Transcranial Brain Stimulation For Treatment Of Psychiatric Disorders

Transcranial magnetic stimulation (TMS) was introduced in the mid 1980s in clinical neurophysiology to study the central motor pathways. Research has been exponentially increased since, and many different methods for brain stimulation have been considered during the last decade. This publication focuses on transcranially applied, non- or low-invasive interventions not requiring an implantable device, i.e. electroconvulsive therapy (ECT), repetitive TMS (rTMS) and transcranial direct current stimulation (tDCS). It provides an excellent overview on this spectrum of fascinating techniques. Many leading experts in this field have contributed to this book. A single chapter summarizes the state of the art in ECT. A series of chapters provides an overview on preclinical research in animals and neuroimaging findings with rTMS and reviews the evidence of efficacy and safety in various psychiatric disorders (affective disorders, schizophrenia and anxiety disorders) also including an article on the application of rTMS in nonpsychiatric diseases, i.e. Parkinson's disease, stroke, pain and tinnitus. Finally, separate reviews discuss very recent innovative approaches in the field of rTMS, i.e. magnetic seizure therapy, theta burst stimulation and deep rTMS. This publication will doubtlessly prove to be essential reading not only to researchers in this field, but also to psychiatrists, neurologists and other clinicians who consider applying these new methods in clinical settings

The aim of this book is to provide a comprehensive review of the use of Transcranial Direct Current Stimulation (tDCS) in different psychiatric conditions. Here we review tDCS clinical studies employing different types of design (from single-session tDCS studies to randomized clinical trials) as well as studies evaluating the impact of tDCS in neurophysiological, behavioral and brain imaging outcomes. Although the understanding about physiological foundations and effectiveness of clinical therapies of psychiatric diseases has been considerably increased during the last decades, our knowledge is still limited, and consequently psychiatric diseases are still a major burden to the individual patient and society. Recently, interest in pathological alterations of neuroplasticity in psychiatric diseases as a critical condition for development, and amelioration of clinical symptoms increased, caused by the fact that new tools, such as functional imaging, and brain stimulation techniques do allow to monitor, and modulate these phenomena in humans. Especially non-invasive brain stimulation techniques evolved as an attractive potential new therapeutic tool. The interest in non-invasive brain stimulation has grown exponentially in the past 25 years, with the development of non-pharmacological, neuromodulatory techniques such as tDCS and repetitive transcranial magnetic stimulation (rTMS). TDCS, although even newer than rTMS, has attracted considerable attention in both basic and clinical research scenarios. In the context of clinical research, tDCS is being increasingly investigated as a novel treatment tool for several psychiatric disorders, such as major depression, schizophrenia and neurocognitive and substance abuse disorders. Transcranial Direct Current Stimulation in Neuropsychiatric Disorders – Clinical Principles and Management intends to serve as a practical guide on the field, attracting the interest of psychiatrists, neurologists and neuroscientists with little or no experience with tDCS, as well as those with a background on tDCS who want to increase their knowledge in any particular psychiatric condition.

Deep Brain Stimulation: A New Frontier in Psychiatry provides an overview of current developments and the future possibilities of deep brain stimulation for patients with therapy-refractory psychiatric disorders. The side-by-side presentation of clinical applications and animal research provides a truly translational approach. Also included is a special chapter on the ethical issues involved in deep brain stimulation in psychiatry. Deep brain stimulation of selected brain areas has been shown to result in a substantial improvement of symptoms and quality of life in patients suffering from obsessive-compulsive disorder, major depressive disorder and drug addiction. Although it is still an experimental therapy and the number of psychiatric patients that are treated is low, its effectiveness and safety makes deep brain stimulation the most promising therapy for treating other serious and life-threatening psychiatric conditions.

"The field of brain stimulation is advancing at rapid pace with a growing number of techniques now approved for the treatment of psychiatric illness. This text acts both as a concise, quick reference for experienced practitioners and a guidebook for residents learning about clinical brain stimulation techniques. The techniques covered include: Electroconvulsive therapy (ECT) -- Deep brain stimulation (DBS) -- Transcranial magnetic stimulation (TMS) -- Vagus nerve stimulation (VNS) -- Magnetic seizure therapy (MST) -- Transcranial direct current stimulation (TDCS) All aspects of these treatments are covered, from patient selection, through the implementation of the technique, to patient aftercare. Potential future applications are discussed and select, up-to-date reference lists guide practitioners to the most important further reading around each technique. Portable, concise and easy to navigate, covering all the need-to-know information, Brain Stimulation in Psychiatry is essential reading for practitioners, residents and medical students in psychiatry and neurology."--Provided by publisher.

Edited by an expert multidisciplinary team, Neuromodulation in Psychiatry is the first reference guide to address both invasive and non-invasive neuromodulation strategies used in psychiatry. Covers basic principles, technical aspects, clinical applications and ethical considerations Presents up-to-date evidence in comprehensive summaries suitable for all levels of experience Each technique is clearly explained along with its implications for real-world clinical practice Allows psychiatrists to make informed decisions regarding neuromodulation for their patients

The past two decades have seen rapid progress in new and less invasive ways to stimulate the brain to study and treat psychiatric disorders. This authoritative reference provides an introduction to this emerging field of brain stimulation in psychiatry. Eight recognized experts present the latest research and results -- and future challenges -- for new techniques to electrically stimulate the central nervous system, including transcranial magnetic stimulation (TMS), magnetic seizure therapy (MST), deep brain stimulation (DBS), and vagus nerve stimulation (VNS). This is the first book to both review these new techniques and place them in the context of existing somatic therapies in psychiatry. Unlike electroconvulsive therapy (ECT, the standard choice for patients with treatment-resistant depression), these breakthrough methods enable us to affect selectively higher cognitive processes and mood systems by electrically stimulating -- directly or indirectly -- focal regions of the cortex and subcortical structures in the brain. The effectiveness of TMS and MST (MST is a higher-dosage, convulsive form of magnetic stimulation) is being studied worldwide. Results are encouraging: TMS has been reported to reduce the frequency of auditory hallucinations when administered to brain regions that show abnormal hyperactivity during hallucinations, and both TMS and MST induce far less electricity and stimulate more focal cortical regions than ECT, thus incurring fewer cognitive side effects. Although DBS -- in which an electrode is implanted in a location relevant to the illness in question -- is more invasive than other modalities, it is able to reach deeper structures in a highly focal way, which may be important for illnesses like obsessive-compulsive disorder, whose circuitry relies heavily on subcortical structures. VNS is less invasive than DBS but more invasive than TMS or MST. Efficacy of VNS is uncertain. Improvement appears to build over time, and the hope is that months or years after implantation patients may show dramatic improvements. Claims of enhanced efficacy with time have never been tested directly, and controlled, randomized trials are needed to determine whether VNS has a role in the treatment of major depression. Its effects are limited to the neuroanatomical connectivity of the vagus nerve. Enriching our knowledge base in this exciting new field means more choices and therapeutic strategies for patients with conditions that resist conventional treatments. This fascinating work is a key reference for the promising future of brain stimulation in psychiatric treatment and is a "must read" for clinicians and residents alike.

This important book discusses today’s most current and cutting-edge applications of Deep Brain Stimulation (DBS). The book begins with reviews of the functional anatomy and physiology of motor and nonmotor aspects of the basal ganglia and their connections which underlie the application of DBS to neurological and psychiatric disorders. This is followed by proposed mechanisms of action of DBS based on functional neuroimaging and neurophysiologic studies in animals and man.