Research Square (Research Square),
Год журнала:
2024,
Номер
unknown
Опубликована: Апрель 9, 2024
Abstract
Transcranial
magnetic
stimulation
(TMS)
and
deep
brain
(DBS)
can
treat
some
neuropsychiatric
disorders,
but
there
is
no
consensus
approach
for
identifying
new
targets.
We
localized
causal
circuit-based
targets
anxiety
that
converged
across
multiple
natural
experiments.
Lesions
(n=451)
TMS
sites
(n=111)
modify
mapped
to
a
common
normative
circuit
(r=0.68,
p=0.01).
In
an
independent
dataset
(n=300),
individualized
site
connectivity
this
predicted
change
(p=0.02).
Subthalamic
DBS
overlapping
the
caused
more
(n=74,
p=0.006),
thus
demonstrating
network-level
effect,
as
was
derived
without
any
subthalamic
sites.
The
specific
trait
versus
state
in
datasets
measured
both
(p=0.003).
Broadly,
illustrates
pathway
discovering
novel
disorders.
American Journal of Psychiatry,
Год журнала:
2025,
Номер
182(4), С. 332 - 340
Опубликована: Апрель 1, 2025
The
field
of
neuromodulation
has
evolved
tremendously
and
now
includes
a
vast
array
interventions
utilizing
different
technologies
that
span
electrical,
magnetic,
ultrasound
forms
stimulation.
evolution
holds
the
promise
fewer
adverse
effects
noninvasive
approach,
increasing
scale
at
which
these
may
be
offered
in
hospital
community
settings.
While
majority
studies
have
focused
on
patients
with
mood
disorders,
predominantly
depression,
there
is
an
unmet
need
for
schizophrenia,
who
are
dire
novel
therapeutic
options.
Advances
neuroimaging
approaches
examining
individual
variability
transdiagnostic
symptoms
lead
to
more
effective
treatments
this
patient
population.
This
overview
explores
modern
landscape
invasive
schizophrenia.
It
begins
involve
diffuse
stimulation
cortex
subcortex
then
reviews
focal
cortical
subcortical
levels.
authors
also
reflect
relationship
between
our
understanding
neurobiology
schizophrenia
interventions.
JAMA Psychiatry,
Год журнала:
2024,
Номер
81(9), С. 936 - 936
Опубликована: Июль 10, 2024
Importance
Bipolar
disorder
(BD)
is
chronic
and
disabling,
with
depression
accounting
for
the
majority
of
time
illness.
Recent
research
demonstrated
a
transformative
advance
in
clinical
efficacy
transcranial
magnetic
stimulation
treatment-resistant
major
depressive
(MDD)
using
an
accelerated
schedule
intermittent
theta-burst
(aiTBS),
but
effectiveness
this
treatment
treatment-refractory
BD
unknown.
Objective
To
evaluate
aiTBS
BD.
Design,
Setting,
Participants
This
randomized
trial,
conducted
from
March
2022
to
February
2024,
included
individuals
moderate
severe
episodes
referred
Penn
outpatient
clinic.
Included
patients
had
2
or
more
prior
failed
antidepressant
trials
by
Antidepressant
Treatment
History
Form
criteria
no
other
primary
psychiatric
diagnosis,
were
receiving
mood
stabilizer
4
weeks,
Montgomery-Åsberg
Depression
Rating
Scale
(MADRS)
score
20
higher.
Intervention
Prior
treatment,
resting-state
functional
resonance
imaging
was
used
compute
personalized
left
dorsolateral
prefrontal
cortex
target
connectivity
subgenual
anterior
cingulate
cortex.
Patients
1:1
10
sessions
per
day
imaging-guided
active
sham
5
days
1
session
hour
at
90%
resting
motor
threshold
90
000
pulses
total.
Main
Outcome
Measures
The
main
outcome
repeated
MADRS
scores
before
after
treatment.
Results
A
total
24
participants
(12
[50%]
female;
12
male;
mean
[SD]
age,
43.3
[16.9]
years)
(n
=
12)
aiTBS.
All
completed
1-month
follow-up.
significantly
lower
group
(mean
[SD],
30.4
[4.8]
baseline;
10.5
[6.7]
treatment)
than
(28.0
[5.4]
25.3
end
(estimated
difference,
–14.75;
95%
CI,
–19.73
–9.77;
P
<
.001;
Cohen
d
,
–2.19).
Conclusion
Relevance
In
effective
symptom
reduction
Further
are
needed
determine
durability
compare
treatments.
Trial
Registration
ClinicalTrials.gov
Identifier:
NCT05228457
