Journal article
Noninvasive Brain Stimulation: Challenges and Opportunities for a New Clinical Specialty
The journal of neuropsychiatry and clinical neurosciences, Vol.30(3), pp.173-179
2018
DOI: 10.1176/appi.neuropsych.17110262
PMID: 29685065
Abstract
Noninvasive brain stimulation refers to a set of technologies and techniques with which to modulate the excitability of the brain via transcranial stimulation. Two major modalities of noninvasive brain stimulation are transcranial magnetic stimulation (TMS) and transcranial current stimulation. Six TMS devices now have approved uses by the U.S. Food and Drug Administration and are used in clinical practice: five for treating medication refractory depression and the sixth for presurgical mapping of motor and speech areas. Several large, multisite clinical trials are currently underway that aim to expand the number of clinical applications of noninvasive brain stimulation in a way that could affect multiple clinical specialties in the coming years, including psychiatry, neurology, pediatrics, neurosurgery, physical therapy, and physical medicine and rehabilitation. In this article, the authors review some of the anticipated challenges facing the incorporation of noninvasive brain stimulation into clinical practice. Specific topics include establishing efficacy, safety, economics, and education. In discussing these topics, the authors focus on the use of TMS in the treatment of medication refractory depression when possible, because this is the most widely accepted clinical indication for TMS to date. These challenges must be thoughtfully considered to realize the potential of noninvasive brain stimulation as an emerging specialty that aims to enhance the current ability to diagnose and treat disorders of the brain.
Details
- Title: Subtitle
- Noninvasive Brain Stimulation: Challenges and Opportunities for a New Clinical Specialty
- Creators
- Aaron D Boes - From the Departments of Pediatrics, Neurology, and Psychiatry, Iowa Neuroimaging and Noninvasive Brain Stimulation Laboratory, University of Iowa Hospitals and Clinics, Iowa City, Iowa (ADB); the Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City, Iowa (NTT); the Department of Neurology, Division of Cognitive Neurology, Berenson-Allen Center for Noninvasive Brain Stimulation, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston (ADB, MSK, APS, DZP, AP-L); and the University of Rochester School of Medicine and Dentistry, Rochester, N.Y. (MSK)Michael S Kelly - From the Departments of Pediatrics, Neurology, and Psychiatry, Iowa Neuroimaging and Noninvasive Brain Stimulation Laboratory, University of Iowa Hospitals and Clinics, Iowa City, Iowa (ADB); the Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City, Iowa (NTT); the Department of Neurology, Division of Cognitive Neurology, Berenson-Allen Center for Noninvasive Brain Stimulation, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston (ADB, MSK, APS, DZP, AP-L); and the University of Rochester School of Medicine and Dentistry, Rochester, N.Y. (MSK)Nicholas T Trapp - From the Departments of Pediatrics, Neurology, and Psychiatry, Iowa Neuroimaging and Noninvasive Brain Stimulation Laboratory, University of Iowa Hospitals and Clinics, Iowa City, Iowa (ADB); the Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City, Iowa (NTT); the Department of Neurology, Division of Cognitive Neurology, Berenson-Allen Center for Noninvasive Brain Stimulation, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston (ADB, MSK, APS, DZP, AP-L); and the University of Rochester School of Medicine and Dentistry, Rochester, N.Y. (MSK)Adam P Stern - From the Departments of Pediatrics, Neurology, and Psychiatry, Iowa Neuroimaging and Noninvasive Brain Stimulation Laboratory, University of Iowa Hospitals and Clinics, Iowa City, Iowa (ADB); the Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City, Iowa (NTT); the Department of Neurology, Division of Cognitive Neurology, Berenson-Allen Center for Noninvasive Brain Stimulation, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston (ADB, MSK, APS, DZP, AP-L); and the University of Rochester School of Medicine and Dentistry, Rochester, N.Y. (MSK)Daniel Z Press - From the Departments of Pediatrics, Neurology, and Psychiatry, Iowa Neuroimaging and Noninvasive Brain Stimulation Laboratory, University of Iowa Hospitals and Clinics, Iowa City, Iowa (ADB); the Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City, Iowa (NTT); the Department of Neurology, Division of Cognitive Neurology, Berenson-Allen Center for Noninvasive Brain Stimulation, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston (ADB, MSK, APS, DZP, AP-L); and the University of Rochester School of Medicine and Dentistry, Rochester, N.Y. (MSK)Alvaro Pascual-Leone - From the Departments of Pediatrics, Neurology, and Psychiatry, Iowa Neuroimaging and Noninvasive Brain Stimulation Laboratory, University of Iowa Hospitals and Clinics, Iowa City, Iowa (ADB); the Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City, Iowa (NTT); the Department of Neurology, Division of Cognitive Neurology, Berenson-Allen Center for Noninvasive Brain Stimulation, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston (ADB, MSK, APS, DZP, AP-L); and the University of Rochester School of Medicine and Dentistry, Rochester, N.Y. (MSK)
- Resource Type
- Journal article
- Publication Details
- The journal of neuropsychiatry and clinical neurosciences, Vol.30(3), pp.173-179
- DOI
- 10.1176/appi.neuropsych.17110262
- PMID
- 29685065
- NLM abbreviation
- J Neuropsychiatry Clin Neurosci
- ISSN
- 0895-0172
- eISSN
- 1545-7222
- Publisher
- United States
- Language
- English
- Date published
- 2018
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurology; Psychiatry; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Neurology (Pediatrics)
- Record Identifier
- 9984003479602771
Metrics
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