bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential Impact of Deep Brain Stimulation or Anterior Capsulotomy on General Functioning, Personality Features and Quality of Life in OCD
Authors: Gabriels L. , Cosyns P. , Nuttin B. 
Published: May 2011

IntroductionResearch on deep brain stimulation (DBS) for treatment refractory obsessive-compulsive disorder (OCD) shows promising effects on symptoms severity.ObjectivesTo compare outcomes between DBS and bilateral capsulotomy on general functioning, personality traits and quality of life.MethodsConsecutive patients with severe and treatment refractory OCD underwent DBS in the anterior limb of the internal capsule (DBS; n = 14) or anterior capsulotomy (CAPS; n = 14). They were tested before surgery (baseline-BL) and after a mean follow-up time (FU) of 19 months (range 14-31 months). Changes in OCD severity were recorded and global assessment of functioning, personality traits, and quality of life were compared between groups.ResultsStatistically significant differential improvements (p < 0.05, Bonferroni corrected) were seen in*General assessment of functioning (Mn ± 95%CI) GAF: DBS_BL:32.9 ± 3.6; DBS_FU:68.6 ± 7.2; CAPS_BL:35.0 ± 2.7; CAPS_FU:56.4 ± 5.9)*Personality traits on MMPI (T-score Mn ± 95%CI) Scale 2-depression: DBS_BL:83.7 ± 6.5; DBS_FU:61.9 ± 6.3; CAPS_BL:81.2 ± 8.6; CAPS_FU:77.6 ± 8.7 Scale 9-mania: DBS_BL:48.8 ± 7.3; DBS_FU:57.0 ± 4.2; CAPS_BL:53.8 ± 7.5; CAPS_FU:45.6 ± 6.2 Scale 0-social introversion: DBS_BL:66.8 ± 5.2; DBS_FU:56.1 ± 4.1; CAPS_BL:67.7 ± 7.0; CAPS_FU:66.4 ± 5.8)* Quality of life: Q-LES-Q Endicott (Mn ± 95%CI) overall score (1-5): DBS_BL:1.2 ± 0.3; DBS_FU:3.4 ± 0.6; CAPS_BL:1.5 ± 0.3; CAPS_FU:2.6 ± 0.4 and in the sub domains feelings (%): DBS_BL:36.8 ± 4.2; DBS_FU:68.6 ± 8.8; CAPS_BL:39.1 ± 5.1; CAPS_FU:54.0 ± 5.9 leisure activities (%): DBS_BL:30.6 ± 5.9; DBS_FU:68.5 ± 7.9; CAPS_BL:40.2 ± 5.4; CAPS_FU:58.3 ± 7.1 social relationships (%):DBS_BL:43.9 ± 5.5; DBS_FU:70.2 ± 8.0; CAPS_BL:46.9 ± 6.8; CAPS_FU:60.1 ± 6.9ConclusionThese findings suggest a superior impact of DBS over capsulotomy on general functioning, personality traits and quality of life. Limits of this study are the small numbers, the fact that DBS and CAPS patients were from a slightly different OCD population and were not randomized to treatment, and differences in postoperative follow-up.
Treatment of Depression Using Sleep Electroencephalogram Modulated Repetitive Transcranial Magnetic Stimulation
Authors: He M. , Gu Z. , Wang X. , Shi H. 
Published: May 2011

Background and purposeThe conventional repetitive transcranial magnetic stimulation (rTMS) has some inadequate of efficacy weak and inadequate for the treatment of depression, easy symptomatic recurrence when stop the treatment. Ours invented the device of sleep electroencephalogram-modulated rTMS (SEM-rTMS) were safe and effective by proved of the animal experiments and clinical pre-test for the treatment of depression. The purpose of this study was to examine the efficacy and safety of SEM-rTMS for the treatment of depression.MethodsAfter 7 days without psychoactive medication, 164 patients with clinically defined depression, were randomly assigned to receive SEM-rTMS (N = 57), conventional rTMS (C-rTMS (N = 55), or sham-rTMS (N = 52) for 30 minutes/time/day for 10 days. Before and after scores on the 24-item Hamilton rating scale for depression (HAMD-24) and the clinical outcome at the 10th-day of therapy for all subjects were analyzed.ResultsTwenty two cases in the SEM-rTMS group improved mood as compared to 6 in the C-rTMS group and 2 in the sham-rTMS group (c2 = 15.89, p = 0.0004). After completion of the rTMS phase of the protocol, a (51 ± 5) % reduction of HAMD-24 scores from the baseline in the SEM-rTMS group compared with a (34 ± 4)% in the C-rTMS group ((q = 26.09, p = 0.001) and a (14 ± 3)% in Sham-rTMS group (q = 57.53,p = 0.000). The 88% total efficacy ratio in the SEM-rTMS group was significant higher than 68% in the C-rTMS group and 20% in the sham-rTMS group (c2 = 12.01, p = 0.0025). No significant side effects were noted.ConclusionIt is efficient and safe to treat depression with repetitive transcranial magnetic stimulation. (The registration. No: ChiCTR-TRC-00000438).
Effects of Repetitive Transcranial Magnetic Stimulation on Hypothalamic-Pituitary-Adrenal axis of Patients With Depression
Authors: He M. , Gu Z. , Wang X. , Tian X. 
Published: May 2011

ObjectiveTo investigate the effects of sleep electroencephalogram-modulated repetitive transcranial magnetic stimulation (SEM-rTMS) and conventional rTMS (C-rTMS) on the activity of hypothalamic-pituitary-adrenal (HPA) axis in patients with depression.MethodsIn a double-blind, randomized controlled trial, 164 patients diagnosed with depression were randomized to treatment with SEM-rTMS (n = 57), C-rTMS (n = 55) or sham rTMS (n = 52) for 30 min every day for 10 d. Before and after treatment plasma concentrations of adrenocorticotropic hormone (ACTH) and cortisol (CORT) were measured, and the 24-item Hamilton Depression Rating Scale (HAMD-24) was used for assessment.ResultsThe HAMD-24 scores and plasma ACTH and CORT concentrations of these depressive patients before treatment were significantly different from those of the normal control group (P < 0.05). The HAMD-24 scores and plasma ACTH and CORT concentrations in the SEM-r TMS group and conventional rTMS group were decreased significantly (P < 0.05). There was a significant positive correlation between the HAMD-24 scores and plasma ACTH (n = 240, r = 0.105, P = 0.048) and CORT concentrations (n = 240, r = 0.126, P = 0.023) in the patients with depression before and after treatment.ConclusionThe antidepressant effect of rTMS, including SEM-rTMS, may be related to its decreasing HPA axis activity. (This trail was registered. No: ChiCTR-TRC-00000465).
EEG Synchronized TMS for Individualized Therapy in Major Depressive Disorder
Authors: Jin Y. , Phillips J. , Huang Yueqin , Heurta Steven 
Published: May 2011

IntroductionEfficacy of conventional repetitive transcranial magnetic stimulation (rTMS) in major depressive disorder (MDD) is limited. The authors report here on an alternative treatment using low energy synchronized TMS (sTMS) at the intrinsic frequency of subjects’ alpha electroencephalogram (EEG).ObjectivesEstablish efficacy and safety profile of sTMS in MDD.Aim(1)Examine the clinical effectiveness of sTMS.(2)Identify adverse effects associated with sTMS.MethodsFifty-two MDD subjects with 17-item Hamilton Depression Rating Scale (HAMD17) scores >17 were enrolled into a randomized, sham controlled, double-blind trial. Current medication remained unchanged during the trial. Depressive symptoms were evaluated by HAMD17 administered weekly.EEGs were recorded at baseline to determine the stimulus frequency and at week 4 to evaluate the physiological effect. sTMS was delivered through three 6000-G cylindrical neodymium magnets synchronously rotating at a rate equal to the subject's intrinsic alpha frequency.ResultsForty-five subjects completed at least 1 week of treatment and were evaluable. Those who received active treatment had superior clinical response to sham (t = 2.54, P = 0.01), where 55.2% in the active treatment group were clinical responders versus 12.5% in sham (X2 = 7.82, P = 0.005). No significant side effects were reported. The clinical improvement was correlated with the degree of EEG improvement (r = .46, P = 0.009).ConclusionsA therapeutic effect in MDD subjects can be achieved through administration of sTMS at the subject's alpha EEG frequency. Because of minimal side effects, this appears to be a safe and effective treatment option.
Repetitive Transcranial Magnetic Stimulation (rTMS) in the Treatment of Medication-Resistant Neuropatic Pain
Authors: Klírová M. , Fricová J. , Šóš P. , Novák T. , Kohútová B. , Masopust V. , Haeckel M. , Rokyta R. 
Published: May 2011

IntroductionTranscranial magnetic stimulation (TMS) is a non-invasive method that induces functional changes in a relatively small area of the cerebral cortex. It is supposed that the effect of the method in therapy of neuropatic pain is based on the induction of spinothalamic tract inhibiton, which leads to the symptom withdrawal.AimTo prove the clinical and electrophysiological effect of rTMS in the therapy of chronic neuropatic pain.Methods29 patients with medication-resistant neuropatic pain were examined by Visual analog scale (VAS), McGill Pain Questionnaire (MPQ) and QST(Quantitative sensory Testing, consisted of von Frey and thermic treshold examination),then treated by high frequency rTMS in the study using double-blind randomized sham-controlled parallel design. rTMS parameters: 5 rTMS sessions (2 weeks treatment), where each session consisted of three 10 Hz rTMS series using:1)85%MT (motor treshold),2)90%MT and3)95%MT.Each rTMS série consisted of 20 pulses in 12 trains. Location of the active coil was administered over the contralateral motor cortex, directed specifically to facial area of homunculus (according to funcional location). Sham coil was angled 90° degrees away from the skull.ResultsConfirmation of a significant decrease of VAS item in active group, trend to improvement in tactile sensation of severed patient faces. The changes of thermic treshold were not found. Sham rTMS did not show any trend for improvement.ConclusionAlthough no general recommendations can be drawn based on our result, our study is another one that suggest rTMS should be considered as an effective and safe treatment option for chronic neuropatic pain.
Clinically effective ect treatment restores visuospatial learning / memory but not attentional flexibility deficits in patients with major depression
Authors: Kontis D. , Kalogerakou S. , Papakosta V.-M. , Theochari E. , Anyfandi E. , Koutroumpi M. , Michopoulos I. , Oulis P. , Poulopoulou C. , Tsaltas E. 
Published: May 2011

IntroductionWe recently demonstrated that patients with major depression (MDD) with and without electroconvulsive therapy referral (ECTs vs. NECTs) qualitatively differ in neuropsychological profile. ECTs presented severe executive but minor visuospatial memory deficits, suggesting mainly frontostriatal involvement; NECTs presented the opposite pattern, compatible with temporohippocampal involvement. Here we follow up on ECT treatment effects on both cognitive domains.Method15 ECTs were assessed with Hamilton Depression (HAMD-24), Hamilton Anxiety (HAMA) and Mini-Mental State Examination (MMSE) scales and 5 tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB) at hospitalisation (PRE-ECT), immediately after ECT (POST-ECT) and 2 months later (FOLLOW-UP). ECTs at FOLLOW-UP were also compared to 15 matched non-psychiatric CONTROLS who underwent neuropsychological testing once.ResultsThere was significant clinical improvement (reflected by reduced HAMD-24 and HAMA scores: p < 0.001) between PRE-ECT and FOLLOW-UP. After a minor decline POST-ECT, MMSE scores showed significant increase at FOLLOW-UP (p < 0.02). At FOLLOW-UP, Paired Associates Learning (PAL) showed significant improvement (p < 0.001). Stockings of Cambridge (SOC) performance also improved (decrease in early abandonments, p < 0.04) POST-ECT and at FOLLOW-UP. However, clinical improvement did not result in improvement in Intra / Extradimensional Shift (IED): at FOLLOW-UP, ECT patients were indistinguishable from CONTROLS in all neuropsychological measures except IED (p < 0.04).ConclusionsClinically successful ECT treatment was accompanied by improved global cognitive functioning, visuospatial memory and spatial planning, but offered no benefit in attentional flexibility. This residual deficit suggests ‘trait’ frontostriatal involvement in this patient group.
Database of MNI stereotactic coordinates for deep brain stimulation targets in neuropsychiatric disorders
Authors: Moser U. , Savli M. , Lanzenberger R. , Kasper S. 
Published: May 2011

IntroductionDeep brain stimulation (DBS) is a promising therapy option for otherwise treatment-resistant neuropsychiatrie disorders, especially in obsessive-compulsive disorder (OCD), major depression (TRD) and Tourette's Syndrome (TS).ObjectiveThe brain coordinates of the DBS targets are mainly reported using measurements in original, unnormalized brains. In the neuroimaging community stereotactic data are mainly indicated in the standardized Montreal Neurological Institute (MNI) space, i.e. a three-dimensional proportional grid system.AimsImproved comparability between targets in DBS studies and molecular and functional neuroimaging data from PET, SPECT, MRI, fMRI, mostly published with stereotactic data.MethodsA comprehensive and systematic literature search for published DBS case reports or studies in TRD, OCD and TS was performed. We extracted the tip positions of electrode leads as provided in the publications or by the authors, and transferred individual coordinates to the standard brain in the MNI space.Results46 publications fulfilled the inclusion criteria. The main targets for the specific disorders and one or two examples of their calculated MNI coordinates are indicated in the table:[MNI coordinates of the main DBS targets]ConclusionsWe provide DBS data of neuropsychiatrie disorders in the MNI space, improving the comparability to molecular, functional and structural neuroimaging data.
Characterization and findings in the electroconvulsive therapy unit of centro hospitalar psiquiátrico de lisboa (CHPL)
Authors: Moutinho A. , Silva Carvalho F. , Mendonça L. , Cunha I. 
Published: May 2011

IntroductionElectroconvulsive therapy is widely used for treatment-resistant psychiatric patients. There is controversy about the minimum seizure duration required for clinical efficacy.ObjectivesCharacterize socio-demographically the electroconvulsive therapy unit of CHPL; find a correlation between improvement on PSAS, PANSS and HAM-D and both mean seizure duration and mean electric charge used; evaluate outcome in patients with seizure < 20s.MethodsThree groups of patients were created according to ICD-10 diagnosis. The scales mentioned were applied at the beginning and end of the treatment: depressed (F31.3-5; F33; F20.4; F25.1) - HAM-D; schizophrenic/ schizoaffective/ bipolar-manic or mixed (F20.X, F25.X, F31.0, F31.6) - PANSS; with any of these diagnosis: PSAS. The correlation between the improvement on each scale and both mean seizure time and mean electric charge was investigated using the Pearson product-moment correlation coefficient. The groups were subdivided by seizure duration (cut-off 20s) and the mean improvement on the different scales was determined for each subgroup.ResultsThere is no correlation between any of the variables analyzed (α = 0,05). HAM-D variation (N = 102): seizure duration (r = 0,004) and electric charge (r = 0,106). PANSS variation (N = 43): seizure duration (r = 0,07) and electric charge (r = 0,046). PSAS variation (N = 147): seizure duration (r = −0,043) and electric charge (r = 0,143). There is no difference statistically significant in mean HAM-D, PANSS or PSAS improvement between subgroups >20s and < 20s (11.29 vs 13.94; 30.85 vs 29.19 and 19.07 vs 22.65, respectively).ConclusionMean seizure duration and electric charge didn’t correlate with clinical outcome. Seizure duration below 20 seconds didn’t imply poorer outcome.
Barriers to consent taking in ECT
Authors: Pereira S.R. , Slattery A. , Beezhold J. 
Published: May 2011

IntroductionThere were 16,482 administrations of Electro-convulsive Therapy (ECT) to 2835 individuals in England between January-March 1999. Controversy still surrounds the safety, ethics and necessity of ECT with some patients reporting severe adverse effects and feeling particularly strongly about it being administered without their consent. NICE guidelines along with the ECT accreditation service (ECTAS) sought to address these concerns and raise standards for ECT in UK.Aims and ObjectiveTo identify any barriers to compliance with NICE guidelines regarding consent for ECT.MethodsAll patients newly started on ECT during a 3 month period at Hellesdon Hospital were enrolled into this study. Case notes were analysed for 16 patients against the 21 standard ECTAS consent criteria.ResultsThe hospital rated good (70–89%) or excellent (90–100%) for all guidance except the one which requires patients to complete some sections of the consent form. Only 63% of the patients had completed these, however 100% went on to sign the consent form before every session. Guidance compliance was excellent for 15 (72%) of items examined.ConclusionsThere is good compliance with NICE guideline relating to consent for ECT. The only barrier to full compliance was inadequate documentation by patients in some sections. Steps to improve patient participation can now be implemented. This will provide assurance that ECT is used appropriately and that the process fully enables informed consent. Further research is required to discover the reasons for unsatisfactory patient participation in the consent process.
Electroconvulsive therapy treated patients’ and their relatives’ attitudes toward electroconvulsive therapy
Authors: Saran O. , Celik S. , Guloksuz S. , Cakmak D. 
Published: May 2011

IntroductionElectroconvulsive therapy (ECT), which is a safe and effective treatment option for many of the psychiatric illnesses, is still negatively perceived by lay public. It could be hypothesized this negative view can affect the patients and their relatives. This study aimed to evaluate the attitudes of patients’ and their relatives’ toward ECT.MethodsSixty-four ECT treated patients were recruited from inpatient units of Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery. Patients were evaluated with Clinical Global Impression Scale, Mini Mental State Examination and Columbia ECT Subjective Side Effects Schedule. Both patients and their relatives were interviewed by using a questionnaire for assessing attitudes toward ECT.ResultsThe mean number of ECT sessions was 8.50 ± 1.85. The most common side effects according to the patients were subjective feeling of slowed down and memory problems. The majority of both patients and their relatives stated that they had not received adequate information about ECT. Moreover, their knowledge about technique and mechanism of ECT was very limited. However, their overall perception of ECT was very positive. The relatives of the patients were more satisfied with the benefits of ECT than the patients.DiscussionAlthough perception of ECT among patients and their relatives was very positive, it should be noted that this was mostly subjective in regard to inadequate knowledge about ECT. Thus, clinicians should pay utmost attention to inform both patients and their relatives about ECT.
Transcranial direct current stimulation (TDCS) for severe drug resistent major depression: A ten days treatment protocol
Authors: Scelzo E. , Ferrucci R. , Bortolomasi M. , Giacopuzzi M. , Priori A. 
Published: May 2011

IntroductionTranscranial direct current stimulation (tDCS) is a non-invasive and safe neuromodulation technique that induces prolonged excitability changes of the human cerebral cortex. We have shown that patients with severe major depression treated with tDCS twice a day for 5 days improve by some 30% their depressive symptoms.ObjectivesTo optimize the tDCS protocol for the treatment of major depression.AimsTo assess the therapeutic efficacy in severe drug resistant major depression of tDCS over the dorso-lateral prefrontal cortex (DLPC) twice a day for ten days.MethodsWe studied 15 hospitalized patients aged 37–68 years, with severe major depression. Mood was evaluated using the Beck Depression Inventory (BDI) and Visual Analogue Scales (VAS). tDCS was delivered over the DLPC (anodal electrode was placed on F3 and cathodal electrode on F4) at the intensity of 2mA, for 20 minutes, twice a day for 10 days. Depression scales were administered at baseline and after the last tDCS session on day 10. Drug treatments were maintained unchanged since six weeks before the tDCS study.ResultsAfter ten days of tDCS the BDI improved by about 40% [(Mean ± SEM) Before: 29.1 ± 3.5; After: 19.4 ± 3.7, p < 0.01]. The feeling of happyness and sadness as evaluated by VAS improved after tDCS (happiness p < 0.01; Sadness p < 0.05).ConclusionsThe improvement reported by patients after ten-days tDCS protocol is greater than that we previously reported after the five-days tDCS protocol. Hence, our preliminary findings suggest that ten-days tDCS protocol should be preferred to the five-days protocol for major depression.
Repetitive transcranial magnetic stimulation influences mood in healthy male volunteers
Authors: Schaller G. , Lenz B. , Friedrich K. , Dygon D. , Richter-Schmidinger T. , Jacobi A. , Müller S.E. , Maihöfner C. , Sperling W. , Kornhuber J. 
Published: May 2011

IntroductionThe influence of repetitive transcranial magnetic stimulation (rTMS) on mood in healthy people is uncertain, as former studies show divergent results. Previous studies in healthy volunteers focused exclusively on the immediate effect of a single session of rTMS on mood.AimsThe aim of this study was to analyse the influence on mood of a series of 9 High Frequency (HF) rTMS stimulations of the left dorsolateral prefrontal cortex (DLPFC).Methods44 young healthy male volunteers were randomly assigned to receive 9 sessions of active HF-rTMS (n = 22) or sham rTMS (n = 22) over the left DLPFC. Each session in the active group consisted of 15 trains of 25 Hz starting with 100% of motor threshold. Sham stimulation was performed following the same protocol, but using a sham coil. The variables of interest were the Beck Depression Inventory (BDI) and Visual Analogue Scales (VAS) which quantified “mood”, “enjoyment” and “energy”.ResultsWe found a significant reduction of the BDI score in the active group (GLM, p < 0.001) whereas no significant changes of the BDI score were caused by sham stimulation (GLM, p = 0.109). We did not find significant differences caused by active or sham stimulation in VAS scales except for the VAS labelled lively/gloomy immediately after stimulation. The active group was found to be more “gloomy” (p = 0.001).ConclusionsOur data support the hypothesis that a 9-day long series of HF-rTMS of the left DLPFC improves mood, analysed by BDI in healthy young men.