The influence of high-frequency repetitive transcranial magnetic stimulation on endogenous estrogen in patients with disorders of consciousness

Autor: Hui Juan Wang, Sheng Quan Zhang, Yu Hua Zhong, Ren Hong He, Jian Zhong Fan, Zhou Zhou
Rok vydání: 2021
Předmět:
Male
Consciousness
medicine.drug_class
Repetitive transcranial magnetic stimulation
medicine.medical_treatment
Biophysics
Prefrontal Cortex
Neurosciences. Biological psychiatry. Neuropsychiatry
Disorders of consciousness
Stimulation
Endogeny
050105 experimental psychology
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
mental disorders
medicine
Humans
0501 psychology and cognitive sciences
Coma
Estradiol
business.industry
General Neuroscience
05 social sciences
Estrogens
medicine.disease
Transcranial Magnetic Stimulation
Dorsolateral prefrontal cortex
Transcranial magnetic stimulation
Treatment Outcome
medicine.anatomical_structure
Estrogen
Anesthesia
Cortical Excitability
Neurology (clinical)
medicine.symptom
business
030217 neurology & neurosurgery
RC321-571
Zdroj: Brain Stimulation, Vol 14, Iss 3, Pp 461-466 (2021)
ISSN: 1935-861X
Popis: Background Repetitive transcranial magnetic stimulation (rTMS) has been proposed as a promising therapeutic intervention for neurological disorders. However, the precise mechanisms of rTMS in neural excitability remains poorly understood. Estradiol is known to have strong influence on cortical excitability. This study aimed to determine whether high-frequency (HF) rTMS influences endogenous estradiol in male patients with disorders of consciousness (DOC). Methods A randomized controlled trial was conducted with a total of 57 male patients with DOC. Eventually, 50 patients completed the study. Twenty-five patients underwent real rTMS, and 25 patients underwent sham rTMS, which were delivered over the dorsolateral prefrontal cortex. The primary outcome measure was the change in serum estradiol from baseline to after 10 sessions of HF-rTMS. The improvement in the total score of the JFK Coma Recovery Scale-Revised (CRS-R) was also assessed. Results Changes in estradiol levels and CRS-R scores from pre-to post-treatment were significantly different between the active rTMS and sham stimulation conditions. A significant enhancement of CRS-R scores in the patients receiving rTMS stimulation was observed compared to the sham group. Serum estradiol levels in patients following HF-rTMS were significantly higher than their baseline levels, whereas no significant changes were found in the sham group from pre-to post-stimulation. The rise in estradiol levels was greater in responders than in non-responders. The changes in estradiol levels were significantly positively correlated with the improvement in CRS-R scores. Conclusion These preliminary findings indicate that serum estradiol levels are affected by HF-rTMS and positively related to clinical responses in male patients with DOC. The elevation of estradiol levels may lay a physiological foundation for successful rTMS treatment for DOC patients by increasing cortical excitability.
Databáze: OpenAIRE
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