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Electrical Brain Stimulation to Treat Neurological Disorders
Published in Bahman Zohuri, Patrick J. McDaniel, Electrical Brain Stimulation for the Treatment of Neurological Disorders, 2019
Bahman Zohuri, Patrick J. McDaniel
Magnetic seizure therapy (MST) is a novel, experimental therapeutic intervention, which combines therapeutic aspects of electroconvulsive therapy (ECT) and transcranial magnetic stimulation, in order to achieve the efficacy of the former with the safety of the latter. MST might prove to be a valuable tool in the treatment of mood disorders, such as major depressive disorder (MDD) and bipolar disorder. Our aim is to review current literature on MST. Methods. OVID and MEDLINE databases were used to search for clinical studies on MST systematically. The terms “magnetic seizure therapy,” “depression,” and “bipolar” were employed. Results. Out of 74 studies, 8 met eligibility criteria. There was considerable variability in the methods employed, and samples sizes were small, limiting the generalization of the results. All studies focused on depressive episodes, but few included patients with bipolar disorder. The studies found reported significant antidepressant effects, with remission rates ranging from 30% to 40%.
A comparison of the safety, feasibility, and tolerability of ECT and ketamine for treatment-resistant depression
Published in Expert Opinion on Drug Safety, 2022
Amanda Tamman, Amit Anand, Sanjay J. Mathew
which was first approved by the U.S. FDA in 2008 will likely continue to grow, although its efficacy for the most treatment-resistant patients falls short of ECT. Regarding experimental neuromodulation approaches, magnetic seizure therapy (MST) is a novel therapeutic approach which aims to elicit therapeutic seizure activity via rapidly alternating magnetic fields instead of electrical stimulation. MST has shown preliminary evidence of efficacy with less cognitive side effects than ECT, however no large-scale comparative studies have been conducted. The NIH has funded the Confirmatory Efficacy and Safety Trial of Magnetic Seizure Therapy for Depression (CREST-MST) trial [197], a two-site double-blind randomized non-inferiority trial of MST compared to ECT in approximately 260 patients with TRD. A recent innovation called Stanford Neuromodulation Therapy (SNT), an accelerated form of intermittent theta-burst stimulation (iTBS) with functional connectivity guided brain targeting, has been found to have rapid antidepressant effects [198]. While the scalability of this approach is uncertain, this is nonetheless an exciting new development in the field.
Is tDCS a potential first line treatment for major depression?
Published in International Review of Psychiatry, 2021
Rachel Woodham, Rachael M. Rimmer, Julian Mutz, Cynthia H. Y. Fu
113 trials (262 treatment arms) that randomized n = 6,750 patients (mean age = 47.9 years, 59% women) met our inclusion criteria. The most studied treatment comparisons were high frequency left rTMS and tDCS compared to sham therapy (40 and 11 treatment comparisons, respectively). In our primary analysis of response rates, 10 out of 18 treatment protocols were associated with higher response rates relative to sham therapy: bitemporal ECT (OR = 8.91, 95% CI 2.57–30.91), high dose right unilateral ECT (OR = 7.27, 95% CI 1.90–27.78), priming TMS (OR = 6.02, 95% CI 2.21–16.38), magnetic seizure therapy (OR = 5.55, 95% CI 1.06–28.99), bilateral rTMS (OR = 4.92, 95% CI 2.93–8.25), bilateral TBS (OR = 4.44, 95% CI 1.47–13.41), low frequency right rTMS (OR = 3.65, 95% CI 2.13–6.24), intermittent theta-burst stimulation (OR = 3.20, 95% CI 1.45–7.08), high frequency left rTMS (OR = 3.17, 95% CI 2.29–4.37), and tDCS (OR = 2.65, 95% CI 1.55–4.55).
Understanding the implications of the biobehavioral basis of nicotine addiction and its impact on the efficacy of treatment
Published in Expert Review of Respiratory Medicine, 2018
Nikki Bozinoff, Bernard Le Foll
It is likely that the next few years will see an increase of the use of brain stimulation as a way to modulate brain function. Such approaches have been used successfully for depression and Parkinson’s disease treatment and are now being applied to substance use disorders more broadly [133]. This is now more feasible because of the development of multiple modalities (magnetic seizure therapy, deep brain stimulation, transcranial direct current stimulation, TMS). Therefore, there are less invasive and less costly approaches that are being more available and that could have an impact in the field.