NURS309 Lecture Notes - Lecture 6: White Matter, Complex Regional Pain Syndrome, Meta-Analysis
22 Jun 2018
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Neurostimulation Treatments
Definition
Neurostimulation treatments use electrical or magnetic stimulation targeting specific brain
regions with noninvasive and invasive techniques
Noninvasive Types
transcranial direct current stimulation (tDCS)
repetitive transcranial magnetic stimulation (rTMS)
electroconvulsive therapy (ECT)
and magnetic seizure therapy (MST)
Invasive surgical techniques
vagus nerve stimulation (VNS)
deep brain stimulation (DBS)
Most have been studied and used in patients with treatment-resistant depression (TRD)
Repetitive Transcranial Magnetic Stimulation (rTMS)
Inductor coil placed against the scalp delivers magnetic field pulses to induce electrical currents
in neural tissue noninvasively
Considered a first-line treatment for MDD for patients who have failed at least 1 antidepressant
treatment
Standard protocols deliver therapy 5 X week for 20 sessions
Repetitive Transcranial Magnetic Stimulation (rTMS) – Side Effects
Scalp pain during stimulation (*40%)
Transient headache after stimulation (*30%),
Cognitive performance no worsening in cognitive domains but also little evidence of
Seizure incidence with rTMS is estimated at *0.01% to 0.1% versus 0.1% to 0.6% on
antidepressant medications and 0.07% to 0.09% spontaneous incidence in the general
population
Transcranial Direct Current Stimulation (tDSC)
Delivers a continuous low amplitude electrical current to a region of the cortex using scalp
electrodes
Used over the left dorsolateral prefrontal cortex with minimum of 2 millamperes for at least 30
minutes per day for 2 weeks, will observe antidepressant effect
3rd line of treatment as further study is required
Transcranial Direct Current Stimulation (tDSC) –Side Effects
Reddening of the skin, itching, burning, heat, and tingling sensations at the site of stimulation
are the most common reported adverse events in more than half of patients
Headaches, blurred vision, ringing in the ears, brighter or illuminated vision, fatigue, nausea,
mild euphoria, reduced concentration, disorientation, insomnia, and anxiety have also been
reported but at low rates
Magnetic Seizure Therapy
MST is a noninvasive convulsive neurostimulation therapy that relies on the principle of
electromagnetic induction to induce an electric field in the brain strong enough to elicit a
generalized tonic-clonic seizure
Further research required – investigational at this time
Seems to be associated with lower rates of headaches and muscle aches
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Neurostimulation treatments use electrical or magnetic stimulation targeting specific brain regions with noninvasive and invasive techniques. Noninvasive types transcranial direct current stimulation (tdcs) repetitive transcranial magnetic stimulation (rtms) electroconvulsive therapy (ect) and magnetic seizure therapy (mst) Invasive surgical techniques vagus nerve stimulation (vns) deep brain stimulation (dbs) Most have been studied and used in patients with treatment-resistant depression (trd) Inductor coil placed against the scalp delivers magnetic field pulses to induce electrical currents in neural tissue noninvasively. Considered a first-line treatment for mdd for patients who have failed at least 1 antidepressant treatment. Standard protocols deliver therapy 5 x week for 20 sessions. Repetitive transcranial magnetic stimulation (rtms) side effects. Cognitive performance no worsening in cognitive domains but also little evidence of. Seizure incidence with rtms is estimated at *0. 01% to 0. 1% versus 0. 1% to 0. 6% on antidepressant medications and 0. 07% to 0. 09% spontaneous incidence in the general population.
