Augmentation strategies in neurostimulation modalities

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F44555601%3A13450%2F24%3A43898388" target="_blank" >RIV/44555601:13450/24:43898388 - isvavai.cz</a>

Výsledek na webu

<a href="https://psychiatria-danubina.com/UserDocsImages/pdf/dnb_vol36_noSuppl%201/dnb_vol36_noSuppl%201.pdf#page=36" target="_blank" >https://psychiatria-danubina.com/UserDocsImages/pdf/dnb_vol36_noSuppl%201/dnb_vol36_noSuppl%201.pdf#page=36</a>

DOI - Digital Object Identifier

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Jazyk výsledku

angličtina

Název v původním jazyce

Augmentation strategies in neurostimulation modalities

Popis výsledku v původním jazyce

Neurostimulation modalities or Noninvasive Brain Stimulation Techniques (NIBS) are widely perceived as powerful tools in the treatment of large variety of neuropsychiatric conditions with very scarce adverse effects and vast efficacy. Electroconvulsive therapy (ECT) was invented nearly 90 years ago and improved in efficacy and tolerability since then. The stigma of ECT is substantially decreasing, however it is the clumsiest aspect of this lifesaving procedure. Transcranial magnetic stimulation (TMS) uses the same electromagnetic force delivered into the brain via magnetic waves inimizing local and side effects of stimulation. Although the transcranial direct and alternating current stimulation (tDCS and tACS) use the lowest current and voltage of the aforementioned techniques, the effect is robust as the portion of delivered electric current is the highest. The up-to-date practice of ECT consist of: the general anesthesia and myorelaxation to eliminate majority of adverse effects; ? the electrode placement, ? the titration of current parameters, waveform (total ?energy?) and session schedule. If refined well, these approaches minimize the side effects (especially ransitory cognitive impairment) and enable the out-patient setting. Furthermore, continuation and maintenance treatment are necessary for full remission. Surprisingly, ECT is the only somatic treatment discontinued once it starts working. In 2019 we administered ECT in older depressed man, and even though we used maximal output of energy of Mecta? Spectrum? 5000 device (200 J), we were unable to induce adequate epileptiform seizure. After discussing with the leader in the field, Harold S. Sackeim from Colombian University New York, we combined two modalities to influence the seizure threshold. We used high frequency TMS over the supplementary motor area prior to ECT, lowered the seizure threshold by half, and demonstrating the feasibility of such treatment. We were the first to do so in a single session. Furthermore, we proceeded with a double-blind, placebo-controlled trial, which confirmed the immediate effect of TMS pre-stimulation on lowering the seizure threshold by an average decrease by 34.55%. Combining various protocols of NIBS and co-stimulation is now being experimentally researched but also used in a general practice. Some new modalities are tested out. Very promising is Focal Electrically Administered Seizure Therapy (FEAST) and some seem to be a dead (Magnetic Seizure Therapy or MST). Nevertheless, need for further co-operation across the nations is essential for success.

Název v anglickém jazyce

Augmentation strategies in neurostimulation modalities

Popis výsledku anglicky

Neurostimulation modalities or Noninvasive Brain Stimulation Techniques (NIBS) are widely perceived as powerful tools in the treatment of large variety of neuropsychiatric conditions with very scarce adverse effects and vast efficacy. Electroconvulsive therapy (ECT) was invented nearly 90 years ago and improved in efficacy and tolerability since then. The stigma of ECT is substantially decreasing, however it is the clumsiest aspect of this lifesaving procedure. Transcranial magnetic stimulation (TMS) uses the same electromagnetic force delivered into the brain via magnetic waves inimizing local and side effects of stimulation. Although the transcranial direct and alternating current stimulation (tDCS and tACS) use the lowest current and voltage of the aforementioned techniques, the effect is robust as the portion of delivered electric current is the highest. The up-to-date practice of ECT consist of: the general anesthesia and myorelaxation to eliminate majority of adverse effects; ? the electrode placement, ? the titration of current parameters, waveform (total ?energy?) and session schedule. If refined well, these approaches minimize the side effects (especially ransitory cognitive impairment) and enable the out-patient setting. Furthermore, continuation and maintenance treatment are necessary for full remission. Surprisingly, ECT is the only somatic treatment discontinued once it starts working. In 2019 we administered ECT in older depressed man, and even though we used maximal output of energy of Mecta? Spectrum? 5000 device (200 J), we were unable to induce adequate epileptiform seizure. After discussing with the leader in the field, Harold S. Sackeim from Colombian University New York, we combined two modalities to influence the seizure threshold. We used high frequency TMS over the supplementary motor area prior to ECT, lowered the seizure threshold by half, and demonstrating the feasibility of such treatment. We were the first to do so in a single session. Furthermore, we proceeded with a double-blind, placebo-controlled trial, which confirmed the immediate effect of TMS pre-stimulation on lowering the seizure threshold by an average decrease by 34.55%. Combining various protocols of NIBS and co-stimulation is now being experimentally researched but also used in a general practice. Some new modalities are tested out. Very promising is Focal Electrically Administered Seizure Therapy (FEAST) and some seem to be a dead (Magnetic Seizure Therapy or MST). Nevertheless, need for further co-operation across the nations is essential for success.

Druh

J_ost - Ostatní články v recenzovaných periodicích

CEP obor

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OECD FORD obor

30210 - Clinical neurology

Projekt

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Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2024

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Psychiatria Danubina

ISSN

0353-5053

e-ISSN

1849-0867

Svazek periodika

17

Číslo periodika v rámci svazku

36

Stát vydavatele periodika

HR - Chorvatská republika

Počet stran výsledku

2

Strana od-do

36-37

Kód UT WoS článku

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EID výsledku v databázi Scopus

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