Masachika Niimi1,2, Tamaki Ishima3, Kenji Hashimoto3, Takatoshi Hara1, Naoki Yamada1,2, Masahiro Abo1. 1. Department of Rehabilitation Medicine, Jikei University School of Medicine. 2. Department of Rehabilitation Medicine, Tokyo General Hospital, Tokyo. 3. Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan.
Abstract
OBJECTIVE: Repetitive transcranial magnetic stimulation (rTMS) improves depressive symptoms and motor function in stroke patients. While metabolic derangement of the kynurenine pathway has been reported in stroke patients, the effect of rTMS on this pathway remains unknown. This study was performed to investigate the effect of rTMS on serum levels of kynurenine and tryptophan in stroke patients. METHODS: Sixty-two stroke patients received rTMS in addition to intensive rehabilitation and 33 stroke patients received intensive rehabilitation alone for 14 days. The rTMS involved low-frequency stimulation (at 1 Hz) of the primary motor cortex on the unaffected side of the cerebrum. The depressive state of the patients was evaluated with the Beck Depression Inventory (BDI) before and after treatment. Motor function of the patients was evaluated with Fugl-Meyer Assessment (FMA). Serum levels of kynurenine and tryptophan levels were also measured before and after treatment. RESULTS: The serum tryptophan level decreased in the group receiving rTMS to the right brain and increased in the group receiving rTMS to the left brain. The serum kynurenine/tryptophan ratio was elevated in the group receiving rTMS to the right brain. The BDI indicated improvement of depressive symptoms in the rehabilitation alone group and the group receiving rTMS to the right brain plus rehabilitation. The FMA improved in all groups. CONCLUSIONS: The effect of low-frequency rTMS on the kynurenine pathway may differ depending on whether it is applied to the right or left cerebral hemisphere.
OBJECTIVE: Repetitive transcranial magnetic stimulation (rTMS) improves depressive symptoms and motor function in strokepatients. While metabolic derangement of the kynurenine pathway has been reported in strokepatients, the effect of rTMS on this pathway remains unknown. This study was performed to investigate the effect of rTMS on serum levels of kynurenine and tryptophan in strokepatients. METHODS: Sixty-two strokepatients received rTMS in addition to intensive rehabilitation and 33 strokepatients received intensive rehabilitation alone for 14 days. The rTMS involved low-frequency stimulation (at 1 Hz) of the primary motor cortex on the unaffected side of the cerebrum. The depressive state of the patients was evaluated with the Beck Depression Inventory (BDI) before and after treatment. Motor function of the patients was evaluated with Fugl-Meyer Assessment (FMA). Serum levels of kynurenine and tryptophan levels were also measured before and after treatment. RESULTS: The serum tryptophan level decreased in the group receiving rTMS to the right brain and increased in the group receiving rTMS to the left brain. The serum kynurenine/tryptophan ratio was elevated in the group receiving rTMS to the right brain. The BDI indicated improvement of depressive symptoms in the rehabilitation alone group and the group receiving rTMS to the right brain plus rehabilitation. The FMA improved in all groups. CONCLUSIONS: The effect of low-frequency rTMS on the kynurenine pathway may differ depending on whether it is applied to the right or left cerebral hemisphere.
Authors: Cristian G Giron; Tim T Z Lin; Rebecca L D Kan; Bella B B Zhang; Suk Yu Yau; Georg S Kranz Journal: Int J Mol Sci Date: 2022-08-26 Impact factor: 6.208
Authors: F Leblhuber; S Geisler; D Ehrlich; K Steiner; G Reibnegger; Dietmar Fuchs; K Kurz Journal: J Neural Transm (Vienna) Date: 2021-07-09 Impact factor: 3.575