Transcranial Magnetic Stimulation in Clinical Psychiatry

by Mark S. George MD (Editor), Robert H. Belmaker MD (Editor)

Overview

As understanding evolves about how different brain regions are involved in carrying out everyday tasks -- and in causing brain diseases when they go awry -- this book describes a new technology that allows physicians to focally stimulate the brain in awake adults through a non-invasive procedure. Transcranial Magnetic Stimulation in Clinical Psychiatry is an accessible and authoritative review of TMS, a procedure that is showing promise as a treatment in several disorders. Its authors explain how the procedure works, then the latest findings in a wide range of situations -- notably in depression, but also in other conditions ranging from migraine to stroke recovery.

This concise overview of TMS offers practical guidance for psychiatrists and other clinicians using it as a therapy, or referring their patients to have this done, as well as updating the field for neuroscientists and neurologists. It begins with background on the physics and safety of TMS, a guide for administering the procedure, and a review of basic neurophysiological studies with TMS, showing how it can be used to measure connectivity and excitability of the cerebral cortex. The heart of book is then devoted to its clinical applications, organized by disorder: • Epilepsy, movement disorders, and pain -- describes the use of TMS in inducing and inhibiting seizures and investigating their pathophysiology; in treating Parkinson's disease; and in relieving pain through motor cortex stimulation• Major depression -- provides a critical review of research in the most-studied clinical application of TMS in psychiatry, where it is used as a therapeutic intervention and a neurophysiological probe• Mania -- explores the effectiveness of TMS in light of its ECT-like properties through a trial of right TMS vs. sham TMS• Anxiety disorders -- reports on investigations on the uses of TMS in treating obsessive-compulsive disorder and posttraumatic stress disorder• Schizophrenia -- reviews studies utilizing single- or paired-pulse TMS to assess cortical inhibition and those that explore effects of extended trains of repetitive TMS in altering symptoms

A further chapter on TMS in brain imaging shows how integrating imaging and TMS allows one to better place the TMS coil, better understand TMS effects on the brain, and improve understanding of how the brain mediates behavior. With a concluding overview of prospects for the future of repetitive TMS, this volume offers a definitive look at this cutting-edge research and provides critical guidance on how and when clinicians might use TMS in their practice.

Product Details

ISBN-13:	9781585626373
Publisher:	American Psychiatric Publishing, Incorporated
Publication date:	04/02/2007
Sold by:	Barnes & Noble
Format:	eBook
Pages:	289
File size:	5 MB
Age Range:	18 Years

About the Author

Mark S. George, M.D., is Director of the Center for Advanced Imaging Research; Director of the Brain Stimulation Laboratory; and University Distinguished Professor of Psychiatry, Radiology, and Neurosciences at the Medical University of South Carolina in Charleston, South Carolina.

Robert H. Belmaker, M.D., is Hoffer-Vickar Professor of Psychiatry at Beer Sheva Mental Health Center and on the Faculty of Health Sciences at the Ben Gurion University of the Negev in Beersheva, Israel. He is President-elect of CINP, the International College of Neuropsychopharmacology.

Table of Contents

ContributorsChapter 1. Overview of transcranial magnetic stimulation: history, mechanisms, physics, and safetyChapter 2. Methods of administering transcranial magnetic stimulationChapter 3. Basic neurophysiological studies with transcranial magnetic stimulationChapter 4. Transcranial magnetic stiumlation in epilepsy, movement disorders, and painChapter 5. Transcranial magnetic stimulation in major depressionChapter 6. Transcranial magnetic stiumulation in maniaChapter 7. Transcranial magnetic stimulation in anxiety disordersChapter 8. Transcranial magnetic stimulation studies of schizophreniaChapter 9. Transcranial magnetic stimulation and brain imagingChapter 10. Repetitive transcratnial magnetic stimulation and related somatic therapies: Prospects for the futureEpilogue for the ClinicianIndex

What People are Saying About This

David H. Avery

In Transcranial Magnetic Stimulation in Clinical Psychiatry, international experts summarize the rapidly growing database concerning TMS. The authors discuss topics ranging from the basic principles of TMS to its practical application. This book will be extremely useful for both the clinician unfamiliar with TMS and the seasoned neuroscience researcher.

Editorial Reviews

Reviewer: Philip G. Janicak, MD (University of Illinois at Chicago College of Medicine)
Description: This book considers the history, mechanisms, physics, and administration of transcranial magnetic stimulation (TMS); basic neurophysiological studies; and the therapeutic application of TMS. It also discusses brain imaging techniques to decipher its mechanism of action and future directions.
Purpose: Given the completely novel therapy TMS represents, the book provides the necessary background in anticipation of FDA approval for treatment of depression.
Audience: Practitioners in psychiatry and neurology and resident trainees are the intended audience. The editors and contributors have international status in this area.
Features: The book covers critical issues beginning with a concise and clearly written overview. It also emphasizes important differences between TMS and ECT and how TMS may fit into a treatment algorithm with other emerging somatic therapies such as vagus nerve stimulation (VNS) and deep brain stimulation (DBS). While TMS is generally well tolerated, the editors appropriately note the need for more information about adverse effects with chronic exposure.
Assessment: Practical issues of administering TMS are well covered and underscore the need for a training and certification process. A discussion is included on the management of an inadvertent seizure, which is uncommon but obviously a serious event. The chapter on basic neurophysiology considers the impact on brain connectivity and excitability but is not as critical for practitioners, serving more as a reference source. Therapeutic application of TMS appropriately emphasizes its use for depression with shorter discussions on neurological disorders, mania, anxiety disorders, and schizophrenia. Discussions also cover combining TMS with imaging to explore how it affects the brain and how the brain mediates behavior. The authors even envision the possibility of an "MRI/TMS machine" which could provide unprecedented research and therapeutic options. While the writing is uneven and overly technical in some discussions, this is a unique compendium which provides the necessary background to use TMS therapeutically and a fascinating glimpse into future applications.

Doody's Review Service

To my knowledge, this is the fist book to compile the large boy of data surrounding the theory and research of [Transcranial Magnetic Stimulation]. It does an admirable job, and the book will be a useful reference source for clinicians, researchers, and those in training.

PsycCRITIQUES

The cutting edge nature of the field is well served by this impressive feat. Trancranial Magnetic Stimulation in Clinical Psychiatry, Published by American Psychiatric Publishing, Inc. serves as a force for unification as well. The editors if this relatively slim (270 pp.), yet impressively comprehensive volume have brought to gather many of the international leading lights in the field. The well-researched and referenced chapters offer back ground on the basic physics and the electrophysiology behind the use of TMS.

The Journal of Nervous and Mental Disease

The authors are well informed, as one would expect from the main research proponents of the method. Both the budding magnet-therapist and the neuroscientist will find technical and scientific details that are essential for their work. The layout is clear and concepts, as well as techniques, are generously and well illustrated.

British Journal of Psychiatry

The authors are well informed, as one would expect from the main research proponents of the method. Both the budding magnet-therapist and the neuroscientist will find technical and scientific details that are essential for their work. The layout is clear and concepts, as well as techniques, are generously and well illustrated.

The cutting edge nature of the field is well served by this impressive feat. Trancranial Magnetic Stimulation in Clinical Psychiatry, Published by American Psychiatric Publishing, Inc. serves as a force for unification as well. The editors if this relatively slim (270 pp.), yet impressively comprehensive volume have brought to gather many of the international leading lights in the field. The well-researched and referenced chapters offer back ground on the basic physics and the electrophysiology behind the use of TMS.

To my knowledge, this is the fist book to compile the large boy of data surrounding the theory and research of [Transcranial Magnetic Stimulation]. It does an admirable job, and the book will be a useful reference source for clinicians, researchers, and those in training.

From the Publisher