Transcranial Magnetic Stimulation in Neuropsychiatry [Hardcover]

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

Book Description

ISBN-10: 0880489480 | ISBN-13: 978-0880489485 | Publication Date: February 2000 | Edition: 1st

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.

Yet it wasn't until quite recently-1985 in fact-that the modern age of TMS began. Since then, TMS has played a pivotal role in exploring and mapping previously uncharted regions within the human brain.

This comprehensive, extensively annotated volume begins by tracing the history of TMS and then addresses-chapter by chapter-the current applications of TMS in specific disorders including movement disorders, epilepsy, major depression, bipolar disorder/mania, anxiety disorders, developmental stuttering and Tourette's syndrome, andschizophrenia. Readers will find "An overview of TMS physics," using a simple circular current loop model to illustrate the application of the relevant principles. "The basic physiology" of what can be measured and what can be affected by TMS, particularly instrumental in the measurement of cortical excitability or connectivity, and therapeutic intervention (e.g., Tourette's syndrome, schizophrenia, and some forms of epilepsy). "A dual focus on the effects of TMS on the motor cortex, "i.e., both the methods used to address the integrity of connection and the techniques used to measure the excitability of the motor cortex. "A comparison of the effects of TMS and ECT" in animal models of depression, showing that their similarities may further support the potential role of TMS as an antidepressant treatment while bringing us closer to the neuropsychiatric mechanism of TMS action. "A review of recent research" that shows how the use of TMS as a primary brain mapping (motor output maps, neuroplasticity, and perception) tool-already a valuable tool for the cognitive neuroscientist-will only increase in the coming years. "Discussions about safety concerns, TMS, and neuroimaging," and how TMS can be used with related therapeutic modalities.

Even with advances in neuroimaging, much of the adult human brain remains a mystery. With its clear text and wealth of illustrations," 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

Review

...a comprehensive review ... serv[ing] ... as an engaging starting point for those who wish to explore ... and as a reference... -- Robert M. Berman, M.D., Assistant Professor of Psychiatry, Yale University School of Medicine, New Haven, Connecticut

...an impressive and well achieved effort ... bring[ing] 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

About 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.

Product Details

• Hardcover: 298 pages
• Publisher: American Psychiatric Press; 1st edition (February 2000)
• Language: English
• ISBN-10: 0880489480
• ISBN-13: 978-0880489485
• Product Dimensions: 9.3 x 6.3 x 1 inches
• Shipping Weight: 1.6 pounds
• Amazon Best Sellers Rank: #1,594,378 in Books (See Top 100 in Books)

More About the Author

Mark S. George, M.D.

Distinguished Professor of Psychiatry, Radiology and Neuroscience
Founding Director, Center for Advanced Imaging Research
Director, Brain Stimulation Laboratory, Psychiatry
Medical University of South Carolina, Charleston

Staff Physician, Ralph H. Johnson VA Medical Center, Charleston, SC

As an undergraduate student in philosophy at Davidson College in Davidson, NC, Dr. George first began studying the relationship between mind and brain, or brain/behavior relationships. He has continued this interest throughout his career with a focus on using brain imaging and brain stimulation to understand depression and devise new treatments.

He received his medical degree from the Medical University of South Carolina in Charleston in 1985, where he continued with dual residencies in both neurology and psychiatry. He is board certified in both areas. Following his residency training he worked for one year (1990-91) as a Visiting Research Fellow in the Raymond Way Neuropsychiatry Research Group at the Institute of Neurology, Queen Square, London, England. During his fellowship he wrote one of the first textbooks in the new area of brain activation and imaging.

He then moved to Washington, DC, working with Dr. Robert Post in the Biological Psychiatry Branch of the Intramural National Institute of Mental Health (NIMH). During his 4 years at NIMH he was one of the first to use functional imaging (particularly oxygen PET) and discovered that specific brain regions change activity during normal emotions. He then started using imaging to understand brain changes that occur in depression and mania, a quest that he and many others are still pursuing. This imaging work directly led to his pioneering use of a non-invasive brain stimulation method, transcranial magnetic stimulation (TMS), as a probe of neuronal circuits regulating mood, and to clinical trials using TMS as an antidepressant. In 1993 while at the NIMH, he discovered that daily prefrontal rTMS over several weeks could treat depression and ever since he has worked to grow the science of TMS, both in terms of how it works in the brain, and in critically evaluating its therapeutic applications, especially in the area of treating depression. This was FDA approved in October, 2008. He has completed the pivotal study in this area with NIH funding and is now investigating its effectiveness in the VA population through a VA cooperative study.

In 1995 he moved back to Charleston from the NIH and built the functional neuroimaging division and brain stimulation laboratories at MUSC. This imaging group has grown into the MUSC Center for Advanced Imaging Research, which is now part of the SC Brain Imaging Center of Excellence. He continues to use imaging (particularly functional MRI) and non-invasive stimulation (TMS, tDCS or VNS), either separately or more recently in combination, to understand the brain regions involved in regulating emotion in health and disease. In June 1998 at MUSC, he also pioneered another new treatment for resistant depression, vagus nerve stimulation (VNS). This was FDA approved in 2006. He and his group have used MRI imaging to understand VNS brain effects.

He is a world expert in brain stimulation, and depression, and is the editor-in-chief of a new journal he launched with Elsevier in 2008 called, Brain Stimulation: Basic, Translation and Clinical Research in Neuromodulation. He has been continuously funded by NIH and other funding agencies since his fellowships. He has received both a NARSAD Young Investigator and Independent Investigator Award to pursue TMS research in depression. He has received numerous international awards including the NARSAD Klerman Award (2000), NARSAD Falcone Award (2008) and the Lifetime Achievement Award (2007) given by the World Federation of Societies of Biological Psychiatry (WFSBP). In 2009 US News and World Report named him one of 14 'medical pioneers who are not holding back'. He is on several editorial review boards and NIH study sections, has published over 300 scientific articles or book chapters, has 8 patents, and has written or edited 6 books.