Vagus Nerve Stimulation (VNS) and Treatment of Depression: To the Brainstem and Beyond

PMID: 21103178

AUTHORS: John P O'Reardon, Pilar Cristancho, Andrew D Peshek

REFERENCE: Psychiatry (Edgmont) 2006 May 3(5):54-63

Neuromodulation appears to be emerging gradually as a new therapeutic
field in psychiatric treatment. It encompasses neuropsychiatric medical
devices, such as vagus nerve stimulation (VNS), transcranial magnetic
stimulation (TMS), deep brain stimulation (DBS), and electroconvulsive
therapy (ECT). As a therapeutic approach to affective disorders,
neuromodulation shifts the focus from the monoamine synapse to neural
circuitry of the brain, which is dysregulated in depression. This neural
circuitry has been elaborated on over the course of 15 years of
neuroimaging research in mood disorders and is now believed to encompass
disturbances in a frontolimbic network. These include reduced
metabolism and blood flow in the prefrontal cortex and anterior
cingulate and pathologically increased activity in the subgenual
cingulate and amygdala.VNS is an implanted device that has established
efficacy in pharmaco-resistant epilepsy. It was approved by the FDA for
the treatment of severe, recurrent unipolar and bipolar depression in
July of 2005. VNS adopts a bottom-up approach to modulating the neural
circuitry of depression by stimulating vagal afferent fibers in the neck
, which carry impulses to the brain stem to target there the locus
ceruleus and dorsal raphe nucleus. Now that VNS has moved beyond the
experimental phase and into the clinic, psychiatrists are faced with
deciding who is an appropriate patient for this surgical implant and how
to integrate VNS into existing treatment in order to optimize both
efficacy and safety.This review of VNS will assess the efficacy and
safety data that led to the FDA approval. We will also review for the
busy clinician how VNS is likely to translate into clinical practice as
a treatment option for patients in need who are suffering from severe
depression.

Modeling of electromagnetic stimulation of the human brain

PMID: 21095888

AUTHORS: Dmitry Lazutkin, Peter Husar

AFFILIATION: Division of Biological Signal Processing, Department of Biomedical Engineering and Medical Informatics, Ilmenau University of Technology, PO Box 100565, 98684, Germany.

REFERENCE: Conf Proc IEEE Eng Med Biol Soc 2010 1():581-4

The World Health Organization estimates depression as a serious threat
to the health of millions of people worldwide. The purpose of this paper
is to introduce the ongoing research devoted to the investigation of a
possibility to use low-field electromagnetic stimulation of the human
brain in the treatment of depressive disorder. In the course of the work
the 3D models of transcranial magnetic stimulation and low-field
magnetic stimulation based upon the use of a layered sphere head model
have been developed. An initial approach towards the realistic human
head reconstruction has been made. The revealed order of the stimulating
electromagnetic field suitable for operation makes it possible to draft
a technical specification for the stimulation device.

Daily left prefrontal transcranial magnetic stimulation therapy for major depressive disorder: a sham-controlled randomized trial

PMID: 20439832

AUTHORS: Mark S George, Sarah H Lisanby, David Avery, William M McDonald, Valerie Durkalski, Martina Pavlicova, Berry Anderson, Ziad Nahas, Peter Bulow, Paul Zarkowski, Paul E Holtzheimer, Theresa Schwartz, Harold A Sackeim

AFFILIATION: Brain Stimulation Division, Department of Psychiatry, Medical University of South Carolina, Charleston, SC 29425, USA. georgem@musc.edu

REFERENCE: Arch Gen Psychiatry 2010 May 67(5):507-16

CONTEXT: Daily left prefrontal repetitive transcranial magnetic
stimulation (rTMS) has been studied as a potential treatment for
depression, but previous work had mixed outcomes and did not adequately
mask sham conditions. OBJECTIVE: To test whether daily left prefrontal
rTMS safely and effectively treats major depressive disorder. DESIGN:
Prospective, multisite, randomized, active sham-controlled (1:1
randomization), duration-adaptive design with 3 weeks of daily weekday
treatment (fixed-dose phase) followed by continued blinded treatment for
up to another 3 weeks in improvers. SETTING: Four US university
hospital clinics. PATIENTS: Approximately 860 outpatients were screened
, yielding 199 antidepressant drug-free patients with unipolar
nonpsychotic major depressive disorder. INTERVENTION: We delivered rTMS
to the left prefrontal cortex at 120% motor threshold (10 Hz, 4-second
train duration, and 26-second intertrain interval) for 37.5 minutes (
3000 pulses per session) using a figure-eight solid-core coil. Sham rTMS
used a similar coil with a metal insert blocking the magnetic field and
scalp electrodes that delivered matched somatosensory sensations. MAIN
OUTCOME MEASURE: In the intention-to-treat sample (n = 190), remission
rates were compared for the 2 treatment arms using logistic regression
and controlling for site, treatment resistance, age, and duration of the
current depressive episode. RESULTS: Patients, treaters, and raters
were effectively masked. Minimal adverse effects did not differ by
treatment arm, with an 88% retention rate (90% sham and 86% active).
Primary efficacy analysis revealed a significant effect of treatment on
the proportion of remitters (14.1% active rTMS and 5.1% sham) (P = .02
). The odds of attaining remission were 4.2 times greater with active
rTMS than with sham (95% confidence interval, 1.32-13.24). The number
needed to treat was 12. Most remitters had low antidepressant treatment
resistance. Almost 30% of patients remitted in the open-label follow-up
(30.2% originally active and 29.6% sham). CONCLUSION: Daily left
prefrontal rTMS as monotherapy produced statistically significant and
clinically meaningful antidepressant therapeutic effects greater than
sham. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00149838.

Antidepressant efficacy of high-frequency transcranial magnetic stimulation over the left dorsolateral prefrontal cortex in double-blind sham-controll

PMID: 18447962
TITLE: Antidepressant efficacy of high-frequency transcranial magnetic stimulation over the left dorsolateral prefrontal cortex in double-blind sham-controlled designs: a meta-analysis.
AUTHORS: D J L G Schutter
AFFILIATION: Experimental Psychology, Utrecht University, Utrecht, The Netherlands. d.schutter@uu.nl
REFERENCE: Psychol Med 2009 Jan 39(1):65-75
BACKGROUND: For more than a decade high-frequency repetitive
transcranial magnetic stimulation (rTMS) has been applied to the left
dorsolateral prefrontal cortex (DLPFC) in search of an alternative
treatment for depression. The aim of this study was to provide an update
on its clinical efficacy by performing a meta-analysis involving double
-blind sham-controlled studies. METHOD: A literature search was
conducted in the databases PubMed and Web of Science in the period
between January 1980 and November 2007 with the search terms 'depression
' and 'transcranial magnetic stimulation'. Thirty double-blind sham-
controlled parallel studies with 1164 patients comparing the percentage
change in depression scores from baseline to endpoint of active versus
sham treatment were included. A random effects meta-analysis was
performed to investigate the clinical efficacy of fast-frequency rTMS
over the left DLPFC in depression. RESULTS: The test for heterogeneity
was not significant (QT=30.46, p=0.39). A significant overall weighted
mean effect size, d=0.39 [95% confidence interval (CI) 0.25-0.54], for
active treatment was observed (z=6.52, p<0.0001). Medication
resistance and intensity of rTMS did not play a role in the effect size
CONCLUSIONS: These findings show that high-frequency rTMS over the
left DLPFC is superior to sham in the treatment of depression. The
effect size is robust and comparable to at least a subset of
commercially available antidepressant drug agents. Current limitations
and future prospects are discussed.

Pico-Tesla Starts Phase III Clinical Trial of Its Proprietary Magnetic (Magneceutical) Therapy for Parkinson`s Disease

This sounds interesting, I at least never heard of this "Pico-Tesla" technology. Read the Press Release here, and a blurb about the method:

Magneceutical Therapy involves the use of an extremely low-level electromagnetic field (EMF) applied by a specially designed device-the Resonator, invented by Dr. Jerry I. Jacobson, along with proprietary therapeutic protocols-intended to improve a number of the signs and symptoms of Parkinson`s and other neurological-based diseases.

A randomized trial of the anti-depressant effects of low- and high-frequency transcranial magnetic stimulation in treatment-resistant depression

PMID: 19105212
TITLE: A randomized trial of the anti-depressant effects of low- and high-frequency transcranial magnetic stimulation in treatment-resistant depression.
AUTHORS: Paul B Fitzgerald, Kate Hoy, Zafiris J Daskalakis, Jayashri Kulkarni
AFFILIATION: Department of Psychological Medicine, Alfred Psychiatry Research Centre, The Alfred and Monash University, Commercial Rd Melbourne, Vic., Australia.
REFERENCE: Depress Anxiety 2009 26(3):229-34
BACKGROUND: The majority of studies investigating the effectiveness of
repetitive transcranial magnetic stimulation (rTMS) as a treatment for
major depression have focused on high-frequency rTMS to the left
prefrontal cortex (HFL-rTMS). In addition, low-frequency right
prefrontal rTMS (LFR-rTMS) has also been shown to have antidepressant
properties. To date only a small number of studies have directly
compared the efficacy of these two approaches. METHODS: The aim of this
study, therefore, was to investigate further whether LFR-rTMS is as
effective as HFL-rTMS in the treatment of major depression. Twenty-seven
patients were randomized to one of two treatment arms (HFL-rTMS or LFR-
rTMS) for 3 weeks with a possible 1-week extension. Non-responders were
offered the opportunity of crossing over to the other treatment type.
Stimulation parameters for HFL-rTMS were 30 stimulation trains of 5 s
duration at 100% of the resting motor threshold (RMT); for LFR-rTMS,
stimulation was applied in four trains of 180 s duration (30 s inter-
train interval) at 110% of the RMT. Stimulation was provided 5-week days
per week. RESULTS: There were significant improvements seen from
baseline to end point irrespective of group and on all clinical outcome
measures. In addition, there was no deterioration in any of the measures
used to assess cognitive change, and significant improvements were seen
on measures of immediate verbal memory and verbal fluency. CONCLUSIONS
: HFL-rTMS and LFR-rTMS appear to be equally efficacious in treating
major depression. This study adds to the growing literature supporting
LFR-rTMS as an additional viable method of rTMS delivery in the
treatment of depression.

OpenStim: The Open Noninvasive Brain Stimulator

An open source rTMS machine ? Read more on this interesting project on the WIKI here.

Smaller, cheaper and more hackable versions of TMS machines are being built. They've put together an open source TMS project that might allow anyone to start an at-home DIY brain hacking lab.

Dial H for Happiness: How Neuroengineering May Change Your Brain

An interesting article on the work of Dr. Bret Schneider at Stanford Medical School and Dr. Ed Boyden at MIT. Read it here.

Call for Papers for a Special Issue: Transcranial Magnetic Stimulation

Get more information here.

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.

Stimulus intensity dependence of cerebral blood volume changes in left frontal lobe by low-frequency rTMS to right frontal lobe: A near-infrared spec

PMID: 18992287  
AUTHORS: Yoshiyuki Aoyama, Naoki Hanaoka, Masaki Kameyama, Masashi Suda, Toshimasa Sato, Mingqiao Song, Masato Fukuda, Masahiko Mikuni
AFFILIATION: Department of Psychiatry and Human Behavior, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi 371-8511, Gunma, Japan.
REFERENCE: Neurosci Res 2009 Jan 63(1):47-51
Repetitive transcranial magnetic stimulation (rTMS) has recently been widely employed for the investigation of brain function and treatment of psychiatric and neurological disorders. Although high and low stimulation frequencies are assumed to activate and deactivate brain function, respectively, the optimal parameters of rTMS for treatment of depression have been determined only on the basis of their clinical efficacy. In this study, we administered a 60-s low-frequency rTMS of three grades low intensities over the right dorsolateral prefrontal cortex (DLPFC) in 10 healthy volunteers, and monitored functional changes of the contralateral DLPFC by near-infrared spectroscopy (NIRS) during and immediately after rTMS. Obtained results demonstrated significant [oxy-Hb] decreases during rTMS, and significant differences in the time courses of [oxy-Hb] changes among three stimulus intensities , that is, [oxy-Hb] decreases were most prominent during the latter half of the stimulation and the first 30s of poststimulation only at 15mm condition (58% intensity). These results suggest that monitoring of brain functional changes due to rTMS using NIRS is useful for elucidating the brain mechanisms underlying the clinical effects of rTMS , and the effects of rTMS over contralateral DLPFC are obtained if the stimulus intensities are more than one-half of the motor thresholds.

Daily left prefrontal repetitive transcranial magnetic stimulation in the acute treatment of major depression: clinical predictors of outcome in a multisite, randomized controlled clinical trial

PMID: 18704101  
AUTHORS: Sarah H Lisanby, Mustafa M Husain, Peter B Rosenquist, Daniel Maixner, Rosben Gutierrez, Andrew Krystal, William Gilmer, Lauren B Marangell, Scott Aaronson, Zafiris J Daskalakis, Randolph Canterbury, Elliott Richelson, Harold A Sackeim, Mark S George
AFFILIATION: 1Division of Brain Stimulation and Therapeutic Modulation, Department of Psychiatry, Columbia University/New York State Psychiatric Institute, New York, NY, USA.
REFERENCE: Neuropsychopharmacology 2009 Jan 34(2):522-34
Randomized controlled trials support the antidepressant efficacy of transcranial magnetic stimulation (TMS); however, there is individual variability in the magnitude of response. Examination of response predictors has been hampered by methodological limitations such as small sample sizes and single-site study designs. Data from a multisite sham- controlled trial of the antidepressant efficacy of TMS provided an opportunity to examine predictors of acute outcome. An open-label extension for patients who failed to improve provided the opportunity for confirmatory analysis. Treatment was administered to the left dorsolateral prefrontal cortex at 10 pulses per second, 120% of motor threshold, for a total of 3000 pulses per day. Change on the Montgomery- Asberg Depression Rating Scale after 4 weeks was the primary efficacy outcome. A total of 301 patients with nonpsychotic unipolar major depression at 23 centers were randomized to active or sham TMS. Univariate predictor analyses showed that the degree of prior treatment resistance in the current episode was a predictor of positive treatment outcome in both the controlled study and the open-label extension trial In the randomized trial, shorter duration of current episode was also associated with a better outcome. In the open-label extension study, absence of anxiety disorder comorbidity was associated with an improved outcome, but duration of current episode was not. The number of prior treatment failures was the strongest predictor for positive response to acute treatment with TMS. Shorter duration of current illness and lack of anxiety comorbidity may also confer an increased likelihood of good antidepressant response to TMS.Neuropsychopharmacology (2009) 34, 522- 534; doi:10.1038/npp.2008.118; published online 13 August 2008.

Repetitive TMS combined with exposure therapy for PTSD: A preliminary study

PMID: 18455908  
AUTHORS: Elizabeth A Osuch, Brenda E Benson, David A Luckenbaugh, Marilla Geraci, Robert M Post, Una McCann
AFFILIATION: Biological Psychiatry Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MA, United States.
REFERENCE: J Anxiety Disord 2009 Jan 23(1):54-9
Treatment for anxiety and post-traumatic stress disorder (PTSD) includes exposure therapy and medications, but some patients are refractory. Few studies of repetitive transcranial magnetic stimulation (rTMS) for anxiety or PTSD exist. In this preliminary report, rTMS was combined with exposure therapy for PTSD. Nine subjects with chronic, treatment- refractory PTSD were studied in a placebo-controlled, crossover design of imaginal exposure therapy with rTMS (1Hz) versus sham. PTSD symptoms , serum and 24h urine were obtained and analyzed. Effect sizes for PTSD symptoms were determined using Cohen's d. Active rTMS showed a larger effect size of improvement for hyperarousal symptoms compared to sham; 24-h urinary norepinephrine and serum T4 increased; serum prolactin decreased. Active rTMS with exposure may have symptomatic and physiological effects. Larger studies are needed to confirm these preliminary findings and verify whether rTMS plus exposure therapy has a role in the treatment of PTSD.

Antidepressant efficacy of high-frequency transcranial magnetic stimulation over the left dorsolateral prefrontal cortex in double-blind sham-control

PMID: 18447962  
AUTHORS: D J L G Schutter
AFFILIATION: Experimental Psychology, Utrecht University, Utrecht, The Netherlands.
REFERENCE: Psychol Med 2009 Jan 39(1):65-75
BACKGROUND: For more than a decade high-frequency repetitive transcranial magnetic stimulation (rTMS) has been applied to the left dorsolateral prefrontal cortex (DLPFC) in search of an alternative treatment for depression. The aim of this study was to provide an update on its clinical efficacy by performing a meta-analysis involving double -blind sham-controlled studies.MethodA literature search was conducted in the databases PubMed and Web of Science in the period between January 1980 and November 2007 with the search terms 'depression' and ' transcranial magnetic stimulation'. Thirty double-blind sham-controlled parallel studies with 1164 patients comparing the percentage change in depression scores from baseline to endpoint of active versus sham treatment were included. A random effects meta-analysis was performed to investigate the clinical efficacy of fast-frequency rTMS over the left DLPFC in depression. RESULTS: The test for heterogeneity was not significant (QT=30.46, p=0.39). A significant overall weighted mean effect size, d=0.39 [95% confidence interval (CI) 0.25-0.54], for active treatment was observed (z=6.52, p<0.0001). Medication resistance and intensity of rTMS did not play a role in the effect size. CONCLUSIONS: These findings show that high-frequency rTMS over the left DLPFC is superior to sham in the treatment of depression. The effect size is robust and comparable to at least a subset of commercially available antidepressant drug agents. Current limitations and future prospects are discussed.

Address update for Mindcare in Canada

Deanna Bertoia

Manager of Clinic Development

Ottawa/Toronto MindCare Centre

Local Ottawa: 613.569.7867

Local Toronto: 647.344.7867

Toll-free: 1.888.726.7867

Fax: 613.715.5833

Deanna{at}mindcarecentres.com

www.mindcarecentres.com

FDA Clears TMS Therapy for the Treatment of Depression

Finally, 3 years after the first presentation of the trial data at the 2005 ACT meeting and one year after the publication of the results in Biological Psychiatry by Jonny O'Reardon the manufacturer Neuronetics got the treatment approved by the FDA for

  

for the treatment of Major Depressive Disorder in adult patients who have failed to achieve satisfactory improvement from one prior antidepressant medication at or above the minimal effective dose and duration in the current episode.

If you want to read the PDF of the full press release click here (beware, language geared to potential investors...).

In order to convince the manufacturer had to do an additional trial. If you want some more information on the development history read the excellent summary from the blog Brain Stimulant.

Vagus nerve stimulation a treatment option, but not for everyone

MayoClinic.com published a short summary on the current state of Vagus Nerve Stimulation (VNS) intended for patient information. Other interesting links on Neurostimulation from their site are:

• Video: Electroconvulsive therapy (ECT) — One woman's journey
• Electroconvulsive therapy (ECT)
• Vagus nerve stimulation
• Deep brain stimulation
• Transcranial magnetic stimulation

Cost-effectiveness of transcranial magnetic stimulation vs. electroconvulsive therapy for severe depression: A multi-centre randomised controlled tria

PMID: 18262655
AUTHORS: Martin Knapp, Renee Romeo, Andrew Mogg, Savitha Eranti, Graham Pluck, Rick Purvis, Richard G Brown, Robert Howard, Michael Philpot, John Rothwell, Denzil Edwards, Declan M McLoughlin
AFFILIATION: Centre for the Economics of Mental Health, King's College London, Institute of Psychiatry, United Kingdom; Personal Social Services Research Unit, London School of Economics, United Kingdom.
REFERENCE: J Affect Disord 2008 Aug 109(3):273-85
BACKGROUND: Electroconvulsive therapy (ECT) has a long history of use in treating depression. Repetitive transcranial magnetic stimulation (rTMS ) has been introduced more recently to the treatment spectrum. Its cost- effectiveness has not been explored. METHOD: Forty-six right-handed people with severe depressive episodes referred for ECT were randomised to receive either ECT twice weekly or rTMS on consecutive weekdays. Health and other service use were recorded for retrospective periods of 3 months prior to initiation of treatment and during the 6 months following the end of allocated treatment. Costs were calculated for the treatment period and the subsequent 6 months, and comparisons made between groups after adjustment for any baseline differences. Cost- effectiveness analysis was conducted with incremental change on the 17- item Hamilton Rating Scale for Depression (HRSD) as the primary outcome measure, and quality-adjusted life years (based on SF6D-generated utility scores with societal weights) as secondary outcome, cost- effectiveness acceptability curves plotted.
RESULTS: Based on the HRSD scores and other outcome measures, rTMS was not as effective as ECT. The cost of a single session of rTMS was lower than the cost of a session of ECT, but overall there were no treatment cost differences. In the treatment and 6-month follow-up periods combined, health and other service costs were not significantly different between the two groups. Informal care costs were higher for the rTMS group. Total treatment, service and informal care costs were also higher for the rTMS group. The cost-effectiveness acceptability curves indicated a very small probability that decision-makers would view rTMS as more cost-effective than ECT.
LIMITATIONS: Small sample size, some sample attrition and a relatively short follow-up period of 6 months for a chronic illness. Productivity losses could not be calculated.
CONCLUSIONS: ECT is more cost-effective than rTMS in the treatment of severe depression.

Magnetic Pulses Zap Migraine Pain

BOSTON, June 27 -- For patients who get migraine with aura, a hand-held magnetic device about the size and shape of a hairdryer can zap the pain before it starts, a researcher said here.

Used at the aura stage, the transcranial magnetic stimulation device was nearly twice as likely as a sham treatment to reduce the incidence of a full migraine headache, according to Yousef Mohammad, M.D., of Ohio State University Medical Center in Columbus.

The industry-sponsored phase III randomized double-blind trial follows earlier research that showed the magnetic stimulation process was effective when used in a hospital setting, Dr. Mohammad told attendees at the American Headache Society meeting.

Dr. Mohammad said the device -- which sends two one-Tesla magnetic pulses into the back of the head -- is also safe, with no serious adverse events attributed to it.

"It feels like a slight pressure at the back of the head and that's it," he said.

The theory is that the magnetic pulses interrupt a process called cortical spreading depression, now thought to be the underlying mechanism for migraine with aura, he said.

A similar technique is being tested in patients with depression.

For this study, patients were randomized to a device that emitted the magnetic pulses or to a sham machine. They were told to use the device when the migraine aura began and to record their pain intensity and symptoms at time of treatment and again 30 minutes, one hour, two hours, 24 hours, and 48 hours later.

The intent-to-treat population of 164 patients had a mean age of 39 and 79% were women. Most patients treated themselves while still pain-free or with mild pain (31% and 40%, respectively) but 23% had moderate pain and 6% said their pain was already severe before they used the machine.

The primary endpoint of the study was absence of pain at the two-hour mark, Dr. Mohammad said, where 39% of the active treatment group had no pain, compared with 20% of those using the sham machine.

The difference was significant at P<0.018, he said.

Rates of symptoms such as nausea, photophobia, and phonophobia in the active treatment group were equal to or lower than those seen in the group using the sham machine, according to Dr. Mohammad.

Because of the lack of adverse events and the previously established safety of the transcranial magnetic stimulation device, he said, "this is a promising treatment for migraines with aura."

He added that it also sets the stage for research in migraines without aura.

The device is not yet approved by the FDA, Dr. Mohammad said, but the okay could come within the next six months, based on the current trial.

He added that medical treatments for migraine with aura work in only about half of all patients and some of those can't tolerate the drugs. "There is a definite need for alternatives," Dr. Mohammad said.

The study was supported by NeuraLieve Inc., of Sunnyvale, Ca., manufacturer of the device. Dr. Mohammad serves on the company's medical advisory board

Primary source: AHS Meeting

Secondary Source: medpageTODAY®
Source reference:
Lipton RB, et al “Transcranial Magnetic Stimulation (TMS) using a portable device is effective for the acute treatment of migraine with aura: Results of a double-blind, sham controlled, randomized study” AHS Meeting 2008; LB abstract 450026.

Job Offer - Ph.D Scholarship in Neuroscience - Neuroplasticity and TMS

Ph.D Scholarship in Neuroscience - Neuroplasticity and TMS

School of Psychiatry, University of New South Wales, Sydney, Australia

The School of Psychiatry at UNSW invites applications for a Ph.D. Scholarship investigating mechanisms of Neuroplasticity, to commence in the 2nd half of 2008. Each scholarship is for $27,500 p.a. for a maximum of 3 years,

The Scholarship will focus on the use of transcranial magnetic stimulation (TMS) and other techniques to investigate mechanisms of neuroplasticity in health, ageing and psychiatric disorders. This scholarship is offered as part of the Brain and Ageing Program, UNSW, a high profile research program funded by the NH&MRC, which aims to evaluate the determinants of age-related cognitive disorders. The successful doctoral student will be working with Professors Colleen Loo and Perminder Sachdev, researchers with a track record in brain stimulation techniques, in conjunction with neurophysiology collaborators, based in Randwick, Sydney.

Applicants are encouraged from students/researchers from a variety of backgrounds, including but not limited to medicine, psychology, neurophysiology and neurology.

For further details, please contact Assoc. Prof Colleen Loo (by phone +61-2-9113 2039, or email.