BACKGROUND

Stroke is a significant health concern globally, and dysphagia has been a very common complication. Early intervention for managing dysphagia is challenging with a lack of universally accepted treatment protocols. Noninvasive repetitive transcranial magnetic stimulation (rTMS) is emerging as a treatment option for stroke dysphagia. However, there is no standardized rTMS treatment protocol for it, leading to challenges in clinical decision-making.

To determine available rTMS protocols for unilateral hemispheric stroke dysphagia.

A scoping review using PubMed, ProQuest, and EBSCOHost databases was conducted using the keywords “dysphagia,” “stroke,” “repetitive transcranial magnetic stimulation,” “conventional therapy,” and “swallowing examination.” Eligible studies published from inception to April 2020 were appraised using the Oxford Centre for Evidence-Based Medicine and analyzed qualitatively.

Out of 42 articles, five randomized controlled trials met the eligibility criteria. A total of 108 patients with stroke and oropharyngeal dysphagia were randomized into one of the following treatment groups: (1) rTMS (unilateral or bilateral); (2) conventional dysphagia therapy (CDT); and (3) combined intervention (CI) of rTMS and CDT. The CI gave significant improvements in swallowing function and quality of life compared to CDT alone. The bilateral rTMS protocol resulted in more significant improvements than unilateral rTMS.

There are various and heterogeneous treatment protocols involving neuromodulation available for stroke dysphagia. The combination of bilateral excitatory-inhibitory rTMS and CDT seems to result in an optimal outcome for swallowing function among patients with unilateral hemispheric stroke dysphagia.

Repeated transcranial magnetic stimulation (rTMS) is one of the commonly used brain stimulation techniques. In order to investigate the effects of rTMS on the excitability of different types of neurons, this study is conducted to investigate the effects of rTMS on the cognitive function of mice and the excitability of hippocampal glutaminergic neurons and gamma-aminobutyric neurons from the perspective of electrophysiology. In this study, mice were randomly divided into glutaminergic control group, glutaminergic magnetic stimulation group, gamma-aminobutyric acid energy control group, and gamma-aminobutyric acid magnetic stimulation group. The four groups of mice were injected with adeno-associated virus to label two types of neurons and were implanted optical fiber. The stimulation groups received 14 days of stimulation and the control groups received 14 days of pseudo-stimulation. The fluorescence intensity of calcium ions in mice was recorded by optical fiber system. Behavioral experiments were conducted to explore the changes of cognitive function in mice. The patch-clamp system was used to detect the changes of neuronal action potential characteristics. The results showed that rTMS significantly improved the cognitive function of mice, increased the amplitude of calcium fluorescence of glutamergic neurons and gamma-aminobutyric neurons in the hippocampus, and enhanced the action potential related indexes of glutamergic neurons and gamma-aminobutyric neurons. The results suggest that rTMS can improve the cognitive ability of mice by enhancing the excitability of hippocampal glutaminergic neurons and gamma-aminobutyric neurons.
Animals ; Mice ; Hippocampus/cytology* ; Transcranial Magnetic Stimulation ; Neurons/physiology* ; Male ; Cognition/physiology* ; gamma-Aminobutyric Acid/metabolism* ; Action Potentials/physiology*

In order to explore effective ways to reduce non-suicidal self-injury (NSSI) among female adolescents, a total of 45 female adolescent patients with NSSI in West China Hospital of Sichuan University and Guizhou Second Provincial People's Hospital from June 2021 to June 2024 were selected randomly that divided into groups A, B and C, with 15 cases in each group. Group A was treated with repeated transcranial magnetic stimulation (rTMS) and bipolar depression triple therapy, and group B was treated with bipolar depression triple therapy to compare the effectiveness and safety. Group C received bipolar depression triple therapy combined with sham stimulation which only produced stimulating sounds but no stimulating magnetic field as a control in the study. After treatment, the Hamilton Anxiety Score (HAMA), Hamilton Depression Score (HAMD) and Nurses' Global Assessment of Suicide Risk (NGASR) in group A were significantly lower than those in group B and C ( P < 0.01). rTMS combined with bipolar depression triple therapy has a definite effect on reducing NSSI in female adolescents, which can reduce the incidence rate of short-term NSSI behavior in patients.
Humans ; Female ; Adolescent ; Self-Injurious Behavior/prevention & control* ; Transcranial Magnetic Stimulation/methods* ; Bipolar Disorder/therapy* ; Combined Modality Therapy ; Treatment Outcome

Parkinson's disease is a neurodegenerative disease that mostly occurs in middle-aged and elderly people. It is characterized by progressive loss of dopaminergic neurons in the substantia nigra and aggregation of Lewy bodies, resulting in a series of motor symptoms and non-motor symptoms. Depression is the most important manifestation of non-motor symptoms, which seriously affects the quality of life of patients. Clinicians often use antidepressant drugs to improve the depressive symptoms of patients with Parkinson 's disease, but it is still urgent to solve the problems of drug side effects and drug resistance caused by such methods. Repetitive transcranial magnetic stimulation is a safe and non-invasive neuromodulation technique that can change the excitability of the corticospinal tract, induce the release of dopamine and other neurotransmitters, and further improve the depressive symptoms of patients with Parkinson 's disease. Based on this, this paper discusses and summarizes the research progress on the efficacy and potential mechanism of repetitive transcranial magnetic stimulation for improving depression in Parkinson 's disease at home and abroad, in order to provide reference for related clinical application research.
Humans ; Parkinson Disease/psychology* ; Transcranial Magnetic Stimulation/methods* ; Depression/etiology*

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.
Algorithms ; Transcranial Magnetic Stimulation/instrumentation* ; Equipment Design ; Humans

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.
Humans ; Transcranial Magnetic Stimulation/methods* ; Transcranial Direct Current Stimulation/methods* ; Brain Diseases/therapy*

OBJECTIVE: This study aims to develop a regional collaborative hierarchical diagnosis and treatment model based on the "Internet+" approach, to address issues such as the uneven distribution of transcranial magnetic stimulation (TMS) treatment resources, information silos, and low patient accessibility in regional medical institutions. METHODS: This model establishes standardized business and information protocols, creating a real-time TMS treatment resource database, develops a regional TMS treatment management platform, and integrates with the Xiamen Health Medical Cloud Platform for collaborative operation. RESULTS: This model enables the internal communication of TMS treatment information within hospitals and sharing across medical institutions, optimizing the rational allocation of TMS treatment resources. CONCLUSION The model effectively optimizes the allocation of TMS treatment resources, significantly enhances the accessibility and quality of medical services, provides valuable insights for hierarchical diagnosis and treatment of other therapeutic models, and contributes to the development of a more organized and efficient hierarchical diagnosis and treatment system.
Transcranial Magnetic Stimulation ; Humans ; Internet

Repetitive transcranial magnetic stimulation (rTMS) is a rapid and effective therapy for major depressive disorder; however, there is significant variability in therapeutic outcomes both within and across individuals, with approximately 50% of patients showing no response to rTMS treatment. Many studies have personalized the stimulation parameters of rTMS (e.g., location and intensity of stimulation) according to the anatomical and functional structure of the brain. In addition to these parameters, the internal states of the individual, such as circadian rhythm, behavior/cognition, neural oscillation, and neuroplasticity, also contribute to the variation in rTMS effects. In this review, we summarize the current literature on the interaction between rTMS and internal states. We propose two possible methods, multimodal treatment, and adaptive closed-loop treatment, to integrate patients' internal states to achieve better rTMS treatment for depression.
Humans ; Transcranial Magnetic Stimulation/methods* ; Depressive Disorder, Major/physiopathology* ; Neuronal Plasticity/physiology* ; Brain/physiopathology*

While multiple step saccades (MSS) are occasionally reported in the healthy population, they are more evident in patients with Parkinson's disease (PD). Therefore, MSS has been suggested as a biological marker for the diagnosis of PD. However, the lack of clarity on the neural mechanism underlying the generation of MSS largely impedes their application in the clinic. We have proposed recently that MSS are triggered by the discrepancy between desired and executed saccades. Accordingly, brain regions involved in saccadic planning and execution might play a role in the generation of MSS. To test this hypothesis, we explored the role of the prefrontal (PFC) and posterior parietal cortex (PPC) in generating MSS by conducting two experiments: electroencephalographic recording and single-pulse transcranial magnetic stimulation in the PFC or PPC of humans while participants were performing a gap saccade task. We found that the PFC and PPC are involved in the generation of MSS.
Humans ; Parietal Lobe/physiology* ; Saccades/physiology* ; Prefrontal Cortex/physiology* ; Male ; Transcranial Magnetic Stimulation ; Female ; Electroencephalography ; Adult ; Young Adult

Attempts have been made to modulate motor sequence learning (MSL) through repetitive transcranial magnetic stimulation, targeting different sites within the sensorimotor network. However, the target with the optimum modulatory effect on neural plasticity associated with MSL remains unclarified. This study was therefore designed to compare the role of the left primary motor cortex and the left supplementary motor area proper (SMAp) in modulating MSL across different complexity levels and for both hands, as well as the associated neuroplasticity by applying intermittent theta burst stimulation together with the electroencephalogram and concurrent transcranial magnetic stimulation. Our data demonstrated the role of SMAp stimulation in modulating neural communication to support MSL, which is achieved by facilitating regional activation and orchestrating neural coupling across distributed brain regions, particularly in interhemispheric connections. These findings may have important clinical implications, particularly for motor rehabilitation in populations such as post-stroke patients.
Humans ; Transcranial Magnetic Stimulation ; Motor Cortex/physiology* ; Male ; Electroencephalography ; Neuronal Plasticity/physiology* ; Female ; Adult ; Evoked Potentials, Motor/physiology* ; Young Adult ; Learning/physiology*