Publicação
Motor cortical inhibitory deficits in patients with obsessive-compulsive disorder–A systematic review and meta-analysis of transcranial magnetic stimulation literature
| Resumo: | Introduction: Obsessive-compulsive disorder (OCD) is a highly prevalent chronic disorder, often refractory to treatment. While remaining elusive, a full understanding of the pathophysiology of OCD is crucial to optimize treatment. Transcranial magnetic stimulation (TMS) is a non-invasive technique that, paired with other neurophysiological techniques, such as electromyography, allows for in vivo assessment of human corticospinal neurophysiology. It has been used in clinical populations, including comparisons of patients with OCD and control volunteers. Results are often contradictory, and it is unclear if such measures change after treatment. Here we summarize research comparing corticospinal excitability between patients with OCD and control volunteers, and explore the effects of treatment with repetitive TMS (rTMS) on these excitability measures. Methods: We conducted a systematic review and meta-analysis of case-control studies comparing various motor cortical excitability measures in patients with OCD and control volunteers. Whenever possible, we meta-analyzed motor cortical excitability changes after rTMS treatment. Results: From 1,282 articles, 17 reporting motor cortex excitability measures were included in quantitative analyses. Meta-analysis regarding cortical silent period shows inhibitory deficits in patients with OCD, when compared to control volunteers. We found no statistically significant differences in the remaining meta-analyses, and no evidence, in patients with OCD, of pre- to post-rTMS changes in resting motor threshold, the only excitability measure for which longitudinal data were reported. Discussion: Our work suggests an inhibitory deficit of motor cortex excitability in patients with OCD when compared to control volunteers. Cortical silent period is believed to reflect activity of GABAB receptors, which is in line with neuroimaging research, showing GABAergic deficits in patients with OCD. Regardless of its effect on OCD symptoms, rTMS apparently does not modify Resting Motor Threshold, possibly because this measure reflects glutamatergic synaptic transmission, while rTMS is believed to mainly influence GABAergic function. Our meta-analyses are limited by the small number of studies included, and their methodological heterogeneity. Nonetheless, cortical silent period is a reliable and easily implementable measurement to assess neurophysiology in humans, in vivo. The present review illustrates the importance of pursuing the study of OCD pathophysiology using cortical silent period and other easily accessible, non-invasive measures of cortical excitability. Systematic review registration: [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020201764], identifier [CRD42020201764]. |
|---|---|
| Autores principais: | Rodrigues da Silva, Daniel |
| Outros Autores: | Maia, Ana; Cotovio, Gonçalo; Oliveira, José; Oliveira-Maia, Albino J.; Oliveira-Maia, AJ; Barahona-Corrêa, J. Bernardo |
| Assunto: | corticospinal excitability meta-analysis obsessive-compulsive disorder (OCD) systematic review transcranial magnetic stimulation Psychiatry and Mental health SDG 3 - Good Health and Well-being |
| Ano: | 2022 |
| País: | Portugal |
| Tipo de documento: | recensão |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Universidade Nova de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório Institucional da UNL |
| _version_ | 1868983351550935040 |
|---|---|
| author | Rodrigues da Silva, Daniel |
| author2 | Maia, Ana Cotovio, Gonçalo Oliveira, José Oliveira-Maia, Albino J. Oliveira-Maia, AJ Barahona-Corrêa, J. Bernardo |
| author2_role | author author author author author author |
| author_facet | Rodrigues da Silva, Daniel Maia, Ana Cotovio, Gonçalo Oliveira, José Oliveira-Maia, Albino J. Oliveira-Maia, AJ Barahona-Corrêa, J. Bernardo |
| author_role | author |
| contributor_name_str_mv | NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) Frontiers Media RUN |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Rodrigues da Silva, Daniel\"},{\"Person.name\":\"Maia, Ana\"},{\"Person.name\":\"Cotovio, Gonçalo\"},{\"Person.name\":\"Oliveira, José\"},{\"Person.name\":\"Oliveira-Maia, Albino J.\"},{\"Person.name\":\"Oliveira-Maia, AJ\",\"Person.identifier.orcid\":\"0000-0001-5071-3007\"},{\"Person.name\":\"Barahona-Corrêa, J. Bernardo\"}] |
| datacite.contributors.contributor.contributorName.fl_str_mv | NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) Frontiers Media RUN |
| datacite.creators.creator.creatorName.fl_str_mv | Rodrigues da Silva, Daniel Maia, Ana Cotovio, Gonçalo Oliveira, José Oliveira-Maia, Albino J. Oliveira-Maia, AJ Barahona-Corrêa, J. Bernardo |
| datacite.date.Accepted.fl_str_mv | 2022-12-07T00:00:00Z |
| datacite.date.available.fl_str_mv | 2023-01-09T22:16:18Z |
| datacite.date.embargoed.fl_str_mv | 2023-01-09T22:16:18Z |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| datacite.subjects.subject.fl_str_mv | corticospinal excitability meta-analysis obsessive-compulsive disorder (OCD) systematic review transcranial magnetic stimulation Psychiatry and Mental health SDG 3 - Good Health and Well-being |
| datacite.titles.title.fl_str_mv | Motor cortical inhibitory deficits in patients with obsessive-compulsive disorder–A systematic review and meta-analysis of transcranial magnetic stimulation literature |
| dc.contributor.none.fl_str_mv | NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) Frontiers Media RUN |
| dc.creator.none.fl_str_mv | Rodrigues da Silva, Daniel Maia, Ana Cotovio, Gonçalo Oliveira, José Oliveira-Maia, Albino J. Oliveira-Maia, AJ Barahona-Corrêa, J. Bernardo |
| dc.date.Accepted.fl_str_mv | 2022-12-07T00:00:00Z |
| dc.date.available.fl_str_mv | 2023-01-09T22:16:18Z |
| dc.date.embargoed.fl_str_mv | 2023-01-09T22:16:18Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://hdl.handle.net/10362/147230 |
| dc.language.none.fl_str_mv | eng |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| dc.subject.none.fl_str_mv | corticospinal excitability meta-analysis obsessive-compulsive disorder (OCD) systematic review transcranial magnetic stimulation Psychiatry and Mental health SDG 3 - Good Health and Well-being |
| dc.title.fl_str_mv | Motor cortical inhibitory deficits in patients with obsessive-compulsive disorder–A systematic review and meta-analysis of transcranial magnetic stimulation literature |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_efa0 |
| description | Introduction: Obsessive-compulsive disorder (OCD) is a highly prevalent chronic disorder, often refractory to treatment. While remaining elusive, a full understanding of the pathophysiology of OCD is crucial to optimize treatment. Transcranial magnetic stimulation (TMS) is a non-invasive technique that, paired with other neurophysiological techniques, such as electromyography, allows for in vivo assessment of human corticospinal neurophysiology. It has been used in clinical populations, including comparisons of patients with OCD and control volunteers. Results are often contradictory, and it is unclear if such measures change after treatment. Here we summarize research comparing corticospinal excitability between patients with OCD and control volunteers, and explore the effects of treatment with repetitive TMS (rTMS) on these excitability measures. Methods: We conducted a systematic review and meta-analysis of case-control studies comparing various motor cortical excitability measures in patients with OCD and control volunteers. Whenever possible, we meta-analyzed motor cortical excitability changes after rTMS treatment. Results: From 1,282 articles, 17 reporting motor cortex excitability measures were included in quantitative analyses. Meta-analysis regarding cortical silent period shows inhibitory deficits in patients with OCD, when compared to control volunteers. We found no statistically significant differences in the remaining meta-analyses, and no evidence, in patients with OCD, of pre- to post-rTMS changes in resting motor threshold, the only excitability measure for which longitudinal data were reported. Discussion: Our work suggests an inhibitory deficit of motor cortex excitability in patients with OCD when compared to control volunteers. Cortical silent period is believed to reflect activity of GABAB receptors, which is in line with neuroimaging research, showing GABAergic deficits in patients with OCD. Regardless of its effect on OCD symptoms, rTMS apparently does not modify Resting Motor Threshold, possibly because this measure reflects glutamatergic synaptic transmission, while rTMS is believed to mainly influence GABAergic function. Our meta-analyses are limited by the small number of studies included, and their methodological heterogeneity. Nonetheless, cortical silent period is a reliable and easily implementable measurement to assess neurophysiology in humans, in vivo. The present review illustrates the importance of pursuing the study of OCD pathophysiology using cortical silent period and other easily accessible, non-invasive measures of cortical excitability. Systematic review registration: [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020201764], identifier [CRD42020201764]. |
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| identifier.url.fl_str_mv | http://hdl.handle.net/10362/147230 |
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| language | eng |
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| person_str_mv | Rodrigues da Silva, Daniel Maia, Ana Cotovio, Gonçalo Oliveira, José Oliveira-Maia, Albino J. Oliveira-Maia, AJ Oliveira-Maia, AJ https://www.ciencia-id.pt/ED15-6691-FEC7 ED15-6691-FEC7 http://orcid.org/0000-0001-5071-3007 0000-0001-5071-3007 Barahona-Corrêa, J. Bernardo |
| publishDate | 2022 |
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| spelling | engenIntroduction: Obsessive-compulsive disorder (OCD) is a highly prevalent chronic disorder, often refractory to treatment. While remaining elusive, a full understanding of the pathophysiology of OCD is crucial to optimize treatment. Transcranial magnetic stimulation (TMS) is a non-invasive technique that, paired with other neurophysiological techniques, such as electromyography, allows for in vivo assessment of human corticospinal neurophysiology. It has been used in clinical populations, including comparisons of patients with OCD and control volunteers. Results are often contradictory, and it is unclear if such measures change after treatment. Here we summarize research comparing corticospinal excitability between patients with OCD and control volunteers, and explore the effects of treatment with repetitive TMS (rTMS) on these excitability measures. Methods: We conducted a systematic review and meta-analysis of case-control studies comparing various motor cortical excitability measures in patients with OCD and control volunteers. Whenever possible, we meta-analyzed motor cortical excitability changes after rTMS treatment. Results: From 1,282 articles, 17 reporting motor cortex excitability measures were included in quantitative analyses. Meta-analysis regarding cortical silent period shows inhibitory deficits in patients with OCD, when compared to control volunteers. We found no statistically significant differences in the remaining meta-analyses, and no evidence, in patients with OCD, of pre- to post-rTMS changes in resting motor threshold, the only excitability measure for which longitudinal data were reported. Discussion: Our work suggests an inhibitory deficit of motor cortex excitability in patients with OCD when compared to control volunteers. Cortical silent period is believed to reflect activity of GABAB receptors, which is in line with neuroimaging research, showing GABAergic deficits in patients with OCD. Regardless of its effect on OCD symptoms, rTMS apparently does not modify Resting Motor Threshold, possibly because this measure reflects glutamatergic synaptic transmission, while rTMS is believed to mainly influence GABAergic function. Our meta-analyses are limited by the small number of studies included, and their methodological heterogeneity. Nonetheless, cortical silent period is a reliable and easily implementable measurement to assess neurophysiology in humans, in vivo. The present review illustrates the importance of pursuing the study of OCD pathophysiology using cortical silent period and other easily accessible, non-invasive measures of cortical excitability. Systematic review registration: [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020201764], identifier [CRD42020201764].application/pdfenMotor cortical inhibitory deficits in patients with obsessive-compulsive disorder–A systematic review and meta-analysis of transcranial magnetic stimulation literatureRodrigues da Silva, DanielMaia, AnaCotovio, GonçaloOliveira, JoséOliveira-Maia, Albino J.PersonalOliveira-Maia, AJDSpacehttp://dspace.org/items/402bb6ca-e5db-422a-9d43-a807d4076d38DSpacehttp://dspace.org/items/402bb6ca-e5db-422a-9d43-a807d4076d38Oliveira-MaiaAlbino JorgeCiência IDhttps://www.ciencia-id.ptED15-6691-FEC7ORCIDhttp://orcid.org0000-0001-5071-3007Researcher IDhttps://www.researcherid.comB-7976-2009Scopus Author IDhttps://www.scopus.com14060820700Barahona-Corrêa, J. BernardoNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)Frontiers MediaHostingInstitutionOrganizationalRUNe-mailmailto:run@unl.ptrun@unl.ptISSNIsPartOf1664-0640URNIsPartOfPURE: 49446939URNIsPartOfPURE UUID: 30efe79e-1ef4-4f05-afa6-31ee7e4f7b1dURNIsPartOfScopus: 85144387555URNIsPartOfWOS: 000901672000001URNIsPartOfPubMed: 36569621DOIIsPartOf10.3389/fpsyt.2022.10504802023-01-09T22:16:18Z2022-12-072022-12-07T00:00:00ZHandlehttp://hdl.handle.net/10362/147230http://purl.org/coar/access_right/c_abf2open accesscorticospinal excitabilitymeta-analysisobsessive-compulsive disorder (OCD)systematic reviewtranscranial magnetic stimulationPsychiatry and Mental healthSDG 3 - Good Health and Well-being925854 bytesother research producthttp://purl.org/coar/resource_type/c_efa0reviewhttp://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://run.unl.pt/bitstreams/bf212829-1c89-4dc2-a01d-7f402307fc43/download |
| spellingShingle | Motor cortical inhibitory deficits in patients with obsessive-compulsive disorder–A systematic review and meta-analysis of transcranial magnetic stimulation literature Rodrigues da Silva, Daniel corticospinal excitability meta-analysis obsessive-compulsive disorder (OCD) systematic review transcranial magnetic stimulation Psychiatry and Mental health SDG 3 - Good Health and Well-being |
| status | SINGLETON |
| subject.fl_str_mv | corticospinal excitability meta-analysis obsessive-compulsive disorder (OCD) systematic review transcranial magnetic stimulation Psychiatry and Mental health SDG 3 - Good Health and Well-being |
| title | Motor cortical inhibitory deficits in patients with obsessive-compulsive disorder–A systematic review and meta-analysis of transcranial magnetic stimulation literature |
| title_full | Motor cortical inhibitory deficits in patients with obsessive-compulsive disorder–A systematic review and meta-analysis of transcranial magnetic stimulation literature |
| title_fullStr | Motor cortical inhibitory deficits in patients with obsessive-compulsive disorder–A systematic review and meta-analysis of transcranial magnetic stimulation literature |
| title_full_unstemmed | Motor cortical inhibitory deficits in patients with obsessive-compulsive disorder–A systematic review and meta-analysis of transcranial magnetic stimulation literature |
| title_short | Motor cortical inhibitory deficits in patients with obsessive-compulsive disorder–A systematic review and meta-analysis of transcranial magnetic stimulation literature |
| title_sort | Motor cortical inhibitory deficits in patients with obsessive-compulsive disorder–A systematic review and meta-analysis of transcranial magnetic stimulation literature |
| topic | corticospinal excitability meta-analysis obsessive-compulsive disorder (OCD) systematic review transcranial magnetic stimulation Psychiatry and Mental health SDG 3 - Good Health and Well-being |
| topic_facet | corticospinal excitability meta-analysis obsessive-compulsive disorder (OCD) systematic review transcranial magnetic stimulation Psychiatry and Mental health SDG 3 - Good Health and Well-being |
| url | http://hdl.handle.net/10362/147230 |
| visible | 1 |