A new book released today chronicles one woman’s 30-year battle with major depression and sheds light on how a novel, non-drug therapy saved her life. 3,000 Pulses intimately documents 62-year-old Martha Rhodes’ nearly lifelong journey with depression and gives a harrowing yet inspirational account of how it is possible to reclaim your life from the powerful grip of mental illness and attempted suicide.
Repetitive Transcranial Magnetic Stimulation For Depressive Disorders By Paul B. Fitzgerald and Z. Jeff Daskalakis -Springer 2013 (ISBN-13: 978-3642364662)
Repetitive transcranial magnetic stimulation (rTMS) treatment is increasingly being used in the management of patients with depression. Nevertheless, considerable ignorance still exists about the treatment in general psychiatric practice. This concise clinical guide will serve as a reference and practical tool for clinicians working with or learning about this treatment technique. The opening chapters provide basic information on the history and development of rTMS treatment and its mechanism of action. Use of the treatment in depression is then addressed in detail, with explanation of the evidence base and discussion of a variety of clinical issues. Side-effects of treatment are explored, and careful consideration is given to the establishment of rTMS treatment programs and the training of clinicians. The final chapters will provide a brief overview of potential rTMS applications in other psychiatric conditions and some background on related treatments.
The relationship between brain oscillatory activity and therapeutic effectiveness of transcranial magnetic stimulation in the treatment of major depressive disorder. Frontiers in Human Neuroscience. February 2013 Volume 7 Article 37
Major depressive disorder (MDD) is marked by disturbances in brain functional connectivity. This connectivity is modulated by rhythmic oscillations of brain electrical activity, which enable coordinated functions across brain regions. Oscillatory activity plays a central role in regulating thinking and memory, mood, cerebral blood flow, and neurotransmitter levels, and restoration of normal oscillatory patterns is associated with effective treatment of MDD. Repetitive transcranial magnetic stimulation (rTMS) is a robust treatment for MDD, but the mechanism of action (MOA) of its benefits for mood disorders remains incompletely understood. Benefits of rTMS have been tied to enhanced neuroplasticity in specific brain pathways. We summarize here the evidence that rTMS entrains and resets thalamocortical oscillators, normalizes regulation and facilitates reemergence of intrinsic cerebral rhythms, and through this mechanism restores normal brain function. This entrainment and resetting may be a critical step in engendering neuroplastic changes and the antidepressant effects of rTMS. It may be possible to modify the method of rTMS administration to enhance this MOA and achieve better antidepressant effectiveness. We propose that rTMS can be administered: (1) synchronized to a patient’s individual alpha frequency (IAF), or synchronized rTMS (sTMS); (2) as a low magnetic field strength sinusoidal waveform; and, (3) broadly to multiple brain areas simultaneously. We present here the theory and evidence indicating that these modifications could enhance the therapeutic effectiveness of rTMS for the treatment of MDD.