Transcranial Magnetic Stimulation in Neuropsychiatry

Transcranial Magnetic Stimulation in Neuropsychiatry

by Mark S. George
     
 

Transcranial magnectic stimulation (TMS) is a neurological technique for inducing motor movement by direct magnetic stimulation of the brain’s motor cortex—while the subject is awake and alert—to measure connectivity and excitability. It depends on the principle of mutual induction (discovered by Michael Faraday in 1831), whereby electrical energy

Overview

Transcranial magnectic stimulation (TMS) is a neurological technique for inducing motor movement by direct magnetic stimulation of the brain’s motor cortex—while the subject is awake and alert—to measure connectivity and excitability. It depends on the principle of mutual induction (discovered by Michael Faraday in 1831), whereby electrical energy can be converted into magnetic fields, and magnetic fields can be converted into electrical energy. The ability to measure the excitability of the motor cortex in important in neuropsychiatry for several reasons: 1) TMS may prove valuable as a diagnostic tool, because there is increasing evidence of altered motor cortex excitability in several neuropsychiatric disorders. 2) Stimulus parameters (especially stimulus intensity) must be adjusted to the patient’s individual motor excitability in repetitive TMS (rTMS) treatment protocols. Therefore, the knowledge of how to measure motor cortex excitability is indispensable. 3) Evidence shows that various rTMS protocols can increase or decrease cortical excitability and thus can be used therapeutically to normalize altered excitability in neuropsychiatry diseases.

How did TMS evolve into the techniques used today? How does it fit into the localization debate (the idea that physiological functions are organized into discrete brain regions), now reenergized by the advent of modern neuroimaging tools (PET, SPECT, and MRI)? How does it differ from ECT? For what disorders is TMS effective, and how is this effectiveness measured? What safety concerns are involved? Where is future research headed?

For the answers to these questions, readers can nowturn to a single source, Transcranial Magnetic Stimulation in Neuropsychiatry. In these fascinating chapters rich with illustrations, current clinical researchers describe how—thanks to TMS—they now have elaborate roadmaps of the brain regions putatively involved in specific disorders including movement disorders, epilepsy, major depression, bipolar disorder/mania, anxiety disorders, developmental stuttering and Tourette’s syndrome, and schizophrenia.

Even with advances in neuroimaging science, much of the adult human brain remains a mystery. Transcranial Magnetic Stimulation in Neuropsychiatry helps shed light on the astonishing intricacies of brain function and organization, and as such is a must-read for anyone interested in how the brain works—clinical researchers of brain function, neuroscientists, neurologists, general psychiatrists, neuropsychiatrists, psychologists, and social workers.

Editorial Reviews

Doody's Review Service
Reviewer: William Scheftner, MD (Rush University Medical Center)
Description: This is an introduction and explication of repetitive transcranial magnetic stimulation (rTMS) to a primary audience of psychiatrists. The editors begin with an historical introduction and progress through basic physics, basic neurophysiological studies, animals models, safety issues, and potential clinical applications. This is a multiauthored book edited by two of the major contributors to the field.
Purpose: ...Many scientists have dreamed of being able to stimulate the brain noninvasively... and simultaneously observe changes in behavior.. the [contributors] detail how transcranial magnetic stimulation... has advanced very close to that goal... as a prelude..., it may be helpful to also remember where TMS fits into the intellectual progression... of localizing function within the brain... it is important to understand the recent technological developments that have paved the way for... current work with TMS. "This book is clearly needed, and the editors have succeeded!"
Audience: This book is written for all levels of basic scientists, research clinicians, and clinicians who want to understand this new technique of investigation and putative treatment primarily within the field of mental health. Research neurologists will find much of interest in the excellent chapters on conduction times and rTMS potential uses in epilepsy research. The editors and contributors are internationally renowned experts in neurophysiology, rTMS, and clinical research in psychiatric disorders.
Features: Initially an historical overview is presented with a pertinent but not overwhelming amount of basic science in four chapters. Safety considerations are thoroughly discussed and the remaining chapters are devoted to rTMS utility in investigating and treating disorders such as Tourette's syndrome, movement disorders, and classical psychiatric syndromes. Excellent bibliographies follow each chapter.
Assessment: The editors have produced a first rate book on rTMS. It is the only one on this subject (to my knowledge) which provides the basic scientist, the research clinician, and the curious clinician with the factual framework and organization to read the literature and grasp the problems and potentials of the field in a compact 295 pages. I recommend this book very highly and am unaware of any other which would permit comparisons. It is an excellent textbook and compendium for this emerging technique.
4 Stars! from Doody
William Scheftner
This is an introduction and explication of repetitive transcranial magnetic stimulation (rTMS) to a primary audience of psychiatrists. The editors begin with an historical introduction and progress through basic physics, basic neurophysiological studies, animals models, safety issues, and potential clinical applications. This is a multiauthored book edited by two of the major contributors to the field. "...Many scientists have dreamed of being able to stimulate the brain noninvasively... and simultaneously observe changes in behavior.. the [contributors] detail how transcranial magnetic stimulation... has advanced very close to that goal... as a prelude..., it may be helpful to also remember where TMS fits into the intellectual progression... of localizing function within the brain... it is important to understand the recent technological developments that have paved the way for... current work with TMS." This book is clearly needed, and the editors have succeeded! This book is written for all levels of basic scientists, research clinicians, and clinicians who want to understand this new technique of investigation and putative treatment primarily within the field of mental health. Research neurologists will find much of interest in the excellent chapters on conduction times and rTMS potential uses in epilepsy research. The editors and contributors are internationally renowned experts in neurophysiology, rTMS, and clinical research in psychiatric disorders. Initially an historical overview is presented with a pertinent but not overwhelming amount of basic science in four chapters. Safety considerations are thoroughly discussed and the remaining chapters are devoted to rTMS utilityin investigating and treating disorders such as Tourette's syndrome, movement disorders, and classical psychiatric syndromes. Excellent bibliographies follow each chapter. The editors have produced a first rate book on rTMS. It is the only one on this subject (to my knowledge) which provides the basic scientist, the research clinician, and the curious clinician with the factual framework and organization to read the literature and grasp the problems and potentials of the field in a compact 295 pages. I recommend this book very highly and am unaware of any other which would permit comparisons. It is an excellent textbook and compendium for this emerging technique.

Product Details

ISBN-13:
9780880489485
Publisher:
American Psychiatric Publishing, Inc.
Publication date:
02/28/2000
Edition description:
New Edition
Pages:
280
Product dimensions:
6.27(w) x 9.32(h) x 0.97(d)

What People are saying about this

Robert M. Berman
...The finely integrated and rich chapters provide a comprehensive review that can serve both as an engaging starting point for those who wish to explore this exciting new area and as a reference work for those already involved in it (Robert M. Berman, M.D., Assistant Professor of Psychiatry, Yale University School of Medicine, New Haven, Connecticut).
Thomas E. Schlaepfer
...an impressive and well achieved effort to bring conceptual and methodological order to a new and very promising field in psychiatry...(Thomas E. Schlaepfer, M.D., Associate Professor of Psychiatry and Mental Hygiene, The Johns Hopkins Hospital and School of Public Health, Associate Professor of Psychiatry, Psychiatric Neuroimaging Group,University Hospital Bern, Switzerland)

Meet the Author

Mark S. George, M.D., is Director of the Functional Imaging Division, Psychiatry, and Psychiatric Neuroimaging at the Ralph H. Johnson VA Medical Center; and Director of the Magnetic Brain Stimulation Laboratory and Professor of Psychiatry, Radiology, and Neurology 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.

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