WD4-1
Clinical effectiveness of repetitive transcranial magnetic stimulation treatment in children with neurodevelopmental disorders - a systematic review
小児の発達障害における反復経頭蓋磁気刺激治療の臨床的効果に関する系統的レビュー
Masuda Fumi（増田 史）1,2，中島 振一郎1，宮崎 貴浩1，垂水 良介1，尾久 守侑1，和田 真孝1，津川 幸子3，三村 將1，野田 賀大1
1Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
2Department of Psychiatry, Shiga University of Medical Science, Shiga, Japan
3Keio University School of Medicine, Tokyo, Japan
Background: Neurodevelopmental disorders diagnosed in childhood is increasing in recent years. To date, a number of repetitive transcranial magnetic stimulation (rTMS) studies have been conducted in children with neurodevelopmental disorders such as autism spectrum disorders (ASD) or attention deficit/hyperactivity disorders (ADHD); however, clinical effectiveness remains unclear. Therefore, we aimed to review the clinical effectiveness of rTMS in these populations. Methods: We searched set terms using PubMed (2004-2018) to examine the clinical trial data of rTMS in children with neurodevelopmental disorders. Results: The search identified 264 articles, 14 of which met inclusion and exclusion criteria. Among them, 12 studies used the conventional rTMS (8 studies for ASD, two for ADHD, and two for tic disorders) and the rest of two studies used theta burst stimulation (TBS) (one for ASD and one for chronic tic disorders). In patients with ASD, low-frequency rTMS and intermittent TBS to the DLPFC induced positive effects on social behavior, including lethargy. In patients with ADHD, low-frequency rTMS to the left DLPFC and high-frequency rTMS to the right DLPFC improved symptoms such as inattentiveness. In patients with tic disorders, low-frequency rTMS to the supplementary motor area improved tic symptoms. Notably, only a few mild adverse effects were reported in this review. Conclusions: This systematic review suggests that rTMS may have clinical effectiveness in children with neurodevelopmental disorders, in terms of inconspicuous symptoms such as lethargy of ASD other than conspicuous symptoms. The results warrant further rTMS studies with a larger sample size that include systematic clinical assessment across neurodevelopmental disorders. | | WD4-2
The relationship between electroencephalography delta activity and cognitive function among in patients with chronic schizophrenia
統合失調症における脳波デルタ波と高次脳機能の関連性
Wada Masataka（和田 真孝）1，垂水 良介1，宮崎 貴浩1，津川 幸子1，本多 栞2，三村 悠1，藤井 進也3，中島 振一郎1，三村 將1，野田 賀大1
1Department of Neuropsychiatry, Keio University School of Medicine
2Graduate School of Media and Governance, Keio University
3Faculty of Environment and Information Studies, Keio University
Background: In patients with schizophrenia, electroencephalography (EEG) delta activity is increased compared to healthy controls. However, the role of EEG delta activity has not been fully elucidated in terms of cognitive function in patients with schizophrenia. Thus, we aimed to investigate the relationship between delta activity and cognitive function in this population.
Methods: Forty-eight patients with chronic schizophrenia underwent resting-state EEG recording. Cognitive function was assessed with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The EEG data were pre-processed and 2 second epochs were extracted. The epoched data were band-pass filtered at delta, theta, alpha, beta, and gamma frequencies and Hilbert-transformed to obtain the amplitude values for delta frequency band. The relationship between neuropsychological examination and root-mean-squared amplitudes for delta frequency bin was tested with the linear regression.This research was in accordance with the Ethical Guidelines for Medical and Health Research Involving Human Subjects.
Results: The delta amplitude was negatively associated with the RBANS total score (p=0.001). In terms of cognitive domains, the delta amplitude was also negatively related to the Immediate memory score, (p=0.006), and Visuospatial/constructional score (p=0.007)
Conclusion: This research revealed that increased EEG delta power was associated with a greater cognitive impairment in chronic patients with schizophrenia, suggesting that delta activity could contribute to the pathophysiology of the cognitive impairment of schizophrenia. |
