Publications by authors named "Martin Schecklmann"

Introduction: Intermittent Theta Burst Stimulation (iTBS), a specific form of repetitive transcranial magnetic stimulation (rTMS) is increasingly used for treating affective disorders. Accelerated iTBS protocols (aiTBS) with shorter treatment duration may lead to equal but faster response rates compared to standard protocols.

Methods: Here, we retrospectively analyzed the records of 66 rTMS in- and out-patients with major depressive disorder in a tertiary care hospital between April 2023 and September 2023.

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  • This study explores how lying and sexual arousal affect motor cortex excitability in heterosexual men and women using motor-evoked potentials (MEPs) while they view arousing images.* -
  • Sixteen heterosexual couples participated in a series of trials where they viewed suggestive images and had to answer questions either truthfully or dishonestly regarding their preferences.* -
  • Results indicated that while both men and women showed higher excitability towards their preferred sexual stimuli, lying increased cortical excitability; however, MEPs are not reliable indicators for diagnosing sexual preference or related conditions.*
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The influence of naps on tinnitus was systematically assessed by exploring the frequency, clinical and demographic characteristics of this phenomenon. 9,724 data from two different tinnitus databases (Tinnitus Hub: n = 6115; Tinnitus Research Initiative (TRI): n = 3627) were included. After separate analysis of the databases, these results were then compared with each other.

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Tinnitus, the perception of sound without an external source, affects 15% of the population, with 2.4% experiencing significant distress. In this review, we summarize the current state of knowledge about tinnitus management with a particular focus on the translation into clinical practice.

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  • - The study investigates the out-of-pocket (OOP) expenses associated with tinnitus in several European countries, revealing significant costs that vary by severity of the condition.
  • - Participants reported annual OOP expenses averaging 368€ for slight, 728€ for moderate, and 1,492€ for severe tinnitus, totaling an estimated 565€ for all tinnitus sufferers due to healthcare visits, treatments, medications, and alternative medicine.
  • - The findings highlight the substantial economic burden of tinnitus, comparable to other major disabilities, indicating a willingness among individuals to invest significant monthly income for relief, and suggesting the total expenses exceed 17 billion € across the countries studied.
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Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique capable of inducing neuroplasticity as measured by changes in peripheral muscle electromyography (EMG) or electroencephalography (EEG) from pre-to-post stimulation. However, temporal courses of neuromodulation during ongoing rTMS are unclear. Monitoring cortical dynamics via TMS-evoked responses using EMG (motor-evoked potentials; MEPs) and EEG (transcranial-evoked potentials; TEPs) during rTMS might provide further essential insights into its mode of action - temporal course of potential modulations.

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  • - The study investigates variations in transcranial magnetic stimulation (TMS) pulse widths among different pulse sources and stimulation intensities, revealing significant differences in average pulse widths compared to manufacturer specifications.
  • - Seven MagVenture® pulse sources were tested, with results showing a mean pulse width of 288.11s, deviating slightly from the expected 280s value; however, variability was low within groups.
  • - A pilot experiment indicated no significant impact of pulse width on motor evoked potential amplitude but showed differences in latencies, suggesting further research is needed to explore the physiological implications of varied pulse lengths and other factors like hardware aging.
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Introduction: Treating major depressive disorder (MDD) with transcranial direct current stimulation (tDCS) devices at home has various logistic advantages compared to tDCS treatment in the clinic. However, preliminary (controlled) studies showed side effects such as skin lesions and difficulties in the implementation of home-based tDCS. Thus, more data are needed regarding the feasibility and possible disadvantages of home-based tDCS.

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Objectives: Tinnitus subtypes are proposed to lie on a continuum of different symptom dimensions rather than be categorical. However, there is no comprehensive empirical data showing this complex relationship between different tinnitus symptoms. The objective of this study is to provide empirical evidence for the dimensional nature of tinnitus and how different auditory and non-auditory symptoms interact with each other through complex interactions.

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Background: Motor hotspot identification represents the first step in the determination of the motor threshold and is the basis for the specification of stimulation intensity used for various Transcranial Magnetic Stimulation (TMS) applications. The level of experimenters' experience and the methodology of motor hotspot identification differ between laboratories. The need for an optimized and time-efficient technique for motor hotspot identification is therefore substantial.

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Background: Hypersomnia poses major challenges to treatment providers given the limitations of available treatment options. In this context, the application of non-invasive brain stimulation techniques such as transcranial electrical stimulation (tES) may open up new avenues to effective treatment. Preliminary evidence suggests both acute and longer-lasting positive effects of transcranial direct current stimulation (tDCS) on vigilance and sleepiness in hypersomniac patients.

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Tinnitus, a frequent disorder, is the conscious perception of a sound in the absence of a corresponding external acoustic sound source in the sense of a phantom sound. Although the majority of people who perceive a tinnitus sound can cope with it and are only minimaly impaired in their quality of lfe, 2-3% of the population perceive tinnitus as a major problem. Recently it has been proposed that the two groups should be differentiated by distict terms: "Tinnitus" describes the auditory or sensory component, whereas "Tinnitus Disorder" reflects the auditory component and the associated suffering.

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Introduction: Obsessive-compulsive disorder (OCD) affects 2-3% of the global population, causing distress in many functioning levels. Standard treatments only lead to a partial recovery, and about 10% of the patients remain treatment-resistant. Deep brain stimulation offers a treatment option for severe, therapy-refractory OCD, with a reported response of about 60%.

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Introduction: Repetitive transcranial magnetic stimulation (rTMS) is used to induce long-lasting changes (aftereffects) in cortical excitability, which are often measured via single-pulse TMS (spTMS) over the motor cortex eliciting motor-evoked potentials (MEPs). rTMS includes various protocols, such as theta-burst stimulation (TBS), paired associative stimulation (PAS), and continuous rTMS with a fixed frequency. Nevertheless, subsequent aftereffects of rTMS are variable and seem to fail repeatability.

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Aims: Motor evoked potentials (MEP) elicited by transcranial magnetic stimulation (TMS) over the primary motor cortex are used as a neurophysiological marker of cortical excitability in clinical and scientific practice. Though, the reliability of this outcome parameter has not been clarified. Using a systematic approach, this work reviews and critically appraises studies on the reliability of MEP outcome parameters derived from hand muscles of healthy subjects and gives a proposal for most reliable TMS practice.

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Objective: The aim of this study was to investigate the reliability of low-frequency and high-frequency repetitive transcranial magnetic stimulation (rTMS) on healthy individuals over the motor cortex. A secondary outcome was the assessment if low-frequency rTMS results in inhibition and high-frequency rTMS results in facilitation.

Methods: In this experiment, 30 healthy participants received on four consecutive days one session each with application of 1 Hz or 20 Hz rTMS over the left motor cortex.

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Introduction: Depression in the elderly is an understudied condition. Psychopharmacological and psychotherapeutic approaches suffer from specific difficulties with this patient group. Brain stimulation techniques such as repetitive transcranial magnetic stimulation (rTMS) offer a therapeutic alternative.

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Background: Tinnitus is a leading cause of disease burden globally. Several therapeutic strategies are recommended in guidelines for the reduction of tinnitus distress; however, little is known about the potentially increased effectiveness of a combination of treatments and personalized treatments for each tinnitus patient.

Methods: Within the Unification of Treatments and Interventions for Tinnitus Patients project, a multicenter, randomized clinical trial is conducted with the aim to compare the effectiveness of single treatments and combined treatments on tinnitus distress (UNITI-RCT).

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(1) Cognitive impairments such as working memory (WM) deficits are amongst the most common dysfunctions characterizing bipolar disorder (BD) patients, severely contributing to functional impairment. We aimed to investigate WM performance and associated brain activation during the acute phase of BD and to observe changes in the same patients during remission. (2) Frontal brain activation was recorded using functional near-infrared spectroscopy (fNIRS) during n-back task conditions (one-back, two-back and three-back) in BD patients in their acute depressive ( = 32) and remitted ( = 15) phases as well as in healthy controls ( = 30).

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Introduction: This study aimed to explore whether body mass index (BMI), systolic blood pressure (RR syst), diastolic blood pressure (RR diast) or heart rate (HR) are associated with tinnitus status and/or severity.

Methods: To that end, we evaluated the influence of tinnitus status and Tinnitus Handicap Inventory (THI) score on BMI, RR syst, RR diast and HR by comparing data from a large sample of patients presenting to a specialized tertiary referral clinic (N = 1066) with data from a population-based control group (N = 9885) by means of linear models.

Results: Tinnitus patients had a significantly lower BMI and higher RR syst, RR diast and HR than non-tinnitus patients; however, the contribution of the case-control status to was very small (0.

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Cognitive behavioral therapy (CBT) was shown to be effective in reducing tinnitus-related distress in numerous controlled trials. Real-world data from tinnitus treatment centers are an important addition to controlled trials for demonstrating the ecological validity of the results from the randomized controlled trials. Thus, we provided the real-world data of 52 patients participating in CBT group therapies during the time period from 2010 to 2019.

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There is preliminary evidence that high-frequency repetitive transcranial magnetic stimulation targeting the right dorsolateral prefrontal cortex (DLPFC) could reduce cue-induced sexual arousal. Here, we aimed to replicate this finding by using transcranial direct current stimulation (tDCS). In a randomized, double-blind, sham-controlled crossover study design, 24 healthy male participants received anodal tDCS over right DLPFC, anodal tDCS over left DLPFC, and sham tDCS with exposure to neutral and sexual video cues before and after each intervention.

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Tinnitus affects a considerable part of the population and develops into a severe disorder in some sufferers. App-based interventions are able to provide low-threshold, cost-effective, and location-independent care for tinnitus patients. Therefore, we developed a smartphone app combining structured counseling with sound therapy and conducted a pilot study to evaluate treatment compliance and symptom improvement (trial registration: DRKS00030007).

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