Browsing by Author "Deng, Zhi-De"

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    Advances in Transcranial Magnetic Stimulation Technology
    (2015-06-05) Peterchev, Angel V; Deng, Zhi-De; Goetz, Stefan
    © 2015 by Wiley-Blackwell. All rights reserved. This chapter provides overview of the state of the art of transcranial magnetic stimulation (TMS) devices, including pulse sources with flexible control of the output waveform parameters and a wide variety of coil designs. It discusses technologies for accurate TMS targeting, including electric field models, frameless stereotaxy, and robotic coil holders. The chapter addresses technological aspects of ancillary coil effects such as heating, noise, vibration, and scalp stimulation. TMS requires high energy pulses that present a technical challenge for the design of practical, flexible, and efficient pulse sources. The chapter covers technical considerations for the integration of TMS and neuroimaging devices. It discusses various coil configurations and their electric field characteristics as well as technical advances in coil field modelling, positioning systems, efficiency and cooling, noise and scalp stimulation, and sham. The chapter summarizes technical considerations for the integration of TMS and neuroimaging devices.
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    Effects of online repetitive transcranial magnetic stimulation (rTMS) on cognitive processing: A meta-analysis and recommendations for future studies.
    (Neuroscience and biobehavioral reviews, 2019-12) Beynel, Lysianne; Appelbaum, Lawrence G; Luber, Bruce; Crowell, Courtney A; Hilbig, Susan A; Lim, Wesley; Nguyen, Duy; Chrapliwy, Nicolas A; Davis, Simon W; Cabeza, Roberto; Lisanby, Sarah H; Deng, Zhi-De
    Online repetitive transcranial magnetic stimulation (rTMS), applied while subjects are performing a task, is widely used to disrupt brain regions underlying cognition. However, online rTMS has also induced "paradoxical enhancement". Given the rapid proliferation of this approach, it is crucial to develop a better understanding of how online stimulation influences cognition, and the optimal parameters to achieve desired effects. To accomplish this goal, a quantitative meta-analysis was performed with random-effects models fitted to reaction time (RT) and accuracy data. The final dataset included 126 studies published between 1998 and 2016, with 244 total effects for reaction times, and 202 for accuracy. Meta-analytically, rTMS at 10 Hz and 20 Hz disrupted accuracy for attention, executive, language, memory, motor, and perception domains, while no effects were found with 1 Hz or 5 Hz. Stimulation applied at and 10 and 20 Hz slowed down RTs in attention and perception tasks. No performance enhancement was found. Meta-regression analysis showed that fMRI-guided targeting and short inter-trial intervals are associated with increased disruptive effects with rTMS.
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    Multifactorial determinants of the neurocognitive effects of electroconvulsive therapy.
    (J ECT, 2014-06) McClintock, Shawn M; Choi, Jimmy; Deng, Zhi-De; Appelbaum, Lawrence G; Krystal, Andrew D; Lisanby, Sarah H
    For many patients with neuropsychiatric illnesses, standard psychiatric treatments with mono or combination pharmacotherapy, psychotherapy, and transcranial magnetic stimulation are ineffective. For these patients with treatment-resistant neuropsychiatric illnesses, a main therapeutic option is electroconvulsive therapy (ECT). Decades of research have found ECT to be highly effective; however, it can also result in adverse neurocognitive effects. Specifically, ECT results in disorientation after each session, anterograde amnesia for recently learned information, and retrograde amnesia for previously learned information. Unfortunately, the neurocognitive effects and underlying mechanisms of action of ECT remain poorly understood. The purpose of this paper was to synthesize the multiple moderating and mediating factors that are thought to underlie the neurocognitive effects of ECT into a coherent model. Such factors include demographic and neuropsychological characteristics, neuropsychiatric symptoms, ECT technical parameters, and ECT-associated neurophysiological changes. Future research is warranted to evaluate and test this model, so that these findings may support the development of more refined clinical seizure therapy delivery approaches and efficacious cognitive remediation strategies to improve the use of this important and widely used intervention tool for neuropsychiatric diseases.
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    Neurocognitive Effects of Combined Electroconvulsive Therapy (ECT) and Venlafaxine in Geriatric Depression: Phase 1 of the PRIDE Study.
    (The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2019-10-12) Lisanby, Sarah H; McClintock, Shawn M; Alexopoulos, George; Bailine, Samuel H; Bernhardt, Elisabeth; Briggs, Mimi C; Cullum, C Munro; Deng, Zhi-De; Dooley, Mary; Geduldig, Emma T; Greenberg, Robert M; Husain, Mustafa M; Kaliora, Styliani; Knapp, Rebecca G; Latoussakis, Vassilios; Liebman, Lauren S; McCall, William V; Mueller, Martina; Petrides, Georgios; Prudic, Joan; Rosenquist, Peter B; Rudorfer, Matthew V; Sampson, Shirlene; Teklehaimanot, Abeba A; Tobias, Kristen G; Weiner, Richard D; Young, Robert C; Kellner, Charles H; CORE/PRIDE Work Group
    OBJECTIVE:There is limited information regarding the tolerability of electroconvulsive therapy (ECT) combined with pharmacotherapy in elderly adults with major depressive disorder (MDD). Addressing this gap, we report acute neurocognitive outcomes from Phase 1 of the Prolonging Remission in Depressed Elderly (PRIDE) study. METHODS:Elderly adults (age ≥60) with MDD received an acute course of 6 times seizure threshold right unilateral ultrabrief pulse (RUL-UB) ECT. Venlafaxine was initiated during the first treatment week and continued throughout the study. A comprehensive neurocognitive battery was administered at baseline and 72 hours following the last ECT session. Statistical significance was defined as a two-sided p-value of less than 0.05. RESULTS:A total of 240 elderly adults were enrolled. Neurocognitive performance acutely declined post ECT on measures of psychomotor and verbal processing speed, autobiographical memory consistency, short-term verbal recall and recognition of learned words, phonemic fluency, and complex visual scanning/cognitive flexibility. The magnitude of change from baseline to end for most neurocognitive measures was modest. CONCLUSION:This is the first study to characterize the neurocognitive effects of combined RUL-UB ECT and venlafaxine in elderly adults with MDD and provides new evidence for the tolerability of RUL-UB ECT in an elderly sample. Of the cognitive domains assessed, only phonemic fluency, complex visual scanning, and cognitive flexibility qualitatively declined from low average to mildly impaired. While some acute changes in neurocognitive performance were statistically significant, the majority of the indices as based on the effect sizes remained relatively stable.
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    Simultaneous transcranial magnetic stimulation and single-neuron recording in alert non-human primates.
    (Nat Neurosci, 2014-08) Mueller, Jerel K; Grigsby, Erinn M; Prevosto, Vincent; Petraglia, Frank W; Rao, Hrishikesh; Deng, Zhi-De; Peterchev, Angel V; Sommer, Marc A; Egner, Tobias; Platt, Michael L; Grill, Warren M
    Transcranial magnetic stimulation (TMS) is a widely used, noninvasive method for stimulating nervous tissue, yet its mechanisms of effect are poorly understood. Here we report new methods for studying the influence of TMS on single neurons in the brain of alert non-human primates. We designed a TMS coil that focuses its effect near the tip of a recording electrode and recording electronics that enable direct acquisition of neuronal signals at the site of peak stimulus strength minimally perturbed by stimulation artifact in awake monkeys (Macaca mulatta). We recorded action potentials within ∼1 ms after 0.4-ms TMS pulses and observed changes in activity that differed significantly for active stimulation as compared with sham stimulation. This methodology is compatible with standard equipment in primate laboratories, allowing easy implementation. Application of these tools will facilitate the refinement of next generation TMS devices, experiments and treatment protocols.
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    Utilizing transcranial direct current stimulation to enhance laparoscopic technical skills training: A randomized controlled trial.
    (Brain stimulation, 2020-05) Cox, Morgan L; Deng, Zhi-De; Palmer, Hannah; Watts, Amanda; Beynel, Lysianne; Young, Jonathan R; Lisanby, Sarah H; Migaly, John; Appelbaum, Lawrence G
    BACKGROUND:Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that delivers constant, low electrical current resulting in changes to cortical excitability. Prior work suggests it may enhance motor learning giving it the potential to augment surgical technical skill acquisition. OBJECTIVES:The aim of this study was to test the efficacy of tDCS, coupled with motor skill training, to accelerate laparoscopic skill acquisition in a pre-registered (NCT03083483), double-blind and placebo-controlled study. We hypothesized that relative to sham tDCS, active tDCS would accelerate the development of laparoscopic technical skills, as measured by the Fundamentals of Laparoscopic Surgery (FLS) Peg Transfer task quantitative metrics. METHODS:In this study, sixty subjects (mean age 22.7 years with 42 females) were randomized into sham or active tDCS in either bilateral primary motor cortex (bM1) or supplementary motor area (SMA) electrode configurations. All subjects practiced the FLS Peg Transfer Task during six 20-min training blocks, which were preceded and followed by a single trial pre-test and post-test. The primary outcome was changes in laparoscopic skill performance over time, quantified by group differences in completion time from pre-test to post-test and learning curves developed from a calculated score accounting for errors. RESULTS:Learning curves calculated over the six 20-min training blocks showed significantly greater improvement in performance for the bM1 group than the sham group (t = 2.07, p = 0.039), with the bM1 group achieving approximately the same amount of improvement in 4 blocks compared to the 6 blocks required of the sham group. The SMA group also showed greater mean improvement than sham, but exhibited more variable learning performance and differences relative to sham were not significant (t = 0.85, p = 0.400). A significant main effect was present for pre-test versus post-test times (F = 133.2, p < 0.001), with lower completion times at post-test, however these did not significantly differ for the training groups. CONCLUSION:Laparoscopic skill training with active bilateral tDCS exhibited significantly greater learning relative to sham. The potential for tDCS to enhance the training of surgical skills, therefore, merits further investigation to determine if these preliminary results may be replicated and extended.