High and low frequency repetitive transcranial magnetic stimulation in smoking cessation: A systematic review

Abstract@#Repetitive Transcranial Magnetic Stimulation is a non-invasive brain stimulation process popularly used to treat psychiatric disorders. Multiple evidence shows effectiveness of rTMS in treating addiction, particularly in tobacco or cigarette users. This study consisted of review of current published literatures on repetitive transcranial magnetic stimulation following predefined eligibility criteria. The studies included evaluated at least one of the epidemiological parameters: (i) the meaning of repetitive transcranial magnetic stimulation (ii) Effectiveness of the Repetitive Transcranial Magnetic Simulation Over Behavioral therapy (iii) rTMS-associated adverse events among tobacco users@*Methodology@#We included published studies discussing rTMS in smoking cessation which examined if these interventions were effective and identified whether it has a severe negative effect on the patients. A total of 104 related studies were identified through database searches (Pubmed, Elsevier, Cochrane). Of which, 53 duplicate studies were removed. Five studies were then excluded with more than 10 years in publication. A total of 28 papers were then included in the study.@*Conclusion@#We conclude that rTMS is more effective in treating addiction in terms of smoking compared to behavioral therapy and rTMS affects triggered desired circuit which may be crucial among tobacco users. Individual neuronal excitability in the specific region’s subsequent induction may impact the therapeutic outcomes. With this, the high-frequency rTMS sequentially applied to the left superior medial frontal cortex and dorsolateral prefrontal cortex may be an effective tool for improving the cessation rate.

Research Progress and Application Prospect of Nerve Rehabilitation by Transcranial Electrical and Magnetic Stimulation / 中国医疗器械杂志

Accidents or diseases may cause impairment or even loss of human motor function, among which stroke is a disease which is most likely to cause disability and seriously endangers social health. During recent years, as a new nerve regulation technology, non-invasive brain stimulation technology can achieve the application of nerve stimulation to the brain, induce and promote neuroplasticity and improve the excitability of cerebral cortex. Especially, transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation(TMS) have shown high therapeutic potential in motor rehabilitation. This paper summarizes the mechanism and progress of the research and application of tDCS and TMS in the field of neurorehabilitation. Its technical challenges and future development trends are provided as well.

Medical Student Selection and Role of TMS in Germany / 医学教育

In Japan, medical schools are making various efforts for the purpose of establishing consistent admission selection processes for securing human resources, which are compatible with individual development goals as medical doctors and admission policies. In Germany, 40% of medical students are selected through the central office (Stiftung fuer Hochschulzulassung) for the allocation of places in higher education, The rest of the students are decided by Medical Universities. In addition to overall Abitur grade, the nationwide medical admission test TMS (Test fuer Medizinische Studiengaenge) is used as one of the selection criteria by many universities in individual selection processes with the aim of choosing the students with better medical specialty aptitude. Similar attempts might be difficult in Japan where private and public universities are mixed. However, it is important to share the firm concept of ‘what type of students should be selected as medical students’.　Here, we introduce the unique selection process of medical students in Germany, especially focusing on the re-introduction of TMS.

Alumni Experience on Postgraduate Medical Training in Transfusion Medicine in Malaysia

@#Introduction: Transfusion Medicine is an evolving filed which integrates multidisciplinary science in providing safe blood and blood products for patients. With an increasing demand for Transfusion Medicine training in Malaysia, a formal survey is needed to evaluate the postgraduate Transfusion Medicine programme offered by Advanced Medical and Dental Institute, Universiti Sains Malaysia to identify areas of deficiency based on the alumni experiences. Methods: An English language survey form was developed specifically to assess the programme contents (overall contents, learning experience in each year, and support in research), the alumni perception on soft-skills gained during the study, and the outcome of the programme. The survey forms were distributed to all alumni between March 2018 and October 2018 via e-mail or hand-delivered. Results: The survey response rate was 79% (37 of 47). A majority (97%) of the transfusion medicine specialists (TMS) in this study reported that the course offered in the program was relevant to their current job. The learning experience which includes course content, student’s placement, facilities, and support in research) were rated between satisfactory and good. Communicating effectively through speaking was the highest reported soft-skill gained during the programme, whereas communicating effectively in writing was the lowest soft-skill gained. On the programme outcome, all TMS agreed that this programme will produce qualified and well trained specialists for current working market. Conclusion: Some improvement in the programme contents and teaching activities are needed to equip the future TMS for the nation.

Application of non-invasive brain stimulation techniques in decision-making behavior / 中华行为医学与脑科学杂志

Non-invasive brain stimulation techniques,including transcranial direct current stimula-tion (TDCS) and transcranial magnetic stimulation (TMS),are safe and non-invasive techniques,which can change the local excitability of the brain. The application of these techniques in the field of psychology,espe-cially decision making,has developed rapidly. These techniques provide the researchers a new perspective to study how people make decisions and to explore the neural mechanisms behind decision-making behaviors. This paper reviews the studies of non-invasive brain stimulation techniques in the field of different decision-making behaviors (risky choice,intertemporal choice and social decision-making) and the problems existing in the current studies,and puts forward some possible solutions.

Intervention Effect of Repetitive TMS on Behavioral Adjustment After Error Commission in Long-Term Methamphetamine Addicts: Evidence From a Two-Choice Oddball Task / 神经科学通报·英文版

Behavioral adjustment plays an important role in the treatment and relapse of drug addiction. Nonetheless, few studies have examined behavioral adjustment and its plasticity following error commission in methamphetamine (METH) dependence, which is detrimental to human health. Thus, we investigated the behavioral adjustment performance following error commission in long-term METH addicts and how it varied with the application of repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC). Twenty-nine male long-term METH addicts (for > 3 years) were randomly assigned to high-frequency (10 Hz, n = 15) or sham (n = 14) rTMS of the left DLPFC during a two-choice oddball task. Twenty-six age-matched, healthy male adults participated in the two-choice oddball task pretest to establish normal performance for comparison. The results showed that 10 Hz rTMS over the left DLPFC significantly decreased the post-error slowing effect in response times of METH addicts. In addition, the 10 Hz rTMS intervention remarkably reduced the reaction times during post-error trials but not post-correct trials. While the 10 Hz rTMS group showed a more pronounced post-error slowing effect than the healthy participants during the pretest, the post-error slowing effect in the posttest of this sample was similar to that in the healthy participants. These results suggest that high-frequency rTMS over the left DLPFC is a useful protocol for the improvement of behavioral adjustment after error commission in long-term METH addicts.

The relationship and clinical significance of TMS1,MBD2 and DNMT1 in hepatocellular carcinoma / 国际检验医学杂志

Objective To observe the expression of methylation related silent target 1 (TMS1),DNA methyltransferase 1 (DNM T1)and methyl CpG binding domain protein 2 (MBD2),and the methylation of the TMS1 gene promoter,in hepatocellular carcinoma (HCC),and to investigate the relationship between the three genes and the clinical diagnostic significance.Methods The protein expression of TMS1,MBD2 and DNMT1 in 48 cases of HCC tissues and 48 case of normal tissues were detected by immunohistochemistry (IHC);the methylation status of TMS1 gene in serum of 34 patients with HCC,26 patients with hepatitis B and 23 healthy controls were analyzed by methylation specific polymerase chain reaction (MSP).Results The posi-tive rates of TMS1 expression in HCC tissues and normal tissues were 26.08% and 97.92%,respectively;the positive rate of MBD2 expression were 18.75% and 80.00%,respectively;the positive rate of expression were 77.08 % and 32.25%,respectively.The positive rates of TMS1 and MBD2 expression in HCC tissues were significantly lower than those in the normal tissues,and DNM T1 expression was higer than that in the normal tissues,and the difference was statistically significant (P<0.05).The expression TMS1 and MBD2 were neg-atively correlated with DNMT1 (P< 0.05).TMS1 protein expression was associated with TNM stage and tumor differentiation but not associated with the age and gender (P<0.05).The methylation detection rates of TMS1 gene in HCC group,hepatitis B group and healthy group were 70.6%,50.0% and 0.0%,respective-ly,and the differences were statistically significant (P<0.05).The methylation detection rate of HCC group and hepatitis b group was obviously higher than the normal group,which aggravated with the increase of tumor grade and stage.Conclusion TMS1 hypermethylation may be an early event in the carcinogenesis of liver tissue,the abnormal expression of TMS1,MBD2 and DNM T1 proteins plays an important role in the oc-currence and the development of HCC,w hich can be used as new molecular markers for the early diagnosis and prognosis of HCC,and become the new targets for the treatment of HCC.

Chasing the Chameleon: Psychogenic Paraparesis Responding to Non-Invasive Brain Stimulation

Neurologic symptoms that develop unconsciously and are incompatible with known pathophysiologic mechanisms or anatomic pathways belong to Conversion Disorder (CD). CD diagnosis is based on the clinical history and the exclusion of physical disorders causing significant distress or social and occupational impairment. In a subgroup of CD, called functional weakness (FW), symptoms affecting limbs may be persistent, thus causing a permanent or transient loss of limb function. Physiotherapy, pharmacotherapy, hypnotherapy and repetitive transcranial magnetic stimulation (rTMS) have been proposed as treatment strategies for FW-CD. Herein, we report a 30 year-old male, presenting with lower limb functional paraparesis, having obtained positive, objectively, and stable effects from a prolonged r-TMS protocol associated to a multidisciplinary approach, including psychological and sexuological counseling, and monitored by gait analysis. We postulate that our rTMS protocol, combined with a multidisciplinary approach may be the proper treatment strategy to improve FW-CD.

Identificación de ácidos polifenólicos en el extracto metanólico de las hojas de terminalia catappa Linn / Identification of polyphenolic acids in the methanolic extract from Terminalia catappa Linn leaves

INTRODUCCIÓN: diferentes extractos de Terminalia Catappa Linn. (Combretaceae) han demostrado de forma internacional, propiedades farmacológicas beneficiosas para la salud humana. Estas propiedades han sido atribuidas en lo fundamental a los polifenoles y glicósidos, encontrados en hojas, corteza y frutos. En Cuba esta especie es catalogada como una planta invasora y existen pocas investigaciones sobre su composición química y estudios farmacológicos. OBJETIVOS: identificar y cuantificar los ácidos polifenólicos presentes en el extracto metanólico de las hojas de T. catappa utilizándose la cromatografía de gases acoplada a espectrometría de masas. MÉTODOS: las hojas amarillo-rojizas fueron secadas, molidas, desgrasadas con hexano y y con posterioridad extraídas con metanol en un baño ultrasónico. El extracto se filtró y el disolvente se eliminó al vacío. El extracto seco se hidrolizó con ácido clorhídrico y se extrajo con acetato de etilo. Se determinó el rendimiento de extracción, las características organolépticas y los polifenoles totales mediante el método de Follin-Ciocalteu. La composición química del extracto hidrolizado se llevó a cabo por cromatografía de gases acoplada a espectrometría de masas, previa formación de los derivados trimetilsilil. RESULTADOS: se obtuvo un líquido de color pardo rojizo oscuro de olor característico. El contenido total de polifenoles fue 184,6 (mg Pirogalol/100 g Extracto). Se detectaron 37 compuestos por cromatografía de gases acoplada a espectrometría de masas en el extracto metanólico hidrolizado. Este extracto está compuesto de manera general por ácidos polifenólicos como el ácido gálico; ácido vanílico; ácido 3,4-dihidroxibenzoico; ácido 2,5-dihidroxi-benzoico y ácido 4- hidroxibenzoico. También se detectaron otros compuestos con elevados contenidos como ácido elágico y ácido levulínico. CONCLUSIONES: el extracto metanólico de hojas de T. catappa que crece en Cuba mostró un elevado contenido de ácidos polifenólicos, donde los ácidos gálico y elágico fueron los mayoritarios. La presencia de estos compuestos pudiera justificar las propiedades medicinales atribuidas a esta especie, a la vez que servirían de base para continuar con futuras pruebas farmacológicas que avalen sus usos con fines farmacéuticos.

INTRODUCTION: Different extracts of Terminalia Catappa Linn. (Combretaceae) internationally have shown pharmacological properties beneficial to human health. These properties have been largely attributed to polyphenols and their glycosides found in the leaves, bark and fruits. In Cuba this species is listed as an invasive plant and there is limited research on its chemical composition and pharmacological studies. OBJECTIVES: To identify and quantify the polyphenolic acids that could be present in the methanol extract of Terminalia catappa leaves using gas chromatography-mass spectrometry. METHODS: The yellow-red leaves were dried, ground, defatted with hexane and then extracted with methanol in an ultrasonic bath. The extract was filtered and the solvent removed under vacuum. The dry extract was hydrolyzed with hydrochloric acid and extracted with ethyl acetate. The extraction yield, the organoleptic characteristics and the total polyphenols by Follin-Ciocalteu method were determined. The chemical composition of the hydrolyzed extract was performed by gas chromatography-mass spectrometry after formation of trimethylsilyl derivatives. RESULTS: A dark reddish brown liquid with a characteristic odor was obtained. The total polyphenol content was 184.6 (mg Pyrogallol/100g extract). By mean of gas chromatography-mass spectrometry a total of 37 compounds were detected in the hydrolyzed methanol extract. This extract consists mainly of polyphenolic acids such as gallic acid; vanillic acid; 3,4-dihydroxybenzoic acid; 2,5-dihydroxybenzoic acid and 4- hydroxybenzoic acid. Other compounds with high content as ellagic acid and levulinic acid were also detected. CONCLUSIONS: The methanolic extract obtained from the leaves of Terminalia catappa growing in Cuba showed a high content of polyphenolic acids where gallic acid and ellagic predominated. The presence of these compounds could justify the medicinal properties attributed to this species, while providing the basis for further future pharmacological evidence to support its use for pharmaceutical purposes.

Efficacy of repetitive transcranial magnetic stimulation on refractory epilepsy in Malaysia

Background & Objective: Modulation of cortical excitability by low frequency repetitive transcranial magnetic stimulation (rTMS) has demonstrated therapeutic use in epilepsy. This study aimed to evaluate the efficacy of low-frequency rTMS on refractory epilepsy in a group of Malaysian subjects. Methods: Nine patients with refractory epilepsy completed the study. All patients received 10 sessions of 1Hz rTMS (1000 pulses per session) at 90% of resting motor threshold. Outcome measures included seizure frequency, Symptom Checklist-90 (SCL-90), Beck Depression Inventory II (BDI II) and Quality of Life in Epilepsy-31 (QOLIE-31). Responders were defined as having ≥ 50% seizure reduction. Results: The mean age was 33.8 years (SD 11.7), with 4 male. Three patients had mesial temporal sclerosis (MTS); 4 with focal cortical dysplasia (FCD) and two lesion-negative. Three patients achieved >50% seizure reduction at 8 weeks post-treatment, with 2 of them had improvement in the number of IED. All of the responders had FCD. The responders were younger (mean 24.7 vs. 38.3 years old), had shorter duration of illness (mean 15.7 vs. 30.5 years) and had less frequent seizure frequency prior to treatment (mean 5.5 vs. 10.8 attacks per week), as compared to the non-responders. Six patients had improvement in BDI-II scores, two in QOLIE-31 and four in SCL-90 post treatment, irrespective of seizure control. The mean scores in BDI-II improved significantly with treatment (p<0.01). Conclusion: rTMS is a potentially promising treatment for epilepsy, esp

Effect of short-interval intracortical inhibition in motor cortex during pre-set on rebound drop jumping performance / 体力科学

This study aimed to assess the effect of short-interval intracortical inhibition (SICI) before a jump off a platform (pre-set) on drop jump (DJ); the purpose was to investigate the relationship between this activity and performance, and the different effects of SICI on agonist and antagonist muscles during pre-set for jump athletes. Jump athletes (Jumper group, n=13) and Other athletes (Other group, n=9) performed DJ from drop heights of 0.30, 0.45, and 0.60 m). DJ performance was evaluated with DJ-index which was calculated from contact time and jump height. SICI was calculated from motor evoked potentials (MEP) recorded using paired-pulse transcranial magnetic stimulation for the medial gastrocnemius (MG) and tibialis anterior (TA) muscles in 7 jump athletes. Significantly higher DJ performance was observed for the Jumper group at all drop heights, and the Jumper group exhibited greater performance for the highest drop height than the Other groups. Significant decreases in SICI for MG were observed for the Jumper groups, and this decrease in inhibition was more prominent for the highest drop height during pre-set. Furthermore, the correlation between SICI for MG and DJ-index was stronger for increased drop heights, and a significantly positive correlation between these variables was observed at a height of 0.60 m. However, the SICI during the pre-set for TA exhibited no significant change under any of the conditions. The results of the present study suggest the importance of selective disinhibition of brain areas associated with the agonistic muscles during pre-set for higher DJ performance.

Estudio de Estimulación Magnética Transcraneal en pacientes con depresión y trastornos del sueño / Transcranial Magnetic Stimulation in patients suffering from depression and sleep disorders

Introducción: la Estimulación Magnética Transcraneal (EMT) es una técnica neurofsiológica, que permite la inducción de una corriente en el cerebro de forma segura y no invasiva. Está basada en los principios de inducción electromagnética descubiertos por el investigador Michael Faraday hace dos siglos. Recién en 1984, Anthony Barker y su equipo de trabajo desarrollaron un estimulador que permitía despolarizar neuronas en la corteza motora y provocar movimientos contralaterales al activar vías corticoespinales, a partir de lo cual se ha logrado su aplicación en clínica psiquiátrica para diferentes trastornos. La EMTr puede utilizarse como complemento de otros métodos neurocientífcos en el estudio de vías motoras centrales, para el estudio de la excitabilidad cortical y en el mapeo de funciones cerebrales corticales, pudiendo combinar la capacidad de resolución temporal y espacial y la potencialidad de activar o interferir en funciones cerebrales. Materiales y métodos: los pacientes fueron seleccionados de acuerdo al diagnóstico bajo la patología F 33 ­ F 51 por el personal del servicio y remitidos a la unidad de Estimulación Magnética Transcraneal. Se les realizó exámenes complementarios como: TAC de cráneo, electroencefalograma, valoración psicológica pre y post EMTr, dentro de un protocolo estrictamente aplicado, sin el cual no se decide proceder a este tratamiento. Resultados: en el presente estudio no se hizo diferenciaciones entre el tipo de depresión y tampoco en lo relacionado a los trastornos del ritmo del sueño. Se encontró satisfacción en la mayoría de pacientes, sometidos a este tratamiento y muchos mejoraron su depresión y calidad de sueño con la estimulación repetitiva, proponiéndose como una nueva opción de tratamiento no farmacológico ni psicoterapéutico; además es accesible a todo tipo de población, siempre y cuando se cuenta con la infraestructura tecnológica para este procedimiento.

ABSTRACT Introduction: transcranial magnetic stimulation (TMS) is a neurophysiological technique that allows electric currents induction into the brain in a safe and noninvasive way. TMS is based on electromagnetic induction discovered by Faraday two centuries ago. Only in 1984, Anthony Barker and his team developed a stimulator that allowed depolarization of neurons in the motor cortex causing contralateral movements by activating corticospinal pathways, from which it has achieved its application on different conditions in psychiatric clinic. TMS can be used with other neuroscientifc methods to combine the ability of temporal and spatial resolution and the potentiality to activate or interfere brain functions when studying central motor pathways, cortical excitability and brain cortical function mapping. Materials and methods: for the study, patients were selected under pathology F33 and F51, diagnosed by medical service personnel and sent to the Magnetic Stimulation Unit. Additional tests such as head CT, EEG, psychological evaluation pre and post rTMS (repetitive TMS) were performed within a strict protocol. If some of the tests could not be carried out, the treatment did not proceed. Results: in this study, differences on type of depression or sleep rhythm disorders were not made. Our results showed that satisfaction was found in the majority of patients undergoing this treatment and many of them even improved with repetitive stimulation their depression and sleep quality, thus, proposing an alternate non-pharmacological or psychotherapeutic treatment. Besides, it is accessible to most people, as long as the technological infrastructure for this procedure is set up.

Perspectives on Next-Generation Newborn Screening

Newborn screening (NBS) has been effective for detecting asymptomatic newborns with inherited metabolic diseases and has facilitated early clinical intervention, which has resulted in significant decreases in the rates of morbidity and mortality caused by these diseases. The outcome of the NBS program heavily depends on technological advances. Since Dr. Robert Guthrie developed a bacterial inhibition assay to screen for metabolic diseases in the early 1960s, use of the NBS program has spread to many countries. Tandem mass spectrometry (TMS) was a second major technological breakthrough that has allowed screening to be extended to disorders of fatty acid and organic acid metabolism as well as to those of amino acid metabolism, and recently screening has also been expanded to include lysosomal storage diseases. TMS can detect multiple analytes rapidly and simultaneously and is currently applied to nearly 80% of the newborn population in Korea. Next-generation sequencing (NGS) technology could be another major breakthrough to improve the current NBS program. To integrate NGS into the NBS program, various considerations about its analytical validity, clinical validity, clinical utility, and ethical, legal, and social implications should be addressed on the basis of population screening. Here, the authors review population screening criteria, the current status of NBS, and recent advances in NGS. In addition, we discuss the practical and ethical issues, opportunities, and challenges regarding the implementation of NGS in NBS.

Repetitive transcranial magnetic stimulation in a rat model of middle cerebral artery occlusion：variation of nerve regeneration microenvironment in infarcted brain areas and recovery of rat neurological function / 中国组织工程研究

BACKGROUND:At home and abroad, a large number of studies have demonstrated that repetitive transcranial magnetic stimulation can evoke changes in cortical excitability that can be sustained beyond the time of stimulation, which provides a new research direction for application of magnetic stimulation in rehabilitation treatment for cerebral infarction. However, its long-term clinical efficacy and safety deserve further investigation. OBJECTIVE: To observe the influence of repetitive transcranial magnetic stimulation on nerve regeneration microenvironment in the infarcted cerebral area and rat neurological functional recovery after cerebral infarction. METHODS:The rats were randomly divided into model group, sham stimulation group and repetitive transcranial magnetic stimulation group (80%, 100% and 120% motor threshold subgroups). Right middle cerebral artery occlusion models were established in rats by the intraluminal suture method. At 24 hours after middle cerebral artery occlusion, 20 Hz repetitive transcranial magnetic stimulation was performed in each repetitive transcranial magnetic stimulation subgroup at the designated motor thresholds. Rats in the sham stimulation group underwent sham stimulation, while the model group rats were not given any treatment. RESULTS AND CONCLUSION: Seven days after middle cerebral artery occlusion, cerebral infarction volume in the repetitive transcranial magnetic stimulation group was significantly less than that in the model and sham stimulation groups (P < 0.05). RT-PCR and Western blot assays showed that at 72 hours after middle cerebral artery occlusion, aquaporin 4/9 mRNA and protein expression in the repetitive transcranial magnetic stimulation group was significantly increased than in the model group (P < 0.05). Compared with 1 day after middle cerebral artery occlusion, neurological deficit scores at 15 days after repetitive transcranial magnetic stimulation was significantly improved (P < 0.05). Immunohistochemical detection results showed that glial fibrilary acidic protein expression in the ischemic penumbra in each repetitive transcranial magnetic stimulation subgroup was significantly lower than that in the model group (P < 0.05). The results reveal that repetitive transcranial magnetic stimulation can aleviate rat neurological deficits and improve nerve regeneration microenvironment by inducing cerebral ischemic tolerance, reducing nerve cel apoptosis and decreasing aquaporin 4/9 mRNA and protein expression.

Interhemispheric Modulation of Dual-Mode, Noninvasive Brain Stimulation on Motor Function

OBJECTIVE: To investigate the effects of simultaneous, bihemispheric, dual-mode stimulation using repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) on motor functions and cortical excitability in healthy individuals. METHODS: Twenty-five healthy, right-handed volunteers (10 men, 15 women; mean age, 25.5 years) were enrolled. All participants received four randomly arranged, dual-mode, simultaneous stimulations under the following conditions: condition 1, high-frequency rTMS over the right primary motor cortex (M1) and sham tDCS over the left M1; condition 2, high-frequency rTMS over the right M1 and anodal tDCS over the left M1; condition 3, high-frequency rTMS over the right M1 and cathodal tDCS over the left M1; and condition 4, sham rTMS and sham tDCS. The cortical excitability of the right M1 and motor functions of the left hand were assessed before and after each simulation. RESULTS: Motor evoked potential (MEP) amplitudes after stimulation were significantly higher than before stimulation, under the conditions 1 and 2. The MEP amplitude in condition 2 was higher than both conditions 3 and 4, while the MEP amplitude in condition 1 was higher than condition 4. The results of the Purdue Pegboard test and the box and block test showed significant improvement in conditions 1 and 2 after stimulation. CONCLUSION: Simultaneous stimulation by anodal tDCS over the left M1 with high-frequency rTMS over the right M1 could produce interhemispheric modulation and homeostatic plasticity, which resulted in modulation of cortical excitability and motor functions.

Novel Approaches of Non-Invasive Stimulation Techniques to Motor Rehabilitation Following Stroke: A Review

This review intends to synthesize our understanding of the effects of novel approach of non-invasive peripheral nerve and brain stimulation techniques in motor rehabilitation and the potential role of these techniques in clinical practice. The ability to induce cortical plasticity with non-invasive stimulation techniques has provided novel and exciting opportunities for examining the role of the human cortex during a variety of behaviors literature concerning non-invasive stimulation technique incorporated into stroke research is young, limiting the ability to draw consistent conclusions. In this review we discuss how these techniques can enhance the effects of a behavioral intervention and the clinical evidence for its use to date.

The masseter motor-evoked potential after transcranial magnetic stimulation in patients with sleep bruxism / 实用口腔医学杂志

Objective:To study the masseter motor evoked potential(MEP)in patients with sleep bruxism(SB)and in healthy con-trols.Methods:30 subjects with SB and 30 healthy controls were included.MEPs were obtained by transcranial magnetic stimulation (TMS).Tests were done during daytime when the subjects were awake.The data were statistically analysed.Results:In the patients AMT was 55(52,55)%,latency of c-MEP (6.7 ±1.3)ms,the amplitude of c-MEP 0.19(0.15,0.29)mV,latency of r-MEP (2.3 ±0.4)ms,the central conduction time(CCT)4.4(3.3,5.2)ms.In the control subjects AMT was 52(52,55)%,latency of c-MEP (6.4 ±0.7)ms,the amplitude of c-MEP 0.23(0.17,0.28)mV,latency of r-MEP (2.4 ±0.4)ms,CCT 4.0 (3.4,4.4) ms.No significant difference was found between the 2 groups in the measurements evoked by TMS.Conclusion:The MEP after TMS in patients with SB is similar to that of healthy subjects,indicating that the excitability of the cortical motor system is not changed in bruxism subjects,at least when evaluated by TMS.

Treatment of Late-Life Depression by Brain Stimulation Techniques

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.

Short latency afferent inhibition in schizophrenia patients

The objective of this study was to test our preliminary in vivo evaluations of central cholinergic abnormalities in schizophrenia patients. Short latency afferent inhibition (SAI) is based on coupling peripheral nerve stimulation with motor cortex Transcranial Magnetic Stimulation (TMS), which has been shown to be a putative marker of central cholinergic activity. Methods: We evaluated SAI in 5 patients with schizophrenia and 5 healthy subjects. Results: The level of SAI was significantly lower in the patients with schizophrenia than in the controls (p=0.008). Conclusion: Our findings suggest involvement of central cholinergic neurotransmission in schizophrenia, which indicates a possible approach for treatment of cognitive dysfunction related to the disease.

Expression of TMS1/ASC gene and activation of caspase-Ⅰ and NF-κB induced by gemcitabine in pancreatic carcinoma cell line PANC-1 / 中华内分泌外科杂志

Objective To investigate the expression of TMS1/ASC gene induced by gemcitabine(GEM) in pancreatic carcinoma cell line PANC-1.To study the relationship between cysteine aspartase(caspase-1),nuclear factor-κB(NF-κB) and the expression of TMS1/ASC.Methods The pancreatic carcinoma cell line PANC-1 was cultured in Dnlbecco's modification of Eagle's medium(DMEM).Methyl thiazolyl tetrazolium (MTT)method was used to measure the effect of GEM at different time points(24,48 h)at different concentrations(1,2,4,8,16 μg/ml) on growth of PANC-l.RT-PCR was used to detect the expression of TMS1/ASC mRNA stimulated by medium alone and by GEM(4.27μg/ml)for 24 h and 48 h.Western blot analysis was performed with inhibitory protein of NF-κB multiclonal antibody,caspase-1 multiclonal antibody and β-actin monoclonal antibody to observe the expression of β-actin,caspase-1 and IκBα in GEM group and in the control group.The activation state of caspase-1 and NF-κB was examined.Results GEM inhibited the growth of PANC-1 cells in a concentrationand-time-dependent manners and its half maximal inhibitory concentration(IC50)was 4.27 μg/ml on 24 h.The expression of TMS1/ASC was 0.3 ±0.004 and 0.63 ±0.007 respectively in GEM group while it was 0.1 ±0.001 and 0.21 ± 0.006 in the control group on 24h and 48h.The difference between the 2 groups at the same time point had statistical significance (P ＜ 0.01).Western blot showed that GEM caused the activation of caspase-1.The expression of IκBα had no obvious differencebetween the 2 groups.GEM couldn't induce the activation of NF-κB.Conclusions GEM can inhibit proliferation of PANC-1 cells and induce their apoptosis.The drug sensitivity decreased with prolongation of exposure time.GEM might induce and increase the expression of TMS1/ASC,which might influence the apoptosis of the cells later.The apoptosis of PANC-1 cells induced by GEM is dependent of caspase-1 signaling pathway and independent of NF-κB signaling pathway.