ABSTRACT
Obsessive-compulsive disorder is a disabling disease with symptoms of repeated and persistent unwanted intrusive thoughts and compulsive behaviors. The current first-line treatment methods mainly include psychopharmacology, psychotherapy, and the combination of both, but nearly 40% patients still show no response to conventional treatment. Among the recently developed treatments, non-invasive brain stimulation techniques, such as transcranial direct current stimulation (tDCS), are expected to alleviate the symptoms of various psychiatric disorders and improve cognitive function. tDCS has been applied to the treatment of depression, schizophrenia, generalized anxiety disorder and other mental diseases, and has achieved definite clinical effect. However, there are few studies about tDCS applying to the obsessive-compulsive disorder, especially in the number of randomized controlled trials. Most of the studies are open trials and case reports, and the results are inconsistent. By reviewing the effect of tDCS in treating obsessive-compulsive disorder patients in existing reports, the possibility of applying tDCS widely to treating obsessive-compulsive disorder in the future is analyzed.
ABSTRACT
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique which can change cortical excitability in targeted area by producing magnetic field pulses with an electromagnetic coil. rTMS treatment has been used to treat various neuropsychiatric disorders including depression. In this review, we evaluate the literature on rTMS for depression by assessing its efficacy on different subtypes of depression and different technical parameters. In particular, we focus on the results of randomized clinical trials and meta-analyses for depression after the US Food and Drug Administration approval in 2008, which acknowledged its efficacy and acceptability. We also review the new forms of rTMS therapy including deep TMS, theta-burst stimulation, and magnetic seizure therapy (MST) that have been under recent investigation. High frequency rTMS over left dorsolateral prefrontal cortex (DLPFC), low frequency rTMS over right DLPFC, or bilateral rTMS is shown to be effective and acceptable in treatment for patients with non-psychotic, unipolar depression either as monotherapy or adjuvant. Deep TMS, theta-burst stimulation and MST are promising new TMS techniques which warrant further research.
Subject(s)
Humans , Depression , Depressive Disorder , Magnetic Fields , Magnets , Prefrontal Cortex , Seizures , Transcranial Magnetic Stimulation , Treatment Outcome , United States Food and Drug AdministrationABSTRACT
@#The neuromechanism of language function recovery in patients with aphasia after stroke is still unclear. It is supported that the language function of aphasia after extensive damage of left hemisphere mainly recovered through activating the right hemisphere of ho-mologous regions to improve the function of speech. Melodic intonation therapy (MIT) can be achieved by melody tone and left hand clap to activate the right hemisphere of the frontal temporal lobe, which is particularly applicable to improve language function of non-fluent aphasia patients with large left hemisphere lesion. Non-invasive brain stimulation techniques (NBS) changes brain activity through stimulat-ing affected or contralateral side, which has been used to facilitate language functional recovery after stroke. Excitatory transcranial stimula-tion on the right hemisphere homology combined with melodic intonation therapy can promote language recovery of patients with extensive damage of left hemisphere after stroke. It is valuable to combine traditional speech training with MIT and NBS to activate related language functional areas to maximum improvement of language recovery after stroke.
ABSTRACT
Due to the low response rate of antidepressant treatment in late-life depression, brain stimulation techniques should be considered when treating elderly patients. Electroconvulsive therapy (ECT) is one of the most frequently used brain stimulation techniques, and shows favorable outcome and acceptable tolerability in the treatment of late-life depression. Hemodynamic change and cognitive impairment are common side effects of ECT, which are transient in most cases. Since cognitive impairment can lead to treatment non-compliance, it should be minimized by controlling electrode position, pulse-width, treatment frequency, etc. Because ECT is followed by rapid cardiovascular change, risk factors should be evaluated and managed properly. Transcranial magnetic stimulation (TMS) and magnetic seizure therapy (MST) are also shown to be effective in treating depression, with less cognitive impairment. However, further research is needed to establish their efficacy in late-life depression.