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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Transcranial magnetic stimulation is an interesting technique for non-invasively stimulating the brain in awake alert humans. It is a powerful research tool for examining brain behavior relationships. Additionally many researchers are investigating whether repeatedly applying TMS to specific regions over several days to weeks might have therapeutic effects. By far the largest amount of work has been done investigating whether daily applications of prefrontal TMS can improve the symptoms of major depression. We review the literature combining TMS with brain imaging, and then overview the clinical work done to date with TMS in depression. The literature to date suggests that daily prefrontal TMS for several weeks clearly has antidepressant effects, but much work remains to establish the effect sizes and improve the methods of delivery in order to improve its potential clinical utility.
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PMID:Repetitive transcranial magnetic stimulation of the prefrontal cortex in depression. 1940 83

One strategy to understand bipolar disorder is to study the mechanism of action of mood-stabilizing drugs, such as valproic acid and lithium. This approach has implicated a number of intracellular signalling elements, such as GSK3beta (glycogen synthase kinase 3beta), ERK (extracellular-signal-regulated kinase)/MAPK (mitogen-activated protein kinase) or protein kinase C. However, lamotrigine does not seem to modulate any of these targets, which is intriguing given that its profile in the clinic differs from that of valproic acid or lithium, with greater efficacy to prevent episodes of depression than mania. The primary target of lamotrigine is the voltage-gated sodium channel, but it is unclear why inhibition of these channels might confer antidepressant efficacy. In healthy volunteers, we found that lamotrigine had a facilitatory effect on the BOLD (blood-oxygen-level-dependent) response to TMS (transcranial magnetic stimulation) of the prefrontal cortex. This effect was in contrast with an inhibitory effect of lamotrigine when TMS was applied over the motor cortex. In a follow-up study, a similar prefrontal specific facilitatory effect was observed in a larger cohort of healthy subjects, whereas valproic acid inhibited motor and prefrontal cortical TMS-induced BOLD response. In vitro, we found that lamotrigine (3-10 microM) enhanced the power of gamma frequency network oscillations induced by kainic acid in the rat hippocampus, an effect that was not observed with valproic acid (100 microM). These data suggest that lamotrigine has a positive effect on corticolimbic network function that may differentiate it from other mood stabilizers. The results are also consistent with the notion of corticolimbic network dysfunction in bipolar disorder.
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PMID:Neural network dysfunction in bipolar depression: clues from the efficacy of lamotrigine. 1975 56

We studied the effects of transcranial magnetic stimulation (TMS, 60 Hz and 0.7 mT for 4 h/day for 14 days) on oxidative and cell damage caused by olfactory bulbectomy (OBX) in Wistar rats. The levels of lipid peroxidation products and caspase-3 were enhanced by OBX, whereas it prompted a reduction in reduced glutathione (GSH) content and antioxidative enzymes activities. The treatment with TMS reverted towards normality the biomarkers indicative of oxidative stress and apoptosis. In conclusion, our data show that TMS induced a protection against cell and oxidative damage induced by OBX, as well as they support the hypothesis that oxidative stress may play an important role in depression.
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PMID:Antioxidant-like effects and protective action of transcranial magnetic stimulation in depression caused by olfactory bulbectomy. 2042 40

Brain imaging studies performed over the past 20 years have generated new knowledge about the specific brain regions involved in the brain diseases that have been classically labeled as psychiatric. These include the mood and anxiety disorders, and the schizophrenias. As a natural next step, clinical researchers have investigated whether the minimally invasive brain stimulation technologies (transcranial magnetic stimulation [TMS] or transcranial direct current stimulation [tDCS]) might potentially treat these disorders. In this review, we critically review the research studies that have examined TMS or tDCS as putative treatments for depression, mania, obsessive-complusive disorder, posttraumatic stress disorder, panic disorder, or schizophrenia. (Separate controversy articles deal with using TMS or tDCS to treat pain or tinnitus. We will not review here the large number of studies using TMS or tDCS as research probes to understand disease mechanisms of psychiatric disorders.) Although there is an extensive body of randomized controlled trials showing antidepressant effects of daily prefrontal repetitive TMS, the magnitude or durability of this effect remains controversial. US Food and Drug Administration approval of TMS for depression was recently granted. There is much less data in all other diseases, and therapeutic effects in other psychiatric conditions, if any, are still controversial. Several issues and problems extend across all psychiatric TMS studies, including the optimal method for a sham control, appropriate coil location, best device parameters (intensity, frequency, dosage, and dosing schedule) and refining what subjects should be doing during treatment (activating pathologic circuits or not). In general, TMS or tDCS as a treatment for most psychiatric disorders remains exciting but controversial, other than prefrontal TMS for depression.
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PMID:Controversy: Repetitive transcranial magnetic stimulation or transcranial direct current stimulation shows efficacy in treating psychiatric diseases (depression, mania, schizophrenia, obsessive-complusive disorder, panic, posttraumatic stress disorder). 2063 99

Looking at novelties and advances in medicine in particular in the treatment of major depressive disorder no principally new antidepressant treatment strategy has been established in clinical routine in the last fifty years. However, regarding the considerable issue of treatment resistance in depression, new therapeutic strategies are urgently required. In this context, repetitive transcranial magnetic stimulation above the dorsolateral prefrontal cortex has been proposed as a potential new treatment option for depression; furthermore, in October 2008 a first rTMS-device (NeuroStar TMS Therapy System) was approved by the FDA for the treatment of treatment resistant major refractory depression in adults. Yet, despite now nearly two decades of research in this field, no final answer concerning its validity for antidepressant treatment in the clinical practice is given. Numerous studies with small sample sizes and heterogeneous designs have been performed in this field yielding to different results. These were subjected to meta-analyses, assessing the antidepressant effect of rTMS, which are briefly summarized in this article. Further, multicentre-trials with larger numbers of patients were performed, which are presented and critically discussed here in more detail. This short review shall thus provide an overview of the current status of knowledge concerning rTMS in depression and it also provides some recommendations for future research in this field.
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PMID:Transcranial magnetic stimulation in depression--lessons from the multicentre trials. 2071 79

Repetitive transcranial magnetic stimulation (rTMS) is currently emerging as one of the first fundamentally new treatments in psychiatric practice for a considerable number of years. Research into the use of rTMS for the treatment of patients with depression has now been conducted for over 15 years. The aim of this article was to review the development of rTMS treatment for depression and the current state of evidence supporting its use. The vast majority of the trials conducted on the technique have evaluated the efficacy of high-frequency rTMS applied to the left dorsolateral prefrontal cortex using a set of parameters very similar to those originally described in the mid-1990s. This 'standard' form of rTMS clearly appears to have antidepressant efficacy, and its effects have now been confirmed in several large-scale clinical trials and a number of meta-analyses: response is better than that of sham stimulation, although the number of responders to treatment is relatively modest. A wide range of alternative forms of rTMS have been, or are currently being, evaluated. Low-frequency stimulation applied to the right prefrontal cortex appears to have similar efficacy to standard treatment and it is possible that the bilateral approaches may prove more effective. Novel methods of stimulation, such as priming stimulation, theta-burst stimulation and deep TMS, appear to be promising although require further evaluation. Significant benefit appears likely to accumulate through the use of methods that involve a more reliable targeting of prefrontal brain regions. Research is also required to evaluate the long-term effects of rTMS treatment, its use as a maintenance therapy and to establish reliable predictors of response to treatment.
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PMID:The effects of repetitive transcranial magnetic stimulation in the treatment of depression. 2115 43

Depression is the most common psychiatric disorder with a particularly important disability due to its evolution to chronicity and treatment-resistance. In the same way, the outcome of bipolar disorder is similar. Only 75% subjects remain remitted in the year following the onset of mood episode and depressive episode leads to worth responsiveness than patients in phase hypo/manic. Thus, treating mood episodes and fighting against resistant and residual symptoms or chronicity of the disorders constitute major clinical issues and economic challenges. They have generated great interest in finding new non-pharmacological approaches such as repetitive transcranial magnetic stimulation (rTMS). TMS is a non-invasive means of focal brain stimulation, rapidly fluctuating magnetic fields. Given the hypothesis that the right and left sides of the dorsolateral prefrontal cortex have opposing effects in mood control, high-frequency rTMS activates the left side and low-frequency to inhibit the right side in the treatment of depression. A literature review was conducted to study the efficacy of rTMS in the treatment of unipolar and bipolar depression, acute mania and long-term maintenance therapy. During the last decade, numerous studies including several meta-analyses have indicated the efficacy of rTMS in acute treatment of major depressive disorder. Overall, rTMS seems to be effective in the treatment of bipolar depression but further trials with larger cohorts should determine optimal parameters of stimulation. There are also few studies about rTMS in the treatment of acute mania. Protocols are reversed than in the treatment of depression. Results are promising but confounded by the presence of concurrent medications. Finally, the literature on the use of maintenance rTMS in the prevention of depressive relapse or as a mood stabiliser is limited. Nevertheless it demonstrates the importance of developing maintenance protocols to maintain the clinical improvement achieved at the end of the acute treatment. New techniques to improve the effectiveness of rTMS are already appearing.
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PMID:[Affective disorders and repetitive transcranial magnetic stimulation: Therapeutic innovations]. 2123 56

Search for new therapeutic methods applied in psychiatric disorders, especially in depression--concern not only pharmacotherapy, but also physical techniques. Electroconvulsive treatment is a recognised and effective method for receiving of antidepressant effects by means of electric head stimulation with eliciting of seizures. During two past decades, a few new techniques using the electrical or magnetic stimulation were tested with respect to their therapeutic antidepressant activity. The trancranial magnetic stimulation TMS, vagus nerve stimulation VNS, magnetic seizure therapy/magnetoconvulsive therapy MST/MCT, deep brain stimulation DBS, and trancranial direct current stimulation tDCS are involved among these techniques. The paper discusses those above mentioned techniques and it makes a critical comparison--in relation to several criteria--with the electroconvulsive treatment and pharmacotherapy.
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PMID:[New techniques of electrical and magnetic stimulation in treatment of depression--comparison with electroconvulsive treatment and pharmacotherapy]. 2144 68

Unlike for depression, only few studies are available today investigating the therapeutic effects of repetitive transcranial magnetic stimulation (rTMS) for anxiety disorders. This review aims to provide information on the current research approaches and main findings regarding the therapeutic use of rTMS in the context of various anxiety disorders. Although positive results have frequently been reported in both open and randomized controlled studies, our review of all identified studies indicates that at present no conclusive evidence of the efficacy of rTMS for the treatment for anxiety disorders is provided. Several treatment parameters have been used, making the interpretation of the results difficult. Moreover, sham-controlled research has often been unable to distinguish between response to rTMS and sham treatment. However, there is a limitation in the rTMS methods that likely impacts only the superficial cortical layers. It is not possible to directly stimulate more distant cortical areas, and also subcortical areas, relevant to the pathogenesis of anxiety disorders, though such effects in subcortical areas are thought to be indirect, via trans-synaptic connections. We thus recommend further studies to clearly determine the role of rTMS in the treatment of anxiety disorders. Key advances in combining TMS with neuroimaging technology may aid in such future developments.
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PMID:The value of repetitive transcranial magnetic stimulation (rTMS) for the treatment of anxiety disorders: an integrative review. 2163 3

The ability to generate memory strategies is a key factor in the performance of episodic memory tasks. Whether the ability to generate memory strategies exerts an influence in the performance of memory tests in the elderly population is still a matter of debate. Here we present results from an experimental memory task (Test of Memory Strategies, TMS), comprised of five lists of words starting from an incidental learning task, and four more lists which progressively gain in their external organization of the material, reducing the necessity of mobilizing complex memory strategies. TMS has been applied to four groups of elderly patients (amnestic Mild Cognitive Impairment - aMCI, multidomain (mMCI), and Vascular Cognitive Impairment - VCI and Depression) and a healthy aging group. In conditions with low organization of the material, the mMCI and VCI groups (both showing a greater executive function impairment) have shown lower performance. However, as the material was progressively organized, they improved their performance. The aMCI group showed similar performance to the control group at the lower level of external organization but did not improve performance in conditions with a high level of external organization. The mMCI and VCI groups showed lower performance on all TMS conditions compared with controls. Discriminant analysis revealed 90% sensitivity and specificity to differentiate between groups based on TMS conditions. These results indicate how executive functions influence performance on memory tasks in elderly subjects with different neuropsychological profiles.
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PMID:Influence of memory strategies on memory test performance: a study in healthy and pathological aging. 2183 21


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