Modulation of motor cortex excitability in obsessive-compulsive disorder: An exploratory study on the relations of neurophysiology measures with clinical outcome

被引:70
作者
Mantovani, Antonio [1 ,2 ]
Rossi, Simone [3 ]
Bassi, Bruce D. [4 ]
Simpson, Helen B. [5 ]
Fallon, Brian A. [5 ]
Lisanby, Sarah H. [6 ]
机构
[1] Columbia Univ, Dept Psychiat, New York State Psychiat Inst, Div Expt Therapeut, New York, NY 10027 USA
[2] Univ Siena, Dept Neurosci, Div Psychiat, I-53100 Siena, Italy
[3] Univ Siena, Neurol & Clin Neurophysiol Sect, Dept Neurol & Neurosensorial Sci, I-53100 Siena, Italy
[4] Univ Michigan, Sch Med, Ann Arbor, MI USA
[5] Columbia Univ, Dept Psychiat, New York State Psychiat Inst, Anxiety Disorders Clin, New York, NY USA
[6] Duke Univ, Dept Psychiat & Behav Sci, Durham, NC USA
关键词
Transcranial magnetic stimulation; Obsessive-compulsive disorder; Supplementary motor area; Motor threshold; Cortical silent period; Short-interval intracortical inhibition; Intracortical facilitation; TRANSCRANIAL MAGNETIC STIMULATION; SILENT PERIOD; 2; PHASES; INTRACORTICAL INHIBITION; CORTICAL EXCITABILITY; METABOLIC-CHANGES; MECHANISMS; PREMOTOR; BRAIN; SCALE;
D O I
10.1016/j.psychres.2013.08.054
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Low-frequency repetitive transcranial magnetic stimulation (rTMS) to supplementary motor area (SMA) showed clinical benefit in obsessive-compulsive disorder (OCD). Here we tested whether clinical improvement was associated with enhanced cortical inhibition as measured by single and paired-pulse TMS variables. In 18 OCD patients receiving 4 weeks of either active or sham rTMS in a double-blind randomized trial, we assessed bilateral resting and active motor thresholds (RMT and AMT), cortical silent period (CSP), short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF). We tested correlations between changes in Yale-Brown Obsessive Compulsive Scale-Self-report (Y-BOCS-SR), Clinical Global Impression-Severity subscale (CGI-S) and cortical excitability measures. Active rTMS increased right hemisphere RMT whose change correlated with Y-BOCS-SR improvement. Baseline RMT hemispheric asymmetry, defined as the difference between left and right hemispheres RMT, and its normalization after active rTMS correlated with Y-BOCS-SR and CGI-S improvements. Active rTMS also increased right hemisphere SICI whose change correlated with Y-BOCS-SR and CGI-S at week 4, and with normalization of baseline RMT hemispheric asymmetry. Treatment-induced changes in cortical excitability measures are consistent with an inhibitory action of SMA rTMS on dysfunctional motor circuits in OCD. Correlations of neurophysiology measures with therapeutic outcome are supportive of the role of SMA in the modulation of OCD symptoms. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:1026 / 1032
页数:7
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