rTMS Center in California

M. Bret Schneider, MD

Diplomate, American Board of Psychiatry and Neurology

828 Portola Road

Portola Valley, CA 94028

Telephone (650) 906-8371

Fax (650) 851-3544

Email: MBSchneiderMD@gmail.com

Web: http://mbschneidermd.googlepages.com

Medtronic’s Brain Stimulator Gets FDA Approval for OCD Patients

Medtronic has just been granted a Humanitarian Device Exemption (HDE) from the FDA for DBS in OCD; read more here.

After Long Wait, Medtronic Starts Big Depression Study

After a delay, Medtronic has started the the pivotal trial of DBS for major depression, read some more here.
On the protocol:

Medtronic's study will start with enrollment of 30 people at five sites, but there are plans to enroll up to 200 patients from 20 sites. Patients in the study will have a device implanted, but for some patients, the device won't be turned on for the first 16 weeks - this way the trial can be randomized between patients who are receiving treatment and not receiving treatment.

Conference on Neuroprosthetic Devices

First International Conference on Neuroprosthetic Devices will take place at National Chiao Tung University, Hsinchu, Taiwan on March 19th and 20th, 2009. The mission of this newly founded conference is to foster West-East interaction and collaboration in the rapidly advancing clinical use of neuroprosthetics. The specific aim of the first conference is to expose unique technological and neurological research opportunities in Taiwan. National Chaio Tung University is one of the best universities in Taiwan and is located right next to the world-famous HsinChu Science Park hosting hundreds of biotechnology, semiconductor, and electronics companies. The conference sessions will cover several key areas in the neuroprosthetic development, such as deep brain stimulation for treatment of Parkinson’s disease and epilepsy, devices for restoring hearing and overcoming muscle paralysis, microelectrode biocompatibility, and novel microelectrode technologies. For detailed conference program and registration information, please visit http://www.bsrc.nctu.edu.tw/ICND/.

A Randomized Trial of rTMS Targeted with MRI Based Neuro-Navigation in Treatment-Resistant Depression

Abstract:
The aim of this study is to investigate whether repetitive transcranial magnetic stimulation (rTMS) targeted to a specific site in the dorsolateral prefrontal cortex (DLPFC), with a neuro-navigational method based on structural MRI, would be more effective than rTMS applied using the standard localization technique. Fifty-one patients with treatment-resistant depression were randomized to receive a 3-week course (with a potential 1-week extension) of high-frequency (10 Hz) left-sided rTMS. Thirty trains (5 s duration) were applied daily 5 days per week at 100% of the resting motor threshold. Treatment was targeted with either the standard 5 cm technique (n=27) or using a neuro-navigational approach (n=24). This involved localizing the scalp location that corresponds to a specific site at the junction of Brodmann areas 46 and 9 in the DLPFC based on each individual subject's MRI scan. There was an overall significant reduction in the Montgomery-Asberg Depression Rating Scale scores over the course of the trial, and a better outcome in the targeted group compared with the standard localization group at 4 weeks (p=0.02). Significant differences were also found on secondary outcome variables. The use of neuro-navigational methods to target a specific DLPFC site appears to enhance response to rTMS treatment in depression. Further research is required to confirm this in larger samples, or to establish whether an alternate method based on surface anatomy, including measurement from motor cortex, can be substituted for the standard 5 cm method.Neuropsychopharmacology advance online publication, 14 January 2009; doi:10.1038/npp.2008.233.