BACKGROUND Depression has become a global public health problem.In recent years,transcranial magnetic stimulation(TMS)has gained considerable attention as a noninvasive treatment for depression.AIM To investigate the ...BACKGROUND Depression has become a global public health problem.In recent years,transcranial magnetic stimulation(TMS)has gained considerable attention as a noninvasive treatment for depression.AIM To investigate the research hotspots and trends in the field of TMS-based depression treatment from a bibliometric perspective.METHODS Using the Web of Science Core Collection,articles published between 2003 and 2022 on TMS-based depression treatment were retrieved from the science citation index expanded.The publication trends and research hotspots were analyzed using VOSviewer,CiteSpace,and the bibliometric online analysis platform.Regression analysis was performed using Microsoft Excel 2021 to predict publication growth trends.RESULTS We identified a total of 702 articles on TMS-based depression treatment with a predominance of clinical studies.Analysis of collaborative networks showed that the United States,the University of Toronto,and Daskalakis ZJ were identified as the most impactful country,institution,and researcher,respectively.In keyword burst analysis,it was found that theta burst stimulation(TBS),functional connectivity,and frequency were the most recent research hotspots.CONCLUSION TMS provides a novel therapeutic option for patients with treatment-resistant depression.Neuroimaging technology enables more precise TMS treatment,while the novel TMS modality,TBS,enhances both therapeutic efficacy and patient experience in TMS-based depression treatment.The integration of neuroimaging techniques with TBS represents a promising research direction for advancing TMS-based depression treatment.This study presents systematic information and recommendations to guide future research on TMS-based depression treatment.展开更多
BACKGROUND The prevalence of addiction makes it a significant public health issue.Recently,transcranial magnetic stimulation(TMS)has garnered significant attention as a promising treatment for addiction.AIM To analyze...BACKGROUND The prevalence of addiction makes it a significant public health issue.Recently,transcranial magnetic stimulation(TMS)has garnered significant attention as a promising treatment for addiction.AIM To analyze development trends and research hotspots in TMS-based addiction treatment using a bibliometric approach.METHODS Articles on TMS-based addiction treatment from 2001 to 2023 were sourced from the Science Citation Index Expanded in the Web of Science Core Collection.CiteSpace software,VOSviewer,the"bibliometrix"R software package,and the bibliometric online analysis platform were used to analyze the current publication trends and hotspots.RESULTS Total 190 articles on TMS-based addiction treatment were identified,with clinical studies being the most prevalent.The United States led in both publication volume and international collaborations.Medical University of South Carolina and Zangen A were the most productive institution and author,respectively.Neurobiology,alcohol use disorder,and repetitive TMS were the most recent research hotspots.CONCLUSION Future research should focus on the neurobiological mechanisms underlying TMS-based addiction treatment.This study offers comprehensive insights and recommendations for advancing research on TMS-based addiction treatment.展开更多
Alzheimer’s disease is a neurodegenerative disease resulting from deficits in synaptic transmission and homeostasis.The Alzheimer’s disease brain tends to be hyperexcitable and hypersynchronized,thereby causing neur...Alzheimer’s disease is a neurodegenerative disease resulting from deficits in synaptic transmission and homeostasis.The Alzheimer’s disease brain tends to be hyperexcitable and hypersynchronized,thereby causing neurodegeneration and ultimately disrupting the operational abilities in daily life,leaving patients incapacitated.Repetitive transcranial magnetic stimulation is a cost-effective,neuro-modulatory technique used for multiple neurological conditions.Over the past two decades,it has been widely used to predict cognitive decline;identify pathophysiological markers;promote neuroplasticity;and assess brain excitability,plasticity,and connectivity.It has also been applied to patients with dementia,because it can yield facilitatory effects on cognition and promote brain recovery after a neurological insult.However,its therapeutic effectiveness at the molecular and synaptic levels has not been elucidated because of a limited number of studies.This study aimed to characterize the neurobiological changes following repetitive transcranial magnetic stimulation treatment,evaluate its effects on synaptic plasticity,and identify the associated mechanisms.This review essentially focuses on changes in the pathology,amyloidogenesis,and clearance pathways,given that amyloid deposition is a major hypothesis in the pathogenesis of Alzheimer’s disease.Apoptotic mechanisms associated with repetitive transcranial magnetic stimulation procedures and different pathways mediating gene transcription,which are closely related to the neural regeneration process,are also highlighted.Finally,we discuss the outcomes of animal studies in which neuroplasticity is modulated and assessed at the structural and functional levels by using repetitive transcranial magnetic stimulation,with the aim to highlight future directions for better clinical translations.展开更多
BACKGROUND Trichotillomania is a challenging to treat psychiatric disorder,with limited evidence for pharmacotherapy.Treatment typically involves medication,cognitive behavioral therapy,and behavioral interventions.Re...BACKGROUND Trichotillomania is a challenging to treat psychiatric disorder,with limited evidence for pharmacotherapy.Treatment typically involves medication,cognitive behavioral therapy,and behavioral interventions.Recently,transcranial magnetic stimulation(TMS)has emerged as a potential treatment strategy.AIM To assess the role of TMS in treating trichotillomania.METHODS A systematic search using specific terms was done in PubMed and Scopus databases for articles published until May 17,2024,related to trichotillomania and TMS.The search included randomized controlled trials,open-label studies,case series,case reports,and retrospective chart reviews,following the Preferred Items for Systematic Reviews and Meta-Analysis guideline.RESULTS We identified 32 articles(6 in PubMed and 26 in Scopus).After removing duplicates and articles that did not meet the selection criteria,we conducted a final analysis of four articles.These included one retrospective study,two case series,and one case study,with a total of 22 patients diagnosed with trichotillomania enrolled across all four studies.The brain areas targeted were the supplementary motor area(SMA),pre-SMA,and left dorsolateral prefrontal cortex.The studies reported an improvement in the severity of symptoms of trichotillomania in the majority of patients with negligible side effects.Nevertheless,it is important to note that the existing studies are mostly of low to moderate quality.CONCLUSION Early evidence suggests repetitive TMS and accelerated continuous theta burst stimulation can help treat trichotillomania adjunctively to other treatments.展开更多
BACKGROUND Repetitive transcranial magnetic stimulation(rTMS)entered clinical practice in China after 2000,first used in psychiatric surgery,and then in neurology and other disciplines.The First Hospital of Jiaxing in...BACKGROUND Repetitive transcranial magnetic stimulation(rTMS)entered clinical practice in China after 2000,first used in psychiatric surgery,and then in neurology and other disciplines.The First Hospital of Jiaxing introduced TMS in 2015.In practical applications,it has been found that different models of instruments and technical parameters can lead to differences in therapeutic efficacy.Therefore,our hospital selected the Danish TMS instrument,which ranks second in China,to test patients with schizophrenia from March 2021 to July 2021,with a focus on comparing the results at 5 Hz,10 Hz,and 15 Hz.The testing time is concentrated between 8:30 to 10:30 in the morning.A contingency plan was made for the quality after inspection before testing.Two evaluators independently control the quality of the contingency plan.The data is independently saved and proofread by two evaluators.The purpose of this study is to translate the research results into clinical practice and provide reference basis.AIM To investigate the effects of rehabilitation therapy using rTMS on the negative symptoms and event-related potential component of P300 in chronic schizophrenia.METHODS One hundred and five patients with chronic schizophrenia were randomly allocated to three groups based on the frequency of rTMS(5,10,or 15 Hz).The patients underwent five sessions of rTMS per week for 5 weeks.We compared the pre-and post-treatment P300 latency and scores for the Scale for Assessment of Negative Symptoms(SANS).RESULTS A significant decrease in SANS score after rTMS was observed in the 10-Hz group(P<0.05),which was not observed in the 5-Hz and 15-Hz groups.There was a significant increase in P300 amplitude in the 10-Hz group after rTMS treatment(P<0.05),but there was no significant change in P300 latency(P>0.05).The improvement of SANS score in the 10-Hz rTMS group was related to patient age and disease course.CONCLUSION rTMS at 10 Hz improved negative symptoms and cognitive function in chronic schizophrenia;however,further studies on the mechanism of action are required to validate our observations.展开更多
[Objectives]To evaluate the effects of repetitive transcranial magnetic stimulation(rTMS)on neurophysiological outcomes in patients with acute stroke.[Methods]A systematic literature search was conducted across PubMed...[Objectives]To evaluate the effects of repetitive transcranial magnetic stimulation(rTMS)on neurophysiological outcomes in patients with acute stroke.[Methods]A systematic literature search was conducted across PubMed,EMBASE,Web of Science,the Cochrane Central Register of Controlled Trials(CENTRAL),and CINAHL databases up to March 1,2025.Randomized controlled trials(RCTs)and clinical controlled trials(CCTs)involving adult patients(≥18 years)with acute ischemic stroke(within 2 weeks of onset)who received rTMS intervention were included.Data on motor evoked potential(MEP)amplitude,resting motor threshold(RMT),and central motor conduction time(CMCT)were extracted.The quality of the studies was assessed using the Cochrane risk of bias tool.Statistical analyses were performed using Stata 18.0,with standardized mean differences(SMDs)and 95%confidence intervals(CIs)calculated.Heterogeneity was evaluated using the I^(2)statistic.[Results]Eight studies involving 932 identified records met the inclusion criteria.Meta-analysis revealed that rTMS significantly increased MEP amplitude(Hedges'g=0.77,95%CI:0.52-1.02,P<0.01)and reduced RMT(Hedges g=-1.13,95%CI:-1.63 to-0.62,P<0.01)in the lesioned hemisphere,indicating enhanced corticospinal excitability.No significant effects were observed on MEP amplitude or RMT in the unaffected hemisphere.Additionally,rTMS did not significantly alter CMCT in either hemisphere.Heterogeneity was low to moderate for most outcomes,and no significant publication bias was detected.[Conclusions]rTMS is a safe and effective intervention for improving corticospinal excitability and motor recovery in patients with acute stroke.Both high-frequency stimulation of the ipsilesional hemisphere and low-frequency stimulation of the contralesional hemisphere have demonstrated beneficial effects,supporting the interhemispheric inhibition model.Future large-scale,multi-center RCTs are needed to optimize rTMS parameters and establish standardized treatment protocols for acute stroke rehabilitation.展开更多
BACKGROUND Adolescent depression manifests through diverse,interconnected symptoms,yet the clinical profile in patients treated with repetitive transcranial magnetic stimulation(rTMS)remains inadequately characterized...BACKGROUND Adolescent depression manifests through diverse,interconnected symptoms,yet the clinical profile in patients treated with repetitive transcranial magnetic stimulation(rTMS)remains inadequately characterized.While rTMS shows therapeutic potential,its efficacy may be overestimated due to limited research and symptom heterogeneity.Identifying key symptom clusters and evaluating their predictive value for treatment response is crucial for optimizing rTMS outcomes in this population.AIM To identify adolescent depression symptom clusters and assess their differential responses to rTMS treatment.METHODS One hundred adolescent patients with first-episode major depressive disorder were randomized into control and study groups.Both groups received sertraline treatment,while the study group additionally underwent 10 sessions of adjunctive rTMS.Depressive symptoms were evaluated using the 17-item Hamilton Depression Rating Scale(HAMD-17)at baseline,week 2,and week 4.RESULTS Hierarchical clustering revealed four distinct symptom clusters:Subjective mood,impaired activity,somatic concerns,and anxiety/insomnia.The main effect of treatment visit showed significant decreases in symptom severity across all clusters.In the study group,the effect size between baseline and week 4 was largest for the subjective mood cluster(Cohen’s d=2.41)and smallest for somatic concerns(Cohen’s d=0.59).In the control group,the largest effect size was observed in the anxiety/insomnia cluster(Cohen’s d=1.20),with the smallest effect in impaired activity(Cohen’s d=0.47).CONCLUSION This study identified four distinct symptom clusters with differential responses to rTMS treatment.The findings demonstrate that rTMS shows greatest efficacy for improving subjective mood symptoms,guiding targeted therapeutic approaches.展开更多
Parkinson’s disease patients,in addition to typical motor symptoms,often experience various psychological symptoms,including depression,anxiety,cognitive impairment,impulse control disorders,and psychotic symptoms.Th...Parkinson’s disease patients,in addition to typical motor symptoms,often experience various psychological symptoms,including depression,anxiety,cognitive impairment,impulse control disorders,and psychotic symptoms.These symptoms severely affect patients’quality of life and may even cause a greater disease burden than motor symptoms.This review focuses on the application progress of transcranial magnetic stimulation(TMS)as a non-invasive neuromodulation technique in the treatment of psychological symptoms in Parkinson’s disease.Studies have shown that repetitive TMS(rTMS)has significant improvement effects on Parkinson’s disease-related depressive symptoms,with mechanisms possibly related to the regulation of the prefrontal-striatal dopamine pathway and the promotion of neuroplasticity.For anxiety symptoms,continuous theta burst stimulation has shown potential in indirect regulation of the amygdala and hippocampal regions.For cognitive impairment,high-frequency rTMS applied to the dorsolateral prefrontal cortex can improve executive function deficits,while bilateral coordinated stimulation protocols help enhance attention and memory functions.For impulse control disorders in Parkinson’s disease patients,inhibitory stimulation applied to the orbitofrontal cortex can alleviate pathological gambling and compulsive behaviors.In terms of sleep disorders,TMS has also shown potential efficacy in regulating circadian rhythms and improving rapid eye movement sleep behavior disorder.However,current research still has limitations such as small sample sizes,non-standardized stimulation protocols,and insufficient evaluation of long-term efficacy.Future research directions should focus on optimizing stimulation parameters,exploring individualized treatment protocols,integrating multimodal imaging assessments,and conducting large-sample randomized controlled trials to clarify the clinical application value of TMS in the rehabilitation of psychological symptoms in Parkinson’s disease,providing new approaches for the comprehensive management of this common neurodegenerative disease.展开更多
BACKGROUND Mild cognitive impairment(MCI)is a high-risk precursor to Alzheimer’s disease characterized by declining memory or other progressive cognitive functions without compromising daily living abilities.AIM To i...BACKGROUND Mild cognitive impairment(MCI)is a high-risk precursor to Alzheimer’s disease characterized by declining memory or other progressive cognitive functions without compromising daily living abilities.AIM To investigate the efficacy of repetitive transcranial magnetic stimulation(rTMS)in patients with MCI.METHODS This retrospective analysis involved 180 patients with MCI who were admitted to The First Hospital of Shanxi Medical University from January 2021 to June 2023.Participants were allocated into the research(n=98,receiving rTMS)and control groups(n=82,receiving sham stimulation).Memory tests,cognitive function assessments,event-related potential–P300 tests,and electroencephalogram(EEG)examinations were conducted pre-treatment and post-treatment.Further,memory quotient(MQ),cognitive function scores,and EEG grading results were compared,along with adverse reaction incidences.RESULTS Pre-treatment MQ scores,long-term and short-term memory,as well as immediate memory scores,demonstrated no notable differences between the groups.Post-treatment,the research group exhibited significant increases in MQ scores,long-term memory,and short-term memory compared to baseline(P<0.05),with these improvements being statistically superior to those in the control group.However,immediate memory scores exhibited no significant change(P>0.05).Further,the research group demonstrated statistically better post-treatment scores on the Revised Wechsler Memory Scale than the control group.Furthermore,post-treatment P300 latency and amplitude improved significantly in the research group,surpassing the control group.EEG grading in the research group improved,and the incidence of adverse reactions was significantly lower than in the control group.CONCLUSION Patients with MCI receiving rTMS therapy demonstrated improved memory and cognitive functions and EEG grading and exhibited high safety with fewer adverse reactions.展开更多
Mild cognitive impairment(MCI),which is a high-risk transitional phase leading to Alzheimer’s disease,is characterized by mild memory deficits and specific cognitive dysfunctions.Without effective intervention,a sign...Mild cognitive impairment(MCI),which is a high-risk transitional phase leading to Alzheimer’s disease,is characterized by mild memory deficits and specific cognitive dysfunctions.Without effective intervention,a significant proportion of patients with MCI progress to dementia.However,current pharmacological treatments are characterized by side effects and poor patient compliance.Therefore,it is necessary to develop effective,noninvasive alternative treatments.Repetitive transcranial magnetic stimulation(rTMS)is becoming a widely studied noninvasive treatment for central nervous system disease.The therapeutic effects of rTMS on patients with MCI and its underlying mechanism are noteworthy issues.Recently,a growing number of studies have shown that meningeal lymphatic vessel damage may be related to cognitive dysfunction.Whether the improvement of the meningeal lymphatic system is an important mechanism through which rTMS improves the clinical manifestations of MCI is worthy of further study.展开更多
Objective:To study the effect of transcranial magnetic stimulation(TMS)on improving motor symptoms in patients with Parkinson’s disease(PD).Methods:60 PD patients who visited the hospital from September 2023 to Augus...Objective:To study the effect of transcranial magnetic stimulation(TMS)on improving motor symptoms in patients with Parkinson’s disease(PD).Methods:60 PD patients who visited the hospital from September 2023 to August 2024 were selected as samples and randomly divided into two groups.Group A received conventional medication plus TMS treatment,while Group B received medication only.The efficacy of motor function improvement,neurological symptoms,mental state,sleep quality,quality of life,and adverse reactions was compared between the two groups.Results:The efficacy of Group A was higher than that of Group B(P<0.05).The scores of the Scales for Outcomes in Parkinson’s Disease-Autonomic(SCOPA-AUT),Mini-Mental State Examination(MMSE),and Pittsburgh Sleep Quality Index(PSQI)in Group A were lower than those in Group B(P<0.05).The quality of life scale(SF-36)score in Group A was higher than that in Group B(P<0.05).The adverse reaction rate in Group A was lower than that in Group B(P<0.05).Conclusion:TMS used in the treatment of PD patients can improve patients’mental state and motor function,optimize sleep quality and quality of life,and is safe and efficient.展开更多
Brain stimulation techniques offer powerful means of modulating the physiology of specific neural structures. In recent years, non-invasive brain stimulation techniques, such as transcranial magnetic stimulation(TMS) ...Brain stimulation techniques offer powerful means of modulating the physiology of specific neural structures. In recent years, non-invasive brain stimulation techniques, such as transcranial magnetic stimulation(TMS) and transcranial direct current stimulation, have emerged as therapeutic tools for neurology and neuroscience. However, the possible repercussions of these techniques remain unclear, and there are few reports on the incisive recovery mechanisms through brain stimulation. Although several studies have recommended the use of non-invasive brain stimulation in clinical neuroscience, with a special emphasis on TMS, the suggested mechanisms of action have not been confirmed directly at the neural level. Insights into the neural mechanisms of non-invasive brain stimulation would unveil the strategies necessary to enhance the safety and efficacy of this progressive approach. Therefore, animal studies investigating the mechanisms of TMSinduced recovery at the neural level are crucial for the elaboration of non-invasive brain stimulation. Translational research done using animal models has several advantages and is able to investigate knowledge gaps by directly targeting neuronal levels. In this review, we have discussed the role of TMS in different animal models, the impact of animal studies on various disease states, and the findings regarding brain function of animal models after TMS in pharmacology research.展开更多
To investigate whether repetitive transcranial magnetic stimulation （rTMS） can improve language function in patients with refractory epilepsy, three right-handed, refractory epilepsy patients who had complained of l...To investigate whether repetitive transcranial magnetic stimulation （rTMS） can improve language function in patients with refractory epilepsy, three right-handed, refractory epilepsy patients who had complained of language dysfunction, were recruited. Over 1 month, 1-Hz rTMS treatment was performed every 3 days. A battery of language production and functional MRI were evaluated in the patients using a standard verb generation task both before and 1 month after rTMS treatment. Significant and lasting improvement in verb production was observed following rTMS treatment. Functional MRI results revealed that the left frontal lobes of two patients were more activated than they had been prior to therapy, and activation was primarily concentrated in the language-related areas. Results demonstrated that low frequency rTMS has potential to improve language function in patients with refractory epilepsy.展开更多
Low frequency （≤ 1 Hz） repetitive transcranial magnetic stimulation （rTMS） can affect the excitability of the cerebral cortex and synaptic plasticity. Although this is a common method for clinical treatment of ce...Low frequency （≤ 1 Hz） repetitive transcranial magnetic stimulation （rTMS） can affect the excitability of the cerebral cortex and synaptic plasticity. Although this is a common method for clinical treatment of cerebral infarction, whether it promotes the recovery of motor function remains controversial. Twenty patients with cerebral infarction combined with hemiparalysis were equally and randomly divided into a low frequency rTMS group and a control group. The patients in the low frequency rTMS group were given 1-Hz rTMS to the contralateral primary motor cortex with a stimulus intensity of 90% motor threshold, 30 minutes/day. The patients in the control group were given sham stimulation. After 14 days of treatment, clinical function scores （National Institute of Health Stroke Scale, Barthel Index, and Fugl-Meyer Assessment） improved significantly in the low frequency rTMS group, and the effects were better than that in the control group. We conclude that low frequency （1 Hz） rTMS for 14 days can help improve motor function after cerebral infarction.展开更多
Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons,and high-frequency repetitive transcranial magnetic stimulation can increase the exc...Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons,and high-frequency repetitive transcranial magnetic stimulation can increase the excitability of cortical neurons.However,there are few studies concerning the use of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper-limb motor function after cerebral infarction.We hypothesized that different frequencies of repetitive transcranial magnetic stimulation in patients with cerebral infarction would produce different effects on the recovery of upper-limb motor function.This study enrolled 127 patients with upper-limb dysfunction during the subacute phase of cerebral infarction.These patients were randomly assigned to three groups.The low-frequency group comprised 42 patients who were treated with 1 Hz repetitive transcranial magnetic stimulation on the contralateral hemisphere primary motor cortex(M1).The high-frequency group comprised 43 patients who were treated with 10 Hz repetitive transcranial magnetic stimulation on ipsilateral M1.Finally,the sham group comprised 42 patients who were treated with 10 Hz of false stimulation on ipsilateral M1.A total of 135 seconds of stimulation was applied in the sham group and high-frequency group.At 2 weeks after treatment,cortical latency of motor-evoked potentials and central motor conduction time were significantly lower compared with before treatment.Moreover,motor function scores were significantly improved.The above indices for the low-and high-frequency groups were significantly different compared with the sham group.However,there was no significant difference between the low-and high-frequency groups.The results show that low-and high-frequency repetitive transcranial magnetic stimulation can similarly improve upper-limb motor function in patients with cerebral infarction.展开更多
Transcranial magnetic stimulation,a type of noninvasive brain stimulation,has become an ancillary therapy for motor function rehabilitation.Most previous studies have focused on the effects of repetitive transcranial ...Transcranial magnetic stimulation,a type of noninvasive brain stimulation,has become an ancillary therapy for motor function rehabilitation.Most previous studies have focused on the effects of repetitive transcranial magnetic stimulation(rTMS)on motor function in stroke patients.There have been relatively few studies on the effects of different modalities of rTMS on lower extremity motor function and corticospinal excitability in patients with stroke.The MEDLINE,Embase,Cochrane Library,ISI Science Citation Index,Physiotherapy Evidence Database,China National Knowledge Infrastructure Library,and ClinicalTrials.gov databases were searched.Parallel or crossover randomized controlled trials that addressed the effectiveness of rTMS in patients with stroke,published from inception to November 28,2019,were included.Standard pairwise meta-analysis was conducted using R version 3.6.1 with the“meta”package.Bayesian network analysis using the Markov chain Monte Carlo algorithm was conducted to investigate the effectiveness of different rTMS protocol interventions.Network meta-analysis results of 18 randomized controlled trials regarding lower extremity motor function recovery revealed that low-frequency rTMS had better efficacy in promoting lower extremity motor function recovery than sham stimulation.Network meta-analysis results of five randomized controlled trials demonstrated that highfrequency rTMS led to higher amplitudes of motor evoked potentials than low-frequency rTMS or sham stimulation.These findings suggest that rTMS can improve motor function in patients with stroke,and that low-frequency rTMS mainly affects motor function,whereas high-frequency rTMS increases the amplitudes of motor evoked potentials.More highquality randomized controlled trials are needed to validate this conclusion.The work was registered in PROSPERO(registration No.CRD42020147055)on April 28,2020.展开更多
Prolife ration of neural stem cells is crucial for promoting neuronal regeneration and repairing cerebral infarction damage.Transcranial magnetic stimulation(TMS)has recently emerged as a tool for inducing endogenous ...Prolife ration of neural stem cells is crucial for promoting neuronal regeneration and repairing cerebral infarction damage.Transcranial magnetic stimulation(TMS)has recently emerged as a tool for inducing endogenous neural stem cell regeneration,but its underlying mechanisms remain unclea r In this study,we found that repetitive TMS effectively promotes the proliferation of oxygen-glucose deprived neural stem cells.Additionally,repetitive TMS reduced the volume of cerebral infa rction in a rat model of ischemic stro ke caused by middle cerebral artery occlusion,im p roved rat cognitive function,and promoted the proliferation of neural stem cells in the ischemic penumbra.RNA-sequencing found that repetitive TMS activated the Wnt signaling pathway in the ischemic penumbra of rats with cerebral ischemia.Furthermore,PCR analysis revealed that repetitive TMS promoted AKT phosphorylation,leading to an increase in mRNA levels of cell cycle-related proteins such as Cdk2 and Cdk4.This effect was also associated with activation of the glycogen synthase kinase 3β/β-catenin signaling pathway,which ultimately promotes the prolife ration of neural stem cells.Subsequently,we validated the effect of repetitive TMS on AKT phosphorylation.We found that repetitive TMS promoted Ca2+influx into neural stem cells by activating the P2 calcium channel/calmodulin pathway,thereby promoting AKT phosphorylation and activating the glycogen synthase kinase 3β/β-catenin pathway.These findings indicate that repetitive TMS can promote the proliferation of endogenous neural stem cells through a Ca2+influx-dependent phosphorylated AKT/glycogen synthase kinase 3β/β-catenin signaling pathway.This study has produced pioneering res ults on the intrinsic mechanism of repetitive TMS to promote neural function recove ry after ischemic stro ke.These results provide a stro ng scientific foundation for the clinical application of repetitive TMS.Moreover,repetitive TMS treatment may not only be an efficient and potential approach to support neurogenesis for further therapeutic applications,but also provide an effective platform for the expansion of neural stem cells.展开更多
Objective To clarify the effects of repetitive transcranial magnetic stimulation (rTMS) on rat motor cortical excitabi- lity and neurofunction after cerebral ischemia-reperfusion injury. Methods After determined awake...Objective To clarify the effects of repetitive transcranial magnetic stimulation (rTMS) on rat motor cortical excitabi- lity and neurofunction after cerebral ischemia-reperfusion injury. Methods After determined awake resting motor threshold (MT) and motor evoked potentials (MEPs) of right hindlimbs, 20 Sprague-Dawley rats were subjected to middle cerebral artery occlusion (MCAO) reperfusion injury, then rTMS were applied to rTMS group (n = 10) at different time, while control group (n = 10) received no stimulation. A week later, MT and MEPs were evaluated again, as well as neurological deficits and infarct volume. The effects of rTMS and MCAO reperfusion injury on these parameters were analyzed. Results After MCAO reperfusion, both MT level and neurological deficit scores increased, distinct focal infarction formed, and latency of MEP elongated. Compared with the control group, the increased extent of MT and neurological scores of rats receiving rTMS were significantly lower (P < 0.05), as well as the infarct volumes reduced significantly(P < 0.05). But MEP was not affected by rTMS obviously. There was a positive linear correlation between postinjury MT and infarct volume (r = 0.64, P < 0.05). Conclusion rTMS may facilitate neurofunction recovery after cerebral ischemia-reperfusion. Postinjury MT could provide prognostic information after MCAO reperfusion injury.展开更多
Repetitive transcranial magnetic stimulation(r TMS)has been shown to effectively improve impaired swallowing in Parkinson's disease(PD)patients with dysphagia.However,little is known about how r TMS affects the co...Repetitive transcranial magnetic stimulation(r TMS)has been shown to effectively improve impaired swallowing in Parkinson's disease(PD)patients with dysphagia.However,little is known about how r TMS affects the corresponding brain regions in this patient group.In this casecontrol study,we examined data from 38 PD patients with dysphagia who received treatment at Beijing Rehabilitation Medicine Academy,Capital Medical University.The patients received high-frequency r TMS of the motor cortex once per day for 10 successive days.Changes in brain activation were compared via functional magnetic resonance imaging in PD patients with dysphagia and healthy controls.The results revealed that before treatment,PD patients with dysphagia showed greater activation in the precentral gyrus,supplementary motor area,and cerebellum compared with healthy controls,and this enhanced activation was weakened after treatment.Furthermore,before treatment,PD patients with dysphagia exhibited decreased activation in the parahippocampal gyrus,caudate nucleus,and left thalamus compared with healthy controls,and this activation increased after treatment.In addition,PD patients with dysphagia reported improved subjective swallowing sensations after r TMS.These findings suggest that swallowing function in PD patients with dysphagia improved after r TMS of the motor cortex.This may have been due to enhanced activation of the caudate nucleus and parahippocampal gyrus.The study protocol was approved by the Ethics Committee of Beijing Rehabilitation Hospital of Capital Medical University(approval No.2018 bkky017)on March 6,2018 and was registered with Chinese Clinical Trial Registry(registration No.Chi CTR 1800017207)on July 18,2018.展开更多
The effect of acupuncture cooperated with low-frequency repetitive transcranial magnetic stimulation （rTMS） on chronic insomnia was explored. Seventy-eight patients with chronic insomnia were randomly allocated into...The effect of acupuncture cooperated with low-frequency repetitive transcranial magnetic stimulation （rTMS） on chronic insomnia was explored. Seventy-eight patients with chronic insomnia were randomly allocated into two groups： treatment group and control group. In the treatment group, the patients received acupuncture combined with rTMS treatment, and those in the control group were given acupuncture cooperated with sham rTMS treatment, 3 days per week for 4 weeks. Before and after treatment, the primary outcomes including the scores on Insomnia Severity Index （ISI） and Pittsburgh Sleep Quality Index （PSQI） and the secondary outcomes including total sleep time （TST）, sleep onset latency （SOL）, wake after sleep onset （WASO）, sleep efficiency （SE%） recorded by sleeping diary and actigraphy were observed in both groups. Seventy-five participants finished the study （38 in treatment group and 37 in control group respectively）. After treatment, the scores in the two groups were improved significantly, more significantly in the treatment group than in the control group. It can be inferred that acupuncture cooperated with rTMS can effectively improve sleep quality, enhance the quality of life of patients and has less side effects.展开更多
基金Supported by the National Natural Science Foundation of China,No.82270916,No.81800748 and No.82371478the Third Affiliated Hospital of Anhui Medical University Basic and Clinical Collaborative Research Enhancement Program Cultivation Special Funding Project,No.2022sfy009.
文摘BACKGROUND Depression has become a global public health problem.In recent years,transcranial magnetic stimulation(TMS)has gained considerable attention as a noninvasive treatment for depression.AIM To investigate the research hotspots and trends in the field of TMS-based depression treatment from a bibliometric perspective.METHODS Using the Web of Science Core Collection,articles published between 2003 and 2022 on TMS-based depression treatment were retrieved from the science citation index expanded.The publication trends and research hotspots were analyzed using VOSviewer,CiteSpace,and the bibliometric online analysis platform.Regression analysis was performed using Microsoft Excel 2021 to predict publication growth trends.RESULTS We identified a total of 702 articles on TMS-based depression treatment with a predominance of clinical studies.Analysis of collaborative networks showed that the United States,the University of Toronto,and Daskalakis ZJ were identified as the most impactful country,institution,and researcher,respectively.In keyword burst analysis,it was found that theta burst stimulation(TBS),functional connectivity,and frequency were the most recent research hotspots.CONCLUSION TMS provides a novel therapeutic option for patients with treatment-resistant depression.Neuroimaging technology enables more precise TMS treatment,while the novel TMS modality,TBS,enhances both therapeutic efficacy and patient experience in TMS-based depression treatment.The integration of neuroimaging techniques with TBS represents a promising research direction for advancing TMS-based depression treatment.This study presents systematic information and recommendations to guide future research on TMS-based depression treatment.
基金Supported by National Natural Science Foundation of China,No.81973620Wenzhou Municipal Science and Technology Bureau,No.Y20220091.
文摘BACKGROUND The prevalence of addiction makes it a significant public health issue.Recently,transcranial magnetic stimulation(TMS)has garnered significant attention as a promising treatment for addiction.AIM To analyze development trends and research hotspots in TMS-based addiction treatment using a bibliometric approach.METHODS Articles on TMS-based addiction treatment from 2001 to 2023 were sourced from the Science Citation Index Expanded in the Web of Science Core Collection.CiteSpace software,VOSviewer,the"bibliometrix"R software package,and the bibliometric online analysis platform were used to analyze the current publication trends and hotspots.RESULTS Total 190 articles on TMS-based addiction treatment were identified,with clinical studies being the most prevalent.The United States led in both publication volume and international collaborations.Medical University of South Carolina and Zangen A were the most productive institution and author,respectively.Neurobiology,alcohol use disorder,and repetitive TMS were the most recent research hotspots.CONCLUSION Future research should focus on the neurobiological mechanisms underlying TMS-based addiction treatment.This study offers comprehensive insights and recommendations for advancing research on TMS-based addiction treatment.
基金supported by the Hefei Comprehensive National Science Center Hefei Brain Project(to KW)the National Natural Science Foundation of China,Nos.31970979(to KW),82101498(to XW)the STI2030-Major Projects,No.2021ZD0201800(to PH).
文摘Alzheimer’s disease is a neurodegenerative disease resulting from deficits in synaptic transmission and homeostasis.The Alzheimer’s disease brain tends to be hyperexcitable and hypersynchronized,thereby causing neurodegeneration and ultimately disrupting the operational abilities in daily life,leaving patients incapacitated.Repetitive transcranial magnetic stimulation is a cost-effective,neuro-modulatory technique used for multiple neurological conditions.Over the past two decades,it has been widely used to predict cognitive decline;identify pathophysiological markers;promote neuroplasticity;and assess brain excitability,plasticity,and connectivity.It has also been applied to patients with dementia,because it can yield facilitatory effects on cognition and promote brain recovery after a neurological insult.However,its therapeutic effectiveness at the molecular and synaptic levels has not been elucidated because of a limited number of studies.This study aimed to characterize the neurobiological changes following repetitive transcranial magnetic stimulation treatment,evaluate its effects on synaptic plasticity,and identify the associated mechanisms.This review essentially focuses on changes in the pathology,amyloidogenesis,and clearance pathways,given that amyloid deposition is a major hypothesis in the pathogenesis of Alzheimer’s disease.Apoptotic mechanisms associated with repetitive transcranial magnetic stimulation procedures and different pathways mediating gene transcription,which are closely related to the neural regeneration process,are also highlighted.Finally,we discuss the outcomes of animal studies in which neuroplasticity is modulated and assessed at the structural and functional levels by using repetitive transcranial magnetic stimulation,with the aim to highlight future directions for better clinical translations.
文摘BACKGROUND Trichotillomania is a challenging to treat psychiatric disorder,with limited evidence for pharmacotherapy.Treatment typically involves medication,cognitive behavioral therapy,and behavioral interventions.Recently,transcranial magnetic stimulation(TMS)has emerged as a potential treatment strategy.AIM To assess the role of TMS in treating trichotillomania.METHODS A systematic search using specific terms was done in PubMed and Scopus databases for articles published until May 17,2024,related to trichotillomania and TMS.The search included randomized controlled trials,open-label studies,case series,case reports,and retrospective chart reviews,following the Preferred Items for Systematic Reviews and Meta-Analysis guideline.RESULTS We identified 32 articles(6 in PubMed and 26 in Scopus).After removing duplicates and articles that did not meet the selection criteria,we conducted a final analysis of four articles.These included one retrospective study,two case series,and one case study,with a total of 22 patients diagnosed with trichotillomania enrolled across all four studies.The brain areas targeted were the supplementary motor area(SMA),pre-SMA,and left dorsolateral prefrontal cortex.The studies reported an improvement in the severity of symptoms of trichotillomania in the majority of patients with negligible side effects.Nevertheless,it is important to note that the existing studies are mostly of low to moderate quality.CONCLUSION Early evidence suggests repetitive TMS and accelerated continuous theta burst stimulation can help treat trichotillomania adjunctively to other treatments.
基金Supported by Key Discipline Construction Project of Neurology of Jiaxing City in Zhejiang Province of China,No.2023-ZC-006.
文摘BACKGROUND Repetitive transcranial magnetic stimulation(rTMS)entered clinical practice in China after 2000,first used in psychiatric surgery,and then in neurology and other disciplines.The First Hospital of Jiaxing introduced TMS in 2015.In practical applications,it has been found that different models of instruments and technical parameters can lead to differences in therapeutic efficacy.Therefore,our hospital selected the Danish TMS instrument,which ranks second in China,to test patients with schizophrenia from March 2021 to July 2021,with a focus on comparing the results at 5 Hz,10 Hz,and 15 Hz.The testing time is concentrated between 8:30 to 10:30 in the morning.A contingency plan was made for the quality after inspection before testing.Two evaluators independently control the quality of the contingency plan.The data is independently saved and proofread by two evaluators.The purpose of this study is to translate the research results into clinical practice and provide reference basis.AIM To investigate the effects of rehabilitation therapy using rTMS on the negative symptoms and event-related potential component of P300 in chronic schizophrenia.METHODS One hundred and five patients with chronic schizophrenia were randomly allocated to three groups based on the frequency of rTMS(5,10,or 15 Hz).The patients underwent five sessions of rTMS per week for 5 weeks.We compared the pre-and post-treatment P300 latency and scores for the Scale for Assessment of Negative Symptoms(SANS).RESULTS A significant decrease in SANS score after rTMS was observed in the 10-Hz group(P<0.05),which was not observed in the 5-Hz and 15-Hz groups.There was a significant increase in P300 amplitude in the 10-Hz group after rTMS treatment(P<0.05),but there was no significant change in P300 latency(P>0.05).The improvement of SANS score in the 10-Hz rTMS group was related to patient age and disease course.CONCLUSION rTMS at 10 Hz improved negative symptoms and cognitive function in chronic schizophrenia;however,further studies on the mechanism of action are required to validate our observations.
文摘[Objectives]To evaluate the effects of repetitive transcranial magnetic stimulation(rTMS)on neurophysiological outcomes in patients with acute stroke.[Methods]A systematic literature search was conducted across PubMed,EMBASE,Web of Science,the Cochrane Central Register of Controlled Trials(CENTRAL),and CINAHL databases up to March 1,2025.Randomized controlled trials(RCTs)and clinical controlled trials(CCTs)involving adult patients(≥18 years)with acute ischemic stroke(within 2 weeks of onset)who received rTMS intervention were included.Data on motor evoked potential(MEP)amplitude,resting motor threshold(RMT),and central motor conduction time(CMCT)were extracted.The quality of the studies was assessed using the Cochrane risk of bias tool.Statistical analyses were performed using Stata 18.0,with standardized mean differences(SMDs)and 95%confidence intervals(CIs)calculated.Heterogeneity was evaluated using the I^(2)statistic.[Results]Eight studies involving 932 identified records met the inclusion criteria.Meta-analysis revealed that rTMS significantly increased MEP amplitude(Hedges'g=0.77,95%CI:0.52-1.02,P<0.01)and reduced RMT(Hedges g=-1.13,95%CI:-1.63 to-0.62,P<0.01)in the lesioned hemisphere,indicating enhanced corticospinal excitability.No significant effects were observed on MEP amplitude or RMT in the unaffected hemisphere.Additionally,rTMS did not significantly alter CMCT in either hemisphere.Heterogeneity was low to moderate for most outcomes,and no significant publication bias was detected.[Conclusions]rTMS is a safe and effective intervention for improving corticospinal excitability and motor recovery in patients with acute stroke.Both high-frequency stimulation of the ipsilesional hemisphere and low-frequency stimulation of the contralesional hemisphere have demonstrated beneficial effects,supporting the interhemispheric inhibition model.Future large-scale,multi-center RCTs are needed to optimize rTMS parameters and establish standardized treatment protocols for acute stroke rehabilitation.
基金Supported by the Hangzhou Medical and Health Science and Technology General Project,No.A20240472 and No.A20210156the Plan Projects of Zhejiang Provincial Department of Science and Technology,No.2025C01103the Major projects of Hangzhou Municipal Health Commission,No.Z20250275.
文摘BACKGROUND Adolescent depression manifests through diverse,interconnected symptoms,yet the clinical profile in patients treated with repetitive transcranial magnetic stimulation(rTMS)remains inadequately characterized.While rTMS shows therapeutic potential,its efficacy may be overestimated due to limited research and symptom heterogeneity.Identifying key symptom clusters and evaluating their predictive value for treatment response is crucial for optimizing rTMS outcomes in this population.AIM To identify adolescent depression symptom clusters and assess their differential responses to rTMS treatment.METHODS One hundred adolescent patients with first-episode major depressive disorder were randomized into control and study groups.Both groups received sertraline treatment,while the study group additionally underwent 10 sessions of adjunctive rTMS.Depressive symptoms were evaluated using the 17-item Hamilton Depression Rating Scale(HAMD-17)at baseline,week 2,and week 4.RESULTS Hierarchical clustering revealed four distinct symptom clusters:Subjective mood,impaired activity,somatic concerns,and anxiety/insomnia.The main effect of treatment visit showed significant decreases in symptom severity across all clusters.In the study group,the effect size between baseline and week 4 was largest for the subjective mood cluster(Cohen’s d=2.41)and smallest for somatic concerns(Cohen’s d=0.59).In the control group,the largest effect size was observed in the anxiety/insomnia cluster(Cohen’s d=1.20),with the smallest effect in impaired activity(Cohen’s d=0.47).CONCLUSION This study identified four distinct symptom clusters with differential responses to rTMS treatment.The findings demonstrate that rTMS shows greatest efficacy for improving subjective mood symptoms,guiding targeted therapeutic approaches.
文摘Parkinson’s disease patients,in addition to typical motor symptoms,often experience various psychological symptoms,including depression,anxiety,cognitive impairment,impulse control disorders,and psychotic symptoms.These symptoms severely affect patients’quality of life and may even cause a greater disease burden than motor symptoms.This review focuses on the application progress of transcranial magnetic stimulation(TMS)as a non-invasive neuromodulation technique in the treatment of psychological symptoms in Parkinson’s disease.Studies have shown that repetitive TMS(rTMS)has significant improvement effects on Parkinson’s disease-related depressive symptoms,with mechanisms possibly related to the regulation of the prefrontal-striatal dopamine pathway and the promotion of neuroplasticity.For anxiety symptoms,continuous theta burst stimulation has shown potential in indirect regulation of the amygdala and hippocampal regions.For cognitive impairment,high-frequency rTMS applied to the dorsolateral prefrontal cortex can improve executive function deficits,while bilateral coordinated stimulation protocols help enhance attention and memory functions.For impulse control disorders in Parkinson’s disease patients,inhibitory stimulation applied to the orbitofrontal cortex can alleviate pathological gambling and compulsive behaviors.In terms of sleep disorders,TMS has also shown potential efficacy in regulating circadian rhythms and improving rapid eye movement sleep behavior disorder.However,current research still has limitations such as small sample sizes,non-standardized stimulation protocols,and insufficient evaluation of long-term efficacy.Future research directions should focus on optimizing stimulation parameters,exploring individualized treatment protocols,integrating multimodal imaging assessments,and conducting large-sample randomized controlled trials to clarify the clinical application value of TMS in the rehabilitation of psychological symptoms in Parkinson’s disease,providing new approaches for the comprehensive management of this common neurodegenerative disease.
文摘BACKGROUND Mild cognitive impairment(MCI)is a high-risk precursor to Alzheimer’s disease characterized by declining memory or other progressive cognitive functions without compromising daily living abilities.AIM To investigate the efficacy of repetitive transcranial magnetic stimulation(rTMS)in patients with MCI.METHODS This retrospective analysis involved 180 patients with MCI who were admitted to The First Hospital of Shanxi Medical University from January 2021 to June 2023.Participants were allocated into the research(n=98,receiving rTMS)and control groups(n=82,receiving sham stimulation).Memory tests,cognitive function assessments,event-related potential–P300 tests,and electroencephalogram(EEG)examinations were conducted pre-treatment and post-treatment.Further,memory quotient(MQ),cognitive function scores,and EEG grading results were compared,along with adverse reaction incidences.RESULTS Pre-treatment MQ scores,long-term and short-term memory,as well as immediate memory scores,demonstrated no notable differences between the groups.Post-treatment,the research group exhibited significant increases in MQ scores,long-term memory,and short-term memory compared to baseline(P<0.05),with these improvements being statistically superior to those in the control group.However,immediate memory scores exhibited no significant change(P>0.05).Further,the research group demonstrated statistically better post-treatment scores on the Revised Wechsler Memory Scale than the control group.Furthermore,post-treatment P300 latency and amplitude improved significantly in the research group,surpassing the control group.EEG grading in the research group improved,and the incidence of adverse reactions was significantly lower than in the control group.CONCLUSION Patients with MCI receiving rTMS therapy demonstrated improved memory and cognitive functions and EEG grading and exhibited high safety with fewer adverse reactions.
基金Supported by the Heilongjiang Provincial Health Commission Scientific Research Project,No.20230404040027the Scientific Technology Project of Qiqihar City,No.CSFGG-2025030.
文摘Mild cognitive impairment(MCI),which is a high-risk transitional phase leading to Alzheimer’s disease,is characterized by mild memory deficits and specific cognitive dysfunctions.Without effective intervention,a significant proportion of patients with MCI progress to dementia.However,current pharmacological treatments are characterized by side effects and poor patient compliance.Therefore,it is necessary to develop effective,noninvasive alternative treatments.Repetitive transcranial magnetic stimulation(rTMS)is becoming a widely studied noninvasive treatment for central nervous system disease.The therapeutic effects of rTMS on patients with MCI and its underlying mechanism are noteworthy issues.Recently,a growing number of studies have shown that meningeal lymphatic vessel damage may be related to cognitive dysfunction.Whether the improvement of the meningeal lymphatic system is an important mechanism through which rTMS improves the clinical manifestations of MCI is worthy of further study.
文摘Objective:To study the effect of transcranial magnetic stimulation(TMS)on improving motor symptoms in patients with Parkinson’s disease(PD).Methods:60 PD patients who visited the hospital from September 2023 to August 2024 were selected as samples and randomly divided into two groups.Group A received conventional medication plus TMS treatment,while Group B received medication only.The efficacy of motor function improvement,neurological symptoms,mental state,sleep quality,quality of life,and adverse reactions was compared between the two groups.Results:The efficacy of Group A was higher than that of Group B(P<0.05).The scores of the Scales for Outcomes in Parkinson’s Disease-Autonomic(SCOPA-AUT),Mini-Mental State Examination(MMSE),and Pittsburgh Sleep Quality Index(PSQI)in Group A were lower than those in Group B(P<0.05).The quality of life scale(SF-36)score in Group A was higher than that in Group B(P<0.05).The adverse reaction rate in Group A was lower than that in Group B(P<0.05).Conclusion:TMS used in the treatment of PD patients can improve patients’mental state and motor function,optimize sleep quality and quality of life,and is safe and efficient.
文摘Brain stimulation techniques offer powerful means of modulating the physiology of specific neural structures. In recent years, non-invasive brain stimulation techniques, such as transcranial magnetic stimulation(TMS) and transcranial direct current stimulation, have emerged as therapeutic tools for neurology and neuroscience. However, the possible repercussions of these techniques remain unclear, and there are few reports on the incisive recovery mechanisms through brain stimulation. Although several studies have recommended the use of non-invasive brain stimulation in clinical neuroscience, with a special emphasis on TMS, the suggested mechanisms of action have not been confirmed directly at the neural level. Insights into the neural mechanisms of non-invasive brain stimulation would unveil the strategies necessary to enhance the safety and efficacy of this progressive approach. Therefore, animal studies investigating the mechanisms of TMSinduced recovery at the neural level are crucial for the elaboration of non-invasive brain stimulation. Translational research done using animal models has several advantages and is able to investigate knowledge gaps by directly targeting neuronal levels. In this review, we have discussed the role of TMS in different animal models, the impact of animal studies on various disease states, and the findings regarding brain function of animal models after TMS in pharmacology research.
文摘To investigate whether repetitive transcranial magnetic stimulation （rTMS） can improve language function in patients with refractory epilepsy, three right-handed, refractory epilepsy patients who had complained of language dysfunction, were recruited. Over 1 month, 1-Hz rTMS treatment was performed every 3 days. A battery of language production and functional MRI were evaluated in the patients using a standard verb generation task both before and 1 month after rTMS treatment. Significant and lasting improvement in verb production was observed following rTMS treatment. Functional MRI results revealed that the left frontal lobes of two patients were more activated than they had been prior to therapy, and activation was primarily concentrated in the language-related areas. Results demonstrated that low frequency rTMS has potential to improve language function in patients with refractory epilepsy.
基金supported by the National Natural Science Foundation of China,No.30540058,30770714the Natural Science Foundation of Beijing of China,No.7052030+2 种基金the Talents Foundation of Organization Department of the Beijing Municipal Committee in Chinathe Beijing Science Plan Project Fund of China,No.Z0005187040191-1the Research Foundation of Capital Medical Development of China,No.2007-2068
文摘Low frequency （≤ 1 Hz） repetitive transcranial magnetic stimulation （rTMS） can affect the excitability of the cerebral cortex and synaptic plasticity. Although this is a common method for clinical treatment of cerebral infarction, whether it promotes the recovery of motor function remains controversial. Twenty patients with cerebral infarction combined with hemiparalysis were equally and randomly divided into a low frequency rTMS group and a control group. The patients in the low frequency rTMS group were given 1-Hz rTMS to the contralateral primary motor cortex with a stimulus intensity of 90% motor threshold, 30 minutes/day. The patients in the control group were given sham stimulation. After 14 days of treatment, clinical function scores （National Institute of Health Stroke Scale, Barthel Index, and Fugl-Meyer Assessment） improved significantly in the low frequency rTMS group, and the effects were better than that in the control group. We conclude that low frequency （1 Hz） rTMS for 14 days can help improve motor function after cerebral infarction.
基金several colleague therapists of the Rehabilitation Medicine Department of the Affiliated Hospital of Qingdao University of China for their support and selfless help
文摘Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons,and high-frequency repetitive transcranial magnetic stimulation can increase the excitability of cortical neurons.However,there are few studies concerning the use of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper-limb motor function after cerebral infarction.We hypothesized that different frequencies of repetitive transcranial magnetic stimulation in patients with cerebral infarction would produce different effects on the recovery of upper-limb motor function.This study enrolled 127 patients with upper-limb dysfunction during the subacute phase of cerebral infarction.These patients were randomly assigned to three groups.The low-frequency group comprised 42 patients who were treated with 1 Hz repetitive transcranial magnetic stimulation on the contralateral hemisphere primary motor cortex(M1).The high-frequency group comprised 43 patients who were treated with 10 Hz repetitive transcranial magnetic stimulation on ipsilateral M1.Finally,the sham group comprised 42 patients who were treated with 10 Hz of false stimulation on ipsilateral M1.A total of 135 seconds of stimulation was applied in the sham group and high-frequency group.At 2 weeks after treatment,cortical latency of motor-evoked potentials and central motor conduction time were significantly lower compared with before treatment.Moreover,motor function scores were significantly improved.The above indices for the low-and high-frequency groups were significantly different compared with the sham group.However,there was no significant difference between the low-and high-frequency groups.The results show that low-and high-frequency repetitive transcranial magnetic stimulation can similarly improve upper-limb motor function in patients with cerebral infarction.
基金supported by the 1·3·5 project for disciplines of excellence-Clinical Research Incubation Project,West China Hospital,Sichuan University,China,No.2020HXFH051(to QG).
文摘Transcranial magnetic stimulation,a type of noninvasive brain stimulation,has become an ancillary therapy for motor function rehabilitation.Most previous studies have focused on the effects of repetitive transcranial magnetic stimulation(rTMS)on motor function in stroke patients.There have been relatively few studies on the effects of different modalities of rTMS on lower extremity motor function and corticospinal excitability in patients with stroke.The MEDLINE,Embase,Cochrane Library,ISI Science Citation Index,Physiotherapy Evidence Database,China National Knowledge Infrastructure Library,and ClinicalTrials.gov databases were searched.Parallel or crossover randomized controlled trials that addressed the effectiveness of rTMS in patients with stroke,published from inception to November 28,2019,were included.Standard pairwise meta-analysis was conducted using R version 3.6.1 with the“meta”package.Bayesian network analysis using the Markov chain Monte Carlo algorithm was conducted to investigate the effectiveness of different rTMS protocol interventions.Network meta-analysis results of 18 randomized controlled trials regarding lower extremity motor function recovery revealed that low-frequency rTMS had better efficacy in promoting lower extremity motor function recovery than sham stimulation.Network meta-analysis results of five randomized controlled trials demonstrated that highfrequency rTMS led to higher amplitudes of motor evoked potentials than low-frequency rTMS or sham stimulation.These findings suggest that rTMS can improve motor function in patients with stroke,and that low-frequency rTMS mainly affects motor function,whereas high-frequency rTMS increases the amplitudes of motor evoked potentials.More highquality randomized controlled trials are needed to validate this conclusion.The work was registered in PROSPERO(registration No.CRD42020147055)on April 28,2020.
基金supported by the National Natural Science Foundation of China,Nos.81672261(to XH),81972151(to HZ),82372568(to JL)the Natural Science Foundation of Guangdong Province,Nos.2019A1515011106(to HZ),2023A1515030080(to JL)。
文摘Prolife ration of neural stem cells is crucial for promoting neuronal regeneration and repairing cerebral infarction damage.Transcranial magnetic stimulation(TMS)has recently emerged as a tool for inducing endogenous neural stem cell regeneration,but its underlying mechanisms remain unclea r In this study,we found that repetitive TMS effectively promotes the proliferation of oxygen-glucose deprived neural stem cells.Additionally,repetitive TMS reduced the volume of cerebral infa rction in a rat model of ischemic stro ke caused by middle cerebral artery occlusion,im p roved rat cognitive function,and promoted the proliferation of neural stem cells in the ischemic penumbra.RNA-sequencing found that repetitive TMS activated the Wnt signaling pathway in the ischemic penumbra of rats with cerebral ischemia.Furthermore,PCR analysis revealed that repetitive TMS promoted AKT phosphorylation,leading to an increase in mRNA levels of cell cycle-related proteins such as Cdk2 and Cdk4.This effect was also associated with activation of the glycogen synthase kinase 3β/β-catenin signaling pathway,which ultimately promotes the prolife ration of neural stem cells.Subsequently,we validated the effect of repetitive TMS on AKT phosphorylation.We found that repetitive TMS promoted Ca2+influx into neural stem cells by activating the P2 calcium channel/calmodulin pathway,thereby promoting AKT phosphorylation and activating the glycogen synthase kinase 3β/β-catenin pathway.These findings indicate that repetitive TMS can promote the proliferation of endogenous neural stem cells through a Ca2+influx-dependent phosphorylated AKT/glycogen synthase kinase 3β/β-catenin signaling pathway.This study has produced pioneering res ults on the intrinsic mechanism of repetitive TMS to promote neural function recove ry after ischemic stro ke.These results provide a stro ng scientific foundation for the clinical application of repetitive TMS.Moreover,repetitive TMS treatment may not only be an efficient and potential approach to support neurogenesis for further therapeutic applications,but also provide an effective platform for the expansion of neural stem cells.
文摘Objective To clarify the effects of repetitive transcranial magnetic stimulation (rTMS) on rat motor cortical excitabi- lity and neurofunction after cerebral ischemia-reperfusion injury. Methods After determined awake resting motor threshold (MT) and motor evoked potentials (MEPs) of right hindlimbs, 20 Sprague-Dawley rats were subjected to middle cerebral artery occlusion (MCAO) reperfusion injury, then rTMS were applied to rTMS group (n = 10) at different time, while control group (n = 10) received no stimulation. A week later, MT and MEPs were evaluated again, as well as neurological deficits and infarct volume. The effects of rTMS and MCAO reperfusion injury on these parameters were analyzed. Results After MCAO reperfusion, both MT level and neurological deficit scores increased, distinct focal infarction formed, and latency of MEP elongated. Compared with the control group, the increased extent of MT and neurological scores of rats receiving rTMS were significantly lower (P < 0.05), as well as the infarct volumes reduced significantly(P < 0.05). But MEP was not affected by rTMS obviously. There was a positive linear correlation between postinjury MT and infarct volume (r = 0.64, P < 0.05). Conclusion rTMS may facilitate neurofunction recovery after cerebral ischemia-reperfusion. Postinjury MT could provide prognostic information after MCAO reperfusion injury.
基金supported by the Beijing Municipal Science and Technology Commission Capital Clinical Feature Applied Research Project of China,No.Z181100001718205(to WJG and PLH)。
文摘Repetitive transcranial magnetic stimulation(r TMS)has been shown to effectively improve impaired swallowing in Parkinson's disease(PD)patients with dysphagia.However,little is known about how r TMS affects the corresponding brain regions in this patient group.In this casecontrol study,we examined data from 38 PD patients with dysphagia who received treatment at Beijing Rehabilitation Medicine Academy,Capital Medical University.The patients received high-frequency r TMS of the motor cortex once per day for 10 successive days.Changes in brain activation were compared via functional magnetic resonance imaging in PD patients with dysphagia and healthy controls.The results revealed that before treatment,PD patients with dysphagia showed greater activation in the precentral gyrus,supplementary motor area,and cerebellum compared with healthy controls,and this enhanced activation was weakened after treatment.Furthermore,before treatment,PD patients with dysphagia exhibited decreased activation in the parahippocampal gyrus,caudate nucleus,and left thalamus compared with healthy controls,and this activation increased after treatment.In addition,PD patients with dysphagia reported improved subjective swallowing sensations after r TMS.These findings suggest that swallowing function in PD patients with dysphagia improved after r TMS of the motor cortex.This may have been due to enhanced activation of the caudate nucleus and parahippocampal gyrus.The study protocol was approved by the Ethics Committee of Beijing Rehabilitation Hospital of Capital Medical University(approval No.2018 bkky017)on March 6,2018 and was registered with Chinese Clinical Trial Registry(registration No.Chi CTR 1800017207)on July 18,2018.
文摘The effect of acupuncture cooperated with low-frequency repetitive transcranial magnetic stimulation （rTMS） on chronic insomnia was explored. Seventy-eight patients with chronic insomnia were randomly allocated into two groups： treatment group and control group. In the treatment group, the patients received acupuncture combined with rTMS treatment, and those in the control group were given acupuncture cooperated with sham rTMS treatment, 3 days per week for 4 weeks. Before and after treatment, the primary outcomes including the scores on Insomnia Severity Index （ISI） and Pittsburgh Sleep Quality Index （PSQI） and the secondary outcomes including total sleep time （TST）, sleep onset latency （SOL）, wake after sleep onset （WASO）, sleep efficiency （SE%） recorded by sleeping diary and actigraphy were observed in both groups. Seventy-five participants finished the study （38 in treatment group and 37 in control group respectively）. After treatment, the scores in the two groups were improved significantly, more significantly in the treatment group than in the control group. It can be inferred that acupuncture cooperated with rTMS can effectively improve sleep quality, enhance the quality of life of patients and has less side effects.
