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Therapeutic prospects and safety of transcranial magnetic stimulation in epilepsy
Published in Hans O Lüders, Deep Brain Stimulation and Epilepsy, 2020
Frithjof Tergau, Bernhard Steinhoff
Transcranial magnetic stimulation (TMS) is a neurophysiological tool which non-invasively gives access to the brain in the intact human. TMS of particular brain areas through the scalp activates cortical neurons, interfering with the physiological function of the neuronal network the activated neurons are involved in. Thus, activation but also distortion of cortical areas enables the investigation of certain brain functions. The physical and biological basis of this technique is described earlier in this book by Pascual-Leone (Chapter 10 ). Several TMS parameters have been defined so far to describe the state of the excitability of the cortical network under physiologic conditions and in several disorders.
EMS support of executive protection and counter-terrorism operations
Published in Jan de Boer, Marcel Dubouloz, Handbook of Disaster Medicine, 2020
David M. La Combe, Christopher M. Grande
Regardless of the choice of physician or non-physician, optimally, the Tactical Medical Specialist (TMS) must be integrated into the team, understand its mission and area of operations, and be given time to plan the details of medical support in advance of deployment. Recent situations throughout the U.S. show the danger of not incorporating medical support. The role of the TMS is not only in the care of the injured, but probably more importantly, as a prevention specialist, and as a medical planner as part of the overall tactical plan. This is true both in military and civilian special operations.
Brain Stimulation Therapies
Published in Bahman Zohuri, Patrick J. McDaniel, Electrical Brain Stimulation for the Treatment of Neurological Disorders, 2019
Bahman Zohuri, Patrick J. McDaniel
TMS is a method of using high-strength pulsed magnetic fields to induce a depolarizing electric current in a localized area of the cerebral cortex. A large, replicated body of multisite, randomized sham-controlled studies has established the safety and effectiveness of a specific TMS device for the treatment of patients with pharmacoresistant major depressive disorder. This chapter reviews the current understanding of the physiologic effects and presumed mechanism of effect of TMS as an antidepressant. In addition, the scientific evidence base for its safety and efficacy are reviewed, along with a summary of its current acceptance by professional societies. The introduction of TMS as an office-based treatment in clinical psychiatry has introduced the need to understand the basic elements of organization and implementation of a TMS treatment option within a psychiatric clinical practice setting. The report by Demitrack and Brock2 provides a broad overview and specific recommendations for the organization of a TMS treatment team and presents a basic framework and clinical approach to the implementation of TMS as a therapeutic technique. Aspects of patient diagnostic assessment, treatment planning, treatment team roles and responsibilities, and patient safety are reviewed.
Transcranial direct current stimulation (tDCS) effects on upper limb motor function in stroke: an overview review of the systematic reviews
Published in Brain Injury, 2023
Jaya Shanker Tedla, Devika Rani Sangadala, Ravi Shankar Reddy, Kumar Gular, Venkata Nagaraj Kakaraparthi, Faisal Asiri
Multiple studies have demonstrated TMS’s effective and safe use in numerous pathologies (13,14). However, TMS can produce undesirable side effects such as headaches; it is also an expensive technology and requires a specific setup (15). Comparatively, tDCS is simple with negligible side effects, and over the past two decades, it has attracted intense interest in the neurology research field (10,16). The effect of tDCS is produced by applying a weak direct electrical current over the scalp, which induces neural plasticity, modulates cortical functioning, and affects the targeted cortical neurons’ membrane potential level and firing rates (17). In addition, the practical benefits of tDCS include being less expensive, portable, and easy to administer; therefore, it can be considered an ideal adjuvant therapy during stroke rehabilitation (11).
Effects of non-invasive brain stimulation (NIBS) on vestibulopathy disorders: a systematic review
Published in Hearing, Balance and Communication, 2023
Bruno Henrique de Souza Fonseca, Pedro Henrique Sousa de Andrade, Otávio Borges, Jessica Mariana de Aquino Miranda, Rodrigo Bazan, Luciane Aparecida Pascucci Sande de Souza, Gustavo José Luvizutto
Another non-invasive neuromodulation technique is the TMS, which uses magnetic pulses through coils placed on the scalp, creating a magnetic field [13]. The TMS can be applied in different ways, with different goals to achieve. A single-pulse TMS is used to analyze functions of the brain, identifying the patient’s resting motor threshold, which is the minimal intensity required for the muscle to contract visibly, while repetitive TMS (rTMS) is responsible for causing changes in cortical excitability for a longer period of time by combining three or more pulses [13–15]. TMS is known for the treatment of depression, but also for other chronic psychiatric and neurological conditions [16]. Zilbly et al. showed that TMS can help in the treatment of symptoms, such as tinnitus, which can appear in some cases of vestibulopathies, reducing its perception level or making it less aggressive [17].
Perceived Invasiveness and Therapeutic Acceptability of Transcranial Magnetic Stimulation
Published in AJOB Neuroscience, 2023
Jack Twiddy, Emily C. Hector, Veljko Dubljević
These findings—from Bluhm et al., as well as our work (as discussed above)—highlight the essential need for additional structured, “bottom-up” collection of qualitative and quantitative empirical data regarding the preferences of current and prospective users of various emerging neurotechnologies, in order to most effectively steer these interventions toward equitable access, the satisfaction of user needs (both in terms of physical and mental health), and deployment in a manner consistent with the fundamental tenets of established bioethical practice. Using these data, clinicians and researchers involved with these technologies can better understand perceptions of patient risk, existing areas of uncertainty to address through user education and public outreach, and the development of social structures and support systems needed to ensure these interventions generate the greatest positive impact possible. TMS and related technologies are of great interest to providers and patients alike due to the potential benefits provided by these treatments, particularly in cases difficult to treat using other methods. However, better alignment of provider and patient values and goals is a fundamental prerequisite to optimizing the use of neurotechnologies, in both the immediate-term and in the future of medicine.