Abstract
Major depression is one of the leading causes of disabling condition worldwide and its treatment is often challenging and unsatisfactory, since many patients become refractory to pharmacological therapies. Transcranial magnetic stimulation (TMS) is a noninvasive neurophysiological investigation mainly used to study the integrity of the primary motor cortex excitability and of the cortico-spinal tract. The development of paired-pulse and repetitive TMS (rTMS) paradigms has allowed investigators to explore the pathophysiology of depressive disorders and other neuropsychiatric diseases linked to brain excitability dysfunctions. Repetitive transcranial magnetic stimulation has also therapeutic and rehabilitative capabilities since it is able to induce changes in the excitability of inhibitory and excitatory neuronal networks that may persist in time. However, the therapeutic effects of rTMS on major depression have been demonstrated by analyzing only the improvement of neuropsychological performance. The aim of this study was to investigate cortical excitability changes on 12 chronically-medicated depressed patients (test group) after rTMS treatment and to correlate neurophysiological findings to neuropsychological outcomes. In detail, we assessed different parameters of cortical excitability before and after active rTMS in the test group, then compared to those of 10 age-matched depressed patients (control group) who underwent sham rTMS. In line with previous studies, at baseline both groups exhibited a significant interhemispheric difference of motor cortex excitability. This neurophysiological imbalance was then reduced in the patients treated with active rTMS, resulting also in a clinical benefit as demonstrated by the improvement in neuropsychological test scores. On the contrary, after sham rTMS, the interhemispheric difference was still evident in the control group. The reported clinical benefits in the test group might be related to the plastic remodeling of synaptic connection induced by rTMS treatment.
| Original language | English |
|---|---|
| Article number | 6493451 |
| Pages (from-to) | 391-403 |
| Number of pages | 13 |
| Journal | IEEE Transactions on Neural Systems and Rehabilitation Engineering |
| Volume | 21 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2013 |
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Keywords
- Biomedical signal processing
- medical information systems
- patient rehabilitation
ASJC Scopus subject areas
- Neuroscience(all)
- Computer Science Applications
- Biomedical Engineering
- Medicine(all)
Cite this
Transcranial magnetic stimulation in the assessment of motor cortex excitability and treatment of drug-resistant major depression. / Spampinato, C.; Aguglia, E.; Concerto, C.; Pennisi, M.; Lanza, G.; Bella, R.; Cantone, M.; Pennisi, G.; Kavasidis, I.; Giordano, D.
In: IEEE Transactions on Neural Systems and Rehabilitation Engineering, Vol. 21, No. 3, 6493451, 2013, p. 391-403.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Transcranial magnetic stimulation in the assessment of motor cortex excitability and treatment of drug-resistant major depression
AU - Spampinato, C.
AU - Aguglia, E.
AU - Concerto, C.
AU - Pennisi, M.
AU - Lanza, G.
AU - Bella, R.
AU - Cantone, M.
AU - Pennisi, G.
AU - Kavasidis, I.
AU - Giordano, D.
PY - 2013
Y1 - 2013
N2 - Major depression is one of the leading causes of disabling condition worldwide and its treatment is often challenging and unsatisfactory, since many patients become refractory to pharmacological therapies. Transcranial magnetic stimulation (TMS) is a noninvasive neurophysiological investigation mainly used to study the integrity of the primary motor cortex excitability and of the cortico-spinal tract. The development of paired-pulse and repetitive TMS (rTMS) paradigms has allowed investigators to explore the pathophysiology of depressive disorders and other neuropsychiatric diseases linked to brain excitability dysfunctions. Repetitive transcranial magnetic stimulation has also therapeutic and rehabilitative capabilities since it is able to induce changes in the excitability of inhibitory and excitatory neuronal networks that may persist in time. However, the therapeutic effects of rTMS on major depression have been demonstrated by analyzing only the improvement of neuropsychological performance. The aim of this study was to investigate cortical excitability changes on 12 chronically-medicated depressed patients (test group) after rTMS treatment and to correlate neurophysiological findings to neuropsychological outcomes. In detail, we assessed different parameters of cortical excitability before and after active rTMS in the test group, then compared to those of 10 age-matched depressed patients (control group) who underwent sham rTMS. In line with previous studies, at baseline both groups exhibited a significant interhemispheric difference of motor cortex excitability. This neurophysiological imbalance was then reduced in the patients treated with active rTMS, resulting also in a clinical benefit as demonstrated by the improvement in neuropsychological test scores. On the contrary, after sham rTMS, the interhemispheric difference was still evident in the control group. The reported clinical benefits in the test group might be related to the plastic remodeling of synaptic connection induced by rTMS treatment.
AB - Major depression is one of the leading causes of disabling condition worldwide and its treatment is often challenging and unsatisfactory, since many patients become refractory to pharmacological therapies. Transcranial magnetic stimulation (TMS) is a noninvasive neurophysiological investigation mainly used to study the integrity of the primary motor cortex excitability and of the cortico-spinal tract. The development of paired-pulse and repetitive TMS (rTMS) paradigms has allowed investigators to explore the pathophysiology of depressive disorders and other neuropsychiatric diseases linked to brain excitability dysfunctions. Repetitive transcranial magnetic stimulation has also therapeutic and rehabilitative capabilities since it is able to induce changes in the excitability of inhibitory and excitatory neuronal networks that may persist in time. However, the therapeutic effects of rTMS on major depression have been demonstrated by analyzing only the improvement of neuropsychological performance. The aim of this study was to investigate cortical excitability changes on 12 chronically-medicated depressed patients (test group) after rTMS treatment and to correlate neurophysiological findings to neuropsychological outcomes. In detail, we assessed different parameters of cortical excitability before and after active rTMS in the test group, then compared to those of 10 age-matched depressed patients (control group) who underwent sham rTMS. In line with previous studies, at baseline both groups exhibited a significant interhemispheric difference of motor cortex excitability. This neurophysiological imbalance was then reduced in the patients treated with active rTMS, resulting also in a clinical benefit as demonstrated by the improvement in neuropsychological test scores. On the contrary, after sham rTMS, the interhemispheric difference was still evident in the control group. The reported clinical benefits in the test group might be related to the plastic remodeling of synaptic connection induced by rTMS treatment.
KW - Biomedical signal processing
KW - medical information systems
KW - patient rehabilitation
UR - http://www.scopus.com/inward/record.url?scp=84877857774&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84877857774&partnerID=8YFLogxK
U2 - 10.1109/TNSRE.2013.2256432
DO - 10.1109/TNSRE.2013.2256432
M3 - Article
VL - 21
SP - 391
EP - 403
JO - IEEE Transactions on Neural Systems and Rehabilitation Engineering
JF - IEEE Transactions on Neural Systems and Rehabilitation Engineering
SN - 1534-4320
IS - 3
M1 - 6493451
ER -