Showing posts with label TMS. Show all posts
Showing posts with label TMS. Show all posts

Saturday, March 28, 2009

TMS possibilities for Parkinson's Disease ?



MIT Technology Review published an article that goes into some research being done at Duke University which could be translated into a possible use for TMS.
Using a spinal cord stimulator on mice that have the rodent equivalent of Parkinson's the researchers were able to control the symptoms as well, or better than, Deep Brain Stimulation.
This makes me wonder if using a TMS coil over the spinal cord could achieve a similar effect for patients with Parkinson's?
Here is the abstract that was published in Science.

Thursday, October 9, 2008

TMS approved for Depression!

WebMD just published a short blurb on one of their blogs stating that the FDA has cleared TMS for use in depression. They go on to state that there is now an indication for use in patients who have failed a trial of one antidepressant.
Now that this indication has been made, what will the next inidication be???? Stay tuned.

Tuesday, March 4, 2008

Post-stroke Depression Treated with TMS

The Archives of General Psychiatry just published a paper from the Department of Psychiatry at University of Iowa about using TMS to treat vascular-related depression. The results were pretty impressive.
Post-stroke depression is a well-known phenomenon, with a large percentage of people that have suffered a stroke showing signs and symptoms of depression. It seems that there is evidence that people with proven vascular disease (one of the side effects of uncontrolled diabetes/cholesterol/hypertension/smoking) have a higher incidence of depression.
These researchers took 90+ patients, with proven vascular disease and depression, and took them off of antidepressants. The divided them into two groups: sham and treatment groups. The treatment group got 12,000 pulses of TMS and the sham got, well, sham treatment with a fake coil. The treatment group a 33% drop on a depression scale while the sham group had a 14% drop, an appropriate placebo effect. The response rate in the placebo group was just under 7% while the response rate in the treatment group was 33%.
In the second experiment the treatment group got 18,000 pulses which resulted in a 42% drop in depression score while the sham group dropped 17%.
Once again, some interesting results that make you scratch your head and wonder if using a three tesla electromagnetic impulse could provide relief of depressive symptoms on par with antidepressants.....
Link

Wednesday, December 26, 2007

IEEE article on TMS




Nice article on TMS, and other neuromodulation technologies,in the IEEE Spectrum. The article was originally written in 2006 but it has some good insight into the world of neuromodulation. Reza Jalinous was interviewed for the TMS portion of the article as well as Dr. Pascual-Leone, whom I learned TMS and tDCS techniques from.


"Assuming that all the new brain stimulation techniques prove effective in the many upcoming trials, the psychiatrist's toolbox will look very different a decade from now. Patients will probably first be offered the less invasive techniques, such as transcranial direct current and magnetic stimulation; then the more invasive ones, such as the seizure therapies; and finally such surgical technologies as deep-brain stimulation and vagus nerve stimulation."

Illustration from IEEE Spectrum, by Matt Mahurin

TMS for Depression: a testimonial

Here is a testimonial from an NBC affiliate on the use of TMS for depression. It seems like the patient had some great results.
When I think about all of the patients I have seen that have had a miserable time with the side effects of antidepressants I can't help but think that one could make an argument for using non-invasive neuromodulation as a first-line treatment.

Head Wounds are Good For You!

At least that is what some studies have found about some Vietnam vets with certain head wounds.
Buzzle blogged about a study on vets with and without PTSD that found injuries to the prefrontal cortex or the amygdala were protective, at least with regard to developing PTSD.
Later in the article there is a suggestion that transcranial magnetic stimulation may play a role in the future treatment of PTSD based on these findings.

Monday, October 1, 2007

TMS Demonstrates Increased Cerebral Blood Flow

Nice write up on an article in Science showing that TMS causes an increase in cerebral blood flow as a result of increased neuronal activity. I will get my hands on the actual article and see what it has to say. But regardless, this is some interesting data which helps open the black box that is the brain just a little bit wider. Nice work by the group at Cal.

Neuroscientists connect neural activity and blood flow in new brain stimulation technique

Neuroscientists at the University of California, Berkeley, have for the first time measured the electrical activity of nerve cells and correlated it to changes in blood flow in response to transcranial magnetic stimulation (TMS), a noninvasive method to stimulate neurons in the brain.

Their findings, reported in the Sept. 28 issue of the journal Science, could substantially improve the effectiveness of brain stimulation as a therapeutic and research tool.

With technological advances over the past decade, TMS has emerged as a promising new tool in neuroscience to treat various clinical disorders, including depression, and to help researchers better understand how the brain functions and is organized.

TMS works by generating magnetic pulses via a wire coil placed on top of the scalp. The pulses pass harmlessly through the skull and induce short, weak electrical currents that alter neural activity. Yet the relative scarcity of data describing the basic effects of TMS, and the uncertainty in how the method achieves its effects, prompted the researchers to conduct their own study.

"There are potentially limitless applications in both the treatment of clinical disorders as well as in fundamental research in neuroscience," said Elena Allen, a graduate student at UC Berkeley's Helen Wills Neuroscience Institute (HWNI) and co-lead author of the study. "For example, TMS could be used to help determine what parts of the brain are used in object recognition or speech comprehension. However, to develop effective applications of TMS, it is first necessary to determine basic information about how the technique works."

Other techniques for studying neural activity in humans, such as functional magnetic resonance imaging (fMRI) or electroencephalogram (EEG), only measure ongoing activity. TMS, on the other hand, offers the opportunity to non-invasively and reversibly manipulate neural activity in a specific brain area.

In a set of experiments, the researchers used TMS to generate weak, electrical currents in the brain with quick 2- to 4-second bursts of magnetic pulses to the visual cortex of cats. Direct measurements of the electrical discharge of nerve cells in the region in response to the pulses revealed that TMS predictably caused an initial flurry of neural activity, significantly increasing cell firing rates. This increased activity lasted 30 to 60 seconds, followed by a relatively lengthy 5 to 10 minutes of decreased activity.

What the researchers were able to determine for the first time was that the neural response to TMS correlated directly to changes in blood flow to the region. Using oxygen sensors and optical imaging, the researchers found that an initial increase in blood flow was followed by a longer period of decreased activity after the magnetic pulses were applied.

"This long-lasting suppression of activity was surprising," said Brian Pasley, a graduate student at HWNI and co-lead author of the study. "We're still trying to understand the physiological mechanisms underlying this effect, but it has implications for how TMS could be used in clinical applications."

The critical confirmation of the connection between blood flow and neural activity means that researchers can use TMS to alter neural activity, and then use fMRI, which tracks blood flow changes, to assess how the nerve cells respond over time.

"One of the most exciting applications of TMS is the ability to non-invasively modify neural activity in specific ways," said Pasley. "The brain is malleable, so brain stimulation may be used to alter and promote specific functions, like learning and memory, or suppress abnormal activity that underlies neurological disorders. If we can figure out the right ways to stimulate the brain, TMS will likely be useful in attempts to improve neural function."

The researchers noted that one of the difficulties in using TMS for specific applications is the fact that its effects vary in different brain regions and individuals.

"Using TMS is inherently challenging because its neural effects can be so variable," said Ralph Freeman, UC Berkeley professor of vision science and optometry and principal investigator of the study. "Fortunately, we can determine empirically what the end result is by making measurements with fMRI. This should be valuable to clinicians who must evaluate the effectiveness of a stimulation treatment. In turn, fMRI may serve as a guide to determine adjustments in treatment parameters."

The study was also co-authored by Thang Duong, a UC Berkeley graduate student in vision science. The National Eye Institute of the National Institutes of Health and the National Science Foundation helped support this research.

Sunday, September 23, 2007

New Posts Coming Soon!

I have been on vacation for a week, then traveling for a week, home for a week and now off again for another conference. I WILL get some new material up here soon.
Just a little tidbit before I go: one of the weeks I spent away in September was at Harvard getting trained on TMS and tDCS. All I can say is that I was blown away with how much clinical potential these techniques have. There are an incredible number of people out there could be helped with these techniques and other techniques that will develop as a result of the research that is going on now. This is not a magic pill that cures all, but they could make a large impact on the quality-of-life of a large portion of the population.
More to come after I get back from my trip out of town for the next week.

Tuesday, August 7, 2007

Better rTMS studies? Where are we headed??

Browsing Pub Med for TMS related subjects and came across an article whose authors include Dr. Pascual-Leone and Dr. Fregni, both from Harvard. They did a meta review of TMS (and incidentally a both prolific researchers looking at rTMS, tDCS etc..) and it's effects on depression from articles published in the last year and it seems that there is an improved effect of TMS on depression in these papers versus earlier studies.
Is this a result of improving science behind the use of TMS, more accurate TMS protocols, more studies????
Anyone have any thoughts on the subject????

Has repetitive transcranial magnetic stimulation (rTMS) treatment for depression improved? A systematic review and meta-analysis comparing the recent vs. the earlier rTMS studies.

Autism and TMS

It seems that there is some evidence that the effects of autism can be altered by TMS. This is news to me, I am going to have to do a little Pub Med sleuthing to see what the word on the scientific street is.
It would make sense that by altering an already skewed balance of hyper and hypo excitability you would be able to alter the balance of the brain activity.
Turns out there is a total dearth of science regarding TMS as a treatment for autism. A PubMed search only gave me one article that was in a journal of scientific hypotheses.
Here is the article from about.com

Tuesday, July 24, 2007

Wired Magazine TMS blurb


I just got the most current issue of Wired about and there was a nice little piece by Melinda Wenner on TMS and it's possibilities.
"Brains are electric — when neurons talk, they speak in voltage. Now, a new technique called transcranial magnetic stimulation may let neuroscientists hack those conversations. TMS translates electric signals into a magnetic field that passes through the skull and into the brain. Too much juice can cause seizures, but calibrate the machine just right and you can actually control brain activity. Treatments for drug-resistant depression, migraines, and post-traumatic stress disorder are in the offing. Further out, some researchers are trying to trigger more restful power naps, and others are working with autistic savants, hoping to inhibit the autism and bring forward the Rain Man level detail processing. That's right: We could all be perpetually happy, relaxed, and brilliant if they'd just mount this thing in a baseball cap."
Hmmm, a baseball cap with a figure 8 coil in it....maybe she is on to something here? As the scientific evidence grows, I am realizing she might not be so far off.

Monday, May 21, 2007

Wired Article on TMS

Interesting blog entry from Wired on the handheld TMS unit by Neuralieve. I know relatively little about the actual power of this unit and I have to admit that I am little skeptical of the ability to accurately focus and the ability to penetrate with such a small unit. A little more reading is in order.....Anyone out there with an opinion on this technology???

Wired Article on TMS

Neuralieve Website

Wednesday, May 16, 2007

Mayo Clinic article on TMS for the public

Here is a link to a post from mayoclinic.com about TMS and how it works. I am curious about who the authors are for this article, I posted about the article that first introduced me to TMS and that article came out of the Mayo Clinic.
Mayoclinic.com

Newsweek Article on TMS

Here is a link to an article that appeared in Newsweek on TMS. It seems to give a fair evaluation of some of the pros and the cons of TMS. Nice that they identified Dr. Pascual-Leone in the article considering the breadth and depth of research that he has done.
Newsweek article