Transcranial Magnetic Stimulation In Neuropsychiatry

Author: Robert H. Belmaker, M. B. George

ISBN/ASIN: 0880489480

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.

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