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4 - Section II – Focal brain stimulation approaches to psychiatric treatment

from Part II - Summary of treatment modalities in psychiatric disorders

Published online by Cambridge University Press:  12 May 2010

By
Antonio Mantovani ,
Arielle D. Stanford ,
Peter Bulow  and
Sarah H. Lisanby
Edited by
Peter Tyrer  and
Kenneth R. Silk
Antonio Mantovani
Affiliation:
Department of Psychiatry Division of Brain Stimulation and Therapeutic Modulation New York State Psychiatric Institute NY USA
Arielle D. Stanford
Affiliation:
Department of Psychiatry Division of Brain Stimulation and Therapeutic Modulation New York State Psychiatric Institute New York, NY USA
Peter Bulow
Affiliation:
Department of Psychiatry Division of Brain Stimulation and Therapeutic Modulation New York State Psychiatric Institute NY USA
Sarah H. Lisanby
Affiliation:
Department of Psychiatry Columbia University; Department of Biological Psychiatry New York State Psychiatric Institute NY USA
Peter Tyrer
Affiliation:
Imperial College of Science, Technology and Medicine, London
Kenneth R. Silk
Affiliation:
University of Michigan, Ann Arbor
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Summary

Editor's note

This chapter illustrates how fast-growing are effective treatments in psychiatry. Twenty years ago the contents of this chapter would hardly be understood by the average clinician; now each new treatment is hammering on the door of clinical practice demanding to be let in. The most researched treatment is transcranial magnetic stimulation (TMS); this has been shown clearly to have antidepressant efficacy and, although not as effective as ECT in severe depression, has fewer adverse effects. All the other treatments are really at the early stage of clinical experience and are not first-line treatments. Magnetic seizure therapy and vagus nerve stimulation may have a role in treatment-resistant depression and deep brain stimulation (DBS) is likely to replace the various forms of leucotomy still practiced in some parts of the world, mainly because DBS can be controlled and directed so much more specifically than the older treatments. Transcranial direct current stimulation (tDCS) may also have antidepressant effects but more studies are needed. We will all be hearing more about these new treatments which have the potential to replace ECT, leucotomy and related treatments entirely.

Introduction

Advances in the science and technology of neuromodulation over the past two decades have led to several interventions that have rekindled clinical and research interest in nonpharmacological somatic therapies. Although electroconvulsive therapy (ECT) remains the only somatic treatment with widespread acceptance and application based upon 70 years of clinical use, transcranial magnetic stimulation (TMS), magnetic seizure therapy (MST), vagus nerve stimulation (VNS), deep brain stimulation (DBS) and transcranial direct current stimulation (tDCS), all offer novel means of potentially treating neuropsychiatric conditions and may provide a better understanding of the brain pathophysiology of these disorders.

Type
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Information
Cambridge Textbook of Effective Treatments in Psychiatry , pp. 83 - 97
Publisher: Cambridge University Press
Print publication year: 2008

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  • Section II – Focal brain stimulation approaches to psychiatric treatment
    • By Antonio Mantovani, Department of Psychiatry Division of Brain Stimulation and Therapeutic Modulation New York State Psychiatric Institute NY USA, Arielle D. Stanford, Department of Psychiatry Division of Brain Stimulation and Therapeutic Modulation New York State Psychiatric Institute New York, NY USA, Peter Bulow, Department of Psychiatry Division of Brain Stimulation and Therapeutic Modulation New York State Psychiatric Institute NY USA, Sarah H. Lisanby, Department of Psychiatry Columbia University; Department of Biological Psychiatry New York State Psychiatric Institute NY USA
  • Edited by Peter Tyrer, Imperial College of Science, Technology and Medicine, London, Kenneth R. Silk, University of Michigan, Ann Arbor
  • Book: Cambridge Textbook of Effective Treatments in Psychiatry
  • Online publication: 12 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544392.006
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  • Section II – Focal brain stimulation approaches to psychiatric treatment
    • By Antonio Mantovani, Department of Psychiatry Division of Brain Stimulation and Therapeutic Modulation New York State Psychiatric Institute NY USA, Arielle D. Stanford, Department of Psychiatry Division of Brain Stimulation and Therapeutic Modulation New York State Psychiatric Institute New York, NY USA, Peter Bulow, Department of Psychiatry Division of Brain Stimulation and Therapeutic Modulation New York State Psychiatric Institute NY USA, Sarah H. Lisanby, Department of Psychiatry Columbia University; Department of Biological Psychiatry New York State Psychiatric Institute NY USA
  • Edited by Peter Tyrer, Imperial College of Science, Technology and Medicine, London, Kenneth R. Silk, University of Michigan, Ann Arbor
  • Book: Cambridge Textbook of Effective Treatments in Psychiatry
  • Online publication: 12 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544392.006
Available formats
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  • Section II – Focal brain stimulation approaches to psychiatric treatment
    • By Antonio Mantovani, Department of Psychiatry Division of Brain Stimulation and Therapeutic Modulation New York State Psychiatric Institute NY USA, Arielle D. Stanford, Department of Psychiatry Division of Brain Stimulation and Therapeutic Modulation New York State Psychiatric Institute New York, NY USA, Peter Bulow, Department of Psychiatry Division of Brain Stimulation and Therapeutic Modulation New York State Psychiatric Institute NY USA, Sarah H. Lisanby, Department of Psychiatry Columbia University; Department of Biological Psychiatry New York State Psychiatric Institute NY USA
  • Edited by Peter Tyrer, Imperial College of Science, Technology and Medicine, London, Kenneth R. Silk, University of Michigan, Ann Arbor
  • Book: Cambridge Textbook of Effective Treatments in Psychiatry
  • Online publication: 12 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544392.006
Available formats
×