BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation RSS feed: Current Issue. BRAIN STIMULATION aims to be the premier journal for publication of original research in the field of neuromodulation. The journal includes: a) original articles (up to 5,000 words); b) brief reports (up to 2,000 words); c) invited and original reviews; d) technology and methodological perspectives (reviews of new devices, description of new methods, etc.); and e) letters to the Editor. Special issues of the journal will be considered based on scientific merit. The scope of BRAIN STIMULATION extends across the entire field of brain stimulation, including noninvasive and invasive techniques and technologies that alter brain function through the use of electrical, magnetic, radiowave, or focally targeted pharmacologic stimulation. This includes investigations that study the effects of brain stimulation on basic processes, such as gene expression and other aspects of molecular biology, neurochemical regulation, functional brain activity, sensorimotor function, and cognitive and affective processes at the systems level. The journal seeks the highest level of research on the biophysics and biopsychophysics of stimulation paradigms as well as the use of these techniques as a probe to outline patterns of neural connectivity. As an equal partner with this basic emphasis, the journal will have strong representation of research on the therapeutic potential and adverse effects of the stimulation technologies. The inclusion of research in therapeutics will represent not only clinical trials, but also conceptual pieces, discussions of ethics as they pertain to this field, services research, etc. http://www.brainstimjrnl.com/?rss=yesElsevier Inc.en © 2010 Elsevier Inc. All rights reserved. BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation1935-861X31January 2010 © 2010 Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.brainstimjrnl.com/article/PIIS1935861X10000033/abstract?rss=yesThe field of brain stimulation continues to expand and grow both clinically and as neuroscience research tools. With Volume 3, the Brain Stimulation editorial board has now processed well over 100 manuscripts. On average, authors are notified of the initial decisions within 4 weeks from submission, and a new online publication (epub) system helps insure that the community rapidly learns of important new brain stimulation-related science. The overall rejection rate is 30% (higher for unsolicited manuscripts). I hope you will find the contents of Volume 3, Issue 1, both interesting and informative as we march into a new decade.From the Editor-in-Chief's Desk Brain Stimulation enters a new decade with Volume 3Mark S. George10.1016/j.brs.2010.01.002BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation 3, 1 (2010)2010-01-20BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation2010-01-2031S1935-861X(09)X0005-7Editorial11http://www.brainstimjrnl.com/article/PIIS1935861X09000503/abstract?rss=yesBackground: Many recent studies have used repetitive transcranial magnetic stimulation (rTMS) to study brain-behavior relationships. However, the pulse-to-pulse neural effects of rapid delivery of multiple TMS pulses are unknown largely because of TMS-evoked electrical artifacts limiting recording of brain activity.Objective: In this study, TMS-related artifacts were removed with independent component analysis (ICA), which allowed for the investigation of the neurophysiologic effects of rTMS with simultaneous electroencephalographic (EEG) recordings.Methods: Repetitive TMS trains of 10Hz, 3 seconds (110% of motor threshold) were delivered to the postcentral gyrus and superior parietal lobule in 16 young adults. Simultaneous EEG recordings were made with a TMS-compatible system. The stereotypical pattern of TMS-related electrical artifacts was identified by ICA.Results: Removal of artifacts allowed for identification of a series of five evoked brain potentials occurring within 100 milliseconds of each TMS pulse. With the exception of the first potential, for both areas targeted, there was a quadratic relationship between potential peak amplitude and pulse number within the TMS train. This was characterized by a decrease, followed by a rise in amplitude.Conclusions: ICA is an effective method for removal of TMS-evoked electrical artifacts in EEG data. With the use of this procedure we found that the physiologic responses to TMS pulses delivered in a high-frequency train of pulses are not independent. The sensitivity of the magnitude of these responses to recent stimulation history suggests a complex recruitment of multiple neuronal events with different temporal dynamics.Brain responses evoked by high-frequency repetitive transcranial magnetic stimulation: An event-related potential studyMassihullah Hamidi, Heleen A. Slagter, Giulio Tononi, Bradley R. Postle10.1016/j.brs.2009.04.001BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation 3, 1 (2010)2009-05-08BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation2009-05-0831S1935-861X(09)X0005-7Original Research214http://www.brainstimjrnl.com/article/PIIS1935861X09000527/abstract?rss=yesBackground: The effect of various drugs was investigated by using transcranial magnetic stimulation (TMS) both in healthy subjects and patients, and the results indicated an influence of antidepressant drugs (ADs) on motor excitability.Objective: The aim of our study was to analyze the effects of two ADs, the tricyclic (TCA) clomipramine and the serotoninergic antidepressant (SSRI) citalopram on the motor cortex excitability in major depressed patients with TMS.Methods: Thirty affected subjects were placed into three groups: two received an intravenous dose of 25 mg clomipramine or 40 mg citalopram, and one received an injection of a placebo. Motor cortex excitability was studied by single and paired TMS before and after 3.5, 8, and 24 hours from administration of the drugs and placebo. Motor cortical excitability was measured using different TMS parameters: resting motor threshold (RMT), motor-evoked potential (MEP) amplitude, intracortical inhibition (ICI), and intracortical facilitation (ICF).Results: The results indicated a temporary but significant increase of RMT and ICI and a decrease of ICF after the administration of both drugs, with a longer inhibition for the clomipramine rather than the citalopram. MEP amplitude was not significantly affected by the antidepressant injections.Conclusions: Our findings highlight that a single intravenous dose of clomipramine or citalopram exerts a significant but transitory suppression of motor cortex excitability in depressed patients. TMS represents a useful research tool in assessing the effects of motor cortical excitability of drugs used in the treatment of mental disorders.Effects of intravenous antidepressant drugs on the excitability of human motor cortex: a study with paired magnetic stimulation on depressed patientsAlessandra Minelli, Marco Bortolomasi, Catia Scassellati, Beatrice Salvoro, Mirko Avesani, Paolo Manganotti10.1016/j.brs.2009.04.003BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation 3, 1 (2010)2009-05-25BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation2009-05-2531S1935-861X(09)X0005-7Original Research1521http://www.brainstimjrnl.com/article/PIIS1935861X09000539/abstract?rss=yesBackground: Motor cortex stimulation has been proposed for treatment of amyotrophic lateral sclerosis (ALS) and preliminary studies have reported a slight reduction of disease progression using both invasive and noninvasive repetitive stimulation of the motor cortex.Objective: The aim of this proof of principle study was to investigate the effects of motor cortex stimulation performed for a prolonged period (about 2 years) on ALS progression.Methods: Two patients were included in the study; the first patient was treated with monthly cycles of repetitive transcranial magnetic stimulation (rTMS) and the second one was treated with chronic epidural motor cortex stimulation. The rate of progression of the disease before and during treatment was compared.Results: The treatments were well tolerated by the patients. Both patients deteriorated during treatment; however, the patient treated with rTMS showed a slight reduction in deterioration rate.Conclusions: Although we cannot be sure whether the effects observed in the patient treated with rTMS can be attributed to this form of stimulation, our study set the groundwork for possible future studies investigating the effects of rTMS, for a prolonged period, on a larger group of ALS patients.Long-term motor cortex stimulation for amyotrophic lateral sclerosisVincenzo Di Lazzaro, Michele Dileone, Fabio Pilato, Paolo Profice, Beatrice Cioni, Mario Meglio, Fabio Papacci, Mario Sabatelli, Gabriella Musumeci, Federico Ranieri, Pietro A. Tonali10.1016/j.brs.2009.04.004BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation 3, 1 (2010)2009-05-25BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation2009-05-2531S1935-861X(09)X0005-7Original Research2227http://www.brainstimjrnl.com/article/PIIS1935861X09000540/abstract?rss=yesBackground: Treatment options are limited in patients with severe, chronic, posttraumatic stress disorder (PTSD). There is little information on the use of electroconvulsive therapy (ECT) for PTSD.Methods: Between January 1, 2005, and December 31, 2005, all consenting adults (n=20) with severe, chronic, extensively antidepressant-refractory PTSD were prospectively treated with a fixed course of 6 bilateral ECT treatments administered on an outpatient basis at a twice-weekly frequency. The primary outcome measure was improvement on the Clinician-Administered Posttraumatic Stress Disorder Scale (CAPS). Baseline refractoriness was defined as a failure to respond to an adequate course of at least 4 different antidepressant drugs along with 12 sessions of cognitive behavior therapy. Response to ECT was defined as at least 30% attenuation of CAPS ratings, and remission as an endpoint CAPS score of 20 or less. After ECT, patients were prescribed sertraline (100-150mg/day) or mirtazapine (15-30mg/day).Results: All but 3 patients completed the ECT course. An intent-to-treat analysis (n=20) showed statistically and clinically significant improvement in the sample as a whole: CAPS scores decreased by a mean of 34.4%, and depression scores by a mean of 51.1%. Most of the improvement in CAPS and depression ratings developed by the third ECT; that is, by day 10 of treatment, itself. The improvement in CAPS ratings was independent of the improvement in depression ratings; and improvement in CAPS did not differ significantly between patients with less severe vs more severe baseline depression. The response rate was 70%; no patient remitted. In the completer analysis (n=17), mean improvements were 40% and 57% for CAPS and depression ratings, respectively, and the response rate was 82%. Treatment gains were maintained at a 4-6 month follow-up.Conclusions: ECT may improve the core symptoms of PTSD independently of improvement in depression, and may therefore be a useful treatment option for patients with severe, chronic, medication- and CBT-refractory PTSD. (http://clinicaltrials.gov; Trial Identifier: NCT00739856)Efficacy of ECT in Chronic, Severe, Antidepressant- and CBT-Refractory PTSD: An Open, Prospective StudyMushtaq A. Margoob, Zaffar Ali, Chittaranjan Andrade10.1016/j.brs.2009.04.005BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation 3, 1 (2010)2009-05-28BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation2009-05-2831S1935-861X(09)X0005-7Original Research2835http://www.brainstimjrnl.com/article/PIIS1935861X09000552/abstract?rss=yesBackground: Postpartum depression (PPD) is a prevalent illness, affecting 10-15% of new mothers. PPD is the most common complication of childbirth and is a significant public health concern. It is known to adversely impact maternal-infant bonding, childrearing practices, and can lead to suicide and infanticide. The current treatment approaches to PPD are suboptimal. Many mothers are reluctant to take medication because of concerns about side effects or exposure of their newborn infant through breastfeeding. The specific aims of this study were to (1) examine acute treatment effectiveness, (2) examine response durability, and (3) assess an effect of repetitive transcranial magnetic stimulation (rTMS) on maternal bonding.Methods: Nine antidepressant-free women with PPD were given 20 rTMS treatments over 4 weeks (10Hz, 120% motor threshold, left dorsolateral prefrontal cortex). Multiple characteristics were assessed at baseline and throughout treatment. Duration of effect was assessed at 30 days, 3 months and 6 months posttreatment.Results: Friedman's tests were conducted on Hamilton Rating Scale for Depression-24 item (HRSD-24), Edinburgh Postnatal Depression Scale (EPDS), Inventory of Depressive Symptomatology-Self-Report (IDS-SR) and Clinical Global Impressions-Severity (CGI-S) scores to compare performances at four time points (baseline, end of Week 2, end of Week 4, and 180-day follow-up). Overall, these results revealed a significant reduction in depressive symptoms by the end of Week 2 of treatment. Analyses yielded a medium effect size (r=0.68) on the primary outcome variable (HRSD-24). Of note, all nine patients remained in treatment for the complete 4 weeks, did not miss any treatment sessions and eight participants achieved remission of symptoms, defined as a HRSD<10 and a CGI-S=1. Analysis of follow-up data indicated robustness of the rTMS treatment over time. At 6-month follow-up, of the eight women that remitted, seven remained in remission without further psychiatric intervention, including the addition of medication and one was lost to follow-up. Results also indicated a significant improvement in bonding.Conclusions: Our results demonstrate promising results for the use of rTMS in the treatment of PPD. Further randomized, sham-controlled studies need to be completed.Repetitive transcranial magnetic stimulation treats postpartum depressionKeith S. Garcia, Patricia Flynn, Katherine J. Pierce, Marty Caudle10.1016/j.brs.2009.06.001BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation 3, 1 (2010)2009-07-09BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation2009-07-0931S1935-861X(09)X0005-7Original Research3641http://www.brainstimjrnl.com/article/PIIS1935861X0900059X/abstract?rss=yesBackground: Because we are interested in noninvasive transcranial brain stimulation as an adjuvant to poststroke walking therapy, we applied transcranial direct current stimulation (tDCS) preferentially to either the left or right lower limb motor cortex (M1) in two separate sessions and assessed the resulting modulation in both cortices.Objective: We hypothesized that tDCS applied preferentially to one lower limb M1 of healthy subjects would induce between-hemisphere opposite sign modulation.Methods: Transcranial magnetic stimulation (TMS) with the coil offset 2cm either side of vertex was used to assess the percentage of change in the rectified motor-evoked potential (MEP) area recorded bilaterally from the vastus lateralis (VL) and tibialis anterior (TA) of 10 subjects during weak tonic contraction.Results: Analysis of variance (ANOVA) revealed an up-regulation of the target cortex and a down-regulation of the nontarget cortex (P=.001) and no effects of hemisphere (left, right) or muscle (TA, VL). Significant modulation was evident in 78% of VL and TA muscles (all P < .05). Excitability increased in 60%, but decreased in 18%. For 43% when excitability increased, a simultaneous decrease in excitability was evident in homologous muscle responses providing support for our hypothesis.Conclusions: The results indicate a modest effectiveness and focality of anodal tDCS when applied to lower limb M1, suggesting in a human model that the strength and depth of polarizing cortical currents induced by tDCS likely depend on interindividual differences in the electrical properties of superficial brain structures.Focal and bidirectional modulation of lower limb motor cortex using anodal transcranial direct current stimulationSangeetha Madhavan, James W. Stinear10.1016/j.brs.2009.06.005BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation 3, 1 (2010)2009-08-12BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation2009-08-1231S1935-861X(09)X0005-7Original Research4250http://www.brainstimjrnl.com/article/PIIS1935861X09000795/abstract?rss=yesRight unilateral ultra-brief electroconvulsive therapy (RUL UB ECT) has been shown to be efficacious with minimal cognitive adverse effects in adult patients with major depression. We present the case of a 14-year-old girl with major depressive disorder with catatonic and psychotic features whose symptoms remitted after 12 treatments of RUL UB ECT.The successful use of right unilateral ultra-brief pulse electroconvulsive therapy in an adolescent with catatoniaJesse C. Rhoads, Nicholas A. Votolato, James L. Young, Richard H. Gilchrist10.1016/j.brs.2009.07.003BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation 3, 1 (2010)2009-08-12BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation2009-08-1231S1935-861X(09)X0005-7Original Research5153http://www.brainstimjrnl.com/article/PIIS1935861X09000436/abstract?rss=yesDepressed patients are currently treated with daily high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) sessions applied to the left dorsolateral prefrontal cortex (DLPFC), spread over a period of 2 weeks or more. An important aspect of the physiology of rTMS could be related to the endocrinologic response of the hypothalamic-pituitary-adrenal (HPA) system. Keck proposed that TMS influences occur at the hypothalamic level, suggesting that the prefrontal cortex participates in the rTMS-induced blunted response of HPA activity.A “hypersensitive” hypothalamic-pituitary-adrenal system could be indicative for a negative clinical high-frequency repetitive transcranial magnetic stimulation outcome in melancholic depressed patientsChris Baeken, Rudi De Raedt, Marie-Anne Vanderhasselt, Lemke Leyman, Johan Schiettecatte, Kris Poppe, Ellen Anckaert, Axel Bossuyt10.1016/j.brs.2009.03.008BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation 3, 1 (2010)2009-05-01BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation2009-05-0131S1935-861X(09)X0005-7Short Communication5457http://www.brainstimjrnl.com/article/PIIS1935861X09000515/abstract?rss=yesTo the Editor: Transcranial direct current stimulation (tDCS) has been reintroduced as a noninvasive method to guide neuroplasticity and modulate cortical function by tonic stimulation with weak direct currents. Within the last several years, it has received increasing attention as an innovative tool for the treatment of a variety of neurologic and psychiatric diorders. Adverse effects have been reported to be rare, mild, and transient under the application of tDCS, according to the present tDCS safety guidelines. Concerning the skin, contact transient irritations such as light itching, slight burning, mild pain, and transient redness have been documented.Anodal skin lesions after treatment with transcranial direct current stimulationElmar Frank, Sylvia Wilfurth, Michael Landgrebe, Peter Eichhammer, Göran Hajak, Berthold Langguth10.1016/j.brs.2009.04.002BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation 3, 1 (2010)2009-05-21BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation2009-05-2131S1935-861X(09)X0005-7Letters to the Editor5859http://www.brainstimjrnl.com/article/PIIS1935861X0900076X/abstract?rss=yesTo the Editor: A placebo is “a substance or procedure…that is objectively without specific activity for the condition being treated.” Placebos are used in an attempt to cancel out the effects of knowledge and expectation, which are known to be powerful.TMS placebos and pathophysiologic conditionsSaxby Pridmore, Prosper Abusah10.1016/j.brs.2009.07.001BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation 3, 1 (2010)2009-08-13BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation2009-08-1331S1935-861X(09)X0005-7Letters to the Editor6060http://www.brainstimjrnl.com/article/PIIS1935861X09000783/abstract?rss=yesTo the Editor: Hardware complications have been reported since the beginning of deep brain stimulation (DBS) use for Parkinson's disease. Most reports include infectious complications and disconnections of the DBS system. We report an unusual case in which hardware dysfunction was revealed by transient positive symptoms. Its diagnostic, probable cause and management are discussed.Paroxysmal positive symptoms caused by hardware malfunctioning in deep brain stimulationDaniel Ciampi de Andrade, Jean-Marc Gurruchaga, Bechir Jarraya, Colette Goujon, Yara Beaugendre, Hélène Lepetit, Naoki Tani, Tomasz Mandat, Krassen Kirov, Gilles Fenelon, Pierre Brugières, Stéphane Palfi10.1016/j.brs.2009.07.002BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation 3, 1 (2010)2009-08-13BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation2009-08-1331S1935-861X(09)X0005-7Letters to the Editor6162http://www.brainstimjrnl.com/article/PIIS1935861X09001168/abstract?rss=yesTable of Contents10.1016/S1935-861X(09)00116-8BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation 3, 1 (2010)2010-01-01BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation2010-01-0131S1935-861X(09)X0005-7FrontmatterA1A1http://www.brainstimjrnl.com/article/PIIS1935861X09001156/abstract?rss=yesEditorial Board10.1016/S1935-861X(09)00115-6BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation 3, 1 (2010)2010-01-01BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation2010-01-0131S1935-861X(09)X0005-7FrontmatterA2A2http://www.brainstimjrnl.com/article/PIIS1935861X0900117X/abstract?rss=yesInformation for Authors10.1016/S1935-861X(09)00117-XBRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation 3, 1 (2010)2010-01-01BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation2010-01-0131S1935-861X(09)X0005-7FrontmatterA3A6