Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

TMS for beginners

3,911 views

Published on

Transcranial magnetic stimulation (TMS) is a noninvasive method to cause depolarization or hyperpolarization in the neurons of the brain.
This video explains the physics of this method and how it can be used in daily practice.
More about magnetic simulators: http://www.neurosoft.ru/eng/product/neuro-msd/index.aspx

  • DOWNLOAD FULL BOOKS, INTO AVAILABLE FORMAT ......................................................................................................................... ......................................................................................................................... 1.DOWNLOAD FULL. PDF EBOOK here { https://tinyurl.com/yxufevpm } ......................................................................................................................... 1.DOWNLOAD FULL. EPUB Ebook here { https://tinyurl.com/yxufevpm } ......................................................................................................................... 1.DOWNLOAD FULL. doc Ebook here { https://tinyurl.com/yxufevpm } ......................................................................................................................... 1.DOWNLOAD FULL. PDF EBOOK here { https://tinyurl.com/yxufevpm } ......................................................................................................................... 1.DOWNLOAD FULL. EPUB Ebook here { https://tinyurl.com/yxufevpm } ......................................................................................................................... 1.DOWNLOAD FULL. doc Ebook here { https://tinyurl.com/yxufevpm } ......................................................................................................................... ......................................................................................................................... ......................................................................................................................... .............. Browse by Genre Available eBooks ......................................................................................................................... Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult,
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • DOWNLOAD FULL BOOKS, INTO AVAILABLE FORMAT ......................................................................................................................... ......................................................................................................................... 1.DOWNLOAD FULL. PDF EBOOK here { https://tinyurl.com/y8nn3gmc } ......................................................................................................................... 1.DOWNLOAD FULL. EPUB Ebook here { https://tinyurl.com/y8nn3gmc } ......................................................................................................................... 1.DOWNLOAD FULL. doc Ebook here { https://tinyurl.com/y8nn3gmc } ......................................................................................................................... 1.DOWNLOAD FULL. PDF EBOOK here { https://tinyurl.com/y8nn3gmc } ......................................................................................................................... 1.DOWNLOAD FULL. EPUB Ebook here { https://tinyurl.com/y8nn3gmc } ......................................................................................................................... 1.DOWNLOAD FULL. doc Ebook here { https://tinyurl.com/y8nn3gmc } ......................................................................................................................... ......................................................................................................................... ......................................................................................................................... .............. Browse by Genre Available eBooks ......................................................................................................................... Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult,
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • DOWNLOAD FULL BOOKS, INTO AVAILABLE FORMAT ......................................................................................................................... ......................................................................................................................... 1.DOWNLOAD FULL. PDF EBOOK here { https://tinyurl.com/y8nn3gmc } ......................................................................................................................... 1.DOWNLOAD FULL. EPUB Ebook here { https://tinyurl.com/y8nn3gmc } ......................................................................................................................... 1.DOWNLOAD FULL. doc Ebook here { https://tinyurl.com/y8nn3gmc } ......................................................................................................................... 1.DOWNLOAD FULL. PDF EBOOK here { https://tinyurl.com/y8nn3gmc } ......................................................................................................................... 1.DOWNLOAD FULL. EPUB Ebook here { https://tinyurl.com/y8nn3gmc } ......................................................................................................................... 1.DOWNLOAD FULL. doc Ebook here { https://tinyurl.com/y8nn3gmc } ......................................................................................................................... ......................................................................................................................... ......................................................................................................................... .............. Browse by Genre Available eBooks ......................................................................................................................... Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult,
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here

TMS for beginners

  1. 1. Alternating magnetic field induces the electrical current in the conductor
  2. 2. In general magnetic stimulator consists of capacitor, coil and switch
  3. 3. T ypes of Coils
  4. 4. Electric field intensity induced below the coils of different types
  5. 5. M agnetic Induction Decrement with Distance
  6. 6. General Rules for Selecting the Appropriate Coil for Certain Application – Small coils have stronger field on the surface but field decreases dramatically with distance. Therefore small coils are suitable for peripheral stimulation in which magnetic field does not need to pass through skull bones – B coils have lower decrease of field with distance. ig Therefore they are used for transcranial stimulation – Ring coils are less focused. Therefore they are used for stimulation of wide areas (for diagnostics) – F igure-of-eight coils are more focused, therefore they are widely used for treatment
  7. 7. H T SW ow M orks
  8. 8. M otor E voked P otential (M P E) Generation
  9. 9. General P eculiarities of M P E: – Amplitude is always lower than amplitude of response recoded from same muscle with supramaximal electrical stimulation of peripherial nerve – Amplitude is variable, but we can speak about steady level We believe that MEP amplitude reflects the quantity of motor neurons ready for excitation at the moment of stimulation M P amplitude = cortex excitability E Variation of M P amplitude = variation of cortex excitability E
  10. 10. F acilitation
  11. 11. M otor E voked P otential E mergence at Arbitrary M uscle T ension Spinal Column T rauma)
  12. 12. Silent P eriod (SP )
  13. 13. IH (Interhemispheric Inhibition) I
  14. 14. L P (L T ong-term P enetration) Time, min MEP variation within 16 minutes after 5 Hz stimulation of motor cortex
  15. 15. H W Can Use T S for B ow e M rain Activity M odulation – We can excite activity (facilitation) – We can inhibit activity (silent period) – We can stimulate one site but get inhibition at another site (interhemispheric inhibition) – We can have long-term post-stimulation effect (long-term penetration)
  16. 16. Daily P ractical Use: Diagnostics
  17. 17. Central M otor Conduction T ime (CM ) CT
  18. 18. Diagnostic T S Use M Main Techniques: – Amplitude of motor evoked potential (MEP) – Amplitude ratio (motor evoked potential/M-wave) – Motor evoked potential facilitation – Central motor conduction time – Triple stimulation test Diagnostic Areas: – Stroke patients – Spinal and brain trauma – Parkinson’ s disease
  19. 19. Daily P ractical Use: T herapeutic
  20. 20. T herapeutic T S Use M Amblyopia[11][12] Amyotrophic lateral sclerosis Auditory hallucinations associated with schizoaffective disorders Chronic pain Dysphasia Dystonia Epilepsy Fibromyalgia Hemispatial neglect Major depression Migraine[13] Obsessive-compulsive disorder Parkinson’s disease Phantom limb Stroke Nonfluent aphasia [14] Tinnitus[15]
  21. 21. T S Use to T M reat Depressions
  22. 22. Is T S Safe? M When user follows Internationally recognized safety guidelines, TMS is safe TMS is not recommended for children, pregnant women, patients with implants and patients with epilepsy “Risk and safety of repetitive transcranial magnetic stimulation: report and suggested guidelines from the International Workshop on the safety of repetitive magnetic stimulation, June 5-7. 1996” by Eric M. Wassermann (accepted for publication: 23 May 1997)
  23. 23. M otor T hreshold (M ) T Minimum intensity required to elicit a small motor evoked potential in at least half of the trials It may be expected that motor threshold depends on the excitability of those elements which are activated by TMS For treatment purposes MT level means intensity of stimulation just enough to excite cortex Stimulation with lower intensities might not be effective and stimulation with higher intensities can be uncomfortable
  24. 24. Stimulation P oint and Coil Orientation in Depression T reatment
  25. 25. T reatment W orkflow 1. Prepare a patient 2. Determine the MT at MT detection point 3. Move coil to stimulation point 4. Set stimulation parameters 5. Run test and observe the patient during the stimulation 6. Make a record
  26. 26. P rotocols for Depression T reatment The majority of our customers apply Neuro-M to treat depression using these protocols: S Over the left frontal dorsolateral cortex (5 cm anterior (parallel to the sagittal line) to the area where the motor threshold is obtained) 5 H 25 trains of 10 seconds each with 20-second pause between the trains. Applied at z, 120% of the motor threshold (protocol used by Dr. Marcolin). or 10 H 30 trains of 4 seconds each with 20-second pause between the trains. Applied at z, 100% of the motor threshold (or 120%, when possible - limited by the power of the device) (protocol used by Dr. Moacyr). The quantity of stimuli for effective treatment is considered as more than 1000 pulses Number of sessions: 15-30 (3-6 weeks)
  27. 27. Video 2
  28. 28. W hat is Cooling System for? In total 1250 pulses at 120% of MT or 1200 pulses at 100 % of MT for depression treatment. The vast majority of patients have MT at about 40-60% of MO (maximum output of Neuro-MS). It means they need to be stimulated at 40-72% of MO. Neuro-MS coil is equipped with built-in temperature sensor which stops the device when coil temperature reaches 41 C and over. In average coil gets overheated after 250 pulses at 5 Hz at maximum intensity. It means that without cooling system Neuro-MS is able to perform standard depression treatment only if we change the coil during the session at least once. With cooling system practically there are no limitation on duration of treatment session.
  29. 29. Stimulation F requency If we consider 72% to be the most wide-spread intensity for stimulation of patients with depressions then maximum achieved frequency is 10 Hz We will name this term “ effective frequency” Maximum intensity drops with frequency increase
  30. 30. W hat is P lacebo-coil for? Placebo coil should: – Look like normal one – Produce click like normal one – But generate low-intensity stimulus
  31. 31. Available at blurb for $52,95 http://www.blurb.com/bookstore/detail/3442787

×