Article

Deep transcranial magnetic stimulation as a treatment for psychiatric disorders: A comprehensive review.

Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
European Psychiatry (Impact Factor: 3.29). 05/2012; DOI: 10.1016/j.eurpsy.2012.02.006
Source: PubMed

ABSTRACT Deep transcranial magnetic stimulation (TMS) is a technique of neuromodulation and neurostimulation based on the principle of electromagnetic induction of an electric field in the brain. The coil (H-coil) used in deep TMS is able to modulate cortical excitability up to a maximum depth of 6cm and is therefore able not only to modulate the activity of the cerebral cortex but also the activity of deeper neural circuits. Deep TMS is largely used for the treatment of drug-resistant major depressive disorder (MDD) and is being tested to treat a very wide range of neurological, psychiatric and medical conditions. The aim of this review is to illustrate the biophysical principles of deep TMS, to explain the pathophysiological basis for its utilization in each psychiatric disorder (major depression, autism, bipolar depression, auditory hallucinations, negative symptoms of schizophrenia), to summarize the results presented thus far in the international scientific literature regarding the use of deep TMS in psychiatry, its side effects and its effects on cognitive functions.

0 Bookmarks
 · 
173 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: With the advent of non-invasive brain stimulation (NIBS), a new decade in the study of language has started. NIBS allows for testing the functional relevance of language-related brain activation and enables the researcher to investigate how neural activation changes in response to focal perturbations. This review focuses on the application of NIBS in the healthy brain. First, some basic mechanisms will be introduced and the prerequisites for carrying out NIBS studies of language are addressed. The next section outlines how NIBS can be used to characterize the contribution of the stimulated area to a task. In this context, novel approaches such as multifocal transcranial magnetic stimulation and the condition-and-perturb approach are discussed. The third part addresses the combination of NIBS and neuroimaging in the study of plasticity. These approaches are particularly suited to investigate short-term reorganization in the healthy brain and may inform models of language recovery in post-stroke aphasia.
    Brain and Language 11/2014; · 3.39 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: By combining transcranial magnetic stimulation (TMS) with intravenous ketamine therapy, we sought to increase the therapeutic value of TMS and, at the same time, to improve the efficacy of intravenous ketamine therapy among depressed patients previously classified as non-responders. In this preliminary report, we provide evidence for a new and much more reliable method of treating patients with treatment resistant depression. Twenty-eight patients with various degrees of treatment unresponsive depression were treated with a combination of TMS and ketamine infusion. Of these patients, twenty received pretreatment for 3 days to 2 weeks involving intensive (thrice daily) rTMS treatment administered 6 or 7 days/week or priming TMS treatment immediately prior to the combination TMS-ketamine infusion combination therapy. Eight patients received neither pretreatment nor priming. All of the 28 patients who did fully participate in the first month of treatment experienced relief of psychiatric symptoms, and showed significant psychosocial recovery. In contrast to previous studies examining ketamine or rTMS individually, the positive outcomes presented here suggest a synergistic effect of the combination therapy of TMS and ketamine infusion.
    Activitas nervosa superior 06/2014; 56(1-2):28-36.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Transcranial magnetic stimulation (TMS) is a noninvasive method of brain stimulation used to treat a variety of neuropsychiatric disorders, but is still in the early stages of study as addiction treatment. We identified 19 human studies using repetitive TMS (rTMS) to manipulate drug craving or use, which exposed a total of 316 adults to active rTMS. Nine studies involved tobacco, six alcohol, three cocaine, and one methamphetamine. The majority of studies targeted high-frequency (5–20 Hz; expected to stimulate neuronal activity) rTMS pulses to the dorsolateral prefrontal cortex. Only five studies were controlled clinical trials: two of four nicotine trials found decreased cigarette smoking; the cocaine trial found decreased cocaine use. Many aspects of optimal treatment remain unknown, including rTMS parameters, duration of treatment, relationship to cue-induced craving, and concomitant treatment. The mechanisms of rTMS potential therapeutic action in treating addictions are poorly understood, but may involve increased dopamine and glutamate function in corticomesolimbic brain circuits and modulation of neural activity in brain circuits that mediate cognitive processes relevant to addiction, such as response inhibition, selective attention, and reactivity to drug-associated cues. rTMS treatment of addiction must be considered experimental at this time, but appears to have a promising future.
    Annals of the New York Academy of Sciences 07/2014; · 4.38 Impact Factor

Full-text

Download
51 Downloads
Available from
May 22, 2014