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rTMS workshop RNCM 1
 

rTMS workshop RNCM 1

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    rTMS workshop RNCM 1 rTMS workshop RNCM 1 Presentation Transcript

    • 4th Annual Computational Neurosciences Workshop Marseille Brain stimulation:Neuro-computational, Experimental, and Clinical approaches May 31st – June 1st 2012 rTMS Treatment in Psychiatry: Stimulation or Interaction? Jean-Arthur MICOULAUD-FRANCHI M.D. Chef de Clinique - Assistant Ph.D. Student in Neuroscience
    • The talk will propose an historical point of view Specifically for the case of Major Depressive Episode (depression), the first major therapeutic goal set for rTMS With 3 historical steps FromStep 1 18th Century: Historical Background Electrical Brain “Stimulation” in Psychiatry P L A N End of the 20th Century :Step 2 Validation of rTMS treatment as a focal brain stimulation ToStep 3 21-22th Century: Future Proposition Electrical Brain “Interaction” in Psychiatry
    • The talk will propose an historical point of view Specifically for the case of Major Depressive Episode, the first major therapeutic goal set for TMS With 3 historical steps FromStep 1 18th Century: Historical Background Electrical Brain “Stimulation” in Psychiatry P L A NStep 2 End of the 20th Century : Validation of rTMS treatment as a focal brain stimulation ToStep 3 21-22th Century: Future Proposition Electrical Brain “Interaction” in Psychiatry
    • Is Electro Convulsive Therapy (ECT)the first use of Electrical Brain Stimulation in Psychiatry? ECT is traditionally presented as the first use of electrical device for brain stimulation in psychiatry Hoy et Fitzgerald 2010, Nature Reviews Neurology S T E P 1 ECT 1930s tDCS 1960s TMS 1990sECT was referred to the supposed protective effect of seizures induce by some epileptics drugs: Camphor and Metrazole (Cerletti and Benetti, 1938) But not, to previous research on Electrical Brain Stimulation in psychiatry. Beaudreau et Finger, 2006
    • In 18th century, Aldani the nephew of Galvani, usedElectrical Brain Stimulation on patients with melancholia Following Galvani’s classic experiments establishing that electric currents were capable of stimulating neuronal tissues S Pile Volta was used to stimulate T E some brain region in patients P 1 Note that Aldani used Electrical stimulation (painfull stimulation) and not Magnetic stimulationFinger et Zaromb, 2006
    • At the end of the 19th century, D’Arsonval developed the principle of TMSFollowing the discovery of the unified and interchangeable nature of electric and magnetic forces  TMS use externally generated changing magnetic field to induce electric current intracranially S T E P 1Note thatTMS is not the application of magnetsused controversially by some psychiatristssince the work of Mesmer (1784) This is not TMS This is TMSHiggins et George, 2006
    • In 1985, first use of modern TMS on human brain Barker et al., first described the use of a pulsed (i.e. changing) magnetic field focused over specific brain regions to induce non painful cerebral cortex activation and muscle action potential Barker S T The Hand-Held Coil shaped E as a circular disc P (more recently as a figure-8) 1The power-source which generates an electric current that is switched on and off repeatedlyElectromyogram (if motor stimulation) Switch to induce the pulseBarker et al. 1985
    • Beaudreau et Finger, 2006Hoy et Fitzgerald 2010, First step : Birth of Focal Brain Stimulation ? ECT 1930s tDCS 1960s TMS 1990s S T Electrical Brain Focal E Stimulation in psychiatry P 1 Pile Volta 18th Century TMS 1990s Electrical Brain Global Camphor Stimulation in psychiatry Metrazole End 19th Century ECT 1930s