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Brain Stimulation for the Treatment of Psychiatric Disorders

Authors: Mark S. George, MD ; Ziad Nahas, MD ; Jeffrey J. Borckardt, MD ; Berry Anderson, MD ; Milton J. Foust, MD ; Carol Burns, MD ; Samet Kose, MD ; E. Baron Short, MDFaculty and Disclosures

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Abstract and Introduction

Abstract

Purpose of Review: There has been a resurgence of interest in brain stimulation techniques as therapies for psychiatric disorders. Various names are used for this class of treatments: neuromodulation, somatic therapies, brain stimulation techniques. The methods in this class range from non-invasive (transcranial magnetic stimulation) to invasive brain surgery (deep brain stimulation).
Recent Findings: Within the past year, the results of several large multicenter trials have been published, clearing the way for US Food and Drug Administration approval of vagus nerve stimulation for recurrent treatment-resistant depression and a pending consideration of approving transcranial magnetic stimulation for the treatment of depression.
Summary: This article reviews the most important recent clinically relevant manuscripts in this rapidly expanding new field.

Introduction

Stimulating the brain as a potential therapy is currently undergoing a profound and fertile expansion. Several new techniques are working their way into clinical use. At the same time, researchers are generating new information about some of the more established brain stimulation techniques such as electroconvulsive therapy (ECT). This review highlights articles published within the past year (2005 or 2006) in this area, with a focus on papers that impact clinical psychiatric practice. Mechanism-based studies are cited if they have high impact, or inform clinical use. Most of the work involves the treatment of depression. The new data emerging from brain stimulation methods is informed by the recent series of studies from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) project, with relatively poor response rates to current medication options in individuals who fail to respond to an initial mediation.[1••,2••] We discuss the techniques in the order of increasing invasiveness.

Papers of particular interest, published within the annual period of review, have been highlighted as:
of special interest
•• of outstanding interest
Additional references related to this topic can also be found in the Current World Literature section in this issue (p. 309).
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