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Role of d-serine in the beneficial effects of repetitive transcranial magnetic stimulation in post-stroke patients

Published online by Cambridge University Press:  29 January 2020

Masachika Niimi Open the ORCID record for Masachika Niimi [Opens in a new window] ,
Yuko Fujita ,
Tamaki Ishima ,
Kenji Hashimoto ,
Nobuyuki Sasaki ,
Takatoshi Hara ,
Naoki Yamada  and
Masahiro Abo
Masachika Niimi*
Affiliation:
Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan Department of Rehabilitation Medicine, Tokyo General Hospital, Tokyo, Japan
Yuko Fujita
Affiliation:
Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
Tamaki Ishima
Affiliation:
Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
Kenji Hashimoto
Affiliation:
Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
Nobuyuki Sasaki
Affiliation:
Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan
Takatoshi Hara
Affiliation:
Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan
Naoki Yamada
Affiliation:
Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan
Masahiro Abo
Affiliation:
Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan
*
Author for correspondence: Masachika Niimi, Email: pomardon2010@gmail.com
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Abstract

Objective:

Abnormalities in neurotransmission via N-methyl-d-aspartic acid receptor (NMDAR) play a role in the pathophysiology of neuropsychiatric disorders. The impact of repetitive transcranial magnetic stimulation (rTMS) on NMDAR-related amino acids remains unknown. We aim to investigate the effects of rTMS on NMDAR-related amino acids in serum of post-stroke patients.

Methods:

Ninety-five consecutive post-stroke patients with upper limb hemiparesis were recruited. In 27 patients, the Beck Depression Inventory (BDI) score was 10 or higher. Twelve depressed patients underwent rehabilitation in combination with rTMS and 15 non-depressed patients underwent rehabilitation only without rTMS for 14 days. 1 Hz rTMS was applied to the primary motor area in the non-lesional hemisphere. BDI was conducted before and after treatment. Serum glutamine, glutamate, glycine, l-serine, and d-serine levels were measured before and after treatment.

Results:

There were no differences between depressed patients and non-depressed patients in clinical characteristics, levels of the five amino acids in serum, and the ratio of amino acids. However, in 27 depressed patients, there was a significant correlation between levels of glutamate in serum and BDI (ρ = 0.428, p = 0.026). BDI decreased significantly in depressed patients after treatment with or without rTMS. d-serine decreased in the rehabilitation with rTMS group, but increased in the rehabilitation without rTMS group. l-serine increased in the rehabilitation with rTMS group, but decreased in the rehabilitation without rTMS group.

Conclusion:

The results suggest that rTMS can modulate NMDAR-related amino acids in blood, producing beneficial effects.

Keywords

N-methyl-D-aspartic acid receptorbrain-derived neurotrophic factorneural plasticitytranscranial magnetic stimulationglutamatergic neurotransmission
Type
Original Article
Information
Acta Neuropsychiatrica , Volume 32 , Issue 3 , June 2020 , pp. 128 - 134
Copyright
© Scandinavian College of Neuropsychopharmacology 2020

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