ObjectiveTo systematically review the efficacy of different stimulation modalities of repetitive transcranial magnetic stimulation (rTMS) combined with SSRI in improving depressed mood after stroke using network meta-analysis. MethodsThe PubMed, EMbase, Cochrane Library, Web of Science, CNKI, VIP, CBM and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) related to the objectives from inception to October 1, 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Network meta-analysis was then performed by using R 4.2.1software. ResultsA total of 25 RCTs involving 2 152 patients were included. Four types of rTMS stimulation combined with SSRIs were included: high-frequency stimulation of the left dorsolateral prefrontal (l-DLPFC), low-frequency stimulation of l-DLPFC, low-frequency stimulation of the right dorsolateral prefrontal (r-DLPFC), and low-frequency stimulation of the bilateral DLPFC. The results of the network meta-analysis showed that the effect of combining four stimulation methods with SSRI in treating depression was better than that of SSRI alone (P<0.05). Probability sorting results showed that low-frequency stimulated bilateral DLPFC (88.9%) > low-frequency stimulated l-DLPFC (63.1%) > high-frequency stimulation l-DLPFC (57.1%) > low-frequency stimulation r-DLPFC (40.4%). There was no statistically significant difference in the incidence of adverse reactions between the four stimulation methods combined with SSRI and the use of SSRI alone (P>0.05). Conclusion rTMS combined with SSRIs is better than SSRIs alone in improving depressed mood after stroke. Low-frequency rTMS stimulation of bilateral DLPFC may be the best. Meanwhile, the safety of different stimulation methods is good.
In the treatment of drug-refractory epilepsy in children, surgical treatment has a good clinical effect. However, for children whose surgical site is difficult to determine and who cannot undergo resectional surgery, neuromodulation techniques are one of the treatments that can be considered. At present, new neuromodulation technologies in children mainly include transcutaneous vagus nerve stimulation (transcutaneous auricular vagus nerve stimulation, ta-VNS), deep brain stimulation (deep brain stimulation, DBS), reactive nerve stimulation (responsive neurostimulation, RNS), transcranial magnetic stimulation (transcranial magnetic stimulation, TMS), transcranial direct current stimulation (transcranial direct current stimulation, TDCS) and transcranial alternating current stimulation (transcranial alternating current stimulation, TACS). This article briefly discussed the clinical efficacy and safety of various currently available neuromodulation technologies, so as to provide a reference for the rational selection and application of neuromodulation technologies, and improve the clinical efficacy and quality of life of children with drug-refractory epilepsy.
ObjectivesTo systematically review the efficacy of repetitive transcranial magnetic stimulation (rTMS) on rehabilitation of unilateral neglect in stroke patients.MethodsPubMed, The Cochrane Library, PEDro, EMbase, CNKI, WanFang Data and VIP databases were searched online for randomized controlled trials (RCTs) of rTMS on rehabilitation of unilateral neglect in stroke patients from inception to March 2017. Two reviewers independently screened literature, extracted data and assessed the quality of included studies. Meta-analysis was then performed by using RevMan 5.3 software.ResultsA total of 12 RCTs involving 303 patients were included. The results of meta-analysis showed that: the stimulate group was superior to the control group in line bisection test (MD=–5.54, 95%CI –6.79 to –4.29, P<0.000 01), line cancellation test (MD=–3.75, 95%CI –4.60 to –2.90,P<0.000 1) and star cancellation test (MD=–22.94, 95%CI –26.52 to –19.35,P<0.000 01). However, there was no significant difference in the score of the modified Barthel index between two groups (MD=3.91, 95%CI–9.52 to 17.34,P=0.57).ConclusionsrTMS appears to improve the symptoms of unilateral neglect in stroke patients. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusions.
The therapeutic effects of transcranial magnetic stimulation (TMS) are closely related to the structure of the stimulation coil. Based on this, this study designed an A-word coil and proposed a multi-strategy fusion multi-objective slime mould algorithm (MSSMA) aimed at optimizing the stimulation depth, focality, and intensity of the coil. MSSMA significantly improved the convergence and distribution of the algorithm by integrating a dual-elite guiding mechanism, a hyperbolic tangent control strategy, and a hybrid polynomial mutation strategy. Furthermore, compared with other stimulation coils, the novel coil optimized by the MSSMA demonstrates superior performance in terms of stimulation depth. To verify the optimization effects, a magnetic field measurement system was established, and a comparison of the measurement data with simulation data confirmed that the proposed algorithm could effectively optimize coil performance. In summary, this study provides a new approach for deep TMS, and the proposed algorithm holds significant reference value for multi-objective engineering optimization problems.
Objective To conduct a bibliometric analysis of research hotspots and development trends in the application of peripheral magnetic stimulation (PMS), systematically review the research evolution, and provide references for future studies. Methods We retrieved PMS-related literature from the Science Citation Index Expanded database in Web of Science Core Collection (January 1, 1989 - March 5, 2025). Using VOSviewer (v1.6.20) and CiteSpace (v6.1.R6), we performed annual publication volume analysis, country/institution/author collaboration network analysis, reference co-citation analysis, and keyword co-occurrence/clustering/burst analysis, with corresponding knowledge mapping visualizations. Results A total of 124 publications were included. Both publication counts and citation frequencies remained low in early years but showed steady annual growth after 2011. The publications originated from 21 countries/regions, with Germany being the most productive nation, Technical University of Munich the leading institution, and Schneider C (from the Research Center of Neuroscience and Rehabilitation Sciences, Laval University, Canada) the most prolific author. Keyword analysis revealed three major research clusters: neuromodulation technologies, physiological mechanisms, and clinical rehabilitation applications. Future research priorities included expanded clinical applications integrating neuroelectrophysiological indicators with rehabilitation assessments, and interdisciplinary optimization of stimulation parameters through engineering approaches. Conclusions PMS has gained widespread clinical application with growing scientific interest. Future studies should focus on current hotspots to advance precision and intelligent development of this technology.
Weightlessness in the space environment affects astronauts’ learning memory and cognitive function. Repetitive transcranial magnetic stimulation has been shown to be effective in improving cognitive dysfunction. In this study, we investigated the effects of repetitive transcranial magnetic stimulation on neural excitability and ion channels in simulated weightlessness mice from a neurophysiological perspective. Young C57 mice were divided into control, hindlimb unloading and magnetic stimulation groups. The mice in the hindlimb unloading and magnetic stimulation groups were treated with hindlimb unloading for 14 days to establish a simulated weightlessness model, while the mice in the magnetic stimulation group were subjected to 14 days of repetitive transcranial magnetic stimulation. Using isolated brain slice patch clamp experiments, the relevant indexes of action potential and the kinetic property changes of voltage-gated sodium and potassium channels were detected to analyze the excitability of neurons and their ion channel mechanisms. The results showed that the behavioral cognitive ability and neuronal excitability of the mice decreased significantly with hindlimb unloading. Repetitive transcranial magnetic stimulation could significantly improve the cognitive impairment and neuroelectrophysiological indexes of the hindlimb unloading mice. Repetitive transcranial magnetic stimulation may change the activation, inactivation and reactivation process of sodium and potassium ion channels by promoting sodium ion outflow and inhibiting potassium ion, and affect the dynamic characteristics of ion channels, so as to enhance the excitability of single neurons and improve the cognitive damage and spatial memory ability of hindlimb unloading mice.
In transcranial magnetic stimulation (TMS), the conductivity of brain tissue is obtained by using diffusion tensor imaging (DTI) data processing. However, the specific impact of different processing methods on the induced electric field in the tissue has not been thoroughly studied. In this paper, we first used magnetic resonance image (MRI) data to create a three-dimensional head model, and then estimated the conductivity of gray matter (GM) and white matter (WM) using four conductivity models, namely scalar (SC), direct mapping (DM), volume normalization (VN) and average conductivity (MC), respectively. Isotropic empirical conductivity values were used for the conductivity of other tissues such as the scalp, skull, and cerebrospinal fluid (CSF), and then the TMS simulations were performed when the coil was parallel and perpendicular to the gyrus of the target. When the coil was perpendicular to the gyrus where the target was located, it was easy to get the maximum electric field in the head model. The maximum electric field in the DM model was 45.66% higher than that in the SC model. The results showed that the conductivity component along the electric field direction of which conductivity model was smaller in TMS, the induced electric field in the corresponding domain corresponding to the conductivity model was larger. This study has guiding significance for TMS precise stimulation.
As a noninvasive neuromodulation technique, transcranial magnetic stimulation (TMS) is widely used in the clinical treatment of neurological and psychiatric diseases, but the mechanism of its action is still unclear. The purpose of this paper is to investigate the effects of different frequencies of magnetic stimulation (MS) on neuronal excitability and voltage-gated potassium channels in the in vitro brain slices from the electrophysiological perspective of neurons. The experiment was divided into stimulus groups and control group, and acute isolated mice brain slices were applied to MS with the same intensity (0.3 T) at different frequencies (20 Hz and 0.5 Hz, 500 pulses) respectively in the stimulus groups. The whole-cell patch clamp technique was used to record the resting membrane potential (RMP), action potential (AP), voltage-gated potassium channels current of hippocampal dentate gyrus (DG) granule cells. The results showed that 20 Hz MS significantly increased the number of APs released and the maximum slope of a single AP, reduced the threshold of AP, half width and time to AP peak amplitude, and improved the excitability of hippocampal neurons. The peak currents of potassium channels were decreased, the inactivation curve of transient outward potassium channels shifted to the left significantly, and the time constant of recovery after inactivation increased significantly. 0.5 Hz MS significantly inhibited neuronal excitability and increased the peak currents of potassium channels, but the dynamic characteristics of potassium channels had little change. The results suggest that the dynamic characteristics of voltage-gated potassium channels and the excitability of hippocampal DG granule neurons may be one of the potential mechanisms of neuromodulation by MS.
Objective To evaluate the systematic reviews of repetitive transcranial magnetic stimulation (rTMS) for insomnia, to provide supporting evidence for clinical practice. Methods PubMed, Embase, Web of Science, Cochrane Library, Elsevier Science Direct, China National Knowledge Infrastructure, SinoMed, Wanfang and Chongqing VIP were searched from databases establishment to May 30, 2022, to find systematic reviews on the treatment of insomnia with rTMS as the main method. The methodological quality, reporting quality and evidence quality of outcome indicators were evaluated by AMSTAR 2, PRISMA 2020 and GRADE. Results A total of 4 systematic reviews published between 2018 and 2021 were included. Further analysis showed that one of the systematic reviews had a low AMSTAR 2 quality rating and the remaining systematic reviews were very low. The average PRISMA 2020 score of these 4 systematic reviews was (20.75±3.27) points, of which 3 systematic reviews had some defects in their reports, and the other one had relatively complete reports. The GRADE evidence quality assessment showed that there were 40 outcome indicators in the included literature, of which 3 outcome indicators (sleep quality, the percentage of S2 sleep in total sleep time, and S3 sleep in percentage of total sleep time) were rated as moderate, 17 were rated as low and 20 were rated as very low. Conclusions The treatment of insomnia by rTMS has achieved certain effects in clinical practice, but the systematic review of rTMS as the main intervention measure for insomnia needs to further improve the quality and standardize related research. The clinical application of rTMS for insomnia should be treated as appropriate.
In recent years, the ongoing development of transcranial electrical stimulation (TES) and transcranial magnetic stimulation (TMS) has demonstrated significant potential in the treatment and rehabilitation of various brain diseases. In particular, the combined application of TES and TMS has shown considerable clinical value due to their potential synergistic effects. This paper first systematically reviews the mechanisms underlying TES and TMS, highlighting their respective advantages and limitations. Subsequently, the potential mechanisms of transcranial electromagnetic combined stimulation are explored, with a particular focus on three combined stimulation protocols: Repetitive TMS (rTMS) with transcranial direct current stimulation (tDCS), rTMS with transcranial alternating current stimulation (tACS), and theta burst TMS (TBS) with tACS, as well as their clinical applications in brain diseases. Finally, the paper analyzes the key challenges in transcranial electromagnetic combined stimulation research and outlines its future development directions. The aim of this paper is to provide a reference for the optimization and application of transcranial electromagnetic combined stimulation schemes in the treatment and rehabilitation of brain diseases.