Mark George

..In the past year, several important studies have been published that extend our understanding of this novel treatment approach...

..In this paper, we investigated the procedures of feature selection to enhance fMRI-based deception detection...

..The brain regions involved in recognition of emotional prosody in healthy subjects is less clear...

..This article reviews the major recent advances with this interesting noninvasive technique for stimulating the brain, critically reviewing the data on whether TMS has anticonvulsant effects or modulates cortical-limbic loops...

..Much more research is needed regarding exactly how to refine and deliver the electrical pulses and how this differentially affects brain function in health and disease...

..Daily left prefrontal repetitive transcranial magnetic stimulation (rTMS) has been studied as a potential treatment for depression, but previous work had mixed outcomes and did not adequately mask sham conditions...

..Whatever road the future takes, TMS is an important new tool that will likely be of interest to neurosurgeons over the next 20 years and perhaps even longer...

..TMS' ability to non-invasively and focally stimulate the brain of an awake human is proving to be a most important development for neuroscience in general, and neuropsychiatry in particular...

..Comments on the clinical utility of VNS in actual clinical practice are provided...

..The methods in this class range from non-invasive (transcranial magnetic stimulation) to invasive brain surgery (deep brain stimulation)...

..No medication interactions were seen. Thus, a single subcutaneous dose of dihydrexidine is tolerated and safe in patients with schizophrenia and does not produce delayed clinical or neuropsychological improvements...

..To better understand these effects on long-term outcome, we compared 12-month VNS+TAU outcomes with those of a comparable TRD group...

..These techniques are transcranial magnetic stimulation, vagus nerve stimulation, and transcranial direct current stimulation. Two of these approaches have FDA approval as therapies...

..These brain stimulation tools, or their next iterations, will play an ever-larger role in clinical neuropsychiatric practice...

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..This study supports theories of blunted limbic and paralimbic activation and abnormal cingulate activity in depression and adds to the growing knowledge of the functional neuroanatomy of depression...

..Preliminary investigations have also used rapid-rate TMS to improve motor speed in Parkinson's disease and mood in depression. TMS is likely to be an important future neuropsychiatric tool...

..Preliminary studies have indicated that daily left prefrontal repetitive transcranial magnetic stimulation might have antidepressant activity. The authors sought to confirm this finding by using a double-blind crossover design...

..He also demonstrated a significant negative bias when he was depressed compared with nondepressed states. This case study demonstrates the state dependency of the defect in human facial emotion recognition...

..Transcranial magnetic stimulation is a promising new research and, perhaps, therapeutic tool, but more work remains before it can be fully integrated in psychiatry's diagnostic and therapeutic armamentarium...

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..In general, TMS or tDCS as a treatment for most psychiatric disorders remains exciting but controversial, other than prefrontal TMS for depression...

..It is a safe, relatively noninvasive, focal brain stimulation treatment that does not involve seizures or implanted wires, and does not have drug-drug interactions or systemic side effects...

..Vagus nerve stimulation (VNS) alters both concentrations of neurotransmitters or their metabolites and functional activity of central nervous system regions dysregulated in mood disorders. An open trial has suggested efficacy...

..These data suggest that PW is an important variable in producing VNS brain effects...

..Decreases were found in the bilateral temporal cortex and right parietal area. Regions of change were consistent with brain structures associated with depression and the afferent pathways of the vagus nerve...

..We failed to find statistically significant TMS clinical antidepressant effects greater than sham. Further studies are needed to fully investigate the potential role, if any, of TMS in BPAD depression...

..CONCLUSIONS: Our results partially support our hypotheses and are generally consistent with neuroanatomical studies of rodent maternal behavior...

..The need for effective, long-term treatment for recurrent or chronic, treatment-resistant depression is well established...

..e., conduct disorder, antisocial personality disorder, etc.)...

..We investigated the relationship between prefrontal cortical atrophy as measured by MRI and the neuropsychological performance of participants diagnosed with DSM-IV-TR schizophrenia...

..Shorter duration of current illness and lack of anxiety comorbidity may also confer an increased likelihood of good antidepressant response to TMS...

..Further work is needed to understand whether these immediate changes vary as a function of TMS use parameters (intensity, frequency, location) and whether they relate to neurobiologic effects and antidepressant mechanisms of TMS...

..82, F = 20.27, P < 0.0001) in measurements of MT. The corticospinal tract's anterior-posterior direction alone contributes 13% of the variance explained...

..These data are consistent with the hypothesis formulated from studies of non-human primates that dihydrexidine and other D1 agonists may be able to modulate prefrontal dopaminergic function...

..Our primary objective was to determine whether TMS effects could be conditioned. Prepulse inhibition represents another relationship between two stimuli, and a secondary assessment was performed to explore this relationship...

..We chose to pilot the safety and therapeutic benefits of chronic and intermittent epidural prefrontal cortical stimulation (EpCS) in patients with treatment-resistant depression...

..Further clinical studies, in addition to prospective cost utilization and health economic investigations, are needed to better understand VNS therapy and the impact it holds on TRD care...

..Despite evidence that prefrontal TMS can have analgesic effects, fast left prefrontal TMS appears to acutely suppress analgesia associated with perceived-control. This effect may be limited to the emotional dimension of pain experience...

..The current study investigates the accuracy and efficiency of 5 different approaches to motor threshold assessment for TMS research and practice applications...

..There is, however, emerging brain imaging evidence that the left prefrontal cortex is involved in pain inhibition in humans...

..This system requires less time and training to find the optimal position for prefrontal coil placement and it saves considerable time compared to the 10-20 EEG system...

..A previous study showed that lamotrigine (LTG) inhibited brain activation induced when TMS was applied over motor cortex, whereas it increased activation induced by TMS applied over prefrontal cortex...

..Future interleaved VNS/fMRI studies to confirm these findings and further clarify the regional neurobiological effects of VNS...

..We analyzed interim results from the open-label phase of a multi-site randomized trial of rTMS as a treatment for depression to investigate whether the procedural pain of left prefrontal rTMS changes over time...

..In this pilot study, we explored corticospinal plasticity in a bed rest model. We hypothesized that the lack of weight bearing would induce cortical reorganization correlating with performance...

..It is unclear whether the motor cortex is the only effective cortical target for managing neuropathic pain, and no published studies to date have investigated the effects of prefrontal stimulation on neuropathic pain...

..07, P < 0.05) and enhanced by valproic acid (t = 2.39, P < 0.05). Lamotrigine and valproic acid have different effects on cortical neuronal excitability as demonstrated by TMS...

..EEG shows potential as a biomarker of response for depression treatments, particularly the brain stimulation devices, which, unlike medications, can focally interact with neural tissue in specific frequency patterns...

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..No studies have investigated the effects of prefrontal cortex stimulation using transcranial magnetic stimulation on postoperative pain...

..Despite this intense treatment regimen, we failed to produce significant side effects. Doses of up to 12,960 pulses per day appear safe and tolerable in healthy young men...

..Phobics may become so anxious, they cannot think clearly or vice versa...

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..Individual results of the lie minus true condition were variable. Results show that functional MRI is a reasonable tool with which to study deception...

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..Repetitive transcranial magnetic stimulation (rTMS) is a new treatment with promise for resistant depression...

..Furthermore, the interleaved TMS/fMRI technique may be a useful tool for investigating regional brain effects of psychoactive compounds...

..This study suggests, as did our earlier study, that alcoholics and not social drinkers, when exposed to alcohol cues, have increased brain activity in areas that reportedly subserve craving for other addictive substances...

..This pilot study supports the cingulate's role in modulating cognition and neuronal connectivity in schizophrenia...

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..g. hearing a tone)...

..To investigate the cerebral hemodynamic response to verbal working memory following sleep deprivation...

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..9) over the year. These data suggest but do not prove that TMS might eventually be used as an adjunctive maintenance treatment for at least some patients with bipolar depression. Much work remains...

..To examine whether differences in patterns of brain activation under baseline conditions relate to the differences in sleep-deprivation vulnerability...

..We hypothesized that TMS would activate known motor circuitry with some additional regions plus some areas dropping out...

..To examine with high precision the differences between function-guided and image-guided transcranial magnetic stimulation (TMS)...

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..To measure motor and auditory cortex blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging (fMRI) response to impulse-like transcranial magnetic stimulation (TMS) pulses as a function of train length...

..If the acutely increased sensitivity sets the stage for the slower chronic anti-pain effects, the increased acute sensitivity does not disappear. Acute and chronic effects of VNS on pain perception merit further research...

..While these results are in the predicted direction, further studies using other designs and higher intensities and frequencies of rTMS are indicated to better describe the local and distant changes induced by rTMS...

..We examined the effects of adjunctive VNS over 24 months in this cohort...

..CONCLUSIONS: Longer-term vagus nerve stimulation treatment was associated with sustained symptomatic benefit and sustained or enhanced functional status in this naturalistic follow-up study...

..These findings contribute toward a convergence in the literature, and the regression models of CMRglc vs. age serve as a normative database to which patients may be compared...

..Improved memory quotient (MQ) was significantly correlated with increased rCBF in the left temporal lobe. These findings from Chinese patients confirm a similar regional neuroanatomic dysfunction as in Western patients with the disease...

..More systematic research is needed on the effectiveness of different strategies for reducing rTMS-related pain and discomfort...

..Several other brain regions showed activation limited to specific subcomponent processes...

..Thus, viewing arousing stimuli, regardless of valence, increased motor cortex excitability. Implications and directions for future research are discussed...

..Yet patients who showed substantial clinical benefit maintained the improvement at remarkably high rates. This durability of benefit was not attributable to alterations in other treatments...

..These preliminary data suggest that baseline fMRI scan activation during a working memory task may correlate with fatigue susceptibility...

..Individually and as a group, EDA correlated with blood flow changes in the OFCx and AC. Specific brain regions were activated during deception, but the present technique lacks good predictive power for individuals...

..This indicates a specific basal ganglia-thalamocortical circuit involved in motor inhibition...

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..CONCLUSIONS: Areas of frontal, cingulate, insula, and temporal cortex appear hypometabolic in association with different components of the severity and course of illness in treatment-resistant unipolar depression...

..This clinical site grant (CSG) proposal is one of four scientifically identical proposals resubmitted under a CSMD mechanism.] ..

..Thus, we plan to use interleaved fMRI and DBS to directly examine the effects of DBS on hypothesized brain circuits and to correlate this with immediate and longer-term (4 week) behavioral outcomes (mood and cognition). ..

..This coordinating Center Grant (CCG) application is submitted under a CSMD mechanism, linked to 4 clinical site grants (CSG). ..