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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S8–S52

and tDCS in neuropsychiatric patients and healthy subjects have

found promising results.

By combining neuroimaging and NIBS new functional models can

be developed and compared in different health and pathology

states, e.g. in the development of any given psychiatric disorder.

Disclosure of interest

Supported by the Federal Ministry

of Research and Education (“Forschungsnetz für psychische

Erkrankungen”, German Center for Brain Stimulation–GCBS–WP5).


Cognitive enhancement in young

healthy subjects using non-invasive

brain stimulation and cognitive


A.K. Brem

Munich, Germany

Transcranial electrical stimulation (tES) is being widely investi-

gated to understand and modulate human brain function. The

interest in using tES to enhance cognitive abilities not only in

patient populations but also in healthy individuals has grown in

recent years. Specifically in combination with cognitive training

tES has shown success in enhancing cognition. However, to date,

we still know little about the impact of interindividual differences

on intervention outcomes. A variety of tES techniques and their

effects in combination with cognitive training, interactive effects of

tES with baseline cognitive abilities and neurophysiological traits

will be presented and following ramifications with regards to the

development of individualised stimulation protocols will be dis-


Disclosure of interest

The author has not supplied his declaration

of competing interest.


Corticospinal excitability predicts

antidepressant response to rTMS

A. Oliveira-Maia

1 ,

, D. Press


, A. Pascual-Leone



Champalimaud Clinical Centre, Champalimaud Centre for the

Unknown, Neuropsychiatry Unit, Lisbon, Portugal


Beth Israel Deaconess Medical Center-Harvard Medical School,

Berenson-Allen Center for Non-invasive Brain Stimulation, Division of

Cognitive Neurology, Department of Neurology, Boston, USA

Corresponding author.

Repetitive transcranial magnetic stimulation (rTMS) targeting the

left dorsolateral prefrontal cortex (DLPFC) is a treatment option

for patients with medication-resistant major depressive disorder

(MDD). However, antidepressant response is variable and there

are currently no response predictors with sufficient accuracy for

clinical use. Here we report on results of an observational open-

label study to determine whether the modulatory effect of 10Hz

motor cortex (MC) rTMS is predictive of the antidepressant effect

of 10Hz DLPFC rTMS. Fifty-one medication-resistant MDD patients

were enrolled for a 10-day treatment course of DLPFC rTMS and

antidepressant response was assessed according to post-treatment

reduction of the 17-item Hamilton Rating Scale for Depression

score. Prior to treatment, we assessed the modulation of motor

evoked potential (MEP) amplitude by MC rTMS. We measured

MEP’s to single pulse TMS using surface electromyography, before

and afterMC rTMS, and calculatedMEPmodulation as the change of

meanMEP amplitude after MC rTMS. MEP modulation proved to be

a robust predictor of reduction of clinician-rated depression sever-

ity following the course of DLPFC rTMS: larger MC rTMS-induced

increase of corticospinal excitability anticipated a better antide-

pressant response. These findings suggest that MC rTMS-induced

modulation of corticospinal excitability warrants further evalua-

tion as a potential predictive biomarker of antidepressant response

to left DLPFC 10Hz rTMS, and could inform future developments of

rTMS to treat depression.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

Symposium: Staging of psychiatric disorders:

Integrating neurobiological findings


Staging in bipolar disorder: Clinical,

biochemical, and functional correlates

I. Grande

Hospital Clinic de Barcelona, Barcelona, Spain

In the field of bipolar disorder, some proposals of a staging

model have been suggested considering the progressive features

of the disorder. The staging model regards special features of

the patients and further draws a route to define the progno-

sis and treatment as well as the neurobiological background of

the disorder. The aim of this model is to identify rational ther-

apeutic targets and provide the most effective and less toxic

intervention in a time-sensitive manner. Advocating for a model

of staging in bipolar disorder that can group the patients accord-

ing to quantitative cut-offs of common practice clinical variables

as well as defining a biochemical correlation seems to be a further

step towards an operative and valid model of staging in bipolar


Disclosure of interest

Dr. I. Grande has received a Juan Rodés Con-

tract (JR15/00012), Instituto de Salud Carlos III, Spanish Ministry of

Economy and Competiveness, Barcelona, Spain and has served as a

consultant for Ferrer and as a speaker for AstraZeneca, Ferrer and



Staging & profiling in addiction, can

we cross the gap from bench to


A. Schellekens

Nijmegen, The Netherlands

Addictive behaviours are highly common (prevalence worldwide

about 10%), with major impact on the individual and society (con-

tributing to 5% of overall DALYs and mortality)

[1,2] .

Though a

number of evidence-based treatments are available, relapse rates

remain high, up to 50%within one year of treatment

[3,4] . S

taging of

addictive behaviors might contribute to improve this prognosis by

indicating which patient could benefit most fromwhich treatment


In DSM-5 clinical staging of addictive disorders is limited to grading

the severity of the disorder, based on criterion counts

[5] .


ever, addictive disorders are highly heterogeneous, with distinct

clinical profiles and neurobiological underpinnings of the disorder.

Reward-processing deficits are considered a hallmark of addiction.

Several additional neurobiological deficits have been identified in

addicted individuals, such as dysfunction of brain stress systems,

anterior cingulate cortex and habenula.

These neurobiological deficits may identify clinical subgroups of

patients with distinct pathophysiology (profiling), or be related to

progression of the disorder (staging). This presentation will focus