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Low and high frequency repetitive transcranial magnetic stimulation on the quality of sleep in patients with major depression
Abstracts / Brain Stimulation 10 (2017) 346e540
Results: Compared to adolescents with no history of suicidal behavior, those with a history of lifetime suicidal behavior had significantly shorter CSP (z¼-2.05, p¼0.0408) and less LICI at 100 ms (z¼2.97, p¼0.0030) and 150 ms (z¼2.72, p¼0.0065) interstimulus intervals. No differences between groups were observed on RMT, SICI, or ICF measures. Discussion: These preliminary data suggest that adolescents with suicidal behavior may have deficits in cortical inhibitory functions, particularly those mediated by the GABAB receptor. Future research should explore whether these GABAergic deficits represent a baseline trait of individuals with suicidal behavior and whether GABAergic inhibitory deficits can indicate acute exacerbations in suicide risk. TMS measures of cortical inhibition show potential as future biomarkers in the assessment of suicide risk. Keywords: cortical inhibition, suicide, transcranial magnetic stimulation, adolescent [0614] LOW AND HIGH FREQUENCY REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION ON THE QUALITY OF SLEEP IN PATIENTS WITH MAJOR DEPRESSION ndez 1, A. Rodríguez J.A. Moo Estrella*1, A. Carrillo Sulub 1, A. Buenfil Herna lez Olvera 2. 1 Autonomous University of Yucatan, Mexico; mara 1, J. Gonza Ca 2 National Institute of Psychiatry Ramon de la Fuente, Mexico Introduction: Sleep disorders are common in depression, present between 50 and 90 % of patients. Insomnia increase the severity of major depressive disorder (MDD), affects response to treatment and raises risk of relapse. Low and High frecuency repetitive transcranial magnetic stimulation (rTMS) seems to be effective for depression treatment, however, some confusion remains about the best parameters to apply in depression associated to sleep disorders. Objective was to determine the effect of low and high frequency rTMS on the sleep quality in patients with depression. Method: Twenty patients, conforming to meet the Diagnostic and Statistical Manual of Mental Disorders criteria for MDD, divided into two groups of rTMS treatment (80% threshold motor), either 15 sessions of 1Hz rTMS applied over the right dorsolateral prefrontal cortex (RDLPFC) or 15
Ă
495
sessions of 5Hz rTMS, applied over the left dorsolateral prefrontal cortex (LDLPFC). In order to compare changes prior and after treatment, the Pittsburgh sleep quality index (PSQI) and insomnia severity index (ISI) were used. Result: ISI reduces with 1hz rTMS treatment (pre ¼ 17.2 ± 6.89, post ¼ 11.0 ± 5.88, p ¼ .011), but not with 5hz rTMS (pre ¼ 15.2 ± 5.37, post ¼ 11.6 ± 5.54, p ¼ .011). Similar results were obtained in the PSQI: 1hz) pre ¼ 14.0 ± 4.94, post ¼ 10.77 ± 2.53 (p ¼ .047) and 5hz) pre ¼ 12.9 ± 3.84, post ¼ 10.8 ± 4.23, (p ¼ .168). Discussion: The results suggest that treatment with low frequency rTM could be more effective in treating depression accompanied of sleep disorders. Keywords: Insomnia, Depression, Low and high fecuency rTMS [0615] HIGH-RESOLUTION ELECTROPHYSIOLOGIC RECORDING DURING DEEP BRAIN STIMULATION SURGERY USING A CUSTOM HYBRID ELECTRODE A.L. Hewitt*, S.M. Stead, B.T. Klassen. Mayo Clinic, USA Introduction: Deep brain stimulation (DBS) is a highly effective therapy for medically refractory Parkinson’s disease and essential tremor, although the precise mechanism by which electrical stimulation exerts its influence remains elusive. Precise electrode placement is critical to avoid stimulation side effects and achieve efficacy. Currently, targeting is achieved based on fitting preoperative imaging to stereotactic atlas coordinates. Actual lead placement is confirmed based upon single-contact microelectrode recordings and intraoperative test stimulation. This can be a timeconsuming process and may require multiple penetrations of brain tissue, raising the intraoperative risks. Requiring separate electrodes for recording and stimulating also limits investigations of how the stimulation affects local neuronal firing. Methods: To address these issues, we have designed a custom single-use hybrid electrode (figure 1) with the ability to simultaneously record multiunit potential activity from microcontacts as well as local field potentials (LFPs) from both microelectrode and macrocontacts. The four macrocontacts are spaced identically to those on the permanently
Results: Compared to adolescents with no history of suicidal behavior, those with a history of lifetime suicidal behavior had significantly shorter CSP (z¼-2.05, p¼0.0408) and less LICI at 100 ms (z¼2.97, p¼0.0030) and 150 ms (z¼2.72, p¼0.0065) interstimulus intervals. No differences between groups were observed on RMT, SICI, or ICF measures. Discussion: These preliminary data suggest that adolescents with suicidal behavior may have deficits in cortical inhibitory functions, particularly those mediated by the GABAB receptor. Future research should explore whether these GABAergic deficits represent a baseline trait of individuals with suicidal behavior and whether GABAergic inhibitory deficits can indicate acute exacerbations in suicide risk. TMS measures of cortical inhibition show potential as future biomarkers in the assessment of suicide risk. Keywords: cortical inhibition, suicide, transcranial magnetic stimulation, adolescent [0614] LOW AND HIGH FREQUENCY REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION ON THE QUALITY OF SLEEP IN PATIENTS WITH MAJOR DEPRESSION ndez 1, A. Rodríguez J.A. Moo Estrella*1, A. Carrillo Sulub 1, A. Buenfil Herna lez Olvera 2. 1 Autonomous University of Yucatan, Mexico; mara 1, J. Gonza Ca 2 National Institute of Psychiatry Ramon de la Fuente, Mexico Introduction: Sleep disorders are common in depression, present between 50 and 90 % of patients. Insomnia increase the severity of major depressive disorder (MDD), affects response to treatment and raises risk of relapse. Low and High frecuency repetitive transcranial magnetic stimulation (rTMS) seems to be effective for depression treatment, however, some confusion remains about the best parameters to apply in depression associated to sleep disorders. Objective was to determine the effect of low and high frequency rTMS on the sleep quality in patients with depression. Method: Twenty patients, conforming to meet the Diagnostic and Statistical Manual of Mental Disorders criteria for MDD, divided into two groups of rTMS treatment (80% threshold motor), either 15 sessions of 1Hz rTMS applied over the right dorsolateral prefrontal cortex (RDLPFC) or 15
Ă
495
sessions of 5Hz rTMS, applied over the left dorsolateral prefrontal cortex (LDLPFC). In order to compare changes prior and after treatment, the Pittsburgh sleep quality index (PSQI) and insomnia severity index (ISI) were used. Result: ISI reduces with 1hz rTMS treatment (pre ¼ 17.2 ± 6.89, post ¼ 11.0 ± 5.88, p ¼ .011), but not with 5hz rTMS (pre ¼ 15.2 ± 5.37, post ¼ 11.6 ± 5.54, p ¼ .011). Similar results were obtained in the PSQI: 1hz) pre ¼ 14.0 ± 4.94, post ¼ 10.77 ± 2.53 (p ¼ .047) and 5hz) pre ¼ 12.9 ± 3.84, post ¼ 10.8 ± 4.23, (p ¼ .168). Discussion: The results suggest that treatment with low frequency rTM could be more effective in treating depression accompanied of sleep disorders. Keywords: Insomnia, Depression, Low and high fecuency rTMS [0615] HIGH-RESOLUTION ELECTROPHYSIOLOGIC RECORDING DURING DEEP BRAIN STIMULATION SURGERY USING A CUSTOM HYBRID ELECTRODE A.L. Hewitt*, S.M. Stead, B.T. Klassen. Mayo Clinic, USA Introduction: Deep brain stimulation (DBS) is a highly effective therapy for medically refractory Parkinson’s disease and essential tremor, although the precise mechanism by which electrical stimulation exerts its influence remains elusive. Precise electrode placement is critical to avoid stimulation side effects and achieve efficacy. Currently, targeting is achieved based on fitting preoperative imaging to stereotactic atlas coordinates. Actual lead placement is confirmed based upon single-contact microelectrode recordings and intraoperative test stimulation. This can be a timeconsuming process and may require multiple penetrations of brain tissue, raising the intraoperative risks. Requiring separate electrodes for recording and stimulating also limits investigations of how the stimulation affects local neuronal firing. Methods: To address these issues, we have designed a custom single-use hybrid electrode (figure 1) with the ability to simultaneously record multiunit potential activity from microcontacts as well as local field potentials (LFPs) from both microelectrode and macrocontacts. The four macrocontacts are spaced identically to those on the permanently