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
Promoting synaptic plasticity and inducing functional reorganization of residual nerve fibers hold clinical significance for restoring motor function following spinal cord injury.Neuromagnetic stimulation targeting th...Promoting synaptic plasticity and inducing functional reorganization of residual nerve fibers hold clinical significance for restoring motor function following spinal cord injury.Neuromagnetic stimulation targeting the nerve roots has been shown to improve motor function by enhancing nerve conduction in the injured spinal cord and restoring the synaptic ultrastructure of both the sensory and motor cortex.However,our understanding of the neurophysiological mechanisms by which nerve root magnetic stimulation facilitates motor function recovery in the spinal cord is limited,and its role in neuroplasticity remains unclear.In this study,we established a model of spinal cord injury in adult male Sprague–Dawley rats by applying moderate compression at the T10 vertebra.We then performed magnetic stimulation on the L5 nerve root for 3 weeks,beginning on day 3 post-injury.At day 22 post-injury,we observed that nerve root magnetic stimulation downregulated the level of interleukin-6 in the injured spinal cord tissue of rats.Additionally,this treatment reduced neuronal damage and glial scar formation,and increased the number of neurons in the injured spinal cord.Furthermore,nerve root magnetic stimulation decreased the levels of acetylcholine,norepinephrine,and dopamine,and increased the expression of synaptic plasticity-related m RNA and proteins PSD95,GAP43,and Synapsin II.Taken together,these results showed that nerve root magnetic stimulation alleviated neuronal damage in the injured spinal cord,regulated synaptic plasticity,and suppressed inflammatory responses.These findings provide laboratory evidence for the clinical application of nerve root magnetic stimulation in the treatment of spinal cord injury.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
Magnetic stimulation has made significant strides in the treatment of psychiatric disorders.Nonetheless,current magnetic stimulation techniques lack the precision to accurately modulate specific nuclei and cannot real...Magnetic stimulation has made significant strides in the treatment of psychiatric disorders.Nonetheless,current magnetic stimulation techniques lack the precision to accurately modulate specific nuclei and cannot realize deep brain magnetic stimulation.To address this,we utilized superparamagnetic iron oxide nanoparticles as mediators to achieve precise targeting and penetration.We investigated the effects of magnetic fields with varying frequencies on neuronal activity and compared the activation effects on neurons using a 10-Hz precise magneto-stimulation system(pMSS)with repetitive transcranial magnetic stimulation in mice.Oxytocin levels,dendritic morphology and density,and mouse behavior were measured before and after pMSS intervention.Our findings suggest that pMSS can activate oxytocinergic neurons,leading to upregulation of oxytocin secretion and neurite outgrowth.As a result,sociability was rapidly improved after a one-week pMSS treatment regimen.These results demonstrate a promising magneto-stimulation method for regulating neuronal activity in deep brain nuclei and provide a promising therapeutic approach for autism spectrum disorder.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
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
[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
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
Repetitive transcranial magnetic stimulation has been increasingly studied in different neurological diseases,and although most studies focus on its effects on neuronal cells,the contribution of nonneuronal cells to t...Repetitive transcranial magnetic stimulation has been increasingly studied in different neurological diseases,and although most studies focus on its effects on neuronal cells,the contribution of nonneuronal cells to the improvement trigge red by repetitive transcranial magnetic stimulation in these diseases has been increasingly suggested.To systematically review the effects of repetitive magnetic stimulation on non-neuronal cells two online databases.Web of Science and PubMed were searched fo r the effects of high-frequency-repetitive transcranial magnetic stimulation,low-frequencyrepetitive transcranial magnetic stimulation,intermittent theta-bu rst stimulation,continuous thetaburst stimulation,or repetitive magnetic stimulation on non-neuronal cells in models of disease and in unlesioned animals or cells.A total of 52 studies were included.The protocol more frequently used was high-frequency-repetitive magnetic stimulation,and in models of disease,most studies report that high-frequency-repetitive magnetic stimulation led to a decrease in astrocyte and mic roglial reactivity,a decrease in the release of pro-inflammatory cyto kines,and an increase of oligodendrocyte proliferation.The trend towards decreased microglial and astrocyte reactivity as well as increased oligodendrocyte proliferation occurred with intermittent theta-burst stimulation and continuous theta-burst stimulation.Few papers analyzed the low-frequency-repetitive transcranial magnetic stimulation protocol,and the parameters evaluated were restricted to the study of astrocyte reactivity and release of pro-inflammatory cytokines,repo rting the absence of effects on these paramete rs.In what concerns the use of magnetic stimulation in unlesioned animals or cells,most articles on all four types of stimulation reported a lack of effects.It is also important to point out that the studies were developed mostly in male rodents,not evaluating possible diffe rential effects of repetitive transcranial magnetic stimulation between sexes.This systematic review supports that thro ugh modulation of glial cells repetitive magnetic stimulation contributes to the neuroprotection or repair in various neurological disease models.Howeve r,it should be noted that there are still few articles focusing on the impact of repetitive magnetic stimulation on non-neuronal cells and most studies did not perform in-depth analyses of the effects,emphasizing the need for more studies in this field.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
Classic paired associative stimulation can improve synaptic plasticity,as demonstrated by animal expe riments and human clinical trials in spinal cord injury patients.Paired associative magnetic stimulation(dual-targe...Classic paired associative stimulation can improve synaptic plasticity,as demonstrated by animal expe riments and human clinical trials in spinal cord injury patients.Paired associative magnetic stimulation(dual-target peripheral and central magnetic stimulation)has been shown to promote neurologic recove ry after stroke.However,it remains unclear whether paired associative magnetic stimulation can promote recovery of lower limb motor dysfunction after spinal cord injury.We hypothesize that the curre nt caused by central and peripheral magnetic stimulation will conve rge at the synapse,which will promote synapse function and improve the motor function of the relevant muscles.Therefore,this study aimed to examine the effects of paired associative magnetic stimulation on neural circuit activation by measuring changes in motor evoked and somatosensory evoked potentials,motor and sensory function of the lower limbs,functional health and activities of daily living,and depression in patients with spinal co rd injury.We will recruit 110 thora cic spinal trauma patients treated in the Department of Spinal Cord Injury,China Rehabilitation Hospital and randomly assign them to expe rimental and control groups in a 1:1 ratio.The trial group(n=55)will be treated with paired associative magnetic stimulation and conventional rehabilitation treatment.The control group(n=55)will be treated with sham stimulation and co nventional rehabilitation treatment.Outcomes will be measured at four time points:baseline and 4,12,and 24 wee ks after the start of inte rvention(active or sham paired associative magnetic stimulation).The primary outcome measure of this trial is change in lower limb American Spinal Injury Association Impairment Scale motor function score from baseline to last follow-up.Secondary outcome measures include changes in lower limb American Spinal Injury Association sensory function sco re,motor evoked potentials,sensory evoked potentials,modified Ashwo rth scale score,Maslach Burnout Invento ry score,and Hamilton Depression Scale score over time.Motor evoked potential latency reflects corticospinal tract transmission time,while amplitude reflects recruitment ability;both measures can help elucidate the mechanism underlying the effect of paired associative magnetic stimulation on synaptic efficiency.Adve rse events will be recorded.Findings from this trial will help to indicate whether paired associative magnetic stimulation(1)promotes recove ry of lower limb sensory and motor function,reduces spasticity,and improves quality of life;(2)promotes neurologic recovery by increasing excitability of spinal cord motor neurons and stimulating synaptic plasticity;and(3)improves rehabilitation outcome in patients with spinal cord injury.Recruitment for this trial began in April 2021 and is currently ongoing.It was approved by the Ethics Committee of Yangzhi Affiliated Rehabilitation Hospital of Tongji University,China(approval No.YZ2020-018)on May 18,2020.The study protocol was registered in the Chinese Clinical Trial Registry(registration number:ChiCTR2100044794)on March 27,2021(protocol version 1.0).This trial will be completed in April 2022.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
[Objectives]To explore the clinical treatment effect of repetitive transcranial magnetic stimulation(rTMS)combined with repetitive magnetic stimulation at Taichong acupoint(LR3)therapy in the treatment of depression.[...[Objectives]To explore the clinical treatment effect of repetitive transcranial magnetic stimulation(rTMS)combined with repetitive magnetic stimulation at Taichong acupoint(LR3)therapy in the treatment of depression.[Methods]60 patients who met the inclusion standard were chosen as the research subjects.They were split into two sets using a randomized parallel control method,with 30 cases each in the experimental and control groups.The experimental group adopted the treatment with rTMS+repetitive magnetic stimulation at Taichong acupoint(LR3),and the control group adopted the treatment with rTMS alone.The course of treatment was 8 weeks.Then the clinical efficacy,Hamilton Depression Scale 17 item score(HAMD-17),Symptom Check List-90(SCL-90),Patient Health Questionnaire-15(PHQ-15)and Pittsburgh Sleep Quality Index(PSQI)were compared.[Results]After treatment,the scores of HAMD-17,SCL-90,PHQ-15 and PSQI in the two groups were lower than those before and 4 weeks after treatment(P<0.05 or P<0.01),and the scores in the experimental group were inferior to those in the control group(P<0.01),The effective rate was 96.66%in the experimental group and 76.47%in the control group(P<0.05).In the course of treatment,no serious adverse reactions happened in either group.[Conclusions]The rTMS combined with repetitive magnetic stimulation at Taichong acupoint(LR3)can enhance the control of depression in the right frontal lobe,significantly improve the symptoms of depression and somatic discomfort,and improve the sleep quality of patients.It has a wide range of application,and is safe and noninvasive,so it is worthy of clinical promotion.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
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
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.
基金supported by the National Natural Science Foundation of China,Nos.81772453(to DX),81974358(to DX),81973157(to JZ),82173646(to JZ),82302866(to YZ)。
文摘Promoting synaptic plasticity and inducing functional reorganization of residual nerve fibers hold clinical significance for restoring motor function following spinal cord injury.Neuromagnetic stimulation targeting the nerve roots has been shown to improve motor function by enhancing nerve conduction in the injured spinal cord and restoring the synaptic ultrastructure of both the sensory and motor cortex.However,our understanding of the neurophysiological mechanisms by which nerve root magnetic stimulation facilitates motor function recovery in the spinal cord is limited,and its role in neuroplasticity remains unclear.In this study,we established a model of spinal cord injury in adult male Sprague–Dawley rats by applying moderate compression at the T10 vertebra.We then performed magnetic stimulation on the L5 nerve root for 3 weeks,beginning on day 3 post-injury.At day 22 post-injury,we observed that nerve root magnetic stimulation downregulated the level of interleukin-6 in the injured spinal cord tissue of rats.Additionally,this treatment reduced neuronal damage and glial scar formation,and increased the number of neurons in the injured spinal cord.Furthermore,nerve root magnetic stimulation decreased the levels of acetylcholine,norepinephrine,and dopamine,and increased the expression of synaptic plasticity-related m RNA and proteins PSD95,GAP43,and Synapsin II.Taken together,these results showed that nerve root magnetic stimulation alleviated neuronal damage in the injured spinal cord,regulated synaptic plasticity,and suppressed inflammatory responses.These findings provide laboratory evidence for the clinical application of nerve root magnetic stimulation in the treatment of spinal cord injury.
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 the China Science and Technology Innovation 2030-Major Project(2022ZD0211700)the Major Program of the National Natural Science Foundation of China(62394312)+2 种基金the National Natural Science Foundation of China(82471536)the Wenzhou Science and Technology Projects(ZY2023006,2024R2002)Oujiang Laboratory(OJQD2022002).
文摘Magnetic stimulation has made significant strides in the treatment of psychiatric disorders.Nonetheless,current magnetic stimulation techniques lack the precision to accurately modulate specific nuclei and cannot realize deep brain magnetic stimulation.To address this,we utilized superparamagnetic iron oxide nanoparticles as mediators to achieve precise targeting and penetration.We investigated the effects of magnetic fields with varying frequencies on neuronal activity and compared the activation effects on neurons using a 10-Hz precise magneto-stimulation system(pMSS)with repetitive transcranial magnetic stimulation in mice.Oxytocin levels,dendritic morphology and density,and mouse behavior were measured before and after pMSS intervention.Our findings suggest that pMSS can activate oxytocinergic neurons,leading to upregulation of oxytocin secretion and neurite outgrowth.As a result,sociability was rapidly improved after a one-week pMSS treatment regimen.These results demonstrate a promising magneto-stimulation method for regulating neuronal activity in deep brain nuclei and provide a promising therapeutic approach for autism spectrum disorder.
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.
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[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.
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.
基金the scope of the CICS-UBI projects UIDP/Multi/00709/2019,UIDB/Multi/00709/2019,UIDP/00709/2020,UIDB/00709/2020,financed by national funds through the Portuguese Foundation for Science and Technology/MCTESby funds to the PPBI-Portuguese Platform of Bio Imaging through the Project POCI-01-0145-FEDER-022122(to GB,MVP,NP)supported by a grant from the Portuguese Foundation for Science and Technology/MCTES(2021.07854.BD)(to IS)。
文摘Repetitive transcranial magnetic stimulation has been increasingly studied in different neurological diseases,and although most studies focus on its effects on neuronal cells,the contribution of nonneuronal cells to the improvement trigge red by repetitive transcranial magnetic stimulation in these diseases has been increasingly suggested.To systematically review the effects of repetitive magnetic stimulation on non-neuronal cells two online databases.Web of Science and PubMed were searched fo r the effects of high-frequency-repetitive transcranial magnetic stimulation,low-frequencyrepetitive transcranial magnetic stimulation,intermittent theta-bu rst stimulation,continuous thetaburst stimulation,or repetitive magnetic stimulation on non-neuronal cells in models of disease and in unlesioned animals or cells.A total of 52 studies were included.The protocol more frequently used was high-frequency-repetitive magnetic stimulation,and in models of disease,most studies report that high-frequency-repetitive magnetic stimulation led to a decrease in astrocyte and mic roglial reactivity,a decrease in the release of pro-inflammatory cyto kines,and an increase of oligodendrocyte proliferation.The trend towards decreased microglial and astrocyte reactivity as well as increased oligodendrocyte proliferation occurred with intermittent theta-burst stimulation and continuous theta-burst stimulation.Few papers analyzed the low-frequency-repetitive transcranial magnetic stimulation protocol,and the parameters evaluated were restricted to the study of astrocyte reactivity and release of pro-inflammatory cytokines,repo rting the absence of effects on these paramete rs.In what concerns the use of magnetic stimulation in unlesioned animals or cells,most articles on all four types of stimulation reported a lack of effects.It is also important to point out that the studies were developed mostly in male rodents,not evaluating possible diffe rential effects of repetitive transcranial magnetic stimulation between sexes.This systematic review supports that thro ugh modulation of glial cells repetitive magnetic stimulation contributes to the neuroprotection or repair in various neurological disease models.Howeve r,it should be noted that there are still few articles focusing on the impact of repetitive magnetic stimulation on non-neuronal cells and most studies did not perform in-depth analyses of the effects,emphasizing the need for more studies in this field.
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.
基金the National Key Research and Development Program of China,No.2020YFC2004202(to DSX)the National Natural Science Foundation of China(General Program),Nos.81772453,81974358(to DSX)Scientific Research Project of Yangzhi Rehabilitation Hospital Affliated to Tongji University,No.KYPY202006(to TTS)。
文摘Classic paired associative stimulation can improve synaptic plasticity,as demonstrated by animal expe riments and human clinical trials in spinal cord injury patients.Paired associative magnetic stimulation(dual-target peripheral and central magnetic stimulation)has been shown to promote neurologic recove ry after stroke.However,it remains unclear whether paired associative magnetic stimulation can promote recovery of lower limb motor dysfunction after spinal cord injury.We hypothesize that the curre nt caused by central and peripheral magnetic stimulation will conve rge at the synapse,which will promote synapse function and improve the motor function of the relevant muscles.Therefore,this study aimed to examine the effects of paired associative magnetic stimulation on neural circuit activation by measuring changes in motor evoked and somatosensory evoked potentials,motor and sensory function of the lower limbs,functional health and activities of daily living,and depression in patients with spinal co rd injury.We will recruit 110 thora cic spinal trauma patients treated in the Department of Spinal Cord Injury,China Rehabilitation Hospital and randomly assign them to expe rimental and control groups in a 1:1 ratio.The trial group(n=55)will be treated with paired associative magnetic stimulation and conventional rehabilitation treatment.The control group(n=55)will be treated with sham stimulation and co nventional rehabilitation treatment.Outcomes will be measured at four time points:baseline and 4,12,and 24 wee ks after the start of inte rvention(active or sham paired associative magnetic stimulation).The primary outcome measure of this trial is change in lower limb American Spinal Injury Association Impairment Scale motor function score from baseline to last follow-up.Secondary outcome measures include changes in lower limb American Spinal Injury Association sensory function sco re,motor evoked potentials,sensory evoked potentials,modified Ashwo rth scale score,Maslach Burnout Invento ry score,and Hamilton Depression Scale score over time.Motor evoked potential latency reflects corticospinal tract transmission time,while amplitude reflects recruitment ability;both measures can help elucidate the mechanism underlying the effect of paired associative magnetic stimulation on synaptic efficiency.Adve rse events will be recorded.Findings from this trial will help to indicate whether paired associative magnetic stimulation(1)promotes recove ry of lower limb sensory and motor function,reduces spasticity,and improves quality of life;(2)promotes neurologic recovery by increasing excitability of spinal cord motor neurons and stimulating synaptic plasticity;and(3)improves rehabilitation outcome in patients with spinal cord injury.Recruitment for this trial began in April 2021 and is currently ongoing.It was approved by the Ethics Committee of Yangzhi Affiliated Rehabilitation Hospital of Tongji University,China(approval No.YZ2020-018)on May 18,2020.The study protocol was registered in the Chinese Clinical Trial Registry(registration number:ChiCTR2100044794)on March 27,2021(protocol version 1.0).This trial will be completed in April 2022.
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 Shaanxi Province Excellent Talents Training Project of Traditional Chinese Medicine (Shaanxi Traditional Chinese Medicine Letter[2020]No.112)Project of Shaanxi Provincial Administration of Traditional Chinese Medicine (2021-ZZ-LC016)Key Project of Shaanxi Science and Technology Department (2022ZDLSF03-09)
文摘[Objectives]To explore the clinical treatment effect of repetitive transcranial magnetic stimulation(rTMS)combined with repetitive magnetic stimulation at Taichong acupoint(LR3)therapy in the treatment of depression.[Methods]60 patients who met the inclusion standard were chosen as the research subjects.They were split into two sets using a randomized parallel control method,with 30 cases each in the experimental and control groups.The experimental group adopted the treatment with rTMS+repetitive magnetic stimulation at Taichong acupoint(LR3),and the control group adopted the treatment with rTMS alone.The course of treatment was 8 weeks.Then the clinical efficacy,Hamilton Depression Scale 17 item score(HAMD-17),Symptom Check List-90(SCL-90),Patient Health Questionnaire-15(PHQ-15)and Pittsburgh Sleep Quality Index(PSQI)were compared.[Results]After treatment,the scores of HAMD-17,SCL-90,PHQ-15 and PSQI in the two groups were lower than those before and 4 weeks after treatment(P<0.05 or P<0.01),and the scores in the experimental group were inferior to those in the control group(P<0.01),The effective rate was 96.66%in the experimental group and 76.47%in the control group(P<0.05).In the course of treatment,no serious adverse reactions happened in either group.[Conclusions]The rTMS combined with repetitive magnetic stimulation at Taichong acupoint(LR3)can enhance the control of depression in the right frontal lobe,significantly improve the symptoms of depression and somatic discomfort,and improve the sleep quality of patients.It has a wide range of application,and is safe and noninvasive,so it is worthy of clinical promotion.
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.
