Brain Stimulation Therapies for Clinicians provides a clear and straightforward analysis of its many therapeutic applications and the technologies and techniques involved in each. This book is an essential reference for any clinician considering the use of electrical stimulation therapies.
A comprehensive survey of the state of current practice, this new edition of Brain Stimulation Therapies for Clinicians provides thoroughly updated information on the growing list of electrical stimulation therapies now in use or under study, including electroconvulsive therapy (ECT), vagus nerve stimulation (VNS), transcranial magnetic stimulation (TMS), deep brain stimulation (DBS), cortical stimulation (CS), and transcranial direct current stimulation (TDCS), as well as new coverage of promising treatments such as low intensity focused ultrasound pulsation (LIFUP) and temporal interference stimulation (TI). After a brief course on the fundamentals of electricity and a refresher on neuroanatomy, the text explores how electricity works within biological systems before progressing to the chapters on individual therapies, which cover the history and evolution of the treatment, the techniques involved, clinical indications, side effects, and an up-to-date review of the evidence base supporting its use. The book is designed to help the reader cut through the initially daunting "alphabet soup" (e.g., ECT, TMS) by providing a clear and straightforward analysis of the prevailing techniques -- an indispensable resource for both clinicians and patients seeking in-depth knowledge of these acronyms and methods. The book's noteworthy features are many: Refinements in treatment protocols since the last edition are discussed in detail. For example, the sections on ECT cover advances such as focal electrically administered seizure therapy (FEAST) and magnetic seizure therapy (MST), while the TMS chapter covers theta burst and recent approval for obsessive-compulsive disorder. The underlying science is addressed in the initial review of electricity and physics, information that is foundational to these treatment modalities, but that clinicians do not encounter in the medical school curriculum. The section also addresses the parameters for brain stimulation and how to determine the right dose. A separate chapter is devoted to low intensity focused ultrasound pulsations (LIFUP) and temporally interfering (TI) electric fields, emerging treatments that have the potential to noninvasively stimulate focal locations deep in the brain without surgery or the implantation of hardware. The section on using DBS for treatment-resistant Parkinson's disease (PD) is thorough, authoritative, and a boon to clinicians assessing the viability and efficacy of treatment options for their PD patients. The new edition retains the amusing, but always informative sidebars highlighting the history of brain experimentation and applications of brain stimulation techniques Written in a down-to-earth, accessible style by authors at the forefront of progress in the field, Brain Stimulation Therapies for Clinicians is a rigorous, evidence based review of clinical data that focuses on what we know, what we don't know, and the strength of the evidence.
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 stimulation comprises an important set of techniques for investigating brain function, some of which promise to treat diseases. This book provides a review of the scientific and technical background required to understand transcranial stimulation, for neuroscientists, neurologists, and psychiatrists.
Even with the rise of newer neuropsychiatric brain stimulation methods, electroconvulsive therapy (ECT) remains a widely used treatment for severe mental illness-and perhaps the most effective for serious mental illness. Optimal treatment requires that psychiatrists be skilled in diagnosis and familiar with the techniques of treatment. That's where Principles and Practice of Electroconvulsive Therapy comes in. With its up-to-date, comprehensive coverage of all aspects of ECT, this is an unrivaled resource for psychiatrists, whether in practice or still in training, striving for maximum treatment efficacy. The book begins with an overview of what ECT is and how it is carried out, followed by a brief history of the therapy, from its earliest applications to its use in modern times. The guide follows the typical course of treatment, discussing the following: - Understanding the indications for ECT and selecting patients who might benefit from this therapy-whether they suffer from depression, mania, schizophrenia, or catatonia - Educating patients and their families on ECT and obtaining patient consent - Conducting a pretreatment medical evaluation and understanding the role of anesthesia - Managing an individual ECT treatment, including choosing the electrical stimulus dose and parameter combination, delivering the electrical stimulus, assisting with recovery problems, etc. - Overseeing the course of treatments, particularly for practitioners not personally conducting the treatments - Managing patients after a course of treatments and preventing relapse - Assessing and managing the memory side effects of ECT The final chapter examines other neuropsychiatric stimulation therapies in relation to ECT and explains how to choose among them. All chapters conclude with easily referenced key points that summarize the most salient ideas. Readers seeking to further educate themselves on ECT will also benefit from the exhaustive reference list. Though particularly useful for psychiatrists and psychiatric residents, Principles and Practice of Electroconvulsive Therapy, with its straightforward style, is a ready resource for any mental health or medical professionals interested in ECT.
Deep brain stimulation for the treatment of patients with Parkinson’s disease was introduced in the 1990s. Initially performed only at academic centers, over the past decade it has become a widespread surgical procedure. A variety of surgical techniques are employed and innovations are introduced frequently. This book is an ideal source of information for the many practicing neurosurgeons who did not learn this surgery during their training but would now like to add it to their practice, as well as an excellent update on exciting new developments in surgery for Parkinson’s disease. This book is designed to provide practicing neurosurgeons with current knowledge on the practical aspects of surgical treatment of patients with Parkinson’s disease. It explains how to identify surgical candidates and determine the optimal surgery, describes the various surgical techniques that are currently employed, and offers insights into how to optimize deep brain stimulation therapy after implantation. The keys to avoidance of surgical complications are carefully elucidated. In addition, an overview is provided of potential advances on the near-term horizon, including closed-loop deep brain stimulation, gene therapy, and optogenetics. All topics are covered by experienced Parkinson’s disease surgeons, in a concise and digestable format. The book will be an ideal source of information for the many practicing neurosurgeons who would like to add deep brain stimulation to their practice, as well as an excellent update on new developments in surgery for Parkinson’s disease.
This book covers the current trends in clinical deep brain stimulation (DBS) research. This collection of papers from experts in the field provides state of the art knowledge and future perspectives in clinical DBS research. A range of topics involved in DBS is presented, ranging from high resolution imaging, electrophysiology and personalized medicine, in a broad range of brain disorders.
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.