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Neuromodulation for Neuropsychiatric Disorders: Novel Techniques -Vagus Nerve Stimulation, Transcranial Magnetic Stimulation, Transcranial Direct Current Stimulation, and Deep Brain Stimulation

  • Russell J. AndrewsEmail author
Chapter

Abstract

The last two decades have seen the development of several neuromodulation techniques that have been applied to the problem of severe, medication-refractory depression – notably vagus nerve stimulation, transcranial magnetic stimulation, transcranial direct current stimulation, and deep brain stimulation. The four techniques are here reviewed from the standpoint of the hardware involved, the techniques of application, the biological effects of the stimulation on the brain (with an emphasis on neuroprotection), and the results obtained in neuropsychiatric disorders to date. Vagus nerve stimulation involves stimulation of the vagus nerve in the cervical region via an electrode encircling the nerve, with that stimulation resulting in effects on many regions in the brain. Transcranial magnetic stimulation uses a focused magnetic field to induce, through the intact skull, electrical stimulation in a specific region of the brain. Transcranial direct current stimulation induces a small current in a portion of the brain, also through the intact skull, via cathode and anode electrodes placed on the scalp. Deep brain stimulation employs a small number of electrodes (usually two – one for each hemisphere) placed through hole(s) in the skull into a specific brain nucleus; the effect of deep brain stimulation as it is presently performed is to reversibly ablate the function of that nucleus or region. Given the rapid developments in the neural-electrical interface, anticipated future developments in deep brain stimulation are considered as well.

Keywords

Deep brain stimulation Depression Mood disorders Neural-electrical interface Neuromodulation Obsessive-compulsive disorder Transcranial direct current stimulation Transcranial magnetic stimulation Vagus nerve stimulation 

Abbreviations

ACTH

adrenocorticotrphic hormone

BDNF

brain derived neurotrophic factor

CNT

carbon nanotube

CBF

cerebral blood flow

CE Mark

certification that a product meets the health and safety requirements of the 27 countries of the European Union plus 4 additional countries included in the European Economic Area

DBS

deep brain stimulation

DTI

diffusion tensor imaging

ECT

electroconvulsive therapy

EEG

electroencephalography

fMRI

functional magnetic resonance imaging

FDA

Food and Drug Administration (USA)

HAM-D

Hamilton Depression Rating Scale

Hz

Hertz (cycles per second)

LTP

long term potentiation

MEA

multi-electrode array

MEG

magnetoencephalography

mRNA

messenger ribonucleic acid

MRI

magnetic resonance imaging

NASA

National Aeronautics and Space Administration (USA)

NMDA

N-methyl-D-aspartate

NEI

neural-electrical interface

NGF

nerve growth factor

NTS

nucleus of the tractus solitarius

OCD

obsessive-compulsive disorder

PC12

pheochromocytoma 12

PET

positron emission tomography

rTMS

repetitive transcranial magnetic stimulation

SCC

subcallosal cingulate

SEM

scanning electron micrograph

STN

subthalamic nucleus

TBS

theta burst suppresion

tDCS

transcranial direct current stimulation

TMS

transcranial magnetic stimulation

TRD

treatment resistant depression

UPDRS

Unified Parkinson’s Disease Rating Scale

VNS

vagus nerve stimulation

YBOCS

Yale-Brown Obsessive-Compulsive Scale

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Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  1. 1.Ames Associate (Smart Systems and Nanotechnology) NASA Ames Research CenterMoffett FieldUSA

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