The brain stimulation therapies range from noninvasive techniques such as transcranial magnetic stimulation (TMS), which applies single or repetitive stimuli at the scalp surface, to deep brain stimulation (DBS), which involves neurosurgical implantation of electrodes in specific brain regions. These interventions differ in many fundamental characteristics, such as whether stimulation results in seizures or is nonconvulsive, is continuous or intermittent, or uses brain activity to determine the timing or site of stimulation.
The brain stimulation techniques thus represent a new class of therapeutics that has already displayed remarkable potential for producing novel therapeutic effects. For example, DBS for Parkinson’s disease produces symptom remission almost instantly in patients whose symptoms are largely refractory to all medications. These therapeutic effects continue in many patients for up to 5 years without symptom progression. These remarkable therapeutic effects may arise because the focal brain stimulation methods trigger therapeutic mechanisms different from those that follow from medications.
Related to this difference in approach, the side effects of the brain stimulation techniques also differ radically from conventional treatments such as medications or medical interventions. All the forms of focal brain stimulation reviewed in this book involve the passage of an electrical current through neural tissue, either peripherally or centrally. However, in general, electricity has no metabolite or other residue. Thus, the therapeutic and adverse effects of these interventions are largely determined by the endogenous or adaptive response of the brain to the electrical stimulation. In this sense, these methods are perhaps more “natural” than some other forms of therapy, although external electricity is not exactly natural. The brain stimulation therapies are thus creating another therapeutic option or class, complementing talking therapies, medications, and rehabilitation, and in some cases replacing ablative surgery.
Anyone who is not working daily in this field can be stymied by all the new information when confronted with a patient who might benefit from one of the brain stimulation techniques. As with genetics or brain imaging, there is an initially daunting “acronym soup” that can hinder access and cause confusion. This book tries to provide a clear and straightforward analysis of the prevailing techniques, and in some sense is an elaborate dictionary for these acronyms and the new methods. The book starts with a quick overview of electricity and physics—elements that are common to all the methods but not taught in medical school. This book is thus intended to be a quick first start, helping clinicians, patients, and researchers efficiently understand the current knowledge about the techniques. As is often found in any new area of technology or medicine, there are some who falsely advocate certain techniques and claim therapeutic effects for which there is little or no supporting evidence.
Readers of this book should gain a good understanding of the current state of brain stimulation therapies. This base can then be used to help patients and provide the background for keeping up with this rapidly evolving and most exciting field.
Contents
1 Introduction
2 Basic Electricity
3 Electrical Brain
4 Electroconvulsive Therapy
5 Vagus Nerve Stimulation
6 Transcranial Magnetic Stimulation
7 Deep Brain Stimulation and Cortical Stimulation
8 Transcranial Direct Current Stimulation
9 Other Techniques
Appendix by Disease
Appendix by Stimulation Method
Index
Book Details
- Hardcover: 203 pages
- Publisher: American Psychiatric Publishing, Inc.; 1 edition (September 15, 2008)
- Language: English
- ISBN-10: 158562280X
- ISBN-13: 978-1585622801
- Product Dimensions: 9.3 x 6.2 x 0.7 inches