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Transcranial magnetic stimulation (TMS) is a non-invasive method that induces functional changes in a relatively small area of the cerebral cortex. It is supposed that the effect of the method in therapy of neuropatic pain is based on the induction of spinothalamic tract inhibiton, which leads to the symptom withdrawal.
To prove the clinical and electrophysiological effect of rTMS in the therapy of chronic neuropatic pain.
29 patients with medication-resistant neuropatic pain were examined by Visual analog scale (VAS), McGill Pain Questionnaire (MPQ) and QST(Quantitative sensory Testing, consisted of von Frey and thermic treshold examination),then treated by high frequency rTMS in the study using double-blind randomized sham-controlled parallel design. rTMS parameters: 5 rTMS sessions (2 weeks treatment), where each session consisted of three 10 Hz rTMS series using:
1) 85%MT (motor treshold),
2) 90%MT and
Each rTMS série consisted of 20 pulses in 12 trains. Location of the active coil was administered over the contralateral motor cortex, directed specifically to facial area of homunculus (according to funcional location). Sham coil was angled 90° degrees away from the skull.
Confirmation of a significant decrease of VAS item in active group, trend to improvement in tactile sensation of severed patient faces. The changes of thermic treshold were not found. Sham rTMS did not show any trend for improvement.
Although no general recommendations can be drawn based on our result, our study is another one that suggest rTMS should be considered as an effective and safe treatment option for chronic neuropatic pain.
The aim of our study was to examine whether the change of current density detected by standardized low resolution brain electromagnetic tomography (sLORETA) is different between responders and non-responders to prefrontal repetitive transcranial magnetic stimulation (rTMS).
A total of 25 inpatients with depressive disorder (DSM-IV criteria), who previously did not respond to at least one antidepressant treatment underwent 4 weeks of rTMS treatment (1 Hz, 100% of motor threshold, 600 pulses/session, 20 session) applied over the right dorsolateral prefrontal cortex. 19-channel EEG was recorded before treatment and 3 days after rTMS treatment. The effect of rTMS on brain electrical activity (revealed by the use of sLORETA, Pascual-Marqui RD, 2002) was measured separately in responders (reduction of MADRS≥50%) and non-responders.
The significant current density increase in alpha 1 band was detected in prefrontal and limbic cortex (Brodman areas 6, 8, 9, 32) bilaterally (p < 0.05, corrected) in a group of nine responders. No significant changes were detected in non-responders.
Our findings implicate that the antidepressant effect of 1 Hz rTMS is connected with a current density increase in alfa 1 band in the prefrontal cortex. Supported by 1M0517 and MZ0PCP2005.
25-OH vitamin D level is an immediate precursor metabolite of the active form of vitamin D that leads to expression of more than 200 genes.
The aim of our study was to examine 25-OH vitamin D deficiency (<50nmol/L) and its relationship to demographic factors in recently hospitalised patients with schizophrenia spectrum disorders (SSD).
We assessed 25-OH vitamin D serum level in 41 SSD patients (54% of males, 46% with first episode, 63% during sunny season [May to October]), mean age 30 ± 10.4 years, within first days of hospitalization. The serum 25-OH vitamin D level was analysed with electrochemiluminiscence, using imunoanalysators Elecsys Roche.
The serum level was significantly higher in sunny season (41.3 ± 27.2 nmol/L) than in November to April (28.4 ± 11.2 nmol/L): t-test, P < .05. Sixty-nine percent of patients suffered from 25-OH vitamin D deficiency (< 50nmol/L) in May to October and 100% during November to April. The 25-OH vitamin D serum levels were not different between males and females, or between first-episode and multiple-episode patients. No significant correlation between age and 25-OH vitamin D level was found.
The high prevalence of 25-OH vitamin D deficiency (< 50nmol/L) suggests that some patients with SSD may benefit from vitamin D supplementation.
This study is a result of the research funded by the project Nr. LO1611 with a financial support from the MEYS under the NPU I program.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
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