Primary types of neuromodulation techniques used in psychiatry and new approaches to treat neurological and psychiatric problem.
Transcranial magnetic stimulation (TMS): There are currently 2 different TMS coils that have been approved by the US Food and Drug Administration (FDA) for the acute treatment of depressed patients who have failed to respond to at least 1 antidepressant medication. Interventional psychiatrists need to understand the fundamental principles behind TMS and demonstrate competency in the delivery and programming of TMS paradigms. A recent multisite, naturalistic, observational study of acute treatment outcomes in clinical practice[2] demonstrated greater than 50% efficacy in sicker populations using TMS.
New guidelines published online May 6 in the Canadian Medical Association Journal have codified a number of major changes in fibromyalgia (FM) diagnosis and treatment. The authors of the new guidelines note that FM diagnosis and care have largely shifted to primary care physicians and away from rheumatologists and other specialists.
At a press conference held at the American Academy of Neurology’s (AAN’s) 2013 Annual Meeting, the release of new AAN guidelines for the evaluation and management of sports-related concussion (SRC) were announced. The recommendations update the 1997 AAN sports concussion practice parameter and were published online in Neurology on March 18, 2013.[1] The new guidelines attempt to address uncertainty and inconsistency in the management of concussion and mild traumatic brain injury (TBI) by addressing 4 clinical questions:
Stroke is a common, potentially devastating disease with potential high morbidity and mortality. Recognition at the onset of acute ischemic stroke is pivotal to changing outcomes such as intravenous thrombolysis. Stroke monitoring is a burgeoning field with various methods described and newer devices that aid in detecting acute or worsening ischemia that can lead to improved bedside and intensive care unit management. This article describes various methods of bedside stroke monitoring including newer techniques of intracranial pressure monitoring using the pressure reactivity index and compensatory reserve index to detect changes in autoregulatory states, noninvasive intracranial pressure monitoring, quantitative EEG with alpha–delta ratio, transcranial Doppler, methods of arteriovenous brain oxygen monitoring such as jugular venous oxygen and near-infrared spectroscopy, invasive brain oxygen probes such as LicoxTM (brain tissue O2), cerebral blood flow probe (CBF HemedexTM) and cerebral microdialysis.
American Academy of Neurology Releases Concussion Guideline Update
Early and aggressive resection of low-grade gliomas (LGGs) leads to increased overall patient survival, decreased malignant progression, and better seizure control. This case series describes the authors’ approach to achieving optimal neurological and surgical outcomes in patients referred by outside neurosurgeons for stereotactic biopsy of tumors believed to be complex or a high surgical risk, due to their diffuse nature on neuroimaging and their obvious infiltration of functional cortex.