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Editorial 2008; 29(Suppl 1): 1-4 PubMed PMID: 19029879 Citation  Keywords:  Electric Stimulation, Electroconvulsive Therapy, Humans, Mental Disorders:physiopathology, Seizures:chemically induced,.   

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Journal Article 2008; 29(Suppl 1): 123-132 PubMed PMID: 19029877 Citation  Keywords:  Deep Brain Stimulation:adverse effects, Humans, Mental Disorders:therapy, Psychiatry, Treatment Outcome,.   

: Deep brain stimulation (DBS) is a reversible surgical procedure that involves stereotactic implantation of electrodes into the targeted brain regions, with a subcutaneously placed pulse generator powering the electrodes via one or two leads. The mechanism of action can be explained by the stimulation-induced modulation of impaired network activity. So far, the main use of DBS has been for neurological conditions, such as essential tremor, motor symptoms in Parkinson's disease, dystonia, epilepsy, and chronic pain. In psychiatry, case series and open studies indicate treatment efficacy of DBS in Gilles de la Tourette syndrome, treatment-resistant obsessive-compulsive disorder, and refractory major depression. Neuroimaging studies have confirmed the effects of DBS on the brain regions implicated in specific neuropsychiatric disorders. It is a well-tolerated method with relatively few serious side effects. Additional well-designed and appropriately powered controlled clinical trials are needed to conclusively establish the efficacy and safety of DBS and to identify the patient population(s) who may benefit most. Ongoing research with stimulation techniques may also significantly contribute to our understanding of major neuropsychiatric disorders....

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Historical Article 2008; 29(Suppl 1): 147-160 PubMed PMID: 19029871 Citation  Keywords:  Clinical Trials as Topic, History, 19th Century, History, 20th Century, Humans, Schizophrenia:physiopathology, Transcranial Magnetic Stimulation:history,.   

: 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....

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Journal Article 2008; 29(Suppl 1): 133-146 PubMed PMID: 19029870 Citation  Keywords:  Depressive Disorder:therapy, Humans, Mental Disorders:therapy, Risk Factors, Vagus Nerve:physiology, Vagus Nerve Stimulation:methods,.   

: Treatment-resistant depression is one of the major challenges in clinical psychiatry, considering that its current treatments are far from optimal. Although known for decades, in the last few years vagus nerve stimulation (VNS) has become increasingly popular as a novel method of treatment of pharmacoresistant depression. In spite of an emerging body of literature concerning the effectiveness and potential mechanisms of action of VNS, some crucial questions regarding those issues remain to be answered. We review the pre-clinical and clinical literature relating to VNS, with the impact of studies of efficacy and safety in treatment of pharmacoresistant depression and also in other clinical applications in the field of psychiatric disorders. We conclude that in light of emerging reports, VNS warrants more controlled studies for the treatment of other forms of depression, including depression in a younger population, and also of other psychiatric disorders. Because of its safety, VNS could potentially become a treatment of choice in fields in which treatment procedures traditionally require the least aggressive methods....

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Journal Article 2008; 29(5): 702-705 PubMed PMID: 18987602 Citation  Keywords:  Animals, Electric Stimulation, Excitatory Postsynaptic Potentials:physiology, Hippocampus:blood supply, Ischemic Attack, Transient:physiopathology, Long-Term Potentiation:physiology, Male, Rats, Rats, Wistar, Synaptic Transmission:physiology,.   

OBJECTIVES: Long-term potentiation (LTP) of neuronal activity in the hippocampus is thought to be a substrate for learning and memory. The influence of ischemia (IS) (hypoxia/hypoglycemia) on induction of LTP of synaptic transmission (ST) by high frequency stimulation (HFS) was investigated in rat hippocampal slices.

METHODS: Neurons were stimulated via Schäffer collaterals and field excitatory postsynaptic potentials (fEPSP) were recorded extracellularly from the CA1 region. LTP was induced by one single train (100 Hz, 1s).

RESULTS: In controls LTP of ST after HFS was 179.70+/-12.53%. Short IS of 2.5-4.5 min elicited a transient failure of ST, with return to former value followed by further increase of fEPSP amplitude to 142.28+/-16.24%, compared to amplitude before IS. HFS was elicited 40 min after exposure to IS and LTP was measured over further 40-60 min. LTP in slices exposed to 2.5-4.5-min IS was 139.94+/-14.01%. IS of 6-7.5 min elicited a prolonged failure of ST, with almost full recovery (96.69+/-14.42%). LTP was not activated 40 min after 6-7.5-min IS and the amplitude of fEPSP was even reduced to 80.14+/-19.19% compared to the former mean value of fEPSP 10 min before HFS.

CONCLUSION: The results revealed that prolonged 6-7.5-min IS influenced induction of LTP of ST in the hippocampus and thus it could have deleterious effects on learning and memory. These findings may have clinical implications in stroke, brain ischemia, sleep apnoe and call for studying the effect of neuroprotectants on the induction of LTP in hippocampus exposed to oxidative stress....

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Journal Article 2008; 29(4): 518-521 PubMed PMID: 18766155 Citation  Keywords:  Adolescent, Adult, Auditory Perception:physiology, Color, Humans, Male, Photic Stimulation, Touch:physiology,.   

OBJECTIVES: It is well known that colour exposure can influence emotions, behaviour and perception. To get further insight into these complex synesthetic phenomena, the effect of colour stimulation on auditory and somatosensory perception was systematically investigated.

METHODS: 14 healthy male volunteers with normal colour vision rated the loudness of auditory stimuli with a standardized scale during exposure to white, red and green light. Furthermore temperature perception was assessed during exposure of the different colours using a thermal sensory analyser.

RESULTS: Colour exposure significantly altered auditory and somatosensory perception. Red light enhanced loudness perception and decreased cold pain thresholds, while green light stimulation reduced loudness perception and increased detection and pain thresholds for warm stimuli.

CONCLUSIONS: This data give further evidence for cross-modal plasticity in human perception. Colour stimulation influences auditory and somatosensory perception and may therefore have potential as a new treatment strategy of phantom perceptions such as tinnitus or chronic pain....

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Case Reports 2008; 29(1): 69-70 PubMed PMID: 18283246 Citation  Keywords:  Adult, Depression:therapy, Female, Humans, Pregnancy, Pregnancy Complications:psychology, Transcranial Magnetic Stimulation:adverse effects, Treatment Outcome,.   

: Sir: For women diagnosed with Recurrent depressive disorder, pregnancy poses a major treatment challenge. Apart from antidepressants, the most commonly used biological therapeutical method is ECT (electroconvulsive therapy). We believe that similar efficacy can be achieved using rTMS as a safer option with substantially less side effects. So far, only a few case-reports reporting the use of rTMS for treatment of pregnant patients with depression were published....

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Journal Article 2007; 28(1): 21-25 PubMed PMID: 17277730 Citation  Keywords:  Adult, Aged, Appetite Regulation:physiology, Body Weight:physiology, Deep Brain Stimulation:adverse effects, Female, Humans, Male, Middle Aged, Parkinson Disease:physiopathology, Retrospective Studies, Subthalamic Nucleus:physiopathology, Weight Gain,.   

: Deep brain stimulation of the subthalamic nucleus (DBS STN) is an effective treatment method in advanced Parkinson's disease (PD) providing marked improvement of its major motor symptoms. In addition, non-motor effects have been reported including weight gain in PD patients after DBS STN. Using retrospective survey, we aimed to evaluate weight changes in our patients with advanced PD treated with DBS STN. We inquired 25 PD patients (16 men, 9 women), of mean age 55 (42-65) years, mean PD duration 15 (9-21) years, who previously received bilateral DBS STN. We obtained valid data from 23 patients. In the first survey, 1 to 45 months after DBS, weight gain was found in all patients comparing to pre-DBS period. The mean increase was 9.4 kg (from 1 to 25 kg). The patients' mean body mass index (BMI) increased from 23.7 to 27.0 kg/m2, i.e. by 3.3 kg/m2 (+2 to +6.1 kg/m2). In the repeated survey one year later, in 12 of the patients body weight moderately decreased, 3 did not change, and 6 patients further increased their weight. Possible explanations of body weight gain after DBS STN include a reduction of energy output related to elimination of dyskinesias, improved alimentation or direct influence on function of lateral hypothalamus by DBS STN....

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