Brain stimulation and other biological non-pharmacological interventions in mental disorders: An umbrella review

Neuroscience & Biobehavioral Reviews, Год журнала: 2022, Номер 139, С. 104743 - 104743

Опубликована: Июнь 14, 2022

Язык: Английский

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Repetitive transcranial magnetic stimulation for obsessive-compulsive disorder: A systematic review and pairwise/network meta-analysis

Journal of Affective Disorders, Год журнала: 2022, Номер 302, С. 302 - 312

Опубликована: Янв. 15, 2022

Background We evaluated the efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) for obsessive-compulsive disorder (OCD), ranked relative different protocols. Methods performed a search randomised, sham-controlled trials rTMS OCD. The primary analysis included both pairwise meta-analysis series frequentist network meta-analyses (NMA) OCD symptom severity. Secondary analyses were carried out on relevant clinical factors safety. Results 21 studies involving 662 patients included. showed that is efficacious across all protocols (Hedges' g=-0.502 [95%CI= -0.708, -0.296]). first NMA, with clustered only by anatomical location, dorsolateral prefrontal cortex (dlPFC) medial frontal efficacious. In second considering each unique combination frequency location separately, low (LF) pre-supplementary motor area (preSMA) stimulation, high (HF) bilateral dlPFC LF right . was highest in terms efficacy, although corresponding confidence intervals overlapped other two Limitations Evidence base mostly small studies, few using similar protocols, giving sparse network. Studies heterogeneous, risk publication bias found. Conclusions compared sham stimulation. dlPFC, HF preSMA significant comparable improvements. Future should further investigate merits these three

Язык: Английский

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Regulatory Clearance and Approval of Therapeutic Protocols of Transcranial Magnetic Stimulation for Psychiatric Disorders

Brain Sciences, Год журнала: 2023, Номер 13(7), С. 1029 - 1029

Опубликована: Июль 5, 2023

Non-invasive brain stimulation techniques (NIBS) have been widely used in both clinical and research contexts neuropsychiatry. They are safe well-tolerated, making NIBS an interesting option for application different settings. Transcranial magnetic (TMS) is one of these strategies. It uses electromagnetic pulses focal modulate ion neuronal activity cortical regions. When applied repeatedly (repetitive transcranial stimulation—rTMS), they thought to induce long-lasting neuroplastic effects, proposed be a therapeutic mechanism rTMS, with efficacy safety initially demonstrated treatment-resistant depression (TRD). Since then, many rTMS treatment protocols emerged other difficult treat psychiatric conditions. Moreover, multiple studies, including large multi-center trials several meta-analyses, confirmed its neuropsychiatric disorders, resulting evidence-based guidelines recommendations. Currently, cleared by regulatory agencies the TRD, comorbid anxiety obsessive compulsive disorder, substance use such as smoking cessation. Importantly, current supports potential future syndromes, negative symptoms schizophrenia post-traumatic stress disorder. More precise knowledge formal indications psychiatry critical enhance decision this area.

Язык: Английский

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Inflammation in obsessive–compulsive disorder: A literature review and hypothesis‐based potential of transcranial photobiomodulation

Journal of Neuroscience Research, Год журнала: 2024, Номер 102(3)

Опубликована: Март 1, 2024

Abstract Obsessive–compulsive disorder (OCD) is a disabling neuropsychiatric that affects about 2%–3% of the global population. Despite availability several treatments, many patients with OCD do not respond adequately, highlighting need for new therapeutic approaches. Recent studies have associated various inflammatory processes pathogenesis OCD, including alterations in peripheral immune cells, cytokine levels, and neuroinflammation. These findings suggest inflammation could be promising target intervention. Transcranial photobiomodulation (t‐PBM) near‐infrared light noninvasive neuromodulation technique has shown potential disorders. However, its efficacy remains to fully explored. This study aimed review literature on detailing associations T‐cell populations, monocytes, NLRP3 inflammasome components, microglial activation, elevated proinflammatory cytokines such as TNF‐α, CRP, IL‐1β, IL‐6. We also examined hypothesis‐based t‐PBM targeting these pathways focusing mechanisms modulation oxidative stress, regulation cell function, reduction deactivation neurotoxic microglia, upregulation BDNF gene expression. Our suggests promising, intervention modulate underlying processes. Future research should focus randomized clinical trials assess t‐PBM's optimal treatment parameters OCD. Biomarker analyses neuroimaging will important understanding relationship between symptom improvement following sessions.

Язык: Английский

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Efficacy and Safety of Accelerated Transcranial Magnetic Stimulation for Obsessive-Compulsive Disorder: A Systematic Review and Meta-Analysis

Asian Journal of Psychiatry, Год журнала: 2025, Номер 106, С. 104420 - 104420

Опубликована: Март 4, 2025

Язык: Английский

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Responsive deep brain stimulation guided by ventral striatal electrophysiology of obsession durably ameliorates compulsion

Neuron, Год журнала: 2023, Номер 112(1), С. 73 - 83.e4

Опубликована: Окт. 20, 2023

Treatment-resistant obsessive-compulsive disorder (OCD) occurs in approximately one-third of OCD patients. Obsessions may fluctuate over time but often occur or worsen the presence internal (emotional state and thoughts) external (visual tactile) triggering stimuli. Obsessive thoughts related compulsive urges (are episodic) so respond well to a time-locked brain stimulation strategy sensitive responsive these symptom fluctuations. Early evidence suggests that neural activity can be captured from ventral striatal regions implicated guide such closed-loop approach. Here, we report on first-in-human application deep (rDBS) striatum for treatment-refractory individual who also had comorbid epilepsy. Self-reported obsessive symptoms provoked OCD-related distress correlated with electrophysiology. rDBS detected time-domain area-based feature invasive electroencephalography low-frequency oscillatory power fluctuations triggered bursts ameliorate fashion. provided rapid, robust, durable improvement obsessions compulsions. These results provide proof concept personalized, physiologically guided DBS OCD.

Язык: Английский

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Novel Approaches for the Treatment of Post-Traumatic Stress Disorder: A Systematic Review of Non-Invasive Brain Stimulation Interventions and Insights from Clinical Trials

Brain Sciences, Год журнала: 2024, Номер 14(3), С. 210 - 210

Опубликована: Фев. 24, 2024

First-line treatments for post-traumatic stress disorder (PTSD) encompass a wide range of pharmacotherapies and psychotherapies. However, many patients fail to respond such interventions, highlighting the need novel approaches. Due its ability modulate cortical activity, non-invasive brain stimulation (NIBS) could represent valuable therapeutic tool. Therefore, aim this systematic review is summarize discuss existing evidence on ameliorative effects NIBS PTSD comorbid anxiety depressive symptoms. Our goal also debate effectiveness an integrated approach characterized by combination psychotherapy. This search was conducted following preferred reporting items reviews meta-analyses (PRISMA) guidelines in PubMed, PsycINFO, PsycARTICLES, PSYINDEX, MEDLINE, ERIC databases. Overall, 31 studies met eligibility criteria, yielding total 26 clinical trials employing transcranial magnetic (TMS) 5 making use direct-current (tDCS). From these studies, it emerged that consistently reduced overall symptoms' severity as well Moreover, we speculate combining with prolonged exposure or cognitive processing therapy might promising ameliorating subjects' conditions.

Язык: Английский

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Repetitive transcranial magnetic stimulation (r-TMS) and selective serotonin reuptake inhibitor-resistance in obsessive-compulsive disorder: A meta-analysis and clinical implications

Comprehensive Psychiatry, Год журнала: 2022, Номер 118, С. 152339 - 152339

Опубликована: Июль 18, 2022

Despite promising results from several randomized controlled trials (RCTs) and meta-analyses, the efficacy of r-TMS as a treatment for OCD remains controversial, at least in part owing to inconsistency trial methodologies heterogeneity outcomes. This meta-analysis attempts explain some this by comparing patients with or without resistance selective serotonin reuptake inhibitors (SSRI), defined using standardized criteria.We conducted pre-registered (PROSPERO ID: 241381) systematic review meta-analysis. English language articles reporting blinded RCTs were retrieved searches MEDLINE, PsycINFO, Cochrane Library databases. Studies subjected subgroup analysis based on four stages resistance, an adaptation published criteria (1 = not resistant, 2 one SSRI failed, 3 two 4 failed plus more CBT failed). Meta-regression analyses investigated patient methodological factors (age, duration OCD, illness severity, stage treatment-resistance, researcher allegiance) possible moderators effect size.Twenty-five independent comparisons (23 studies) included. Overall, showed medium-sized reduction Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores (Hedge's g: -0.47; 95%CI: - 0.67 -0.27) moderate (I2 39.8%). Assessment publication bias Trim Fill suggested reduced size that remained significant (g: -0.29; -0.51 -0.07). Subgroup found those studies including non-resistant (stage 1) -0.65; -1.05 -0.25, k 7) low SSRI-resistance 2) (g:-0.47; -0.86 -0.09, 6) produced statistically heterogeneity, while highly resistant -0.39; -0.90 0.11, 4) -0.36; -0.75 0.03, 8) did not. Intriguingly, only moderator meta-regression was severity baseline depressive symptoms. All evidence allegiance favour intervention therefore caution is required interpreting reported sizes.This shows effective but largely failing respond trial. As consequence, may be best implemented earlier care pathway. These findings would have major implications clinical service development, further well-powered RCTs, which eliminate allegiance, are needed before definitive conclusions can drawn.

Язык: Английский

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Neuromodulation of OCD: A review of invasive and non-invasive methods

Frontiers in Neurology, Год журнала: 2022, Номер 13

Опубликована: Авг. 9, 2022

Early research into neural correlates of obsessive compulsive disorder (OCD) has focused on individual components, several network-based models have emerged from more recent data dysfunction within brain networks, including the lateral orbitofrontal cortex (lOFC)-ventromedial caudate, limbic, salience, and default mode networks. Moreover, interplay between multiple networks been increasingly recognized. As understanding circuitry underlying pathophysiology OCD continues to evolve, so will too our ability specifically target these using invasive noninvasive methods. This review discusses rationale for theory behind neuromodulation in treatment OCD.

Язык: Английский

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Efficacy and safety of repetitive transcranial magnetic stimulation in children and adolescents with depression: A systematic review and preliminary meta-analysis

Journal of Affective Disorders, Год журнала: 2022, Номер 320, С. 305 - 312

Опубликована: Сен. 27, 2022

Язык: Английский

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