A meta-analysis of cortical inhibition and excitability using transcranial magnetic stimulation in psychiatric disorders

作者：Radhu Natasha; de Jesus Danilo R; Ravindran Lakshmi N; Zanjani Anosha; Fitzgerald Paul B; Daskalakis Zafiris J^*

来源：Clinical Neurophysiology, 2013, 124(7): 1309-1320.

DOI：10.1016/j.clinph.2013.01.014

• Transcranial magnetic stimulation
• Motor cortex
• Psychiatric disorders
• Neurophysiology
• Cortical inhibition
• Cortical excitation

Objective: To evaluate transcranial magnetic stimulation (TMS) measures of inhibition and excitation in obsessive-compulsive disorder (OCD), major depressive disorder (MDD) and schizophrenia (SCZ). %26lt;br%26gt;Methods: Paradigms 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. %26lt;br%26gt;Results: A significant Hedge%26apos;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%26apos;s g was shown for decreased SICI (g = 0.476, 95% confidence interval [0.331, 0.620], p = 0.000). %26lt;br%26gt;Conclusion: Inhibitory deficits are a ubiquitous finding across OCD, MDD, SCZ and enhancement of intracortical facilitation is specific to OCD. Significance: Provides a clear platform from which diagnostic procedures can be developed.

• 出版日期2013-7