Journal of psychiatric research
-
tDCS is a promising novel therapeutic intervention for major depression (MD). However, clinical trials to date have reported conflicting results concerning its efficacy, which likely resulted from low statistical power. Thus, we carried out a systematic review and meta-analysis on randomized, double-blind and controlled trials of tDCS in MD with a focus on clinically relevant outcomes, namely response and remission rates. ⋯ The clinical utility of tDCS as a treatment for MD remains unclear when clinically relevant outcomes such as response and remission rates are considered. Future studies should include larger and more representative samples, investigate how tDCS compares to other therapeutic neuromodulation techniques, as well as identify optimal stimulation parameters.
-
Randomized Controlled Trial
Unilateral repetitive transcranial magnetic stimulation of the motor cortex does not affect cognition in patients with fibromyalgia.
Repetitive transcranial magnetic stimulation (rTMS) induces changes in neuronal activity that may affect cognition. We assessed cognitive functions, in patients with fibromyalgia participating in a sham-controlled randomized trial of rTMS for pain management. We randomly assigned 38 non depressed fibromyalgia patients (American College of Rheumatology criteria) to the active (n = 20) and sham (n = 18) rTMS treatment groups, in a double-blind manner. rTMS was applied to the left primary motor cortex (10 Hz at 80% of rest motor threshold). ⋯ The actively treated and sham-treated groups were similar in terms of clinical and neuropsychological variables at baseline. No difference in overall neuropsychological performance with respect to baseline was found between these two groups, but a significant improvement over time was observed in the rTMS group, for several measurements of attention/executive function (the Symbol Digit Modalities Test and the Stroop Color Word Test). Unilateral rTMS of the motor cortex over a three-month period did not modify cognitive functions in patients with chronic pain. rTMS may have mild beneficial cognitive effects, but confirmation is required in larger groups of patients.