By Ananda Pandurangi, MD, MBBS, DLFAPA
Dr. Pandurangi, Distinguished Career Professor of Psychiatry at Virginia Commonwealth University (VCU) who served as director of Brain Stimulation Therapies at VCU presented on the topic of Transcranial Magnetic Stimulation (TMS): State of the Art and Future Opportunities.
Dr. Pandurangi introduced the concept of Therapeutic Neuromodulation as a method of influencing the behavior of neural circuits to achieve a targeted clinical benefit. He outlined currently available neuromodulation technologies including ECT, DBS, VNS, TMS and tDCS, with the focus on TMS.
The putative mechanism of the action of TMS, especially in alleviating depression was presented following details on stimulation patterns, including high and low frequency stimulation and theta burst stimulation. Various sites of stimulation were shown schematically, such as left and right dorsolateral prefrontal cortex, supplemental motor area, left and right temporo-parietal junction, for different psychiatric disorders such as major depression, OCD, Smoking cessation and auditory hallucinations. Eight currently available devices were mentioned. Data was then presented on TMS studies on depression at VCU and summary data from studies using TMS and other brain stimulation techniques in depression, OCD, schizophrenia and smoking, shown graphically.
The presentation ended with a mention of future opportunities, such as development of new coils for TMS, optogenetic and laser stimulation.
