Neuromodulation : journal of the International Neuromodulation Society
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Review Practice Guideline
Transcranial Magnetic Stimulation for Pain, Headache, and Comorbid Depression: INS-NANS Expert Consensus Panel Review and Recommendation.
While transcranial magnetic stimulation (TMS) has been studied for the treatment of psychiatric disorders, emerging evidence supports its use for pain and headache by stimulating either motor cortex (M1) or dorsolateral prefrontal cortex (DLPFC). However, its clinical implementation is hindered due to a lack of consensus in the quality of clinical evidence and treatment recommendation/guideline(s). Thus, working collaboratively, this multinational multidisciplinary expert panel aims to: 1) assess and rate the existing outcome evidence of TMS in various pain/headache conditions; 2) provide TMS treatment recommendation/guidelines for the evaluated conditions and comorbid depression; and 3) assess the cost-effectiveness and technical issues relevant to the long-term clinical implementation of TMS for pain and headache. ⋯ After extensive literature review, the panel provided recommendations and treatment guidelines for TMS in managing neuropathic pain and headaches. In addition, the panel also recommended more outcome and cost-effectiveness studies to assess the feasibility of the long-term clinical implementation of the treatment.
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There is a great public health need to identify novel treatment strategies for opioid use disorder (OUD) in order to reduce relapse and overdose. Noninvasive brain stimulation (NIBS) has demonstrated preliminary effectiveness for substance use, but little is known about its use in OUD. Neuromodulation may represent a potential adjunctive treatment modality for OUD, so we conducted a systematic review to understand the state of the current research in this field. ⋯ There is a dearth of research in the area of noninvasive brain stimulation for OUD. NIBS represents a novel treatment modality that should be further investigated for OUD.
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Randomized Controlled Trial
The Effects of Anodal Transcranial Direct Current Stimulation on the Walking Performance of Chronic Hemiplegic Patients.
To evaluate the effect of a single session of tDCS over the primary motor cortex of the lower limb (M1-LL) vs. placebo on the walking performance in chronic hemiplegic patients. ⋯ The authors reported no conflict of interest.
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Patients with major depressive disorder (MDD) who received electroconvulsive therapy (ECT) often seek transcranial magnetic stimulation (TMS) therapy as a less invasive treatment option. How prior history of ECT and its responsiveness may affect TMS treatment outcomes for MDD is unclear. We aim to contribute evidence to this important clinical question. ⋯ Although limited by the retrospective nature of this analysis, the results suggest that history of the past ECT, regardless of responsiveness to ECT, may not independently portend differential TMS treatment outcomes.
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The methodology used for the application of repetitive transcranial magnetic stimulation (TMS) is such that it may induce a placebo effect. Respectively, adverse events (AEs) can occur when using a placebo, a phenomenon called nocebo. The primary aim of our meta-analysis is to establish the nocebo phenomena during TMS. Safety and tolerability of TMS were also studied. ⋯ TMS is a safe and well-tolerated intervention. Nocebo phenomena do occur during TMS treatment and should be acknowledged during clinical trial design and daily clinical practice.