A Case Series of Continuous Theta Burst Stimulation Treatment for the Supplementary Motor Area Twice a Day in Patients with Obsessive-Compulsive Disorder: A Real World TMS Registry Study in Japan

Journal of Personalized Medicine, Год журнала: 2023, Номер 13(5), С. 875 - 875

Опубликована: Май 22, 2023

Obsessive-compulsive disorder (OCD) is a psychiatric characterized by patterns in which unwanted thoughts and fears are evoked as obsessions furthermore, compulsive behaviors provoked repeatedly, with prevalence rate of 2% the population. These obsessive-compulsive symptoms disrupt daily life cause great distress to individual. At present, OCD treated antidepressants, mainly selective serotonin reuptake inhibitors, psychotherapy, including exposure response prevention method. However, these approaches may only show certain level efficacy, approximately 50% patients treatment resistance. This situation has led research development neuromodulation therapies, transcranial magnetic stimulation treatment, for worldwide recent years. In this case series, we retrospectively analyzed TMS registry data continuous theta burst (cTBS) therapy targeting bilateral supplementary motor cortex six whose had not improved pharmacotherapy. The results suggest that cTBS area reduce OCD, despite limitations an open-label preliminary series. present findings warrant further validation randomized, sham-controlled trial larger sample size future.

Язык: 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, Год журнала: 2023, Номер 29(2), С. 109 - 118

Опубликована: Дек. 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

Язык: Английский

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Deep brain stimulation of the ventral anterior limb of the capsula interna in patients with treatment-refractory anorexia nervosa

Brain stimulation, Год журнала: 2021, Номер 14(6), С. 1528 - 1530

Опубликована: Окт. 22, 2021

Anorexia nervosa (AN) is a severe and often chronic psychiatric disorder with high morbidity mortality [[1]Steinhausen H.C. Outcome of eating disorders.Child Adolesc Psychiatr Clin N Am. 2009; 18: 225-242Abstract Full Text PDF PubMed Scopus (265) Google Scholar]. Pilot studies cases showed mixed but promising effects deep brain stimulation (DBS) as last-resort treatment option for life-threatening treatment-refractory AN [[2]Lipsman N. et al.Deep the subcallosal cingulate anorexia nervosa: 1 year follow-up an open-label trial.Lancet Psychiatr. 2017; 4: 285-294Abstract (83) Scholar,[3]Liu W. nucleus accumbens long-term study.Brain Stimul. 2020; 13: 643-649Abstract (14) The present study (N = 4) first to target DBS in at ventral anterior limb capsula interna (vALIC), part reward circuitry. vALIC-DBS strong long-lasting obsessive-compulsive (OCD). We hypothesized that, due clinical neurobiological similarities between OCD, may exert comparable AN. included sample patients exceptionally Although challenging, they reflect prototypical that be eligible last resort [[4]Bergfeld I.O. al.Invasive non-invasive neurostimulation OCD.Curr Top Behav Neurosci. 2021; 49: 399-436https://doi.org/10.1007/7854_2020_206Crossref (8) Inclusion criteria primary diagnosis AN, Body Mass Index (BMI) < 15, Global Assessment Function score (GAF-score) 45 or less ≥2 years [[5]Association A.P. Diagnostic statistical manual mental disorders.fifth ed. 2013Crossref Scholar], illness duration ≥10 lack response typical modes including ≥1 inpatient hospitalization. conducted bilateral stereotactic implantation electrodes vALIC. In accordance our [[6]Denys D. al.Efficacy internal capsule refractory disorder: cohort 70 patients.Am J 177: 265-271https://doi.org/10.1176/appi.ajp.2019.19060656Crossref (56) Scholar] comprised four sequential phases: preoperative (T-1), surgery (T0), optimization (3–9 months; T1-T2) maintenance phase (12 T2-T4) (Supplement 1, methods analysis). During received standard medical care, regular visits nurse-practitioner psychiatrist. No major psychopharmacological adjustments were made. Primary outcome measures 1) change body mass index (BMI), 2) Yale-Brown-Cornell Eating Disorder Scale (YBC-EDS)-score [[7]Mazure C.M. al.The scale: development, use, reliability validity.J Res. 1994; 28: 425-445Crossref (176) 3) Quality Life (ED-QOL)-score [[8]Engel S.G. al.Development psychometric validation disorder-specific health-related quality life instrument.Int Eat Disord. 2006; 39: 62-71Crossref (135) established side safety through frequent intensive monitoring by psychiatrist, checks vital parameters, laboratory assessments ECG. All assessed using (self-report) questionnaires. Four female enrolled 2016 2020. Patients had mean age 39 (SD 10) 21 3). Average baseline BMI was 12.5 1.0) kg/m2, indicating extremely Monopolar middle two contacts switched on T1 (pulse width 90 μs, frequency 130 ms) voltage 3.0 V (2.5–3.5 V). voltages T2, T3 T4 respectively 3.8 (3.0–5.0 V), (3.0–4.5 V) (2.7–4.8 Adjustment intensity occurred steps 0,5 V, later fine-tuning 0,1 V. Pulse remained unchanged during study. increased substantially significantly end (5.32 kg/m2; +42.8%; P .017) (Fig. 1). YBC-EDS significant improvement over time (−23.9%; .012). This effect driven decreases Preoccupation Rituals subscales (−16.2%; .026, −31.1%; .001, respectively). corresponded secondary EDE-Q, which improvements Restraint Concern (P .039 .024, HAM-D HAM-A additional (−36.7% −47.9%, ED-QOL subscale Physical Health .005) 2, Table 1: results). Evidently, there are points discussion. low (categorized 'very severe' DSM-5), average improved one postoperatively DSM-5 category 'mild'. increase primarily seen patients. other subjects only mild BMI. rate 50% Improvement also observed psychological outcomes. Two out categorized responders (≥35% decrease YBC-EDS). reported preoccupations rituals, experiencing them rewarding. There eating-related behavior like purging caloric checking, depression anxiety symptoms, have great importance AN-patients [[9]Hudson J.I. prevalence correlates disorders National Comorbidity Survey Replication.Biol 2007; 61: 348-358Abstract (3197) subjective their state life. majority rituals lost rewarding properties, leaving more room healthier behavior. confirmed still would prefer DBS, even though did not reach complete remission. no intraoperative adverse events any Nevertheless, 28 (SAE's) occurred, being probably nine possibly related intervention. Probable SAE's (hypo)manic symptoms. Possible consisted self-destructive (autointoxication, auto-mutilation aggression). mostly severity its somatic complications rather than (n 11). number reflects challenging nature this Transient hypomanic impulsive symptoms caused downregulation emotion regulation circuitries Scholar,[10]Figee M. restores frontostriatal network activity disorder.Nat 2013; 16: 386-387Crossref (278) hypothesize inhibits positive reinforcement ritualistic making useless coping strategy. develop alternative strategies such behavior, explaining some (S)AE's. Three following psychotherapy. provided open-label, therefore results might influenced placebo non-specific effects. These however minimized one-year period. Though small size vALIC limits power, it deemed sufficient answer basic research questions. To best knowledge, indicate valid, safe feasible intervention Our findings pave way larger size. Registered Netherlands Trial Register (https://www.trialregister.nl/trial/3322): NL3322 (NTR3469). authors declare competing interests. funding study, sponsors. RJTM supported unrestricted ABC Talent Grant. is/are supplementary data article: Download .docx (.02 MB) Help docx files Multimedia component 2

Язык: Английский

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Why Has Deep Brain Stimulation Had So Little Impact in Psychiatry?

Frontiers in Neurology, Год журнала: 2021, Номер 12

Опубликована: Дек. 14, 2021

Over two decades ago, the first scientific publication on deep brain stimulation (DBS) in psychiatry was published. The evidence for effectiveness of DBS several psychiatric disorders has been steadily accumulating since report Obsessive Compulsive Disorder (OCD) 1999. However, number patients treated with is lagging behind, particularly comparison neurology. indications worldwide probably does not exceed 500, compared to almost 300,000 neurological that have within same period 20 years. It lack patients, knowledge, technology, or efficacy hinders its development and application psychiatry. Here, we discuss reasons gap between neurology psychiatry, which seemed involve social signature

Язык: Английский

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A meta-analysis of the effects of non-invasive brain stimulation on obsessive-compulsive disorder

Psychiatry Research, Год журнала: 2022, Номер 312, С. 114530 - 114530

Опубликована: Март 30, 2022

Язык: Английский

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