Transcranial magnetic stimulation for obsessive-compulsive disorder and post-traumatic stress disorder: A comprehensive systematic review and analysis of therapeutic benefits, cortical targets, and psychopathophysiological mechanisms

Progress in Neuro-Psychopharmacology and Biological Psychiatry, Journal Year: 2024, Volume and Issue: 136, P. 111147 - 111147

Published: Sept. 16, 2024

Transcranial magnetic stimulation (TMS) is a safe non-invasive treatment technique. We systematically reviewed randomised controlled trials (RCTs) applying TMS in obsessive compulsive disorder (OCD) and post-traumatic stress (PTSD) to analyse its therapeutic benefits explore the relationship between cortical target psychopathophysiology. included 47 (35 for OCD) found 22.7 % symptom improvement OCD 29.4 PTSD. Eight targets were investigated four PTSD, yielding similar results. Bilateral dlPFC-TMS exhibited greatest change (32.3 OCD, N = 4 studies; 35.7 1 studies), followed by right (24.4 8; 26.7 10), left (22.9 6; 23.1 1). mPFC-TMS showed promising results, although evidence limited (N 2 studies each PTSD) findings PTSD conflicting. Despite clinical improvement, reports lacked consistent solid rationale selection, revealing gap research that complicates interpretation of hinders development optimisation. Future should adopt hypothesis-driven approach rather than relying solely on correlations from imaging studies, integrating neurobiological processes with affective, behavioural, cognitive states, thereby doing justice complexity human experience mental illness.

Language: Английский

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Global prevalence of obsessive-compulsive disorder in pregnancy and postpartum: a systematic review and meta-analysis

Journal of Affective Disorders Reports, Journal Year: 2024, Volume and Issue: unknown, P. 100846 - 100846

Published: Sept. 1, 2024

Language: Английский

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The Efficacy of Transcranial Magnetic Stimulation in the Treatment of Obsessive-Compulsive Disorder: An Umbrella Review of Meta-Analyses

CNS Spectrums, Journal Year: 2023, Volume and Issue: 29(2), P. 109 - 118

Published: Dec. 6, 2023

Repetitive transcranial magnetic stimulation (rTMS) has been increasingly used for treating obsessive-compulsive disorder (OCD). Although several meta-analyses have explored its effectiveness and safety, there is no umbrella review specifically focused on rTMS OCD. This followed Preferred Reporting Items Systematic Reviews Meta-Analyses (PRISMA) guidelines analyzed relevant

Language: Английский

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Lessons learned from a multimodal sensor-based eHealth approach for treating pediatric obsessive-compulsive disorder

Frontiers in Digital Health, Journal Year: 2024, Volume and Issue: 6

Published: Sept. 24, 2024

Introduction The present study investigates the feasibility and usability of a sensor-based eHealth treatment in psychotherapy for pediatric obsessive-compulsive disorder (OCD), explores promises pitfalls this novel approach. With interventions, therapy can be delivered patient's home environment, leading to more ecologically valid symptom assessment access experts even rural areas. Furthermore, sensors help indicate emotional physical state during treatment. Finally, using exposure with response prevention (E/RP) individualize prevent avoidance behavior. Methods In study, we developed subsequently evaluated multimodal intervention 14 video sessions cognitive-behavioral (CBT) 20 patients OCD aged 12-18. During E/RP, recorded eye movements gaze direction via trackers, an ECG chest strap captured heart rate (HR) identify stress responses. Additionally, motion detected approach Results results promising application sensor-supported OCD, such that technology was well-accepted by participants, therapeutic relationship successfully established context internet-based Patients, their parents, therapists all showed high levels satisfaction form rated wearable environment as helpful, fewer symptoms perceived at end Discussion goal gain better understanding psychological physiological processes occur exposure-based online addition, 10 key considerations preparing conducting CBT children adolescents are explored article. This has potential overcome limitations interventions allowing real-time transmission objective data therapists, once challenges regarding technical support hardware software addressed. Clinical Trial Registration www.ClinicalTrials.gov , identifier (NCT05291611).

Language: Английский

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Transcranial Magnetic Stimulation to Treat Neuropathic Pain: A Bibliometric Analysis

Published: Jan. 15, 2024

Neuropathic pain is caused by a lesion or disease of the somatosensory system and one most incapacitating types, representing significant non met medical need. Due to increase in research field since innovative therapeutic strategies are required, namely intractable neuropathic pain, neurostimulation has been used. Within this approaches, transcranial magnetic stimulation (TMS) that uses transient produce electrical currents over cortex emerges literature. Since an area expansion due putative role TMS, we performed bibliometric analysis Scopus with primary objective identify scientific production related use TMS manage pain. The had no restrictions focused on characteristics literature retrieved, collaboration main topics from inception July 6, 2023. A total 474 articles were collected. biggest co-occurrence between terms “neuropathic pain” “transcranial stimulation” was obtained. journal “Clinical Neurophysiology” leads Top 5 productive sources. United States country 50% documents being “review articles” followed France 56% “original articles”. Lefaucheur, JP Saitoh, Y two influents authors. frequent type article”. This study allows perform general overview application for useful establish future directions field.

Language: Английский

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The Inflexible Mind: A Critical Factor in Understanding and Addressing COVID-19 Vaccine Hesitancy

Journal of Psychiatric Research, Journal Year: 2024, Volume and Issue: 179, P. 360 - 365

Published: Sept. 23, 2024

Language: Английский

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Considerations for the treatment of obsessive-compulsive disorder in patients who have comorbid major depression

Expert Review of Neurotherapeutics, Journal Year: 2023, Volume and Issue: 23(11), P. 955 - 967

Published: Oct. 9, 2023

ABSTRACTIntroduction Obsessive-compulsive disorder (OCD) is a debilitating psychiatric that affects significant number of individuals worldwide. Major depressive (MDD) among the most common comorbidities reported in people with OCD. The emergence MDD OCD can be attributed to increased severity symptoms and their profound impact on daily functioning. Depressive also modify course OCD.Areas covered In this review, authors explore potential shared neurobiological mechanisms may underlie both MDD, such as disturbed sleep patterns, immunological dysregulations, neuroendocrine changes. Furthermore, they address challenges clinicians face when managing comorbid MDD. discuss range treatment options for associated including augmentation strategies serotonin reuptake inhibitors (e.g. aripiprazole), psychotherapy (especially CBT/EPR), transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT), deep brain (DBS).Expert opinion Although there no 'rule thumb' or universally acceptable strategy many clinicians, authors, tend adopt unique transdiagnostic approach related disorders, focusing known effective across diagnoses. Nevertheless, existing 'cisdiagnostic approaches' still retain importance, i.e. specific therapeutic tailored more severe forms individual disorders.KEYWORDS: Deep stimulationdepressionelectroconvulsive therapymajor disorderobsessive-compulsive disorderpharmacotherapypsychotherapytranscranial Article highlights Approximately 65% patients develop depression.The reason high comorbidity rate remains uncertain, it could either burden obsessive-compulsive underlying disorders.Some options, like pharmacotherapy (SSRIs), CBT, TMS, DBS, disorders. efficacy ECT unclear.In order effectively manage simultaneous occurrence depression, we propose treatment.Clinicians should not naïve ignore 'cisdiagnostic' approaches, developed treatment-refractory and/or neuropsychiatric syndromes.Declaration interestThe have other relevant affiliations financial involvement any organization entity interest conflict subject matter materials discussed manuscript apart from those disclosed.Reviewer disclosuresPeer reviewers relationships disclose.Additional informationFundingL Fontenelle supported by Fundação de Amparo à Pesquisa do Estado Rio Janeiro (FAPERJ; grant # CNE E-26/200.950/2021, Janeiro, RJ, Brazil), intramural grants D'Or Institute Research Education (IDOR, Brazil).

Language: Английский

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Toward a neurocircuit-based sequential bilateral transcranial magnetic stimulation for treatment of obsessive-compulsive disorder

Brain stimulation, Journal Year: 2023, Volume and Issue: 16(6), P. 1585 - 1587

Published: Oct. 30, 2023

Individuals diagnosed with obsessive-compulsive disorder (OCD) present a substantial demand for innovative therapeutic interventions, given that they often endure significant residual symptoms despite undergoing treatment [[1]Fineberg N.A. Hollander E. Pallanti S. Walitza Grünblatt Dell'Osso B.M. et al.Clinical advances in disorder.Int Clin Psychopharmacol. 2020; 35: 173-193Crossref PubMed Scopus (63) Google Scholar]. The prevailing body of research has predominantly explored the utility repetitive transcranial magnetic stimulation (rTMS) as non-invasive cerebral technique alternative interventions. High frequency rTMS (HF-rTMS; ≥5 Hz) can produce local increase cortical excitability, whereas low (LF-rTMS; ≤1 decreases excitability [[2]Fox M.D. Buckner R.L. Liu H. Chakravarty M.M. Lozano A.M. Pascual-Leone A. Resting-state networks link invasive and noninvasive brain across diverse psychiatric neurological diseases.Proc Natl Acad Sci USA. 2014; 111Crossref (414) Intermittent theta burst (iTBS), complex kind rTMS, significantly reduces both duration discomfort compared to traditional HF-rTMS. Additionally, abbreviated facilitates higher dosages per session, spaced protocols multiple stimulations sessions day, multifocal approaches, including bilateral [[3]Schwippel T. Schroeder P.A. Fallgatter A.J. Plewnia C. Clinical review: use theta-burst mental disorders tinnitus.Prog Neuro-Psychopharmacol Biol Psychiatry. 2019; 92: 285-300Crossref (28) Increased insight normalizing effects neurostimulation on cortico-striatal-thalamic-cortical (CSTC) loops – through neuroimaging animal provides novel opportunities further optimize strategies. Different targets which focus putative OCD-related dysfunctions CSCT neuro-circuitry have been explored, mainly dorsolateral prefrontal cortex (DLPFC), anterior cingulate (ACC), supplementary motor area (SMA), orbitofrontal (OFC), medial [[4]Pellegrini L. Garg K. Enara Gottlieb D.S. Wellsted D. Albert U. al.Repetitive (r-TMS) selective serotonin reuptake inhibitor-resistance disorder: meta-analysis clinical implications.Compr Psychiatr. 2022; 118152339Crossref (3) findings thus far shown promise but exhibit inconsistencies, likely attributable, at least part, array employed, variables such target localization, laterality, frequency, duration, duration. Consequently, imperative task hand is development more efficacious strategy. In this study, we conducted sequential protocol OCD six patients (5 males 1 female, mean age 17.5 ± 8.36 years). average illness was3.42 2.54 years, baseline Y-BOCS score was 24.67 3.88. Detailed data be found material. study received approval from Eighth Affiliated Hospital Sun Yat-sen University, all provided informed consent their participation treatment. Participants underwent total 5 week. All elements our are administered one session starting left right OFC followed by DLPFC then SMA (Fig. Table S2). Thus, 4800 pulses were delivered 24,000 overall course. separated fifteen-minute intersession interval. resting threshold (RMT) set 100%, did not report any instances headache, seizures, or other adverse events. Overall, well tolerated. As illustrated Fig. 1, exhibited reduction scores. revealed yielded improvements symptoms. To comprehend mechanisms underlying DLPFC, OFC, SMA, must consider roles within interconnected circuits, where these regions assume pivotal significance. Neuroimaging involvement parallel, partly cortico-striato-thalamo-cortical circuits play role various aspects OCD, sensorimotor, cognitive, affective, motivational processes [[5]Stein D.J. Costa D.L.C. Lochner Miguel E.C. Reddy Y.C.J. Shavitt R.G. al.Obsessive–compulsive disorder.Nat Rev Dis Prim. 5: 1-46Crossref (217) There five distinct CSTC implicated OCD: sensorimotor circuit, comprising putamen, thalamus; ventral affective includes nucleus accumbens (NAcc), dorsal cognitive encompassing dorsomedial (dmPFC), caudate, involving inferior frontal gyrus (IFG), ventrolateral (vlPFC), fronto-limbic characterized amygdala ventromedial (vmPFC) [[6]van den Heuvel O.A. van Wingen G. Soriano-Mas Alonso P. Chamberlain S.R. Nakamae al.Brain circuitry compulsivity.Eur Neuropsychopharmacol. 2016; 26: 810-827Crossref (186) Given overlapping involved phenotypes, Elizabeth al. [[7]Shephard Stern E.R. Batistuzzo M.C. Godoy P.B.G. al.Toward neurocircuit-based taxonomy guide obsessive–compulsive disorder.Mol 2021; 4583-4604Crossref (69) Scholar] posited effective would require targeting concurrently. recent attempts dedicated approaches directly dysfunctional circuits. Our primarily focused method stimulating specific particular emphasis addressing three primary loops: involve respectively. A prominent theory posits high synchrony spontaneous neural activity between homotopic hemispheres fundamental functional structural attribute typical human brains. Nevertheless, individuals disorders, trait deviates norm [[8]Deng Qi Xu J. Jiang Zhang F. Dai N. al.Reduced interhemispheric connectivity patients.Front 10: 418Crossref (19) asymmetry subcortical considered contributing factor [[9]Kong X.-Z. Boedhoe P.S.W. Abe Y. Ameis S.H. Arnold P.D. al.Mapping ENIGMA consortium.Biol 87: 1022-1034Abstract Full Text PDF positron Emission Tomography (PET) also acute symptomatic opposite perfusion responses hemisphere [[10]Scott Rauch Mmaj Nathaniel M. Alpert PhD. Lee Baer Hans C.R. Breiter Cary R. Savage Fischman Md PhD Alan Regional blood flow measured during symptom provocation using oxygen 15-LabeledCarbon dioxide emission Tomography.Arch Gen 1994; 51: 62-70Crossref (771) This indicates manifest anomalous [[11]Jia Ou Chen Ma Zhan Lv al.Disrupted inter- intra-hemispheric rest medication-free disorder.Front Neurosci. 15Crossref (6) it plausible robust strategy restore normalization involves TMS opposed unilateral stimulation. Moreover, there evidence suggest high-frequency applied enhances metabolic regions, while low-frequency side diminishes [[12]Plewnia Brendel B. Schwippel Nieratschker V. Ethofer Kammer al.Treatment major depressive stimulation: randomized, double-blind, placebo-controlled multicenter trial (TBS-D).Eur Arch Psychiatr 271: 1231-1243Crossref (4) Building upon findings, adopted protocol. summary, represents potentially superior approach combines protocols. controlled trials necessary rigorously evaluate promising findings. supported grants Shenzhen Science Technology Innovation Program [JCYJ20220530144400002] Futian District Health Wellness [FTWS2023007].

Language: Английский

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Durability of deep transcranial magnetic stimulation for veterans with treatment resistant depression with comorbid suicide risk and PTSD symptoms

Psychiatry Research, Journal Year: 2023, Volume and Issue: 332, P. 115690 - 115690

Published: Dec. 23, 2023

Language: Английский

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The promise and challenges of transcranial magnetic stimulation and deep brain stimulation as therapeutic options for obsessive-compulsive disorder

Expert Review of Neurotherapeutics, Journal Year: 2024, Volume and Issue: 24(2), P. 145 - 158

Published: Jan. 22, 2024

Introduction Obsessive compulsive disorder (OCD) represents a complex and often difficult to treat disorder. Pharmacological psychotherapeutic interventions are associated with sub-optimal outcomes, 40–60% of patients resistant first line therapies thus left few treatment options. OCD is underpinned by aberrant neurocircuitry within cortical, striatal, thalamic brain networks. Considering the impairments that underlie symptomology, neurostimulation provide an opportunity modulate psychopathology in personalized manner. Also, probing pathological neural networks, enhanced understanding disease states can be obtained.

Language: Английский

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