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Neurostimulation Therapies

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Antidepressants

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 250))

Abstract

Depression is one of the most disabling conditions in the world. In many cases patients continue to suffer with depressive disorders despite a series of adequate trials of medication and psychotherapy. Neuromodulation treatments offer a qualitatively different modality of treatment that can frequently prove efficacious in these treatment-refractory patients. The field of neuromodulation focuses on the use of electrical/electromagnetic energy, both invasively and noninvasively, to interface with and ultimately alter activity within the human brain for therapeutic purposes. These treatments provide another set of options to offer patients when clinically indicated, and knowledge of their safety, risks and benefits, and appropriate clinical application is essential for modern psychiatrists and other mental health professionals. Although neuromodulation techniques hold tremendous promise, only three such treatments are currently approved by the United States Food and Drug Administration (FDA) for the treatment of major depressive disorder: electroconvulsive therapy (ECT), vagus nerve stimulation (VNS), and repetitive transcranial magnetic stimulation (rTMS). Additionally, numerous other neurostimulation modalities (deep brain stimulation [DBS], magnetic seizure therapy [MST], transcranial electric stimulation [tES], and trigeminal nerve stimulation [TNS]), though currently experimental, show considerable therapeutic promise. Researchers are actively looking for ways to optimize outcomes and clinical benefits by making neuromodulation treatments safer, more efficacious, and more durable.

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Abbreviations

BDNF:

Brain-derived neurotrophic factor

ECT:

Electroconvulsive therapy

EEG:

Electroencephalography

MRI:

Magnetic resonance imaging

MST:

Magnetic seizure therapy

PET:

Positron emission tomography

rTMS:

Repetitive transcranial magnetic stimulation

SPECT:

Single positron emission computed tomography

tACS:

Transcranial alternating current stimulation

tDCS:

Transcranial direct current stimulation

TMS:

Transcranial magnetic stimulation

tRNS:

Transcranial random noise stimulation

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Acknowledgment

Special thanks to Britt Gott, MS, for her valuable editorial input on content for this chapter.

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Authors and Affiliations

  1. University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    Nicholas T. Trapp

  2. Washington University School of Medicine, St. Louis, MO, USA

    Willa Xiong & Charles R. Conway

  3. John Cochran Division, VA St. Louis Health Care System, St. Louis, MO, USA

    Charles R. Conway

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  1. Nicholas T. Trapp
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  2. Willa Xiong
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  3. Charles R. Conway
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Correspondence to Charles R. Conway .

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  1. School of Medicine-Wichita, University of Kansas, Wichita, KS, USA

    Matthew Macaluso

  2. School of Medicine-Wichita, University of Kansas, Wichita, KS, USA

    Sheldon H. Preskorn

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Trapp, N.T., Xiong, W., Conway, C.R. (2018). Neurostimulation Therapies. In: Macaluso, M., Preskorn, S. (eds) Antidepressants. Handbook of Experimental Pharmacology, vol 250. Springer, Cham. https://doi.org/10.1007/164_2018_157

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