​Repetitive transcranial magnetic stimulation (rTMS) treatment is increasingly being used in the management of patients with depression. Nevertheless, considerable ignorance still exists about the treatment in general psychiatric practice. This concise clinical guide will serve as a reference and practical tool for clinicians working with or learning about this treatment technique. The opening chapters provide basic information on the history and development of rTMS treatment and its mechanism of action. Use of the treatment in depression is then addressed in detail, with explanation of the evidence base and discussion of a variety of clinical issues. Side-effects of treatment are explored, and careful consideration is given to the establishment of rTMS treatment programs and the training of clinicians. The final chapters will provide a brief overview of potential rTMS applications in other psychiatric conditions and some background on related treatments.
Repetitive transcranial magnetic stimulation (rTMS) treatment is increasingly a standard part of the management of patients with depression supported by a rapidly expanding research base. This new expanded and amended concise clinical guide will serve as a reference and practical tool for clinicians working with or learning about this treatment technique. The opening chapters provide basic information on the history and development of rTMS treatment and its mechanism of action. Use of the treatment in depression is then addressed in detail, with explanation of the evidence base and discussion of a variety of clinical issues. Side-effects of treatment are explored, and careful consideration is given to the establishment of rTMS treatment programs. There is an updated review of the use of a rTMS applications in other psychiatric conditions such as obsessive-compulsive disorder. New chapters in this edition address the use of deep TMS, theta burst stimulation, accelerated forms of rTMS and what to do in patients not responding to initial therapy. In addition, the various approaches to treatment targeting are addressed in detail. This book will provide the rTMS practitioner or interested generalist an up-to-date and comprehensive understanding of the field as well as provide considerable practical clinical advice.
The Clinical Guide serves as a reference tool for clinicians in the administration of transcranial magnetic stimulation (TMS) for neuropsychiatric disorders. The primary intent of this Guide is to focus on the clinical applications of TMS and to offer detailed information on the safe and effective administration of TMS with consideration of the neurophysiological effects particularly in relation to safety, targeting specific cortical areas and practical issues such as the length of treatment sessions and the durability of the TMS response. The Guide focuses on the evidenced based literature and utilizes this literature to inform specific recommendations on the use of rTMS in a clinical setting. The efficacy and safety of TMS for neuropsychiatric disorders, including its use in special populations, such as the elderly, will be reviewed to facilitate clinical decision-making. The Guide will also outline setting up a TMS service including practical issues such as considerations for the qualifications of the person administering the treatment, the use of concomitant medications, what equipment is necessary to have in the treatment room and monitoring the outcomes to treatment. The Guide is intended to be a practical reference for the practicing clinician in the safe and effective administration of TMS.
A guide to the use of transcranial magnetic stimulation to reversibly disrupt cortical functioning as a means of studying perceptual and cognitive functions.
Covers the diagnostic and clinical applications of transcranial magnetic stimulation (TMS) and offers cutting-edge, in-depth guidance on the use of TMS to study brain physiology and pathophysiology as well as its current and future therapeutic uses. Readers will find the essential up-to-date information they need to make the most of this dynamic method. Delivers a detailed analysis of the physics of magnetic stimulation as well as basic mechanisms of how magnetic stimulation activates neural tissue. Presents expert guidance on the clinical uses of TMS as well as its therapeutic and research applications.
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.
Edited by clinicians who were involved with transcranial magnetic stimulation (TMS) from the beginning, Transcranial Magnetic Stimulation: Clinical Applications for Psychiatric Practice offers everything the mental health practitioner needs to know about this innovative and well-established treatment. It is increasingly clear that different combinations of biological, neurobehavioral, and symptomatic factors contribute to the problem of "treatment resistance" in psychiatric disorders. Fortunately, a number of neuromodulation approaches, including TMS, are providing more options for clinicians to combat psychiatric problems. However, guidance about how to identify patients who are good candidates for TMS and how to comanage them during treatment is scarce because instruction on this modality has yet to be integrated into most psychiatry residencies. Thus, this text fills a great need, providing clinicians with an evidence-based foundation for the efficacy and safety of TMS. Despite the rapid growth of this innovative option, many practitioners are unclear about how best to utilize TMS. The book addresses these clinical concerns systematically and thoroughly: - Clinical vignettes illustrate how to identify appropriate patients for referral to a TMS clinician. - Discussions of treatment resistance, psychiatric and medical comorbidities, and preparation of the patient for TMS are included. - Because TMS is likely to be used concurrently with other treatments, the book explains how to best integrate this modality with psychotherapy, pharmacotherapy, and other forms of neuromodulation to improve outcomes. - In-depth coverage is provided on how to coordinate efforts between the primary treatment and TMS teams to assure the best outcomes during acute, continuation, and maintenance treatment. - Chapters provide a review of topic-specific literature, as well as clinical vignettes that highlight how to integrate TMS into patient care. - Key clinical points summarize the optimal clinical application of TMS for the general mental health provider. - The evolving nature of TMS research, such as the ongoing development of this and related technologies, as well as its expanding use as a potential treatment for other clinical neuropsychiatric conditions, is also addressed. Transcranial Magnetic Stimulation: Clinical Applications for Psychiatric Practice guides the general psychiatrist and mental health clinician on how to integrate this treatment modality into their practice by presenting an update on the current clinical role of TMS and a road map to its potential future.
Transcranial magnetic stimulation (TMS) is a widely used non-invasive brain stimulation technique. It represents an exciting new frontier in neuroscience research and can be used to examine neural processes, providing insights into pathophysiology and treating a variety of neuropsychiatric illnesses. A Practical Guide to Transcranial Magnetic Stimulation Neurophysiology and Treatment Studies presents an overview of the use of TMS as both an investigational tool and as treatment for neurological and psychiatric disorders. The chapters include an overview of the history and basic principles of TMS and repetitive TMS (rTMS), the different types of TMS coils, different stimulation approaches, the use of neuronavigation, and safety considerations. The utility of single and paired TMS techniques to measure cortical inhibition, facilitation, connectivity and reactivity in motor and non-motor brain areas, the different methods of using TMS to induce brain plasticity, and use of TMS in cognitive studies are explored. It also covers TMS and rTMS combined with electroencephalography (EEG) in neurophysiological studies. The authors provide a summary of the clinical applications of TMS in neurological and psychiatric disorders including depression, schizophrenia, stroke, Parkinson disease, and pain. This up-to-date volume provides a compendious review of the use of TMS and rTMS that will help guide the utility of this methodology in both clinical and research settings. This practical guide will be a useful resource for those new to the field, as well as experienced users, for both research and clinical settings.
