One century of healing currents into the brain from the scalp: From electroconvulsive therapy to repetitive transcranial magnetic stimulation for neuropsychiatric disorders.

Electroconvulsive therapy (ECT) was applied for the first time in humans in 1938: after 80 years, it remains conceptually similar today except for modifications of the original protocol aimed to reduce adverse effects (as persistent memory deficits) without losing clinical efficacy. We illustrate the stages of development as well as ups and downs of ECT use in the last eighty years, and the impact that it still maintains for treatment of certain psychiatric conditions. Targeted, individualized and safe noninvasive neuromodulatory interventions are now possible for many neuropsychiatric disorders thanks to repetitive transcranial magnetic stimulation (rTMS) that injects currents in the brain through electromagnetic induction, powerful enough to depolarize cortical neurons and related networks. Although ECT and rTMS differ in basic concepts, mechanisms, tolerability, side effects and acceptability, and beyond their conceptual remoteness (ECT) or proximity (rTMS) to "precision medicine" approaches, the two brain stimulation techniques may be considered as complementary rather than competing in the current treatment of certain neuropsychiatric disorders.

Thirty years of transcranial magnetic stimulation: where do we stand?

Transcranial magnetic stimulation (TMS) has been first described 30 years ago, and since then has gained enormous attention by neurologists, psychiatrists, neurosurgeons, clinical neurophysiologists, psychologists, and neuroscientist alike. In the early days, it was primarily used to test integrity of the corticospinal tract. Beyond further developments of TMS in diagnostics, mapping and monitoring of the motor system, major other applications expanded into using TMS as research tool in the cognitive neurosciences, and as therapeutic tool in neurological and psychiatric disease by virtue of inducing long-term change in excitability and connectivity of the stimulated brain networks. This mini-review will highlight these developments by reviewing the 10 most frequently cited TMS publications. Despite the tremendous popularity and success of TMS as a non-invasive technique to stimulate the human brain, several aims remain unresolved. This review will end with highlighting those 10 most frequently cited papers that have been published in 2014-2016 to indicate the currently hottest topics in TMS research and major avenues of development.

Use of cortical stimulation in neuropathic pain, tinnitus, depression, and movement disorders.

Medical treatment must strike a balance between benefit and risk. As the field of neuromodulation develops, decreased invasiveness, in combination with maintenance of efficacy, has become a goal. We provide a review of the history of cortical stimulation from its origins to the current state. The first part discusses neuropathic pain and the nonpharmacological treatment options used. The second part covers transitions to tinnitus, believed by many to be another deafferentation disorder, its classification, and treatment. The third part focuses on major depression. The fourth section concludes with the discussion of the use of cortical stimulation in movement disorders. Each part discusses the development of the field, describes the current care protocols, and suggests future avenues for research needed to advance neuromodulation.

Magnetic fields in noninvasive brain stimulation.

The idea that magnetic fields could be used therapeutically arose 2000 years ago. These therapeutic possibilities were expanded after the discovery of electromagnetic induction by the Englishman Michael Faraday and the American Joseph Henry. In 1896, Arsène d'Arsonval reported his experience with noninvasive brain magnetic stimulation to the scientific French community. In the second half of the 20th century, changing magnetic fields emerged as a noninvasive tool to study the nervous system and to modulate neural function. In 1985, Barker, Jalinous, and Freeston presented transcranial magnetic stimulation, a relatively focal and painless technique. Transcranial magnetic stimulation has been proposed as a clinical neurophysiology tool and as a potential adjuvant treatment for psychiatric and neurologic conditions. This article aims to contextualize the progress of use of magnetic fields in the history of neuroscience and medical sciences, until 1985.

[From shock therapies to new neuromodulation techniques]. / Des thérapies de choc aux nouvelles techniques de neuromodulation.

The first shock therapies date back to 1933 with the Sakel therapy. Electric induction experiments led to electroconvulsive therapy first used by Ugo Cerletti and Lucio Bini in 1938. Today, transcranial magnetic stimulation offers new therapeutic perspectives for the treatment of mental disorders. Similarly, deep brain stimulation techniques have been developed for the treatment of compulsive obsessive disorders and severe and treatment-resistant depression.

Magnetic flimmers: 'light in the electromagnetic darkness'.

Transcranial magnetic stimulation has become an important field for both research in neuroscience and for therapy since Barker in 1985 showed that it was possible to stimulate the human motor cortex with an electromagnet. Today for instance, transcranial magnetic stimulation can be used to measure nerve conduction velocities and to create virtual lesions in the brain. The latter option creates the possibility to inactivate parts of the brain temporarily without permanent damage. In 2008, the American Food and Drugs Administration approved repetitive transcranial magnetic stimulation as a therapy for major depression under strict conditions. Repetitive transcranial magnetic stimulation has not yet been cleared for treatment of other diseases, including schizophrenia, anxiety disorders, obesity and Parkinson's disease, but results seem promising. Transcranial magnetic stimulation, however, was not invented at the end of the 20th century. The discovery of electromagnetism, the enthusiasm for electricity and electrotherapy, and the interest in Beard's concept of neurasthenia already resulted in the first electromagnetic treatments in the late 19th and early 20th century. In this article, we provide a history of electromagnetic stimulation circa 1900. From the data, we conclude that Mesmer's late 18th century ideas of 'animal magnetism' and the 19th century absence of physiological proof had a negative influence on the acceptance of this therapy during the first decades of the 20th century. Electromagnetism disappeared from neurological textbooks in the early 20th century to recur at the end of that century.

Transcranial direct current stimulation--update 2011.

Non-invasive brain stimulation with weak direct currents (transcranial direct current stimulation (tDCS)) has emerged as one of the major tools to induce neuroplastic cortical excitability alterations in humans since its (re-) introduction to the arsenal of plasticity-inducing brain stimulation tools. In this review, we gather newly emerged knowledge about the effect of tDCS on brain function in both, basic and applied research. This overview will deliver an update of the last two years of research, because especially during this time numerous important studies were published covering the above-mentioned fields.

Brain mapping using transcranial magnetic stimulation.

Transcranial magnetic stimulation (TMS) is a novel brain stimulation technique that has advanced the understanding of brain physiology, and has diagnostic value as well as therapeutic potential for several neuropsychiatric disorders. The stimulation involves restricted cortical and subcortical regions, and, when used in combination with a visually guided technique, results in improved accuracy to target specific areas, which may also influence the outcome desired. This article reviews the principles underlying the mechanism of action of TMS, and discusses its use to obtain functional maps of the motor and visual cortex, including technical considerations for accuracy and reproducibility of mapping procedures.

Transcranial magnetic stimulation: a historical evaluation and future prognosis of therapeutically relevant ethical concerns.

Transcranial Magnetic Stimulation (TMS) is a non-invasive neurostimulatory and neuromodulatory technique increasingly used in clinical and research practices around the world. Historically, the ethical considerations guiding the therapeutic practice of TMS were largely concerned with aspects of subject safety in clinical trials. While safety remains of paramount importance, the recent US Food and Drug Administration approval of the Neuronetics NeuroStar TMS device for the treatment of specific medication-resistant depression has raised a number of additional ethical concerns, including marketing, off-label use and technician certification. This article provides an overview of the history of TMS and highlights the ethical questions that are likely arise as the therapeutic use of TMS continues to expand.

Electrified minds: transcranial direct current stimulation (tDCS) and galvanic vestibular stimulation (GVS) as methods of non-invasive brain stimulation in neuropsychology--a review of current data and future implications.

Transcranial direct current stimulation (tDCS) is a noninvasive, low-cost and easy-to-use technique that can be applied to modify cerebral excitability. This is achieved by weak direct currents to shift the resting potential of cortical neurons. These currents are applied by attaching two electrodes (usually one anode and one cathode) to distinct areas of the skull. Galvanic Vestibular Stimulation (GVS) is a variant of tDCS where the electrodes are attached to the mastoids behind the ears in order to stimulate the vestibular system. tDCS and GVS are safe when standard procedures are used. We describe the basic physiological mechanisms and application of these procedures. We also review current data on the effects of tDCS and GVS in healthy subjects as well as clinical populations. Significant effects of such stimulation have been reported for motor, visual, somatosensory, attentional, vestibular and cognitive/emotional function as well as for a range of neurological and psychiatric disorders. Moreover, both techniques may induce neuroplastic changes which make them promising techniques in the field of neurorehabilitation. A number of open research questions that could be addressed with tDCS or GVS are formulated in the domains of sensory and motor processing, spatial and nonspatial attention including neglect, spatial cognition and body cognition disorders, as well as novel treatments for various neuropsychological disorders. We conclude that the literature suggests that tDCS and GVS are exciting and easily applicable research tools for neuropsychological as well as clinical-therapeutic investigations.

Transcranial magnetic stimulation in schizophrenia.

Transcranial magnetic stimulation (TMS) is a non-invasive and painless way of stimulating the neural tissue (cerebral cortex, spinal roots, and cranial and peripheral nerves). The first attempts at stimulating the neural tissue date back to 1896 by d'Arsonval; however, it was successfully carried out by Barker and colleagues in Sheffield, UK, in 1985. It soon became a useful tool in neuroscience for neurophysiologists and neurologists and psychiatrists. The original single-pulse TMS, largely used as an investigative tool, was further refined and developed in the early 1990s into what is known as repetitive TMS (rTMS), having a frequency range of 1-60 Hz. The stimulation by both TMS and rTMS of various cortical regions displayed alteration of movement, mood, and behavior, leading researchers to investigate a number of psychiatric and neuropsychiatric disorders, as well as to explore its therapeutic potential. There is now a large amount of literature on the use of TMS/rTMS in depression; however, its use in schizophrenia, both as an investigative and certainly as a therapeutic tool is relatively recent with a limited but increasing number of publications. In this article, we will outline the principles of TMS/rTMS and critically review their use in schizophrenia both as investigative and potential therapeutic tools.

The Ferrier Lecture 2004 what can transcranial magnetic stimulation tell us about how the brain works?

Transcranial magnetic stimulation (TMS) is a technique whereby parts of the cerebral cortex and underlying white matter can be excited by a brief electrical current induced by a similarly brief, rapidly fluctuating magnetic field which is itself produced by rapidly discharging a current through an insulated coil held against the scalp. When combined with magnetic resonance structural and functional images of the subject's brain, the stimulation can be directed at specific cortical areas. Over a period of only 15 years, TMS has revealed hitherto unsuspected aspects of brain function, such as the role of distant parts of the brain in recovery from stroke, and has helped to resolve several previously intractable disputes, such as the neuronal basis of conscious awareness. This article describes and discusses the origins and nature of TMS, its applications and limitations, and its especial usefulness in conjunction with other techniques of evaluating or imaging brain activity.

Tickling the brain: studying visual sensation, perception and cognition by transcranial magnetic stimulation.

Transcranial magnetic stimulation (TMS) is a means of stimulating the brain from outside the skull with little, and occasionally no discomfort for the subject. A single TMS pulse, lasting less than 1 ms, can briefly disrupt the normal activity of a targeted region of the brain for tens of milliseconds, allowing the effects of disruption on specific perceptual and cognitive tasks to be measured behaviorally. Rapid, repeated pulses can disrupt activity for correspondingly longer periods. The reversibility of the effects make it possible to create 'virtual patients' who can be tested in the same way as actual patients with real brain damage in order to explore regional functional specialization. Although several aspects of TMS continue to be evaluated, such as its safety, the extent and localization of the effective region of induced electrical current, the importance of the waveform of the pulse, the configuration and positioning of the coil, its productivity has been firmly established in little more than 10 years of systematic use. Examples of the latter are given from investigations of the nature of visual phosphenes produced by TMS applied to different regions of the visual cortex in normal subjects and subjects with occipital or ocular damage in an attempt to reveal the role of visual cortex in visual awareness.