assessing-primary-motor-cortex-excitability-excitability-modulation

Assessing Primary Motor Cortex Excitability and Excitability Modulation by Pairing Transcranial Magnetic Stimulation with Electromyography

We describe a protocol to assess motor cortex excitability and its modulation, through paired use of electromyography (EMG) and repetitive transcranial ...

conventional-repetitive-transcranial-magnetic-stimulation-for

Conventional Repetitive Transcranial Magnetic Stimulation for Depression: A Step-by-Step Protocol

Repetitive Transcranial Magnetic Stimulation (rTMS) is a non-invasive approach for brain stimulation, with proven effectiveness and efficacy to treat ...

protocol-for-repetitive-transcranial-magnetic-stimulation-with

Protocol for Repetitive Transcranial Magnetic Stimulation with Symptom Provocation to Treat Obsessive-compulsive Disorder

Obsessive-compulsive disorder (OCD) is a chronic, debilitating neuropsychiatric disorder characterized by the presence of obsessions and/or compulsions ...

Champalimaud Foundation

Universidade de Lisboa

Lesion network mapping is a neuroimaging technique that explores the network of regions functionally connected to lesions causing a common syndrome. The technique uses resting state functional connectivity from large databases of healthy individuals, i.e., connectomes, and has allowed for important insight into the potential network mechanisms underlying several neuropsychiatric disorders. However, concerns regarding reproducibility have arisen, that may be due to the use of different connectomes, with variable MRI acquisition parameters and preprocessing methods. Here, we tested the impact of using different connectomes on the results of lesion network mapping for mania. We found results were reliable and consistent independent of the connectome used.

Lesion network mapping of mania using different normative connectomes.

Transcranial Magnetic Stimulation (TMS) is a non-invasive brain stimulation technique that was cleared by the Food and Drug Administration (FDA) for the treatment of Obsessive-Compulsive Disorder (OCD) in 2018. The approved protocol includes individualized symptom provocation before each stimulation session, to elicit a moderate level of obsessional distress. Although symptom provocation can be a delicate, demanding, and uncomfortable procedure, structured training methods for those who are going to apply it are not available. Here, we describe a model for training in symptom provocation for TMS technicians, developed at the Champalimaud Clinical Centre in Lisbon, Portugal. Our programme includes two-sessions dedicated to clinical communication and symptom provocation techniques from a theoretical and practical perspective. Additionally, supervision meetings are conducted during treatment of patients, allowing regular case discussion and redefinition of symptom provocation hierarchy, as needed. In addition to having a strong practical component, our training program is short and pragmatic, allowing for easy implementation and fluid transition to clinical practice. By sharing our experience, we hope to contribute to systematize training procedures required for symptom provocation in the context of TMS, and to qualitatively describe a methodology that can be used for implementation of TMS programmes for the treatment of OCD.

Symptom provocation for treatment of obsessive-compulsive disorder using transcranial magnetic stimulation: A step-by-step guide for professional training.

Transcranial Magnetic Stimulation (TMS) allows for cortical-excitability (CE) assessment and its modulation has been associated with neuroplasticity-like phenomena, thought to be impaired in neuropsychiatric disorders. However, the stability of these measures has been challenged, defying their potential as biomarkers. This study aimed to test the temporal stability of cortical-excitability modulation and study the impact of individual and methodological factors in determining within- and between-subject variability.

ArticleTotal : 3	Year
Publication title	2025
Publication title	2025
Publication title	2025

Article	Year
Lesion network mapping of mania using different normative connectomes. Brain structure & function\| PubMed ID: 35575827	2022
Symptom provocation for treatment of obsessive-compulsive disorder using transcranial magnetic stimulation: A step-by-step guide for professional training. Frontiers in psychiatry\| PubMed ID: 35990054	2022
Replicability of motor cortex-excitability modulation by intermittent theta burst stimulation. Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology\| PubMed ID: 37269770	2023
Reducing motor evoked potential amplitude variability through normalization. Frontiers in psychiatry\| PubMed ID: 38356910	2024

Francisco Faro Viana

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