Brain Stimulation in Psychiatric Treatment

The past two decades have seen rapid progress in new and less invasive ways to stimulate the brain to study and treat psychiatric disorders. This comprehensive reference volume provides an introduction to this emerging field of brain stimulation in psychiatry. Eight recognized experts present the latest research and results - and future challenges - on new techniques to electrically stimulate the central nervous system, including transcranial magnetic stimulation (TMS), magnetic seizure therapy (MST), deep brain stimulation (DBS), and vagus nerve stimulation (VNS). This is the first book to both review these new techniques and place them in the context of existing somatic therapies in psychiatry. Unlike electroconvulsive therapy (ECT, still the treatment of choice for patients with depression), these breakthrough methods enable us to affect selectively higher cognitive processes and mood systems by electrically stimulating - directly or indirectly - focal regions of the cortex and subcortical structures in the brain. The degree of effectiveness of TMS and MST (MST is a higher dosage convulsive form of magnetic stimulation) is being studied worldwide and has yet to be proven. Results are encouraging: TMS has been reported to reduce the frequency of auditory hallucinations when administered to regions of the brain that demonstrate abnormal hyperactivity during hallucinations, and both TMS and MST induce far less electricity and stimulate more focal regions of the cortex than ECT and thus incur fewer cognitive side effects. Although DBS, where an electrode is implanted in a location relevant to the illness in question, is more invasive than other modalities, it is able to reach deeper structures in a highly focal way, which may turn out to be important for illnesses like obsessive-compulsive disorder, whose circuitry relies heavily on subcortical structures. VNS is less invasive than DBS but more invasive than TMS or MST. Unlike other methods, its effects are limited to the neuroanatomical connectivity of the vagus nerve, which means it is more difficult to tailor the administration of VNS than other forms of brain stimulation. Enriching our knowledge base in this exciting new field means more choices and therapeutic strategies for patients with conditions that resist conventional treatments. This fascinating work is a key reference for the promising future of brain stimulation in psychiatric treatment, and is a "must read" for clinicians and residents alike.