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Evidence of transcranial direct current stimulation-generated electric fields at subthalamic level in human brain in vivo
Transcranial direct current stimulation (tDCS) is a promising brain modulation technique for several disease conditions. With this technique, some portion of the current penetrates through the scalp to the cortex and modulates cortical excitability, but a recent human cadaver study questions the amount. This insufficient intracerebral penetration of currents may partially explain the inconsistent and mixed results in tDCS studies to date. Experimental validation of a transcranial alternating current stimulation-generated electric field (EF) in vivo has been performed on the cortical (using electrocorticography, ECoG, electrodes), subcortical (using stereo electroencephalography, SEEG, electrodes) and deeper thalamic/subthalamic levels (using DBS electrodes).Single pulse TMS to the DLPFC, compared to a matched sham control, induces a direct, causal increase in caudate, cingulate, and thalamic BOLD signal
In the 20 years since our group established the feasibility of performing interleaved TMS/fMRI, no studies have reported direct comparisons of active prefrontal stimulation with a matched sham. Thus, for all studies there is concern about what is truly the TMS effect on cortical neurons.61% of unmedicated treatment resistant depression patients who did not respond to acute TMS treatment responded after four weeks of twice weekly deep TMS in the Brainsway pivotal trial
An acute course of dTMS typically involves treatments delivered 5 days a week, for 4 weeks. Should more treatments be given if the patient has not responded? Data are needed to inform decisions about the best next steps for acute non-responders.A Double-Blind Study Exploring the Use of Transcranial Direct Current Stimulation (tDCS) to Potentially Enhance Mindfulness Meditation (E-Meditation)
In the past decade, Western medicine has seen increased interest in mindfulness-based interventions (MBIs) for the treatment of neuropsychiatric disorders [1]. MBIs are associated with improvements in physical, mental, and social well-being, along with decreased feelings of stress, anxiety, depressive symptoms, rumination, and cognitive reactivity. MBIs also improve pleasant affect, life satisfaction, empathy, and task performance [2]. Although still considered in their infancy, MBIs are a promising complement to standard neuropsychiatric interventions.The Clinical TMS Society Consensus Review and Treatment Recommendations for TMS Therapy for Major Depressive Disorder
TMS therapy uses a computerized, electromechanical medical device to produce and deliver non-invasive, magnetic stimulation using brief duration, rapidly alternating, or pulsed, magnetic fields to induce electrical currents directed at spatially discrete regions of the cerebral cortex. This method of cortical stimulation by application of brief magnetic pulses to the head is known as transcranial magnetic stimulation or TMS. When pulses of TMS are delivered repetitively, this is called repetitive TMS, or rTMS.A Two-site Pilot Randomized 3 Day Trial of High Dose Left Prefrontal Repetitive Transcranial Magnetic Stimulation (rTMS) for Suicidal Inpatients
Suicide attempts and completed suicides are common, yet there are no proven acute medication or device treatments for treating a suicidal crisis. Repeated daily left prefrontal repetitive transcranial magnetic stimulation (rTMS) for 4–6 weeks is a new FDA-approved treatment for acute depression. Some open-label rTMS studies have found rapid reductions in suicidality.2010 Updated Avery-George-Holtzheimer Database of rTMS depression studies
Transcranial magnetic stimulation (TMS) is a rapidly advancing tool used for the acute treatment of depressed patients. Beginning in 1993, researchers and clinicians have used a variety of TMS methods to study its antidepressant efficacy. As the studies began to unfold, it became clear that various researchers were stimulating in different ways, and that these variables (coil type, location, dose, frequency) might impact clinical outcome. In 1998, several researchers tabulated the then-published TMS depression studies into a workable and easily accessible excel spreadsheet and made this list available for free download from the first internet website of the International Society for Transcranial Stimulation (ISTS).
