, Milan, Italy
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Shpiner DS, McInerney KF, Miller M, Allen J, Rice J, Luca CC, Adams D, Gomes-Osman J. High frequency repetitive transcranial magnetic stimulation for primary progressive apraxia of speech: A case series. Brain Stimul 2019; 12:1581-1582. [PMID: 31326367 DOI: 10.1016/j.brs.2019.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 07/10/2019] [Indexed: 12/12/2022] Open
Affiliation(s)
- Danielle S Shpiner
- University of Miami Miller School of Medicine, Department of Neurology, 1120 NW 14th Street, Suite 1383, Miami, FL, 33136, USA.
| | - Katalina F McInerney
- University of Miami Miller School of Medicine, Department of Neurology, 1120 NW 14th Street, Suite 1383, Miami, FL, 33136, USA.
| | - Melissa Miller
- University of Miami Miller School of Medicine, Department of Otolaryngology, Division of Speech and Language Pathology, 1121 NW 14 Street, Miami, FL, 33136, USA.
| | - Justine Allen
- University of Florida, Swallowing Systems Core, Dental Tower, DG130, 1395 Center Drive, Gainesville, FL, 32610, USA.
| | - Jordyn Rice
- University of Miami Miller School of Medicine, Department of Physical Therapy, 5915 Ponce de Leon Boulevard, 5th Floor, Coral Gables, FL, 33146, USA.
| | - Corneliu C Luca
- University of Miami Miller School of Medicine, Department of Neurology, 1120 NW 14th Street, Suite 1383, Miami, FL, 33136, USA.
| | - David Adams
- University of Miami Miller School of Medicine, Department of Neurology, 1120 NW 14th Street, Suite 1383, Miami, FL, 33136, USA.
| | - Joyce Gomes-Osman
- University of Miami Miller School of Medicine, Department of Physical Therapy, 5915 Ponce de Leon Boulevard, 5th Floor, Coral Gables, FL, 33146, USA.
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Vanacore N, Canevelli M. Transcranial direct current stimulation as a therapeutic opportunity in PSP. Neurology 2019; 93:235-236. [DOI: 10.1212/wnl.0000000000007889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Madden DL, Sale MV, O'Sullivan J, Robinson GA. Improved language production with transcranial direct current stimulation in progressive supranuclear palsy. Neuropsychologia 2019; 127:148-157. [PMID: 30836131 DOI: 10.1016/j.neuropsychologia.2019.02.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 12/19/2018] [Accepted: 02/28/2019] [Indexed: 01/05/2023]
Abstract
Progressive supranuclear palsy (PSP) is an atypical parkinsonian disorder that can present with language production deficits in addition to the characteristic progressive parkinsonian motor symptoms. Although typical parkinsonism treatments such as pharmacotherapy are not effective in PSP, non-invasive brain stimulation techniques such as transcranial direct current stimulation (tDCS) have shown promise for treating cognitive deficits relating to this disorder. We report the case of KN, who presented with reduced verbal fluency and connected speech production in the context of PSP. KN completed a set of language tasks, followed by an alternate version of the tasks in conjunction with either sham or active tDCS over the left dorsolateral prefrontal cortex (DLPFC) across four sessions. Results showed improved performance with active stimulation compared to sham stimulation for phonemic fluency and action naming, as well as mixed results suggesting possible benefits for connected speech production. There were no benefits of active stimulation for control tasks, indicating that tDCS can produce specific benefits for phonemic fluency, action naming, and connected speech production in PSP. These promising, preliminary findings warrant further investigation into whether these benefits of tDCS can be a useful therapeutic tool for PSP patients to maintain language.
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Affiliation(s)
- Daniel L Madden
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, St. Lucia, Brisbane, QLD, 4072, Australia
| | - Martin V Sale
- School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Brisbane, QLD, 4072, Australia; Queensland Brain Institute, The University of Queensland, St. Lucia, Brisbane, QLD, 4072, Australia
| | - John O'Sullivan
- Neurology Department, Royal Brisbane and Women's Hospital, Herston, Brisbane, Australia; Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Brisbane, Australia
| | - Gail A Robinson
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, St. Lucia, Brisbane, QLD, 4072, Australia; Queensland Brain Institute, The University of Queensland, St. Lucia, Brisbane, QLD, 4072, Australia; Neurology Department, Royal Brisbane and Women's Hospital, Herston, Brisbane, Australia.
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Tilley E, McLoughlin J, Koblar SA, Doeltgen SH, Stern C, White S, Peters MDJ. Effectiveness of allied health therapy in the symptomatic management of progressive supranuclear palsy: a systematic review. ACTA ACUST UNITED AC 2018; 14:148-95. [PMID: 27532657 DOI: 10.11124/jbisrir-2016-2002352] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Progressive supranuclear palsy (PSP) is an adult onset neurodegenerative condition associated with mobility, balance, speech, swallowing, vision and cognitive changes. The condition is diagnosed using the National Institute for Neurological Disorders and Stroke (NINDS) and the Society of Progressive Supranuclear Palsy (SPSP) criteria. Therapeutic interventions for PSP are important, and a healthcare team should include a physiotherapist, occupational therapist and speech therapist. Mobility, speech and swallowing problems are commonly experienced, and aspiration pneumonia is the leading cause of death. A preliminary search of the literature has indicated that beyond small case series, there is very little evidence to guide specific allied health therapies in PSP. Many strategies for optimizing independence and function for PSP predominately rely on data extrapolated from the study of Parkinson's disease. OBJECTIVES The objective of this review was to examine the effectiveness of physical, occupational and speech therapy interventions in the symptomatic management of PSP. INCLUSION CRITERIA TYPES OF PARTICIPANTS This review included participants with PSP as per the NINDS and the SPSP criteria, aged over 40 years of age from all community and clinical settings. TYPES OF INTERVENTIONS This review included studies evaluating any allied health therapy that addressed mobility, vision, swallowing, communication or cognitive/neuropsychiatric difficulties experienced by patients with PSP. Studies examining interventions within the current scope of practice, and emerging interventions (non-invasive brain stimulation therapy) were eligible for inclusion. TYPES OF COMPARATOR The effectiveness of interventions of interest was compared with usual care and/or baseline measurements. OUTCOMES Outcomes of interest included the degree of change, or no change, in the symptoms experienced by patients with PSP relevant to allied health. These included difficulties with mobility, vision, swallowing, communication and cognition. TYPES OF STUDIES All types of quantitative study designs published in English from the time of development of the NINDS and the SPSP criteria in 1996-2014 were considered for inclusion. SEARCH STRATEGY A broad range of synonyms for PSP and a three-step search strategy was utilized to identify possible published and unpublished studies from 11 different databases. An initial limited search via MEDLINE (PubMed), CINAHL, Health Informit, PsycINFO, PEDRO, OTSeeker and SpeechBite was undertaken followed by analysis of the text words contained in the title and abstract, and of the index terms used to describe the article. A second search using all identified keywords and index terms was then undertaken across all included databases. Third, hand-searching was conducted and the reference list of all identified reports and articles was searched for additional studies. METHODOLOGICAL QUALITY Critical appraisal was conducted by two independent reviewers using standardized instruments. DATA EXTRACTION Quantitative data were extracted from articles included in the review using standardized data extraction tools. DATA SYNTHESIS As the quantitative articles examined different interventions, pooling of data was not appropriate. Instead, the findings were presented in narrative summary and tabular form. RESULTS Following methodological appraisal, six studies were included in the review. Aside from one small quasi-randomized control study, most studies were small case series and one was a case report. Five of the six studies examined the effectiveness of a range of different physiotherapy rehabilitation programs targeting gait, balance and physical capability, with one study also targeting gaze control. The sixth study examined non-invasive brain stimulation in improving gait and midline symptoms in PSP. No studies examined the effectiveness of occupational therapy or speech therapy interventions in PSP. CONCLUSIONS Research into the effectiveness of allied health therapeutic interventions for PSP symptoms is in its infancy. This review found preliminary evidence to support the use of various physiotherapy rehabilitation programs to improve balance, gait and gaze control in people affected by PSP. Further research is urgently required to identify effective interventions to manage mobility, vision, swallowing, communication and cognitive/neuropsychiatric symptoms associated with this devastating condition.
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Affiliation(s)
- Erica Tilley
- 1The Joanna Briggs Institute, Faculty of Health Sciences, The University of Adelaide, South Australia, Australia 2Faculty of Medicine, School of Health Sciences, Nursing and Health Sciences, Flinders University, South Australia, Australia 3Faculty of Health Sciences, School of Medicine, University of Adelaide, South Australia, Australia
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Shoeibi A, Litvan I. Therapeutic options for Progressive Supranuclear Palsy including investigational drugs. Expert Opin Orphan Drugs 2017. [DOI: 10.1080/21678707.2017.1335596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Ali Shoeibi
- Movement Disorder Center, UC San Diego Department of Neurosciences, La Jolla, CA, USA
- Department of Neurology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Irene Litvan
- Movement Disorder Center, UC San Diego Department of Neurosciences, La Jolla, CA, USA
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Chieffo R, Ferrari F, Battista P, Houdayer E, Nuara A, Alemanno F, Abutalebi J, Zangen A, Comi G, Cappa SF, Leocani L. Excitatory Deep Transcranial Magnetic Stimulation With H-Coil Over the Right Homologous Broca’s Region Improves Naming in Chronic Post-stroke Aphasia. Neurorehabil Neural Repair 2013; 28:291-8. [DOI: 10.1177/1545968313508471] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. The role of the right hemisphere in poststroke aphasia recovery is still controversial and the effects of repetitive transcranial magnetic stimulation (rTMS) over the right homologous Broca’s region have been seldom investigated. Objective. This study aimed to compare the effect of excitatory, inhibitory, and sham rTMS delivered with H-coil over the right inferior frontal gyrus in chronic aphasic patients. Methods. Five right-handed poststroke aphasic patients underwent a picture naming task before and immediately after each of 3 sessions of rTMS: excitatory (10 Hz), inhibitory (1 Hz), and sham rTMS, in random sequence and separated by at least 1 week. Results. Only the excitatory 10-Hz stimulation was associated with a significant improvement in naming performance ( P = .043) and was significantly more effective than 1-Hz rTMS ( P = .043). Conclusions. A single session of excitatory deep brain rTMS over the right inferior frontal gyrus with H-coil significantly improves naming in right-handed chronic poststroke aphasic patients. This result is in line with the hypothesis of a positive, rather than detrimental, role of the right hemisphere in chronic aphasia due to a left-hemispheric stroke.
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Affiliation(s)
- Raffaella Chieffo
- Scientific Institute Hospital San Raffaele, Milan, Italy
- Vita-Salute University and San Raffaele Scientific Institute, Milan, Italy
| | - Federico Ferrari
- Vita-Salute University and San Raffaele Scientific Institute, Milan, Italy
| | | | - Elise Houdayer
- Scientific Institute Hospital San Raffaele, Milan, Italy
| | - Arturo Nuara
- Scientific Institute Hospital San Raffaele, Milan, Italy
- Vita-Salute University and San Raffaele Scientific Institute, Milan, Italy
| | - Federica Alemanno
- Scientific Institute Hospital San Raffaele, Milan, Italy
- Vita-Salute University and San Raffaele Scientific Institute, Milan, Italy
| | - Jubin Abutalebi
- Vita-Salute University and San Raffaele Scientific Institute, Milan, Italy
| | | | - Giancarlo Comi
- Scientific Institute Hospital San Raffaele, Milan, Italy
- Vita-Salute University and San Raffaele Scientific Institute, Milan, Italy
| | - Stefano F. Cappa
- Vita-Salute University and San Raffaele Scientific Institute, Milan, Italy
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