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TITLE:
Bridging the skull: electroconvulsive therapy
(ECT) and repetitive transcranial magnetic stimulation (rTMS) in psychiatry.
AUTHOR:
Kirkcaldie M; Pridmore S; Reid P
AUTHOR AFFILIATION:
Department of Psychological Medicine, Royal
Hobart Hospital, Tasmania, Australia.
SOURCE:
Convuls Ther 1997 Jun;13(2):83-91
NLM CIT. ID:
97397489
ABSTRACT:
A brief account of repetitive transcranial
magnetic stimulation (rTMS) with reference to electroconvulsive therapy (ECT) is given,
identifying similarities and dissimilarities, and discussing their potential therapeutic
roles. The insulating properties of the skull prevent specific, noninvasive stimulation of
particular brain regions by direct electrical means. ECT allows electrical stimulation of
the cortex, but its concomitant seizures and distributed electrical currents can have
adverse effects on patients. By contrast, magnetic fields pass almost without attenuation
through the skull, and can induce secondary electrical currents in localized areas of the
brain. Subconvulsive rTMS does not require seizure or general anesthetic, and does not
affect memory. Recent studies suggest that rTMS has therapeutic potential for mood
disorders, for which ECT is well established. rTMS is a new technology with the potential
to treat some mental disorders currently treated with ECT, with fewer side effects. ECT
will almost certainly remain the treatment of choice in some situations, but ECT and rTMS
may be alternatives for other patients. It is possible that rTMS will become established
in some areas where ECT is not used. Further research will define these roles and evaluate
the utility of rTMS.
MAIN MESH SUBJECTS:
*Electroconvulsive Therapy/ADVERSE EFFECTS
Magnetics/ADVERSE EFFECTS/*THERAPEUTIC USE
Mental Disorders/*THERAPY
ADDITIONAL MESH SUBJECTS:
Brain/PHYSIOLOGY
Depressive Disorder/THERAPY
Human
Skull/PHYSIOLOGY
PUBLICATION TYPES:
JOURNAL ARTICLE
REVIEW
REVIEW, TUTORIAL
LANGUAGE:
Eng
On Sabbatical!
When my office
lease expired at the end of 2004, I decided to turn it into a
"sabbatical" from my private practice. Many years ago, in my
grandfather's 89th year of life, he told me, "John, it is important
to smell the roses while you can still smell them." His life
gave living a very good reputation. It is also true that the
pursuit of that philosophy required my grandfather to to re-open his
assay office/ore market in Wickenburg, Arizona as a 75-year-old because
he had run a little short of retirement money. Thus, if blessed with his
luck and health, I'll be back.. --jjh
