Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
3043519 | Clinical Neurophysiology | 2013 | 12 Pages |
ObjectiveTo evaluate transcranial magnetic stimulation (TMS) measures of inhibition and excitation in obsessive–compulsive disorder (OCD), major depressive disorder (MDD) and schizophrenia (SCZ).MethodsParadigms included: short-interval cortical inhibition (SICI), cortical silent period (CSP), resting motor threshold, intracortical facilitation, and motor evoked potential amplitude. A literature search was performed using PubMed, Ovid Medline, Embase Psychiatry and PsycINFO 1990 through April 2012.ResultsA significant Hedge’s g was found for decreased SICI (g = 0.572, 95% confidence interval [0.179, 0.966], p = 0.004), enhanced intracortical facilitation (g = 0.446, 95% confidence interval [0.042, 0.849], p = 0.030) and decreased CSP (g = −0.466, 95% confidence interval [−0.881, −0.052], p = 0.027) within the OCD population. For MDD, significant effect sizes were demonstrated for decreased SICI (g = 0.641, 95% confidence interval [0.384, 0.898], p = 0.000) and shortened CSP (g = −1.232, 95% confidence interval [−1.530, −0.933], p = 0.000). In SCZ, a significant Hedge’s g was shown for decreased SICI (g = 0.476, 95% confidence interval [0.331, 0.620], p = 0.000).ConclusionInhibitory deficits are a ubiquitous finding across OCD, MDD, SCZ and enhancement of intracortical facilitation is specific to OCD.SignificanceProvides a clear platform from which diagnostic procedures can be developed.
► Motor cortex inhibitory and excitatory transcranial magnetic stimulation paradigms were quantitatively assessed in severe psychiatric illnesses. ► Inhibitory deficits are a ubiquitous finding across obsessive–compulsive disorder, major depressive disorder and schizophrenia, by contrast, enhancement of intracortical facilitation is specific to obsessive–compulsive disorder. ► Limitations of transcranial magnetic stimulation studies are reviewed and potential future applications are discussed.