Author
Fady Rachid
Bio: Fady Rachid is an academic researcher. The author has contributed to research in topics: Transcranial magnetic stimulation & Motor cortex. The author has an hindex of 3, co-authored 4 publications receiving 375 citations.
Papers
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Paris 12 Val de Marne University1, University Medical Center Groningen2, Eindhoven University of Technology3, University Hospital of Lausanne4, French Institute of Health and Medical Research5, Università Campus Bio-Medico6, University of Belgrade7, University of Cologne8, Ludwig Maximilian University of Munich9, École Polytechnique Fédérale de Lausanne10, Turku University Hospital11, University of Regensburg12, Università telematica San Raffaele13, Paris Descartes University14, Paracelsus Private Medical University of Salzburg15, University of Bern16, Universidade Nova de Lisboa17, Medical Park18, University of Göttingen19, University of Messina20, Central European Institute of Technology21, University of Siena22, University of Turku23, University of Tübingen24
TL;DR: These updated recommendations take into account all rTMS publications, including data prior to 2014, as well as currently reviewed literature until the end of 2018, and are based on the differences reached in therapeutic efficacy of real vs. sham rT MS protocols.
822 citations
Paris 12 Val de Marne University1, University Medical Center Groningen2, Eindhoven University of Technology3, University Hospital of Lausanne4, French Institute of Health and Medical Research5, Università Campus Bio-Medico6, University of Belgrade7, University of Cologne8, Ludwig Maximilian University of Munich9, École Polytechnique Fédérale de Lausanne10, Turku University Hospital11, University of Regensburg12, Università telematica San Raffaele13, Paris Descartes University14, Paracelsus Private Medical University of Salzburg15, University of Bern16, Universidade Nova de Lisboa17, Medical Park18, University of Göttingen19, University of Messina20, Central European Institute of Technology21, University of Siena22, University of Turku23, University of Tübingen24
TL;DR: Jean-Pascal Lefaucheur, André Aleman, Chris Baeken, David H. Benninger, Jérôme Brunelin, Vincenzo Di Lazzaro, Saša R. Filipovic, Emmanuel Poulet, Angelo Quartarone, Irena Rektorová, Simone Rossi, Hanna Sahlsten, Martin Schecklmann, David Szekely, Ulf Ziemann.
77 citations
TL;DR: In this paper, a review of clinical research on repetitive transcranial magnetic stimulation (rTMS) for major depressive disorder (MDD) has been presented. But, the authors focus on the use of rTMS in the treatment of depression.
Abstract: Purpose of reviewAfter three decades of clinical research on repetitive transcranial magnetic stimulation (rTMS), major depressive disorder (MDD) has proven to be the primary field of application. MDD poses a major challenge for health systems worldwide, emphasizing the need for improving clinical e
61 citations
TL;DR: The study critically assessed the evidence base for therapeutic application of repetitive transcranial magnetic stimulation (rTMS) in neurological and psychiatric disorders based on the test of excess significance, which statistically compares the expected versus observed number of “positive” datasets.
Abstract: ized clinical trials (RCTs) that were evaluated as “representative of the field” and “presenting low risk of bias.” Afterwards, they compared the combined effect size of these trials with the combined effect size of all datasets for a given disorder. As more “positive” datasets were observed than expected, the authors concluded that “caution is warranted in accepting rTMS as an established treatment for neuropsychiatric disorders.” The whole field of brain stimulation, and rTMS in particular, is experiencing an expansion of the investigation of its clinical applications in neuropsychiatric disorders. In this context, it is of utmost importance to systematically and rationally appraise the literature to better guide patients, clinicians, and policy makers in their decisions. Thus, we appreciate the effort of Amad et al. [1] and also share some of their critical views. However, we would like to discuss important methodological issues that limit the study’s overall conclusion. First, the authors selected two RCTs to represent all rTMS interventions. However, these trials employed particular variants of TMS. For instance, Levkovitz et al. [2] employed the H1-coil rTMS (“deepTMS”), which uses a non-focal, bilateral method of brain stimulation [2] and is considered a distinct rTMS modality; whereas the study of Leuchter et al. [3], despite clearly presenting biases (e.g., attrition rate of 40%), used a low-field magnetic stimulation modality. Both rTMS modalities are not commonly used in clinical practice and are delivered by equipment designed specifically for depression. In fact, high-frequency rTMS, the most used modality for depression, has an effect size at least two times higher than estimated by Amad et al. [1] according to recent meta-analyses [4, 5]. As the authors stated that the true effect size of an intervention is “exploratory by nature,” it is surprising that they evaluated only specific subvariants of rTMS and did not consider other or additional RCTs, or carefully designed meta-analyses in their estimations. Second, the authors wrote that the evidence of rTMS “appears [to be] strongly favorable for almost every condition [evaluated].” This is not supported by their own data. For instance, no evidence for this claim was found for any of the psychiatric disorders investigated, except for depression (but see above). For neurologic disorders, the issues arose from two specific meta-analyses: chronic neuropathic pain (18/25 “positive” datasets) and post-stroke depression (22/24 “positive” datasets). However, these studies were methodologically problematic. For instance, the post-stroke depression meta-analysis [6] included several datasets that are not internationally accessible and had low quality, whereas the chronic neuropathic pain meta-analysis [7] included many single-session rTMS trials, which evaluated only short-term rTMS effects and were not necessarily designed to evaluate long-term efficacy. Third, the authors failed to grasp the particularities involved in different rTMS modalities. Critically, rTMS effects vary according to the frequency, intensity (defined as the percentage applied according to the resting motor threshold), number of pulses, number Dear Editor, Amad et al. [1] have critically assessed the evidence base for therapeutic application of repetitive transcranial magnetic stimulation (rTMS) in neurological and psychiatric disorders based on the test of excess significance, which statistically compares the expected versus observed number of “positive” datasets. For estimating the effect size of rTMS, the authors selected two large randomReceived: October 26, 2019 Accepted after revision: November 7, 2019 Published online: December 3, 2019
2 citations
Cited by
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University of Siena1, University of Göttingen2, UCL Institute of Neurology3, City College of New York4, National Institutes of Health5, Brown University6, University of Toronto7, Università Campus Bio-Medico8, Beth Israel Deaconess Medical Center9, Medical University of South Carolina10, Cincinnati Children's Hospital Medical Center11, Aristotle University of Thessaloniki12, Aalto University13, Paris 12 Val de Marne University14, Vita-Salute San Raffaele University15, University of Trento16, Ludwig Maximilian University of Munich17, Harvard University18, Duke University19, University of Messina20, Copenhagen University Hospital21, Fukushima Medical University22, Ben-Gurion University of the Negev23, University of Tübingen24
TL;DR: New operational guidelines are provided for safety in planning future trials based on traditional and patterned TMS protocols, as well as a summary of the minimal training requirements for operators, and a note on ethics of neuroenhancement.
387 citations
TL;DR: In this article, the authors focus on spinal cord stimulation (SCS) therapies discussed within the framework of other invasive, minimally invasive, and non-invasive neuromodulation therapies.
118 citations
16 Jun 2020
TL;DR: It is demonstrated that the combination of neuroimaging and neurostimulation techniques allows a better understanding of how brain plasticity can be modulated to promote the reorganization of neural networks.
Abstract: Stroke is a leading cause of acquired, permanent disability worldwide. Although the treatment of acute stroke has been improved considerably, the majority of patients to date are left disabled with a considerable impact on functional independence and quality of life. As the absolute number of stroke survivors is likely to further increase due to the demographic changes in our aging societies, new strategies are needed in order to improve neurorehabilitation. The most critical driver of functional recovery post-stroke is neural reorganization. For developing novel, neurobiologically informed strategies to promote recovery of function, an improved understanding of the mechanisms enabling plasticity and recovery is mandatory. This review provides a comprehensive survey of recent developments in the field of stroke recovery using neuroimaging and non-invasive brain stimulation. We discuss current concepts of how the brain reorganizes its functional architecture to overcome stroke-induced deficits, and also present evidence for maladaptive effects interfering with recovery. We demonstrate that the combination of neuroimaging and neurostimulation techniques allows a better understanding of how brain plasticity can be modulated to promote the reorganization of neural networks. Finally, neurotechnology-based treatment strategies allowing patient-tailored interventions to achieve enhanced treatment responses are discussed. The review also highlights important limitations of current models, and finally closes with possible solutions and future directions.
112 citations
TL;DR: Transcranial direct current stimulation (tDCS) has shown mixed results for depression treatment and should be considered for further studies.
Abstract: Background Transcranial direct current stimulation (tDCS) has shown mixed results for depression treatment. Objective To perform a systematic review and meta-analysis of trials using tDCS to improve depressive symptoms. Methods A systematic review was performed from the first date available to January 06, 2020 in PubMed, EMBASE, Cochrane Library, and additional sources. We included randomized, sham-controlled clinical trials (RCTs) enrolling participants with an acute depressive episode and compared the efficacy of active versus sham tDCS, including association with other interventions. The primary outcome was the Hedges' g for continuous depression scores; secondary outcomes included odds ratios (ORs) and number needed to treat (NNT) for response, remission, and acceptability. Random effects models were employed. Sources of heterogeneity were explored via metaregression, sensitivity analyses, subgroup analyses, and bias assessment. Results We included 23 RCTs (25 datasets, 1,092 participants), most (57%) presenting a low risk of bias. Active tDCS was superior to sham regarding endpoint depression scores (k = 25, g = 0.46, 95% confidence interval [CI]: 0.22-0.70), and also achieved superior response (k = 18, 33.3% vs. 16.56%, OR = 2.28 [1.52-3.42], NNT = 6) and remission (k = 18, 19.12% vs. 9.78%, OR = 2.12 [1.42-3.16], NNT = 10.7) rates. Moreover, active tDCS was as acceptable as sham. No risk of publication bias was identified. Cumulative meta-analysis showed that effect sizes are basically unchanged since total sample reached 439 participants. Conclusions TDCS is modestly effective in treating depressive episodes. Further well-designed, large-scale RCTs are warranted.
85 citations
City College of New York1, Wake Forest University2, University of Florida3, University of Minnesota4, University of Vienna5, University of Szeged6, University of Coimbra7, Otto-von-Guericke University Magdeburg8, Tehran University of Medical Sciences9, Eindhoven University of Technology10, Centre for Addiction and Mental Health11, Université libre de Bruxelles12, Harvard University13, Copenhagen University Hospital14, University of New South Wales15, University College London16, Monash University17, Shahed University18, University of São Paulo19, University of Graz20, Max Planck Society21, Nagoya Institute of Technology22, University of Calgary23, Albert Einstein College of Medicine24, Research Medical Center25, Universidade Federal do Espírito Santo26, ETH Zurich27, Manipal University28, University of Zurich29, Beth Israel Deaconess Medical Center30, University of Oxford31, Technical University of Denmark32, Shanghai Mental Health Center33, University of Science and Technology of China34, McGovern Institute for Brain Research35
TL;DR: To facilitate the re-establishment of access to NIBS clinical services and research operations during the current COVID-19 pandemic and possible future outbreaks, a framework for balancing the importance of NIBS operations with safety considerations, while addressing the needs of all stakeholders is developed.
83 citations