A comprehensive survey of the state of current practice, this new edition provides thoroughly updated information on the growing list of electrical stimulation therapies now in use or under study.

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.

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.

The past two decades have seen rapid progress in new and less invasive ways to stimulate the brain to study and treat psychiatric disorders. This authoritative reference provides an introduction to this emerging field of brain stimulation in psychiatry. Eight recognized experts present the latest research and results -- and future challenges -- for new techniques to electrically stimulate the central nervous system, including transcranial magnetic stimulation (TMS), magnetic seizure therapy (MST), deep brain stimulation (DBS), and vagus nerve stimulation (VNS). This is the first book to both review these new techniques and place them in the context of existing somatic therapies in psychiatry. Unlike electroconvulsive therapy (ECT, the standard choice for patients with treatment-resistant depression), these breakthrough methods enable us to affect selectively higher cognitive processes and mood systems by electrically stimulating -- directly or indirectly -- focal regions of the cortex and subcortical structures in the brain. The effectiveness of TMS and MST (MST is a higher-dosage, convulsive form of magnetic stimulation) is being studied worldwide. Results are encouraging: TMS has been reported to reduce the frequency of auditory hallucinations when administered to brain regions that show abnormal hyperactivity during hallucinations, and both TMS and MST induce far less electricity and stimulate more focal cortical regions than ECT, thus incurring fewer cognitive side effects. Although DBS -- in which an electrode is implanted in a location relevant to the illness in question -- is more invasive than other modalities, it is able to reach deeper structures in a highly focal way, which may be important for illnesses like obsessive-compulsive disorder, whose circuitry relies heavily on subcortical structures. VNS is less invasive than DBS but more invasive than TMS or MST. Efficacy of VNS is uncertain. Improvement appears to build over time, and the hope is that months or years after implantation patients may show dramatic improvements. Claims of enhanced efficacy with time have never been tested directly, and controlled, randomized trials are needed to determine whether VNS has a role in the treatment of major depression. Its effects are limited to the neuroanatomical connectivity of the vagus nerve. Enriching our knowledge base in this exciting new field means more choices and therapeutic strategies for patients with conditions that resist conventional treatments. This fascinating work is a key reference for the promising future of brain stimulation in psychiatric treatment and is a "must read" for clinicians and residents alike.

Transcranial magnetic stimulation (TMS) was introduced in the mid 1980s in clinical neurophysiology to study the central motor pathways. Research has been exponentially increased since, and many different methods for brain stimulation have been considered during the last decade. This publication focuses on transcranially applied, non- or low-invasive interventions not requiring an implantable device, i.e. electroconvulsive therapy (ECT), repetitive TMS (rTMS) and transcranial direct current stimulation (tDCS). It provides an excellent overview on this spectrum of fascinating techniques. Many leading experts in this field have contributed to this book. A single chapter summarizes the state of the art in ECT. A series of chapters provides an overview on preclinical research in animals and neuroimaging findings with rTMS and reviews the evidence of efficacy and safety in various psychiatric disorders (affective disorders, schizophrenia and anxiety disorders) also including an article on the application of rTMS in nonpsychiatric diseases, i.e. Parkinson's disease, stroke, pain and tinnitus. Finally, separate reviews discuss very recent innovative approaches in the field of rTMS, i.e. magnetic seizure therapy, theta burst stimulation and deep rTMS. This publication will doubtlessly prove to be essential reading not only to researchers in this field, but also to psychiatrists, neurologists and other clinicians who consider applying these new methods in clinical settings

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.

Electroconvulsive therapy (ECT) is a psychiatric treatment involving the induction of a seizure through the transmission of electricity in the brain. Because of exploitation movies and greatly heightened drug company promotional activities ECT was used less frequently in the 1980s and 1990s. Eventually these movies were understood as unrealistic. Now these drugs are increasingly recognized as dangers to body health. Because of recent refinements and a far better scientific understanding of the clinical procedures and mechanisms underpinning ECT, this treatment modality has seen a resurgence in use and widespread appreciation of its safety. This book is the new definitive reference on electroconvulsive and neuromodulation therapies. It comprehensively covers the scientific basis and clinical practice of ECT as well as comparisons between ECT and medication therapies including the new generation of antipsychotic drugs. It also provides readers with administrative perspectives and specific details for the management of this modality in clinical practice. The new forms of nonconvulsive electrical and magnetic brain stimulation therapy are also covered in detail, in a separate section. The chapter authors are leading scholars and clinicians.